Extensive research and clinical observations in the past 20 years confirmed that the cessation of ovarian function at menopause does not stop the process of sex steroid hormone synthesis in females. Indeed, multiple extra-ovarian tissues contain the same enzymatic machinery the ovary uses which can maintain a significant rate of local hormonal synthesis sufficient to cause pathological outcomes. This is commonly termed “intracrine”. However, two obstacles face intracrinology. Firstly, wide clinical appreciation of this mechanism in causing disease and in targeting it with therapy does not currently exist. Secondly, blood hormonal assays are used in the clinic to diagnose and manage intracrine based disorders. This could be entirely misleading, since hormonal synthesis, action and metabolism occur within the tissue and, therefore, measuring blood levels is not reflective of the actual disease environment. This thesis presents evidence of significant intracrine based disorders in menopausal women that could be effectively managed by tackling the core intracrine mechanism. Three protocols are investigated emphasizing the usefulness of menopausal intracrine estrogen inhibition. The first presents a joint objective of treating menopausal symptoms using estrogenic replacement therapy while reducing breast cancer risk using long-term aromatase inhibitors. Aromatase inhibition is used to suppress the local estrogen synthesis in the breast. The second protocol is a new method of acute inhibition of breast estrogens to improve the accuracy of breast imaging techniques. This method showed a benefit in reducing the benign parenchymal enhancement during breast MRI indicating a potential improvement in specificity. The third protocol involves using aromatase inhibitors in the treatment of severe endometriosis that did not respond to oophorectomy. The pathogenesis of breast cancer, endometriosis and fibroids are believed to involve intracrine estrogen activity. Another significant contribution presented in this thesis is the development of a new technique that enables minimally invasive tissue assays of hormones in their genuine site of synthesis rather than indirectly in the blood. The new assay requires only microliter volumes of sample and employs a novel digital microfluidics technology. Estrogen and other sex steroids were extracted from droplet-scale breast tissue and blood samples.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 4 uppsatser.

In this field study, female social workers perspectives have been collected, on interventions regarding sexual and reproductive health in the public sector in Argentina. The purpose was primary empirical and secondary to analyze empirical data using critical theory. The methodology was qualitative and the theoretical framework was created using an abductive approach. Thirteen female social workers were interviewed in the municipality of general Pueyrredón, in the province of Buenos Aires. Empirical data was categorized using the hermeneutic approach; described and analyzed using critical theory. Results presented challenges regarding lack of accessibility, continuity and accountability, from the nation, the province and the municipality. Moreover, results show challenges on how to target vulnerable groups, adolescents, people with low intellectual disability, people from neighboring countries, and from the north of Argentina. In addition, there were challenges on how to increase correct use and use of contraceptives. Suggestions were to make interventions more adaptable and creative. Stressed challenges were regarding male involvement in sexual and reproductive health decisions, gender violence, the patriarchal society, and the macho culture. Critical theory highlighted challenges created by Argentina’s societal structures, structures that contribute to oppression of service users, making them powerless and marginalized. By increasing the knowledge of critical social work theory in social work education, there would be more tools for social workers to use it in practice. When using critical social work theory all levels in a society shall be included. Specific policies and interventions are requested to battle female discrimination.

This dissertation begins with the finding that in the United States Black women are four times as likely to die due to pregnancy related complications than their white counterparts as well as the finding that Black children are 2 to 2.5 times as likely to die before their first birthday. Given this, the project examines the intersections between Black women’s reproductive experiences and the condition of reproductive health and access in the state of Texas. In order to accomplish this, the research situates the grassroots organizing work of a collective of mothers of color alongside national and state level legislation and data about maternal and infant health disparities. The work not only situates ethnographic experiences within the larger repertoire of quantitative health literature on disparities but it also historicizes the work alongside Black Feminist theories of the body, history, and Black women’s reproduction. Drawing from extended participant observations, interviews, focus groups, policy research, statistics, and archival work, this project unpacks the large disparity that exists in maternal and infant health outcomes for African-American women and the ways in which policy, community organizing, and other geo-political factors contribute to, mediate, or remedy this phenomenon. Given the data presented, this projects suggests that (re)creating supportive communities and support networks may be an effective way of mediating stress caused by long-term exposures to racism and ultimately healing the negative maternal health outcomes for black women. / text

This thesis examines Doe v. Canada, a case brought before the Ontario Court of Appeals with the purpose to declare that the definition of “assisted conception” set forth by the respective regulations discriminated against lesbian women. The regulatory framework of assisted conception is embedded with heteronormativity, heterosexism and an over medicalization of reproduction. The traditional liberal conception of rights, embedded in the Court’s decision did not allowed lesbian women to have access to assisted conception free from barriers that other women, seeking insemination with semen donated by their spouse or sexual partner, do not have to endure. However, If we shift our perspective of rights from a liberal view to a relational approach, we will be able consider such decisions from a perspective that takes into account not only the physical health implications of the use of this technology, but also all other social, psychological and contextual relevant factors.

