Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 120 131 Mario Lourenco Urology Department, Francisco Gentil Portuguese Institute of Oncology, Coimbra, Portugal Duarte Brito Urology Department, Francisco Gentil Portuguese Institute of Oncology, Coimbra, Portugal Bruno Pereira Urology Department, Cova da Beira University Hospital Centre, Covilhã, Portugal 2019 04 24 2019 10 20 Objective: To review in literature about the concept of premature ejaculation from physiology to treatment. Materials and methods: A literature search conducted with Pubmed and Cochrane. Results: An accurate clinical history is the best diagnostic method, and in the majority of the cases it is enough to differentiate between primary and acquired premature ejaculation. Nowadays the treatment is not curative but is effective in increasing the Intravaginal Ejaculatory Latency Time, improving the couple’s sexual satisfaction. Conclusion: Although PE is the most frequent sexual dysfunction, it is still sub-diagnosed. Combining behavioural techniques with pharmacotherapy is the best way of treatment.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1121 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1121/490

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 132 140 Shervin Assari Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, CA, United States Mohsen Bazargan Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, CA, United States AND Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States 2019 01 08 2019 10 01 Objective: The positive effect of high socioeconomic position (SEP) on health is well established. According Minorities’ Diminished Returns (MDRs) theory, however, the SEP-health link is smaller for Blacks compared to Whites. Using a 25-year follow up data of a national sample, this study tested racial differences in the effects of marital status on life expectancy among American adults. Materials and methods: The data of Americans’ Changing Lives (ACL, 1986 – 2011) were used. The ACL is a nationally representative longitudinal cohort study followed 3,361 White or Blacks adults from 1986 to 2011. The predictor of interest was marital status in 1986. Confounders included demographic factors (age and gender), SEP (education and employment), health behaviors (drinking, smoking, and physical activity), and health status (depressive symptoms, chronic disease, and self-rated health) all measured at baseline. Race was the moderator variable. All-cause mortality was the main dependent variable (outcome). Cox proportional hazard modeling was applied for data analysis. Results: In the overall sample, individuals who were married at baseline had a lower risk of mortality during the 25 years of follow up. Race altered the effect of marital status on life expectancy, indicating smaller protective effect for Blacks relative to Whites. Race –specific Cox regression models showed an association between marital status and life expectancy for White but not Black Americans. Conclusion: In line with the MDRs theory, the health gain that follows marital status is diminished for Black Americans compared to White Americans. Only equalizing SEP across racial groups may not be adequate for eliminating racial/ethnic health inequalities. Policies should go beyond SEP and reduce societal and structural barriers that disproportionately hinder Blacks from translating their SEP indicators to desirable health outcomes. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1039 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1039/491

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 173 175 Zinat Ghanbari Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Maryam Pesikhani Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Tahereh Eftekhar Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran leila pourali Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Atiyeh Vatanchi Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Soudabeh Darvish Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Elnaz Ayati Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2019 03 10 2019 10 15 Objective: To report the neglected pessary in a patient with pelvic organ prolapse. Pelvic organ prolapse (POP) is one of the most important medical challenges in women especially elderly. One of the conservative treatments of symptomatic POP is pessary placement. Case report: A 84-year-old woman, para 10 was referred to female pelvic floor clinic of an academic hospital for vaginal bleeding and neglected vaginal pessary. Vaginal examination in the pelvic floor clinic revealed an entrapped ring pessary in severely atrophic vaginal mucosa with purulent discharge. Conclusion: Although pessary is the first choice and one of the best conservative treatment for pelvic organ prolapse, it shouldn’t be used for poor cooperative patient who cannot comply with regular follow-up visits which may cause harmful complications. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1084 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1084/496

