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PubMedDate not supplied

A case of monorecidive syphilitic chancre.

A 24-year-old man who had been in contact with a woman who had infectious syphilis developed a painless sore on his penis. His general practitioner prescribed tetracycline (250 mg four times a day for seven days). After approximately one month he developed another painless sore at the same site as the previous one. The diagnosis of syphilis was confirmed by dark-field microscopy and serologic tests. Reinfection was thought to be unlikely because he denied having sexual intercourse after the first visit to his general practitioner. Thus, the new lesion was thought to be a case of monorecidive syphilitic chancre.

Adult↗

PubMed1997

Sexual behavior and injection drug use during pregnancy and vertical transmission of HIV-1.

We evaluated maternal sexual behavior and injection drug use practices as possible risk factors for vertical transmission of human immunodeficiency virus type 1 (HIV-1). Data were analyzed from the Mothers and Infants Cohort Study, a prospective study in Brooklyn and the Bronx, New York. A total of 207 mother-infant sets were enrolled between 1986 and 1991 and followed for up to 4 years after the enrollment visit during pregnancy. HIV-1 transmission occurred in 49 of 201 mother-infant sets, yielding an overall transmission rate of 24.4% (95% confidence interval (CI) = 18.7% to 31.0%). Increased frequency of vaginal intercourse after the first trimester of pregnancy was positively associated with vertical transmission of HIV-1 (trend p = 0.03). A lifetime history of injection drug use was not associated with vertical transmission. However, a history of combined cocaine and heroin injection after the first trimester of pregnancy was associated with vertical HIV-1 transmission, particularly among women with CD4+ lymphocyte levels of 20% or higher (risk ratio = 4.0; 95% CI = 2.0 to 8.1). Cocaine and heroin injection drug use after the first trimester accounted for most of the relation between preterm birth and vertical HIV-1 transmission in this cohort. Maternal coinfection with hepatitis C virus or human T-cell lymphotropic virus types I and II could not explain these observations, because coinfection with these viruses had no detectable effect on HIV-1 transmission. These results suggest that maternal sexual behavior and injection drug use practices during the second and third trimester of pregnancy may modify the risk of vertical HIV-1 transmission.

Acquired Immunodeficiency Syndrome↗

PubMed2006

CCR5 expression and duration of high risk sexual activity among HIV-seronegative men who have sex with men.

OBJECTIVES: To test the hypothesis that in comparison with those with shorter risk duration, individuals with longer HIV risk duration would have reduced susceptibility to HIV-1 infection as measured by CCR5 expression, and to evaluate whether variation in CCR5 expression could be explained by known genetic polymorphisms. DESIGN AND METHODS: A cross-sectional study of HIV-1 exposed but uninfected men who have sex with men. The risk duration was estimated from self-reported years since first receptive anal intercourse. CCR5 expression on peripheral blood CD4+ monocytes and T cells was determined by flow cytometry. The CCR5-Delta32 mutation and polymorphisms in the CCR5 promoter and CCR2 as well as the copy number of CCL3L1 were analyzed by polymerase chain reaction. Plasma levels of MIP-1alpha (CCL3), MIP-1beta (CCL4) and RANTES (CCL5) were also measured. As risk duration varied with age, analyses were restricted to 67 individuals aged 30-49 years. RESULTS: Multiple linear regression analyses, adjusted for age and race, showed a significant negative association between HIV risk duration and CCR5 expression on monocytes (P = 0.01), and in a separate model, a similar negative association with CCR5 expression on T cells (P = 0.03). Low CCR5 expression was attributable mainly to CCR5-Delta32 heterozygosity and the CCR5-59029G allele. CONCLUSIONS: We confirmed a role for reduced CCR5 expression in HIV-1 resistance. CCR5-Delta32 heterozygosity and the CCR5-59029G allele were significant predictors of low CCR5 expression. Individuals with high CCR5 expression who resisted infection despite long HIV risk duration form an interesting group within which to search for additional mechanisms of resistance to HIV infection.

Adult↗

PubMed2004

Botulinum toxin in the treatment of refractory vaginismus.

