Factors related to knowledge, attitudes, and behaviors regarding cervical cancer among Yemeni women.

BACKGROUND: Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women. METHODS: This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant's age, education level, working outside the household, and family history of CxCa. RESULTS: Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past. CONCLUSION: This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women's lives, it is necessary to raise women's awareness of this disease, especially among those with lower education and those not involved in work outside their homes.

Higher number of steps is related to lower endogenous progesterone but not estradiol levels in women.

OBJECTIVES: Sex steroid hormones are important not only for reproduction but also for many aspects of women's health, including the risk of breast cancer. Physical activity has been shown to influence sex hormone levels in women. This study aimed to investigate a relationship between the average daily number of steps and the sex hormone (estradiol and progesterone) levels in premenopausal women. MATERIALS AND METHODS: Data were collected from 85 healthy, urban women of reproductive age who performed at least 180 minutes/week of moderate physical activity for two complete menstrual cycles. Physical activity was measured using wrist bands. Estradiol and progesterone concentrations were measured in daily-collected saliva samples in the second menstrual cycle. RESULTS: There was a significant negative association between the average number of steps taken daily and salivary progesterone levels after adjusting for potential confounding factors (age, BMI). Women who took more than 10,000 steps a day had significantly lower progesterone levels compared to women who took less than 10,000 steps. The association between physical activity and estradiol levels was statistically insignificant. DISCUSSION: Our results indicate that taking at least 10,000 steps a day reduces progesterone levels, but this intensity of physical activity may not be high enough to affect estradiol levels. Daily step tracking is a valuable element of health promotion, but currently recommended levels of physical activity may not be high enough for healthy premenopausal women to significantly reduce both sex hormone levels and thus their risk of postmenopausal breast cancer.

Antenatal Classes in the Context of Prenatal Anxiety and Depression during the COVID-19 Pandemic.

Perinatal maternal anxiety and depression negatively affect intrauterine fetal development, birth outcome, breastfeeding initiation, duration, and milk composition. Antenatal classes potentially reduce the anxiety of pregnant women and may thus contribute to healthy infant development. The study investigates the relationship between participation in online or in-person antenatal classes and levels of anxiety and depression in Polish women during the COVID-19 pandemic. The study group included 1774 adult, non-smoking pregnant women. We compared the state anxiety (STAI-State) and depression levels (EPDS) in women who (i) attended antenatal classes in-person, (ii) attended online classes, and (iii) did not attend any of them. The statistical analyses included a GLM model and trend analysis, while controlling for maternal trait anxiety, age, pregnancy complications, trimester of pregnancy, previous pregnancies, and COVID-19 infections. We observed statistically significant differences in the level of anxiety (and depression). Women who did attend antenatal classes in person had the lowest levels of anxiety and depression. Considering the importance of maternal mental well-being on fetal development, birth outcome, and breastfeeding, in-person participation in antenatal classes should be recommended to pregnant women.

Inflammaging: Blame the sons. Relationships between the number of sons and the level of inflammatory mediators among post-reproductive women.

OBJECTIVES: Reproduction is costly, but sons and daughters differently influence maternal physiology, also in older age. In particular, having sons may negatively influence maternal health and may be associated with a shorter life span of mothers. Sons may also contribute to increased inflammaging, a chronic sub-clinical systemic inflammatory state characterized by elevated levels of serum inflammatory mediators. The aim of this study was to examine the impact of the total number of children, and the number of daughters and sons separately on concentrations of C-reactive protein (CRP), and proinflammatory cytokines such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α). MATERIALS AND METHODS: The participants were 378 women aged 45-92 who had 3.9 (SD 2.12, median = 4, range = 0-13) children, including 2.1 (SD 1.46, median = 2, range = 0-8) sons and 1.8 (SD 1.44, median = 2, range = 0-7) daughters on average. RESULTS: We found a positive relationship between the overall number of children and IL-6 levels. CRP and IL-6 concentrations were positively associated with the number of sons but not with the number of daughters. Each son increased maternal CRP level by 11%, and IL-6 level by 6%. Neither the total number of children nor the number of daughters or sons were related to the TNF-α concentration. DISCUSSION: Aging-associated inflammation in post-reproductive mothers with a higher number of sons supports the hypothesis of trade-offs between reproduction and health. Furthermore, these results provide new evidence contributing to the idea that having sons may have more detrimental effects on the maternal organism than having daughters.

Disgust sensitivity in relation to menstrual cycle phase in women with and without an infection.

OBJECTIVES: The compensatory prophylaxis hypothesis (CPH) proposes that evolved psychological mechanisms enhance the avoidance of potential contaminants during periods of reproductive immunomodulation in order to decrease a chance of infection. However, the results of previous studies are inconclusive. Our aim was to investigate the differences in disgust sensitivity during phases of menstrual cycle in regularly cycling young healthy women and among women who reported having an infection. METHODS: The disgust sensitivity was measured using Two Domains of the Three Domain Disgust Scale (TDDS), Padua Inventory (PI), and photographs during the internet-based survey. Women (N = 527) were divided by phases of menstrual cycle using two different methods on the basis of reported cycle length and the number of days since the onset of their most recent menstrual bleeding. RESULTS: The women who had an infection and who were in luteal phase had higher scores in Pathogen Disgust Domain than women in follicular phase. However, they did not differ in other assessments of disgust sensitivity. CONCLUSIONS: The results provide weak support for the CPH hypothesis. We found differences in disgust sensitivity in women who declared having an infection-participants in the luteal phase scored higher in the Pathogen Domain Scale of TDDS than women in the follicular phase. We suggest that future studies should measure levels of sex steroids and immunological markers of infection.

Sons May Be Bad for Maternal Health at Older Age: New Evidence for Costs of Reproduction in Humans.

