The athlete’s energy needs vary widely depending on whether she’s competing, but generally, Serena Williams sticks to eating later in the day. Her favorite foods to munch on for lunch are usually high in protein with plenty of greens (via Women’s Health). And what about dinner? Although she doesn’t regularly spend hours in the kitchen because she just lacks the time, Williams told Women’s Health that she greatly enjoys cooking. She also revealed, “I get inspired by what I see on Instagram,” including trends like rainbow cake and chia seed pudding. She approves of Taco Tuesdays, too.

Would Williams, a four-time Olympic gold medalist (via Team USA), make a special exception to her often breakfast-free routine to eat with another Olympic medallist? Indian badminton player PV Sindhu told the Mid-Day newspaper that she would like to have breakfast with Serena Williams if she could choose to dine with any famous stranger. She considers Williams “jovial and friendly” and thinks it would be pleasant to be around in the morning.

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Dear Readers,

Most of you have probably heard of antioxidants. They’re good for you, right? But what are they, exactly? “Antioxidant” is a chemistry term that simply means preventing oxidation, which is the transfer of tiny, electrically charged particles known as electrons.

Antioxidants protect us from free radicals, which damage our cells and may lead to cancer, heart disease, and Alzheimer’s. Free radicals are unstable molecules that wish to become stable. In doing so, they rob another cell of an electron needed for stability. The cell that has been robbed is now susceptible to damage. Free radicals result from food digestion, everyday cellular activity, and outside sources like smoking and air pollution.

Studies on the role of antioxidants and disease prevention have produced mixed results. In the Women’s Health Study, over 39,000 women took 600 IU of vitamin E or placebo every other day for ten years. At the end of the study, the rates of stroke, heart attack, and cancer were not lower among those taking vitamin E. However, there was a significant twenty-four percent reduction in death from stroke and heart attack (1).

There was another large study of beta-carotene supplementation in men who were heavy smokers. The study was aborted because there was a significant increase in lung cancer among those taking the supplement than those given the placebo (2).

Antioxidants in their natural food state may have health benefits that are not found when taking them in supplement form. A possible explanation of this is the x-factor. When consuming foods that contain antioxidants, one also gets fiber and other nutrients in that food that cannot be found in a supplement. The x-factor could be a combination of nutrients that have a health benefit or even be a factor that has not yet been identified. Remember, the science of nutrition is still in its infancy, and there is still much to be revealed.

Listed below are particular antioxidants and their food sources:

• Vitamin C — oranges, grapefruit, lemons, cantaloupe, kohlrabi, broccoli

• Vitamin E- nuts & seeds

• Beta-carotene-carrots, sweet potatoes, spinach, broccoli, winter squash, cantaloupe

• Polyphenols — red grapes, red wine, coffee, chocolate, legumes

• Lutein-spinach, kale, egg yolk

• Selenium- beef, pork, turkey, fish, chicken, shellfish, nuts, seeds, soy products

• Manganese-pineapple, nuts, beans, spinach

Remember, a diet rich in fruits and vegetables, whole grains, legumes, nuts, seeds, and lean proteins, along with a healthy body weight, is the best bet for keeping us healthy.

Until next time, be healthy!

——

Leanne McCrate, RD, LD, CNSC,

aka Dear Dietitian, is an award-winning dietitian based in Missouri.

Today’s breaking news and more in your inbox

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RAMANATHAPURAM

For Kalaiselvi, a health volunteer from Mandapam block in Ramanathapuram district, the day starts as early as 6 a.m. nowadays. She goes from door to door in the assigned areas in her ward on her two-wheeler with a list of patients, who were treated for various non-communicable diseases in government hospitals.

With the launch of the ‘Makkalai Thedi Maruthuvam,’ (an initiative of the State government to reach out to the poor people), the district administration has 112 trained women health volunteers to take care of the patients in four blocks including Mandapam.

One among them is Kalaiselvi. She says that she underwent training on how to check blood pressure, blood sugar level of patients. ‘It has really been a satisfying experience for me as I feel happy when the patients show progress,’ she explained.

Collector J U Chandrakala said on Sunday that the Health Department officials had imparted training to over 100 women health volunteers on the basics of screening patients, checking their BP level while visiting their houses. The routine check-up helped in understanding the health condition and depending on the need basic drugs are given.

The volunteers are the fulcrum of the entire programme as they play the catalyst role between doctors and patients. The tests taken by the volunteers are reviewed periodically by doctors. According to the reports submitted, the patients health card would be gauged by the doctors at the GH or at the PHCs, Ms Chandrakala said.

Like Kalaiselvi, a SHG member, through the Mahalir Thittam, they were chosen for door-to-door checks of patients requiring medical intervention or screening. After training them, they have been handling the patients and giving them the required drugs.

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Women’s health: Tubal pregnancy its symptoms

The most commonly sites of ectopic pregnancy are fallopian tubes. It can also occur in cervix, cornu of uterus or at the scar site.

Posted on Aug 29, 2021 | Author NA

The most commonly sites of ectopic pregnancy are fallopian tubes. It can also occur in cervix, cornu of uterus or at the scar site.

Tubal pregnancy is the most common among ectopic pregnancy

If not diagnosed timely it can lead to a dangerous condition like tubal abortion or tubal rupture wherein there will be massive bleeding in the abdominal cavity (haemoperitoneum) which can even lead to shock.

So, its important to seek emergency medical help if you have any signs or symptoms of an ectopic pregnancy including severe abdominal or pelvic pain accompanied by vaginal bleeding, extreme lightheadedness or fainting and shoulder pain after your missed periods. It can be diagnosed by Ultrasound and Beta HCG levels.

Dr Rizwana Habib

Professor Gyne and Obstetrics and

Head of the Unit at LD Hospital Srinagar

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Little Brian Eliot Tracy was born last week at 34 weeks gestation. Natasha Tracy, his mother, suffered from preeclampsia and hemorrhaging, which doctors believe may have been brought from her having COVID-19 at 16 weeks. (Natasha Tracy)

SANDY — Data shows COVID-19 can cause devastating complications for both pregnant women and their babies. But many are putting off the vaccination for fear it will prevent them from getting pregnant in the first place.

Medical experts say there is no evidence that the COVID-19 vaccine causes infertility and explain why misinformation online is false.

Natasha Tracy is now a mom to four kids. “Well, it’s been eight days now since we had our baby!” she said.

Little Brian was born at 34 weeks and just came home from the newborn intensive care unit on Wednesday. At 16 weeks pregnant, Tracy was hesitant to get the COVID-19 vaccine.

“There’s just so much information and misinformation … I just wasn’t confident because a lot of the people on social media that I interacted with weren’t confident, so it was difficult to overcome that,” she said. “I wanted to talk to my doctor and I literally got it — COVID — five days before my scheduled appointment.”

She says it was an awful experience. “I was sick in bed for three weeks, like, I literally cannot get out of bed and I was short of breath and I was miserable,” Tracy said.

Doctors fear her COVID-19 infection could have led to her preterm labor. She also suffered severe preeclampsia, heart palpitations and hemorrhaging post-delivery — all symptoms she hadn’t experienced during her first three pregnancies.

“It was really surprising to all my doctors and nurses that I had it and that was so severe,” she said.

“If you get COVID, your risk of having a preterm birth is higher,” said Dr. Sean Esplin, maternal fetal medicine physician and senior medical director for women’s health at Intermountain Healthcare.

We have enough data now to say this is safe during pregnancy, (it) doesn’t cause problems during pregnancy, that it doesn’t cause infertility.

–Dr. Sean Esplin

Esplin said pregnancy is already an often anxiety-inducing time for women. He understands why it might be a difficult decision. “I think it’s normal and OK for people to be a little bit worried about it … they want to do what’s right for their baby, right? And so I understand that,” he said. “Being pregnant during the pandemic just amplifies that.”

However, he reassures people that not only is the vaccine safe during pregnancy and can prevent complications, it will not prevent someone from getting pregnant in the first place.

“The American Society of Reproductive Medicine has made a very definitive statement saying there is no evidence that this causes problems with infertility,” he said.

