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Objectives: The effects of B-Lynch (UCS) compression sutures applied in postpartum hemorrhage cases due to uterine atony on menstrual pattern, fertility, obstetric outcomes, dysmenorrhea and dyspareunia were evaluated. Material and methods: Between January 2012 and March 2017, 77 patients (study group 37, control group 40) diagnosed postpartum hemorrhage in our clinic were included in the study. The long-term results of the patients were evaluated comparatively. Results: In the B-Lynch UCS group, an increase in the postoperative menstrual cycle length and the intensity of dyspareunia measured by the VAS score, and a statistically significant decrease in the duration of menstrual bleeding were observed. In the control group, a decrease in the self-estimated time of postpartum menstrual bleeding and a statistically significant increase in dyspareunia VAS values were observed. There was a statistically significant difference between the groups in terms of menstrual cycle length only after treatment. Conclusions: B-Lynch UCS can be used effectively and safely in PPH due to uterine atony without causing any additional pathology in menstrual pattern, fertility, dysmenorrhea and dyspareunia complaints other than the length of the menstrual cycle. [ABSTRACT FROM AUTHOR]

The high number of child marriage dispensation applications is still a social problem in Indonesia, especially in the context of reproductive health and child welfare. This study aims to analyze the factors influencing the submission and decision of marriage dispensation and its implications for children's health and social life. The method used in this research is the Normative Juridical method, with analytical descriptive research specifications. Data were collected through literature studies and interviews using secondary data. Of the 190 dispensation applications, 147 were granted, 18 were rejected, 14 were revoked, 2 were annulled, and 6 are still in the trial process. The main reasons for dispensation applications included pregnancy before marriage, dropping out of school, parental concerns, and sexual relations outside marriage. The results showed that in deciding dispensations, judges considered aspects of mental health, social life, Islamic law, and reproductive health. Although the reproductive health aspect is considered important, in cases of pregnancy outside marriage, this consideration is often not a top priority because the child's reproductive organs are already functioning despite the health risks. The implication of this research is the importance of strategic steps from the government to handle child marriage dispensation through education, strengthening regulations, and cooperation between ministries and community organizations in protecting children's reproductive health rights. In addition, religious courts are expected to consider health, mental, social, and economic aspects thoroughly and provide guidance related to reproductive health risks. Courts are also expected to improve documentation of decision publications to support further research. [ABSTRACT FROM AUTHOR]

Purpose: This study examined demographic, practice, and area‐level characteristics associated with family physicians' (FP) provision of maternity care. Methods: Using the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs' maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county‐level factors (percentage of reproductive‐age women, the number of obstetrician–gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive‐age women). We performed summary statistics and multivariate logistic regression analyses. Results: Of the 59,903 FPs in the sample, 7.5% provided maternity care. FPs practicing in rural were 2.5 times more likely to provide maternity care than those practicing in urban areas. FPs in academic (odds ratio [OR] 4.6, 95% confidence interval [CI] 4.1–5.1) and safety‐net settings (OR 1.9, 1.7–2.1) had greater odds of providing maternity care. FPs in the bottom quintile with no or fewer OBGYNs and CNMs had a higher likelihood of maternity care provision (OR 2.1, 1.8–2.3) than those in the top quintile, with more OBGYNs and CNMs. Conclusions: FPs in high‐needs areas, such as rural and safety net settings, and areas with fewer CNMs or OBGYNs are more likely to provide maternity care, demonstrating the importance of FPs in meeting the needs of women with limited maternity care access. Our study findings highlight the importance of considering the contributions of FPs to maternity care as the organizations prioritize resource allocation to areas of highest need. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Sexualforschung is the property of Georg Thieme Verlag Stuttgart and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The urogenital microbiota is increasingly gaining recognition as a significant contributor to reproductive health. Recent studies suggest that microbiota can serve as predictors for fertility treatment outcomes. Our objective was to investigate the degree of similarity in microbial composition between patient-collected urine and vaginal samples in a subfertile population. We enrolled women of reproductive age (20–44 years) diagnosed with subfertility and requiring in vitro fertilization (IVF) or IVF with intracytoplasmic sperm injection (IVF-ICSI) treatment. They self-collected both mid-stream urine samples and vaginal swabs before commencing the IVF or IVF-ICSI procedure. All samples were analysed using the intergenic spacer profiling (IS-pro) technique, a rapid clinical microbiota analysis tool. The main outcome measures were the degree of similarity of microbial composition between the two different, but simultaneously collected, samples. Our findings revealed a high correlation (R squared of 0.78) in microbiota profiles between paired urine and vaginal samples from individual patients. Nevertheless, the urinary microbiota profiles contained fewer species compared to the vaginal microbiota, resulting in minor but distinguishable differences. Furthermore, different subfertility diagnoses appeared to be associated with differences in microbial profiles. A noteworthy observation was the exclusive presence of Escherichia coli (E. coli) in both samples of women diagnosed with male factor subfertility. In conclusion, since urinary microbiota profiles seem to represent a diluted version of the vaginal microbiota, vaginal microbiome sampling to predict fertility treatment outcome seems preferable. To enhance the success of fertility treatments, further research is needed to gain deeper insights into a putative causal role of microbiota in the mechanisms of subfertility. [ABSTRACT FROM AUTHOR]

Since its global uptake, 'obstetric violence' is increasingly used to capture any/all violations during reproductive healthcare, with few conceptual limits. Consequently, it runs the risk of becoming an overgeneralised concept, making it difficult to operationalise in socio-legal reform efforts. This article draws on the Latin American origins of the concept and aims to provide a theoretical framework to support a focused and coherent socio-legal reform agenda. It offers a universal definition of violence, being the violation of physical or psychological integrity, and localises this definition using the 'view from everywhere'. The article proposes that violence will qualify as 'obstetric violence' if the violation of integrity occurs in the context of antenatal, intrapartum and postnatal care. Further, the subject of the violence is the birthing woman, trans or non-binary person. Thinking in terms of a 'continuum of violence' in reproductive healthcare ensures that different forms of obstetric violence are recognised and helps envisage overlaps with other violences. [ABSTRACT FROM AUTHOR]

This article discusses the results of ethnographic research conducted in the municipality of Verona (Veneto Region, Northeast Italy), during 2018, aimed at analysing the reproductive health needs of migrant women, and their access to such services in the territory. The research highlighted that, in addition to many critical structural-organizational issues, there was an emotional obstacle to the use of services – that is, the feeling of fear. In this paper, therefore, we will try to reflect on the role exercised by fear in the relationship between migrant women and reproductive health services. We interpret this emotion not as the expression of an individual experience and feeling, but rather as an example of "embedded thinking"; the result of a social construction that reflects dynamics and power relationships, capable of transforming feelings into practices. [ABSTRACT FROM AUTHOR]

