Cervical cancer screening and chinese women: insights from focus groups.

OBJECTIVE: Despite extensive efforts to raise awareness, Papanicolaou (Pap) testing rates among Chinese women living in North America remain low compared with Euro-American women. Although the lower Pap testing rate and ensuing health repercussions among Chinese women are well characterized, mechanisms underlying such health disparities are not. The aim of this study was to use a qualitative approach to delineate such mechanisms. Qualitative approaches to understand constructs within the domain of sexual and reproductive health have been shown to be particularly appropriate, and offer a nuanced view of sexuality that is not afforded by traditional quantitative methods. METHOD: We carried out two focus groups aimed at exploring how Mandarin-speaking and English-speaking Chinese women experience Pap testing (N = 12). The women were invited to partake in the focus groups from having participated in a large-scale quantitative study. Participants were all first-generation immigrants and their average age was 53-years-old. We used content analyses to analyze transcripts and extract themes. RESULTS AND DISCUSSION: The women heavily endorsed traditional Chinese medicine philosophy, conceptualizing physical health holistically, and valuing preventative measures over screening and interceptive measures. Pap testing was described as qualitatively different from other screening procedures, such that women assigned a sexually charged meaning to Pap testing, often discussing it in relation to sexual activity and promiscuity. Women expressed their preference for the compulsory and depersonalized manner that Pap tests are performed in their home country of China, as this lessens the embarrassment associated with undergoing Pap testing. CONCLUSION: Three mechanisms may contribute to lower Pap testing among middle-aged first-generation Chinese immigrants: preference for Chinese medicine philosophy, perceived sexualization of Pap testing, and the institutionalization of medical care. Implications for improving the reproductive health of Chinese women are discussed.

Psychological profiles among women with vulvar vestibulitis syndrome: a chart review.

The purpose of this study was to assess the prevalence and type of psychological distress in women with vulvar vestibulitis syndrome (VVS). A retrospective chart review was conducted of all women receiving a diagnosis of VVS referred to a tertiary care facility during a two-year period. Brief psychological questionnaires, including the Personality Assessment Screener, Fear of Negative Evaluation Scale, Golombok-Rust Inventory of Sexual Satisfaction, and the Phobia Rating Scale were administered. Fifty-consecutive cases were reviewed along with 12-15 month follow-up data for 41 cases. Phobic anxiety to vaginal touch or entry was significantly higher in women with VVS than normative data. Fear of Negative Evaluation was a strong associated feature, and for 30% approached clinically significant levels. Twenty-six percent showed a moderate, while another 26% showed a mild clinically distressed profile. Negative affect and social withdrawal were among the most frequently endorsed variables. Improvement in allodynia and intercourse were both related to these psychological variables, and a multiple regression analysis supported the use of psychological instruments in addition to standard medical assessment. A subgroup of women with VVS display clinically significant broad based psychological distress that warrants additional assessment. The use of psychological questionnaires in addition to medical assessment of women with VVS may provide valuable information predictive of treatment needs and response.

Melatonin protects against the effects of chronic stress on sexual behaviour in male rats.

The effects of chronic mild stress (CMS) on both sexual behaviour and wet dog shakes (WDS), a serotonergic type 2A (5-HT2A) receptor-mediated behaviour, were explored in the male rat. In addition, the possible attenuation of these effects by chronic treatment with melatonin, a putative 5-HT2A antagonist, was examined. The CMS procedure resulted in a significant increase in WDS and an overall decrease in all aspects of sexual behaviour. Concurrent melatonin administration attenuated the CMS-induced effects on sexual behaviour, but not the effects on either spontaneous WDS or WDS in response to the 5-HT2A agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane, suggesting a mechanism of action other than exclusive 5-HT2A antagonism. These results are the first to demonstrate that melatonin significantly protects against the detrimental effects of a chronic stressor on sexual behaviour.

Paradoxical effects of chronic corticosterone on forced swim behaviours in aged male and female rats.

