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Background: Pregnancy is a physiological phenomenon accompanied by numerous physical and psychological changes. Fear of contracting diseases such as coronavirus disease 2019 (COVID-19) or other illnesses for which scientific knowledge is still incomplete can create anxieties in pregnant women, impacting their mental health. Objectives: The present study aimed to determine the association between fear of infection with COVID-19 and the mental health of pregnant women. Methods: A cross-sectional study was conducted on 164 pregnant women attending Ayatollah Mousavi Hospital in Zanjan, Iran, in 2021. Participants were randomly selected. Data were collected using demographic questionnaires, the Depression, Anxiety, and Stress Scale (DASS-21), and the Fear of Disease Coronaviruses Scale (FDCS). Data were analyzed using Spearman’s correlation coefficient and simple linear regression in SPSS 21 software. Results: Results demonstrated that 23.4% of participants experienced anxiety, 18.2% experienced depression, and only 1.2% experienced stress. Fear of infection was positively and significantly correlated with anxiety (r= 0.18, p=0.01). Additionally, income adequacy (r= -0.24, p=0.002), perceived economic status (r= -0.16, p=0.04), and spousal support (r= -0.19, p=0.01) were also negatively and significantly correlated with fear of infection. Conclusion: Findings reveal that the COVID-19 pandemic can culminate in fear and anxiety in pregnant women. Spousal support during this sensitive period and feelings of marital satisfaction can relieve anxiety in women.

Introduction: Considering the prevalence of high-risk pregnancies in developing countries, the increase in maternal and fetal morbidity and mortality, as well as the adverse effects of these pregnancies on the mental health of couples، it is necessary to understand the experience of high-risk pregnancy in couples. Since one of the most realistic ways to achieve the challenges ahead is to use people's own experiences, this study was conducted with aim to explain the experience of couples with high-risk pregnancies.Methods: This qualitative study was conducted in 2018 on couples with high-risk pregnancies in the health centers and Sayad Hospital in Gorgan. The participants were selected in a purposeful way and with maximum diversity for structured in-depth interviews. Guba and Lincoln criteria were used for data accuracy. The data collection and analysis was done simultaneously based on the contract qualitative content analysis process based on Granheim's method and by MAXQDA software (version 10).Results: Totally, 23 couples with high-risk pregnancies participated. The age range of women was 20-45 years and men were 22-52 years. The contents included the concern and fear of couples for maternal and fetal health, the way to deal with the problem, and need to comprehensive services and support of the relatives.Conclusion: Considering the worry about maternal and fetal health and the lack of comprehensive services, paying attention to increasing information and acquiring skills to cope with problems and a healthy lifestyle in couples, as well as providing comprehensive supportive services and support of the relatives is required in order to couples have a good experience of high-risk pregnancy by reducing high-risk pregnancy complications.

Abstract Background Sexual problems and diminished sexual quality of life can adversely affect the physical, psychological, and emotional health of women. The present study was done to determine the social intermediate factors of health associated with sexual quality of life in women of reproductive age. Design Systematic review and Meta-analysis. Data sources Embase, Web of Science, PubMed/Medline (NLM), ProQuest, and CENTRAL. Eligibility criteria Observational studies (cross-sectional, case-control, cohort) from 2010 to 2022 with no language constraints were included. The sexual quality of life, as the main variable of the study, has been evaluated using Symonds women’s sexual quality of life scale (SQOL-F). The health social determinants intermediate factors based on WHO model were considered as exposure variables. Data extraction and synthesis The data of included studies were extracted by two independent persons through a researcher-made checklist according to the study aims. Quality assessment of studies was done using Newcastle-Ottawa instrument. R software (Version R-4.2.1) were used for meta-analysis. Publication bias was evaluated by Egger & Begg tests. Sensitivity analysis was done through one-out remove approach. Results Eventually, 15 studies were eligible to be included in this systematic review and meta-analysis. Variables of depression, quality of marital relation, body image, self-esteem, physical activity, and sexual function were among the health social intermediate factors associated with sexual quality of life. Publication bias had no effect on the obtained results; no study affecting the results was found through sensitivity analysis. Conclusion Considering the relationship between modifiable factors and sexual quality of life, it seems that identification of these factors can be an important step towards designing interventional studies to help women experience enhanced sexual quality of life.

Background & aim: Gestational diabetes is is associated with some degree of sexual dysfunction in women. Therefore, this study aimed to explore the perceptions and experiences of women with gestational diabetes regarding their sexual function.Methods: This study was a qualitative research using the conventional content analysis approach and was conducted from April to December 2020 in Mazandaran Province, Iran. The participants included 15 women with gestational diabetes, six key individuals, and two husbands of women with gestational diabetes who were selected using a purposive sampling. The data were collected through in-depth semi-structured interviews. The content analysis approach was used based on the Graneheim and Lundman (2004) method. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness. MAXQDA10 software was used for data management.Results: Data analysis illustrated four themes: "sexual problems in women with gestational diabetes", "worries and problems caused by gestational diabetes", "non-comprehensive services", and " need to empower the individuals and significant others ". Conclusion: Worries and problems caused by gestational diabetes that develop in women who receive inappropriate and non-comprehensive services can affect their sexual function. Therefore the supportive role of health care providers and significant others are necessary to empower the patients to overcome their sexual problems.

Background & aim: Infertility has serious implications on psychological and social well-being as well as the sexual life. Considering that sexual health is an essential element of human health, the present study was performed to explore the experiences of Iranian infertile women regarding their sexual health. Methods: This qualitative study was conducted using conventional content analysis (Lundman and Graneheim's approach) in Tehran, Iran from November to March 2018. Twenty infertile women (aged 25-42 years old with various reasons for infertility), who were selected purposefully, participated in this study. The data were collected through in-depth semi-structured interviews All interviews were tape-recorded and transcribed verbatim. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness. Results: Three themes emerged from the data analysis including 1) Impact of the process of diagnosis and treatment on women’s sexuality 2) Psychological, behavioral, interpersonal and economic factors influencing sexual health, and 3) cultural and religious norms affecting sexual life. Conclusion: Infertile women's sexual health is influenced by the process of diagnosis and treatment; psychological reactions to infertility, economic, personal, and cultural-belief system.

Objectives: Type 1 diabetes mellitus (T1DM) can profoundly influence different dimension of health such as sexual and reproductive health (SRH). The aim of this study is to develop and evaluate the psychometric properties of the Sexual and Reproductive Health Questionnaire for Women with Type 1 Diabetes Mellitus (SRHQ-WT1DM). Materials and Methods: This protocol for a sequential exploratory mixed-methods study has two phases. Conducting a literature review, the first phase of the study will develop the items of SRHQ-WT1DM. Data analysis in this phase will be performed using directed content analysis and according to the framework proposed by the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) for SRH in women. The second phase will evaluate the psychometric properties of SRHQWT1DM through a methodological study. Face and content validity will be evaluated both qualitatively and quantitatively, and construct validity will be done by exploratory factor analysis and convergent validity. The questionnaire’s reliability and stability will be examined using internal consistency (by Cronbach’s alpha calculation) and test-retest method (by Intra class correlation coefficient calculation), respectively. Descriptive statistics, Pearson correlation coefficient, and independent t-test will also be used. Women with T1DM who are of childbearing age and have unknown mental disorders will be selected as participants in the study from the Iranian Diabetes Society. Discussion: Development and psychometric evaluation of a specific tool for SRH assessment in women will help identify and fulfill their SRH-related needs and improve dimensions of their SRH.