OBJECTIVE: To investigate the efficacy of botulinum toxin injection to treat women with moderate and severe vaginismus. METHODS: Twenty-four women referred to our clinic from February 2002 to February 2004 (mean age 25 years; range 19-34 years) with third- to fourth-degree vaginismus were recruited for this study. These women had previous unsuccessful treatments. Botulinum toxin (150-400 mIU) was injected into the puborectalis muscles in 3 sites on each side of the vagina. RESULTS: Twenty-three patients (95.8%) had vaginal examinations 1 week postoperatively that showed little or no vaginismus, 18 (75%) achieved satisfactory intercourse after the first injection, 4 (16.7%) had mild pain, 1 was cured after a second injection, 1 patient refused vaginal examination and did not attempt to have coitus, and another had no coitus as a result of her husband's secondary impotence. The women were followed up for a mean of 12.3 months (range 2-24 months), and there were no cases of recurrence. CONCLUSION: In refractory cases of vaginismus when conventional therapies have failed, local injection of botulinum toxin can be considered. LEVEL OF EVIDENCE: III.

Adult↗

PubMed2003

Sex in Australia: experiences of commercial sex in a representative sample of adults.

OBJECTIVE: To describe the characteristics of Australian adults' experience of commercial sex. METHOD: Telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years (response rate 73.1%; 69.4% men, 77.6% women). Respondents were asked about their experiences both as clients and as sex workers. Socio-demographic and health factors associated with experience of commercial sex were explored for men. RESULTS: Almost one in six Australian men (15.6%) have ever paid for sex; 1.9% had done so in the past year. Of men who had ever paid for sex, 97% had paid for sex with a woman and 3% for sex with a man. Very few women (0.1%) had ever paid for sex. Twice as many men (0.9%) as women (0.5%) had ever been paid for sex; two-thirds of these men (0.6%) were paid by other men. Condom use during vaginal sex was highest in parlours and brothels and with escorts, and lowest for street sex work. Two-thirds of women who had ever been paid for sex had done so only overseas. One in 10 men who had paid for sex had only done so overseas. Men who had paid for sex were more likely than other men to smoke, to drink more alcohol, to have had a sexually transmitted infection or been tested for HIV, to have more sexual partners, to have first had vaginal intercourse before 16, and to have had heterosexual anal intercourse. CONCLUSION: Sex work overseas, where condom use may not be common, represents a potential source of HIV or sexually transmitted infection.

Adolescent↗

PubMed2005

Efficacy and safety of oral tadalafil in the treatment of men in Canada with erectile dysfunction: a randomized, double-blind, parallel, placebo-controlled clinical trial.

INTRODUCTION: Erectile dysfunction (ED) is a highly prevalent, often undertreated condition. AIM: This 12-week, double-blind, parallel, placebo-controlled study was conducted at 25 sites in Canada to evaluate the efficacy and safety of oral tadalafil, a phosphodiesterase type 5 inhibitor, for the treatment of ED. METHODS: Men with ED of organic, psychogenic, or mixed etiology were stratified by baseline ED severity then randomly assigned to placebo (N = 50), tadalafil 10 mg (N = 103), or tadalafil 20 mg (N = 100), taken as needed (maximum, once daily). MAIN OUTCOME MEASURES: Efficacy was assessed by the International Index of Erectile Function (IIEF), a Sexual Encounter Profile diary, and a global assessment question (GAQ). RESULTS: Tadalafil 10 mg and tadalafil 20 mg significantly improved erectile function compared with placebo (P < 0.001, all measures). At end point, the mean IIEF erectile function (EF) domain scores were 14.5, 21.2, and 23.3 of a possible score of 30 for placebo, tadalafil 10 mg, and tadalafil 20 mg, respectively. Patients treated with tadalafil reported greater change from baseline on the IIEF EF domain score compared with placebo, regardless of baseline ED severity. During treatment, the mean per-patient proportion of successful intercourse attempts was higher for tadalafil 10 mg and 20 mg than for placebo (placebo, 31.9%; tadalafil 10 mg, 56.7%; and tadalafil 20 mg, 61.5%), and a greater proportion of patients reported improved erections with tadalafil (GAQ; placebo, 22.0%; tadalafil 10 mg, 67.0%; tadalafil 20 mg, 79.0%). Fifty percent and 62% of patients treated with tadalafil 10 mg and 20 mg, respectively, achieved successful sexual intercourse after their first dose, compared with 31% with placebo. Treatment-emergent adverse events were generally mild or moderate. CONCLUSION: Tadalafil was an effective, well-tolerated therapy for ED of broad-spectrum etiology and severity.