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 141 145 Tahereh Eftekhar Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran Marjan Ghaemi Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran Aref Abedi Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahboobeh Shirazi Fetal and Neonatal Research Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran 2019 05 07 2019 08 25 Objective: Heavy menstrual bleeding is one of the most frequent complaints of women. Various therapeutic approaches have been applied to treat this condition. In this study, we compared the efficacy of mefenamic acid and misoprostol in reducing menorrhagia. Materials and methods: This is a randomized clinical trial study performed on 60 patients with menorrhagia. They were divided into two equal groups and randomly received mefenamic acid or misoprostol. Cycle duration, bleeding volume (according to the pictorial blood assessment chart), hemoglobin, hematocrit, and pad count were recorded before and after treatment. Side effects of treatment regimens were recorded. Results: Blood loss volume per menstruation day in the mefenamic acid group was 118.40 ± 36.26 ml before treatment which decreased to 48.50 ± 24.71 ml after treatment (p = 0.262). Misoprostol reduced menstrual bleeding volume from 135.37 ± 34.85 ml per day to 49.40 ± 32.161 ml (p = 0.003). Mean duration of the menstrual period in patients receiveding mefenamic acid was 9.50 ± 3.27 days which decreased to 7.73 ± 2.14 days after treatment (p = 0.001). The similar change occurred in the misoprostol group and the mean duration of the menstrual period decreased from 7.70 ± 2.10 to 6.37 ± 2.29 days (p = 0.002). The number of pads used by patients in the mefenamic acid group before treatment was 23.20 ± 12.61 which was decreased to 14.33 ± 5.86 after treatment (p = 0.001). This alteration in misoprostol group was from 20.67 ± 6.12 to 15.53 ± 6.49 (p = 0.001). Conclusion: Misoprostol can significantly reduce menstrual bleeding. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1129 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1129/492

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 146 153 Emily Olig School of Medicine, University of North Dakota, Dakota, USA Shanalee Mountan School of Medicine, University of North Dakota, Dakota, USA James Beal Department of Family and Community Medicine, School of Medicine, University of North Dakota, Dakota, USA Abe Sahmoun Department of Internal Medicine, School of Medicine, University of North Dakota, Dakota, USA 2019 05 06 2019 11 13 Objective: The evaluation of racial disparities in access to and use of infertility services in the U.S. has been documented. The aims of this study were to: 1) investigate racial differences in length of time women report attempting to become pregnant until seeking medical help; and 2) determine the predictors of seeking medical help to achieve pregnancy. Materials and methods: The National Survey of Family Growth 2011-2015 was used to analyze the duration women attempted to get pregnant among those who sought medical help. Results: 563 women reported seeking medical help to achieve pregnancy. The majority 422 (81%) were white. Multiple linear regression showed that age (β = .93; p = .00), having less than high school education (β = 14.64; p = .01), and higher body mass index (β = .59; p = .00) are significantly associated with an increased length of time for seeking medical help to get pregnant. Religions other than Catholic or Protestant (β = -8.63; p = .04) is significantly associated with a decreased length of time for seeking medical help to get pregnant. Race was not associated with a significant difference in the length of time attempting to become pregnant (β = -1.80; p = .44). Conclusion: Age, education attainment, religious affiliation, and body mass index are significantly associated with the length of time pursuing pregnancy. Once women have utilized medical resources, racial differences in the length of time pursuing pregnancy are not apparent. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1127 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1127/493

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 154 159 Seyedeh Mahsa Poormoosavi Research and Clinical Center for Infertility, Department of Histology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran Mohammad Behmanesh Department of Histology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran Sima Janati Department of Obstetrics and Gynecology, School of Medicine, Research and Clinical Center for Infertility, Dezful University of Medical Sciences, Dezful, Iran Hossein Najafzadehvarzi Department of pharmacology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran 2019 04 15 2019 10 09 Objective: To assess the correlation between the levels of BPA in the serum and follicular fluid (FF) using oocyte morphology. Materials and methods: In this cross-sectional research, oocyte, FF, and serum samples were obtained from a sample population consisting of 90 women undergone in vitro fertilization in Ganjavian Hospital in Dezful, Iran during October 2017-March 2018. The ELISA kit was utilized for the measurement of the BPA levels. In addition, oocyte morphology simultaneous with inverted optical microscopy. Results: Follicular fluid BPA levels had no significant effect on MII oocytes (p ≥ 0.05). However, the mean levels of degenerated oocytes and germinal vesicle (GV) were significantly higher in the women with high BPA levels in the FF (p ≤ 0.05). Moreover, the mean counts of MII oocytes and oocytes were significantly higher in the women with serum BPA levels of ≤ 50 ng/ml (p ≤ 0.05), while the mean count of GV oocytes was significantly higher in the women with serum BPA levels of ≥ 150 ng/ml (p ≤ 0.05). Conclusion: According to the results, higher FF BPA levels were associated with the higher counts of GVs and oocytes, while oocytes with higher maturity can be achieved in lower levels of BPA in the serum of patients. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1116 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1116/494

