TITLE:
The family and demographic change in Sri Lanka.
AUTHOR:
Caldwell B
AFFILIATION:
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
SOURCE:
Health Transit Rev 1996;6 Suppl:45-60
ABSTRACT:
Sri Lanka has almost completed the demographic transition with low mortality rates and fertility rates approaching
replacement levels. Sri Lanka shares these characteristics with the South Indian states of Kerala and Tamil Nadu in
contrast to elsewhere in South Asia where mortality and especially fertility rates remain much higher. A key part of the
explanation for these differences lies in the nature of the family. The Sri Lankan family is essentially the conjugal unit of
husband, wife and dependent children whereas in northern South Asia agnatic relations between son and parents are
central to family structure. Related to this family system the position of women in Sri Lankan society was relatively high
in South Asian terms. Consequently women had a strong say in health and fertility behaviour. When required, for
example, mothers take the initiative in seeking health care for themselves and their children. Importantly family structure
has facilitated female education which is associated with both mortality and fertility decline. There are few concerns that
the values imparted by secular education are contrary to the values of the family or to women's roles within it. The
egalitarian family structure has also contributed to fertility decline by raising the costs of children and reducing the
long-run benefits to be gained from them. Sri Lanka is particularly distinctive in the contribution of changes in female age
at marriage to its fertility decline, marriage age having risen six years this century. This change has been accompanied in
recent times by a shift from family-arranged to self-selected (love) marriage. The explanation lies in changes in the
socio-economic system which have reduced the centrality of the family in wider social and economic relations, and
placed a greater premium on an individual's own abilities and attributes.
TITLE:
The social construction of infertility: the case of the matrilineal Nayars in south India.
AUTHOR:
Neff DL
AFFILIATION:
Department of Anthropology, University of Wisconsin, Madison 53706.
SOURCE:
Soc Sci Med 1994 Aug;39(4):475-85
ABSTRACT:
This paper explores the relationship between central Kerala Nayar social constructions of fertility and gender, and the
Nayar institution of matrilineality, one of the most extreme cases of matrilineality documented in the anthropological
literature. The article shows that social responsibility and consequence are implicated in central Kerala Nayar
constructions of infertility and that these are traced matrilineally. It is the duty of matrilineal kin to attend to the family god
of fertility and to the needs of females of the matrilineage to see that they foster progeny in the kin group's best interests.
When this responsibility is violated, powerful forms of negative consequences may transpire for all lineage members, in
the idiom of curses of family fertility gods. In the ritual of pampin tullal performed to propitiate these gods, concepts of
fertility are extended to include other, 'auspicious' forms of prosperity. In ritual, unattached Nayar women serve as proxy
for the well-being of the matrilineage. These unattached women--infertile, unmarried, 'separated', and
widowed--are, for the natal kin group, symbolic virgins (kanya), the life force (sakti) of which lineage members seek to
harness for their well-being. The concept of fertility is thus extended to include marriage proposals, job offers, and other
health and economic concerns of lineage members.
TITLE:
Asian women's use of family planning services.
AUTHOR:
Hennink M, Cooper P, Diamond I
AFFILIATION:
Department of Social Statistics, University of Southampton, UK.
SOURCE:
Br J Fam Plann 1998 Jul;24(2):43-52
ABSTRACT:
Detailed research on the family planning needs of Asian women is extremely important in informing public policy in the
new purchaser-provider environment of the National Health Service (NHS), which was introduced in 1991. In depth
interviews were conducted with Asian women of Indian, Pakistani and Bangladeshi backgrounds in the South and West
Regional Health Authority area, to investigate their family planning behaviour and use of family planning services. This
research shows significant diversity in the knowledge and use of contraception between married professional women,
married non-professional women and unmarried women. This paper examines the different family planning service
implications for each group of women. The results show that professional married women and unmarried women are
able to meet their family planning needs by utilising existing family planning services. However, married
non-professional women experience significant difficulties in using family planning services largely due to
communication problems with health professionals and their low levels of personal autonomy. Most Asian women in this
study showed a strong preference for a female GP and a non-Asian GP for sexual health and contraceptive services.
