Context: The Women’s Health Initiative (WHI) study, published in July 2002, had a significant impact on the prescribing of hormone replacement therapy (HRT). The controversy surrounding the findings, however, has led to much uncertainty regarding the prescription of HRT. Aims and Objectives: The aim of this study is to determine both the initial and the continued impact of the WHI study on the prescribing of HRT in a defined South African population and to determine whether HRT was appropriately individualised based on recommendations published subsequent to the WHI study. Setting: Claims data from a Managed Healthcare Organisation (MHO) that administers for a number of medical aid schemes in South Africa. Method: A retrospective drug utilisation review (DUR) was conducted to identify HRT-related prescribing patterns in the defined populations. The time-frame of the dataset included January 2002, to assess prescribing patterns prior to the publication of the WHI study, January 2003 to determine the initial impact of the WHI study, and January 2005 to assess the continued impact. An extensive, additional dataset of all the HRT users in the defined populations was utilised to conduct a sub-group analysis and determine whether HRT had been appropriately individualised. Key Findings: The percentage of patients in the dataset using HRT decreased from 30.05 percent in January 2002 to 28.30 percent in January 2003 and to 23.24 percent in January 2005, with the latter decrease reaching statistical significance. Although sex hormones and modulators (G03) of the genital system were the most frequently prescribed drug class in all three years of the study period, the prescribing frequency decreased significantly from 10.40 percent in January 2002 to 9.32 percent in January 2003 and 7.44 percent in January 2005. The most noteworthy change in the prescribing of HRT was a 3.95 percent decrease in the prescribing of conjugated equine estrogen (CEE), with a corresponding 2.53 percent increase in the prescribing of estradiol between January 2002 and January 2003. However, less pronounced changes were observed in the prescribing frequencies of other types of HRT, including medroxyprogesterone and estrogen (the HRT type investigated in the estrogen plus progestin phase of the WHI study). Patients initiating HRT post-WHI publication were generally found to be in the younger menopausal age categories (40 to 49 years). These patients were more likely to have been initiated on HRT types other than those investigated in the WHI study and were at a higher risk for disease states for which HRT use is beneficial, such as osteoporosis. Patients discontinuing HRT post-WHI publication were generally found to be in the older menopausal age categories (60 to 69 years), were more likely to have been combined HRT users (although not necessarily the type investigated in the WHI study) and were at a higher risk for disease states for which HRT use is considered harmful or has an uncertain effect, such as diseases affecting the cardiovascular system. Conclusion: It can be concluded that the WHI study did have an impact on the prescribing of HRT in the defined South African population of this study, but that the impact was considerably less than the impact reported in global studies. It was also determined that HRT was appropriately individualised according to recommendations made subsequent to publication of the WHI study.

This ethnographically informed dissertation focuses on the ways rural Yucatec Maya women, midwives and state health care workers participate in the production of childbirth and maternal health care practices. It further addresses how state health programs influence the relationships and interactions between these groups. Although childbirth practices in Yucatan have always been characterized by contestation, negotiation and change, their intensity and speed have significantly increased over the last decade. Drastic changes in the maternal health of rural indigenous communities in Mexico and throughout the world are directly connected to intensified state interventions that favor biomedicine over traditional health systems. In rural Yucatan, state health programs such as Oportunidades and Seguro Popular support a biomedical approach to birth by distributing medical resources to government clinics/hospitals and encouraging program participation of poor women through conditional cash incentives. This dissertation seeks to interrogate changing childbirth practices in a rural indigenous community in Quintana Roo, MX to gain a deeper understanding of the complex politics that shape local understandings and approaches to childbirth. It further explores how shifting social relations and political alliances are created within the context of reproductive health. This ethnography highlights how Yucatec Maya women envision a productive, yet negotiated, relationship with the state that allows them control of their prenatal and maternal health while engaging with state health programs. Focusing on the cultural production of childbirth in a rural community in southwestern Quintana Roo, this research seeks to explore the dynamic ways in which indigenous communities are reproduced over time through moments of engagement and contestation with the state. The Maya women in this dissertation exist at the margins of the Mexican government’s concerns, policies, and resources. Yet, even at the margins the influence and power of state ideology and policies intimately affect the lives of rural indigenous women. The core argument of this dissertation is that these women, who rely on traditional and historical experience, create strategies for survival and social reproduction despite their marginalized position within the Mexican state. This research draws from over a decade of fieldwork. Predissertation fieldwork took place during the summer months of 2002, 2003, 2004, 2007, 2008, and 2010. I completed my dissertation fieldwork from January to October of 2013. During that time, I conducted 60 formal and informal interviews and a small survey. Additionally, a large portion of my research took place with a local family that consisted of female healers and health educators, whom I extensively interviewed and conducted hundreds of hours of participant observation. The family was the locus of authoritative knowledge in the community and they provided vital insights into community life and local understandings and approaches to reproductive health. This dissertation follows the Latin American tradition of using testimonios to articulate—and reflexively examine—the layered meanings and intersecting politics that shape changing childbirth practices in rural Yucatan.