3',5'-Cyclic-GMP Phosphodiesterases↗

PubMed2005

"Honey moon" meningitis.

Streptococcus agalactiae is a rare cause of meningitis in healthy non-pregnant adults. A case of S. agalactiae meningitis is reported in a previously healthy young woman following sexual intercourse for the first time. The vaginal flora was the verified source of infection.

Adolescent↗

PubMed1983

Cavernosal alpha-blockade: a new technique for investigating and treating erectile impotence.

Intravacernosal injection of phenoxybenzamine, in a dose too small to have significant general effects, caused full erection lasting between half an hour and 30 hours in 30 of 4 potent men (2 normal, 2 anorgasmic) and in 6 of 11 impotent men. In the remaining potent man and 3 of the remaining eleven impotent men have had sexual intercourse, for the first time for months or years, while under the drug. The practical implications of this new discovery are discussed.

Adult↗

PubMed2024

Causal association of menstrual reproductive factors on the risk of osteoarthritis: A univariate and multivariate Mendelian randomization study.

OBJECTIVE: Several observational studies have revealed a potential relationship between menstrual reproductive factors (MRF) and osteoarthritis (OA). However, the precise causal relationship remains elusive. This study performed Mendelian randomization (MR) to provide deeper insights into this relationship. METHODS: Utilizing summary statistics of genome-wide association studies (GWAS), we conducted univariate MR to estimate 2 menstrual factors (Age at menarche, AAM; Age at menopause, AMP) and 5 reproductive factors (Age at first live birth, AFB; Age at last live birth, ALB; Number of live births, NLB; Age first had sexual intercourse, AFSI; Age started oral contraceptive pill, ASOC) on OA (overall OA, OOA; knee OA, KOA and hip OA, HOA). The sample size of MRF ranged from 123846 to 406457, and the OA sample size range from 393873 to 484598. Inverse variance weighted (IVW) method was used as the primary MR analysis methods, and MR Egger, weighted median was performed as supplements. Sensitivity analysis was employed to test for heterogeneity and horizontal pleiotropy. Finally, multivariable MR was utilized to adjust for the influence of BMI on OA. RESULTS: After conducting multiple tests (P<0.0023) and adjusting for BMI, MR analysis indicated that a lower AFB will increase the risk of OOA (odds ratio [OR] = 0.97, 95% confidence interval [CI]: 0.95-0.99, P = 3.39×10-4) and KOA (OR = 0.60, 95% CI: 0.47-0.78, P = 1.07×10-4). ALB (OR = 0.61, 95% CI: 0.45-0.84, P = 2.06×10-3) and Age AFSI (OR = 0.66, 95% CI: 0.53-0.82, P = 2.42×10-4) were negatively associated with KOA. In addition, our results showed that earlier AMP adversely affected HOA (OR = 1.12, 95% CI: 1.01-1.23, P = 0.033), and earlier ASOC promote the development of OOA (OR = 0.97, 95% CI: 0.95-1.00, P = 0.032) and KOA (OR = 0.58, 95% CI: 0.40-0.84, P = 4.49×10-3). ALB (OR = 0.98, 95% CI: 0.96-1.00, P = 0.030) and AFSI (OR = 0.98, 95% CI: 0.97-0.99, P = 2.66×10-3) also showed a negative association with OOA but they all did not pass multiple tests. The effects of AAM and NLB on OA were insignificant after BMI correction. CONCLUSION: This research Certificates that Early AFB promotes the development of OOA, meanwhile early AFB, ALB, and AFSI are also risk factors of KOA. Reproductive factors, especially those related to birth, may have the greatest impact on KOA. It provides guidance for promoting women's appropriate age fertility and strengthening perinatal care.