TITLE:
Return of fertility following discontinuation of Norplant-II subdermal implants.
AUTHOR:
Buckshee K, Chatterjee P, Dhall GI, Hazra MN, Kodkany BS, Lalitha K, Logambal A, Manchanda P, Nanda
UK, RaiChoudhury G, et al
AFFILIATION:
ICMR Task Force on Hormonal Contraception.
Division of Human Resource Development Research, Indian Council of Medical Research, Ansari Nagar, New Delhi.
SOURCE:
Contraception 1995 Apr;51(4):237-42
ABSTRACT:
A total of 627 women who had discontinued the use of the Norplant-II implants for various reasons and were exposed to
the risk of pregnancy were followed-up for two years for return of fertility. The cumulative conception rates in women
who had discontinued due to planning pregnancy were 80.3 per 100 women at one year and 88.3 per 100 women at two
years. The majority of women who did conceive (90 percent), had full-term normal live births; about 4 percent of
women had spontaneous abortions, the remaining 6 percent decided on elective termination of pregnancy (ETP). The
cumulative conception rates in women who discontinued due to bleeding irregularities and 'other reasons' were 64.5 and
55.8 per 100 women at one year and 77.9 and 75.1 per 100 women at two years, respectively. These rates were
significantly lower as compared to those observed in women who discontinued due to planning pregnancy. A large
proportion, about 40 percent, of women who conceived after discontinuation of the method due to bleeding irregularities
and "other reasons," opted for ETP indicating that many women in these two groups did not desire another child and that
such women need to be counselled for adopting another method of contraception. The spontaneous abortion rates
observed in ex-users of Norplant-II implants (1.7 to 4.4% pregnancies) were comparable to the spontaneous abortion
rates prior to Norplant-II implant use (3.6% pregnancies) indicating that ex-users of Norplant-II implants were not at a
higher risk of spontaneous abortion.
TITLE:
Vaginal bleeding patterns of women using different contraceptive methods (implants,
injectables, IUDs, oral pills)--an Indian experience. An ICMR Task Force Study.
Indian Council of Medical Research.
AUTHOR:
Datey S, Gaur LN, Saxena BN
AFFILIATION:
Division of Human Resource Development Research Indian Council of Medical Research, New Delhi.
SOURCE:
Contraception 1995 Mar;51(3):155-65
ABSTRACT:
Irregularity in vaginal bleeding patterns is the most common clinical side effect causing discontinuation of the method
reported by the-users of the newer contraceptive methods, especially hormonal ones. An objective assessment of
vaginal bleeding pattern is, therefore, critical in evaluation of a new contraceptive method for its acceptance and
continued use. The menstrual diary records of women participating in clinical trials of several contraceptive methods
undertaken by the Indian Council of Medical Research were analysed. It was observed that the long-acting
progestogen-only hormonal contraceptives like levonorgestrel (LNG)-releasing subdermal implants Norplant or
intrauterine devices (LNG-IUD) as well as injectable contraceptive NET-EN 200mg given 2 or 3 monthly produced
disturbances in bleeding pattern in the majority of their users. Very heavy or prolonged bleeding, a potential health hazard
was uncommon and a shift more towards infrequent bleeding was observed. In Norplant-II implants users, 75 to 80% of
women had irregularities in bleeding pattern during the first year of use which improved with prolonged use. However,
even at 4 years of use, about half of the users of Norplant-II implants continued to have irregular bleeding patterns. The
bleeding disturbances occurred in 80% users of 200mg NET-EN injectable contraceptives also during first year of use,
however unlike Norplant-II implants users, there was no improvement with prolonged use. Combined monthly
injectable contraceptives containing 50mg NET-EN and 5mg estradiol valerate caused less bleeding problems with half
of the users experiencing normal pattern during one year of its use. Combined low-dose oral pills, both triphasic and
monophasic, produced much better cycle control as compared to any of the other hormonal contraceptive-treated
groups; about 90% of combined oral pill users had normal bleeding patterns during one year of method use. The use of
copper IUDs was associated with increased bleeding in 18 to 20% of women during the initial period of three months
which improved with prolonged use. It was observed that the women having frequent or prolonged bleeding had
discontinued the contraceptive method more often as compared to those having delayed bleeding episodes or
oligomenorrhoea. However, discontinuation rates due to bleeding irregularities at one year were lower in Norplant-II
implants users as compared to other long acting hormonal contraceptive methods such as injectables or IUDs in spite of
similar or better bleeding patterns in women using these methods.
