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Background and purpose: Menopause is one of the four critical stages in women which make them vulnerable to effective, strong, persistant and permanent hormonal changes. Therefore, assessment of menopauseal age and its enfluencing factors are very important.
Materials and methods : This is a descriptive study on rural and urban women living in mazandaran province whose menopausal period started 12 months before the study. Sampling was done through clastering method by calling in the houses of 3036 menopasual women.Data on demographic,anthropometric,obstetric menstruation, menopause, reproduction, breast feeding and stress were recorded in questionnaire. Weight, blood pressure and hight were measured and analyzed using statistical analysis of varionce, X2 , regresion and t test.
Results: Mean menopausal age of the women under study was 47.93 ± 4.37 and 3.7% of the women prior to 40 years of age were menopause. Statistical analysis did not show any statistical relationship between menopausal age and education, economic condition, BMÏ, being left handed, using contraceptive, history of menopause and stresses between the women with early and late menopause. Howere, there was significant relationship between age of menopause with profession, number of pregnancies, age of the latest pregnancies, menopausal age of mother and sister(P<0.05).Âlso this study showed that there is a significant relationship between the age of menopause in defferent cities of mazandaran.
Çonclusion: Çonsidering the low mean menopausal in this study and also in other studies done in Ïran compared to developed countries and the complications due to low age of menopause, it is recommended that special clinics to be established for menopause women and more information and services be available to them.

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Background and purpose: Services of triangle centers in terms of training are counseling, prevention, and treatment in the three areas of sexually transmitted diseases, HIV / AIDS and drugs abuse. Healthcare providers of these centers have little respect for women’s reproductive health needs (including safe motherhood). The health care centers do not provide enough sexual services including sexually transmitted diseases, HIV/AIDS and drug abuse to patients. The aim of this study was to determine and compare the most common SRH needs of individuals of this two types of centers. Material and Methods: In this cross-sectional study, for determining the sexual and reproductive health needs of the women in two groups, a standardized questionnaire of SRH needs assessment was used. The frequency of sexual and reproductive health needs of 600 women referred to health centers (group I: 514 women) and triangular center (Group II: 86 women) were evaluated Results: The most common SRH needs of women was cesarean section (need to safe delivery) in both two types of centers in the domain of safe motherhood, the use of traditional methods of contraception (need to spacing in childbearing) in the domain of family planning in the clients of the both two types of centers, being multi-partner of participants’ husband (need to general and sexual health) in health care centers and being multi-partner of participants in triangle center in the domain of sexual history and practices (that the prevalence in two types of centers was very low, turbid and cheese form vaginal discharge (need to general and sexual health) in both types of centers in the domain of sexually transmitted infection, poor knowledge about routes of HIV transmission (need to knowledge about HIV/AIDS) in the domain of HIV/AIDS, and husband's sexual coercion (need to general, mental and sexual health) in the domain of violence. Among these needs, cesarean section (domain of safe motherhood) was more common than the others. Conclusion: Considering that the most common SRH needs was related to safe motherhood domain (high rate of cesarean section), so, in order to save sources and solve some problems including stigma, it is recommended that these two types of centers be integrated.

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Background and purpose: General anesthesia for oocyte retrieval may interfere with outcomes and success rate of assisted reproductive technology. This study was performed to compare the outcomes of assisted reproductive technology in women regarding recovery time, patient satisfaction and postoperative side effects using remifentanil-propofol and alfentanil-propofol. Materials and methods: We studied 102 women who were scheduled for oocyte retrieval. The patients were randomly allocated into two groups. General anesthesia was performed with remifentanil-propofol (group I) or alfentanil-propofol (group II). The numbers of oocytes collated, fertilized, transferal and pregnancy rate were recorded. Hemodynamic variables, patient satisfaction, recovery time and side effects were also recorded. Results: There were no significant differences in oocytes collected and pregnancy rates between the two groups. But fertilization was significantly higher in remifentanil-propofol group (P= 0.01). The recovery of patients in remifentanil-propofol was significantly rapid (P= 0.01). Intraoperative hemodynamic parameters, postoperative satisfaction and side effects were found to be similar in both groups. Conclusion: Remifentanil-propofol is of great benefit in providing an earlier recovery, however, both remifentanil-propofol and alfentanil-propofol regimens are suitable for oocyte retrieval.