He said 22 organizations, including the American College of Obstetrics and Gynecology, the Society for Maternal-Fetal Medicine, and the Centers for Disease Control and Prevention recently came together recommending both women who are either trying to conceive or who already are pregnant get vaccinated.

“Their whole job is to monitor and to look at the risks and benefits and to take the data and actually synthesize it to make a recommendation about what the right thing to do is,” he said. “We have enough data now to say this is safe during pregnancy, (it) doesn’t cause problems during pregnancy, that it doesn’t cause infertility.”

Misinformation circulating online erroneously suggests the vaccine could cause infertility by mistakenly attacking syncytin-1, a protein in the placenta that helps the placenta attach to the wall of the uterus. “That statement was made without any real evidence and as people have gone and looked at these two proteins, there’s really not a lot of similarity between them,” he explained. “There’s absolutely no reason to think that antibodies to the spike protein would actually affect syncytin-1.”

Esplin cited a recent study from ScienceDirect of women undergoing IVF who either had the vaccine, had a natural COVID-19 infection or had no antibodies at all. “They went ahead and did the embryo transfers to see if the rate of implantation and pregnancy success was the same. It was exactly the same in all three groups,” Esplin said.

While Esplin acknowledged there isn’t as much data in children, Esplin said it’s safe. “There is no documented risk of infertility in younger people either,” he said, adding that hospitals are seeing more and more sick children. He said the American Academy of Pediatrics is also recommending that children and teenagers who are eligible should get vaccinated.

Tracy got vaccinated about three months after she recovered from COVID-19 in July. “I could have prevented it, and that’s the sad part,” she said.

Don’t be afraid of the vaccine. It’s so much more mild than getting COVID.

–Natasha Tracy

If she could turn back the clock she would. “I wish I would have jumped on that vaccine when I first had the chance because I really do think that things would have been different,” she said.

Tracy urged other women to take the vaccine. “Don’t be afraid of the vaccine. It’s so much more mild than getting COVID,” she continued.

“If you want to do what’s best for your baby, get vaccinated,” Esplin added.

He said with the recent surge in cases due to the delta variant, hospitals are seeing more severe cases of COVID-19 among pregnant women. “The baby relies completely, obviously, on the mother’s ability to get oxygen and when that’s compromised, it can cause big problems for the baby,” he said.

“We don’t have people who deliver early because of the vaccine. We don’t have people who are in the ICU because of the vaccine,” Esplin added. “It’s the disease itself that’s causing those increased risks, and your best way to avoid that is to get vaccinated.”

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Abdullah M Al-Shahrani,1 Elhadi Miskeen,2 Farah Shroff,3 Suaad Elnour,2 Rawan Algahtani,4 Ilham Youssry,5 Samar Ahmed6

1Department of Family Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia; 2Department of Obstetrics and Gynaecology, College of Medicine, University of Bisha, Bisha, Saudi Arabia; 3Department of Family Practice, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; 4College of Medicine, University of Bisha, Bisha, Saudi Arabia; 5Department of Pediatrics, Cairo University, Cairo, Egypt; 6Forensic medicine and clinical toxicology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence: Abdullah M Al-Shahrani
Department of Family Medicine, College of Medicine, University of Bisha, P.O. Box 1290, Bisha, 61922, Saudi Arabia
Tel +966504639678
Email [email protected]

Objective: The severity and chronicity of PMS can lead to the impairment of studies, and it can also affect relationships, activities, quality of life (QoL), and academic performance. This study aimed to determine PMS frequency and its associated factors in order to assess the quality of life (QoL) among female medical students at Bisha University, Saudi Arabia.
Methods: This study was cross-sectional and included 388 female medical students in the Faculty of Medical Applied Sciences and the Faculty of Medicine at Bisha University. The participants all filled in a self-administered questionnaire. The Premenstrual Syndrome Scale (PSS) was used based on the diagnostic and statistical criteria for PMS assessment. PMS was diagnosed after the presence of five or more severe premenstrual symptoms had been resolved following menstruation (adapted from American Psychiatric Association).
Data Analysis: The data obtained were analyzed using SPSS 25.0. A chi-square test was used to test the associations between the study variables. A logistic regression analysis technique was used to select the group of variables. Participants were asked to provide consent to participate in the study. IRB was obtained from the University of Bisha, College of Medicine.
Results: The participants were aged 19.5 ± 4.9 years, and the prevalence of PMS was 64.9%. Most of the female students were of extroverted personality types (35%). In addition, 13.4% were obese or overweight, and 19.5% of the 50% with PMS exercised regularly (p p Conclusion: PMS significantly influenced daily activities related to quality of life and homework. Moreover, almost half of the female students experienced the effects of menstruation in their learning environment. Therefore, among female students, the modification of risk factors should be considered a critical intervention point.

Keywords: PMS, medical students, quality of life, University of Bisha, Saudi Arabia

Introduction

Premenstrual syndrome (PMS) is a common gynecological disorder that usually presents with physical and behavioral symptoms that appear a few days before menstruation and disappear after menstruation.1 Considerable morbidities associated with PMS have been reported to affect women’s daily life and quality of life, and this is particularly true for female students.2,3

Students usually neglect the symptoms of PMS; therefore, PMS affects their quality of life (QoL) more than estimated and described. Healthcare providers should be aware of PMS during routine checkups.4 Women’s negative attitudes toward menstruation include irritability, anxiety, fatigue, and dysmenorrhea.5

Menstrual-related depression has been reported as a significant morbidity among female university students.6–8 Approximately 37.2% of female university students are at high or very high risk of a mental disorder.8 According to the World Health Organization, 20–31% of university female students worldwide have at least one mental disorder associated with menstrual issues.9,10

PMS is associated with a lower positive academic affect and lower frontal rest asymmetry scores,11 which are themselves related to reward processing dysfunction, lower productivity, and an interference with studies.12–14 However, the latter point has been less frequently studied, specifically among Saudi female university students. This study aimed to determine PMS frequency and its associated factors in order to assess quality of life (QoL) among female medical students at Bisha University, Bisha, Saudi Arabia.

Methodology

• Design: This study was cross-sectional and examined PMS among female medical students in the Faculty of Medical Applied Sciences and the Faculty of Medicine at Bisha University.
• Setting: The University of Bisha is a newly established university that was created to serve the local population in the town of Bisha and its surrounding villages and small towns. There are three medical colleges for women and more than 850 students in the different programs.
• Study sampling and data collection: After providing informed consent, 388 female students participated in this study; their ages ranged from 18 to 25 years (mean of 19.5 ± 4.9 years).

The Raosoft program was used for sample size estimation. A questionnaire designed for a previous study15 was used for data collection. The questionnaire included questions related to sociodemographic characteristics and personality types, as well as menstruation-related characteristics, use of medications, and the presence of PMS in family history. We also recorded some habits and medical characteristics (cigarette smoking, tea, coffee, drinks, sweets, cola, special food, obesity, and exercise). The recall bias was avoided by carefully selecting research questions, data collection method, and a prospective study design.

For evaluation, we used the Premenstrual Syndrome Scale (PSS) and the health-related quality of life (QoL) questionnaire. The Premenstrual Syndrome Scale (PSS) was used for the evaluation and diagnosis of PMS.16 The diagnosis of PMS was based on the presence of five or more severe premenstrual symptoms that resolved following menstruation (adapted from the American Psychiatric Association).17

The health-related quality-of-life subscales in this study included: general well-being, interface with homework, satisfaction with research and career, control over studying, and stress from university study conditions. We examined the relationship between quality of life and the impact of menstruation on the study environment.

The data obtained were analyzed using SPSS 25.0. A chi-square test was used to test the associations between the study variables. In terms of ethical clearance, each participant enrolled in the study after providing informed consent. IRB was obtained from the University of Bisha, College of Medicine, ref no. UBCOM/H-06-BH087 (06/25).

Results

The prevalence of PMS among the studied population was 252/388 (64.9%). The factors that statistically significantly affected PMS were urban residency and being a non-smoker (p < 0.05). The details related to all significant and non-significant factors for all variables are available in Table 1.