Introduction: Cervical cancer has been recognized as an important health problem in women. Infection with some genotypes of human papillomavirus (HPV) is the most important risk factor associated with cervical cancer. The present study was conducted with aim to estimate the prevalence of genital HPV in suburban women. Methods: In this systematic and meta-analysis study from February 20 to March 20, 2023, databases of Web of Science, Scopus, PubMed and Embase and Google scholar search engine were searched without time restrictions using the keywords such as "papillomavirus", "genital wart" and "suburban population" and relevant synonyms. In the selection criteria, observational studies on the prevalence of genital papillomavirus in suburban women were included. Heterogeneity of the studies was evaluated with I2 and Cochran's Q test. Funnel plot and Egger & Begg tests were used to assess the publication bias of the studies. Results: Finally, 10 studies with a sample size of 65,813 remained in accordance with the purpose of our study. The results of the meta-analysis showed that the overall prevalence of HPV in suburban women was 17% (95% CI: 13-21%) and HPV/16 genotype with a prevalence of 18% (95% CI: 13-23%) was the most common genotype in the affected people. Conclusion: In general, the prevalence of genital papilloma virus infection was relatively high in suburban women. This result can be useful for policy makers in planning preventive strategies for cervical cancer in poor and low-income environments.

Nowadays, polycystic ovary syndrome (PCOS) and cognitive dysfunction are major health problems among female. This narrative review aimed to investigate cognitive dysfunction in female with PCOS. English and Persian articles published in PubMed, Scopus, Web of Science, Google Scholar, PsycINFO, Scientific Information Database, and Cochrane Database of Systematic Reviews until May 2022 were searched. Sixteen studies involving 850 female with PCOS and 974 controls were assessed. In these studies, the association between biochemical factors and symptoms of PCOS and memory, attention, executive functioning, information processing speed, and visuospatial skills was evaluated. The literature review revealed the possible cognitive changes in female with PCOS. This study summarized the different aspects of cognitive function in female with PCOS due to medication, psychological problems (mood disorders caused by disease symptoms and complications), and biochemical markers, such as metabolic and sex hormone abnormalities. Considering the existing scientific gap regarding the possibility of cognitive complications in female with PCOS, further biological studies should be conducted to evaluate the potential mechanisms involved.

Introduction: Although pregnancy is a pleasant period for most women, it is often a stressful period with physiological and psychological changes. Physical health and mental health are two general dimensions of quality of life. It seems that the quality of life has an effect on the sexual function of pregnant women. Therefore, this study was conducted with aim to compare the relationship between sexual function and the quality of life of pregnant women in different trimesters of pregnancy. Methods: This cross-sectional study was conducted in 2019 on 360 pregnant women (120 pregnant women in each trimester) referring to the pregnancy care clinic of Rasht public Hospitals. The tools were questionnaires of demographic characteristics, FSFI sexual function, and quality of life SF-36. Data analysis was done using SPSS statistical software (version 23) and t-test, Chi-square, ANOVA and Pearson's correlation coefficient. P

Abstract Background Postpartum weight retention (PPWR) causes obesity, chronic diseases, and occurring adverse maternal-fetal and neonatal outcomes. Given the social factors’ effect on health and disease and considering the lack of information on social determinants of health (SDH) effects on PPWR, this study was conducted to survey the relationship between SDH and PPWR based on the World Health Organization (WHO) model. Methods A cross-sectional study was performed on 400 women six months after delivery in 2020. Twelve health centers were randomly selected from the three universities of Medical Sciences in the city of Tehran, Iran. Participants were selected by convenience method and based on eligibility. Questionnaires used included: Lifestyle Profile Health Promoting II, Short Form Postpartum Quality of Life Questionnaire, Multidimensional Scale of Perceived Social Support, Postpartum Social Support, Depression Anxiety Stress Scales, and questionnaires designed by reviewing the literature about breastfeeding, sleep, contraceptive, child health, unhealthy behaviors, postpartum nutritional awareness/beliefs, body satisfaction, access to postpartum care, socioeconomic status, demographic, and obstetric questionnaire. Data analysis was performed in SPSS-23, and the relationship model was examined using the path analysis method in LISREL-8.8. Results Path analysis indicated the direct effect of six intermediate factors on PPWR including: gestational weight gain (β = 0.42), access to postpartum care (β = 0.11), postpartum nutritional awareness/beliefs (β=-0.17), anxiety (β = 0.09), sleep duration (β=-0.09), pre-pregnancy body mass index (β = 0.09). Among the structural factors, woman’s education and socioeconomic status had an indirect negative effect on PPWR. The model fit indices showed good fit (RMSE = 0/05, GFI = 0.92, CFI = 0.92, χ2/df = 2.17). Conclusion The results indicate the effect of structural and intermediate determinants of health on PPWR. It is recommended to use the proposed model as an appropriate framework in the research, design, and implementation of programs to prevent and control PPWR.

Objectives: Educational status affects all aspects of life, including sex life. Regarding the relationship between women’s sexual satisfaction and their education level, contradictory results have been obtained so far. This systematic review aimed to summarize the existing knowledge in this area. Methods: In this study, three electronic databases, including PubMed, Scopus, and Web of Science were searched for all the related articles published from 1 January, 2000 to 28 June, 2022. The MeSH keywords including "educational status", "education", and "sexual satisfaction" were combined with Boolean operators of AND and OR. There were no geographical constraints in this study. Inclusion criteria were all observational articles evaluating the relationship between the educational status of heterosexual, nonpregnant, and non-sick women with sexual satisfaction. The quality of articles was assessed by the Newcastle-Ottawa scale (NOS) and the data were analyzed qualitatively. Result: Out of a total of 4984 retrieved articles, nine studies with a sample size of 10488 women were included in this systematic review (2003-2021). In subjects with sexual dysfunction and mental health problems, as well as those affected by economic pressure, sexual satisfaction was predicted by the mentioned factors and not by the education level. Generally, in the studies where it was possible to compare the participants with all levels of education (illiterate to academic) and there was no sexual dysfunction, mental health problems, and economic pressure, women’s level of education was the predictor of their sexual satisfaction. Conclusions: According to our results, education was the most effective predictor of women’s sexual satisfaction in stable conditions without sexual dysfunction. Education can improve women’s educability, knowledge, and attitudes towards sexual issues, thereby increasing their sexual satisfaction. However, for a more definite conclusion, high-quality and larger studies are needed to measure the relationship between sexual satisfaction and women’s education.

Introduction: There is a possibility of more accumulation of environmental pollutants due to lower levels of iron in the body of women. Different results have been reported on the association of lead with breast cancer, therefore, this systematic review study was performed with aim to determine the relationship between lead and breast cancer. Methods: In this review study, to find the related articles, international databases (Web of Science, Embase, Scopus, Google Scholar and PubMed) and national (Irandoc, Magiran, SID and IranMedex) were searched with different keyword combinations related to "Lead" And "Breast Cancer" obtained from MESH in 2000 to 2022. Selection of articles was based on inclusion and exclusion criteria and articles' quality was assessed using the Newcastle Ottawa scale. Results: Out of 4057 articles reviewed, 13 articles had good quality. All studies were in English and were observational. According to most studies, serum lead levels were not associated with breast cancer, but lead levels in bone and breast tissue were also associated with exposure to lead as an environmental contaminant with breast cancer. Conclusion: Different ways of exposure to lead have led to different results and it cannot be certainty said that exposure to lead causes breast cancer, while this relationship also depends on the method of measuring lead. In this regard, long-term studies with accurate measurement of environmental lead and body tissues, especially for women at higher risk are recommended.