Humans↗

PubMed1999

Interactions between oral contraceptives and antifungals/antibacterials. Is contraceptive failure the result?

The effectiveness of oral contraceptives may be impaired by concomitant treatment with antimicrobials. This may occur because of reductions in plasma concentrations of ethinylestradiol by the induction of hepatic metabolism, as for rifampicin (rifampin) and possibly griseofulvin, or in a small percentage of women because of interference with enterohepatic recirculation. There are no scientific data to support the anecdotal evidence that the concomitant use of combined oral contraceptives and antimicrobials reduces contraceptive efficacy in the majority of women. It has been postulated that there is a subset of women in whom the enterohepatic recirculation of ethinylestradiol plays an important role. In these women the action of an antimicrobial may reduce the efficacy of oral contraceptives by interfering with this mechanism. Studies that have quantitatively examined these effects may have failed to include women from this subset because of the small numbers involved in the studies. On the other hand, there are no good prospective studies comparing contraceptive failure rates between compliant women who use combined oral contraceptives with and without antimicrobials. All women using combined oral contraceptives should be informed of the very low level of risk of interactions with antimicrobials (probably about 1%) and that it is not possible to identify who may be at risk. Women concerned about this low level of risk should be given information about the use of barrier methods or avoidance of intercourse during the first 7 days of concomitant antimicrobial therapy and for 7 subsequent days. Women who have had previous contraceptive failures or developed breakthrough bleeding during concomitant antimicrobial use should be strongly advised to follow these precautions, as they may be part of the subset of women at higher risk of contraceptive failure.

Animals↗

PubMedDate not supplied

[Psychosocial and sexual aspects of pregnant adolescents at Belém-Pará].

Pregnancy is a major factor that modifies psychosocial aspects of the adolescents. A study with 120 pregnant adolescents aged 12 to 18 years, without regarding gestational age, was carried out at Prenatal Risk Program in the Secretaria Estadual de Saúde, Belém-Pará, from 10/1991 to 04/1992. At the first encounter, it was made an approach of psychosocial and sexual subjects, with the following results: onset of menarche primarily between 12-13 years old (median 12.2 years old); beginning of sexual practice at 14 years old in 50.9% of the adolescents. 56.6% were pregnant at 16 years old. Most of the adolescents (98.4%) first had sexual intercourse with their boy friends and by their own wish (72.5%). In one year of loving affair, 67.5% of the adolescents have already begun sexual activities, this attitude more prevalent among the younger(79.4%). Adolescents had learned about sexuality mainly from mates (65.1%). Although 55.9% of the adolescents were aware of some contraceptive method, just 13.3% of them used one. The majority of the pregnant adolescents (96.7%) were financially supported by their families. Respectively, 30.3% and 32.1% of these girls left school before or during pregnancy. The risk factors that may contribute to an early and unintended pregnancy among adolescents, specially the younger ones, were pointed out: little information about sex and contraceptive methods, limited practice on their use and a high rate of precocious sexual activities.

English Abstract↗

PubMedDate not supplied

[Sex knowledge and behavior in male high school students].

INTRODUCTION: Adolescent sexual activity has increased in the last 30 years. Nowadays approximately 73% of male adolescent had sexual intercourse by the age of 18. Practice is not always followed by adequate knowledge and behavior. Therefore, it is of utmost importance to have appropriate education on sexual life and contraception in order to prevent unwanted pregnancies, abortions and spreading of sexually transmitted diseases. MATERIAL AND METHODS: Sexual behavior and knowledge was surveyed in a high school in Novi Sad among 520 male students, aged 15-19, in order to prepare lectures on sexual topics. RESULTS: Most information male teenagers got from different forms of mass-media (63.65%) and through communication with friends (50.58%). The communication with parents (5%) and experts (1%) is poor. According to their opinion, 69% have enough knowledge about sexuality and 62% about contraception, but 75.77% want further education from experts. 90% participated in some kind of sexual activity by the age of 18, and 84.3% had sexual intercourse for the first time at the age of 15.55 years, on average. artificial abortion occurred only in one case of pregnancy. Almost all young men knew about AIDS. The most common known means of contraception was condom (90%) and 70% consider it as the best method. 90% of male students consider abortion harmful, because it can cause infertility (51.38%). DISCUSSION: Most knowledge on sex life and contraception male adolescents gain from magazines, TV and friends, which can not be accepted as appropriate and undoubtedly can be incorrect and inadequate. Communication with parents and teachers is poor. Male adolescents are aware of their need for more education on these subjects and they want it from experts. CONCLUSION: Young men are not educated about sexual life and contraception well enough. Proper sexual education among adolescents is of great importance for psychic and reproductive health of young people.

