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PubMed1989

Feminism and regulation collide: the Food and Drug Administration's approval of the cervical cap.

In May 1988, the Prentif Cavity Rim cervical cap, a barrier method of contraception, was approved by the Food and Drug Administration (FDA) for contraceptive purposes in the United States. This paper describes some of the events leading to the approval of the cervical cap as a contraceptive. Of major interest is the unprecedented involvement of the feminist health movement in clinic-based research, policy making, and distribution of the cervical cap. The recall of the Vimule cervical cap, the use of lay health workers in fitting an experimental device, and the feminist providers' response to the FDA's regulation of the cervical cap are detailed.

Contraceptive Devices, Female↗
PubMed2005

The feminization of the physician assistant profession.

Although the physician assistant profession has historically been male-dominated, women now comprise over sixty percent of physician assistants (PAs) in the U.S. This paper explores the reason for the increase of women into the physician assistant profession in recent decades and whether gender differences exist in how PAs are utilized. Twenty-one qualitative interviews with male and female physician assistants and key informants were conducted to assess the reasons for the influx of women. In addition, data from the American Academy of Physician Assistants Census Survey (n = 16, 569) were analyzed to assess current gender differences in employment characteristics of PAs. In the interviews, female PAs reported entering the profession because it allowed them to practice within the medical model without having the high expense and demanding schedule of medical school. In fact, they claimed that the profession was quite compatible with family life. Significant gender differences were found in work characteristics, primary employer type, and practice specialty. Although women tend to concentrate in practice areas of women and children's health, evidence suggests that they are moving beyond these traditional roles into areas such as internal medicine and surgery.

Adult↗
PubMed2003

Women and retirement planning: towards the "feminization of poverty" in an aging Hong Kong.

Hong Kong's population is aging but retirement research is largely missing from the research agenda in Hong Kong. This study, based on a telephone survey of 1,078 respondents, examines middle-aged adult's retirement planning activities in Hong Kong. The findings show men are more likely to be involved in financial planning, while women are more likely to take part in some forms of health, living arrangement and psychological planning for retirement. Further, there are age, education and income differences in the various forms of retirement planning activities within genders. Women are living longer; because of their lack of financial retirement planning, they are prime candidates for poverty. The discussion concludes with policy implications related to assisting midlife individuals, in particular women, in planning for retirement.

Age Factors↗
PubMed2006

The feminization of bereavement among community-dwelling older adults.

We examined gender differences in frequency and sociodemographic predictors of spousal, non-spousal family, and friendship bereavement events among community-dwelling older adults using data from the UAB Study of Aging. Analysis involved a 30-month observation period of 893 subjects. There were significant differences between women and men for all types of loss. Significant differences were also found in the sociodemographic predictors of loss between and within gender categories. This study revealed the extent to which older women disproportionately bear the burden of loss and points to the need for greater attention to bereavement as a women's issue.

Aged↗
PubMed1996

Incomplete testicular feminization syndrome: studies on androgen receptor(AR) function, AR gene analysis, and aromatase activities at puberty and long-term observations of clinical and hormonal features from infancy to puberty.

A female infant with partial androgen insensitivity (PAIS) was first seen at 4 months of age with slight virilization of the genitalia and externally palpable testes. Sex chromosome was 46,XY. She received left orchidectomy and exploratory laparotomy at 2 yr of age. At exploratory laparotomy, neither a uterus nor fallopian tubes were found. The right testis was preserved by fixing it at the external inguinal ring expecting spontaneous pubertal maturation. After discharge, serum levels of LH, FSH, testosterone (T) and estradiol (E2) were measured annually, and the steroid responses to hCG stimulation were examined every two yr. At the age of 10 yr, she developed breasts and a very feminine body habitus. At 12 yr, she received a clitoroplasty and right orchidectomy. The fibroblast cultures were made from the genital skin whereby androgen receptor (AR) binding was assessed by radioreceptor assay using 3H-DHT as the ligand, and thermoinstability of AR was noted despite normal maximum binding (Bmax) and dissociation constant (Kd) at 22 degrees C. But another binding experiment with 3H-Mibolerone resulted in the lack of receptor binding. AR gene analysis with direct sequencing of coding exons of the gene revealed no abnormality of the AR gene. 5 alpha-reductase activity was normal. Aromatase activity appeared to be enhanced in the genital skin fibroblast (GSF) cells as well as in the testicular tissue. The results of these studies indicated that the patient had PAIS with impaired AR functions and increased aromatase activity. After the discharge, the patient has maintained feminine phenotype, receiving estrogen therapy with mestranol 0.02 mg/day po.

Aging↗
PubMed2003

Estrogen and non-feminizing estrogen for Alzheimer's disease.

The preventive effect of estrogen on Alzheimer's disease (AD) has become clearer with many epidemiological reports. However, the therapeutic effects of estrogen have been controversial until now. In our trials, estrogen treatment showed a beneficial therapeutic effect for women with mild to moderate AD. Improvement of cognitive function was recognized during the third week from the beginning of administration and maintained as long as estrogen treatment continued. The longer the duration of HRT, the more HRT is useful for the prevention and therapy of AD. However, in most cases, administration of estrogen is discontinued because of the adverse effects on the uterus and breast. J 861 is a derivative of estradiol-17alpha, which has little effect on the sexual organs. The effects of estradiol-17beta (E2) and J 861 on neuronal function and vascular factors were investigated. J 861 was suggested to prevent both the intracellular calcium increase and peroxidation induced by amyloid beta (Abeta), more effectively than E2. The effect of J 861 may be related with both the direct non-genomic and the ER-mediated systems. J 861 showed neurotrophic effects like E2. J 861 inhibited the adhesion of monocytes to vascular endothelium, more effectively than E2. Also, J 861 suppressed the expression of adhesive factors, such as E-selectin and intercellular cell adhesion molecule-1 (ICAM-1), more effectively than E2.

