The effect of regular fitness training, sex hormones, and turnover of selected bone markers on sclerostin levels in young women.

Introduction: Regular physical activity (PA) is a recognized factor stimulating bone formation. In recent years, osteocytes have been shown to be involved in the metabolism of bone tissue in addition to osteoblasts and osteoclasts. The aim of the study was to analyze the effects of regular fitness training, sex hormones, and selected bone turnover markers on sclerostin levels in young women. Material and methods: The cross-sectional study involved 78 women including 39 who regularly engaged in fitness training (for 1 h three times a week for 3 months) and 39 leading a sedentary lifestyle. Anthropometric measurements and glucose, lipids, insulin, estradiol, testosterone, free testosterone, androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate, intact parathyroid hormone (iPTH), vitamin D, osteocalcin, ß isomer of C-terminal telopeptide of type I collagen (ß-CTx) and sclerostin levels were measured. Results: Activity of women (study group) who were on a high level of PA ranged between 2262 and 6606 MET/min/week (mean, 3843.16; SD = 1230). All of the control group were on low level of PA (198-1617 MET/min/week; mean, 841.06; SD = 302.01). Significantly higher levels of iPTH and ß-CTx were observed in the study than in the control group (p < 0.01). We did not observe differences in vitamin D (p > 0.12), osteocalcin (p > 0.23), or sclerostin levels (p > 0.37) between groups. There were significant negative correlations between log10 sclerostin and log10 DHEA levels (r = -0.24; p < 0.05). A multivariate stepwise backward linear regression model for sclerostin as an independent variable, with the explanatory variables physical activity, estradiol, testosterone, and DHEA levels, did not reveal any effect on changes of sclerostin levels. The model with the explanatory variables vitamin D, iPTH, ß-CTx, and osteocalcin also did not show effects on changes of sclerostin levels. Conclusions: Our results show that regular fitness training, sex hormones, vitamin D, iPTH, ß-CTx, and osteocalcin did not influence circulating sclerostin levels in young women.

Quality of Sex Life in Intestinal Stoma Patients-A Literature Review.

INTRODUCTION: Stoma surgery may reduce the quality of life, including sex life. A literature review was undertaken to explore what factors impact on the sexual health and sexuality of people with a stoma. METHODOLOGY: A review of the literature was undertaken using the online databases Cochrane, PsychInfo, Embase and Pubmed. The search was limited to articles on colostomates and ileostomates in the English language that were peer-reviewed and written in the past 5 years. RESULTS: Intestinal stoma surgery affects many aspects of a patient's life, including body image, relationship with a partner and quality of sex life. The introduction of perioperative educational programmes for patients qualified for ostomy surgery and their relatives will provide the necessary support in the face of physical and mental difficulties that may be associated with the procedure.

Eating Behaviours in Sportswomen from the Silesian Training in Different Sports Disciplines.

Eating disorders are characterized by abnormal, unhealthy eating habits, and disordered body image. In severe cases, it can cause serious health consequences, including cardiac problems, osteoporosis, infertility, or missing menstrual periods. In women competitively training sports, the main cause for disordered eating behaviours are factors associated with dissatisfaction with their appearance and body image and a need to reduce body weight. Factors related to dissatisfaction with one's own appearance and body image, a need to reduce body weight, a negative perception of themselves and their bodies, the pressure in sports circles, and stress are predictors for eating disorders. The aim of the study was to compare eating behaviours, body satisfaction, and taking various actions related to body mass reduction among women training competitively in volleyball, athletics, gymnastics, and young women not participating in sports. MATERIAL AND METHODS: The study covered a group of girls and young women from the Silesian, Poland, who represented three sports disciplines (volleyball, athletics, and gymnastics), of which 30 girls were used as a control group (B). The study was conducted using a study questionnaire. RESULTS: The study participants ate regularly and consumed all food groups during a week. The majority of girls from A1 (83.33%), A3 (53.33%), and B (80%) groups expressed their dissatisfaction with their body weight. In the group of gymnasts, a positive correlation was noted between the need to reduce body weight and regular eating (r = 0.449; p = 0.013). In the group of volleyball players, it was demonstrated that the higher the competitive experience and the greater the training load, the more regular their eating was (r = 0.475; p = 0.009). CONCLUSIONS: The importance of a diagnosis of early signs of eating disorders in girls and women as a basic component contributing to FAT development implies that further studies in this area, as well as education of the entire sports circle are necessary.