Table 1 Sociodemographic Characteristics. Evaluation of PMS and QoL Among Students of Medical Applied Sciences and Medicine at Bisha University, Saudi Arabia (n = 388)

Age at menarche ranged from 11 to 17 years, with a mean of 13.42 ± 1.25 years. The length of menstrual cycle ranged from 19 to 80 days, with a mean of 28.51 ± 4.83 days, while the duration of menstrual flow ranged from 2 to 11 days, with a mean of 6.12 ± 1.35 days. Dysmenorrhea was found in 53.6% of the female students. Of them, 39.2% had a family history of PMS (Table 2). The menstrual characteristics studied showed a statistically insignificant difference between the women with PMS and those without PMS (p > 0.05 for all variables; Table 2).

Table 2 Menstrual Characteristics. Evaluation of PMS and QoL Among Students of Medical Applied Sciences and Medicine at Bisha University, Saudi Arabia (n = 388)

The symptoms reported to be statistically significantly associated with PMS were depressive affect and anxiety, fatigue and irritability, and bloating and painful or tender breasts (p = 0.007, 0.002, and 0.005, respectively). Other symptoms were also commonly reported, although the association with PMS was not statistically significant (Table 3).

Table 3 Symptoms Related to PMS. Evaluation of PMS and QoL Among Students of Medical Applied Sciences and Medicine at Bisha University, Saudi Arabia (n = 388)

Menstruation significantly affected the related quality of life subscales concerning the homework interface (p < 0.05). However, the most common effect of menstruation on the learning environment was stress in relation to reading (42.3%). Naturally, there were also superordinate effects of menstruation (Table 4 and Figure 1).

Table 4 Study-Related Quality of Life Subscales. Evaluation of PMS and QoL Among Students of Medical Applied Sciences and Medicine at Bisha University, Saudi Arabia (n = 388)

Figure 1 Learning-related QoL subscales by percentage among the study population. Evaluation of PMS and QoL among students of medical applied sciences and medicine at Bisha University, Saudi Arabia (n = 388).

Discussion

PMS disorder affects university women and influences their quality of life (QoL), academic performance, and social engagement. Therefore, studying this disorder among female students at Bisha University could help solve many of their educational and social problems related to academic performance.

With limited available data, this study addressed health determinants that influence academic performance and quality of life while studying. PMS among university students at Bisha Medical was found to be high (64.9%); however, prevalence was relatively low compared to 88.0% among Turkish university students.18 The prevalence of PMS among female medical students at Bisha University is higher than that reported in Taiwan (39.5%),19 Thailand (28–51%),20 and Egypt (34%).21 However, the most commonly reported prevalence ranged from 20% to 30%.9,10 At Bisha University, PMS prevalence was lower than at King Saud University (80.1%)22 and King-Khalid and King Saud Universities (67.4%),3 and higher than at King Abdulaziz University, Jeddah (60.9%).23 Moreover, in Saudi universities, more than 98% of PMS sufferers practiced self-medication.24 Although it is difficult to explain differences in PMS prevalence, they might possibly be due to the different social and ethnic backgrounds of the participants and our own sample limitations. Furthermore, there is no consensus in the research literature regarding how many symptoms must be present to warrant a PMS diagnosis.

This study found that PMS in these groups was associated with depressive affect, anxiety, fatigue, irritability, bloating, and painful or tender breasts. These factors were most likely related to the diagnosis of PMS and were recognized as alarming. Although these findings are inconsistent with those in international literature studies,20,25,26 we suggest that the similarities may be due to the participants belonging to the same age group and being university students. The presence of alarming symptoms helps in planning educational sessions to prevent further consequences that might distress PMS.

This study showed that menstruation significantly affected academic performance and related quality of life (p < 0.05). Almost all participants were affected at different levels. The students experienced severe symptoms that affected their daily activities and negatively impacted their academic performance. Studies have reported that the severity of PMS prevents normal activities and significantly affects quality of life and academic performance.25,27 However, the prevalence of PMS is difficult to determine in Bisha, because most students are from nearby villages and have varied access to healthcare. Therefore, it is important to design a project-based intervention that supports female students. In so doing, the university’s administrative staff could consider the unique situation of female students and could help them academically and psychologically. However, the study is limited to the current research because of medical students. Therefore, without further evidence, the results or conclusions may not be representative of a larger population.

Conclusions

PMS was shown to significantly affect study-related quality of life and the homework interface. In addition, almost half of the female students experienced the effects of menstruation in their learning environment. Therefore, for female students, modification of risk factors is an important intervention point.

Recommendations

The recommendations provided lead to the design of a project-based intervention to support female students. The University of Bisha could use a dedicated multidisciplinary support team, including nurses, gynecological staff, and psychiatric clinicians. Female students should also consider risk factor modifications. The university’s administrative staff should also consider the particular situation of female students and should provide academic and psychological support for their specific needs.

Abbreviations

QoL, quality of life; PSS, Premenstrual Syndrome Scale; PMS, premenstrual syndrome.

Ethics Approval and Consent

This study was conducted in accordance with the Declaration of Helsinki. Institutional Review Board was obtained from the University of Bisha, College of Medicine, ref no. UBCOM/H-06-BH087 (06/25). Each participant enrolled in the study after providing informed consent.

Acknowledgments

The authors extend their appreciation to the Deanship of Scientific Research at the University of Bisha Saudi Arabia for funding this work under grant number 54.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Funding

This research was funded by the Deanship of Scientific Research at the University of Bisha Saudi Arabia, grant number 54.

Disclosure

The authors declare no conflict of interest.

References

1. Durand H, Monahan K, McGuire E. Prevalence and impact of dysmenorrhea among university students in Ireland. Pain Med. 2021. doi:10.1093/pm/pnab122

2. Badrasawi MM, Zidan SJ, Natour N, et al. Binge eating symptoms are associated with the severity of premenstrual symptoms among university students, Cross Sectional Study from Palestine. Int J Eat Disord. 2021;9(1):1–9. doi:10.1186/s40337-021-00425-5

3. Majeed-Saidan MMA, AlKharraz N, Kaaki K, AlTawil N, Alenezy S, Ahamed SS. Prevalence of premenstrual syndrome levels and its management among female students of medical and non-medical colleges in Riyadh. Cureus. 2020;12. doi:10.7759/cureus.11595

4. Bilir E, Yıldız Ş, Yakın K, Ata B. The impact of dysmenorrhea and premenstrual syndrome on academic performance of college students, and their willingness to seek help. J Turk Soc Obstet Gynecol. 2020;17(3):196–201. doi:10.4274/tjod.galenos.2020.97266

5. Abbas K, Usman G, Ahmed M, et al. Physical and psychological symptoms associated with premenstrual syndrome and their impact on the daily routine of women in a low socioeconomic status locality. Cureus. 2020;12:e10821. doi:10.7759/cureus.10821

6. Hayashida H, Shimura M, Sugama K, Kanda K, Suzuki K. Effects of the menstrual cycle and acute aerobic exercise on cytokine levels. J Sports Med Doping Stud. 2015;6(01):2161–2673. doi:10.4172/2161-0673.1000173

7. Hayashida H, Shimura M, Sugama K. Exercise-induced inflammation during different phases of the menstrual cycle. J Physiother Phys Rehabil. 2016;1:1–6. doi:10.4172/2573-0312.1000121

8. Whatnall MC, Patterson AJ, Siew YY, Kay-Lambkin F, Hutchesson MJ. Are psychological distress and resilience associated with dietary intake among Australian university students? Int J Environ Res Public Health. 2019;16(21):4099. doi:10.3390/ijerph16214099

9. Auerbach RP, Alonso J, Axinn WG, et al. Mental disorders among college students in the World Health Organization world mental health surveys. Psychol Med. 2016;46(14):2955–2970. doi:10.1017/s0033291716001665

10. Auerbach RP, Collaborators WW-I, Mortier P, et al. WHO world mental health surveys international college student project: prevalence and distribution of mental disorders. J Abnorm Psychol. 2018;127(7):623–638. doi:10.1037/abn0000362

11. Liu Q, Wang Y-S, Wang Y-S, Zhang W-J, Wang Y. Effects of biofeedback training on resting-state electrophysiology and emotion: evidences from the females with premenstrual syndrome. Neuropsychiatry. 2017;7(05):700–705. doi:10.4172/Neuropsychiatry.1000267

12. Berridge KC, Robinson T. Parsing reward. Trends Neurosci. 2003;26(9):507–513. Erratum in 2003, 26, 581. doi:10.1016/j.tins.2003.09.001

13. Pizzagalli DA, Sherwood RJ, Henriques JB, Davidson RJ. Frontal brain asymmetry and reward responsiveness: a Source-Localization Study. Psychol Sci. 2005;16(10):805–813. doi:10.1111/j.1467-9280.2005.01618.x

14. Heinemann LA, Minh TD, Filonenko A, Uhl-Hochgräber K. Explorative evaluation of the impact of severe premenstrual disorders on work absenteeism and productivity. Womens Health Issues. 2010;20(1):58–65. doi:10.1016/j.whi.2009.09.005

15. Sahin S, Ozdemir K, Unsal A. Evaluation of premenstrual syndrome and quality of life in university students. J Pak Med Assoc. 2014;64:915–922.