Orientador: Priscila Gava Mazzola / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T11:39:26Z (GMT). No. of bitstreams: 1 Costa_LarissaSaitoda_M.pdf: 1703771 bytes, checksum: cad484500b66f36f1f44735876ed798f (MD5) Previous issue date: 2014 / Resumo: Durante tratamentos oncológicos, ginecológicos e obstétricos, a mulher pode desenvolver complicações que requerem a sua admissão em uma Unidade de Terapia Intensiva (UTI). Neste contexto, a atuação do farmacêutico clínico nas reuniões à beira leito da equipe intensivista e a realização de intervenções farmacêuticas contribui para a otimização da terapia medicamentosa, a redução de erros de prescrição e consequentemente, para a segurança da paciente. Este estudo objetivou avaliar o impacto que a incorporação da Farmácia Clínica à equipe multidisciplinar de uma UTI especializada em saúde da mulher pode gerar na terapia medicamentosa de sujeitos internados neste local. Foram realizadas intervenções farmacêuticas por meio da análise de prescrições e da discussão de casos clínicos durante as visitas à beira leito junto à equipe multidisciplinar. Estas intervenções, bem como os erros de prescrição identificados, foram documentados, quantificados e classificados. Foram acompanhados 222 sujeitos ao longo do estudo, com uma média de 5,89 ± 6,44 prescrições por sujeito. Foram identificados 101 erros de prescrição, dos quais 87 foram prevenidos. Os mais prevalentes foram dosagem maior que a correta (22[21,78%]), medicamento não seguro por presença de interação medicamentosa (IM) (20[19,80%]) e medicamento não seguro na lactação (15[14,85%]). Foram realizadas 127 intervenções, das quais 113 foram aceitas, 5 parcialmente aceitas e 9 não aceitas. As mais prevalentes foram ajuste de dose (30[23,62%]), interações medicamentosas (20[15,74%]) e informações sobre medicamentos (17[13,39%]). Pode-se concluir que a implementação da Farmácia Clínica contribuiu para a redução de riscos provenientes da terapia medicamentosa na área de terapia intensiva na saúde da mulher / Abstract: During gynecological, oncological and obstetrical treatments, a woman may develop complications requiring her admission to an Intensive Care Unit (ICU). In this context, the role of the clinical pharmacist in multidisciplinary meetings at bedside visits contributes to patient safety by performing pharmacy interventions. This study aimed to evaluate the impact that the incorporation of Clinical Pharmacy in the multidisciplinary team of a specialized ICU in women¿s health can generate in drug therapy of hospitalized subjects in that place. Pharmacy interventions were performed through the analysis of patient¿s prescriptions and clinical case discussions during bedside visits. These interventions and prescription errors found in prescriptions were documented, quantified and classified. We followed 222 subjetcs throughout the study, with an average of 5,89 ± 6,44 prescriptions.The most prevalent were dosage higher than the correct (22 [21.78%]), unsafe medicine for the presence of drug interaction (IM) (20 [19.80%]) and unsafe medication during lactation (15 [14 dosage 85%]). A total of 127 interventions were performed, of which 113 were accepted, 5 partially accepted and 9 not accepted. The most prevalent were dose adjustment (30 [23.62%]), drug interactions (20 [15.74%]) and drug information (17 [13.39%]). We can conclude that Clinical Pharmacy implementation contributed to reduce risks from drug therapy in intensive care in women¿s health area / Mestrado / Ciencias Biomedicas / Mestra em Ciências Médicas

Orientadores: Maria de Lurdes Zanolli, Roberto Teixeira Mendes / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T12:51:00Z (GMT). No. of bitstreams: 1 Queiroz_PatriciaHelenaBreno_D.pdf: 2651235 bytes, checksum: 6f5fb1ee7f755286f20c3b8766b25740 (MD5) Previous issue date: 2014 / Resumo: Este trabalho teve como objetivo geral compreender a influência das avós de bebês, filhos de mães adolescentes, no exercício e duração do aleitamento materno nos primeiros seis meses de vida; buscando entender na perspectiva das avós e das mães adolescentes o papel que as avós desempenham na gestação e maternidade adolescente e as concepções destas mulheres acerca do estabelecer e vivenciar a amamentação. A pesquisa seguiu um delineamento de caráter exploratório e natureza qualitativa. As