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 13 3 2019 12 01 160 166 Farideh Akhlaghi Women's Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Zeynab Baygi Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohsen Miri Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mona Najafi Clinical Research Development Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2019 05 02 2019 10 20 Objective: Women frequently experience perineal damage after a vaginal delivery. This study aimed to investigate the effect of perineal massage (PM) during labor on the need for episiotomies. Materials and methods: The study is a double-blind randomized clinical trial conducted with 99 patients (n=49 controls; n=50 cases). Participants comprised of nulliparous pregnant women aged from 18 to 35 years in the 37th-42nd week of gestation, who referred to the Um-al-Banin Hospital of Mashhad from July to October 2018, for vaginal delivery and were in the active stage of labor. Allocation to study groups was based on a random allocation list generated by a software application. PM was performed for the cases in the active stage four times, each lasting for two minutes at intervals of half an hour. The massage was continued at the beginning of the second stage of labor for ten minutes. Control women received routine care. The delivery was practiced by a midwife who was blinded to the study groups and the performance or non-performance of massage. Data were analyzed in SPSS software version 16. Results: The need for episiotomy was significantly lower in the PM group than in the control group (p = 0.05). Spontaneous perineal tears were significantly higher in mothers of the PM group (p = 0.05. The spontaneous tear degree in the 20 mothers who did not require episiotomy (p = 0.5) and the degree of perineal tear in mothers who needed an episiotomy (n = 79; p hods: Retrospective analysis of all maternal deaths occurring in the Guru Gobind Singh Medical College & Hospital, Faridkot, Punjab, India was done from Jan 2010 to Dec 2012. Every maternal death was scrutinized from various aspects like direct cause of death, age, locality, antenatal care and gestational age. Results:The total number of deliveries has risen from 957 in 2010 to 1063 in 2012 at the same time the maternal mortality ratio has increased from 835.94 in 2010 to 2054.55 per one live birth in 2012. Haemorrhage (24.12%) and sepsis (18.9%) were the most common causes of death followed closely by pregnancy induced hypertension including eclampsia (15.5%). Anemia (12.06%) contributed to the most common indirect cause of death. Conclusion:Implementation of the various maternity schemes has had no significant impact on the profile of dying mothers. There is a need to stress the importance of good antenatal care in reducing Maternal Mortality Ratio. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/195 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/195/190

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 9 2 2015 06 15 93 100 Mansoreh Norrozi Valie-Asr Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. Fedyeh Haghollahi Valie-Asr Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. Fatemeh Ramezanzadeh Valie-Asr Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran. Parichehr Hanachi Department of Biology, Biochemistry Unite, Faculty of Basic Sciences, Alzahra University, Tehran, Iran. 2015 10 16 Objective: To find out whether or not soy milk as a Objective: phytoestrogen product can improve the quality of life of the Iranian postmenopausal women. Materials and methods:  Participants of this randomized clinical trial were 57 healthy postmenopausal women. All eligible women were randomly divided into two groups of soy milk (SG) and control (CG). Individuals in the SG (n = 34) received 500 ml soy milk including genistein (28.86 mg/dl) and daidzein (8.25 mg/dl) per day, while the participants in the CG (n = 23) received 500 ml low fat cow milk per day during 8 months. Both groups also took daily calcium-D capsules (500 mg calcium and 200 IU D3). The quality of life of all participants was examined twice (at the baseline and the end of the eighth month) using the menopause-specific quality of life (MENQOL) questionnaire. Results: A total of 57 healthy postmenopausal women Results: with a mean age of 52.13 (3.05) years were included in this study.Despitethe significant but weak difference was observed between SG and CG in the sexual domain score (the mean of percent change: 0.46% vs. 33.94%, respectively; p = 0.031), while significant relationship was found between the soy milk consumption and improvement in the domains studied (vasomotor, psychosocial and physical). Conclusion: Overall our findings showed that soy mi Conclusion: lk does not improve the quality of life in  postmenopausal women. But to achieve more reliable results, it is recommended further study to be done with a larger sample size, more prolonged, and with participants having severer vasomotor symptoms. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/193 https://jfrh.tums.ac.ir/index.php/jfrh/ar