Women's oral health issues: an exploration of the literature

As interest in women's health issues grows, there is increasing concern that today's practice of medicine may not meet the health needs of women. A primary reason is the gender bias that has been inherent in medical education, research and clinical practice. The prevailing medical viewpoint has often been that the male body is considered to be the norm and that the female body exactly the same except for the reproductive function. This attitude has led to a lack of interest in researching gender differences and a consequent lack of knowledge of women's health issues. Fortunately, there is a movement for change. The Women's Health Interschool Curriculum Committee was formed in January 1992 to develop curricula concerning women's health and examine bias that may exist in existing curricula. The Canadian Women's Health Network has been growing across the country and there have been calls to create a new specialty in women's health. According to Angell, this proposal for a new specialty was provocatively debated in the Journal of Women's Health, which started publication in 1992. There is also a growing concern on how to conduct better research to address women's health needs. As more attention is paid to women's health issues, what will happen in the area of oral health? In health care, it would seem that the mouth has become completely separated from the rest of the body. Health conferences rarely have any oral health content at all. To correct this problem, there must be an increase in general awareness of the importance of oral health as it relates to the overall health of both women and men. Good oral health is more than just decay-free teeth. Oral health encompasses the teeth, the supporting periodontal structures, soft tissues of the mouth and oral pharynx area, temporomandibular joints and muscles of mastication. The mouth is a gateway to the body and will also reflect many systemic health problems, such as diabetes, leukemia and lupus. The second step would be the recognition that women may have different oral health needs and issues than men. The common view may be that teeth are gender free, but how can this be when teeth exist in a body, and that body is male or female? For many years, the primary acknowledged difference between men and women's oral health was pregnancy gingivitis. Like medicine, dentistry must re-examine the viewpoint that women's oral health differs from men's only as it is influenced by reproductive processes. There are many areas where women's oral health may differ from that of men. This paper will explore the literature for potential women's oral health issues in the areas of oral hygiene behaviours, esthetics, eating disorders, temporomandibular disorders, and hormonal influences on periodontal health.     

Strategies for empowering women's voices in the medical culture

Power and knowledge are closely connected, and this is no less true for the medical profession than it is for any other sphere of life. Knowledge is constructed by voice. Unfortunately, women's voices are often silent in the factory where medical knowledge is produced. Medicalization and ignoring are symptoms of the medical oppression of women's voices. Empowerment of women's voices at various levels within the medical culture is essential for influence and social reconstruction. In this regard, a research project on alternative approaches to physician-patient communication as well as research methods is presented. Knowledge constructed from women's voices will be neglected by medical power unless it can hold up to systematic investigative procedures. Sensitive and sensible research from women's voices requires methodology that preserves women's messages and transforms them into medical knowledge. Such efforts may ultimately lead toward construction of a feminine medical epistemology--a medical knowledge that reflects women's reality.     

Contrast-enhanced ultrasound studies in gynecological practice]

Childbirth is essentially women's business, a natural female act being performed since the beginning of mankind. However, as Western society has evolved, so too has the management of childbirth. It is the medical profession that has gained control of providing care for childbearing women, to the detriment of many women's experiences. The societal expectations on childbearing women, the iatrogenic effects of pregnancy being treated as an illness under the medical model, and the implications for the profession of midwifery will be discussed.     

The risk of teen mothers having low birth weight babies: implications of recent medical research for school health personnel

This article reviews recent medical research on the relationship between young maternal age and the incidence of low birth weight infants. One line of research, "nature," emphasizes biological factors in early adolescence such as immaturity of the female reproductive system and inadequate prenatal weight gain. "Nurture," another research focus, stresses sociocultural attributes of teen mothers such as poverty and minority status. Young maternal age alone does not explain the higher rates of low birth weight infants born to adolescent females. Both biological and sociocultural factors, plus lifestyle choices made by adolescents, combine to raise or lower the risk of delivering a low birth weight infant. School health personnel need to link their health promotion efforts to those of other community organizations serving adolescents and their families.     