Purpose of Review: We systematically reviewed research to identify sexual health inequities among Native American adolescents and young adults. We highlight strengths and opportunities in the literature and outline principles for addressing sexual health inequities among Native American adolescents and young adults. Recent findings: We identified fourteen articles that assess and/or provide recommendations to improve sexual health inequities among Native American adolescents and young adults. Summary: Overall, the most addressed topic among the articles analyzed is condom use, including condom use intention and condom use self-efficacy. This speaks to the need to provide Native American adolescents and young adults with the necessary tools to boost their intentions, self-efficacy, and knowledge when it comes to condom use skills. Findings may guide researchers, educators, and curriculum developers to better the sexual health and well-being of vulnerable youth. [ABSTRACT FROM AUTHOR]

Background As per the National Family Health Survey (NFHS-4, 2015–16) report, 40% of women aged 15–49 in India experienced intimate partner violence (IPV), with emotional abuse significantly associated with negative reproductive health (RH) outcomes. Methods The study uses secondary data from the NFHS-4 and conducts statistical analysis based on information gathered from 8766 married women aged 15–49 years in Northeast India. Bivariate analysis followed by multiple logistic regression analysis is performed to understand the relationship between IPV and its effects on women's RH. Results The findings indicate that ever-married women in Northeast India have faced physical violence (25.1%), sexual violence (11.8%), emotional abuse (6.4%) and severe violence (5.3%). Among all women who participated in the study, 6.9% had experienced non-live births, 4.2% miscarriages, 2.4% abortions, 0.3% stillbirths, 16.9% terminated pregnancies and 2.1% sexually transmitted infections (STI). Sexually abused women (SAW) showed higher likelihoods of non-live births, STIs, miscarriages, abortions and pregnancy terminations. SAW had a 65% higher risk of miscarriages, while those experiencing physical violence had a 64% increased risk of abortions. Conclusion IPV significantly impacts women's RH in Northeast India. This study presents evidence from surveys on sexual and RH among married women affected by IPV in Northeast India. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper tries to analyze Revolutionary Road from the perspectives of body narrative and feminist jurisprudence. The second part, “The Pain of Childbirth”, and the third part, “The Bewilderment Between the Soul and the Body”, talk about female physical and mental health, respectively. The fourth part, “The Trespass of the Body”, promotes Reproductive Health Rights and Birthing Rights, thus further exploring how the women, as the subject of desire, trespass their heavy human bodies, how they overcome the unbearable lightness of their bodies, how they control and subdue their bodies, and how they finally gain salvation and revolution. [ABSTRACT FROM AUTHOR]

Increasing scholarly attention has been paid to the reproductive injustices experienced by Indigenous women. However, the breastfeeding experiences of Indigenous women have infrequently been explored. This study uses a qualitative description research approach to explore the breastfeeding experiences of Indigenous women members of a non-federally recognized tribe in the Gulf South. Key themes included: 1) Shifting generational practices; 2) Lack of institutional resources; 3) Inadequate support from healthcare providers; and 4) Institutional and community supports for breastfeeding. These findings highlight the need for increased institutional and community support, and breastfeeding education, so that Indigenous women can reach their breastfeeding goals. [ABSTRACT FROM AUTHOR]

Background/Objectives: Male infertility is a prevalent issue impacting numerous couples worldwide. This review aims to evaluate the effectiveness of empirical therapies for male infertility, focusing on both lifestyle modifications and medical treatments. This study provides a comprehensive overview of interventions aimed at improving male fertility outcomes. Methods: A thorough review of the existing literature was conducted, encompassing studies on lifestyle changes such as dietary changes, smoking cessation, alcohol moderation, and exercise. Additionally, medical treatments including selective estrogen receptor modulators, gonadotropins, aromatase inhibitors, phosphodiesterase-5 inhibitors, antioxidants, dopamine agonists, kallikrein, indomethacin, low-dose corticosteroids, alpha-blockers, and nitric oxide donors were evaluated. The study population included males diagnosed with infertility, focusing on various underlying causes. Results: Lifestyle modifications were found to have a positive impact on sperm quality. Evidence shows that a healthy diet, smoking cessation, moderate alcohol consumption, and regular exercise improve fertility outcomes. Medical treatments demonstrated significant improvements in sperm production and quality. Selective estrogen receptor modulators and gonadotropins enhanced sperm parameters. Aromatase inhibitors and phosphodiesterase-5 inhibitors specifically improved sperm motility and increased pregnancy rates. Antioxidants, such as vitamins E and C and coenzyme Q10, reduced oxidative stress and enhanced sperm counts, motility, and morphology. Dopamine agonists, particularly cabergoline, normalized prolactin levels and improved fertility outcomes. Kallikrein therapy improved sperm parameters and increased pregnancy rates. Indomethacin treatment was associated with increased sperm concentrations and motility. Low-dose corticosteroids and alpha-blockers showed variable results, and nitric oxide donors like L-arginine enhanced sperm counts and motility. Conclusions: Empirical therapies, including lifestyle modifications and medical treatments, significantly enhance sperm quality and reproductive potential. These integrated approaches are essential in improving fertility outcomes in males. However, further extensive randomized trials are necessary to definitively establish the most effective treatments. [ABSTRACT FROM AUTHOR]

Most EU member states fail to provide essential sexual and reproductive health services to undocumented migrants, a vulnerable population facing limited access, utilization, and worse health-related outcomes. This study systematically reviewed the literature on access to and use of these services, as well as related health, economic, and migratory outcomes for undocumented migrants in the EU-EFTA region. The systematic review is reported based on the PRISMA 2020 checklist and includes 37 studies published between 2017 and 2024. Included studies were based upon original quantitative, qualitative, or mixed-methods data; conducted in one or more European countries; and published in one or more of the following languages: English, Spanish, French, Portuguese, or Romanian. A quality assessment was conducted using the CASP checklist for qualitative studies and the NHLBI Study Quality Assessment Tools for quantitative studies. The findings revealed numerous access barriers, including refusal of care, lack of knowledge about national healthcare schemes, bureaucratic hurdles, and affordability issues. Even when care was available, stigma, fear of deportation, socio-economic precarity, and abuse further hindered utilization. These barriers contributed to generally worse reproductive health outcomes for undocumented migrants in Europe, though the findings may not generalize to all EU-EFTA countries. [ABSTRACT FROM AUTHOR]

