Effects of khat (Catha edulis) consumption on reproductive functions: a review.

OBJECTIVE: To review research findings on the effects of khat (Catha edulis) chewing on reproductive functions. DATA SOURCES: Retrieval and critical review of relevant articles and abstracts cited in international and local journals, literature searches on Medline and Medchem from 1961 to 2002. DATA SYNTHESIS: Analysis of published data and limited interviews of regular khat users revealed that khat chewing lowers libido in humans and may also lead to sexual impotence following long term use. In pregnant women, consumption of khat affects growth of foetus by inhibiting utero-placental blood flow and as a consequence, impairs foetal growth. CONCLUSION: Detailed studies on the effects of khat on reproduction are lacking. However, the limited available data reveal that chewing of khat has a negative impact on human reproductive health. Khat is genotoxic and has teratogenic effects on the foetus if regularly consumed by pregnant mothers. Since low birth weight is a well-established risk factor for both perinatal and young infant death, khat chewing during pregnancy may be one of the factors contributing to infant mortality in communities where khat is commonly chewed. Khat consumption affects the potency of male sexuality by affecting spermatogenesis and plasma testosterone concentration. However, the precise mechanisms by which khat may affect the male reproductive physiology have not been elucidated.

The prevalence of endometriosis among African-American and African-indigenous women.

Endometriosis is gynaecological disorder, characterized by the growth of endometrial tissue outside the uterine cavity. It is the most common cause of pelvic pain and occurs in 20-25% of women with infertility. Although Sampson first described endometriosis in 1927, studies on the prevalence of endometriosis among African women are still lacking. The current thinking is that endometriosis rarely affects women from the African origin. However, in African-American women in the USA, endometriosis is one of the commonest indications for major gynaecological surgery and hysterectomy, and is associated with long hospital stay and high hospital charges. There is also some evidence that endometriosis is more commonly found in African-American patients from private practice than in African-American patients treated in public hospitals. The prevalence of endometriosis in African-indigenous women with infertility seems low, possibly due to a different life style (early pregnancy, increased risk for PID and blocked Fallopian tubes) and due to lack of laparascopic facilities and specific training of African gynecologists to diagnose ascites caused by endometriosis appear to be more frequently observed in African-indigenous of African-American women than in women with other ethnic backgrounds.