TITLE:
Clinical presentation of gynecologic infections among Indian women.
AUTHOR:
Singh V, Sehgal A, Satyanarayana L, Gupta MM, Parashari A, Chattopadhya D
AFFILIATION:
Institute of Cytology and Preventive Oncology, Maulana Azad Medical College Campus, New Delhi, India.
SOURCE:
Obstet Gynecol 1995 Feb;85(2):215-9
ABSTRACT:
OBJECTIVE: To study the clinical presentation of different gynecologic infections among Indian women. METHODS:
This was a cross-sectional study of 257 women that included clinical, cytologic, colposcopic, and microbiologic
screening for various gynecologic infections. RESULTS: Human papillomavirus (HPV) was the leading infection,
affecting 127 (49.4%) women; however, overt warts were only seen in seven (2.7%) patients. Women infected with HPV
had a 60.3-fold higher risk of developing a bleeding ectopia compared to those with other infections; women with an
unhealthy cervix and cervical ectopias also had an increased risk of HPV infection (7.6- and 2.8-fold, respectively).
Bacterial vaginosis, detected in 33.5% of the women studied, had an increased risk of bleeding ectopia (9.3-fold),
cervical ectopia (3.1-fold), cervicitis (2.9-fold), vaginitis (6.9-fold), and cervical hypertrophy (2.1-fold). Chlamydial
infection, detected in 23.3% of the patient population, was associated with an eightfold increase in the risk of an unhealthy
cervix and a fourfold increase in risk of a hypertrophied cervix. Immunoglobulin-A antibodies to the herpes simplex virus
were detected in 53 (20.6%) women. More than half (55.2%) of the women had two or more infections, and the mean
delay of seeking medical treatment was 7-13 months. CONCLUSION: The specific finding of bleeding cervices was
associated with HPV and bacterial vaginosis, hypertrophied cervices with chlamydia and bacterial vaginosis, and
unhealthy cervices with chlamydia and HPV infections.
TITLE:
Ethnic differences in insulin and glucose response to glucose between white and Indian
women with polycystic ovary syndrome.
AUTHOR:
Norman RJ, Mahabeer S, Masters S
AFFILIATION:
Reproductive Medicine Unit, University of Adelaide, Queen Elizabeth Hospital, Woodville, South Australia.
SOURCE:
Fertil Steril 1995 Jan;63(1):58-62
ABSTRACT:
OBJECTIVE: To examine different patterns of glucose and insulin secretion in women (of both Indian and white ethnic
backgrounds) with polycystic ovary syndrome (PCOS). DESIGN: A 75-g oral glucose tolerance test was performed in
11 subjects from each group. SETTING: Reproductive Medicine and Gynecological Clinics from The Queen Elizabeth
Hospital, Woodville, South Australia, and King Edward the VIIIth Hospital, Durban, South Africa. PATIENTS: Couples
were grouped as follows: Indian nonobese and obese PCOS, Indian nonobese and obese reference subjects, white
nonobese and obese PCOS, white nonobese and obese reference subjects. MAIN OUTCOME MEASURE: Insulin and
glucose in plasma after oral glucose testing. RESULTS: Indian PCOS and nonobese reference subjects had higher
insulin responses than whites. The ethnic difference was less pronounced in obese women. There were no ethnic
differences in glucose response. CONCLUSION: This study demonstrates that the ethnic background of subjects with
PCOS needs to be considered in studies on the metabolic parameters in this condition.