Abstract Background To improve the sexual-reproductive health (SRH) of women with type-1 diabetes mellitus (T1DM), plans should be formulated on the basis of the existing situation. The situation can be examined by a valid tool conforming to the specific domains of SRH in the target group. The present study seeks to develop and assess the psychometric properties of the SRH Profile of Women with T1DM. Method Based on the extracted concepts of SRH Profile of Women with T1DM in a previously conducted study, a tool was designed using the following steps: The selection of the conceptual model, explaining the objectives, designing the roadmap and development of the tool. In the psychometric assessment phase, the content, face and construct validity (convergent validity and principal component analysis) were assessed with the participation of 365 married women of reproductive age with T1DM. The reliability of the tool was determined by the internal consistency method (Cronbach’s alpha) and its stability using the test-retest method (Intraclass Correlation Coefficients). Results The SRH Profile of Women with T1DM was formed with 53 items in two sections. Twenty-six items were about safe motherhood and reproductive system; 27 items were about the three components of concerns about the reproductive system health and function, sexual health and function, and violence related to T1DM. The three components in the second section explained 49.44% of the total variance. Cronbach’s alpha was 0.872 and the total intra-cluster correlation coefficient was 0.946. Conclusion SRH Profile of Women with T1DM is a valid, reliable, and specific tool for assessing sexual-reproductive health in women with type-1 diabetes mellitus.

Abstract Aim The aim of this study was to investigate the psychometric properties of the Persian version of the Vaginal Penetration Cognition Questionnaire (VPCQ). Design Cross‐sectional study. Methods This research was conducted in two phases from June 2019 to February 2020. Phase I: The World Health Organization Protocol of forward–backward translation and an expert panel in order to determine face and content validity. Phase II: Survey development with 352 eligible women with sexual pain disorders, construct validity, internal consistency and construct reliability were evaluated. Results The exploratory factor analysis showed that the Persian version of VPCQ has three factors that explained 53.94% of the total variance. Confirmatory factor analysis also confirmed the fit of the three‐factor model. Convergent and divergent validity were confirmed for all factors. The average measure ICC was 0.99 (95% CI 0.98 to 0.99). The absolute reliability with estimated SEM of 2.67 and MDC% of 28% approved the reliability of the questionnaire.

Objectives: Quality of sexual life can be influenced by cultural and social contexts. This study aimed to investigate the relationship between structural determinants of health (such as education, income level, job, culture, and ethnicity) and quality of sexual life in women. Methods: In this systematic review, we searched six databases, including Web of Science, Scopus, ProQuest, PubMed/Medline (NLM), Cochrane, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to obtain all the related observational studies (cross-sectional, cohort, and case-control). Results: Nine studies met the inclusion criteria. Based on the Newcastle-Ottawa Scale (NOS), the risk of bias in most of the included studies was fair. According to the results, the relationship between education level and quality of sexual life among women was significant in four studies. Also, in one study, job and income level were significantly correlated with women’s quality of sexual life. Conclusions: Based on the results, structural determinants of health, including education, job, and income level were significantly related with women’s quality of sexual life.

Introduction: Sexual activity changes during pregnancy due to hormonal and physical changes in pregnant women. This leads to a higher prevalence of sexual dysfunction in pregnancy. Evaluation of sexual function with special tools is necessary to determine sexual dysfunction during pregnancy. Pregnancy Sexual Response Inventory is one of these tools. The present study was performed aimed to translate and determine the psychometric properties, and validate the Pregnancy Sexual Response Inventory (PSRI). Methods: This correlation type descriptive-analytical study was translated from English to Persian "Forward / Backward" to translate, psychometrics, and validate the Pregnancy Sexual Response Inventory (PSRI) in 2021. After consulting the experts and pregnant mothers, the content and face validity of the scale were determined qualitatively. The final version of the questionnaire was completed by 260 pregnant women in Rasht, chosen via convenience sampling. The reliability of the questionnaire was assessed by Cronbach's alpha coefficient and Inter class correlation coefficient (ICC). The reliability and validity of the questionnaire structure was done by confirmatory factor analysis using AMOS software and other statistical analyzes using SPSS statistical software. P< 0.05 was considered statistically significant. Results: Intra-class correlation was shown for each scale between 0.602 and 0.902. There was also a moderate to high correlation between each subscale and the total score of the PSRI questionnaire. All indices of goodness indicated that all subscales of this questionnaire are suitable to measure pregnancy sexual response and activity. Conclusion: The psychometric properties of the PSRI Scale showed the high reliability and validity of this scale and the possibility of using this tool in Iran.

Introduction: Postponed childbearing is a social phenomenon in Iranian families. There is a controversy about its effect on mental health. Therefore, this study was conducted aimed to determine the role of childbearing in the rate of depression, stress, and anxiety in Iranian women of childbearing age. Methods: This cross-sectional study was performed in 2021 on 581 eligible non-pregnant married women from 31 provinces of Iran. Non-random available sampling was performed as electronic form in virtual space. Data were analyzed by Demographic and Medical History Questionnaire, Sleep Quality (adapted from LSQ), Marital Satisfaction (EMS), Perceived Social Support (MSMPSS), Socioeconomic Status (Ghodratnama Questionnaire), and Stress-Anxiety-Depression (DASS-21). Data were analyzed by SPSS software (version 22) and Independent t-test, Chi-square, and binary logistic regression. P

Background & aim: Research has demonstrated the negative effects of type-1 diabetes mellitus (T1DM) on the female sexual health and reproductive function. The present study was conducted to develop the concept of sexual and reproductive health (SRH) in women with T1DM.Methods: This concept development was conducted by directed content analysis of relevant literature. A search was carried out for articles published from 2000 to 2019 in English databases including PubMed, Web of Science, Scopus, Embase and Persian databases including Magiran, SID, and IranDoc and search engine such as Google Scholar based on a search strategy developed for each database using Boolean operators. The initial matrix was designed based on the framework proposed by the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) and information resources related to them for the concept of women's sexual and reproductive health (SRH). The selected articles were analyzed using directed content analysis with deductive approach proposed by Hsieh and Shannon. Results: The final codes were extracted from the review of 151 articles based on their conceptual differences and similarities, and categories were then defined and a matrix was developed. Four categories were extracted in this study for the concept of SRH in women with T1DM, including reproductive system, safe motherhood, sexual and gender-based violence, and sexual function, along with 20 subcategories.Conclusion: The findings can be utilized to develop specific tools for assessing SRH in women with T1DM as well as designing programs targeting SRH promotion in this vulnerable group.