16. Erbil N, Karaca A, Kiriş T. Investigation of premenstrual syndrome and contributing factors among university students. Turk J Med Sci. 2010;40:565–573. doi:10.3906/sag-0812-2

17. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Washington, DC, USA: American Psychiatric Pub; 2013. Available from: https://www.psychiatry.org/psychiatrists/practice/dsm. Accessed February20, 2021.

18. Polat A, Celik H, Gurates B, et al. Prevalence of primary dysmenorrhea in young adult female university students. Arch Gynecol Obstet. 2009;279(4):527–532. doi:10.1007/s00404-008-0750-0

19. Cheng S-H, Shih -C-C, Yang Y-K, Chen K-T, Chang Y-H, Yang Y-C. Factors associated with premenstrual syndrome—A survey of new female university students. Kaohsiung J Med Sci. 2013;29(2):100–105. doi:10.1016/j.kjms.2012.08.017

20. Thu M, Diaz EO, Kapaw S. Premenstrual syndrome among female university students in Thailand. AU J Technol. 2006;9:158–162.

21. De Sanctis V, Soliman AT, Elsedfy H, Soliman NA, Elalaily R, El Kholy M. Dysmenorrhea in adolescents and young adults: a review in different countries. Acta Biomed. 2016;87:233–246.

22. Hashim RT, Alkhalifah SS, Alsalman AA, et al. Prevalence of primary dysmenorrhea and its effect on the quality of life amongst female medical students at King Saud University, Riyadh, Saudi Arabia. Saudi Med J. 2020;41(3):283–289. doi:10.15537/smj.2020.3.24988

23. Ibrahim NKR, Alghamdi MS, Al-Shaibani AN, et al. Dysmenorrhea among female medical students in King Abdulaziz University: prevalence, predictors and outcome. Pak J Med Sci. 2015;31(6):1312–1317. doi:10.12669/pjms.316.8752

24. Alshahrani SM, Alavudeen SS, Alakhali KM, Al-Worafi YM, Bahamdan AK, Vigneshwaran E. Self-medication among King Khalid University students, Saudi Arabia. Health Policy (New York). 2019;12:243–249. doi:10.2147/rmhp.s230257

25. Tolossa FW, Bekele ML. Prevalence, impacts and medical managements of premenstrual syndrome among female students: Cross-Sectional Study in college of health sciences, Mekelle University, Mekelle, Northern Ethiopia. BMC Womens Health. 2014;14(1):52. doi:10.1186/1472-6874-14-52

26. Mahesh A, Zubair S, Tirmizi A, Ali SS. Frequency and associated factors of premenstrual syndrome in medical college girls. Med Channel. 2011;17:34–38.

27. Zegeye DT, Megabiaw B, Mulu A. Age at menarche and the menstrual pattern of secondary school adolescents in Northwest Ethiopia. BMC Womens Health. 2009;9(1):29. doi:10.1186/1472-6874-9-29

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With evidence estimating that nearly one-fourth of the world’s women and girls face challenges related to menstrual management — including stigma, privacy, and access to affordable materials — a commentary in JAMA reinforces the need to engage the public in understanding the importance of menstrual health. This includes sufficient funding and more research to educate young people, their parents and communities about the process of menstruation, along with the clinicians who serve them.

“A culture of silence around the issues of menstruation needs to be broken,” said Marni Sommer, DrPH, MSN, RN, associate professor of sociomedical sciences at Columbia University Mailman School of Public Health. “Menstrual equity is a human rights and public health issue, with racial, socioeconomic, and sex disparities intertwined,” said co-author Diana J. Mason, PhD, RN, senior policy service professor at the Center for Health Policy and Media Engagement, George Washington University School of Nursing.

Evidence from low as well as high resource countries shows that significant menstruation-related challenges are faced by schoolgirls, displaced adolescent girls and women, as well as women in the workplace, and many of these disparities intensified during the pandemic. Additional data highlight how those affected by homelessness face issues that go beyond access to products, and how they encounter barriers to manage their periods with dignity.

“At a minimum, access to free menstrual products in all public spaces is needed, as Scotland has done. In addition, attention is essential to assure all people with periods have access to safe, private spaces with water and soap for changing their menstrual products in comfort,” noted Sommer.

To promote menstrual equity Sommer and Mason make the following points:

• Policy makers in the U.S. should eliminate state sales taxes on menstrual products.
• High-quality menstrual products should be available for free in schools, prisons, homeless shelters, and health care facilities.
• Health professionals should advocate for free access to menstrual products.

• The U.S. should open the door for coverage of menstrual products under Medicaid and propose increasing the monthly benefit for adolescent girls and women of childbearing age under The Temporary Assistance for Needy Families.
• We need to underscore the relevance of menstrual health and hygiene to all UN 17 Sustainable Development Goals.

“Women, adolescent girls, and all people with periods in the U.S. and around the world must be able to manage their periods with dignity and comfort, without stigma or shame,” said Mason.

Story Source:

Materials provided by Columbia University’s Mailman School of Public Health. Note: Content may be edited for style and length.

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Originally Appeared Here

Express News Service

THIRUVANANTHAPURAM: Despite a biological predisposition for better longevity, more women fall victim to Covid mostly due to delay in getting timely treatment. Though it is found that men are more at risk of Covid when compared to women, health experts are of the opinion that lack of timely care leads to an increase in deaths among women. 

The situation has worsened with the lack of proper monitoring of patients in home care, which has led to an increase in severity of disease and death toll. It is a significant factor considering that over 90% of the Covid-infected patients undergo home isolation. 

To be sure, more men than women died of Covid in the first and second waves. The women fared better on the back of their strong survival nature, as it has been the case of other diseases affecting humans. 
But health experts have always raised concerns over the social factors undoing the biological benefits of women in healthcare. 

Anecdotal evidence suggests that women and elderly in home quarantine are late to report the severity of illness after being infected. “Women have a tendency to neglect their health. Exposure, severity and immunity are the factors that determine the treatment outcome. However, the late presentation of patients in hospital leads to poor outcomes irrespective of the age and gender,” said Dr Aneesh Raj, a consultant intensivist.

According to him, women are prone to ignore the symptoms and indulge in self-treatment. “They often respond that they thought they would not have Covid.  They are reluctant to undergo testing even on the directions of a doctor. Some straightaway start treating themselves with antibiotics, which has no role in Covid,” he said.

Though the health department’s guideline is to conduct an RT-PCR test if a symptomatic person tests negative in a rapid antigen tests, doctors complain that people hesitate to repeat the test. Dr N M Arun, internal medicine specialist and public health activist, said a section of people are hesitant to go to hospitals during the pandemic spread. “There is a gender issue at play in healthcare. Women get less care and they do not care themselves. In the case of elderly, it is often the neglect from family members that leads to poor outcomes,” he said.