TITLE:
Lipoprotein lipids in androgen excess--a study among Indian women.
AUTHOR:
Maitra A, Meherji PK, Desai MP, Gokral JS, Donde UM, Joshi UM
AFFILIATION:
Institute for Research in Reproduction (ICMR) Parel, Bombay, India.
SOURCE:
Int J Fertil Menopausal Stud 1994 Jul-Aug;39(4):218-22
ABSTRACT:
OBJECTIVE--To assess changes in lipoprotein-lipid profile vis-a-vis putative risk of atherosclerotic diseases, among
a group of hyperandrogenic women. SUBJECTS AND METHODS--Women studied were among those being
screened for polycystic ovarian disease (PCOD) at the Reproductive Endocrinology Clinic of the institute. They all had
oligomenorrhea/chronic anovulation as their problem and had clinical or laboratory evidence of hyperandrogenism, viz.,
hirsutism or elevated serum testosterone levels. Lipoprotein-lipid profiles obtained in 51 such women were compared
with those of 11 controls with normal menstrual cycles and no evidence of hyperandrogenism. RESULTS--No
significant changes were observed in any of the lipoprotein-lipid variables which could be attributed to
hyperandrogenism per se. However, a combined effect of obesity and raised circulating androgens in causing a
significant change in the lipoprotein-lipid profile (increased cholesterol, LDL-C/HDL-C, and cholesterol/HDL-C) was
clearly discernible from the study. CONCLUSIONS--Hyperandrogenism by itself may not signal a risk for
atherosclerotic diseases. However, the potential of such risk would be significantly enhanced if obesity is associated with
high circulating levels of androgens.
TITLE:
Self-reported symptoms of gynecological morbidity and their treatment in south
India.
AUTHOR:
Bhatia JC, Cleland J
AFFILIATION:
Indian Institute of Management, Bangalore, India.
SOURCE:
Stud Fam Plann 1995 Jul-Aug;26(4):203-16
ABSTRACT:
This article presents an analysis of self-reported symptoms of gynecological problems among 3,600 recent mothers in
Karnataka State, India. Approximately one-third of all women reported at least one current symptom; the most common
were a feeling of weakness and tiredness (suggestive of anemia); menstrual disorders; white or colored vaginal
discharge (suggestive of lower reproductive tract infection); and lower abdominal pain and discharge with fever
(suggestive of acute pelvic inflammatory disease). Obstetric morbidity, associated with the last live birth, was strongly
predictive of current gynecological symptoms. Women who delivered their last child in a private institution were
significantly less likely to report symptoms than were those who delivered at home or in a government hospital. Nonusers
or users of reversible contraceptive methods were also less likely to report symptoms of morbid conditions than were
sterilized women. These associations persisted in analyses controlling for potentially confounding economic and
demographic characteristics, and have far-reaching policy implications.
TITLE:
A controlled assessment of the in vitro fertilization performance of British women of
Indian origin compared with white women.
AUTHOR:
Mahmud G, Lopez Bernal A, Yudkin P, Ledger W, Barlow DH
AFFILIATION:
Nuffield Department of Obstetrics and Gynaecology, Oxford Radcliffe Hospital, Headington, United Kingdom.
SOURCE:
Fertil Steril 1995 Jul;64(1):103-6
ABSTRACT:
OBJECTIVE: To compare the reproductive performance of Indian versus white women in IVF. DESIGN: Controlled
comparative clinical study. SETTING: In vitro fertilization center based in university department in large tertiary level
hospital. PATIENTS: Results from first IVF treatment cycles in 44 Indian patients were compared with results from 88
white patients, matched by age and body mass index, over the same treatment year. The patients were selected from a
prospectively collected IVF databank. INTERVENTIONS: Standard luteal-phase start long GnRH analogue regime.