adolescentes e as avós dos bebês foram convidadas a participar da pesquisa, a partir do último trimestre de gestação e conceder mais quatro entrevistas orientadas por roteiro semiestruturado, no puerpério imediato, aos 30, 120 e 180 dias após o nascimento, entre 14 de fevereiro de 2012 e 14 de maio de 2013. O material produzido após a leitura das transcrições das entrevistas foi agrupado em categorias e subcategorias e interpretado utilizando-se da Análise de Conteúdo Temático. Participaram do estudo 25 duplas de adolescentes e suas mães ou sogras. Quando perguntadas durante o pré-natal se sabiam o que era aleitamento materno (AM), 05 adolescentes reconheceram o conceito e 13 só o fizeram após uma explicação. Durante a visita no pós-parto imediato, 22 "recém-mães" informaram que não foram orientadas sobre AM durante o pré-natal, mas todas indicaram a equipe de enfermagem do Alojamento Conjunto do hospital, como responsável pelas orientações sobre amamentação. Na visita de 30 dias, 15 jovens referiram terem frequentado o ambulatório de AM no puerpério mediato, o que foi considerado importante para adequar a técnica de amamentação; duas relataram não terem continuado a amamentação de seus bebês quando em suas casas; quatro não completaram 30 dias de AM e substituíram por fórmulas introduzidas sob a recomendação de profissionais de saúde (farmacêutico, enfermeiro, pediatra). Dez de 19 de adolescentes que mantiveram o AM até o quarto mês foram orientadas pelo pediatra para a introdução de alimentos complementares. Somente nove bebês foram amamentados exclusivamente por seis meses. As mães e sogras atuam na retaguarda porque precisam retornar às suas atividades cotidianas e as adolescentes assumem o cuidado do bebê e muitas vezes, o trabalho doméstico. Neste contexto, os papéis de mãe e avó são definidos e a avós respeitam as escolhas de suas filhas. Intervenções dirigidas tanto para as adolescentes quanto para as avós, durante o período perinatal podem ter um efeito prolongador na amamentação, principalmente em famílias de mulheres-avós trabalhadoras que vão além do papel de "mãe de família" e contribuem para a subsistência desta / Abstract: This study aimed to understand the influence of grandparents of babies, children of adolescent mothers, exercise and duration of breastfeeding in the first six months of life; seeking to understand the perspective of grandparents and teenage mothers the role that grandparents play in pregnancy and teen motherhood and the conceptions of these women about the experience and establish breastfeeding. The research followed an exploration of character design and qualitative nature. The teenagers and grandmothers invited to participate in the study, from the last trimester of pregnancy and give four interviews guided by semi-structured, postpartum, 30, 120 and 180 days after birth, between February 14 2012 and May 14, 2013. The research design followed an exploratory and qualitative nature. The teenagers and grandmothers invited to participate in the research, from the last trimester of pregnancy and grant four semi-structured interviews guided by, postpartum, 30, 120 and 180 days after birth, between February 14 2012 and May 14, 2013. The material produced after reading the transcripts of the interviews, clustered into categories and subcategories and interpreted using the Thematic Content Analysis. The study included 25 pairs of adolescents and their mothers or mothers in law. When asked during the prenatal whether they knew what breastfeeding (BF) was, 05 adolescents recognized the concept and only 13 did so after an explanation. During the visit in the immediate postpartum period, 22 "new mothers" reported that were not oriented on BF during the prenatal, but all indicated the nursing staff of the hospital rooming, as responsible for the hospital on the guidelines breastfeeding. In 30-day visit, 15 young people reported having attended the outpatient clinic mediate the puerperium, which was considered important to adequate breastfeeding technique; two reported not have continued breastfeeding their babies while in their homes; four did not complete 30 days of BF and replaced by formulas introduced on the recommendation of health professionals (pharmacist, nurse, pediatrician). Of the19 adolescent, 10 maintained their AM until the fourth month, told by the