The effects of chronically administered corticosterone on forced swim test and open field test behaviours were explored in aged male and female rats. Though corticosterone has typically been associated with depressive behaviours, recent data have suggested a putative antidepressive effect of corticosterone. The current study used the forced swim test as a model of antidepressant efficacy in order to explore this. Aged male and female rats received either corticosterone (20 mg/kg) or the vehicle for 10 days before testing in the forced swim test, then for an additional 3 days before testing in the open field test. On day 11, each animal was individually tested on the duration of swimming, immobile, and struggling behaviours, and on day 14, for the display of rearing and line crossing behaviours. Results revealed that corticosterone significantly increased swimming and decreased immobility behaviour in females, but failed to do so in males. Additionally, there was a main effect of corticosterone on struggling behaviour such that it decreased it in males. There were no effects of corticosterone or sex on open field test behaviours, suggesting that the present findings are not accounted for by a general effect of corticosterone on motor behaviour. Overall, the data suggest that chronically administered corticosterone possesses effects that are sex-specific, and that it may exert mildly antidepressive effects in females, but the opposite effects in males. These data are consistent with emerging evidence that corticosterone may play a paradoxical antidepressive effect.

Chronic corticosterone enhances the rewarding effect of hypothalamic self-stimulation in rats.

Excessive levels of glucocorticoids have been implicated in the etiology of affective disorders in humans, and in a range of behavioral deficits in animals. In the present study, we used an established regimen of corticosterone administration (40 mg/kg, for 21 days) to determine its effects upon responding for rewarding brain stimulation in rats. After chronic treatment, subjects exhibited an unexpected but significantly increased sensitivity to the rewarding effects of brain stimulation. These results suggest that chronic, high levels of corticosterone are unlikely to cause anhedonia in rodents.

Sex differences in forced-swim and open-field test behaviours after chronic administration of melatonin.

The effects of melatonin administered chronically on forced-swim test and open-field test behaviours were examined in male and female rats. The forced-swim test has been shown to be sensitive to all major classes of antidepressants and evidence indicates that melatonin possesses putative antidepressive properties. Male and female Long-Evans rats received either a regimen of chronic administration of melatonin or the control condition for 14 days via the drinking water. On day 15, each animal was individually introduced into a swim chamber, and was scored for 15 min on the duration of swimming, struggling, and immobility. After 24 h, each animal was again tested in the forced-swim test for 10 min. On day 18, all animals were tested in the open-field test apparatus for 5 min. Results revealed that females consistently showed higher activity levels than males in the forced-swim and open-field tests. Melatonin significantly increased struggling in males on day 15, but failed to do so in females. Also, whereas melatonin-treated females showed higher levels of behavioural immobility during their first exposure to the forced-swim test, this effect was prevented upon a second exposure. In both males and females, melatonin decreased swimming in the forced-swim test while increasing open-field ambulatory behaviour. Therefore, it is unlikely that melatonin's mechanism of action is a general inhibitory effect on motor activity. Taken together, the results suggest that the effects of melatonin treatment on forced-swim test behaviours are sex- and test-dependent.

Melatonin enhances sexual behavior in the male rat.

Anecdotal reports suggest that melatonin enhances libido in men. However, controlled trials remain to be published for any species. Accordingly, adult male rats were chronically treated for 12 weeks with melatonin via the drinking water. On the 13th week, all males were tested in the presence of sexually receptive females on measures of sexual behavior. Moreover, because of the established inverse relationship between male sexual behavior and serotonergic type 2A (5-HT(2A)) receptor activity, "wet-dog shakes" (WDS), a 5-HT(2A) receptor mediated behavior, were measured concurrently. All aspects of sexual activity were significantly facilitated in males treated with melatonin. In addition, there was a consistent, progressive reduction in the frequency of WDS, suggestive of a temporal decrement in serotonergic receptor activity and supportive of previous indications that melatonin possesses 5-HT(2A) antagonistic properties. These results provide the first empirical evidence for a facilitatory role of melatonin in sexual behavior, and suggest that its mechanism of action may involve the 5-HT(2A) receptor.

Nefazodone attenuates the stress-induced facilitation of wet dog shaking behaviour but not the facilitation of sexual behaviour in female rats.