Ovarian stimulation with FSH and hMG. Transvaginal ultrasound-guided oocyte recovery. In vitro fertilization and ET
following established protocols. MAIN OUTCOME MEASURES: Rates of abandoned cycles, egg retrievals, ETs,
clinical pregnancies, miscarriages, and live births were compared in the first IVF treatment cycle. Cumulative pregnancy
rates (PRs) over three cycles in the two groups of patients were also compared. RESULTS: More cycles were
abandoned in the Indian than in the white group: 22.7% versus 9.1%. The Indian live birth rate per cycle was worse:
9.1% versus 22.7%. The performance of the two groups was otherwise similar: ovarian stimulation with hMG and FSH
required 26.0 required 26.0 ampules in the Indian group versus 24.6 ampules in the white group, mean number of follicles
on the day of egg retrieval 8.7 versus 8.7, mean number of eggs 5.9 versus 5.8, fertilization rate 82.4% versus 82.5%; ET
rate 73.5% versus 82.5, mean number of embryos transferred 2.1 versus 1.8, and clinical PR per cycle started 18.2%
versus 27.3%. CONCLUSIONS: Under the same IVF regime, Indians performed worse than whites at the stage of
ovarian stimulation (higher rate of abandoned cycles for poor response) and in live birth rate. Cumulative conception and
live birth rates also tended to be worse in Indians than in whites.
TITLE:
Genital tuberculosis--a major pelvic factor causing infertility in Indian women.
AUTHOR:
Parikh FR, Nadkarni SG, Kamat SA, Naik N, Soonawala SB, Parikh RM
AFFILIATION:
Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay, India.
SOURCE:
Fertil Steril 1997 Mar;67(3):497-500
ABSTRACT:
OBJECTIVE: To study the effect of tuberculosis, a common infectious disease in the Indian subcontinent, on the female
pelvic factor and its subsequent effect on female fertility. DESIGN: Retrospective case studies. SETTING: Department
of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay, India.
PATIENT(S): Three hundred women, between the ages of 25 and 35 years, with tubal factor as a cause of their infertile
state. RESULT(S): One hundred seventeen women with a tubal factor were found to have tuberculosis as the cause of
tubal blockage. On laparoscopy, 49.5% were found to have simple tubal blockage, 15.3% showed tubo-ovarian masses,
and 23.9% had a frozen pelvis. Seventy-five percent complained of menstrual irregularities, thus indicating endometrial
involvement; 25.6% of these women underwent an IVF procedure. The pregnancy rate after IVF-ET was 16.6% per
transfer. CONCLUSION(S): This study highlights the fact that tuberculosis, a chronic infectious disease, is one of the
major etiologic factors of female tubal infertility, especially on the Indian subcontinent.
TITLE:
The ecology of low natural fertility in Ladakh.
AUTHOR:
Wiley AS
AFFILIATION:
Department of Anthropology, Binghamton University (SUNY) 13902-6000, USA.
SOURCE:
J Biosoc Sci 1998 Oct;30(4):457-80
ABSTRACT:
The existence of very low rates of fertility among non-contracepting human populations has intrigued researchers in
demography and reproductive ecology. Long inter-birth intervals, driven primarily by the lactational amenorrhoea
associated with breast-feeding, have been shown to be important determinants of low natural fertility in several
populations. Other reports have suggested that sterility brought about by sexually transmitted diseases (STDs) might also
explain low fertility in some populations, especially in Africa. This report presents an analysis of 1981 Indian census data
that documents low natural fertility in Ladakh, a high-altitude region of the Himalaya in north India. In Ladakh, there is
evidence for low rates of marriage among women that may be attributable to the practice of polyandry, but also high
rates of primary and secondary sterility within marriage, resulting in low completed parities for post-reproductive age
married women. Age-specific fertility rates derived from the number of current births are also unexpectedly low.
Hypotheses to explain very low fertility in Ladakh are considered from among the likely proximate determinants and
evaluated using two supplementary sources of information derived from fieldwork in Ladakh in the early 1990s. The
most likely explanations for low marital fertility include sterility from STDs, high rates of fetal loss, and possibly nutritional
contraints on ovarian hormone status.