The politics of women's health: setting a global agenda

The last decade has been marked by a rapid growth in the women's health movement around the world. There has been a marked shift in activities away from the developed countries, as campaigns increase in intensity in Africa, Asia, and Latin America. The practice of women's health politics has also become increasingly international with sustained and effective collaboration across the north-south divide. Both the goals of these campaigns and their methods vary with the circumstances of the women involved. But despite this diversity, common themes can be identified: reproductive self-determination; affordable, effective, and humane medical care; satisfaction of basic needs; a safe workplace; and freedom from violence.     

The determinants of the duration of postpartum sexual abstinence in West Africa: a multilevel analysis

The question of how postpartum sexual abstinence responds to social change in West Africa is important because declines in the practice could increase fertility levels and worsen child and maternal health. This study uses data from the late 1970s in Cote d'Ivoire, Ghana, and Cameroon to examine effects of modernization and women's status on the length of abstinence. The results show that modernization and female status should be associated with declines in abstinence, which could lead to an increase in fertility and deterioration in maternal and child health.     

The Thematic Apperception Test and attitudes toward achievement in women: A new look at the motive to avoid success and a new method of measurement.

Asked 163 male and 165 female students to write stories to 1 of 3 versions of M. S. Horner's Thematic Apperception Test (TAT) verbal cue used to measure women's "motive to avoid success": a successful medical student who was a single female, a single male, or a married female. Ss then answered an objective questionnaire about the cue figure. Story protocols, classified as positive, mixed, or negative on the basis of success-related content, were significantly (p     

Being born female is dangerous for your health.

In this article, the author explores how gender inequity is manifested in poor reproductive and mental health outcomes, including unwanted pregnancy, unsafe abortion, maternal mortality, sexually transmitted infections, depression, and psychosomatic symptoms. Briefly described is a landmark 1994 United Nations conference emphasizing that gender inequity adversely affects women's reproductive health, particularly in developing countries, and the implementation of its recommendations is tracked. Although there is increased recognition of oppression's toll on women's physical and emotional health as well as their intellectual and social potential, progress toward equity goals is uneven and slow. Psychologists as a group play many roles--for example, in research, education, policy, law, communications, industry, international development, and private practice--through which they can make professional contributions to gender equity as a focus or underlying principle. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender sensitivity in medical curricula

Both sex--the biologic aspects of being female or male--and gender--the cultural roles and meanings ascribed to each sex--are determinants of health. Medical education, research and practice have all suffered from a lack of attention to gender and a limited awareness of the effects of the sex-role stereotypes prevalent in our society. The Women's Health Interschool Curriculum Committee of Ontario has developed criteria for assessing the gender sensitivity of medical curricula. In this article, the effects of medicine's historical blindness to gender are explored, as are practical approaches to creating curricula whose content, language and process are gender-sensitive. Specific areas addressed include ensuring that women and men are equally represented, when appropriate, that men are not portrayed as the prototype of normal (and women as deviant), that language is inclusive and that women's health and illness are not limited to reproductive function. By eliminating or at least addressing the subtle and often unintentional gender stereotyping in lecture material, illustrations and problems used in problem-based learning, medical educators can undertake a much-needed transformation of curriculum.     

Lateral cradling preferences in humans (Homo sapiens): Similarities within families.

Women (Homo sapiens) tend to cradle infants on the left side of the body. Results are reported of a survey of family photograph albums. We found that left-side cradling frequencies (LCFs) are higher in women than in men and that there are strong significant correlations between the LCFs of mothers and daughters, sisters, and maternal grandmothers and granddaughters. There may be a genetic influence on lateral cradling tendencies; women's left-side cradling preferences were found to be repeated with subsequent children. Heritability of women's LCF has an upper limit of 0.82, and the regression of daughters' mean LCF on mothers' LCF gives a heritability of 0.93?±?0.29. The data may be interpreted in two ways: There may be sex-limited genes (i.e., genes that express themselves only in women) for lateral cradling preferences, or women may learn cradling preferences from their mothers and other female relatives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deinstitutionalization and women: Assessing the consequences of public policy.