High investment in reproductive processes at the expense of other physiological functions may result in poor maternal health. Health status at older age can be reliably assessed by self-rated health, which is a strong predictor of mortality. We investigated trade-offs between reproduction and health by analysing relationships between self-rated health and the total number of children ever born by a woman, and the number of her sons and daughters among 559 post-reproductive women aged 45-92 from Poland. The number of sons, but not the number of daughters or the total number of children, was significantly associated with self-rated health, adjusted to potential confounders (age, education, marital status, current smoking, and body mass index). Each son increased the odds of reporting poor health by 11% (odds ratio = 0.89; 95% confidence interval = 0.81-0.99). Sons are more energetically and immunologically demanding for the maternal organism which may explain why having sons has more negative influence on maternal health in older age than having daughters. In order to understand trade-offs between reproduction and maternal health not only the total number of children but also sex of the children should be taken into account.

La donna è mobile? Lack of cyclical shifts in facial symmetry, and facial and body masculinity preferences-A hormone based study.

Although under investigation for more than two decades, a common agreement on the occurrence of cyclical shifts in women's masculinity and symmetry preferences is still missing. Such shifts are considered to be an important feature of sexual selection as they supposedly direct women's attention towards cues for "good genes" (e.g. masculinity and symmetry) during times when probability of conception is the highest. Multiple studies have, however, failed to find these shifts. We attempt to address this lack of agreement analysing a sample of 110 healthy women, using intra-participant design and repeated measurements of oestradiol and LH during the cycle. To ensure the reliable detection of increased conception probability, both LH- based ovulation tests and multiple oestradiol measurements were used. We found no significant differences between women's preferences during different cycle phases for either body or facial masculinity, or for facial symmetry. Differences remained non-significant after controlling for participants' sexual openness, relationship status, and self-judged attractiveness. We suggest that putative cyclical shifts in preferences for cues for good genes are either very small (impossible to be tracked even with a relatively large sample) or they are far more complex than previously assumed, and further studies accounting for more confounding variables should be undertaken.

Lack of support for relation between woman's masculinity preference, estradiol level and mating context.

It has been proposed that women's preferences for male facial sexual dimorphism are positively correlated with conception probability and differ between short- and long-term mating contexts. In this study, we tested this assumption by analyzing relationships between estradiol levels to the women's preferences of male faces that were manipulated to vary in masculinity. Estradiol was measured in daily saliva samples throughout the entire menstrual cycle collected by Polish women with regular menstrual cycles. In our analyses, we included the three most commonly used definitions of the fertile window in the literature. After computing the overall masculinity preference of each participant and measuring hormone levels, we found that i) the timing of ovulation varied greatly among women (between -11 and -17days from the onset of the next menses, counting backwards), ii) there was no relationship between daily, measured during the day of the test (N=83) or average for the cycle (N=115) estradiol levels and masculinity preferences, iii) there were no differences in masculinity preferences between women in low- and high-conception probability phases of the cycle, and iv) there were no differences in masculinity preferences between short- and long-term mating contexts. Our results do not support the idea that women's preferences for a potential sexual partner's facial masculinity fluctuate throughout the cycle.

Digit ratio (2D:4D) does not correlate with daily 17ß-estradiol and progesterone concentrations in healthy women of reproductive age.

OBJECTIVES: Second-to-fourth digit ratio (2D:4D) is proposed as a proxy for the prenatal balance of sex hormones, is related to hormone-dependent characteristics in adult life, and is a possible predictor of disease later in life. Here, we studied the relationship between 2D:4D and ovarian steroid hormones (17ß-estradiol and progesterone) among women of reproductive age. METHODS: From 186 healthy premenopausal women, aged 24-37 years, we collected saliva samples daily during the entire menstrual cycle. Data on reproductive and lifestyle characteristics were collected via questionnaires, and anthropometric measurements were performed. RESULTS: No statistically significant relationships were detected between adult women's sex hormone concentrations (17ß-estradiol and progesterone) during the menstrual cycle and 2D:4D, in either left or right hand, when controlling for size at birth, body mass index, and physical activity. CONCLUSIONS: This study shows, for the first time in a large sample of women of reproductive age, that 2D:4D is not a predictor of adult women's sex hormone concentration. The lack of relationship may be because 2D:4D might be genetically determined and is not related to maternal nutritional environment during fetal development. These results support the hypothesis that, in contrast to the nutritional quality of the fetal environment, the fetal hormonal environment (reflected by 2D:4D) does not determine reproductive physiology in later life.

Apolipoprotein E (ApoE) polymorphism is related to differences in potential fertility in women: a case of antagonistic pleiotropy?

The alleles that are detrimental to health, especially in older age, are thought to persist in populations because they also confer some benefits for individuals (through antagonistic pleiotropy). The ApoE4 allele at the ApoE locus, encoding apolipoprotein E (ApoE), significantly increases risk of poor health, and yet it is present in many populations at relatively high frequencies. Why has it not been replaced by natural selection with the health-beneficial ApoE3 allele? ApoE is a major supplier of cholesterol precursor for the production of ovarian oestrogen and progesterone, thus ApoE has been suggested as the potential candidate gene that may cause variation in reproductive performance. Our results support this hypothesis showing that in 117 regularly menstruating women those with genotypes with at least one ApoE4 allele had significantly higher levels of mean luteal progesterone (144.21 pmol l(-1)) than women with genotypes without ApoE4 (120.49 pmol l(-1)), which indicates higher potential fertility. The hormonal profiles were based on daily data for entire menstrual cycles. We suggest that the finding of higher progesterone in women with ApoE4 allele could provide first strong evidence for an evolutionary mechanism of maintaining the ancestral and health-worsening ApoE4 allele in human populations.