Knowledge and opinions of patients and medical staff about patients' rights.

OBJECTIVES: The awareness of patients' rights among medical personnel and patients themselves, together with their opinions concerning these rights, is a challenging issue for health professionals. Patients' rights are very specific legal regulations that have been drafted to protect patients' dignity and autonomy. The main objective of this research was to assess the knowledge of patients' rights among medical personnel of health care institutions and among patients themselves. Specific objectives were also adopted, such as: assessment of the impact of the mode of hospital admissions on the knowledge of patients' rights, analysis of factors influencing the knowledge of patients' rights and the analysis of sources of knowledge concerning patients' rights. MATERIAL AND METHODS: The study was conducted among two groups: patients and medical personnel. A group of 618 patients (including 411 women and 207 men) and 901 medical professionals (doctors, nurses, midwives) was examined via a questionnaire designed to verify their knowledge of patients' rights and to collect their opinions on the applicable laws. An integral part of the questionnaire for patients was The Hospital Anxiety and Depression Scale (HADS). RESULTS: The research showed a high knowledge of patient's rights demonstrated by the surveyed doctors, nurses and midwives. Good knowledge of patients' rights among healthcare professionals was reflected in good level of informing patients about their rights, which correlates with their high level of awareness. CONCLUSIONS: The following conclusions were drawn based on the research: education, seniority and profession determine the knowledge and respecting patients' rights, the mode of admission to hospital is a factor determining the knowledge of applicable patients' rights, medical staff's lack of knowledge about existing patients' rights has a significant impact on exercising these rights or their violation.

The impact of competitive sports on menstrual cycle and menstrual disorders, including premenstrual syndrome, premenstrual dysphoric disorder and hormonal imbalances.

OBJECTIVES: With the considerable increase of female participation in youth sports, it has become crucial for medical professionals, coaches and parents to improve their competitiveness by understanding the conditions for which these females are at elevated risk and mitigating possible health consequences. The aim of this study was to evaluate the effect competitive sports have on the disorders of the menstrual cycle, to investigate the frequency of PMS (premenstrual syndrome)/PMDD (premenstrual dysphoric order) in professional female athletes and to identify risk factors predisposing for PMS and PMDD. Additionally, the levels of selected hormones such as serum estradiol, FSH, LH and prolactin were investigated to identify any hormonal perturbances that might have influence or be the risk factors for menstrual dysfunctions. MATERIAL AND METHODS: The study group consisted of 75 professional athletes (girls and young women at the age of 16-22) who lived on the territory of Silesia. The control group consisted of 50 girls and young women at the same age, who did not practice any sport. The research tools included daily diary of PMS symptoms created in line with The American College of Obstetricians and Gynecologists (ACOG) recommendations and ICD-10 diagnostic criteria, daily diary of PMDD symptoms created according to DSM-V diagnostic criteria of the American Psychiatric Association (APA) and premenstrual symptoms screening tool (PSST). RESULTS: The analysis of menstrual cycle disorders showed statistical significance for heavy menstrual bleeding (p = 0.01) and longer breaks between menstrual bleeds (p = 0.01). PMDD was diagnosed in 8% and PMS in more than 42% of respondents. The incidence of PMDD was not at significant variance between the groups (9.33% in contrast to 6.0%), while incidence of PMS was statistically different in both groups (p = 0.045) (49.33% vs 32.0%). A significant correlation between PMS, average age (p = 0.00001) and menarche age (p = 0.03) in young active athletes has been shown. The risk of PMS increased with age (by 1.71 with each year) (p = 0.0007). CONCLUSIONS: A number of other risk factors predisposing for PMS and PMDD has also been identified. The findings of these researches will enable the athletic care network to provide better care for young female athletes.