Adolescent↗

PubMedDate not supplied

Differences in teenage pregnancy rates among five developed countries: the roles of sexual activity and contraceptive use.

CONTEXT: Adolescent pregnancy, birth, abortion and sexually transmitted disease (STD) rates are much higher in the United States than in most other developed countries. METHODS: Government statistics or nationally representative survey data were supplemented with data collected by private organizations or for regional or local populations to conduct studies of adolescent births, abortions, sexual activity and contraceptive use in Canada, the United States, Sweden, France and Great Britain. RESULTS: Adolescent childbearing is more common in the United States (22% of women reported having had a child before age 20) than in Great Britain (15%), Canada (11%), France (6%) and Sweden (4%); differences are even greater for births to younger teenagers. A lower proportion of teenage pregnancies are resolved through abortion in the United States than in the other countries; however, because of their high pregnancy rate, U.S. teenagers have the highest abortion rate. The age of sexual debut varies little across countries, yet American teenagers are the most likely to have multiple partners. A greater proportion of U.S. women reported no contraceptive use at either first or recent intercourse (25% and 20%, respectively) than reported nonuse in France (11% and 12%, respectively), Great Britain (21% and 4%, respectively) and Sweden (22% and 7%, respectively). CONCLUSIONS: Data on contraceptive use are more important than data on sexual activity in explaining variation in levels of adolescent pregnancy and childbearing among the five developed countries; however, the higher level of multiple sexual partnership among American teenagers may help explain their higher STD rates.

Abortion, Induced↗

PubMed1991

[Venous leakage and role of the suspensory ligament of the penis: anatomo-surgical observations and therapeutic suggestions].

From April 1988 to October 1990 we treated 80 patients by D.D.V. ligation and successive tightening of the cavernous bodies with simultaneous corporo-pubic suspension with four non-absorbable dorsal stiches. In 58 of them, further ligation have not been necessary; the remaining 22 patients had also to be treated with cavernous crura ligation (16 Pts.) and Urettiro-glandular lysis (6 Pts.). The immediate post-operative functional success (satisfactory sexual intercourse), in the first group, was 88%, in the second one was 80%. The 12-months follow up (50 Pts.) has shown a success rate of 77.5. In the technique we propose (corporo-tightening and pubic suspension - C.T.P.S.) there are two advantages: the reduction of the cavernous outflow and the improvement of the erection angle, making coitus easier.

Adult↗

PubMed1985

[110 cases of longitudinal septa of the vagina].

A retrospective analysis of 110 longitudinal septa ov the vagina which were seen at the Hotel-Dieu in Paris, demonstrated the following features: They were well tolerated and were discovered by chance in nearly 60% of cases, causing symptoms in 40% of cases. These symptoms were: dyspareunia, apareunia, haemorrhage at the first act of intercourse and more recently signs connected with the increasing use of tampons for the periods. They were complete in 49% of cases and incomplete in 51% of cases mainly in the upper part of the vagina. They were associated: in 26% of cases with a bicornuate-bicervical uterus, in 64% of cases with a septate uterus, the septum being total in 54% of the cases, in almost 10% of cases there was either a normal uterus or communicating uteri. There were fewer than 1% of normal uteri above septa that included the cervix and the vaginal vault. Clinical study of these malformations of the uterus and the vagina lead one to be able to make a hypothesis about the embryology: the fusion of the Müllerian canals and then the absorption of the septum where they join starts at the level of the isthmus. All morphological abnormalities of the uterus occur between the 55th and the 68th day of fetal life. The treatment is surgical, which is simple but has to be carried out very carefully. It consists of division or removal of the septum and should be done when the symptoms make it necessary, or during delivery when it gives rise to a dystocia or to a tear, which occurs but rarely.