PROGRAM DESCRIPTION: Growing Up GREAT! (GUG) is a sexual and reproductive health (SRH) program for adolescents aged 10-14 years in Kinshasa, Democratic Republic of the Congo (DRC). The multilevel program takes an ecological approach to foster community examination of gender inequitable norms and to increase adolescents SRH knowledge, skills, and gender-equitable attitudes. GUG design, piloting, and scale-up were informed by a theory of change and responsive feedback mechanisms (RFMs) during piloting and scale-up. RESPONSIVE FEEDBACK MECHANISMS: The program engaged stakeholders via quarterly learning meetings to review monitoring data, evaluation results, and practice-based knowledge and to subsequently identify challenges and develop solutions. The program commissioned rapid research on specific intervention elements to improve implementation and documented scale-up learnings using the World Health Organization/ExpandNet framework. ACHIEVEMENTS: RFMs used in the pilot period allowed the program to address community concerns by intensifying orientation activities with parents and schools, shifting the calendar of activities to increase male engagement, and increasing facilitator training length to improve facilitation quality. Using RFMs during scale-up prompted further adaptations for program sustainability, including recommendations for task-shifting from NGO facilitators to community health workers. CONCLUSION: GUG used RFMs from pilot through scale-up to foster a learning culture among local partners, implementers at headquarters, and global research partners. Using responsive feedback (RF) enabled timely response to the evolving implementation context, resulting in strategic program adaptations that fostered increased community support of the project. Other successes due, at least in part, to this RF approach include incorporation of the program into DRCs national adolescent health strategy, and rapid response to the COVID-19 pandemic in educational strategies for program beneficiaries.

OBJECTIVES: Many cisgender women affected by homelessness and substance use desire pregnancy and parenthood. Provider discomfort with patient-centered counseling about reproductive choices and supporting reproductive decisions of these women poses barriers to reproductive healthcare access. METHODS: We used participatory research methods to develop a half-day workshop for San Francisco-based medical and social service providers to improve reproductive counseling of women experiencing homelessness and/or who use substances. Guided by a stakeholder group comprising cisgender women with lived experience and providers, goals of the workshop included increasing provider empathy, advancing patient-centered reproductive health communication, and eliminating extraneous questions in care settings that perpetuate stigma. We used pre/post surveys to evaluate acceptability and effects of the workshop on participants attitudes and confidence in providing reproductive health counseling. We repeated surveys one month post-event to investigate lasting effects. RESULTS: Forty-two San Francisco-based medical and social service providers participated in the workshop. Compared to pre-test, post-test scores indicated reduced biases about: childbearing among unhoused women (p

Abstract Introduction The prevalence of Rheumatoid Arthritis (RA) has been steadily increasing over the last thirty years, particularly among women. Due to the conflicting results of various studies on the link between rheumatoid arthritis and reproductive health, we have undertaken this study to explore their relationship. Methods This cross-sectional study utilized primary data from5557 women involved in the Fasa Persian Cohort in the years 2013 to 2018. The study examined the frequency of RA and its association with various factors related to reproductive health, including age at first pregnancy, number of alive children, history of abortion, and infertility. SPSS software was utilized for data analysis, with the significance level set at p

Abstract Background Historically, family planning discussions have predominantly centred on women, overlooking the crucial role men play in contraception. This is particularly concerning in regions like Sub-Saharan Africa (SSA), where reproductive health challenges are pronounced. South Africa, a key country within SSA, continues to grapple with issues such as high unintended pregnancy rates and increasing pregnancy-related mortality. Understanding the factors that deter male contraceptive use is essential for achieving universal access to sexual and reproductive health (SRH) services. This study investigates the socioeconomic disparities influencing male contraceptive use in South Africa, drawing on data from the 2016 South Africa Demographic Health Survey. Methods The study utilised data from the 2016 South African Demographic and Health Survey, which employed a stratified, two-stage sampling design across all provinces based on the 2011 Census. The survey focused on men aged 15–59 using the “Man’s Questionnaire.” Various socio-demographic and attitudinal variables were analysed using STATA 17. The analysis included multinomial logistic regression to identify determinants of male contraceptive use and the Erreygers Normalized Concentration Index to assess socioeconomic inequalities in contraceptive uptake. Results Among the surveyed men, 47% reported not using any contraception, 40% used male methods, and 13% relied on their partners’ contraceptive use. A majority began sexual activity between the ages of 14–17 (54%), resided in urban areas (56%), were unmarried (67%), and had attained secondary education (70%). Notably, 78% disagreed that contraception is solely a woman’s responsibility, and 64% expressed positive attitudes toward contraception. Age, marital status, and education level emerged as significant factors influencing contraceptive use. The study revealed a slight pro-rich inequality in male contraception use, with socioeconomic status (SES) being the most significant contributor to this disparity (223.22%). This suggests that higher SES is associated with increased inequality in the adoption of modern male contraceptive methods. Conclusion These findings highlight the impact of socioeconomic disparities and entrenched cultural beliefs on male contraceptive use in South Africa. To address these challenges, comprehensive strategies that prioritise education, expand family planning media campaigns and ensure equitable access to contraception are urgently needed.

Abstract Background In Pakistan, family planning has traditionally been perceived as primarily a women’s concern, resulting in the exclusion of men from relevant initiatives. This situation is further exacerbated by cultural and social barriers that hinder men’s access to family planning services. This study addresses a significant research gap by assessing the extent of family planning service provision for men in urban areas of Karachi. It delves into the exploration of men’s involvement in family planning service delivery, identifies existing gaps in services catering to men, records men’s perceptions of accessibility and acceptability of these services, and ultimately offers recommendations to enhance men’s involvement and strengthen service provision to better meet their needs. Methods We employed a qualitative exploratory research design using semi-structured interviews to investigate perceptions regarding family planning service provision to men. This approach involved 25 interviews, comprising eight key informant interviews with stakeholders, eight with service providers, and nine in-depth interviews with married men. Results This study highlights the limited engagement of men in family planning programs, primarily due to entrenched sociocultural norms that confine female healthcare providers to serving women, hindering men’s involvement. While national and provincial policies endorse men’s participation, they lack defined roles for male providers. Behavioral and information-sharing barriers at the community level discourage male healthcare providers from collaborating with females. Family planning programs, except for NGO-led vasectomy projects, fail to adequately address men’s needs. Despite policy recognition, implementation remains inadequate. Bridging the men’s involvement gap necessitates more male providers and improved contraceptive stigma combat training. Further research is vital to explore effective methods for involving men in community and service delivery in family planning. Conclusion There is a need to change the perception that contraception is solely the responsibility of women, as men’s participation in family planning in Karachi is limited. Engaging men can yield positive health and non-health outcomes. Culturally sensitive services, developed with community input using a couple-centered approach, are crucial for equitable family planning. Further research is needed to explore men’s inclusion strategies in service provision and utilization.

