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Sexual guilt and anxiety linked to worse sexual functioning

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Women with stronger sexual guilt and anxiety report poorer sexual functioning, a study of sexually active women in Indonesia finds.

Sexual functioning is the ability to experience healthy, satisfying sexual activity, including desire, arousal, lubrication, orgasm and satisfaction, and the absence of pain during sex.

The study authors note that traditional values in Indonesian society discourage discussion of sexual issues, with sex remaining largely taboo.

They suggest young people face conflicting social and cultural views that foster sexual guilt and anxiety.

Sex guilt is a generalised expectation of punishment for violating standards of appropriate sexual behaviour.

Individuals with strong sex guilt may avoid sex, lack sexual initiative and struggle to process sexual stimuli. Sex anxiety concerns others’ opinions and possible breaches of social norms.

Participants were 169 women aged 19 to 40 from Greater Jakarta, recruited via an online survey shared on social media and WhatsApp.

Of those surveyed, 59 per cent were married, 44 per cent had children and 56 per cent held a bachelor’s or master’s degree.

They completed assessments of sexual functioning (Female Sexual Function Index), sex guilt (Brief Mosher Sex Guilt Inventory) and sex anxiety (Sex Anxiety Inventory).

Results showed higher sex guilt and sex anxiety were linked to worse sexual functioning.

There were no differences in sex guilt, sexual functioning or sex anxiety between participants with and without children. Single women tended to report worse sexual functioning than other groups.

Study authors Mia Audina Olivia and Ahmad Naufalul Umam concluded: “Our main finding confirmed the global dynamics on how sexual guilt and anxiety may hinder one’s sexual functioning, while the demographic data showed that sexual functioning in Indonesian women’s context is tied with normative relationship of marriage.”

The researchers noted that the study design does not allow causal conclusions to be drawn from the results.

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75% of new mothers struggle with body image, study finds

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Up to 75 per cent of Australian women report concerns about their body image after giving birth, with many feeling pressure to “bounce back” to pre-pregnancy shape.

A review of 36 studies found these struggles are shaped by partners, families and cultural expectations, and that social pressure can even trigger eating disorders for the first time.

The analysis showed that social and interpersonal factors can either protect against or worsen body dissatisfaction and disordered eating during pregnancy and the first year after birth.

Researchers at Flinders University in Australia found that supportive partners and strong social networks help women feel more positive about their bodies, while unrealistic media portrayals and appearance-focused comments can cause harm.

Lead author Madeleine Rhodes, a PhD candidate at Flinders, said: “We wanted to understand how new and expecting mums are affected by the people and environment close to them when it comes to their bodies and eating habits.

“Whilst support from partners, family, friends, and healthcare professionals can help women feel better about their bodies, negative comments and social pressure to ‘bounce back’ make things worse.”

Protective factors included emotional and practical support from loved ones and clear, non-judgemental guidance from healthcare providers.

Risk factors included appearance-related comments, interpersonal abuse and pressure to conform to thin ideals. Some women reported that weight-related advice triggered distress, especially those with a history of eating disorders.

Healthcare professionals were identified as vital sources of reassurance, yet many women said conversations about body changes were absent or overly focused on weight.

Professor Ivanka Prichard, senior author, said: “The cultural obsession with ‘getting your body back’ is harmful and unrealistic.

“This is a public health issue with real consequences for mothers, babies, and families.

“By shifting the focus from individual responsibility to shared support, we can create healthier outcomes for everyone.”

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NICE recommends new age-based thresholds for ovarian cancer screening

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The National Institute for Health and Care Excellence (NICE) has proposed age-based thresholds for ovarian cancer screening to help identify women at higher risk earlier.

Previously, testing has used a blood test for cancer antigen 125 (CA125), a protein marker linked to ovarian cancer, with women showing 35 IU/mL or above referred for checks regardless of age.

Experts say this fixed threshold can miss cancers in older women while prompting unnecessary investigations in younger women.

In a draft update to guidelines, the NICE proposes more personalised criteria to reflect changing risk with age.

It adds that CA125 alone is not accurate enough to guide decisions for women under 40 and recommends ultrasound for those with persistent symptoms.

Eric Power, deputy director of the centre for guidelines at NICE, said: “The committee’s proposed recommendations will ensure more personalised, targeted testing, so women at greatest risk of ovarian cancer are identified and referred sooner.

“This tailored approach will mean GPs can make more informed decisions about which patients need urgent investigation, while reducing unnecessary ultrasound scans, freeing up NHS resources.

“These updates will ensure that our guideline reflects the latest evidence and will help improve the detection of cancer and ensure those who need it get swift treatment.”

The draft also proposes that people aged 60 and over with unexplained weight loss of more than five per cent over six months receive further investigation or suspected cancer pathway referral.

Amid rising hormone replacement therapy use in England, NICE also calls for more research into when unexpected bleeding while on HRT should trigger checks for endometrial cancer, which affects the womb lining.

There are an estimated 7,000 new ovarian cancer cases and nearly 4,000 deaths in the UK each year.

Only one in five patients are diagnosed early, when treatment is more likely to succeed.

Of those diagnosed early, 93 per cent survive more than five years, compared with 13 per cent diagnosed later.

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Research aims to shed light on chronic UTIs

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A new database on chronic urinary tract infections aims to help explain why millions of women and girls worldwide develop persistent infections that can defy treatment.

A growing body of research suggests persistent, antibiotic-resistant UTIs may be caused by bacteria that embed deep within the bladder wall, potentially evading both the immune system and conventional treatments.

This phenomenon, known as intracellular bacterial colonisation, means bacteria live inside cells rather than on their surface.

While it is not new, a medical case study of a child with chronic infections, led by University of Sydney researchers, suggests its long-term impact may be underestimated.

The case study found no antibiotic regimen, including aggressive long-term courses, could eliminate the infection because bacteria were embedded in the epithelium, the bladder’s inner lining.

Samples showed no improvement despite years of treatment, raising concerns about current approaches, which remain limited to antibiotic therapy and diathermy, a surgical technique using heat from an electrical current to cut or coagulate the bladder lining, and which carries an increased risk of cancer development if performed repeatedly.

Lead researcher Dr Arthika Manoharan, from the Charles Perkins Centre and the School of Medical Sciences, said some girls as young as five are treated with antibiotics for years, often relapsing as soon as treatment stops.

As a result of the published case study, children under 15 will be the focus of the new database built by Dr Manoharan, which aims to understand why some people develop chronic UTIs.

She said she hopes it will help remove the long-held assumption that UTIs are linked to sexual activity.

She said: “Often people think of UTIs only affecting adult women who are sexually active, which is not the case.

“There are many cases where this issue starts in childhood, with no clear cause.

“This can have a huge impact to their quality of life at a time when they should be enjoying school, playing sports and simply being kids.

“The longer consequences of persistent UTIs can be severe.

“Some women see their employment affected due to chronic incontinence; others are unable to maintain a sexual relationship.

“Many echo the same sentiment: One minute you’re fine, the next you’re in agony and can’t leave the house.”

The research team said it hopes the database will help explore whether immune system evasion or genetic predisposition could explain why some children develop chronic UTIs while others do not.

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