pediatrician for the introduction of complementary foods. Only nine babies were exclusively breastfed for six months. Mothers and mothers in law act in rearward backwards because they need to return to their daily activities and teenagers take care of the baby and often the housework. The roles of mother and grandmother defined and grandparents respected the choices of their daughters. Interventions aimed both to teens and to grandparents during the perinatal period can have an effect on prolonging breastfeeding, especially in families of working women-grandmothers who go beyond the role of "mother of the family" and contribute to the subsistence of this / Doutorado / Saude da Criança e do Adolescente / Doutora em Ciências

Urinary incontinence is a health condition that is associated with involuntary leakage of urine. Stress urinary incontinence (SUI) describes involuntary leakage of urine on effort or exertion and can impact one’s ability to participate in activities and affect quality of life. Furthermore, clinical management of this health condition is challenging as individuals who experience urinary incontinence often do not report this concern to a health care provider. Stress urinary incontinence is not typically a health concern associated with young, healthy athletes. However, researchers have begun to examine the presence of this health condition amongst both a younger population and in athletes. Therefore, the purpose of this study is to assess the prevalence of stress urinary incontinence in collegiate female athletes. This study involved the development of an electronic survey tool to assess the prevalence of SUI in the female collegiate athlete. Female collegiate athletes from six different NCAA Division I schools were asked to complete the survey. The overall response rate for the survey was 32.6% (333/1020). Results indicate that SUI does in fact occur in NCAA Division I collegiate female athletes. Overall, 68.5% of female collegiate athletes surveyed reported ever experiencing SUI. During daily life activities (cough, sneeze, laugh), 54.2% of female collegiate athletes reported experiencing SUI. During participation in their sport, 40.0% of female collegiate athletes reported experiencing SUI, referred to as sports-related SUI. When reporting SUI experienced during either sport participation or during other exercise-based activities, 58.2% of female collegiate athletes reported SUI. The proportion of female athletes reporting sports-related SUI varied by sport. The highest prevalence of leakage in sport was reported by gymnasts (80%) and the lowest prevalence was reported by those who participated in rifle (0%). Over half (52.3%) of female athletes who reported sports-related SUI said their symptoms first began in high school. While majority of female collegiate athletes stated they did not avoid their sport because of SUI, one-fifth (20.5%) of athletes with sports-related SUI reported they alter how they move in their sport out of concern for leakage. The impact of sports-related SUI on other aspects of life (family, social, or school life) were reported to be minimal. Athletes who experience sports-related SUI are most likely to tell either a teammate (49%) or no one (36%). Very few female athletes have told someone in healthcare about this concern: doctor (3%), athletic trainer (4%); physical therapist (1%). Furthermore, only 3% of female collegiate athlete with sports-related SUI reported ever seeking treatment and only 25.8% reported they would find value in seeing a healthcare provider to discuss SUI. Most (76.7%) female collegiate athletes, whether they reported SUI or not, stated they had never been instructed on exercises to strengthen the pelvic floor muscles and 60.6% reported they would find educational programs involving exercises to decrease or prevent SUI beneficial. In conclusion, SUI does occur in the female collegiate athlete and is often not reported to healthcare providers. Based on this information, the general practice of screening athletes for relevant health conditions during pre-participation physicals may need to include additional questions for SUI. Further investigation needs to explore how to best engage and educate female collegiate athletes on the subject of SUI and how to successfully communicate with and address those with the condition.