Background: Infertility is defined as failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. The prevalence of couples with infertility increased every year. Treatment success for male infertility remains suboptimal despite the advancements of the therapies. Hence, a comprehensive understanding regarding spermatogenesis is needed to improve existing infertility treatments. Animal models are commonly used in studies regarding male infertility. Aluminum chloride (AlCl3) has been established as an infertility-inducing agent. Aim: This study investigates the optimal dosage of AlCl3 in infertility mice model. Method: Male Balb/c mice, aged 3 months and have proven to be fertile with an average body weight of 26,96, randomly assigned to four groups. The control group received oral gavage with sterile aquadest, while the treatment groups were administrated AlCl3 at doses of 100mg/kgBW, 150mg/kg BW, 200mg/kg BW orally over a 53-day period. Assessment of the sperm motility, concentration, morphology, viability, hormone levels, and testicular histopathology were included in this study. Results: Administration of AlCl3 did not significantly affect body weight, testicular weight, and hormone levels. However, semen analysis showed a reduction in seminal parameters among treatment groups, supported by testicular histopathology. Conclusion: Utilizing AlCl3 to induce infertility in mice models is not quite effective and displayed variable efficacy across different dosage. Further investigations are needed to elucidate optimal dosage, route of administration, and timing to establish reliable mice infertility models. [Open Vet J 2024; 14(9.000): 2315-2324]

Background: Reproductive health, crucial for public health and sustainable development, encompasses family planning and contraceptive use. However, global disparities persist in the adoption of family planning, highlighting the need for a comprehensive understanding of the complex factors shaping these reproductive health choices. Materials and Methods: Following Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we conducted a systematic search of the Scopus, ScienceDirect, PubMed, Web of Science, and ProQuest databases from July to August 2023. Inclusive criteria covered various study designs and populations, ranging from individuals to communities, and encompassed sociocultural factors. The review included open access articles published between 2018 and 2023, utilizing a combination of the keywords: Family planning determinants, Contraceptive use factors, Sociocultural factors in family planning, Individual-level influences on family planning, and Factors affecting contraceptive choices. Results: Data from 25 selected studies underscore the critical influence of determinants at both individual and community levels in shaping family planning behaviors. Key drivers at the individual level included education, age, knowledge, and attitudes. At the community level, factors such as geographical disparities and healthcare accessibility played pivotal roles. Sociocultural determinants, including media exposure, gender norms, and spousal dynamics, highlighted the need for culturally sensitive strategies. Conclusions: Advancing equitable family planning requires education, improved access, peer influence, and the active participation of husbands and male partners. Comprehensive programs should bridge the gap between knowledge and action, reduce disparities, and ensure equal access to contraception. Context-specific research and evaluating interventions are crucial steps toward achieving global reproductive health objectives.

Abstract Erectile dysfunction (ED) is prevalent among males experiencing fertility challenges, yet attitudes towards actively treating ED in this group are under-researched. From a cohort of 1256 men with reproductive needs, 303 were identified with ED. The survey encompassed 296 respondents who correctly completed the second questionnaire, revealing that 50.3% sought ED treatment, with higher ED severity increasing the likelihood of seeking treatment. Infertile men were more likely to seek treatment than those with pregnancy loss (OR 3.18, 95% CI 1.74–5.83). Men with normal semen parameters were more open to ED therapy (OR 3.02, 95% CI 1.69–5.36), whereas those undergoing Assisted Reproduction Treatment were less inclined (OR 0.32, 95% CI 0.18–0.58). PDE-5 inhibitors (PDE-5Is) were preferred by 51.0% of those seeking treatment, with 29.7% of men with pregnancy loss and 60.1% of infertile men choosing PDE-5Is as their first option. Concerns included potential adverse effects of PDE-5Is on fetal health (78.7% of men with pregnancy loss) and on sperm quality (44.2% of infertile men). In conclusion, the different fertility requirements, semen parameters, and whether received ART are significant factors influencing the acceptance of treatment, PDE-5Is utilization among individuals in men with couple pregnancy loss is notably limited.

Abstract Background Conflict in Syria since 2011 led to over one million Syrians fleeing to Lebanon, predominantly from economically disadvantaged areas with low literacy and high child marriage rates. Over 90% live in extreme poverty, in informal tented settlements with minimal access to education, healthcare or employment. Displacement and poverty have further increased early marriages and unplanned pregnancies, and curtailed access to sexual and reproductive healthcare (SRH) in the Bekaa valley. This is exacerbated by increasing rates of sexual and gender-based violence (SGBV), intimate partner violence and domestic violence. Study design We aimed to explore SRH beliefs and practices and teach on key SRH topics through focus group discussions (FGD) and questionnaires, co-designed with Syrian practitioners, conducted with Syrian men and women. FGD were recorded, transcribed and thematically analysed. Questionnaires collected demographics and explored SRH beliefs and practices. Findings 24 FGD with 203 participants, 72.4% female and 27.6% men. 90.1% participants were married with an average age-gap of 6.3 years between partners. Teenage marriage rates were 55.6% for women, and 47.4% delivered their first child before the age of 20. 43.6% participants were not using any contraception. Findings demonstrate the impacts of SRH cultural norms and changes due to displacement, financial crisis, and increased exposure to technology and NGOs. Conclusions SRH is multifaceted and contested, requiring systemic improvements in access to care, employment and education. This small but important proof-of-concept study demonstrates the possibility of engaging men and women in SRH discussion; paramount to empowering communities and challenging intergenerational SGBV.