Impact of COVID-19 on pregnancy and delivery - current knowledge.

The World Health Organization announced on 12 March 2020 a global pandemic of the new SARS-CoV-2 coronavirus causing COVID-19 disease associated with pneumonia and acute respiratory failure. SARS-CoV-2 has caused so far over 6.66 million recorded cases, of which 393,000 ended in death (as of June 1, 2020). Despite the demographic statistics of incidence, there is no current recording of cases in the group of pregnant or perinatal women. Changes occurring in the female body system during pregnancy also affect and alter the immune system, and as studies based on other viral respiratory infections have shown, the population of pregnant women is at risk of having a severe course of the disease. The aim of the study is to summarize current reports on the course of COVID-19 disease in a group of pregnant women and the possible impact of SARS-CoV-2 on the foetus and vertical transmission, taking into account changes occurring in the woman's immune system during pregnancy. Available advice and recommendations for antenatal and perinatal care of pregnant women during the pandemic period are also included.

Circulating sclerostin levels in relation to nutritional status, sex hormones and selected bone turnover biochemical markers levels in peri- and postmenopausal women.

OBJECTIVES: Hormonal changes during the peri- and postmenopausal age, especially decreasing estradiol levels as the result of the expired ovarian function, are an established link of the pathogenesis of postmenopausal osteoporosis. The objective of the study was to examine the association between the circulating sclerostin levels and nutritional status, sex hormones and selected bone markers turnover levels in peri- and postmenopausal women. MATERIAL AND METHODS: The study enrolled 84 stable-body mass women (31 perimenopausal and 54 postmenopausal). Anthropometric measurements and serum estrone, testosterone, androstenedione, DHEA-S, osteocalcin, ß-CTx, 25-OHVitamin D and sclerostin levels were obtained. RESULTS: There were not any differences between body mass, BMI, body fat and waist circumference between the study groups. The serum androstenedione and DHEA-S levels were similar in both study groups. However, estrone and total testosterone levels were observed to be notably higher in the perimenopausal group, unlike in the postmenopausal group (124.1 pg/mL vs. 98.3 pg/mL, p < 0.01 and 0.3 pg/mL vs. 0.22 pg/mL, p < 0.01, respectively). Higher plasma osteocalcin and ß-CTx levels were shown in the postmenopausal rather than in the perimenopausal group (19.8 ng/mL vs. 16.8 ng/mL, p < 0.001 and 0.35 ng/mL vs. 0.29 ng/mL, p < 0.05, respectively). Plasma sclerostin and 25-OH-Vitamin D levels were similar. There was not any correlation between plasma sclerostin levels and the other studied parameters. In the multivariate regression analyses, sclerostin levels were proportional to the androstenedione ones (b = 0.06; p < 0.05) but inversely related to the log10(testosterone) levels (b = -0.18; p < 0.05). CONCLUSIONS: Circulating sclerostin levels are similar in peri- and postmenopausal women and are related to the androstenedione and testosterone levels regardless of the nutritional status.

Menstrual Cycle Disorders in Professional Female Rhythmic Gymnasts.

The aim of this research was to compare menstrual cycles, menstrual disorders, and the prevalence of premenstrual syndrome (PMS)and premenstrual dysphoric disorder (PMDD) in professional female gymnasts and their peers who donot practice any sport, and to identify factors causing a predisposition to premenstrual tension syndrome and premenstrual dysphoric disorders in both groups. The prospective study involved apopulation of 85 girls. The study group consisted of 45 professional female gymnasts (15-17 years of age) who lived inthe territory of Silesia, in the southern area of Poland. The control group consisted of 40 girls of the same age who lived in the same area but did not professionally practice any sport. The research tools included a questionnaire, a daily diary of PMS symptoms, a daily diary of PMDD symptoms, and a premenstrual symptom screening tool (PSST). The study showed that intensive physical activity undertaken by girls before their first menstruation is a menarche-delaying factor andthat competitive sport promotes premenstrual syndrome and premenstrual dysphoric disorder. The risk factors for PMS and PMDD were also identified, andincluded alcohol and coffee consumption.