Prior research has pointed to an association between a history of traumatic events and premenstrual syndrome (PMS) in women. The objective of this study was to further investigate the relationship between trauma and PMS among female veterans, a population with high rates of sexual and physical abuse, as well as combat-related exposures. We conducted a case-control study of 502 women veterans under the age of 52 who were associated with the Iowa City Veterans Affairs Medical Center. Trauma history, gynecological health, mental health (including posttraumatic stress disorder), and other variables were obtained through telephone interview. Cases were women who had moderate to severe PMS as defined by validated criteria and controls were women without PMS. The prevalence of PMS was 14.3%. Thirty-three percent of subjects reported a completed sexual assault, 29% a combat-related trauma, and 86% a non-combat related trauma. Factors significantly associated with PMS (p<0.05) in the univariate analysis were: attempted, completed, and number of rapes during a woman's lifetime; rape before age 18; rape during military service; childhood sexual abuse; and number of non-combat related traumas. Childhood physical abuse and combat-related trauma were not associated with PMS in univariate analyses. In our final multivariate model, lifetime completed sexual assault was associated with PMS (odds ratio =2.42, 95% confidence interval = 1.33-4.40). Findings from this study among female veterans indicate that a history of trauma, particularly sexual trauma, is associated with moderate to severe PMS. Further study is warranted to confirm temporal relationships and causal mechanisms.

Dual method use, or the concurrent use of one contraceptive method to prevent pregnancy and another to reduce the risk of sexually transmitted infections (STIs), is an ideal practice for young women but is underutilized. In a recent National Survey of Family Growth (NSFG) study, 7.4% of women of reproductive age reported dual method use at last intercourse. In the same NSFG study, dual method use at last intercourse among women 15-20 years old was somewhat higher at 22.8%; still, this estimate indicates low utilization when compared to recent trends in the prevalence of single-contraceptive method use by young women. Apart from the NSFG and some smaller scale studies, there have been minimal efforts to explore dual method use in high-risk populations of young women such as college students. This is surprising, given that college students typically have more opportunities to be sexually active than other groups and often engage in serial monogamy or have multiple sexual partners during their college years. This study aimed to add to previous research on women’s health and contraception by assessing college women’s contraceptive use, including dual method use, and examining factors that influence contraceptive decision-making. Female students at ETSU were surveyed through the Department of Psychology research participation system from Oct 2017-Dec 2017. Students received class credit for survey completion. Data were analyzed using descriptive statistics in SPSS (Version 24.0). To be consistent with previous studies on health behaviors of college-aged women, the final dataset included only female college students between ages 18 and 25 (n=379). About one-fifth (21.1%) of women reported current dual method use. Of particular interest, only 30.5% of women who indicated sexual activity in the past six months also reported dual method use. Nevertheless, most women reported positive feelings about dual method use and indicated they would not find it hard to achieve dual method use; 69.1% reported feeling great or good about dual method use, and 74.5% indicated that it would not be hard to use condoms plus another form of birth control together correctly. Future efforts to study dual method use in college women should include close examination of subgroups who have yet to commit to dual method use but have positive attitudes and intentions regarding dual method use. Results of this study also indicate a need to implement educational and promotional strategies in college environments to better inform college-aged women about dual method use and its benefits.