Floods are major Extreme Weather Events (EWEs) that are more frequent and intense. Floods has multifarious dire impacts on human health, but health implications of floods are limitedly examined from a gender lens, particularly in the context of developing countries, like Bangladesh. Floods periodically hit in Bangladesh. The 2017 was a catastrophic year for Bangladesh. The year experienced two consecutive floods that were more catastrophic in the last couple of decades and direly affected 24 districts of the country. The floods resulted in health stress and intensifying exposure to manifold health vulnerabilities. Our study aimed to investigate gendered health complications caused by the floods and the impacts of the confluence of the floods and vulnerabilities relating to water, sanitation, health care facilities on reproductive health. To explore gendered dimensions of health, we conducted 280 household surveys, 4 Focus Group Discussions, 4 In-Depth Interviews, and 6 Key Informant Interviews within the framework of mixed-method research in a northern flood-prone district named Jamalpur. Our findings showed that 84.6% of the respondents stated water gets polluted during floods, and 69.6% identified polluted water as a major challenge while collecting water during floods. Due to living with polluted floodwater, fever (66.4%) and diarrheal diseases (55.4%) were most common among women. In respect to reproductive health, 75% of the females reported improper menstrual management causing mental shocks and vaginal infections; over 66.4% females noted remaining without any measures. To mitigate health vulnerability, majority of the rural women (78.6%) encountered challenges – including the dearth of available medicine and poor transportation and communication. Health vulnerability also increased when poor communities failed to afford the cost of medicine because of poor economic condition and food insecurity. Consequently, our study recommends for fostering health education and the immediate deployment of health care facilities on an emergency basis to reduce health complications, especially among marginal groups (e.g., women and children). Future research can explore how the intersection of economic insecurity and flood whet differential health complications among poor and non-poor.

BACKGROUND: A longstanding gap in the reproductive health field has been the availability of a screening instrument that can reliably predict a persons likelihood of becoming pregnant. The Desire to Avoid Pregnancy Scale is a new measure; understanding its sensitivity and specificity as a screening tool for pregnancy as well as its predictive ability and how this varies by socio-demographic factors is important to inform its implementation. METHODS: This analysis was conducted on a cohort of 994 non-pregnant participants recruited in October 2018 and followed up for one year. The cohort was recruited using social media as well as advertisements in a university, school, abortion clinic and outreach sexual health service. Almost 90% of eligible participants completed follow-up at 12 months; those lost to follow-up were not significantly different on key socio-demographic factors. We used baseline DAP score and a binary variable of whether participants experienced pregnancy during the study to assess the sensitivity, specificity, area under the ROC curve (AUROC) and positive and negative predictive values (PPV and NPV) of the DAP at a range of cut-points. We also examined how the predictive ability of the DAP varied according to socio-demographic factors and by the time frame considered (e.g., pregnancy within 3, 6, 9 and 12 months). RESULTS: At a cut-point of 2 on the 0-4 range of the DAP scale, the DAP had a sensitivity of 0.78, a specificity of 0.81 and an excellent AUROC of 0.87. In this sample the cumulative incidence of pregnancy was 16% (95%CI 13%, 18%) making the PPV 43% and the NPV 95% at this cut-point. The DAP score was the factor most strongly associated with pregnancy, even after age and number of children were taken into account. The association between baseline DAP score and pregnancy did not differ across time frames. CONCLUSIONS: This is the first study to assess the DAP scale as a screening tool and shows that its predictive ability is superior to the limited pre-existing pregnancy prediction tools. Based on our findings, the DAP could be used with a cut-point selected according to the purpose.

Endometriosis is a common estrogen-dependent disorder wherein uterine lining tissue (endometrium) is found mainly in the pelvis where it causes inflammation, chronic pelvic pain, pain with intercourse and menses, and infertility. Recent evidence also supports a systemic inflammatory component that underlies associated co-morbidities, e.g., migraines and cardiovascular and autoimmune diseases. Genetics and environment contribute significantly to disease risk, and with the explosion of omics technologies, underlying mechanisms of symptoms are increasingly being elucidated, although novel and effective therapeutics for pain and infertility have lagged behind these advances. Moreover, there are stark disparities in diagnosis, access to care, and treatment among persons of color and transgender/nonbinary identity, socioeconomically disadvantaged populations, and adolescents, and a disturbing low awareness among health care providers, policymakers, and the lay public about endometriosis, which, if left undiagnosed and under-treated can lead to significant fibrosis, infertility, depression, and markedly diminished quality of life. This review summarizes endometriosis epidemiology, compelling evidence for its pathogenesis, mechanisms underlying its pathophysiology in the age of precision medicine, recent biomarker discovery, novel therapeutic approaches, and issues around reproductive justice for marginalized populations with this disorder spanning the past 100 years. As we enter the next revolution in health care and biomedical research, with rich molecular and clinical datasets, single-cell omics, and population-level data, endometriosis is well positioned to benefit from data-driven research leveraging computational and artificial intelligence approaches integrating data and predicting disease risk, diagnosis, response to medical and surgical therapies, and prognosis for recurrence.

Advancing the health goals of society requires human resources management of health as one of the most important tools. Providing the opportunity according to the skill and knowledge of service providers is the basis for providing quality services while considering the cost. This article explains the position of reproductive health scholars as a group to advance the health goals of mothers and babies.

Heavy metals are harmful environmental pollutants that have attracted widespread attention, attributed to their health hazards to humans and animals. Due to the non-degradable property of heavy metals, organisms are inevitably exposed to heavy metals such as arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg). Several studies revealed that heavy metals can cause reproductive damage by the excessive production of reactive oxygen species (ROS), which exacerbates oxidative stress, inflammation, and endocrine disruption. Natural antioxidants, mainly polyphenols, carotenoids, and vitamins, have been shown to mitigate heavy metal-induced reproductive toxicity potentially. In this review, accumulated evidences on the influences of four non-essential heavy metals As, Cd, Pb, and Hg on both males and females reproductive system were established. The purpose of this review is to explore the potential mechanisms of the effects of heavy metals on reproductive function and point out the potential biomarkers of natural antioxidants interventions toward heavy metal-induced reproductive toxicity. Notably, increasing evidence proven that the regulations of hypothalamic-pituitary-gonadal axis, Nrf2, MAPK, or NF-κB pathways are the important mechanisms for the amelioration of heavy metal induced reproductive toxicity by natural antioxidants. It also provided a promising guidance for prevention and management of heavy metal-induced reproductive toxicity. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to explore women's perception of men with different addictions in terms of their short- and long-term mate value. Objectives: 2,525 women (age range: 18–40, M = 28.35, SD = 6.39) were randomized to six conditions in a vignette-based experiment where a male of otherwise high mating value was described as suffering from either gambling, gaming, cannabis, anabolic androgenic steroid, and alcohol addiction or as not suffering from addiction (control). Results: Regarding long-term mate value of the target, the control target was rated higher than each of the targets. The gaming target was rated higher than the alcohol, cannabis, and gambling targets. Finally, the AAS target was rated as higher on long-term mate value than the alcohol and gambling addiction targets. Conclusions: Overall, women seem to perceive risk-taking in the face of uncertainty, reflected by gambling addiction, as an attractive behavioral tendency in men in terms of short-term mating. In contrast, potential long-term mates with gaming or chemical addictions are viewed more negatively, probably because it signals inadequate time and resources to be invested in a relationship. [ABSTRACT FROM AUTHOR]