Introduction: One of the goals of the third millennium development is maternal and neonatal health. One of the harmful factors of health is natural disasters. This study was performed aimed to determine maternal complications in Kermanshah earthquake in 2017. Methods: This cross-sectional study was conducted on 850 women who had delivery in Imam Khomeini hospital of Eslam Abad Gharb. The earthquake group included the women who had delivered in the earthquake of 2017 and the non-earthquake group included the women who were delivered in the same hospital in 2016. All data obtained from patients' records. Data were analyzed by SPSS software (version 21) and Independent t-test, and Mann-Whitney test, Chi-square and Fisher exact test. P

Background: Female sexual dysfunction is one of the major health problems of women after childbirth. So, the present study was conducted with the aim of localizing the postpartum sexual function and dyspareunia (The Carol Scale).Methods: This methodological study conducted in 2019-2020 on 200 woman during three months after vaginal delivery. The original version of the Carol scale is in Spanish, which after obtaining permission from the tool developer, was translated into Persian using protocol of forward-backward translation. First, the face and content validity and then the construct validity were determined by confirmatory factor analysis. The reliability was determined by the test-retest method as well as the Intra class correlation coefficient (ICC).Findings: Structural factor analysis was performed using confirmatory factor analysis and four factors of original tool were confirmed. The fit of the four-factor model was confirmed ideal fit based on goodness of fit indices. All reliability indices reported good internal consistency and the overall ICC was 0.793 which indicates the stability or repeatability of the scale over time.Conclusion: The Persian version of the Carol scale has evidence supporting reliability, validity, and responsiveness and can be used for assessment of postpartum sexual function and dyspareunia among Iranian women after vaginal delivery.

Introduction: Menopause is a physiological period in a woman's life that is accompanied by symptoms or complications which may need treatment. This study was conducted with aim to consolidate the existing knowledge to evaluate the effect of fennel on sexual health of postmenopausal women. Methods: In this review study, to find the clinical trial studies which evaluated the effect of fennel (oral, inhaled or vaginal) on sexual health of postmenopausal women, the databases of PubMed/Medline(NLM), SCOPUS, Web of Sciences, ProQuest, The Cochrane library, and Google scholar were searched from 2000 to 2021 with no language restrictions with the keywords of "Sexual Satisfaction", "Sexual function", "Sexual life", "fennel", "Menopause" and related terms. The primary outcome was evaluation of sexual health in postmenopausal women. Studies which their full text was in Persian or English entered the study. The Cochran checklist was used to assess the quality of studies. Results: Seven studies with 570 postmenopausal women included in this review according to inclusion criteria. Based on the results, the positive effect of fennel in various forms of inhaled, oral and vaginal alone or in combination with other herbal medicines on the sexual health of postmenopausal women has been reported in six studies. Only one study comparing it with citalopram found no effect of fennel. Conclusion: It seems that fennel is a drug which affects sexual health in postmenopausal women. In future studies on fennel, it is suggested that the evaluation of side effects and cost-effectiveness be considered.

Background & aim: There is sufficient information about female sexual function, but few studies have investigated postpartum female sexual function. Postpartum women’s sexual function may be dramatically affected by childbirth. This study aimed to explore women's perceptions and experiences of the concept of postpartum sexual function.Methods: This qualitative study was conducted using a directed content analysis approach based on Female Sexual Function Index (FSFI) between 2018 and 2019. Data were collected through semi-structured interviews with 13 women referred to the health centers of Babol University of Medical Sciences, Babol, Iran and were selected, purposively. The data were analyzed manually using directed content analysis adopted by Hsieh and Shannon (2005).Results: Overall, eleven categories emerged from the analysis. The six emerged categories were related to the predetermined components, namely sexual desire, arousal, lubrication, pain, orgasm, and satisfaction. The remaining five newly emerging categories included changes in the frequency of sexual intercourse, disturbed situation, changes in intimacy and relationship, physical (anatomical) changes, and psychological consequences.Conclusion: The results showed some new categories, in addition to the components of FSFI, which could be added to the concept of sexual function in postpartum period. Therefore, health service providers should consider these new additional concepts in the assessment, care, and treatment of female sexual dysfunction in postpartum women.

Plain English summary Eating Disorders (EDs) are defined by abnormal eating habits that affect a person's health. Eating disorders are common in Iranian young people. Early recognition of EDs can reduce its physical, psychiatric, psychosocial outcomes, improve the prognosis, and minimize the impact on patients and their families. However, timely recognition of EDs is difficult because of the variety of signs and presentations. The SCOFF (Sick-Control-One stone-Fat-Food) is a valuable screening questionnaire for rapid identification of people at risk for EDs. This study was conducted to translate and evaluate the psychometric properties of the SCOFF questionnaire in Iranian university students. The results of our study suggest that the 5-item Persian version of the SCOFF is a valid questionnaire in EDs screening.

Abstract Background Diagnosis and treatment of breast cancer potentially leads to sexual dysfunction and sexual distress in women and negatively affects their quality of life (QoL). This study aimed at determining the effect of PLISSIT based counseling on sexual function, sexual distress, and QoL in women surviving breast cancer. Methods In this pre-test, post-test, single-group semi-experimental study, 65 women surviving breast cancer who were referred to the selected centers were included in the study via the available sampling method. Data gathering tools included a researcher-made demographic questionnaire, female sexual function index, beck depression inventory-II, State‐Trait Anxiety Inventory, World Health Organization QoL-Brief, and Female Sexual Distress Scale-Revised. The counseling program (7 sessions 60 min each) was designed based on the PLISSIT model. The sexual function, sexual distress, and QoL were evaluated before, and 2 and 4 weeks after the intervention. To compare the mean scores of variables before and after the intervention, repeated-measured ANOVA was used. Results The findings showed that PLISSIT based counseling significantly reduced sexual distress and increased the scores of QoL and all its domains, as well as sexual function and all its domains in women surviving breast cancer (p

Introduction: Episiotomy is one of the causes that can affect mothers' postpartum quality of life. Aloe Vera plant has been suggested as one of the ways to heal wounds and reduce pain. Regarding to these properties, several clinical trial studies have been conducted to determine the effect of aloe vera on episiotomy pain relief and wound healing, and different findings have been reported. This study was performed with aim to determine the effect of Aloe Vera on episiotomy pain relief and wound healing. Methods: In this systematic review study, the databases of Scopus, PubMed (MEDLINE), Embase, Proquest, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library and Web of Science were searched using the keywords of "pain", "Wound", "Healing", "Episiotomy", " Perineum" and "Aleo Vera" by OR and AND without time, language and geographical limitation until 23 April 2021. The quality of the articles was evaluated using the Cochran Group tool and data were analyzed by Stata software (version 14). Cochran test and I2 index were used to assess the heterogeneity of the articles. Results: Finally, 9 articles with sample size of 611 people were included in this systematic review study. Preliminary studies showed the effectiveness of Aloe Vera in wound healing and pain relief. Four studies with sample size of 258 patients had the potential to perform the meta-analysis for pain outcome. Results of the meta-analysis showed that Aloe vera can reduce pain intensity compared to the control group (P

Plain language summary As a sexual dysfunction, Vaginismus prevents sexual penetration through involuntary and frequent spasms of the muscles in the one-third of vagina's outer part. Factors such as negative beliefs about sex, cultural factors, fear of pain, injury, bleeding and so forth play significant roles in the prediction of vaginismus. Therefore, given the multidimensionality of vaginismus and the need to pay attention to all biological, psychological and social dimensions in treating it, and since the bio-psychosocial model is a strong framework for the factors contributing to sexual problems whose recognition will lead to the design of multidimensional treatments, the present study was conducted on 180 Iranian women with vaginismus to investigate the bio-psychological factors associated with vaginismus. The present study showed that the fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education from the bio-psychosocial model were the final predictors of vaginismus diagnosis score. Therefore, this model can be used in designing interventions for the treatment of vaginismus, especially in the psychological and interpersonal domains.