The effects of chronic stress both alone and in combination with the antidepressant, nefazodone, which possesses antagonistic activity at the 5-HT2A receptor, were examined on the 5-HT2A receptor-mediated behaviour, wet dog shaking and sexual behaviour. Ovariectomized female rats received either a chronic stressor or no stress for 30 days, and half of each group received concurrent nefazodone treatment (100 mg/kg/day). Following treatment with either estrogen, or estrogen combined with progesterone, sexual behaviour and wet dog shaking were recorded. Chronic stress alone was found to facilitate sexual behaviour and increase wet dog shaking, while nefazodone administration alone was without effect. Furthermore, nefazodone completely attenuated the stress-induced facilitation of wet dog shaking, but not sexual behaviour.

Corticosterone regulation of 5-HT2A receptor-mediated behaviors: attenuation by melatonin.

The effects of chronic corticosterone treatment on sexual behavior and on wet-dog shakes (WDS), a serotonergic type 2A (5-HT2A) receptor-mediated behavior, were explored in the male rat. In addition, the effects of acute melatonin treatment, both alone and in combination with corticosterone, were investigated. Chronic injections of corticosterone resulted in an overall decrease in consummatory measures of sexual behavior, and an increase in WDS. Furthermore, although an acute injection of melatonin alone had no effect on any recorded behavior, it attenuated the effects of corticosterone on sexual behavior and WDS. The data suggest that in the context of 5-HT2A receptor-mediated behaviors, melatonin has possible implications as a 5-HT2A antagonist.

Chronic stress effects on sexual behavior in male and female rats: mediation by 5-HT2A receptors.

The effects of chronic psychosocial stress on sexual behavior and on the serotonergic type 2A (5-HT2A) receptor-mediated behavior "wet dog shakes" (WDS) were investigated in male and female rats. In Experiment 1, both bilaterally adrenalectomized and sham-adrenalectomized female rats were assigned to either a psychosocial stress condition or a control condition for 62 days. On the 63rd day, estrogen-primed females were compared on measures of sexual behavior and WDS. Immediately after the behavioral tests, the same rats were primed with a subthreshold level of progesterone. Three hours after the administration of progesterone, rats were again scored for sexual behavior and WDS. Psychosocial stress was found to facilitate sexual behavior and increase WDS in sham-adrenalectomized female rats providing they were primed with both estrogen and progesterone. In Experiment 2, intact male rats were assigned to either the psychosocial stress condition or the control condition for 30 days. On the 31st day, males were compared on measures of sexual behavior and WDS. No significant differences were revealed on the spontaneous expression of sexual behavior and WDS. Subsequently, males were retested following the administration of the 5-HT2A agonist, DOI. Psychosocial stress resulted in a significant decrease in male sexual behavior and a concurrent increase in WDS, following the administration of DOI. Taken together, these results suggest that chronic psychosocial stress facilitates female sexual behavior and inhibits male sexual behavior, and that the effects of stress on sexual behavior may be mediated by 5-HT2A receptor activity.

The antidepressant, nefazodone, attenuates corticosterone-induced increases in 5-HT2A receptor-mediated behaviors in the female rat.

The effects of chronic corticosterone administration on sexual behavior and on wet-dog shakes, a 5-HT2A mediated behavior, were investigated in the female rat. In addition, effects of the antidepressant nefazodone, a selective 5-HT2A receptor antagonist, both alone and in combination with corticosterone were examined. Testing was conducted in ovariectomized animals primed with estrogen and progesterone. Corticosterone was found to significantly increase sexual receptivity, sexual proceptivity and wet dog shakes. While nefazodone alone had no significant effects, it completely attenuated the corticosterone-induced increases in both sexual behavior and wet dog shakes. This suggests that corticosterone influences sexual behavior and wet dog shakes via a 5-HT2A receptor mechanism.

Effects of housing conditions and 5-HT2A activation on male rat sexual behavior.

Adult male rats were housed individually or in groups for a period of 39 days. In Experiment 1, the effects of housing conditions on sexual behavior and concurrent spontaneous "wet dog shaking" (WDS) were investigated. Individual housing significantly impaired male sexual behavior and resulted in a trend toward increased WDS. In Experiment 2, the effects of housing conditions were examined following administration of the serotonergic type 2A (5-HT2A) agonist DOI. Individual housing significantly increased DOI-induced WDS. The implications of these findings are discussed in the context of stress-induced corticosterone secretion and the possible regulatory effect on 5-HT2A receptors.