Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery
Garcia-Perez, H., Sioban D. Harlow, C.A. Erdmann, and C. Denman. 2010. "Pelvic Pain and Associated Characteristics Among Women in Northern Mexico." International Perspectives on Sexual and Reproductive Health, 36(2): 90-98.
CONTEXT: Until recently, the reproductive health agenda has focused on a restricted number of morbidity indicators, particularly those associated with life-threatening diseases. However, gynecologic morbidities that are a source of pelvic pain, although not life-threatening, do impose a substantial burden because of their potential to reduce women's overall well-being. METHODS: In 2005,a cross-sectional population-based study was conducted in Hermosillo, Mexico, to assess self-reported pelvic pain conditions in a random sample of 1,307 women aged 25-54. The 12-month prevalence of each condition was calculated, and logistic regression was used to assess the association between pelvic pain and social, demographic, anthropometric and reproductive characteristics, and other medical conditions. RESULTS: The 12-month prevalence of pelvic pain during menstruation among 1,007 menstruating women was 40%. Pelvic pain during or after sexual intercourse was reported by 12% of the 1,183 sexually active respondents. Among 1,201 nonpregnant women, 6% reported chronic pelvic pain. In adjusted analyses, younger age (25-34 years) and having a history of STIs or pelvic inflammatory disease (PID) were associated with an increased risk of pain during menstruation and chronic pelvic pain (odds ratios,1.6-3.1). An interaction term for younger age and history of STIs or PID was associated with an elevated risk of intercourse-related pelvic pain (6.4). Chronic pelvic pain and pain during menstruation were more frequently reported as interfering with daily activities than was intercourse-related pelvic pain. The proportion of women who had talked with a physician about their condition was highest among those with chronic pelvic pain (40%). CONCLUSION: Pelvic pain associated with menstruation, pelvic pain during or after sexual intercourse, and chronic pelvic pain are common complaints among Mexican women of reproductive age. Health care providers should pay greater attention to these conditions. International Perspectives on Sexual and Reproductive Health, 2010, 36(2):90-98
Country of focus: Mexico.