Reviews and analyzes the literature concerning deinstitutionalization and women and highlights specific ways in which a major public policy initiative has affected the lives of both chronically mentally ill women and women who have been charged with the responsibility of caring for the chronically mentally ill. Special effects of deinstitutionalization on mentally ill women are evident in such areas as sexual exploitation and violence, homelessness, diversion into the criminal justice system, and stigmatization. A group of studies points to special circumstances pertaining to sexual behavior and reproductive control in a deinstitutionalized female population. It is suggested that the expectations of women's behavior based on societal role definitions have affected service planning for this population and that the use of such criteria for program planning runs the risk of injuring patients of both sexes. The need for more conceptual work and research on deinstitutionalization is stressed; however, because deinstitutionalization is an exceedingly complex phenomenon, the importance of remaining sensitive to the wide variety of circumstances that contribute to its outcomes is emphasized. (72 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testicular cancer risk and maternal parity: a population-based cohort study

The aim was to study, in a population-based cohort design, whether first-born sons run a higher risk of testicular cancer than later born sons; to investigate whether this difference in risk was affected by birth cohort, age of the son, maternal age, interval to previous delivery and other reproductive factors; and, finally, to evaluate to what extent changes in women's parity over time might explain the increasing incidence of testicular cancer. By using data from the Civil Registration System, a database was established of all women born in Denmark since 1935 and all their children alive in 1968 or born later. Sons with testicular cancer were identified in the Danish Cancer Registry. Among 1015994 sons followed for 15981 967 person-years, 626 developed testicular cancer (443 non-seminomas, 183 seminomas). Later born sons had a decreased risk of testicular cancer (RR = 0.80, 95% CI = 0.67-0.95) compared with first-born sons. The RR was 0.79 (95% CI = 0.64-0.98) for non-seminomas and 0.81 (95% CI = 0.58-1.13) for seminomas. There was no association between testicular cancer risk and overall parity of the mother, maternal or paternal age at the birth of the son, or maternal age at first birth. The decreased risk of testicular cancer among later born sons was not modified by age, birth cohort, interval to the previous birth, sex of the first-born child, or maternal age at birth of the son or at first birth. The increased proportion of first-borns from birth cohort 1946 to birth cohort 1969 only explained around 3% of an approximated two-fold increase in incidence between the cohorts. Our data document a distinctly higher risk of testicular cancer in first-born compared with later born sons and suggest that the most likely explanation should be sought among exposures in utero. The increase in the proportion of first-borns in the population has only contributed marginally to the increase in testicular cancer incidence.     

Critique of Miller's "Chance, choice, and the future of reproduction."

Discusses W. B. Miller's (see record 1984-17604-001) argument that the decision of whether to have a child involves a psychological process in which an individual freely chooses from among many alternatives. It is asserted that the political context of today, in which women's reproductive rights are an issue of great controversy, constrains such ideologically based freedom. Political, legal, and social conditions that limit women's reproductive control are described. Miller's support of progenics, which favors a particular type of offspring in evolutionary terms, is questioned. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial aspects of selected issues in women's reproductive health: Current status and future directions.

Emphasizing research published in the past decade, this article presents a summary and evaluation of psychosocial investigations of women's reproductive health, with a focus on selected aspects of menstruation, pregnancy and birth, infertility, and menopause. In some areas, studies have focused on negative physical and psychological concomitants of these health issues. However, research reveals substantial individual variability, with most women adapting well to reproductive health changes. Although methodological and conceptual shortcomings have limited firm conclusions, research has advanced our understanding of the multivariate biological, psychological, and social influences on women's reproductive health and associated outcomes. Understanding and promoting women's reproductive health across the lifespan requires biopsychosocial approaches to research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Craniofacial electromyogram activation response: another indicator of anesthetic depth

The female gametophyte is an absolutely essential structure for angiosperm reproduction. It produces the egg cell and central cell (which give rise to the embryo and endosperm, respectively) and mediates several reproductive processes including pollen tube guidance, fertilization, the induction of seed development, and perhaps also maternal control of embryo development. Although much has been learned about these processes at the cytological level, specific molecules mediating and controlling megagametogenesis and female gametophyte function have not been identified. A genetic approach to the identification of such molecules has been initiated in Arabidopsis and maize. Although genetic analyses are still in their infancy, mutations affecting female gametophyte function and specific steps of megagametogenesis have already been identified. Large-scale genetic screens aimed at identifying mutants affecting every step of megagametogenesis and female gametophyte function are in progress; the characterization of genes identified in these screens should go a long way toward defining the molecules that are required for female gametophyte development and function.     