Communication is a crucial tool in all forms of interaction. The medical world without communication is inconceivable. Guided by Austin's speech act theory, this work explores how doctors relay bad news in the form of infertility diagnoses in a reproductive health clinic in Kenya and the responses of male patients to this news. It is a qualitative study in a public health facility in Nakuru town in Nakuru County, Kenya. The two male patients recruited for this study were willing to participate without payment or coercion. The conversation on reproductive health problems between the doctor and male patients was collected using participant observation. The diagnosis of male infertility can be a significant source of distress for male patients as it challenges traditional perceptions of masculinity. Similar locutionary and illocutionary acts can elicit very different perlocutionary acts. An utterance, once made, cannot be altered, nor can its effect. A man's emotional response to an infertility diagnosis is profound and irreversible. Bad news in a reproductive health clinic includes male infertility diagnoses, a condition that impacts the masculine identity of a man and threatens his entire existence. [ABSTRACT FROM AUTHOR]

Abstract People are inundated with popular press reports about medical research concerning what is healthy, get advice from doctors, and hear personal anecdotes. How do people integrate conflicting anecdotal and statistical information when making medical decisions? In four experiments (N = 4126), we tested how people use conflicting information to judge the efficacy of artificial and real medical treatments. Participants read an anecdote from someone in a clinical trial, or who had undergone a medical treatment previously, for whom the medical treatment was ineffective. We found that reading anecdotes for either artificial or real medical treatments shifted participants’ beliefs about the efficacy of a medical treatment. We observed this result even when the anecdote was uninformative, was paired with an icon array, or when participants were provided with thorough medical decision aids about reproductive health procedures. Our findings highlight the pervasive effect of anecdotes on medical decision making.

Abstract Ensuring proper menstrual hygiene management remains a significant challenge for young women in India. The term "exclusive use of hygienic period products during menstruation" refers to relying solely on period products like sanitary pads, tampons, or menstrual cups. Poor menstrual hygiene practices not only increase the risk of reproductive tract infections but also lead to various negative health outcomes, including discomfort and potential complications. This study explores factors associated with the exclusive use of period products during menstruation aged 15–24, investigates geographic disparities, examines rural–urban gaps, and assesses inequality in India. Utilizing data from the fifth National Family Health Survey (NFHS-5), responses from 2,41,180 women aged 15 to 24 were analysed using logistic regression and multivariate decomposition analyses to explore socioeconomic predictors. Moran's I statistics also assessed spatial dependency, while Lorenz curves and Gini coefficients measured inequality. Quintile and LISA maps visualized regional disparities. The study found that 76.15% of women in India reported exclusive use of hygienic period products during menstruation. Rural areas reported a lower percentage of exclusive use of hygienic period products (72.32%) during menstruation compared to urban areas (89.37%). Key factors associated with the exclusive use of hygienic period products among 15–24-year-old women in India include age, education, place of residence, wealth, access to media, and healthcare discussions. Geographically, central districts exhibited the lowest coverage ( 85). The GINI coefficient of 0.39 highlighted moderate inequality in distribution. Decomposition analysis revealed that household wealth contributed 49.25% to rural–urban differences, followed by education (13.41%), media access (7.97%), and region (4.97%). This study highlights significant regional disparities and low utilization of hygienic period products among young women in India, particularly in central districts. Policymakers should prioritize interventions targeting these regions, addressing socio-economic disparities. Strategies to promote education, improve media access, and enhance household wealth can facilitate menstrual hygiene adoption. Initiatives to reduce sanitary napkin costs and increase accessibility, particularly in rural areas, are crucial to mitigating geographical disparities nationwide.

Background: Adolescence is a period of emotional, mental, and physical change. To improve health-seeking behavior, reduce risky sexual behaviors, and increase knowledge about sexual and reproductive health, adolescents need support and access to services. The increasing availability of mobile apps requires a thorough evaluation of the quality and classification of these mobile apps so that accurate and evidence-based information can reach their users. Because smartphones are a private (intimate) technology, they are a promising means of closing this gap. However, research focusing on sexual health promotion programs delivered through smartphones is still rare. Purposes: Developing and testing a smartphone and internet-based comprehensive sex education app. Methods: This study employed Research and Development consisting of 4 stages, namely Literature Study, Development Stage, Validity Expert, and Trial. Result: The SEMAR app has seven features, ranging from mental health education to human relationships. The convenience score is 70%. The results of the trial show that this application effectively improves health education. 50-83% agree to use it. The sex stigma variable has the most extensive r (r=0.955), which means it has a solid and positive relationship. Conclusion: This application benefits adolescents in improving health education and adolescent reproductive health.

Abstract Background The composition of the vaginal microbiota during the menstrual cycle is dynamic, with some women remaining eu- or dysbiotic and others transitioning between these states. What defines these dynamics, and whether these differences are microbiome-intrinsic or mostly driven by the host is unknown. To address this, we characterized 49 healthy, young women by metagenomic sequencing of daily vaginal swabs during a menstrual cycle. We classified the dynamics of the vaginal microbiome and assessed the impact of host behavior as well as microbiome differences at the species, strain, gene, and phage levels. Results Based on the daily shifts in community state types (CSTs) during a menstrual cycle, the vaginal microbiome was classified into four Vaginal Community Dynamics (VCDs) and reported in a classification tool, named VALODY: constant eubiotic, constant dysbiotic, menses-related, and unstable dysbiotic. The abundance of bacteria, phages, and bacterial gene content was compared between the four VCDs. Women with different VCDs showed significant differences in relative phage abundance and bacterial composition even when assigned to the same CST. Women with unstable VCDs had higher phage counts and were more likely dominated by L. iners. Their Gardnerella spp. strains were also more likely to harbor bacteriocin-coding genes. Conclusions The VCDs present a novel time series classification that highlights the complexity of varying degrees of vaginal dysbiosis. Knowing the differences in phage gene abundances and the genomic strains present allows a deeper understanding of the initiation and maintenance of permanent dysbiosis. Applying the VCDs to further characterize the different types of microbiome dynamics qualifies the investigation of disease and enables comparisons at individual and population levels. Based on our data, to be able to classify a dysbiotic sample into the accurate VCD, clinicians would need two to three mid-cycle samples and two samples during menses. In the future, it will be important to address whether transient VCDs pose a similar risk profile to persistent dysbiosis with similar clinical outcomes. This framework may aid interdisciplinary translational teams in deciphering the role of the vaginal microbiome in women’s health and reproduction. Video Abstract

Abstract Introduction Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia. Methods This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis. Results The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services. Conclusion The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.