Possible factors favouring women
Presence of female sex hormone  estrogen
XX sex chromosome in females
Lower risky behaviours such as smoking

Negative factors
Hesitancy to get tested soon after the onset
Poor monitoring of  health in home quarantine
Hesitancy to get timely treatment while in home quarantine

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Originally Appeared Here

1 INTRODUCTION

The mental health consequences of the COVID-19 pandemic and its associated restrictions have been significant around the world. A systematic review of studies of the effects of COVID-19 on psychological outcomes published up to May 2020 reported high rates of symptoms of anxiety, depression, post-traumatic stress disorder, psychological distress, and stress during the COVID-19 pandemic in the general populations of China, Spain, Italy, Iran, the United States, Turkey, Nepal, and Denmark (Xiong et al., 2020). The risk factors associated with these distress measures included female gender, younger age group (≤40 years), having a chronic or psychiatric illness, being unemployed, a student, or frequently exposed to social media or news about COVID-19.

KEY POINTS

• An anonymous online survey of preferred policy options to assist post-COVID-19 mental health recovery was launched in July 2020.
• More than 9000 people completed the survey.
• Almost half of the respondents reported that having a publicly available plan about management of future pandemics would be ‘very helpful’.
• Two policies related to mental health support, one to financial support, and one to support for community organisations were endorsed as ‘very helpful’ by more than 30% of respondents.
• Government preparedness for future pandemics and support for mental health, individual finance, and community organisations should be policy priorities in the post-COVID-19 recovery phase.

In Australia, the first confirmed case of COVID-19 was identified in late January 2020 (Australian Government, 2020). Although the spread of the virus was initially slow, by late March increased cases and hospitalisations prompted the government to order national lockdown measures to slow the spread. Measures included staying at home except for a few specified reasons, working from home if possible, physical distancing, limiting in-person interactions, avoiding visits to residential aged care facilities, limiting attendance at weddings and funerals, cancelling travel, and online learning from home replacing attendance at educational institutions.

Containment of COVID-19 restricted freedom to socialise, work, conduct business, participate in cultural activities, and attend milestone events such as weddings and funerals. As in other countries, these multiple losses caused widespread disenfranchised grief and exacted a heavy toll on people’s mental health and well-being in Australia (Fisher & Kirkman, 2020). Poor mental health has adverse consequences for quality of life and physical health, as well as for people’s social and economic participation. The pandemic has reinforced unfortunate truths about the social determinants of health: the hardships caused by restrictions on freedom are inflicted unequally on citizens. Women, young people, and people who are socially disadvantaged experienced a heavier toll (Fisher et al., 2020).

Four days after the COVID-19 restrictions were implemented in April 2020, our group launched a short, anonymous online survey of people living in Australia aged at least 18 years to estimate population prevalence of clinically significant symptoms of depression and generalised anxiety. It included questions about demographics and experiences of COVID-19 and the associated restrictions. Two widely used standardised psychometric instruments were incorporated to assess symptoms of depression and anxiety: The Patient Health Questionnaire 9 (PHQ-9) (Kroenke et al., 2001) and the Generalised Anxiety Disorder Scale 7 (GAD-7) (Spitzer et al., 2006). More than 13,000 people completed the survey which showed that, in the first month of COVID-19 restrictions, more than one in four had clinically significant symptoms of depression (PHQ-9 ≥ 10) and more than one in five had clinically significant symptoms of anxiety (GAD-7 ≥ 10), at least double the rates found in prior surveys conducted in a non-COVID time (Fisher et al., 2020). A smaller study conducted around the same time identified similar estimates of clinically significant symptoms of depression and anxiety (Dawel et al., 2020).

The United Nations (2020) recommends that all countries plan a response to the mental health consequences of the pandemic. Commentary about Australia’s response has called for increased healthcare services, including treatment of serious mental illness (McGorry, 2020) and ‘low intensity’ telehealth and online programs (Christensen, 2020) for people who are at risk of mental health problems or have mild symptoms. However, these necessary services are only part of the solution. Just as public health responses to COVID-19 have been crucial to protect Australians’ physical health, public mental health initiatives will be essential for full social and economic recovery. Indeed, the first of the three U.N. recommendations for post-COVID-19 recovery is to apply a ‘whole-of-society’ approach to promote, protect, and care for mental health (United Nations, 2020).

Public mental health is the art and science of enhancing mental health and well-being and preventing mental illness (The Lancet Editorial, 2016). It requires organised efforts and informed choices of public and private organisations, communities, and individuals. Mental health is profoundly influenced by the circumstances of people’s lives; risks and protective factors accumulate throughout the life course. Risks include exposure to adverse childhood experiences, violence, poverty, displacement, stigma, and discrimination. Conversely, mental health is supported by inclusive communities, gender equality, social and economic resources, and healthy relationships (Carbone, 2020). Public mental health is underpinned by human rights principles and a commitment to reducing mental health inequalities.

Like public health, public mental health relies on understanding the nature and distribution of the social and environmental determinants of mental health; applying universal evidence-based strategies to address modifiable risks; monitoring and evaluation; prioritising promotion, primary prevention, and early intervention; regulation and governance to influence policy; and employing participatory approaches that empower people, especially disadvantaged groups (State of Victoria, 2021). This requires a whole of government approach and the participation of civil society, industry, and communities (Global & Women’s Health, 2021).

Although Australia has experienced fewer COVID-19 infections and deaths than most other countries, the social and economic consequences of the pandemic have been significant, particularly for those who are socio-economically disadvantaged and marginalised. O’Sullivan et al. (2020) assert that the government’s policy responses will have long-term impacts across all areas of social and economic life, including on social equality and cohesion. They argue, therefore, that strong community engagement and participation are essential in developing policy responses (O’Sullivan, Rahamathulla, & Pawar, 2020).

To inform the development of recovery policy, the aim of this research was to gauge the opinions of people in Australia about policies to help them recover from the consequences of the COVID-19 pandemic and its associated restrictions.

2 METHOD

This study was approved by Monash University Human Research Ethics Committee (2020-24080-45948). An anonymous online survey of people aged 18 years and older in Australia was available from 1 July to 31 August 2020. At that time, restrictions had eased in Australia except in Victoria where stringent restrictions were in place because of rapidly rising numbers of people infected with the virus. The survey repeated the questions from the survey we conducted in April 2020 (Fisher et al., 2020). In addition, 16 potential policies to help people recover were listed and respondents were asked whether each policy would help them recover from the COVID-19 restrictions; response options were ‘Not at all helpful’, ‘Somewhat helpful’, and ‘Very helpful’. The proposed policies were created using expert opinion and analysis of almost 14,000 responses to an open-ended question in the April survey.

Sociodemographic information collected was sex (female, male, non-binary), age, country of birth, place of residence, main occupation, and living situation.

2.1 Data management and statistical analysis

Data on Australian State, urban/rural residence, and Socioeconomic Indices for Areas (SEIFA) (Australian Bureau of Statistics, 2013) were derived from each respondent’s postcode using the most recent Australian Bureau of Statistics data (Australian Bureau of Statistics, 2019).

Population proportions and 95% confidence intervals of responses to questions about whether each policy would help respondents to recover from the COVID-19 restrictions were estimated, adjusting for differences in socio-demographic characteristics between the sample and the Australian population. The adjustments were made using weights for proportions of age groups, genders, SEIFA deciles, and states in the sample and the corresponding information in the population (Australian Bureau of Statistics, 2019).

A ‘heatmap’ was created to illustrate the proportions of people who endorsed each policy as ‘Very helpful’ for them, stratified by gender (female, male, non-binary), age group (18–29, 30–59, 60, and higher), place of residence (urban, regional/rural), and SEIFA groups (lowest 60%, highest 40%) simultaneously. The proportions were grouped as <10%, 10%–19%, 20%–29%, 30%–40%, and >40%.

Only complete data were included in analyses. The analyses were conducted using STATA Version 16 (StataCorp., College Station, TX).

3 RESULTS

In all, 9220 people completed the survey. Just over half resided in Victoria, more than two thirds identified as women, and one quarter was born overseas (Table 1).