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. It is characterized by oligomenorrhea/menstrual irregularity, androgen excess, and polycystic ovary morphology. Currently there are three distinct diagnostic criteria used to ascertain PCOS in the population: The National Institutes of Health (NIH) criteria created in 1990 and later reviewed in 2012, the Rotterdam criteria established in 2003, and the most recent criteria by the Androgen Excess & PCOS Society (AE-PCOS) criteria developed in 2006. Some prevalence studies suggest that PCOS affects 6.5-8% of the population while others state 10-20% qualify for a PCOS diagnosis. Recent literature shows patients with PCOS have a 43% prevalence rate or 2-fold higher rate than the age-adjusted sample of all ages in the general US population of developing Metabolic Syndrome (Met-S ) (Apridonidze et al. 2005; Essah, Wickham, and Nestler 2007). This is important because it can alert physicians to refer their PCOS patients to a nutritionist or endocrinologist as a preventive measurement. OBJECTIVES: This thesis based on The Ovulation and Menstruation Health (OM) Pilot Study, sets out to accomplish the following: ascertain the prevalence of PCOS in different racial/ethnic groups, determine Body-Mass Index (BMI) distribution patterns in PCOS participants based on how they were diagnosed (by a physician/self-diagnosed), and most importantly to determine the prevalence of Met-S risk factors in PCOS vs. Non-PCOS groups. METHODS: The (OM) Pilot Study is an online survey with clinical, community, and online recruitment. After a consent and screening process, the survey asks questions related to demographics, anthropometrics, menstrual cycles, contraceptive history, medications and supplement use, PCOS, reproductive health, general health, diet and lifestyle and lastly, pregnancy and birth history. The questions in this online survey, were designed for an 8th-grade reading level to improve comprehension by a diverse cohort of women. This was done to help address the lack of diversity and PCOS ascertainment in pre-existing cohorts. RESULTS: Following recruitment for The OM Pilot Study, 388 participants completed the consent form and 4 declined consent. 384 completed screener and 34 were deemed not eligible because: 18 were no longer menstruating and 16 were unable/unwilling to provide an email address to the receive survey; thus 350 were eligible. Of those 350 participants that were deemed eligible, only 283 started survey. 283 individuals determined to be eligible based on their gender, capacity to menstruate, and age started the survey. Age eligibility was ≥18 years old. 249 completed the survey through its last section (XIII. Pregnancy & Birth History). Of the 283 participants who enrolled and were eligible to partake in the study, 177 (64.1%) identified as White, 22 (7.97%) as Hispanic/Latina/Spanish Origin, 34 (12.3%) as Black/African American, 4 (1.4%) as East Asian, 5 (1.8%) as Southeast Asian, 7 (2.5%) as South Asian, 27 (9.8%) selected more than 1 race/ethnicity, and 7 (2.5%) chose not to answer (Table 5). Participants from the PCOS group had higher prevalence for all the risk factors for Met-S when compared to Non-PCOS group: abdominal fat determined as those who tend to gain weight around stomach/waist (73% versus 60%), abdominal fat ascertained by body figure (33% versus 17%), hypertension (6.9% versus 3.1%), high cholesterol (20.7% versus 8.8%), diabetes (5.3% versus 1.0%), non-alcoholic fatty liver disease (NAFLD) (5.2% versus 0.5%), and lastly sleep apnea (SA) (5.2% versus 2.1%). More noticeably is the absolute difference in prevalence in abdominal fat as determined by the body figure image in which the PCOS group (33%) had a 16% higher prevalence than the Non-PCOS group (17%). Participants that reported having PCOS diagnosed by a physician (37) had a higher prevalence of overweight/obese women (73%) than those that self-diagnosed (23) with PCOS (56.5%). CONCLUSIONS: The OM Pilot Study has demonstrated that it is possible to launch and recruit a diverse sample group representative of the actual population. With this new tool, future studies can better assess risk factors associated with Met-S in PCOS patients taking into consideration their racial/ethnic background.