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Background and purpose: Sexual health is a state of physical, mental and social well-being in relation to sexuality. This study aimed to determine the status of sexual function, its dimensions, and its socio-demographic predictors in women of reproductive age in Tabriz, Iran, in 2013. Materials and methods: Data were collected by Female Sexual Function Index (FSFI) scale and socio-demographic questionnaire. General liner model analysis was used for modeling of socio-demographic predictors of sexual function. Results: The mean score of sexual function was 65.9 ± 15.8 of the possible range of 0-100. Prevalence of sexual dysfunction was 66%. Sufficiency of household income for expenses and the level of satisfaction of spouse were predictors of sexual function in women. Conclusion: With attention to significant impact of the sexual function on health of women and their families, determining the effective factors on sexual satisfaction can assist strengthening of families.

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Background and purpose: Adolescent-mothers communication about reproductive health is one of the strategies that could decrease youth risky behaviors. This study aimed to find out the desire for communication, its level and content between adolescents and their mothers on reproductive health.

Materials and methods: In a descriptive study, 655 high school girls in Mazandaran, Iran were selected via stratified sampling (2015-16). The level of communication between adolescents and their mothers or any problem on this, the desire to talk to mothers and their active interaction about reproductive health was examined by adapted standard questionnaires.

Results: The mean score for adolescent’s knowledge on reproductive health was 5.76±1.45 out of 10. The mean scores for level of communication between adolescents and their mothers, any problems in the communication and the desire to talk to mothers were 34.12± 6.10, 31.83± 4.31, and 7.58± 4.17, respectively. The main topics of talks were puberty (83.7%) and sexual relationship (15.5%). The maximum duration of talks was 5-10 minutes (33%) in the preceding six months (35.4%). About one third of the girls were satisfied with the talks to their mothers (34.5%) and felt comfortable in having a discussion with them about reproductive health (31.3%).

Conclusion: Most adolescents did not communicate with mothers about reproductive health and their knowledge on it was weak. The adolescent-mothers communication and solving any barrier on this should be addressed. Nevertheless, implementation of programs on reproductive health sensitize both adolescents and mothers on the importance of having communication about it.

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Background and purpose: Empowerment is considered as one of the health efficiency components and is regarded as a personal right. In the Millennium Development Goals there is a particular focus on women's empowerment. women's empowerment and self-esteem and the interconnection between these concepts are highly important and can help in achieving sustainable development. In current study we aimed at investigating the relationship between self-esteem and empowerment of women in reproductive decisions.

Materials and methods: A descriptive-correlation study was carried out in 400 women attending health centers affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran. The subjects were recruited using multistage cluster sampling. Three questionnaires were used to collect the data, including socio-demographic characteristics, women's empowerment in reproductive decision-making, and the Rosenberg Self-Esteem Scale. Data analysis was done in SPSS V17 .

Results: Our study showed an average level of women's empowerment in reproductive decision-making. We found a direct correlation between self-esteem and empowerment of women in reproductive decision-making (r=0.34, P< 0.001).

Conclusion: Empowerment of women in general and in family planning domain requires special attention. Self-esteem is associated with women's empowerment in reproductive decision-making.

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Background and purpose: Sexual and Reproductive Health (SRH) is not merely limited to women's reproductive age, but it covers women's life from birth to death. The success of sexual and reproductive health programs could depend on the attitude and behavior of their male partners. Therefore, the aim of this study was to review male involvement in women's sexual and reproductive health.
Materials and methods: In this review, search was conducted in electronic databases such as Google scholar, Science direct, Pubmed, Scopus, Magiran, SID, and Cochrane for studies published between 1990 and 2016.  The search keywords included Men's participation, Sexual health, Reproductive health, and Women. One hundred twenty articles were found of which 65 were included in this study.
Results: Male involvement was classified according to nine themes: 1) family planning, 2) pregnancy care, 3) infant care and breastfeeding, 4) girl's puberty, 5) violence against women, 6) decision for abortion and after-care 7) protecting women against HIV, 8) supports during menopause and middle-age, and 9) diseases like gynecological cancer.
Conclusion: Positive impact of men's involvement on women's SRH was reported in almost all studies. Improving women's health is a universal goal which can be achieved by increasing men's awareness about their responsibilities.
 

