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Youth is a key period of life to ensure future well-being, especially in relation to sexuality. The general objective is to analyze the sexual education of young people today regarding sexual practices and to study the use of contraceptive methods. Material(s) and Method(s): It is a cross-sectional, observational study of cases. Designed a digital questionnaire made with Google consisting of 26 items and 3 blocks: social-demographic data, female sexuality and sexual health. Data analysis the statistical program SPSS 25.0. Result(s): The sample obtained: 1320 women. Social-demographic data: ages between 15 and 29 years and 58.3% of the women had a partner. The most frequent sexual orientation: 77% heterosexual. Female sexuality: for 63.9% of women, sex is an important part of their relationships and 43.3% consider themselves attractive people. The most rejected practices: anal sex, during menstruation or with the light on. 4.7% do not feel prepared to require their sexual partner to use a condom. 9.7% are not able to request sexual practices that they want. 6.2% state that they do not avoid any practice despite the fact that some of them cause discomfort. During the Covid-19 situation, the frequency of sexual relations decreases by 49% and the absent practices of viral transmission via online increase. Regarding sexual education, we observe that the majority have been provided by friends, that is, unqualified personnel. The most explained topics are focused on the traditional aspects of sexual health and human development, therefore it is an education that is not of quality, data confirmed by 58% of women. The contraceptive methods most used by women are condoms and oral contraceptives, whose main purpose is the prevention of pregnancy and sexually transmitted infections (condoms). Its use can have negative connotations such as decreased sexual desire, excitement, sensitivity and orgasm disorders. Conclusion(s): Currently, young women perceive sexuality more and more naturally, talking about it without fear or censorship. Sex educators are mostly not qualified personnel. The SARS-CoV2 (Covid-19) situation increases the number of sexual practices online, decreasing it. The contraceptive methods most used by women are condoms and oral contraceptives.Copyright © 2023
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The proceedings contain 31 papers. The topics discussed include: migraine with aura in the population of Buenos Aires, Argentina: association analysis of 6 SNPs;mnemonic method in Portuguese for headaches in ER;patterns of libido, sexual activity and sexual function in female migraineurs;algorithm in the preventive treatment of cluster headache in Mexican patients;monoclonal antibodies in patients with migraine. experience in a headache service;analyzing cortical expression patterns of migraine-associated genes: A new perspective on migraine genetics;impact of COVID-19 pandemic lockdown on migraine patients in Latin America;long-term effectiveness of combined unilateral sphenopalatine and occipital nerve stimulation in patients with refractory chronic cluster headache;a neuropsychological profile-based classification outperforms ICHD-3 in terms of disability: exploratory analysis with anatomical correlates;strategic planning for the headache committee of the Colombian Association of Neurology-ACN - proposal;and botulinum toxin a in the preventive treatment of chronic migraine;experience in Argentine headache center.
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Background: The EMA-approved, erythroid maturation agent, luspatercept, has been shown to decrease transfusion burden in patients with transfusion-dependent thalassemia (TDT). Aims: In this multicenter, retrospective cross-sectional study, real-world data from the use of luspatercept in TDT patients, managed in 5 major Thalassemia Centers in Greece are presented. Methods: Inclusion criteria included TDT patients, having received luspatercept as per approved indications for at least 3 months. Data cut-off date was 31/1/2022. We estimated the quantity of blood (in cc of Packed Red Blood Cells -PRBC) received over 12 weeks for the intervals: 12 weeks before starting treatment (baseline);1-12 weeks;5-16 weeks and 13-24 weeks post starting therapy. Changes in mean pre-transfusion hemoglobin (Hb), uric acid, creatinine, lactic acid dehydrogenase (LDH), white blood cells (WBC) and platelets counts were analyzed for these same respective periods. Adverse events (AE) were recorded. Statistical analysis performed with RStudio v.3.6.2. Results: Main results of the study are shown in Table 1. Forty-nine patients (median age: 46 years range:15-64, sex: M:F/33:16) received Luspatercept every 21 days. Data for weeks 5-16 and 13-24 were available for 30 and 16 patients, respectively. The initial dose of luspatercept was 1 mg/kg and increased selectively up to 1.25mg/kg based on tolerability and efficacy and according to guidelines. A statistically significant (p<0.005) decrease in PRBC transfused in all 12-weeks' intervals analyzed compared to baseline was observed. No statistically significant decrease of PRBC transfused was found between the intervals 5-16weeks and 13-24 weeks compared to the initial interval of 1-12 weeks. There was not a significant change for the mean pre-transfusion Hb compared to baseline. A statistically significant (p<0.005) increase in uric acid, creatinine, LDH , WBC and platelets was observed for the interval 1-12 weeks in comparison with baseline (mean: 6.42±1.64mg/dl vs 5.48±1.6mg/dl, 0.87±0.16mg/dl vs 0.83±0.18mg/dl, 352±205mg/dl vs 204±62mg/dl, 11.78x109 ±5.29x109/L vs 10.36x109±4.35x109/L, and 450x109±221x109/L vs 415x109±202x109/L, respectively. Similar difference was observed between the 13-24 weeks interval and baseline only for uric acid, LDH and platelets (mean: 6.28±1.41mg/dl vs 5.48±1.6mg/dl p=0.003, 406±301mg/dl vs 204±62mg/dl p=0.014, 467x109±226x109/L vs 415x109±202x109/L p<0.008 respectively). Twenty five out of 49 patients reported AE. The most common AE included bone pain 16/49 (32.6%) and fatigue 7/49 (14.2%). Frequent urination, headache, swelling at injection site, blurry vision, tearing, libido decrease, tachycardia, periorbital oedema, dizziness, and exacerbation of manic-depressive episodes were also reported. Twelve patients discontinued treatment. Reasons for discontinuation included: non-response to treatment (7 patients), adverse events (3 patients), non-compliance (1 patient), death due to COVID19 infection (1 patient). Summary/Conclusion: Real world data on the use of luspatercept in TDT parallel results from the trial, showing heterogeneous and lasting efficacy and acceptable toxicity. Longer follow up and increased number of patients are required to validate these initial observations. (Table Presented).