Worldwide, between 5 and 18% of postmenopausal women experience depression. While the associations of estrogens with depression have been researched extensively, relations with other postmenopausal hormones remain unclear. We evaluated the association of follicle stimulating hormone (FSH) levels with prevalent depression the Kuopio Ischaemic Heart Disease Risk Factor Study (n = 588). Study participants were postmenopausal women aged 53 to 73 years and not using hormone therapy at enrollment (1998-2001). FSH was measured by radioimmuno-assays. Depression symptoms were measured using a scale based on DSM-III criteria (score range = 0-12), with a score ≥5 indicative of probable depression. We assessed the relation of FSH levels with depression in multivariable linear and logistic models adjusting for age, body mass index, estradiol, antidepressant use, and other factors, and evaluated effect modification by age. In adjusted analyses of all participants, higher FSH levels were associated with lower prevalence of depression (OR comparing ≥50 vs/L = 0.50, P = 0.02). Each 10-unit increase in FSH was associated with a 17% lower prevalence of depression (95% CI 0.70-0.99). Regression coefficients for Quartiles (Q) 2-4 vs. Q1 of FSH were 0.208, -0.170, -0.472, respectively (P = 0.14). Associations were mainly observed in older women (OR 0.47, P = 0.05; ages 64-73 years). Higher FSH levels in older postmenopausal women were associated with lower prevalence of depression and depressive symptoms, independent of estradiol, adiposity measures, and other factors. Further research is warranted to evaluate mechanisms underlying these associations, including effects of FSH on immune function.

Bakgrund: Endometrios är en sjukdom som drabbar 10% av alla kvinnor i världen. Endometrios har komplexa symtom och det finns fortfarande stora kunskapsluckor om sjukdomen. Syfte: Att beskriva kvinnors upplevelser av att ha sjukdomen endometrios. Metod: Studien genomfördes som en litteraturstudie med induktiv ansats, och 11 resultatartiklar inkluderades och bearbetades. Resultatartiklarna bearbetades genom att resultaten granskades, sammanställdes och kategorier skapades. Resultat: I resultatet framgick att kvinnor med endometrios upplevde många olika symtom som gav inverkan på flera aspekter av deras liv. Kvinnor upplevde att diagnosen försenades då de inte blev betrodda av hälso- och sjukvården eller av vänner och familj som kunde normalisera deras symtom. Resultatet delades in i fem huvudkategorier: Upplevelser av fysiska, psykiska och emotionella symtom, Upplevelser av mötet med hälso- och sjukvården, Upplevelser av behandlingsformer, Upplevelser av intima relationer och sexualitet och Upplevelser av att inte bli tagen på allvar. Konklusion: Endometrios kan påverka flera dimensioner av kvinnans hälsa och liv. Det är av vikt att sjukvården tillgodoser kvinnans fysiska och psykiska välbefinnande. En ökad medvetenhet om hur sjukdomen påverkar kvinnan och hennes livssituation är väsentligt i ett omvårdnadsperspektiv. / Background: Endometriosis is a disease that affects 10% of all women in the world. Endometriosis generates complex symptoms and there are still substantial knowledge gaps about this disease. Objective: To describe women’s experiences of having the disease endometriosis. Method: The study was conducted as a literature study with an inductive approach, where 11 result articles were used and processed. The articles were processed by reviewing and compiling the results and thereafter categories were created. Results: In the result it appeared that women with endometriosis experienced multiple different symptoms that had impact on numerous aspects of their life. Women experienced a delay in diagnosis due to not being believed by healthcare professionals and family and friends who could normalize their symptoms. The analysis resulted in five main categories: Experiences of physical, psychological and emotional symptoms, Experiences of encounters with healthcare, Experiences of treatment, Experiences of intimate relationships and sexuality and Experiences of not being taken seriously. Conclusion: Endometriosis can impact multiple different aspects of women’s lives. It is of importance that healthcare meets the needs of the women’s psychological and physical well-being. An increased awareness of how the disease affects the woman and her life situation is essential from a nursing perspective.