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Background and purpose: Violence is one of the main aspects of gender inequality that is a major barrier to achieving the goals of global reproductive health. It is directly associated with women's access to health care and health outcomes. In a systematic review, we aimed to investigate the articles on the relationship between intimate partner violence and women's reproductive health.
Materials and methods: Electronic databases including, Scopus, ProQuest, PubMed, and Google Scholar were searched for articles published in English between 2010 and 2017.
Results: After evaluation, 31 articles were selected. The lowest and highest prevalence of violence was associated with physical violence (2.8%) and psychological violence (75.9%), respectively. Moreover, violence was found to be associated with six domains of reproductive health including, not using contraceptive methods, abortion, genital tract diseases, poor pregnancy outcomes, and not using reproductive health services.
Conclusion: Systematic review of studies investigated, showed a strong relationship between domestic violence and major aspects of reproductive health. Therefore, it is necessary to prevent domestic violence in order to promote the health of whole community.

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Background and purpose: Infertility is one of the most commonly diagnosed disease in women that is associated with physical, psychological, and social problems. A major problem that such women are faced with is on their sexual and reproductive health (SRH). Despite extensive studies on the satisfaction and sexual function of infertile couples, there is no studies that investigates SRH issues. The current study aimed at investigating SRH and its related factors among women.
Materials and methods: A cross sectional study was conducted and 400 women attending two infertility centers in Sari, Iran, were recruited using convenience sampling (2016-2017). Inclusion criteria included women > 18 years of age with infertility (primary or secondary) with any cause. The Sexual and Reproductive Health Needs Assessment Questionnaire was administered. The participants recorded their stress scores (0-5). Descriptive statistics were reported and logistic regression was used to evaluate the factors related to SRH.
Results: The SRH was found to be inappropriate in 250 (62.5%) women. According to multivariate regression analysis, inappropriate decision making in self health care (AOR=1.75, 95% CI (1.06-2.9)), high stress level (AOR=1.39, 95%, CI (1.14-1.7)), old age at marriage (AOR=0.94, 95% CI (0.9-0.99)), and secondary infertility (AOR=4.5, 95% CI (2.6-7.9)) were associated with SRH.
Conclusion: Factors such as the person making decision about health care, the level of stress, and age at marriage were found to be the variables which could improve SRH in infertile women by appropriate planning and preventive measures.
 

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Background and purpose: Female reproductive empowerment refers to the ability and rights to make free decisions in reproductive activities such as number of children and birth intervals. This study was designed to investigate the relationship between childbearing motivations and women reproductive empowerment.
Materials and methods: In this descriptive-correlational study, 810 women living in both urban (n=500) and rural (n= 310) areas participated. They were selected via two stage cluster sampling in Sari healthcare centers, 2017. Data were collected using a demographic-reproductive characteristics checklist, the Childbearing Questionnaire (CBQ), and Women's Empowerment Questionnaire. Data analysis was done applying independent t-test, one-way ANOVA, Pearson correlation coefficient, and linear regression.
Results: There was no significant association in the mean score for women reproductive empowerment in urban and rural areas (91.65± 12.86, 91.46±13.14, respectively, P= 0.593). The present study showed that women reproductive empowerment was directly associated with positive dimension of childbearing motivations (β=0.13, P <0.001) while it was inversely associated with negative dimension of childbearing motivations (β= -0.30, P <0.001). Also, women employment status (β=0.11, P= 0.003), husband's educational background (β=0.13, P= 0.029), and age of the last child (β= -0.07, P= 0.021) were amongst the factors affecting women reproductive empowerment.
Conclusion: Women reproductive empowerment is associated with diferent socio-economic factors among which husbands' educational level is believed to be highly effective. Therefore, appropriate planning on this issue is of great benefit in improving women reproductive empowerment.
 