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The COVID-19 pandemic resulted in unprecedented stressors for college students, and minority stress faced by LGBTQ + college students has been exacerbated by the pandemic. Associations between stress and sexual desire are complex, but research suggests that stress may be associated with higher solitary sexual desire and lower dyadic sexual desire. The current study examined associations between sexual desire and a multidimensional measure of pandemic stress among LGBTQ + and cisgender, heterosexual (cis-het) college students. Participants (N = 377, 57% LGBTQ+) completed an online survey during the Spring 2021 semester that included the Sexual Desire Inventory and a multidimensional COVID Stress Measure. LGBTQ + students reported higher stress in multiple domains-isolation, academics, living situation, concerns about racism and prejudice, and health care access-relative to cis-het students. For LGBTQ + and cis-het students, higher overall COVID stress, as well as higher stress related specifically to isolation and to the virus itself, were associated with higher solitary and dyadic sexual desire. Greater concern about racism and prejudice during the pandemic was associated with higher solitary sexual desire, especially for LGBTQ+ students. Our findings underscore the importance of sexuality as a means of seeking connection during an event that disrupted college students' lives in many ways. We highlight implications for university professionals, particularly the need to support LGBTQ +-affirming organizations, mental health resources, and sexual health resources as students return to college campuses. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement This study indicates that LGBTQ + college students experienced higher stress than their cisgender, heterosexual counterparts during the COVID-19 pandemic, and that higher stress was associated with higher sexual desire among LGBTQ + and cisgender, heterosexual college students. Results point to the importance of providing LGBTQ +-affirming mental and sexual health resources as students return to college campuses in the aftermath of the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Introduction: Hormonal effects of prolactinomas include central hypogonadism, infertility, and breast symptoms. When the mass is large enough to abut or compress the optic chiasm, prompt treatment is critical to preserve vision. Prolactin secretion is usually proportional to the size of the adenoma. This case describes a patient who presented with prominent vision changes and was found to have a large pituitary macroadenoma with lower than expected prolactin elevation, highlighting the dilemma between medical versus surgical treatment. Case Description: A previously healthy 32 year old male first noticed vision changes in October 2019 when he was unable to see the dots to focus a camera. Due to the COVID-19 pandemic, he delayed seeking care. When he visited a neuro-ophthalmologist in September 2020, he was noted to have dense left eye and mild right eye temporal defects, left afferent pupillary defect, and left greater than right optic disc pallor suspicious for a sellar lesion. MRI in September 2020 showed a sellar and suprasellar mass measuring 3.4 cm tall with left greater than right optic chiasm compression. He was referred to endocrinology, where further history revealed low libido. Physical exam showed BMI 38.7, lipomastia, normal body hair, and normal testicular volume bilaterally. In September 2020, labs showed prolactin 302.4 ng/ml [reference range (RR) 4-15.2 ng/ml], confirmed by dilution to eliminate hook effect, testosterone 119 ng/dl [RR 250-110 ng/dl], FSH 2.0 mIU/ml [RR 1.6-8 mIU/ml], and LH 1.7 mIU/ml [RR 1.5-9.3 mIU/ml], confirming hyperprolactinemia and central hypogonadism, though prolactin was lower than expected given the size of the pituitary mass. Cabergoline was started with goals to shrink the adenoma, alleviate optic chiasm compression and restore gonadal function. By October 2020, the patient’s prolactin normalized and he was tolerating cabergoline. By December, there was marked reduction in the size of the pituitary mass on MRI to 2.1 cm in height. He had significant improvement in visual fields, improved visual acuity, slightly less prominent afferent papillary defect, and improving libido. Discussion: This case illustrates the classic presentation of a patient with a large prolactinoma with hormonal and mass effects. It highlights the role of primary dopamine agonist therapy to treat large prolactinomas causing visual impairment with lower than expected prolactin given the size of the pituitary mass. In this case, the pituitary adenoma may have been an inefficient prolactin secretor due to being poorly differentiated or partially cystic, but treating medically was effective in quickly shrinking the mass and improving his vision, thus avoiding the need for surgery.