TABLE 1.
Socio-demographic characteristics of the 9220 participants

	n	%
State
Victoria	4844	52.5
New South Wales	1796	19.5
Queensland	972	10.5
Western Australia	530	5.7
South Australia	533	5.8
Tasmania	240	2.6
Australian Capital Territory	261	2.8
Northern Territory	44	0.5
SEIFA quintiles
Quintile 1 (Lowest socio-economic position)	858	9.3
Quintile 2	1022	11.1
Quintile 3	1362	14.8
Quintile 4	2158	23.4
Quintile 5 (Highest socio-economic position)	3820	41.4
Gender
Female	6434	69.8
Male	2726	29.6
Non-binary	60	0.7
Age group
18–29	1348	14.6
30–39	1758	19.1
40–49	1763	19.1
50–59	1871	20.3
60–69	1592	17.3
70+	888	9.6
Living situation
On your own	1811	19.6
With only your partner/your partner and children/adult family members	6434	69.8
With children and without a partner	340	3.7
In a shared house with non-family members/Other	635	6.9
Born overseas	2246	24.4
Main occupation
A paid job	5511	59.8
Doing unpaid work caring for children/dependent relatives only or unemployed	903	9.8
Student	1038	11.3
Retired	1768	19.2

• Abbreviation: SEIFA, Socio-economic Indices for Areas.

3.1 Most and least helpful policies

The weighted proportions of respondents who rated the proposed policies as ‘very’, ‘somewhat’, and ‘not at all’ helpful are shown in Table 2. The most emphatically endorsed policy was ‘To have a publicly available plan about management of future pandemics’. Almost half of the respondents rated this as likely to be ‘very helpful’ in their recovery from the COVID-19 restrictions. Four other policies were rated as ‘very helpful’ by more than 30% of all respondents: two related to mental health support, one to individual financial support for living expenses, and one to support for community organisations.

TABLE 2.
Population proportions (%) of the opinions about whether the proposed policies would help the respondent recover from the COVID-19 restrictions (sorted by highest to lowest proportions of ‘very helpful’)

Policy	Very helpful	Somewhat helpful	Not at all helpful
To have a publicly available plan about management of future pandemics	46.1	37	16.9
Financial support for living expenses	33.9	38.5	27.5
Additional support for community organisations (e.g. Men’s Sheds, community choirs, sports clubs, environmental groups)	32.0	39.7	28.3
Access to face-to-face counselling with a mental health professional	30.5	38.3	31.3
A GP asking me about my mental health	30.1	42.5	27.4
Training for employers to manage employees’ mental health needs during the transition from working at home	28.7	35.2	36.1
Information about how to manage my emotional well-being	28.6	48.4	23
Access to telehealth for my physical health needs	27.3	44.6	28.1
A public statement of recognition, appreciation and thanks from the Prime Minister to people in Australia for limiting the spread of COVID-19 by following the restrictions	26.8	38	35.1
Access to telehealth counselling with a mental health professional	25.7	40	34.3
Free access to mobile apps and online programs to help me manage my emotional well-being	25.2	40.1	34.7
Information about how to resume my work and social life safely	22.4	52	25.6
More affordable childcare	21.5	23.9	54.5
Public ceremonies or events to acknowledge what we have given and done together to limit the spread of COVID-19	20.5	38.2	41.4
Individual help and support to find a job	18.3	29.3	52.4
A GP asking me about my use of alcohol	13.8	32.6	53.7

• aPost-stratification weighted by: State, Socio-economic Indices for Areas decile, gender, and age.

Nine policies were rated as ‘not at all helpful’ by more than 30% of respondents. Four of these were rated as ‘not at all helpful’ by more than 40% of respondents. They concerned more affordable childcare, individual support to find a job, public ceremonies to acknowledge people’s sacrifices during the pandemic, and general practitioners (GPs) asking about alcohol consumption.

3.2 Demographic differences in policy preferences

Differences between subgroups in their policy preferences are shown in the heatmap (Table 3) which displays the proportions rating the policies as ‘very helpful’ by gender, age, place of residence, and socioeconomic subgroups. Having a publicly available plan for managing future pandemics was universally the most endorsed policy. Apart from people aged 60 years and older, financial support for living expenses was rated as ‘very helpful’ by between one third and half of people in all subgroups. Respondents identifying as women or non-binary rated more policies as ‘very helpful’ than respondents who identified as men. Similarly, higher proportions of respondents in the youngest and middle age groups reported that the suggested policies would help them recover than those in the oldest age group. It is notable that higher proportions of people living in urban and more socioeconomically advantaged areas endorsed some policies as very helpful than did people from regional and rural areas and less advantaged people. Five proposed policies relating to mental health support were endorsed by more than 30% of people who identified as women or non-binary and by people in the youngest age group.

TABLE 3.
‘Heatmap’ of the ‘Very helpful’ policies by gender, age, region, and SEIFA subgroups

4 DISCUSSION

The findings of this population study can be used to guide policy development to support people in Australia as they recover from COVID-19 and the restrictions that have been imposed to control its spread. They indicate that needs and policy preferences vary between population groups and that targeted policies may be needed to optimise their benefits.

This study has strengths and limitations. Strengths include the large sample, which was broadly representative and weighted to reflect the Australian population, and that the proposed potential policies were informed by expert opinions and data from analysis of free-text comments from respondents to survey 1. A limitation is that the list of suggested policies was restricted in the interest of survey brevity. Other policy suggestions may have rated more (or less) highly than those offered.

Although there is potential for the virus to resurface, Australia’s successful management of the pandemic allows federal, state, and local governments to focus on the transition from the acute to the recovery phase of the pandemic. One of the first steps towards recovery is to ensure universal access to and uptake of COVID-19 immunisation. Governments are implementing a staged immunisation program that will reduce the risk of future restrictions. However, to counter the significant economic and mental health consequences of the 2020 restrictions, well-designed recovery policies are also needed. Fakhruddin et al. (2020) argue that, for the recovery to be effective, the policy response needs to be comprehensive and combined with an improved data ecosystem between the public health system and the community where ‘communities feed information into the public health system and the feedback loop offers a fast and direct way to provide people with details of potential actions they can take’ (Fakhruddin, Blanchard, & Ragupathy, 2020). Others contend that policies should address the social determinants of health and promote social solidarity as this will improve population health, economic performance, and management of future pandemics (Lynch, 2020).

In this survey, the most popular proposed policy across all demographic categories was for a publicly available pandemic management plan. This is particularly notable because a key recommendation after the H1N1 pandemic in 2009 was that a comprehensive plan for managing pandemics be developed for the whole of Australia (Department of Health & Ageing, 2011). Had this recommendation been implemented then, it is likely that Australia’s response to the COVID-19 pandemic would have been more swift, better coordinated among the commonwealth and state and territory governments, and therefore more efficient and effective. That this policy was prioritised by survey respondents over all others suggests that they believe a well-prepared country with detailed plans of action and established infrastructure is most likely to protect its citizens from many of the other problems for which solutions are now being sought. It supports the argument made by others that governments need to change the mindset from ‘if’ to ‘when’ future pandemics will occur (Fakhruddin et al., 2020).

The policy suggestion to increase support for community organisations also received strong endorsement. Strengthening community organisations would afford opportunities for local communities to provide mutual support through shared experiences which in turn benefits mental health: the contribution to mental health of organisations such as Men’s Sheds (Kelly et al., 2021), choirs (Moss et al., 2017; Williams et al., 2018), sports clubs (Eime et al., 2010; Jenkin et al., 2018), and environmental working groups (Pich, 2020) is well documented.

The gender and age differences in policy preferences suggest that targeted recovery policies are also needed. Respondents who identified as women or non-binary and respondents in the youngest age group were more likely than those who identified as men and people in the older age groups to endorse receiving financial support to help with living expenses. This is unsurprising because women and young people were more likely than other groups to have experienced job loss and financial hardship as a result of COVID-19 restrictions (Kabatek, 2020; Wood et al., 2021). Women were also less likely than men to receive JobKeeper, the government financial support for maintaining a connection to the workplace, because it excluded short-term casual positions, occupied in the hardest-hit industries mostly by women (Wood et al., 2021). The age gradient for the support of this policy is likely linked to the greater loss of job and income by younger groups and greater proportion of people over the age of 60 who are not reliant on employment for living expenses. O’Sullivan et al. argue that continued financial support for vulnerable groups may be needed to avoid exacerbating existing inequalities (O’Sullivan et al., 2020).