This thesis examines Doe v. Canada, a case brought before the Ontario Court of Appeals with the purpose to declare that the definition of “assisted conception” set forth by the respective regulations discriminated against lesbian women. The regulatory framework of assisted conception is embedded with heteronormativity, heterosexism and an over medicalization of reproduction. The traditional liberal conception of rights, embedded in the Court’s decision did not allowed lesbian women to have access to assisted conception free from barriers that other women, seeking insemination with semen donated by their spouse or sexual partner, do not have to endure. However, If we shift our perspective of rights from a liberal view to a relational approach, we will be able consider such decisions from a perspective that takes into account not only the physical health implications of the use of this technology, but also all other social, psychological and contextual relevant factors.

As a contraceptive technology, women’s sterilization is a medical event that is uniquely situated in relation to the dominant discursive link between women and reproduction. Intended as a contraceptive option that permanently ends a woman’s potential ability to sexually reproduce, women’s sterilization presents a significant point for exploring the discursive formation of femininity, and how the concepts thereof relate to broader questions of access, control, and regulation of sterilization and the female sterilization patient. This study uses a Foucauldian feminist theory of discourse to explore such questions in a qualitative discourse analysis of women’s sterilization, from both a historical perspective and from within contemporary medical texts. Sterilization has had a particularly tumultuous history in the provision of reproductive healthcare for women; situated within public health and welfare discourse that differentiates the “unfit” from the “fit” reproducers, women have been forcibly sterilized under classist and racist eugenic programs, while subtle yet coercive forms of sterilization abuse continue to occur as inequality of reproductive healthcare access is an ongoing issue for immigrant women, poor women, and women of colour. In light of this historical analysis, as well as the impact of feminist and bioethics discourse upon contemporary medical practice, an analysis of medical texts further explores the association of women with reproduction in the discursive form of the sterilization patient. This study argues that the sterilization patient is situated within a discourse of ideal femininity, associated with normalized forms of mothering, sexuality, and family structure. Given the historical link between the discursive “fit” reproducer, these concepts have continued implications for women’s experience of accessing sterilization as a contraceptive option. / Thesis (Master, Sociology) -- Queen's University, 2007-07-17 17:09:15.595

Cambodian youth live in a country undergoing rapid development and modernization. The srey kalip or modern women of Phnom Penh are an emerging demographic group of young urban females driving social change in the context of globalization. Despite their obvious presence in society, very little is known about this growing demographic and even less is known about their sexual behavior. This research employed a range of ethnographic methodologies in order to capture one essence of Phnom Penh’s modern women—their reproductive health seeking behavior. The results of this study indicate that the adoption of a modern identity has changed constructions of traditional Khmer femininity. This introduced “liberalism” challenges traditional ideas about what it means to be a Khmer woman and what it means to be a sexual woman. The srey kalip’s sexual and reproductive health needs present a much broader profile than the existing health system is capable of providing for. The availability of existing sexual and reproductive health services does not dovetail with their modern identity. This inability to acquire adequate reproductive health care is a consequence of the disjunction between the srey kalip’s modern identity and a less modern health system. The tension between the modern and traditional body are drawn into focus when the srey kalip seek medical care for reproductive health services and are unable to obtain care that meets their unique needs. This is not a problem restricted to Cambodia. Many developing nations around the world have populations of urban youth who are more globally interconnected and more modern than their parent’s generation. Ministries of Health and health service providers around the world need to develop innovative and dynamic strategies to meet the sexual health needs of their burgeoning modern youth populations. The opportunity to meet the sexual and reproductive health needs of youth is a task that Ministries of Health around the world cannot afford to waste.

Thesis (M.P.H.)--Georgia State University, 2007. / Title from file title page. Russ Toal, committee chair; Catherine McCarroll, Joseph Mulinare, committee members. Electronic text (83 p. : ill.) : digital, PDF file. Description based on contents viewed Jan 8, 2008. Includes bibliographical references (p. 79-83).

Thesis (LL. M.)--University of Toronto, 2005. / Cover title. Includes bibliographical references (leaves 79-87).