Sexual Function of Postmenopausal Women Addicted to Alcohol.

Introduction: Alcoholism impairs female sexual functions (decreased sex drive, reduced vaginal fluid, difficulty to experience orgasm). AIM: The aim of this study was to evaluate the course of perimenopausal period and sexual life of female alcoholics. Methods: 97 women at the age of 40⁻60 years were qualified with a diagnosed history of alcoholism (studied group). For the control group, 92 women at the age of 40⁻60 without a history of alcoholism were qualified. Questionnaires assessing female sexual function (Female Sexual Function Index-FSFI), the severity of perimenopausal symptoms (Menopause Rating Scale-MRS) and the degree of alcohol addiction (Michigan Alcoholism Screening Test-MAST) were obtained from each participant. Main outcome measures: To assess the sexual function of perimenopausal women addicted to alcohol. RESULTS: The studied and control groups were significantly different (p = 0.00) in terms of severity of menopausal symptoms (MRS). The research showed lower quality of sexual life (FSFI) of women from the studied group. Conclusions: Population of women with diagnosed alcohol dependence enter the menopausal stage at the similar age as the population of female non-drinkers. The time of alcohol abuse is an important factor having an impact on both the course of menopause and the dynamics of the perimenopause period, leading to symptom escalation. The population of female alcoholics shows a decrease in sexual activity and the prevalence of sexual disorders.

Causes and frequency of tocophobia - own experiences.

OBJECTIVES: The phenomenon of tocophobia (pathological fear of labor) has not been fully explored. Currently, there are no diagnostic criteria that would enable its detection or make it recognizable as a disease entity. The aim of study was to determine the degree of anxiety/tocophobia as well as to learn about and analyze the causes of this phenomenon in Polish pregnant women. MATERIAL AND METHODS: The prospective study included 120 pregnant women in the third trimester of gestation from February to May 2016. The study was performed with the use of a standardized and revised version of the Labor Anxi-ety Questionnaire (KLP II) designed by Putynski and Paciorek (1997) as well as a proprietary interview questionnaire and structured data documentation form. RESULTS: In 6.7% of the subjects, the level of labor anxiety was very high (> 18 in KLP II). It was the highest in women over 30 years of age (Pearson's chi squared test = 0.00422; p < 0.05). It has been shown that successive childbirths have an im-pact on the degree of anxiety (p = 0.04217).The highest level of anxiety was noted in primiparous women. In 85% of the subjects, anxiety was caused by fear of labor pain. 56.7% of the tested women did not use any professional help in the preparation for childbirth and motherhood. CONCLUSIONS: Primiparas and women over 30 years of age experience very high levels of fear significantly more frequently. The lack of proper preparation for childbirth determines the occurrence of tocophobia. Ante-natal classes and prenatal education based on standards of obstetric care should be promoted in order to reduce or eliminate fear of natural labor.

Does anxiety modify sexuality of pregnant women?