More than one third of respondents who identified as women or non-binary and those in the youngest age group reported that policies relating to mental health support would benefit their recovery. Results of the first survey showed that people in these groups were more likely than those in other groups to experience clinically significant symptoms of depression and anxiety (Fisher et al., 2020). In the case of women, this was in part explained by their disproportionate burden of unpaid work such as home schooling and caring for dependent family members: they shouldered an extra hour each day more than men of unpaid work, on top of their existing heavier load (Hammarberg et al., 2020; Wood et al., 2021). In addition to policies that directly support mental health, policies to reduce the burden on women of unpaid work are likely to benefit their mental health. With regard to the mental health needs of young people, the authors of an OECD report based on surveys from 90 youth organisations from 48 countries recommend government initiatives to promote inclusive and fair recovery for all generations (OECD, 2020). They include providing targeted policies and services for the most vulnerable youth populations, including young people not in employment, education, or training; young migrants; homeless youth; and young women, adolescents, and children facing increased risks of domestic violence.

Some suggested policies were supported by fewer than half of respondents. They included provision of more affordable childcare, which is surprising given economists’ arguments that childcare should be made cheaper to enable more women to do more paid work and to drive economic recovery (Wood et al., 2020). We can only speculate that women caring for young children, who could benefit from such a policy, were less likely than other women to complete the survey because of limited discretionary time. The suggestion that GPs ask about alcohol use was also unpopular, despite the finding that about one in five respondents to survey 1 reported drinking more alcohol than before the pandemic (Tran et al., 2020). Unwillingness to be asked about alcohol intake by a GP could arise from perceived stigma or respondents’ self-assessment of alcohol intake as unproblematic. Nevertheless, other policies to address the adverse social and health effects of excessive alcohol consumption appear to be warranted.

5 CONCLUSION

Although Australia has experienced fewer COVID-19 infections and deaths than most other countries, the social and economic consequences of the pandemic have been significant, particularly for those who are socio-economically disadvantaged and marginalised. To address this, federal, state, and local governments now need to focus on the transition from the acute to the recovery phase of the pandemic. This study found that for people in Australia, the preferred policy options for the post-COVID-19 recovery phase are government preparedness for future pandemics and support for mental health, individual finance, and community organisations.

ACKNOWLEDGEMENT

The authors are very grateful to the Living With COVID-19 Restrictions in Australia Working Group including Dr Jayagowri Sastry, Ms Hau Nguyen, Ms Sally Popplestone, Ms Ruby Stocker, Dr Claire Stubber, and Ms Karin Smith who contributed to the design of the survey.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

REFERENCES

• Australian Bureau of Statistics. (2013). Socio-economic indexes for areas. http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa
• Australian Bureau of Statistics. (2019). 3101.0 – Australian demographic statistics, Sep 2019. https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3101.0Sep%202019?OpenDocument
• Australian Government. (2020). First confirmed case of novel coronavirus in Australia. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/first-confirmed-case-of-novel-coronavirus-in-australia
• Carbone, S. (2020, September 14). We can’t ignore mental illness prevention in a COVID-19 world. The Conversation.
• Christensen, H. (2020). Silver linings: Mental health lessons from COVID-19. https://insightplus.mja.com.au/2020/46/silver-linings-mental-health-lessons-from-covid-19/?utm_source=InSight%2B&utm_campaign=4aea4fff76-EMAIL_CAMPAIGN_2020_11_20_04_55&utm_medium=email&utm_term=0_7346f35e23-4aea4fff76-42357625.Insight+.
• Dawel, A., Shou, Y., Smithson, M., Cherbuin, N., Banfield, M., Calear, A. L., Farrer, L. M., Gray, D., Gulliver, A., Housen, T., McCallum, S. M., Morse, A. R., Murray, K., Newman, E., Rodney Harris, R. M., & Batterham, P. J. (2020). The effect of COVID-19 on mental health and wellbeing in a representative sample of Australian adults. Frontiers in Psychiatry, 11(1026), 579985. https://doi.org/10.3389/fpsyt.2020.579985
• Department of Health and Ageing. (2011). Review of Australia’s Health Sector Response to Pandemic (H1N1) 2009: Lessons identified. Australian Government.
• Eime, R. M., Harvey, J. T., Brown, W. J., & Payne, W. R. (2010). Does sports club participation contribute to health-related quality of life? Medicine and Science in Sports and Exercise, 42(5), 1022– 1028. https://doi.org/10.1249/MSS.0b013e3181c3adaa
• Fakhruddin, B., Blanchard, K., & Ragupathy, D. (2020). Are we there yet? The transition from response to recovery for the COVID-19 pandemic. Progress in Disaster Science, 7, 100– 102. https://doi.org/10.1016/j.pdisas.2020.100102
• Fisher, J., & Kirkman, M. (2020). Coronavirus: Recognising disenfranchised grief amid COVID-19. https://lens.monash.edu/@medicine-health/2020/03/26/1379888/coronavirus-recognising-disenfranchised-grief-and-covid-19
• Fisher, J. R. W., Tran, T. D., Hammarberg, K., Sastry, J., Nguyen, H., Rowe, H., Popplestone, S., Stocker, R., Stubber, C., & Kirkman, M. (2020). Mental health of people in Australia in the first month of COVID-19 restrictions: A national survey. Medical Journal of Australia, 213(10), 458– 464.
• Global and Women’s Health. (2021). Covid-19 restrictions and mental health policy brief. https://www.monash.edu/__data/assets/pdf_file/0006/2548284/covid-19-restrictions-and-mental-health-policy-brief.pdf
• Hammarberg, K., Tran, T., Kirkman, M., & Fisher, J. (2020). Sex and age differences in clinically significant symptoms of depression and anxiety among people in Australia in the first month of COVID-19 restrictions: A national survey. BMJ Open, 10(11), e042696. https://doi.org/10.1136/bmjopen-2020-042696
• Jenkin, C. R., Eime, R. M., Westerbeek, H., & van Uffelen, J. G. Z. (2018). Sport for adults aged 50+ years: Participation benefits and barriers. Journal of Aging and Physical Activity, 26(3), 363– 371. https://doi.org/10.1123/japa.2017-0092
• Kabatek, J. (2020, October 2). 5 charts on how COVID-19 is hitting Australia’s young adults hard. The Conversation.
• Kelly, D., Steiner, A., Mason, H., & Teasdale, S. (2021). Men’s sheds as an alternative healthcare route? A qualitative study of the impact of Men’s sheds on user’s health improvement behaviours. BMC Public Health, 21(1), 553. https://doi.org/10.1186/s12889-021-10585-3
• Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606– 613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
• Lynch, J. (2020). Health equity, social policy, and promoting recovery from COVID-19. Journal of Health Politics, Policy and Law, 45(6), 983– 995. https://doi.org/10.1215/03616878-8641518
• McGorry, P. (2020). Mental health and COVID-19: Are we really all in this together? Medical Journal of Australia, 213(10), 454– 455. https://doi.org/10.5694/mja2.50834
• Moss, H., Lynch, J., & O’Donoghue, J. (2017). Exploring the perceived health benefits of singing in a choir: An international cross-sectional mixed-methods study. Perspectives in Public Health, 138(3), 160– 168. https://doi.org/10.1177/1757913917739652
• O’Sullivan, D., Rahamathulla, M., & Pawar, M. (2020). The impact and implications of COVID-19: An Australian perspective. The International Journal of Community and Social Development, 2(2), 134– 151. https://doi.org/10.1177/2516602620937922
• OECD. (2020). OECD policy responses to coronavirus (COVID-19), youth and COVID-19: Response, recovery and resilience. https://www.oecd.org/coronavirus/policy-responses/youth-and-covid-19-response-recovery-and-resilience-c40e61c6/
• Pich, J. (2020). Participation in environmental enhancement and conservation activities for health and well-being in adults: A review of quantitative and qualitative evidence. Public Health Nursing, 37(1), 144– 146. https://doi.org/10.1111/phn.12680
• Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092– 1097. https://doi.org/10.1001/archinte.166.10.1092
• State of, V. (2021). Royal Commission into Victoria’s Mental Health System, Final Report, A new approach to mental health and wellbeing in Victoria. https://finalreport.rcvmhs.vic.gov.au/wp-content/uploads/2021/02/RCVMHS_FinalReport_Vol1_Accessible.pdf:
• The Lancet Editorial. (2016). What can public health do for mental health? The Lancet, 387(10038), 2576. https://doi.org/10.1016/S0140-6736(16)30887-X
• Tran, T. D., Hammarberg, K., Kirkman, M., Nguyen, H. T. M., & Fisher, J. (2020). Alcohol use and mental health status during the first months of COVID-19 pandemic in Australia. Journal of Affective Disorders, 277, 810– 813. https://doi.org/10.1016/j.jad.2020.09.012
• United Nations. (2020). Policy brief: COVID-19 and the need for action on mental health. https://www.un.org/sites/un2.un.org/files/un_policy_brief-covid_and_mental_health_final.pdf
• Williams, E., Dingle, G. A., & Clift, S. (2018). A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition. European Journal of Public Health, 28(6), 1035– 1042. https://doi.org/10.1093/eurpub/cky115
• Wood, D., Griffiths, K., & Crowley, T. (2021). Women’s work: The impact of the COVID crisis on Australian women. https://grattan.edu.au/report/womens-work/:
• Wood, D., Griffiths, K., & Emslie, O. (2020). Cheaper childcare: A practical plan to boost female workforce participation. https://grattan.edu.au/wp-content/uploads/2020/08/Cheaper-Childcare-Grattan-Institute-Report.pdf
• Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M. W., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, A., & McIntyre, R. S. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, 277, 55– 64. https://doi.org/10.1016/j.jad.2020.08.001

