Pain Rating in Women with Provoked Vestibulodynia: Evaluating Influence of Race.

BACKGROUND: Chronic pain may be perceived differently according to gender and race, which may affect physical health and psychological wellbeing. We evaluated daily pain ratings in black women as compared to white women with provoked vestibulodynia (PVD). METHODS: Seventy-one women (44 black, 27 white) rated pain severity with tampon insertion and sexual intercourse and recorded daily vulvar pain level on a visual analogue scale (0 = no pain to 10 = worst pain imaginable). In addition, they completed the Brief Pain Inventory (BPI) Interference Scale and Hamilton Anxiety Depression Scale (HADS). Multivariate analysis was performed to determine the effect of race on pain intensity after adjusting for functional impairment, affective distress and demographic characteristics. RESULTS: Pain ratings from tampon insertion (6.37 ± 1.89 vs. 5.61 ± 1.98, p = .12) and sexual intercourse (6.28 ± 2.11 vs. 5.29 ± 2.50, p = 0.24) were similar, but daily vulvar pain (4.57 ± 2.27 vs 2.74 ± 2.43, p = <.01) was significantly higher in black women. BPI-interference scores were associated with small, but significant increases in tampon insertion pain (p = <.01, beta = .06 units) and daily pain (p < .01, beta = .10 units) and to a lesser degree with sexual intercourse pain when corrected for multiple comparisons (p = .05, beta = .06 units). Race had no effect on pain after adjusting for other variables. CONCLUSION: While race was associated with functional impairment, after accounting for this, race was not associated with level of vulvar pain with PVD.

[The voice of women subjected to female genital mutilation in the Region of Murcia (Spain)]. / La voz de las mujeres sometidas a mutilación genital femenina en la Región de Murcia.

OBJECTIVE: To explore the perceptions of a group of women who underwent female genital mutilation on the impact of this practice on their sexual and reproductive health. METHODS: We performed a phenomenological qualitative study in a sample of 9 sub-Saharan Africa women, whose mean age was 30 years old and who had lived in Spain for 1 to 14 years. These women underwent genital mutilation in their countries of origin. Data was collected using a socio-demographic survey and an in-depth, structured personal interview. Subsequently, we performed a thematic discourse analysis. RESULTS: The discourses were grouped into four categories related to participants' perceptions of female genital mutilation. These categories were intimate relationships, pregnancy, childbirth, and social impact. CONCLUSIONS: The practice of female genital mutilation is maintained due to social and family pressure, transmitted from generation to generation and silenced by women themselves. This practice affects their sexual and reproductive health, as demonstrated by anorgasmia and dyspareunia. The women were satisfied with the healthcare received during pregnancy and childbirth. Nevertheless, most of them were not satisfied with family planning.

[Comparison of climacteric symptoms among women in Mexico City and women of a Mayan community of Yucatan]. / Comparación de los síntomas del climaterio entre mujeres de la Ciudad de México y mujeres de una comunidad maya del estado de Yucatán.

OBJECTIVE: to compare the climacteric symptoms between women from Mexico City and those from a Mayan community of the state of Yucatan. METHODS: In two groups of women, Group I) Spanish-speaking women from Mexico City and Group II) Maya speaking women from the state of Yucatan, 22 climacteric symptoms were evaluated using an analog visual scale (AVS) and the SUMEVA index. For statistical analysis t student test was used as well as Chi squared. RESULTS: 105 women, 50 of Mexico City and 55 of Maxcanu, Yucatan were studied. When comparing the groups no difference was found in age (52.5 +/- 6.5 vs 53.7 +/- 6.2, for group I and II respectively), the body mass index was significantly smaller in group I (29.7 +/- 5.0 vs 34.0 +/- 6.0, p < 0.001). In group 1, 15 of the 22 evaluated symptoms were significantly more intense in Group I, as well as the SUMEVA (Sum of Analog Visual Scale) index (71.4 +/- 44.5 vs 45.8 +/- 24.8, p < 0.001). The proportion of symptomatic women for each one of the symptoms was similar in both groups except for hair fall that was significantly greater in group I (74% vs 52%). CONCLUSION: climacteric symptoms were perceived with more intensity by Mexico City women, which allows suppose that western culture influence can be the responsible.

Menopausal symptoms and ethnicity: the Study of Women's Health Across the Nation.

A number of studies have suggested that ethnic background influences a woman's perception of her symptoms. The Study of Women's Health Across the Nation (SWAN) is a multiethnic, longitudinal, cohort study of US women that includes non-Hispanic Caucasian, African-American, Chinese, Japanese and Hispanic women. The initial strategy for this seven-site study involved community-based recruitment of non-Hispanic Caucasians at each site, plus one minority ethnic group. Since ethnicity varies with many other factors, measures of education, acculturation, social status, psychological wellbeing and financial strain were all taken into account in interpreting symptom onset, frequency and severity of the common menopausal symptoms. Biological and physical measures were also assessed and related to symptoms. Most symptoms varied by ethnicity. Vasomotor symptoms were more prevalent in African-American and Hispanic women and were also more common in women with greater BMI, challenging the widely held belief that obesity is protective against vasomotor symptoms. Vaginal dryness was present in 30-40% of SWAN participants at baseline, and was most prevalent in Hispanic women. Among Hispanic women, symptoms varied by country of origin. Acculturation appears to play a complex role in menopausal symptomatology. We conclude that ethnicity should be taken into account when interpreting menopausal symptom presentation in women.

Sexual dysfunction in women: population based epidemiological study.

Sexual dysfunction is defined as a disturbance of the processes that characterise the sexual response cycle or as pain associated with sexual intercourse. The objective of this epidemiological study, conducted in a representative sample of the population of women aged 20 and older in Casablanca, Morocco, is to determine the prevalence of sexual dysfunction in women. Criteria of sexual dysfunction followed classification by DSM-IV. The mean age of the sample (n = 728) was 36.76 +/- 12.67 years; 29% had no education, 78% pursued no professional activity; and 58% were married. The main results were that 26.6% had sexual dysfunction always or often during the 6 months before the study. The most common finding was hypoactive sexual desire disorder, and age, financial dependency, number of children, and sexual harassment were positively associated. The prevalence of remaining disorders resembled that found in the literature. Even though these women were aware about their disorder and its negative impact on their lives, only 17% of them asked for help.