Introduction: Given the importance of sexual issues in women's lives and being affected by various factors such as pregnancy and diabetes, and the existence of limited research on sexual function in women with gestational diabetes, this study was performed with aim to compare sexual function of women with gestational diabetes and low risk pregnant women in third trimester of pregnancy. Methods: This descriptive-analytical study was performed on 300 women with gestational diabetes low-risk pregnant women in the clinics affiliated to Mazandaran University of Medical Sciences in 2019. Demographic data were collected using researcher-made Demographic-Midwifery Questionnaire, and data related to sexual function using Female Sexual Function Index questionnaire Data were analyzed by SPSS software (version 23) and Independent t-test, Mann Whitney, Chi-square and Multiple linear regression. P

Objective Recent studies have shown a possible association between vitamin D deficiency and the severity of primary dysmenorrhea. The present study aimed to investigate the effect of vitamin D supplementation on pain and systemic symptoms in patients with primary dysmenorrhea. Methods This double-blind, randomized, placebo-controlled trial was conducted on female students aged 18 to 32 years with primary dysmenorrhea and vitamin D deficiency (25 [OH]D

Abstract Background and objective Many studies have been conducted in Iran on the postpartum quality of life, and the majority have used the general quality of life questionnaire. With a specific tool in this context, the dimensions of maternal postpartum quality of life can be more accurately determined. The present study was conducted to determine psychometric properties and validate the Persian version of the Maternal Postpartum Quality of Life Questionnaire (MAPP-QOL). Materials and methods The present methodological study was conducted in 2018. The original version of MAPP-QOL was translated into Persian by both forward and backward translation. In a cross-sectional study, the Persian version was completed by 407 eligible postpartum women aged 18 to 47 and living in Tehran. Reliability of the questionnaire was assessed using Cronbach's alpha coefficient and test–retest. For construct validity, exploratory and confirmatory factor analyses were used. Results The MAPP-QOL showed good content validity; content validity ratio (CVR) ranged from 0.6 to 1.00, and content validity index (CVI) ranged from 0.7 to 1.00. Using exploratory factor analysis, five factors, including Socioeconomic; Relational/Family-Friends; Psychological/Baby; Health & functioning; and Relational/Spouse-Partner, were extracted, which together explained 78.84% of the total variance. After modifications of CFA, the confirmatory factor analysis showed an acceptable goodness-of-fit. AVE value Above 0.5 exhibited appropriate convergent validity, and AVE greater than MSV confirmed divergent validity. The Cronbach's alpha, McDonald's Omega, Composite reliability and maximum reliability H of the five extracted factors were excellent (> 0.9). Also, the AIC values of the factors were good (between 0.721 to 0.859). Conclusion The 38-item Persian version of the postpartum quality of life questionnaire is adequately reliable for postpartum women in Iran. Given its appropriate psychometric properties, this scale is fit to be used in future studies on postpartum women.

Abstract Background Some women avoid sexual intercourse during pregnancy due to the physiological changes they undergo during this period as well as their fear of causing harm to the fetus and to themselves, which can lead to problems in sexual health. The aim of the present study was to investigate the effects of a sexual health education package on the dimensions of sexual health in pregnant women. Methods This randomized, longitudinal, clinical trial was carried out in 2018–2019 on 154 pregnant women in early to late pregnancy who presented to comprehensive health centers in Rasht, Iran, and were divided into three groups: Group A or the training group (50 participants), Group B or the self-training group (53 participants), and Group C or the control group (51 participants). The study tools included the Pregnancy Sexual Response Inventory (PSRI), the Sexual Quality of Life-Female (SQOL-F) and the Sexual Violence Questionnaire. The dimensions of sexual health were examined before beginning each intervention in each trimester of pregnancy and then at the end of pregnancy using these questionnaires. The collected data were analyzed using statistical tests, namely the Chi-square test, one-way ANOVA, Cochrane’s test, and the repeated measures ANOVA at a significance level of P

Background: Female sexual dysfunction is one of the major health problems of women after childbirth. So, the present study was conducted with the aim of localizing the postpartum sexual function and dyspareunia assessment tool (The Carol Scale). Methods: This methodological study was conducted in 2019-2020 on 200 woman during three months after vaginal delivery. The original version of the Carol scale is in Spanish, which after obtaining permission from the tool developer, was translated into Persian using the protocol of forward-backward translation. First, the face and content validity, and then the construct validity, were determined by confirmatory factor analysis. The reliability was determined by the test-retest method as well as the Intraclass Correlation Coefficient (ICC). Data analysis was performed using SPSS and LISREL software. Findings: Structural factor analysis was performed using confirmatory factor analysis, and four factors of original tool were confirmed. The fit of the four-factor model was confirmed ideal fit based on goodness of fit indices. All reliability indices reported good internal consistency and the overall ICC was 0.793, which indicated the stability or repeatability of the scale over time. Conclusion: The Persian version of the Carol scale has evidence-supporting reliability, validity, and responsiveness; it can be used to assess postpartum sexual function and dyspareunia among Iranian women after vaginal delivery.

Introduction: Postpartum weight retention has a significant effect on obesity, chronic disease, and adverse maternal, fetal, and neonatal outcomes. Nowadays, social factors are of the basic causes of health and disease. The present systematic review was conducted with aim to investigate the relationship between social determinants of health and postpartum weight retention in Iranian studies. Methods:In this systematic review, Persian and English observational articles (cohort, case-control, cross-sectional) were searched in databases of PubMed, Google Scholar, Scopus, Embase, Web of Science, SID, Magiran, Irandoc using the different combination of keywords related to “Social determinants of health” And “postpartum weight retention” obtained from Medical Subject Headings (MeSH) from 2000 to 2019. The articles were selected based on the inclusion and exclusion criteria. The quality of selected studies was evaluated using the Newcastle–Ottawa Scale. Results: From 485 reviewed articles, eight studies were selected. Social determinants of health were classified into structural and intermediate groups based on the WHO model. The structural determinants included education, occupation, income, and residence area. Intermediate determinants were classified into three domains of behavioral factors, biological factors, and psychosocial factors based on this model. According to the results of the reviewed studies, a statistically significant relationship was observed between postpartum weight retention with mother's education, exercise, postpartum functional status, exclusive breastfeeding, formula feeding, pre-pregnancy weight, gestational weight gain, parity, mode of delivery, age, depression, and anxiety. Conclusion: The results of the current systematic review illustrated the impact of structural and intermediate social determinants of health- including women's education and factors in behavioral, biological, and psychosocial domains- on postpartum weight retention. This result confirms the need for health authorities and staff to pay more attention to these influencing factors along with other medical factors to help prevent or reduce the extent of this problem and its complications.