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Rumors and myths about COVID-19 vaccine effects on all aspects of reproduction and sexual functioning have spread like a Delta variant of viral misinformation across social media platforms, where people swap rumors of erectile dysfunction and fertility disruptions following vaccination. Yet studies so far have not linked the vaccines with problems related to pregnancy, menstrual cycles, erectile performance or sperm quality. The evidence does show that COVID-19 can involve problems in all of these areas.

Health officials have tried to ease concerns by explaining that data from clinical trials and hundreds of millions of vaccinations support the safety of the shots. Scientific American spoke with four experts in reproductive and sexual biology about pervasive myths, the evidence against them and the real damage to health caused by COVID-19. Below is a series of conclusions that can be drawn from studies of vaccinated people and those who have had the disease.

Vaccination is not associated with adverse effects in pregnancy. COVID-19 is the real threat.

The U.S. Centers for Disease Control and Prevention updated its recommendations in early August, strengthening its advice that people who are pregnant or breastfeeding should be vaccinated against COVID-19.

The U.K.’s Medicines and Healthcare Products Regulatory Agency (MHRA) found this month that “there is no pattern … to suggest that any of the COVID-19 vaccines used in the UK increase the risk of congenital anomalies or birth complications. Pregnant women have reported similar suspected reactions to the vaccines as people who are not pregnant.”

If infected with the virus, pregnant people are at highly increased risk for severe disease and complications from COVID-19, compared with their same-age counterparts, says Tara Shirazian, an associate professor and a gynecologist at NYU Langone Health.

The immune system effects of pregnancy itself make an infection about five times more likely, says Jane Frederick, a reproductive endocrinology and fertility specialist and medical director of HRC Fertility in California. “You get infected more quickly, and pregnant women can go downhill fast,” she adds.

People should take the opportunity to get vaccinated before conceiving, but the vaccine is safe across all three trimesters of pregnancy, says Mary Rosser, director of integrated women’s health at the Department of Obstetrics & Gynecology at Columbia University Irving Medical Center. In early August, 22 medical groups released a joint statement saying that “the best way for pregnant individuals to protect themselves against the potential harm from COVID-19 infection is to be vaccinated.”

The vaccines show no fertility effects, including among people using assisted reproductive techniques.

One origin of fertility falsehoods about the vaccines may be a letter co-written by a former Pfizer researcher and sent to the European Medicines Agency (EMA) in December 2020. The two authors asked that all vaccine studies be suspended. They claimed that vaccine-induced antibodies against a protein that SARS-CoV-2 uses to enter human cells might also attack another human protein needed for embryo implantation. SARS-CoV-2 is the virus that causes COVID.

A study published in June 2021 compared the success of transferring embryos to women who carried antibodies to SARS-CoV-2 after vaccination or infection to success rates among those without antibodies. The presence of antibodies did not appear to affect such rates during 171 transfer attempts.

In a New York Times essay, a pair of immunologists described their work showing that the sequences of amino acids that make up the implantation-related protein and those that make up the virus spike protein are not similar and that spike-targeting antibodies do not cross-react with the implantation protein.

Stress may be responsible for menstrual cycle problems following vaccination.

Some vaccinated women have reported disruptions to their monthly cycle. “We are not dismissing them,” Rosser says. “What they say about their own bodies is important, and they know their bodies best.”

But nothing in the vaccines is a likely candidate to explain these complaints. Experts agree that a probable indirect factor is stress. Getting a new vaccine is itself stressful, Shirazian says, and many kinds of stressors can throw off a menstrual cycle. The physiological effects of these tensions might disrupt pathways that drive menstrual timing.

The good news, Rosser says, is that any menstrual effects appear to be transient. “I’ve talked to enough women in the last eight months, and it seems as though whatever it is, it’s short-lived,” she says.

In early August EMA released a report noting that no cause-and-effect association had been established between complaints of menstrual disruptions and COVID-19 vaccination. Separately, MHRA found no link between menstrual disorders and COVID vaccines.

Some descriptions of menstrual problems mention clotting during heavier periods. Shirazian says that the term “blood clot” as it relates to menstrual flow is different from the term used medically to describe a clot in a blood vessel. “They have nothing to do with each other,” she says. The clotting of menstrual blood happens as the blood exits the vessels and is not a risk for blocking flow to tissues.

COVID-19 may affect the menstrual cycle.

Becoming ill with COVID is associated with clotting in the medical sense—producing pulmonary embolisms that block blood flow to the lungs, for instance. Some evidence also points to the effects of SARS-CoV-2 on menstrual cycles. A small study of 177 patients who had COVID-19, published in September 2020, showed that 28 percent experienced cycle disruptions, including less bleeding and a longer cycle.

Infectious diseases themselves also are a stressor, Rosser says. “Illness causes stress,” she adds. And next to any menstrual cycle disruptions that might follow vaccination, “it’s 100 percent worse to have COVID, if you had to choose between the two,” Shirazian says.

Vaccines do not threaten sperm or erectile function, but COVID-19 does.

Ranjith Ramasamy, director of reproductive urology at the University of Miami, has published several studies describing the novel coronavirus in penile and testicular tissue and its effects on erectile dysfunction. He and his colleagues also looked at the potential effects of vaccines in these areas and found none.

To Ramasamy, the most unsurprising observation was how COVID-19 interferes with erections, which rely on blood flow. “COVID affects the blood vessels that supply organs, and the penis is not much different from other organs that require a lot of blood,” he says.

What was more surprising was the presence of SARS-CoV-2 in penile tissue even nine months after an infection. These results were from a small study of people with penile implants because of severe erectile dysfunction. The rich blood supply to the penis seems to have ensured a route for the virus to these tissues, Ramasamy says.

Like many viruses, SARS-CoV-2 also finds its way into the testes, where it can enter cells and cause damage. A biopsy study of testis tissue from six people who died of COVID-19 showed the virus still lingering in a sample from one of the patients and decreased sperm counts in another three. A sample from a patient who had survived the disease also showed persistent SARS-CoV-2 in the testes.

Ramasamy and his colleagues have found no detrimental changes in sperm counts and other fertility measures after vaccination. “One of the biggest myths with the vaccine was that it could affect fertility,” he says, and finding no negative effect on sperm counts “was very reassuring.”

Some last words on vaccination and the ill effects of COVID-19.

All of the experts had the same take-home message: the key to protecting against the reproductive and sexual effects of COVID-19 is to get vaccinated.

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