Bacterial vaginosis is one of the most common reproductive health problems in women. Lactobacillus spp. play a leading role in the vaginal biocenosis and provide local antimicrobial defense, but not all species are equally capable of protecting the vaginal ecosystem from pathogens. Diagnostic methods in practical healthcare do not allow identification of Lactobacillus spp. species, which limits the ability to comprehensively assess the status of the vaginal biocenosis. We conducted a study in which we compared microscopy data of the examined smear with the detection of Lactobacillus spp. and other microorganisms. The aim of the study was to evaluate the species composition of Lactobacillus spp. from the vagina depending on morphologic characteristics and composition of associated flora. The study included 64 conditionally healthy women of reproductive age from 18 to 35 years old. The study of species composition of the vaginal biocenosis and typing of lactobacilli was carried out by real-time PCR methods. The obtained results were processed using generally accepted methods of descriptive and ordinal statistics. During the study, it was found that the vaginal biocenosis was dominated by species of Lactobacillus spp. L. crispatus, L. vaginalis, L. iners and L. jensenii. L. johnsonii was rarely found, and L. acidophilus was not detected. Typing results showed that the vagina was more frequently colonized by more than one species of Lactobacillus spp. while a single species of Lactobacillus spp. was detected less frequently. A correlation was found between Lactobacillus spp. species and bacilli thickness. If thick bacilli are detected in gynecological smear microscopy, they belong to the species L. crispatus, which has high colonization resistance and is a factor in the stability of the vaginal biocenosis. If smear microscopy reveals thin bacilli, then these are species of L. iners and L. jensenii. These representatives of Lactobacillus spp. are not directly related to the dysbiotic state of the vagina, but may indicate the possible development of dysbiosis in the future.

Abstract Obesity increases the risk of chronic kidney disease. We have previously demonstrated the benefits of preconception maternal weight loss on fertility and pregnancy outcomes in a mouse model of maternal obesity. Here, we elucidate if preconception weight loss, either by diet modification or the glucose-like peptide 1 agonist liraglutide, used in the treatment of diabetes and obesity, improves maternal kidney outcomes in late gestation. C57BL/6 female mice were fed either a high-fat-diet (HFD) or a chow (control) diet for 8 weeks. To induce pre-pregnancy weight loss, HFD-fed dams were switched to chow diet (HFD-C) or administered liraglutide (0.3 mg/kg subcutaneous) whilst continuing on HFD (HFD-L). Liraglutide was discontinued one week prior to mating. HFD-V mice continued on HFD, with saline injections. A group of HFD-fed dams were ‘diet switched’ to chow after conception (post-conception, HFD-PC). Maternal body weight and glucose tolerance were measured: (1) preconception and (2) during late gestation followed by blood, urine and kidney collection. Serum creatinine, urinary creatinine and albumin, kidney tissue gene expression and protein were measured. In the preconception period, HFD-L and HFD-C mothers have lower urine albumin:creatinine ratios (UACR) and fatty acid synthase (FAS) protein expression (P

تهدف الدراسة الراهنة إلي التعرف علي الفروق الريفية الحضرية في الصحة الإنجابية بمحافظة الوادي الجديد . من خلال إجراء دراسة ميدانية علي عينة من السيدات المتزوجات في الفئة العمرية من (15-49عام ) بريف وحضر مدينة الخارجة وبلغ عددهم 375 سيدة ، وتمثلت مؤشرات الصحة الإنجابية في الدراسة في استخدام وسائل تنظيم الأسرة ، تغطية الرعاية الصحية للحمل والولادة ، انتشار ظاهرة ختان الإناث .والكشف عن الفروق بين الريف والحضر في هذه المؤشرات، وأظهرت النتائج ارتفاع المستوي التعليمي لعينة الدراسة،ارتفاع مؤشر الصحة الإنجابية فيما يتعلق بنسبة استخدام وسائل تنظيم الأسرة في الريف والحضر ، وتم العثور علي فروق بين الريف والحضر فيما يتعلق بمؤشر تغطية رعاية الحمل والولادة ، وتبين وجود مشكلات تتمثل فى نقص وقصور فى الخدمات الصحية وعدم توافر الأطباء وبعد المسافة بين محل الإقامة ومرافق الرعاية الصحية، كما تبين وجود فروق ريفية حضرية فيما يتعلق بمؤشر ختان الإناث فلا تزال المناطق الريفية بمدينة الخارجة أكثر تمسكاً بهذه الممارسة ، مما يعكس العادات والتقاليد الثقافية والأعراف الاجتماعية. وخلص البحث لمجموعة من التوصيات أهمها تعزيز برامج وحملات التثقيف الصحي ، تحسين الخدمات الصحية المقدمة للسكان داخل المحافظة، التأكيد علي دور الرائدات الريفيات ورجال الدين في التوعية المباشرة بموضوع الصحة الإنجابية .AbstractThe current study aims to identify rural-urban differences in reproductive health in New Valley Governorate. By conducting a field study on a sample of married women in the age group (15-49 years) in rural and urban areas of the city of Kharga, numbering 375 women. The reproductive health indicators in the study were the use of family planning methods, health care coverage for pregnancy and childbirth, and the spread of the phenomenon of female circumcision. And revealing the differences between rural and urban areas in these indicators, the results showed a high educational level of the study sample, a high reproductive health index with regard to the percentage of use of family planning methods in rural and urban areas, and differences were found between rural and urban areas with regard to the indicator of coverage of pregnancy and childbirth care, and it was found that There are problems represented in the lack and insufficiency of health services, the lack of doctors, and the distance between the place of residence and health care facilities. It was also shown that there are rural-urban differences with regard to the female circumcision index. The rural areas of the city of Kharga are still more committed to this practice, which reflects cultural customs and traditions and social norms. The research concluded with a set of recommendations, the most important of which are strengthening health education programs and campaigns, improving health services provided to the population within the governorate, and emphasizing the role of rural women pioneers and clergy in direct awareness of the issue of reproductive health.

