Midlife sexuality among Thai adults: Adjustment to aging in the Thai family context

Vaginal 11-point and volumetric dose related to late vaginal complications in patients with cervical cancer treated with external beam radiotherapy and image-guided adaptive brachytherapy

OBJECTIVE

To investigate the vaginal 11-point and volumetric dose-toxicity relationships in definitive cervical cancer radiotherapy.

METHODS

A retrospective cohort study of patients with cervical cancer with a complete response of at least 12 months was performed. Additional per vaginal examinations and patient-scoring questionnaires on the date of patient enrolment were assessed for vaginal strictures. Retrospective dosimetric analysis of vaginal 11-point and volumetric doses was performed with descriptive and probit analyses to investigate dose-toxicity relationships.

RESULTS

Ninety-seven patients were included in the study, with a 20-month median follow-up. The incidence rate of grade 3 vaginal strictures was 22.7%. A comparison between patients with grade 1-3 vaginal strictures revealed significant differences in age, stage, initial tumour size, and vaginal involvement. PIBS + 2, PIBS, PIBS-2, D + 5, and D2cc were all significantly different among grade 1-3 vaginal strictures and showed significant probit coefficients. The lateral dose points were significantly higher in grade 2 strictures, but negative probit coefficients failed to establish causal inferences. Post-estimation analyses yielded effective doses (ED) for 15% and 20% probability of grade 3 vaginal strictures (ED15 and ED20) for PIBS + 2 at 57.4 and 111 Gy₃, respectively. PIBS-2 yielded an ED20 of 7 Gy₃. D + 5 yielded positive ED10, ED15, and ED20 values of 52.2, 66.6, and 78 Gy₃, respectively.

CONCLUSIONS

This study showed a significant relationship between age, tumour size, and lower-third vaginal involvement with the incidence of vaginal toxicity. The goal of a cumulative radiotherapy dose of ≤ 55 Gy₃ to PIBS + 2, ≤5 Gy₃ to PIBS-2, and ≤ 65 Gy₃ to D + 5 points may reduce the risk of grade 3 vaginal stenosis to less than 15-20%.

Association of sociodemographic and reproductive variables with menopause-specific quality of life using principal component analysis

We aimed to determine whether sociodemographic and reproductive variables jointly or independently were associated with menopause-specific quality of life (MENQOL). A total of 250 Bengali-speaking Hindu women (peri- and postmenopausal) were recruited from West Bengal, India. Data on MENQOL (vasomotor, physical, psychosocial, sexual, and quality-of-life domains), sociodemographic, and reproductive variables were collected. Principal component (PC) analysis was used to identify PCs for sociodemographic and/or reproductive variables: PC1 (sociodemographic), PC2 (sociodemographic and reproductive), PC3, and PC4 (reproductive). PC scores were used in multiple regression analyses to determine associations with MENQOL. For perimenopausal women, PC1 and PC3 were inversely associated with the sexual domain; PC2 was positively associated with vasomotor, sexual domain, and quality of life; and PC3 was positively associated with the physical domain. For postmenopausal women, PC1 and PC3 were inversely associated with the sexual and psychosocial domains, respectively; PC2 was positively associated with the sexual domain and quality of life; and PC4 was positively associated with the psychosocial domain. The factors associated with MENQOL PCs were similar for perimenopausal and postmenopausal women. Health planners should consider early and midlife factors associated with MENQOL to improve women's midlife health.

Sexual Experience of Iranian Women in Their Middle Life: A Qualitative Approach

BACKGROUND

Sexual problems are common among the middle-aged women; however, there is no deep understanding of sexuality in midlife. The current study aimed to investigate Iranian women's attitudes and experiences about sexual life changes in midlife.

METHODS

This is a descriptive qualitative study. Seventeen women aged 40 -65 years old were purposively selected from urban health centers in Gorgan, Iran, in 2015. Face-to-face, semi-structured and in-depth interviews were conducted for data collection until data saturation was attained. The resulting data were analyzed based on Graneheim and Lundman's approach. MAXQDA 10 was used for organization of data.

RESULTS

Data analysis demonstrated seventh sub-themes and three themes. The emerged themes were entitled (1) "Continuous paradox over being a sexual agent" with three subthemes of beliefs on asexuality as socially accepted view for women in midlife, changing in motivation for sex and changing in sexual performance, (2) "Considering menopause; opportunities and threats for sexual life" with two subthemes of menopause related cons for sexual life and menopause related pros in sexual life, and (3) "Coping strategies for changes in sexuality in midlife" with two subthemes of different psychological reactions to changes that have influenced the sex and take practical steps for restoration of sexual attraction.

CONCLUSION

The findings demonstrated that middle-aged women in a male-dominant culture encounter paradox over being a sexual agent. In a bio-psycho-social approach, they perceived menopause as an opportunity or threat for their own sexuality. Following the conflicts, threats and changes of sexuality in midlife, they adopt diverse coping strategies to improve their sexual relationships and preserve their family.

Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: findings from a population based survey

Background

Sexual health is one of the key dimensions of health across all ages. Understanding risky sexual behaviors remains an important area of public health research. This study aimed to explore sexual health, risky sexual behaviors and factors associated with recent condom use as condom use is considered a main intervention proven to reduce negative health consequences of risky sexual behaviors, specifically related to sexually transmitted infections and unintended pregnancies. A stratified two-stage cluster sampling technique survey was conducted in Chiang Mai, Thailand. Information was obtained about age of first sexual intercourse, sexual activity, condom use, number of partners and history of drug/alcohol use prior to sexual activities within the past 3 months. A weighted analysis was performed to account for data clustering.

Results

It is estimated that most men (93%) and women (86%) in Chiang Mai have engaged in sexual intercourse. More than 70% of the people in Chiang Mai over age 30 remained sexually active in the past 3 months, even for populations over age 50. Eight percent of male teenagers reported having more than one sexual partner in the past 3 months. Regular condom use was reported in less than 5% of the population (6.6% men and 3.1% women).

Conclusions

Our study demonstrated that sexual health is an important public health issue across all age groups. Condom use has been promoted as one way to minimize and prevent unintended consequences of sexual behavior but overall use remains low.

Electronic supplementary material

The online version of this article (10.1186/s13104-017-3055-1) contains supplementary material, which is available to authorized users.

The Influence of Sexual Attitudes on Mid-to Late-Life Sexual Well-Being: Age, Not Gender, as a Salient Factor

The influence of sexual attitudes on sexual activity and expression has been relatively understudied in older populations. In the current study, we sought to understand the role sexual attitudes have on sexual well-being among middle-aged and young-old adults. Using a diverse sample of participants over the age of 45 ( N = 384), a path model was analyzed to determine whether sexual attitudes contributed to sexual well-being. The model was then compared by gender. Results indicated: a) only age-relative sexual attitudes significantly contributed to sexual well-being; and b) the model was equally robust for both men and women, even though women held slightly more positive age-relative sexual attitudes than men. Therefore, among middle-aged and young-old adults, sexual well-being may be reduced by harboring negative ageist sexual attitudes. Efforts should be made to reduce stigma surrounding continued sexual activity and expression among the aged.