 

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Background and purpose: Sexual self-efficacy as one of the major issues of sexual health is influenced by various individual and interpersonal factors in different socio-cultural contexts. The aim of this study was to investigate sexual self-efficacy and related factors in reproductive-aged diabetic women.
Materials and methods: This cross-sectional study was conducted in 410 diabetic women attending endocrinology centers affiliated to Mazandaran University of Medical Sciences, 2019-2020. The participants were selected by simple random sampling. Data were collected using Vaziri sexual self-efficacy questionnaire, the Female Sexual Function Index (FSFI), ENRICH Marital Satisfaction Scale, and Goldberg Big Five personality traits. Data were analyzed applying Independent t-test, ANOA, Pearson correlation coefficient, and Backward Stepwise Regression.
Results: The mean score for sexual self-efficacy was 15.93±5.70 (95% CI: 15.37-16.48). Multiple linear regression showed that spouse's education (β= 1.27, P= 0.026), spouse's age (β= -0.09, P= 0.013), conscientiousness (β= 0.09, P= 0.014), occupation (β= -2.26, P= 0.022), satisfaction from socioeconomic class (β= 0.93, P= 0.024), sexual function (β= 0.23, P< 0.0001), marital satisfaction (β= 0.06, P< 0.0001), and taking antidepressants (β= -1.13, P= 0.051) explained 59% of the variance of sexual self-efficacy score.
Conclusion: Various sociodemographic and socioeconomic factors affect the sexual self-efficacy of diabetic women in reproductive age, so, it is necessary to use a multi-disciplinary approach in providing sexual health care services for these women. 

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 Background and purpose: Factors associated with menstrual irregularities are highly important. This study aimed to determine the association between age at menarche and menstrual irregularities in reproductive period.
Materials and methods: This prospective longitudinal study, was done in women participating in Tehran Lipid and Glucose Study who did not reach menarche at the time of enrollment, but their age of menarche was recorded later during follow-up visits. The subjects were divided into three groups based on the age of menarche: 1- menarcheal age< 11 years; 2- menarcheal age 11-15 years, and 3-menarcheal age>15 years. The odds of menstrual irregularities were compared between these groups considering group 2 as reference. Statistical analyses were performed in STATA V13.
Results: The odds of menstrual irregularities in women of group 1 was two times higher than those in group 2 (OR = 2.0, 95% CI: 1.1-3.8) that was 2.2 times higher (OR = 2.2, 95% CI: 1.1-4.2) after adjusting for age and body mass index.
Conclusion: Menarcheal age <11 years increases the risk of menstrual irregularities in reproductive women and should be considered as an influential factor in assessment of women with menstrual irregularities.

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Background and purpose: Obesity is a growing public health concern worldwide. This study examined the prevalence of obesity/overweight and its relation with cumulative socioeconomic risk in women of reproductive age in Mazandaran province, Iran.
Materials and methods: In this descriptive correlational study using a multi-stage cluster sampling method, 540 married women aged 15-45 referred to primary health centers in Mazandaran province were recruited (2020). Body mass index was categorized into three levels: obese (≥30), overweight (25-29.9), and normal (18.5-24.9). Socio-economic status was classified using generalized Oaxaca-Blinder decomposition method. Each of the socio-economic variables (8 indicators) was given a score of zero or one, and then the scores were added up. The scores of ≥5, 3-5, and ≤2 were considered good, average, and poor, respectively. The relationship between socio-economic variables and different levels of body mass index was assessed once separately and once cumulatively in binary regression.
Results: The prevalence of obesity and overweight was 23.3% and 48.5%, respectively. The socio-economic status of 26.2% of the participants was classified as good, 64.3% as average, and 9.5% as poor. There was a significant positive and negative relationship between obesity in women with their number of children (OR: 2.72, 95% CI: 1.50-5.17) and obesity in their parents (OR: 0.43, 95% CI: 0.19-0.94) respectively. Statistical tests did not show significant relationship between women's obesity and their cumulative socio-economic status (P>0.05).
Conclusion: The prevalence of obesity and overweight among women of reproductive age, regardless of their socio-economic status, has reached epidemic proportions. Extensive studies are suggested to better understand the factors that contribute to obesity and to provide a more accurate explanation for the rapid increase in obesity among various socio-economic groups.