Alzheimer Disease↗
PubMed2002

Feminizing Sertoli cell tumor associated with Peutz-Jeghers syndrome.

Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by the association of mucocutaneous pigmentation and multiple gastrointestinal hamartomatous polyps and with an increased risk of developing gonadal sex tumors besides other malignancies. We describe a 7 1/2 year-old boy with PJS and bilateral gynecomastia. He has had buccal pigmentation since 1.5 years and had been operated for rectal polyp excision at 3.5 years. On physical examination, his height was at the 90th percentile, and his height age and bone age were 9 and 10 1/2 years, respectively. Increased melanotic buccal pigmentation of the lips and bilateral gynecomastia were noticed. Both of the testes were firm, non-tender and smooth on the surface, and each measured 8 ml. Hormonal measurements were all in the prepubertal range. Testis ultrasonography showed bilateral hyperechogenic areas within the glands. When he was operated for invagination and an ileum segment full of polyps was resected, bilateral testicular biopsies were also performed. Histopathological evaluation of the testes revealed bilateral multicentric benign Sertoli cell tumors. The aromatase inhibitor testolactone was started to slow skeletal maturation. On the basis of this and previous reports, PJS associated with sex-cord tumors is increasingly recognized in males as well as in females.

Antineoplastic Agents, Hormonal↗
PubMed2004

Feminizing genitoplasty: a synopsis of issues relating to genital surgery in intersex individuals.

This review of the literature relevant to genitoplasty explores multiple factors that could impact and improve long-term outcomes. In 1998, surgeons began a dialogue that fostered interactive multidisciplinary exchanges regarding necessity, timing, and risks related to genitoplasty. Prior practice had embraced a simplistic approach--make an intersexed child resemble either a typical boy or girl. But surgery was never 'perfect' because function was often sacrificed for form, the goal being to create an aesthetic appearance. Compounding the difficulties of this type of surgery were the demands of the patients and parents for clarity, sure direction, and surgery that looked cosmetically authentic and provided good function. They demanded answers that medical experts could not readily provide regarding long-term outcomes. To increase patient satisfaction, we seek such outcomes and knowledge to better our understanding for optimal patient management and care. A review of current research is provided that might have important implications impacting surgical issues. Knowledge garnered from fields other than surgery is explored for potential applications that could improve surgical outcomes. Surgical technique modifications may be part of the solution to a complex problem, but they are not the sole solution. A multidisciplinary approach is required because to this date, surgical promise is limited at best. Better understanding of the anatomy and physiology, as well as the related hormonal environment and its impact on healing, may be the key toward improvement of outcomes and heightened patient satisfaction.

Adolescent↗
PubMedDate not supplied

Interaction of testosterone and testosterone receptor complexes with nuclei of skeletal muscle from intact male mice and from mice bearing the testicular feminization (Tfm) mutant gene.

With the nuclear exchange assay and the nuclear retention assay it is shown that the androgen insensitivity of Tfm mice is probably due to a defect of the nuclear acceptor sites for the testosterone receptor complex. Further on the results obtained point strongly to the possibility that hormone free androgen receptor is localized in the nuclei and in the cytoplasma according to the "equilibrium model". A practicable method for separation of unbound steroids from nuclei is described.

Androgen-Insensitivity Syndrome↗
PubMed1986

Feminization in a galactosemic girl in the presence of hypergonadotropic hypogonadism.

A galactosemic girl has been followed in our clinic since her 8th day of life when the diagnosis of transferase-deficiency galactosemia was made until her present age of 21 years. Although she presented with direct hyperbilirubinemia and severe liver dysfunction, her subsequent somatic and intellectual development under a strict galactose-free diet was normal. Liver function normalized. Her pubertal stage was Tanner B II and PH II at age 11.7 years and progressed normally to B V and PH V, but menarche did not occur. At age 16.8 years, low estradiol (51 pmol/L) and high gonadotropin levels (LH 44 U/L; FSH 43 U/L) were measured. Severely hypoplastic ovaries with a streak-like aspect were seen on laparoscopy. Sex chromatin was positive. Follow-up studies over the next 4 years confirmed elevated LH and FSH levels with an excessive response to stimulation with LHRH and persistently low estradiol levels (41 to 117 pmol/L). After an intravenous load of 200 mg DHEA-S, plasma estrone levels rose 1.8-fold and estradiol 11.4-fold above basal, demonstrating prompt conversion of androgens to estrogens. For over one year, the patient has been treated with the synthetic progestin norethisterone (15 mg per day for 10 days in a row every month) which has resulted in regular menstrual bleedings.

Adult↗
PubMedDate not supplied

[AIDS' feminization: a question of gender?].

Based on the data presented in the AIDS Epidemical Report published by the Health State Department, we notice that throughout the trajectory of this epidemic in our country, the data relating to women remained invisible (although present), the vulnerability of feminine population was hidden amongst the other categories, and that shows the need of understanding AIDS as a disease of both men and women, and its prevention, thought and improved within a perspective of gender.

Acquired Immunodeficiency Syndrome↗