Various parameters of sexual functioning were assessed in a prospective, crossover investigation of 53 surgically menopausal women. Patients randomly received either an estrogen-androgen combined preparation, an estrogen-alone drug, an androgen-alone drug, or a placebo. Also included were a group of women who had undergone hysterectomy and whose ovaries had been left intact. Two treatment phases, each of 3 months' duration, were separated by an intervening placebo month. Additionally, plasma levels of total estrogens and testosterone were assayed four times during the study concurrent with monitoring of sexual behaviors. It was clear that exogenous androgen enhanced the intensity of sexual desire and arousal and the frequency of sexual fantasies in hysterectomized and oophorectomized women. However, there was no evidence that testosterone affected physiologic response or interpersonal aspects of sexual behavior. These findings suggest that the major impact of androgen in women is on sexual motivation and not on sexual activity per se.

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Psychological adjustment, lifestyle, and sleep parameters were investigated in 634 older community residents. Participants were divided into three categories: good sleepers, poor sleepers experiencing high distress, and poor sleepers experiencing minimal distress. Results indicate that (1) highly distressed poor sleepers manifested an anxious, depressed, negative cognitive-affective set; (2) many coped well with age related changes in sleep quality--they resembled good sleepers in the relative absence of psychological maladjustment they displayed; (3) the three groups had similar lifestyles, but they differed in the cognitive-affective evaluation of their activities, (4) the insomnia complaint is itself multifaceted and is comprised of three distinct elements--difficulty sleeping, distress, and daytime fatigue; (5) sleep practices (e.g., naps, bedtimes) are not implicated in chronic poor sleep; and (6) many commonly held assumptions about sleep disruptions in older individuals are myth rather than reality. Implications for better understanding and treating insomnia in older individuals are discussed.

Using a multidimensional approach to measure stress, this study prospectively examined the influence of maternal stress, social support and coping styles on labor/delivery complications and infant birth weight. Beginning in the third month of pregnancy, stress was assessed monthly. In each trimester, data on social support, coping strategies, lifestyle behaviors and pregnancy progress were collected. One month following delivery, information on labor, delivery and infant status was obtained. The final sample consisted of 80 women. The results demonstrated that women who experienced greater stress during pregnancy had a more difficult labor/delivery, even after controlling for parity. Younger maternal age was also linked with intrapartum complications. Perceived prenatal social support emerged as a predictor of infant birth weight. Women who reported less satisfaction with their social support in the second trimester gave birth to infants of lower birth weight. The results suggest an association between specific psychosocial variables and negative birth outcomes.

This prospective study examines the influence of maternal stress, social support and lifestyle variables reported over the course of pregnancy on subsequent gestational and intrapartum complications. Demographic and biomedical factors were also studied. One hundred and two women were followed on a monthly basis beginning in the third month of pregnancy. Measures of daily stress (hassles), state-anxiety (STAI-state) and pregnancy-specific stress were taken monthly. Pregnancy progress and lifestyle behaviors such as smoking, caffeine and alcohol intake were assessed by trimester. One month following delivery, a telephone interview was conducted to inquire about the labor/delivery and infant status. Sixty-three per cent of the women experienced a pregnancy complication. Three groups consisting of women who experienced gestational complications, intrapartum complications only, and no complications were formed. Women who subsequently experienced gestational complications reported over the course of their pregnancy higher levels of state-anxiety, daily hassles and pregnancy-specific stress beginning in the third month of pregnancy. Women who experienced complications during the intrapartum period only reported higher daily hassles during pregnancy and consumed more caffeinated beverages compared to the other groups. Primiparous women were more likely to experience gestational and/or intrapartum complications than multiparous women. These findings support a role for psychosocial variables in pregnancy complications. The results indicate that certain psychosocial and lifestyle variables may be differentially associated with complications occurring at various phases of pregnancy.