Background and Aim: Length of delivery is among the factors affecting maternal and neonatal delivery outcomes. The effect of acupressure on decreasing the length of delivery stages has been recently evaluated. The aim of this study was to assess the effect of acupressure on gallbladder (GB21) acupoints on the duration of delivery. Materials and Methods: This clinical trial included 174 nulliparous women hospitalized in Mofateh Maternity Hospital in Varamin City who were eligible to enter the study. The women were randomly placed into three groups: pressure on GB21, pressure on inappropriate point (sham) and control groups. Intervention was applied during 3stages: at 3-5cm, 6-7cm, and 8-10cm dilatations at the first stage of labor and the lengths of delivery stages were measured. Data were analyzed using one-way ANOVA, Kruskal Wallis, Tukey, Bonfferoni and chi-square. Results: Mean values for duration of the first stage of delivery in GB21, sham and control groups were 257.67±72.86, 289.31±118.72, and 245.09±80.82 min (P>0.05) and for the lengths of the second stage of labor were 71.98±39.89, 64.31±22.91 and 71.50±32.02 min respectively (P>0.05). Mean values for the lengths of the third stage in the GB21, sham and control groups were 5.17±0.9, 5.43±1.4, and 6.29±2.2 min respectively (P>0.05). There was no significant differences among the 3 groups in regard to Apgar Scores (p

Abstract Aim The present study was designed with the aim to predict Pap smear screening beliefs based on Big Five personality traits. Design The present cross‐sectional study was conducted with 235 women over 18 years of age in Tehran (Iran) in 2018. Methods The data collection tools included the demographic information questionnaire, Pap Smear Belief Questionnaire (PSBQ) and the 10‐item measure of the Big Five personality traits. Results People with Agreeableness personality trait were more faced with risks and Barriers and factors associated with Pap smear screening beliefs; and those with Conscientiousness personality trait were more faced with risks and Barriers. Results of the present study can help to understand how the personality affects decision‐making and interactions. Therefore, consequences of counselling about screening beliefs and behavioural changes can be improved by personality‐based education.

Introduction: It is important to pay attention to the sexual function of women of childbearing age due to long-term conflict with it and its impact on personal health, marital relations and childbearing. The phytoestrogenic effect of the Vitex agnus-castus plant on sexual function of postmenopausal women as well as in limited animal studies has been shown to improve, enhance sexual behavior and hormones, but it has not been studied in women of childbearing age. Therefore, this study was performed with aim to determine the effect of Vitex agnus-castus plant consumption on sexual dysfunction in women of childbearing age. Methods: This double-blind clinical trial study was performed on 102 women referred to Alzahra Women's Clinic of Rasht for doing Pap smears in 2019. Eligible candidates completed the Female Sexual Function Index (FSFI) questionnaire; if they were placed in the group of sexual dysfunction and then randomly assigned to two groups of Vitex agnus-castus tablet or placebo. FSFI questionnaire was again completed after 4 weeks. Data were analyzed by SPSS software (version 21) and Chi-square, Fisher, Mann-Whitney, Independent-t and paired t-test. P

Introduction: Several controversial evidences have been recently reported on the use of prostate-specific antigens in the diagnosis of polycystic ovary syndrome (PCOS). This systematic review and meta-analysis study was performed with aim to determine the levels of prostate-specific antigens (PSA) in patients with PCOS. Methods: In this systematic and meta-analytical review, an electronic search was conducted in the databases of PubMed, Web of Science, Scopus, and Cochran Library. EndNote X6, Stata 14, and Review Manager 5.3 were used to manage the searched articles, data analysis, and quality evaluation. Begg's test and Egger's test were used to evaluate the publication bias. Results: In this study, 17 studies with 1,467 participants were included. Meta-analysis results showed that the amount of Prostate specific antigen in PCOS patients was significantly higher than the control group (Standardized mean difference: 1.83, 95% CI: 1.26-2.39; P

Introduction: Primary dysmenorrhea is considered as one of the main problems in women. This review study aimed to characterize the effect of micronutrients on primary dysmenorrhea. Methods: In this systematic and meta‐analysis study, the articles were searched at Cochrane library, PubMed, Scopus, Web of Science databases. The searching process was conducted with the key terms related to dysmenorrhea and micronutrients. Risk of bias assessment was performed, using Rev Man 5.3 software. In view of the heterogeneity of some of the studies, they were analyzed, using a qualitative method (n=10), and only 6 studies were included in Meta analyze. STATA statistical software version 11 was used for the analysis. Results: In this study, finally 16 clinical trials were investigated. Most micronutrients studied in the relevant articles had anti-inflammatory and analgesic properties with a desirable effect on dysmenorrhea pain relief. Vitamins (K, D, B1, and E) and calcium, magnesium, zinc sulfate and boron contributed effectively to dysmenorrhea pain management. Two months after the intervention, there was a significant mean decrease in the pain score for the vitamin D intervention group (SMD: -1.02, 95% CI: -1.9 to – 0.14, P =0.024) , as well as in the vitamin E intervention group compared to placebo group (SMD: - 0.47,95% CI:-0.74 to – 0.2, P = 0.001). Conclusion: Despite the paucity of related research, the studies indicated the potential effects of micronutrients on reducing the pain severity in primary dysmenorrhea. But more studies are needed to confirm the safety and effectiveness of various types of micronutrients on primary dysmenorrhea.

Introduction: Controlling postpartum pain affects maternal care of baby and mother's return to normal life. Studies have shown the effect of pressure on the 3- liver point in reducing uterine-induced pain, such as menstrual pain. Therefore, this study was performed with aim to evaluate the effect of 3-liver pressure point on postpartum severity of pain. Methods: This controlled randomized clinical trial study was performed on 150 mothers who had normal delivery and complained of postpartum pain in the postpartum ward of Shahid Sadoughi Hospital in Yazd in 2017-2018. Mothers were randomly divided into three groups of 3-liver pressure point (n=50), Sham group (n=50) and Ibuprofen group (n=50). All three groups received oral Ibuprofen 400 mg every 6 hours up to 24 hours if they had moderate or severe pain. In the 3-liver pressure point group (intervention group), the pressure was applied to the 3-liver point for 10 minutes on each foot, and in the Sham group, the same pressure was applied to the ectopic point. The Control group received medication only (routine care). Pain was measured every 6 hours before, 30 and 120 minutes after each intervention. Data analysis was performed using SPSS software (version 16) and tests of Chi-square, Friedman, Kruskal Wallis, Wilcoxon, and GEE)Generalized Estimation Equations (. P

Objectives: Given the increased morbidity and mortality rates in high-risk pregnancies, which are associated with stress, this study aimed to investigate the predictors of the mental health of mothers during high-risk pregnancy. Materials and Methods: To this end, 750 eligible couples referring to hospitals and public health centers of Gorgan (2016-2017) were selected using stratified-cluster random sampling method. Then, pregnancy worries and social support questionnaires were completed by mothers and mental health questionnaire was completed by the couples. Next, the correlation level was measured by Pearson correlation coefficient. Finally, the contribution of each variable as the predictor of maternal mental health was discussed by utilizing stepwise regression analysis. Results: The mean score of worry was 34.57 among the mothers, which was lower than the mean value while the support score was 14.45 which was higher than the mean value. The strongest predictors of the mental health of mothers with high-risk pregnancy were mother’s worry, the mental health of fathers, and the social support with standard coefficients of 0.447, 0.153, and -0.88, respectively. Conclusions: In general, counseling and care programs are recommended for high-risk pregnant mothers in order to reduce their worries while increasing the mental health of the spouses and encouraging important relatives to attract further social support and improve the maternal mental health.