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The COVID-19 pandemic has adversely affected population mental health. Periods of psychological distress can induce menstrual dysfunction. We previously demonstrated a significant disruption in women's reproductive health during the first 6 months of the pandemic. The present study investigates longer-term reproductive and mental health disturbances. A cross-sectional online survey was completed by 1335 women of reproductive age in April 2021. It included validated standardized measures of depression (PHQ-9), anxiety (GAD-7) and sleep quality (PSQI). 581 (56%) of women reported an overall change in their menstrual cycle since the beginning of the pandemic. There was no change in median cycle length [28 days (28-30)] or days of menses [5 (4-5)], but there was a wider variability in minimum (p<0.0001) and maximum (p<0.0001) cycle length. There was a significant increase in heavy menstrual bleeding, painful periods and missed periods compared to pre-pandemic (all p<0.0001). 64% of women reported worsening pre-menstrual symptoms. Rates of severe depression, anxiety and poor sleep were more than double those from large scale representative community samples. Poor sleep quality was an independent predictor of overall change in menstrual cycle (OR=1.11, 95%CI 1.05-1.18), and missed periods (OR=1.11, 95%CI 1.03-1.19) during the pandemic. Increased anxiety was independently associated with a change from non-painful to painful periods (OR=1.06, 95%CI 1.01-1.11) and worsening of pre-menstrual symptoms (OR=1.06, 95%CI 1.01-1.07) during the pandemic. The COVID-19 pandemic continues to bear a significant impact on female reproductive health. Increased levels of psychological distress and poor sleep are associated with menstrual cycle disruption.
Subject(s)
COVID-19 , Pandemics , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Mental Health , Reproductive Health , Sleep Quality , Surveys and QuestionnairesABSTRACT
Background: Coronavirus disease-2019 (COVID-19) has claimed innumerous lives globally resulting in increased stress affecting woman's menstrual, sexual, and mental health, an area of significant concern. The study was aimed to understand the effect of COVID-19 severity on menstrual and mental health. Method: A cross-sectional survey using a closed-ended questionnaire was conducted on COVID-19 positive women of reproductive age (18-45 years), admitted at School of Medical Sciences and Research, Greater Noida, during the period of April 1, 2021, to May 31, 2021. One-hundred and thirteen patients were enrolled to evaluate any change in a menstrual pattern along with alteration in sleep and sexual drive. Depression Anxiety Stress Scale-21 was used to assess mental health. Results were analyzed using the Chi-square test.
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Background: The COVID-19 pandemic has profoundly affected the lives of the global population. It is known that periods of stress and psychological distress can affect women's menstrual cycles. We therefore performed an observational study of women's reproductive health over the course of the pandemic thus far. Materials and Methods: An anonymous digital survey was shared by the authors via social media in September 2020. All women of reproductive age were invited to complete the survey. Results: 1031 women completed the survey. Mean age was 36.7 ± 6.6 years (range, 15-54). 693/70% reported recording their cycles using an app or diary. 233/23% were using hormonal contraception. 441/46% reported a change in their menstrual cycle since the beginning of the pandemic. 483/53% reported worsening premenstrual symptoms, 100/18% reported new menorrhagia (p = 0.003) and 173/30% new dysmenorrhea (p < 0.0001) compared to before the pandemic. 72/9% reported missed periods who not previously missed periods (p = 0.003) and the median number of missed periods was 2 (1-3). 17/21% of those who "occasionally" missed periods pre-pandemic missed periods "often" during pandemic. 467/45% reported a reduced libido. There was no change in the median cycle length (28 days) or days of bleeding (5) but there was a wider variability of cycle length (p = 0.01) and a 1 day median decrease in the minimum (p < 0.0001) and maximum (p = 0.009) cycle length. Women reported a median 2 kg increase in self-reported weight and a 30-min increase in median weekly exercise. 517/50% of women stated that their diet was worse and 232/23% that it was better than before the pandemic. 407/40% reported working more and 169/16% were working less. Women related a significant increase in low mood (p < 0.0001), poor appetite (p < 0.0001), binge eating (p < 0.0001), poor concentration (p < 0.0001), anxiety (p < 0.0001), poor sleep (p < 0.0001), loneliness (p < 0.0001) and excess alcohol use (p < 0.0001). Specific stressors reported included work stress (499/48%), difficulty accessing healthcare (254/25%), change in financial (201/19%) situation, difficulties with home schooling (191/19%) or childcare (99/10%), family or partner conflict (170/16%), family illness or bereavement (156/15%). Conclusions: The COVID-19 pandemic has significantly impacted the reproductive health of women. The long term health implications of this are yet to be determined and future studies should address this.