Abnormalities, Multiple↗

PubMed1993

Premarital sexuality: a five-year follow-up study of attitudes and behavior by dating stage.

This paper presents the results of a survey on premarital sex conducted in 1988. The study focused on what respondents considered proper sexual behavior, what they reported they did, and what they thought others were doing at five stages of dating. Respondents were asked about cohabitation, the effect of AIDS on their premarital attitudes and behavior, and their views regarding the morality of premarital sex. When compared to the results of a similar study conducted in 1983, the data provided some evidence of change in premarital sexual attitudes and behavior. Female respondents in the 1988 sample showed lower levels of sexual intercourse at all five dating stages than did their counterparts in the 1983 study. However, males in the 1988 sample reported higher levels of sexual intercourse for the first four stages of dating than did males in the 1983 survey. In general, both males and females in the 1988 sample reported changing their attitudes and behavior regarding premarital sex in the direction of greater conservatism since hearing about AIDS. Attitudinal change was more widespread than actual behavioral change.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Survivors of sexual abuse: clinical, lifestyle and reproductive consequences.

BACKGROUND: In recent years, an increase in the prevalence of sexual abuse of women has been reported in Canada and elsewhere. However, there are few empirical data on the extent of the problem in Canadian aboriginal populations. The authors investigated the presence of a reported history of sexual abuse and other health determinants in a sample of women attending a community health centre with a substantial aboriginal population. This allowed determination of whether reported sexual abuse and its associated demographic and health-related effects were different for aboriginal and non-aboriginal women. METHODS: A sample of 1696 women was selected from women attending a community health centre in a predominantly low-income inner-city area of Winnipeg for a cross-sectional survey designed to study the association between sexual behavior and cervical infections. The survey was conducted between November 1992 and March 1995 and involved a clinical examination, laboratory tests and an interviewer-administered questionnaire. A substudy was conducted among 1003 women who were asked 2 questions about sexual abuse. RESULTS: The overall response rate for the main study was 87%. Of the 1003 women who were asked the questions about sexual abuse, 843 (84.0%) responded. Among the respondents, 368 (43.6%) were aboriginal. Overall, 308 (36.5%) of the respondents reported having been sexually abused, 74.0% of the incidents having occurred during childhood. The prevalence was higher among aboriginal women than among non-aboriginal women (44.8% v. 30.1%, p < 0.001). Women who had been sexually abused were younger when they first had sexual intercourse, they had multiple partners, and they had a history of sexually transmitted diseases. In addition, non-aboriginal women who had been sexually abused were more likely than those who had not been abused to have been separated or divorced, unemployed and multiparous and to have used an intrauterine device rather than oral contraceptives. Aboriginal women who had been sexually abused were more likely than those who had not been abused to have been separated or divorced, unemployed and multiparous and to have used an intrauterine device rather than oral contraceptives. Aboriginal women who had been sexually abused were more likely than those who had not been abused to have had abnormal Papanicolaou smears. The proportion of smokers was higher among the abused women than among the non-abused women in both ethnic groups. INTERPRETATION: A history of sexual abuse was associated with other clinical, lifestyle and reproductive factors. This suggests that sexual abuse may be associated with subsequent health behaviors, beyond specific physical and psychosocial disorders. Aboriginal and non-aboriginal women who have suffered sexual abuse showed substantial differences in their subsequent health and health-related behaviours.

Adult↗

PubMed2003

The amount and timing of parent-adolescent sexual communication as predictors of late adolescent sexual risk-taking behaviors.

The present study examined the moderating role of timing of first discussion of sexual intercourse with mothers and fathers on the relationship between the amount of sexual communication and sexual risk-taking behaviors in late adolescence. Late adolescents (N = 214) completed questionnaire measures regarding the amount and timing of sexual communication with their mothers and fathers. In addition, the participants provided information about their various sexual risk-taking behaviors. In general, the results suggest that timing of first discussion of sexual intercourse contributes additional variance in several sexually risky behaviors beyond that contributed by the amount of communication with both fathers and mothers. The implications of these findings are discussed.

Adolescent↗