Factors underlying unmet need for family planning in the Philippines

The prevalence of unmet need for family planning is a primary justification for family planning programs, but the causes of unmet need have not been much explored. This article investigates four explanations for unmet need: (1) as an artifact of inaccurate measurement of fertility preferences and contraceptive practice; (2) as a reflection of weakly held fertility preferences; (3) as a result of women's perceiving themselves to be at low risk of conceiving; (4) as due to excessive costs of contraception. The explanations are examined using quantitative and qualitative data collected in 1993 from currently married women and their husbands in two provinces in the Philippines. The results indicate that the preference-behavior discrepancy commonly termed "unmet need" is not an artifact of survey measurement. The most important factors accounting for this discrepancy are the strength of women's reproductive preferences, husbands' fertility preferences, and the perceived detrimental side effects of contraception. Inaccessible family planning services appear to carry little weight in this setting. Modification of services to make them more attentive to other obstacles to contraceptive use would improve their effectiveness in reducing unmet need.     

Female condition influences preferences for sexual dimorphism in faces of male humans (Homo sapiens).

In some species, female condition correlates positively with preferences for male secondary sexual traits. Women's preferences for sexually dimorphic characteristics in male faces (facial masculinity) have recently been reported to covary with self-reported attractiveness. As women's attractiveness has been proposed to signal reproductive condition, the findings in human (Homo sapiens) and other species may reflect similar processes. The current study investigated whether the covariation between condition and preferences for masculinity would generalize to 2 further measures of female attractiveness: other-rated facial attractiveness and waist-to-hip ratio (WHR). Women with high (unattractive) WHR and/or relatively low other-rated facial attractiveness preferred more "feminine" male faces when choosing faces for a long-term relationship than when choosing for a short-term relationship, possibly reflecting diverse tactics in female mate choice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Husbands' reproductive health knowledge, attitudes, and behavior in Uttar Pradesh, India

To enhance the reproductive health status of couples in developing countries, the knowledge, attitudes, and behavior of both women and men must be investigated, especially where women depend on men for the decision to seek care. This study analyzes data from a survey of 6,727 husbands from five districts in the northern state of Uttar Pradesh, India. Data are presented on men's knowledge of women's health and on their own sexual behavior outside the context of marriage, on their perceptions of sexual morbidity and their attempts at treatment for specific conditions, and on their opinions concerning the social role of wives. Findings indicate that men know little about maternal morbidity or sexual morbidity conditions. Few husbands reported that they had had sexual experience outside of marriage and the majority of these few said they had had such a relationship with more than one partner. Of men who said they had had reproductive morbidity symptoms, many said they had not sought treatment. Men's views concerning the role of wives indicate a low level of women's autonomy in this region of India. Results indicate a pressing need for reproductive health education that targets both women and men in Uttar Pradesh.     

Characterization of Plasmodium falciparum glutamate dehydrogenase-soluble antigen

There are limited data on the factors associated with menopausal hot flashes, a common and potentially morbid condition. The objective of this study was to identify predictors of menopausal hot flashes. To meet this objective, 233 naturally perimenopausal or post-menopausal women (ages 45-65) attending a large urban hospital center primary care clinic, mammography unit, or women's health practice were enrolled. The women responded to a self-administered questionnaire assessing selected demographic factors, reproductive history, and behavioral factors. Sixty-seven percent of respondents experienced hot flashes, with 63% reporting frequent hot flashes (at least one hot flash per day) and 60% with hot flashes describing the hot flashes as severe. Women with hot flashes were significantly more likely to have mothers who experienced hot flashes (OR = 4.4, CI = 2.0-10.0) or to be smokers (OR = 2.0, CI = 1.2-3.5). There were no statistically significant associations between hot flashes and other selected demographic, reproductive, or behavior characteristics. These results reveal that menopausal hot flashes are associated with a maternal history of hot flashes as well as with cigarette smoking. These results may help physicians to counsel their patients about smoking cessation.