TITLE:
Polycystic ovaries and associated metabolic abnormalities in Indian subcontinent Asian
women.
AUTHOR:
Rodin DA, Bano G, Bland JM, Taylor K, Nussey SS
AFFILIATION:
Division of Gastroenterology, Endocrinology and Metabolism, St. George's Hospital Medical School, London, UK.
SOURCE:
Clin Endocrinol (Oxf) 1998 Jul;49(1):91-9
ABSTRACT:
OBJECTIVES: To determine the prevalence of polycystic ovaries (PCO) in Asian women living in England who are of
Indian subcontinent origin or ancestry and to investigate the relationship between the presence of PCO and/or
non-insulin dependent diabetes mellitus (NIDDM) and insulin sensitivity and other metabolic parameters. DESIGN: A
random sample of Indian subcontinent Asian women was obtained from the lists of local General Practitioners and a
translating service. These women were invited to attend for a medical history questionnaire, examination, venous blood
sample for hormonal assessment and transvaginal ovarian ultrasonography. Groups of women without PCO or NIDDM,
with NIDDM but not PCO, with PCO but not NIDDM and with both NIDDM and PCO were drawn at random from this
population and from Indian subcontinent Asian women attending the Diabetes Unit. They underwent further studies,
including measurement of insulin sensitivity using a short intravenous insulin tolerance test. SUBJECTS: 212 Indian
subcontinent Asian women aged 18-40 took part in the initial study. Insulin sensitivity was measured in 13 women
without PCO or NIDDM, 13 women with NIDDM but not PCO, 15 women with PCO but not NIDDM and 12 women
with both NIDDM and PCO. MEASUREMENTS: The main outcome measures were prevalence of polycystic ovaries,
clinical features of hyperandrogenism, fertility, blood pressure, serum gonadotrophins, testosterone and sex hormone
binding globulin, fasting blood lipids, glucose and insulin, and insulin sensitivity. RESULTS: The prevalence of PCO in
Indian subcontinent Asian women was 52% (110/212). There were significant associations between PCO and menstrual
irregularity; infertility; the Ferriman and Gallwey score for body hair distribution; the presence of acanthosis nigricans
and the fasting blood glucose concentration. There were no differences between women with PCO and those with
normal ovarian morphology with respect to systolic and diastolic blood pressure, fasting total, HDL and LDL cholesterol
and triglyceride concentrations. The subgroup of women without PCO or NIDDM had the highest insulin sensitivity
(189.1 +/- 46.4 mumol glucose/l/min, mean +/- SD) and the women with both PCO and NIDDM had the lowest insulin
sensitivity (80.5 +/- 30.9 mumol glucose/l/min). There was no significant difference in insulin sensitivity between those
with PCO but not NIDDM (125.0 +/- 59.5 mumol glucose/l/min) and those with NIDDM but not PCO (120.8 + 38.0
mumol glucose/l/min). The effects of NIDDM and PCO on insulin sensitivity were independent; the effect of PCO on
insulin sensitivity was -60 mumol glucose/l/min (95% confidence interval -100 to -21, P = 0.004) and the effect of
NIDDM was -68 mumol glucose/l/min (95% confidence interval -105 to -31, P < 0.001). There were no significant
relationships between insulin sensitivity and fasting plasma insulin, systolic or diastolic blood pressure, fasting serum
cholesterol or triglyceride. CONCLUSIONS: The prevalence of polycystic ovaries in Indian subcontinent Asian women
is very high and it has significant clinical associations. Polycystic ovaries and non-insulin dependent diabetes mellitus are
associated with similar degrees of reduced insulin sensitivity in this population. Their effects are independent suggesting
that these changes in insulin sensitivity involve different mechanisms. Polycystic ovaries unlike non-insulin dependent
diabetes mellitus, are not associated with a defect in the secretion of insulin.
TITLE:
A controlled comparison of ovarian response to controlled stimulation in first
generation Asian women compared with white Caucasians undergoing in vitro
fertilisation.