Background: Female sexual dysfunction in the postpartum period is one of the major health problems of women. The aim of this study was to determine the postpartum sexual dysfunction and its related factors in Iranian women. Methods: In this systematic review and meta-analysis study, Iranian articles published at PubMed, Scopus, Web of Science, ProQuest, Magiran, Scientific Information Database (SID), IranMedex, IranDoc were searched by keywords related to "postpartum sexual function". The inclusion criteria were as the studies, which used standard tools to measure sexual function, and included observational studies (from 1990 to 2019). Egger statistical test was used to investigate the probability of bias in the publication bias. Data were analyzed using STATA 14 software. Findings: Finally, after quality assessment by Newcastle Ottawa instrument, 12 articles were analyzed. The overall mean score of sexual function after sensitivity analysis was 22.30 [95% confidence interval (CI): 21.8-22.8], the lowest score was in the sexual desire dimension as 3.52 (95% CI, 3.2-20-3.84), and in the sexual satisfaction dimension, it was 4.28 (5 95% CI: 4.4-4.03). Factors related to sexual function included individual and demographic factors, medical factors, and emotional and psychological factors. Conclusion: The postpartum sexual function in Iranian women is influenced by several factors; so it is recommended to pay attention to the sexual dimension of women's postpartum counseling, and to plan interventional measures in this regard.

Introduction: Puberty is the period of developmental changes from childhood to adulthood and the acquisition of fertility. The time of puberty likely affects future risks such as cancer, metabolic syndrome and cardiovascular diseases. Many evidences point to the role of environmental exposure in changing the time of puberty. This review article was performed with aim to investigate the effect of lead on pubertytime in girls and boys based on the studies performed in this field. Methods: In this review article, English and Persian articles related to observational studies which were indexed in databases of Embase, PubMed, Scopus, ISI Web of Science, SID, and Google Scholar during 2000-2018 with different combinations of the keywords of "lead” and "Puberty" were selected from Medical Subject Headings (MESH). From 182 reviewed articles, 12 articled related to the aim were selected based on inclusion and exclusion criteria and quality of reporting articles according to STROBEchecklist. Results: 12 articles were classified in two domains of lead effects on the puberty of girls and boys. The results of most studies showed that there was a statistically significant association between blood lead levels in girls, especially high levels, with delayed appearance of menarche, development of breast and growth of pubic hair. In boys, there was a statistically significant association between blood lead levels, especially high levels, with a delay in the process of puberty, including increased testicular mass and growth of pubic hair. Conclusion: Lead can affect the natural process of puberty, and especially is effective in delaying puberty of girls and boys.

Background: Breast Cancer is highly prevalent among women. The supportive care needs of such patients not only affect their quality of life (QoL) but also that of their family caregivers. The present study aimed to assess the correlation between the supportive care needs of women with breast cancer and the QoL of their family caregivers.Methods: The present cross-sectional study was conducted from September 2017 to June 2018. Thetarget populations were breast cancer patients (N=150) and their primary family caregivers (N=150) who attended the Omid Chemotherapy and Radiotherapy Center affiliated with Hormozgan University ofMedical Sciences, Bandar Abbas, Iran. Data collection tools included a demographic information form, the Supportive Care Needs Survey-Short Form 34, and the Caregiver Quality of Life Index-Cancer Scale. The data were analyzed using SPSS software (version 22.0) with descriptive statistics and Pearson’s correlationcoefficient. PResults: The mean age of the patients was 45.76±10.44 years. Of the family caregivers, 99 (66%) were the patients ’spouses. Of the different dimensions of the supportive care needs, the score for the physical needs (40.60±23.50) was the highest. In terms of the QoL of the family caregivers, mental and emotional burden scored the highest (20.19±7.38). There was a significant correlation between the caregivers’ mental and emotional burden and the physical needs of the patients (r=0.19, P=0.02).Conclusion: The result of the present study showed that physical needs were the most common supportive care needs of patients with breast cancer. Such needs also significantly undermined the QoL of the caregivers in terms of emotional burden and financial concerns.

Introduction: Regarding high prevalence of postpartum pain and side-effects of pharmaceutical analgesics on maternal and neonatal health, the present study aimed to explore the effect of Melissa officinalis on after-pain among mothers hospitalized in Asgariyeh Hospital, Isfahan, 2016. Methods: In this single-blind clinical trial, 110 women with moderate to severe after-pain were divided into two M.officinalis and mefenamic acid groups by random allocation. Samples in the first group received 250mg of mefenamic acid and the second group received 395mg of M.officinalis oral capsules every 6hours for 24hours following childbirth. The primary outcome (After-pain) was assessed using a numeric 10-point scale before intervention, 1,2 and 3hours after the first intervention and every 6hours to 24hours after delivery for each of second, third and fourth interventions. Data were analyzed, using SPSS by independent t-test, Mann-Whitney and chi-square test. Results: The demographic and obstetric variables and after-pain severity before the intervention in both groups were homogenous (P>0.05). Pain intensity wasn’t significantly different between the two groups during first and second hours after the first intervention, but there was a significant difference in the third hour (P

Background Polycystic ovarian syndrome is an endocrine disorder with many complications. This syndrome is a growing concern among adolescents around the world, with varying reports of its prevalence in different parts of the world. Objective This study aimed to determine the prevalence of polycystic ovary syndrome in adolescents by a systematic review and meta-analysis. Materials and Methods In this study, a search for published articles with an English language limitation and without a time limit was done in different databases (Scopus, PubMed, and Web of Science, Emabse and Cochrane) in January 2019. The 12 studies that met the criteria for entering a qualitative assessment scale of 5 and higher were subjected to systematic review and meta-analysis. Egger and Begg's tests were used to check the publication bias. Data were analyzed with STATA software, version 11.1. Results Twelve studies were included for meta-analysis. The total number of participants in the study was 149,477. The average quality score of all studies was 8.67 (range: 5–10). The prevalence of polycystic ovarian syndrome in adolescents based on the Rotterdam criteria was 11.04% (95% CI: 6.84–16.09%), based on the National Institute of Health criteria, it was 3.39% (95% CI: 0.28–9.54%), and based on Androgen Excess and Polycystic Ovary Syndrome Society, it was 8.03% (95% CI: 6.24–10.01%) Conclusion The result of this study showed that there is a variation in the prevalence of PCOS in adolescents based on different criteria; we suggest more community-based studies among adolescences in different parts of the world.

Background: Sexual problems are prevalent in women with multiple sclerosis (MS), and sexual self-efficacy as an effective variable plays an important role in sexual health and sexual quality of life of these women. The aim of this study was to determine the predictors of sexual self-efficacy in women with multiple sclerosis. Methods: This descriptive analytical study was conducted in Tehran, Iran, with participation of 200 women with MS, who referred to the Iranian MS society, had Expanded Disability Status Scale (EDSS) ≥ 7, and met the inclusion criteria in year 2019; they were selected using convenience sampling method. For data collection and assess the predictor factors of sexual self-efficacy in women with MS, related standard questionnaires were used. Data were analyzed using Pearson correlation coefficient, t-test, one-way ANOVA, and multiple linear regression model via SPSS software. Findings: The mean age of participants was 36.33 ± 5.22 years, and the mean score of sexual self-efficacy was 16.54 ± 7.27. After entering the significant variables derived from measuring the relationship between each variable individually with the score of sexual self-efficacy in multiple linear regression model for controlling confounders, sexual dysfunction (P = 0.001), anxiety (P = 0.024), stress (P = 0.006), and the number of sexual intercourse (P = 0.013) were significantly predictor factors of sexual self-efficacy in women with MS. Conclusion: The sexual dysfunction, anxiety, stress, and the number of sexual intercourse significantly predicted sexual self-efficacy in women with MS. Therefore, considering these factors in the treatment process of these patients can help to promote sexual self-efficacy and empower them in sexual life.