Abstract Background Pregnancy termination is an essential component of reproductive healthcare. In Southern Africa, an estimated 23% of all pregnancies end in termination of pregnancy, against a backdrop of high rates of unintended pregnancies and unsafe pregnancy terminations, which contributes to maternal morbidity and mortality. Understanding the reasons for pregnancy termination may remain incomplete if seen in isolation of interpersonal (including family, peer, and partner), community, institutional, and public policy factors. This study therefore aimed to use a socio-ecological framework to qualitatively explore, in Soweto, South Africa, i) reasons for pregnancy termination amongst women aged 18–28 years, and ii) factors characterising the decision to terminate. Methods In-depth interviews were conducted between February to March 2022 with ten participants of varying parity, who underwent a termination of pregnancy since being enrolled in the Bukhali trial, set in Soweto, South Africa. A semi-structured, in-depth interview guide, based on the socioecological domains, was used. The data was analysed using reflexive thematic analysis, and a deductive approach. Results An application of the socio-ecological framework indicated that the direct reasons to terminate a pregnancy fell into the individual and interpersonal domains of the socioecological framework. Key reasons included financial dependence and insecurity, feeling unready to have a child (again), and a lack of support from family and partners for the participant and their pregnancy. In addition to these reasons, Factors that characterised the participants’ decision experience were identified across all socio-ecological domains and included the availability of social support and (lack of) accessibility to termination services. The COVID-19 pandemic and resultant lockdown policies also indirectly impacted participants’ decisions through detrimental changes in interpersonal support and financial situation. Conclusions Amongst the South African women included in this study, the decision to terminate a pregnancy was made within a complex structural and social context. Insight into the reasons why women choose to terminate helps to better align legal termination services with women’s needs across multiple sectors, for example by reducing judgement within healthcare settings and improving access to social and mental health support.

Abstract Background There is a dearth of research examining the couple characteristics in determining contractive utilization behavior in developing countries. This study fills the gap by analyzing the roles of women’s intra-household bargaining power and spousal age differentials in predicting contraceptive utilization behavior in Pakistani women. Methods A sample of 13,331, excluding pregnant and sexually inactive married women aged 15–49, was extracted from the Pakistan Demographic and Health Survey 2017–18. The dataset is cross-sectional. Exploratory analysis was used to examine the pattern of contraceptive knowledge, types of contraceptive utilization, and intention to use contraceptives among women. Furthermore, binary regressions were employed to examine the association of women's intrahousehold bargaining power and spousal age difference with contraceptive utilization without and after accounting for all potential covariates. Results Only 33% of women use contraceptives, while 30% express an intention to use contraceptives in the future. Almost all women (98%) knew about modern contraceptives. Compared to same-age couples, higher odds of current contraceptive use are observed among women whose husbands are at least 20 years older than them or whose husbands are young to them. The odds of the intention to use contraceptives tend to increase with the increase in spousal age difference. Women’s intra-household bargaining is a significant predictor of current contraceptive utilization and intention to use contraceptives. Conclusion Findings underscore the importance of considering the couple’s characteristics in reproductive healthcare programming and policies. Recommendation Greater women's intra-household bargaining power and smaller spousal age differences are associated with higher contraceptive usage. Empowering women and promoting their decision-making authority within households can enhance reproductive health outcomes.

Keemi Ereme,1 Kaidee Akullo,2 Quetzal A Class,2 Erica Hinz2 1Obstetrics and Gynecology, University of Washington, Seattle, WA, USA; 2Obstetrics and Gynecology, University of Illinois-Chicago, Chicago, IL, USACorrespondence: Keemi Ereme, University of Washington, 1959 NE Pacific St, Box 356460, Seattle, WA, 98195, USA, Tel +1 301-704-4668, Email kereme@uw.eduIntroduction: The study examines the feasibility, quality of counseling, and knowledge after a virtual Group Contraception Counseling (GCC) session.Methods: At an urban academic hospital, we recruited English-speaking pregnant women aged 15– 49 who had access to a video-enabled electronic device. Participants engaged in a standardized 45-minute educational session about contraceptive methods in groups of two to five persons conducted over a video conferencing platform. The primary outcome was participant perceived quality of contraception counseling measured by the Person-Centered Contraception Counseling (PCCC) scale. The secondary outcomes were knowledge change before and after counseling, and postpartum contraception uptake. We used an adjusted multivariable linear regression model to analyze knowledge scores.Results: Twenty-two participants completed the study. Participants identified primarily as Black or Hispanic/Latinx (78%), in a partnership (50%), having completed college (59%), and having an annual income of less than &dollar;50,000 (78%). A total of 77% of participants recorded a perfect score for quality of counseling using the Person-Centered Contraceptive Counseling (PCCC) scale. There was an increase in knowledge after counseling (Mean difference (M)=0.07, p< 0.01). Notably, certain subsets of participants had decrease in knowledge scores after counseling. Participants who used postpartum contraception were more likely to have increase in knowledge after counseling compared to those who did not (Mean difference (M)=0.09, p< 0.01).Conclusion: Our findings suggest virtual group contraception counseling is feasible for providing high-quality counseling and can possibly increase contraceptive knowledge.Keywords: contraception, contraceptive counseling, group counseling, reproductive health, pregnancy, person-centered contraceptive counseling

Introduction. Sexual health is a fundamental aspect of overall well-being, quality of life, and a sense of fulfillment. A significant percentage of men with spinal cord injury (SCI) experience ejaculatory issues (95%), poor semen quality (75%), and erectile dysfunction (80%), making it impossible for them to conceive without medical assistance. Material and methods. The bibliographic resources were analyzed and selected from databases such as PubMed, SCOPUS, HINARI, and Web of Science to identify studies on the desired topic. Following the initial research, 128 items were identified, and 32 representative articles were selected for this synthesis article. Results. Damage to the spinal cord can result in partial or complete loss of function below the level of the injury. These injuries lead to impaired ejaculatory and erectile function in addition to reproductive issues, which might include abnormal sperm motility, morphology, and viability, as well as reduced spermatogenesis. Challenges such as loss of bladder and bowel function, changes in physical appearance, spasms, lack of communication, and stereotypes can affect sexual life of men with SCI. Conclusions. Studying sexual dysfunction in disabled men is essential for promoting comprehensive healthcare, supporting mental health, fostering healthy relationships, and advocating for the rights and inclusion of individuals with disabilities. Understanding the mechanisms affecting sexual function in people with SCI is of particular practical interest both in medical practice and in subsequent studies on patients.