AUTHOR:
Lashen H, Afnan M, Sharif K
AFFILIATION:
Department of Obstetrics and Gynaecology, Solihull Hospital, West Midlands, UK.
SOURCE:
Br J Obstet Gynaecol 1999 May;106(5):407-9
ABSTRACT:
OBJECTIVE: To compare ovarian response to controlled stimulation among Asian women from the Indian
sub-continent and white Caucasian women undergoing in vitro fertilisation (IVF). DESIGN: Nested case-control study.
SETTING: Assisted Conception Unit, Birmingham Women's Hospital. SAMPLE: One hundred and eight first
generation Asian patients (born in the Indian sub-continent) and 216 white Caucasian controls, all of whom received
IVF treatment in the period 1994 to 1997, were selected for the study. The two groups were matched for age to within
one year, early follicular phase follicle stimulating hormone, indication for treatment, gonadotrophin dose and year of
treatment. The outcome of treatment was not known when the controls were selected. RESULTS: There was no
statistically significant difference between the two groups in the duration of stimulation, egg number, number of embryos
produced, fertilisation rate, clinical pregnancy rate, miscarriage rate, cycle cancellation rate and implantation rate.
CONCLUSION: Under the same IVF protocol Asian women's response to controlled ovarian stimulation and IVF
outcome are comparable to their white Caucasian peers.
TITLE:
Women in a south Indian fishing village: role identity, continuity, and the expe
rience
of menopause.
AUTHOR:
George T
AFFILIATION:
SOURCE:
Health Care Women Int 1996 Jul-Aug;17(4):271-9
ABSTRACT:
A study was conducted of the experience of menopause among middle-aged women in
a fishing village on the
southwest coast of India. These women live in a harsh environment with a standar
d of living that would be considered
economically deprived by an outsider. The women have established their identity
as fish sellers. Although they reported
experiencing some of the physiological symptoms of menopause typically reported
in Western literature, the symptoms
were not cause for complaint, and none of them sought medical treatment for them
. Nor did these women go through an
identity crisis at midlife; they continued to identify themselves as well-establ
ished fish sellers, not as redundant, aging
housewives. Furthermore, menopause gave them much more time and freedom to pursu
e their fish-selling business.
This paper posits that their continuity in identity accounts for their freedom f
rom the psychological symptoms some
Western women experience at midlife.
TITLE:
Study in sexuality of medical college students in
India
AUTHOR:
Aggarwal O; Sharma AK; Chhabra P
AFFILIATION:
SOURCE:
JOURNAL OF ADOLESCENT HEALTH 2000, Vol 26, Iss 3,
pp 226-229
ABSTRACT:
Purpose: In India, talking about sex is taboo.
Little is known about the knowledge, attitude, and
sexual behavior of adolescents. This study was
carried out with the purpose of examining: (a) the
knowledge of medical students about sex, (b) the
sources of learning about sex, and (c) the sexual
behavior and practices of young adults.Methods:
This study was carried out among the undergraduate
students of a medical college in Delhi. A
pretested, semiclosed-type questionnaire was
voluntarily filled out by the students.
Confidentiality and secrecy was assured.Results:
Of 500 students, 73% participated in the study.
Knowledge regarding sexual intercourse,
masturbation, contraception, and sexually
transmitted diseases was satisfactory among 70%,
74.8%, 83.5%, and 92.6% of the respondents,
respectively. Common source of knowledge about sex
were friends (74.5%), pornographic films (56.2%),
and books and magazines (55.1%). Only one fifth
could communicate with teachers, parents, and
persons of the other gender about sex. About 417
of the students viewed homosexuality as normal
behavior. Sexual intercourse had been experienced
by 11.8% of respondents. The mean age of first
sexual intercourse was 17.5 years. Eighty-five
percent strongly favored introduction of sex
education at school level.Conclusion: Evidence is
provided for the need to improve knowledge about
different aspects of sex among a sample of Indian
medical students. (C) Society for Adolescent
Medicine, 2000.