Background: Pregnancy affects women’s sexual function. Although previous studies have introduced various factors affecting sexual function, but few studies have examined the prognostic factors on sexual dysfunction during pregnancy. These factors are influenced by cultural issues of each society. This study aimed to determine the prognostic factors of sexual dysfunction in selected pregnant women in Tehran City, Iran. Methods: This descriptive analytical study was conducted on 250 pregnant women in Tehran selected using convenience sampling method. The data collection instrument consisted of a questionnaire for individual and midwifery information, female sexual function index, Enrich marital satisfaction questionnaire (short version), female sexual distress scale, and prenatal distress questionnaire. The data were analyzed via SPSS software using Kolmogorov-Smirnov, one-way ANOVA, Pearson correlation, and linear regression (Enter method) statistical tests. The significance level was considered to be less than 0.05. Findings: The mean (standard deviation) of sexual function score was 22.27 (9.73), and the majority of pregnant women (72%) had sexual dysfunction. Among the areas of sexual function, women had the highest rates of sexual dysfunction in the area of “pain”. The duration of marriage, prenatal distress, and sexual distress were significantly predictive factors of sexual dysfunction in pregnant women (P < 0.05). Conclusion: The duration of marriage, prenatal distress, and sexual distress significantly predicted sexual dysfunction in pregnant women. Knowing these factors is an important achievement for better prenatal care and designing interventional studies to improve sexual health during pregnancy.

Introduction: Some studies have shown the relationship between vitamin D3 deficiency, with primary dysmenorrhea and associated systemic symptoms. However, the relationship between pain severity and serum vitamin D level is not known. Therefore, this study was performed with aim to investigate the relationship between the severity of primary dysmenorrhea and associated systemic symptoms with serum levels of vitamin D. Methods: This cross-sectional study was performed on 143 students with primary dysmenorrhea in dormitories of Shahid Beheshti University of Medical Sciences in 2018. Data related to menstruation cycle and severity of primary dysmenorrhea were collected using demographic questionnaire, menstrual status and pain index. The serum level of 25-hydroxyvitamin D3 was determined by LIASON device, by Chemiluiminescence method and was analyzed in DiaSorin kit. Data were analyzed by SPSS software (version 24) and Mann-Whitney test and independent t-test. PResults: No significant relationship was found between the mean score of primary dysmenorrhea and serum vitamin D levels (P>0.05). There was a significant relationship between severity of headache, fatigue, nausea and vomiting with serum vitamin D levels (P 0.05). Conclusion: There is no significant relationship between severity of primary dysmenorrhea and serum vitamin D levels, but significant relationship was found with severity of headache, fatigue, nausea and vomiting. Performing larger studies in a non-homogeneous society is suggested for closer evaluation of this relationship.

Introduction: Postpartum pain is one of the common problems in mothers، and mothers tend to use medicinal plants for soothing the pain. In recent years، the clinical performance، according to evidence، was noticed. Therefore، this clinical trial was designed and implemented to determine the effects of Zataria multiflora Boiss capsule and Ibuprofen on postpartum pain. Method: This randomized double-blinded clinical trial was performed on 100 mothers that had natural vaginal birth in Imam Khomeini hospital in Ahwaz in 2016. The women were randomly assigned into two groups of Zataria multiflora Boiss capsule and Ibuprofen. Then, the subjects received one capsule every 6 h for 24 h. The pain intensity was studied before each intervention and 1 h after that using the numerical scale of pain. The data were analyzed by SPSS software (version 18) and statistical tests, including Mann-Whitney U test، t-test، Chi-square test, and Repeated measures. P-value less than 0.05 was considered statistically significant. Results:In this study, both groups had no statistically significant difference in the interventions, such as the age، number of delivery, and weight of neonate (P>0/05). Comparing the mean scores of postpartum pain intensity between the two groups after the fourth intervention showed no significant difference (P=0/057), and in both groups, the intensity of postpartum pain decreased. Conclusion: According to the results of the present study, Zataria moltiflora Boiss capsule similar to Ibuprofen can decrease the postpartum pain intensity.

Introduction: Osteoporosis is a major health problem in women throughout the world. Based on the available evidence, delivery can play an important role in women's bone mineral density. Therefore, this study was performed with aim to determine the correlation between parity and bone mineral density through systematic review and. Methods: In this systematic review and meta-analysis study, for finding the related articles, the databases of PubMed, Scopus, Cochran library and Web of Science databases were searched without time limitation and with English language restriction by using of the keywords of Parity and Bone Mineral Density (BMD) or Bone Mineral Content or bone density. The adapted Newcastle-Ottawa Scale was used to assess the quality of the cross-sectional articles. Funnel plot and Egger's test was used for publication bias assessing. Q-test and I2 index were used for evaluation of heterogeneity. Fisher’s 𝑟-to-𝑧 transformation was calculated for the studies. Results: In this study, a total of 1336 papers were reviewed and 11 studies involving 5141 women were included in this meta-analysis. The decreasing trend in lumbar spine, femur and total hip BMD was observed in women with parity ≥5 compared to non-parity women. In nulliparous women, the mean of BMD in lumbar spine was (M:0.93 ,95%CI;0.75-1.11, Phetrogeneity

Introduction: Women's screening beliefs play an important role in their performance. Since a short form questionnaire is necessary in the assessment of screening beliefs in Iranian society, this study was conducted with the aim of psychometric evaluation of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) among Iranian women. Methods: In this cross-sectional methodological study, 300 Iranian women who were aged 18 years or older, and who were attending healthcare centers of Shahid Beheshti University of Medical Sciences, were selected in 2017-18. After a backward-forward translation procedure of BCSBQ was carried out, the face, content and construct validity of breast cancer-screening beliefs questionnaire were evaluated. In addition, the reliability was measured using the Cronbach's alpha and intra class correlation coefficients. Results: The results of the exploratory and confirmatory factor analysis were used to extract three distinct factors, including: attitude, knowledge, and barriers to screening. The three-factor model fit was accepted for all factors based on standard indices (RMSEA = 0.12, χ2 = 2.832, GFI = 0.87, AGFI = 0.8, CFI = 0.94, NFI = 0.92). In addition, the instrument’s reliability was measured using the Cronbach's alpha coefficient. The instrument had an appropriate Cronbach alpha (0.78). The interclass correlation coefficient was obtained to be 0.93 within a range of 0.83-0.97. Conclusion: The three-factor structure of the BCSBQ-12 had appropriate validity and reliability among Iranian women. Considering its appropriate psychometric properties, this instrument can be employed in subsequent studies to measure women's breast cancer screening beliefs in Iran.