OBJECTIVES: The aim of this study was to evaluate the influence of anxiety on women's sexuality during pregnancy. MATERIAL AND METHODS: The prospective study involved 520 pregnant women at the age of 18-45. 168 of them were quali¬fied for the final analysis. The research tools were: a self-designed questionnaire for women and standardized STAI scale. RESULTS: The state and trait anxiety in pregnant women was evaluated during all trimesters of pregnancy. State anxiety was stronger among women with a strong tendency to feelings of anxiety. The authors also tried to determine the correlation between women's assessment of their relationship with the partners and its impact on state and trait anxiety during all three trimesters of pregnancy. Self assessment of relations between partners had statistically significant impact on the increase in state anxiety (p = 0.04) in multiparous women, who reported impairment of their relations with the partner, and had statistically significant impact on the increase in the trait anxiety in primiparous women (p = 0.02) and multiparous (p = 0.05) women, who reported deterioration of partnership especially in the second trimester of their pregnancy. Lower anxiety level in the second trimester contributed to the increased sexual activity. CONCLUSIONS: Anxiety level during pregnancy significantly affected the quality of sexual activity. Lower anxiety level in the second trimester contributed to the increased sexual activity.

Menstrual Cycle and the Prevalence of Premenstrual Syndrome/Premenstrual Dysphoric Disorder in Adolescent Athletes.

STUDY OBJECTIVE: The purpose of this study was to assess the menstrual cycle, menstrual disorders and premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD) in girls and young women participating in competitive sports. The impact of PMS/PMDD symptoms on the quality of life was also analyzed. DESIGN: The prospective study encompassed 125 girls and young women with the aim to determine the presence of menstrual disorders and the prevalence of PMS/PMDD. PARTICIPANTS: The studied group was composed of 75 female athletes aged 16 to 22 years. The control group included 50 healthy girls and young women who did not practice competitive sports. SETTING: The studied athletes and the controls prospectively evaluated their 2 consecutive menstrual cycles by using a questionnaire. INTERVENTIONS: The research tools were a purpose-built questionnaire, a daily log of PMS symptoms according to the American College of Obstetricians and Gynecologists' guidelines, and a daily log of PMDD symptoms based on the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria. MAIN OUTCOME MEASURES: To determine the impact of competitive sports on the menstrual cycle, menstrual disorders, and the prevalence of PMS/PMDD in girls and young women. RESULTS: Intensive physical exercise delayed menarche. PMDD was diagnosed in 8% and PMS in 42.4% of all respondents. The prevalence of PMDD did not differ significantly between the groups (9.33% versus 6.00%). PMS was significantly more frequent among athletes than among controls (49.33% versus 32%, P = .045). The prevalence of PMS correlated significantly with mean age (P = .00001) and age at menarche (P = .03) in athletes. PMS was more frequent in older athletes and in girls with older age at menarche. CONCLUSION: Competitive sports, older mean age, older age at menarche, length of sporting career, and intensity of training are conducive to PMS. The prevalence of PMS increases with the duration and intensification of competitive exercises.

Changes in the sexual function during pregnancy.

INTRODUCTION: The physiological changes during each trimester of pregnancy have a significant impact on women's sexual behavior. AIM: The aim of the work was to assess changes in the sexual function during pregnancy. METHODS: The prospective study encompassed 520 pregnant women aged between 18 and 45, of whom 168 were qualified for the final analysis. The research tool was a purpose-designed research questionnaire and the standardized Female Sexual Function Index. MAIN OUTCOME MEASURES: To assess changes in the sexual function among pregnant women aged 18-45 in the three pregnancy trimesters. RESULTS: All the studied parameters, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain, decreased significantly with the progression of pregnancy. Analyzing the frequency of sexual intercourse in the studied group before and during pregnancy, a statistically significant decrease (P<0.000001) was observed. Sexual desire changed statistically significantly (P=0.0004). The direction of change concerned decreased sexual desire in the three trimesters compared with the situation before pregnancy. Statistical significance was demonstrated for: decreased sexual desire (P=0.00007), partner's reluctance (P=0.002), and pregnancy-related changes in appearance (P=0.03). CONCLUSIONS: Sexual function was compromised and sexual activity decreased as the pregnancy progressed. Changes in the domains of arousal, lubrication, and orgasm were particularly notable in primaparae in the third trimester of pregnancy. Unsatisfying partner relationship was a significant factor affecting the quality of sexual life during pregnancy.