A government survey released Thursday shows about 60 percent of women with hysterectomies recently had a Pap test.

For years, experts have said there's no need to screen women who had a total hysterectomy for reasons other than cancer. A total hysterectomy removes the uterus and cervix.

The Centers for Disease Control and Prevention surveyed thousands of women ages 30 and older who had a hysterectomy. Those who recently had Pap tests fell from 73 percent in 2000 to 59 percent in 2010.

Experts say some tests may have been warranted, but the others were probably done because Paps have long been part of annual doctor visits. 

Disgust may play a role in a sexual dysfunction that often renders penetration impossible, new research finds, perhaps revealing a psychological component to physical sexual complaints.

Specifically, women with a disorder called vaginismus are more likely than healthy women or women who have other sexual disorders to feel disgust in response to sexual byproducts such as semen. Vaginismus is a condition in which the pelvic muscles involuntarily contract when penetrated; it often prevents penis-in-vagina intercourse entirely. Though the exact number of women affected is unknown, vaginismus is an uncommon condition, according to the National Institutes of Health.

The new results suggest that involuntary disgust could cause this contraction as a defense mechanism, researchers say.

"In this sense, disgust acts as an emotional equivalent to a cold shower," said Mark van Overveld, a postdoctoral researcher at Erasmus University Rotterdam.

Objectively, van Overveld told LiveScience, sex is a disgusting activity. The bodily fluids and contact with body parts involved are often considered gross or taboo. "From that perspective," van Overveld said, "it is actually quite surprising that people even manage to engage in the act of sexual intercourse at all." 

The researchers developed a sex-specific questionnaire, focusing largely on questions such as how disgusting it would be to handle someone else's, or one's own, sexual fluids. They first tested the questionnaire on 762 students and university employees to make sure it accurately measured sexual disgust. They found that it did.

Next, the researchers recruited 39 women with lifelong vaginismus, 45 women with dyspareunia, or pain during sexual intercourse, and 28 men with erectile dysfunction and asked them to fill out the questionnaire. [ Top 10 Stigmatized Health Disorders ]

The answers revealed that women with vaginismus were more likely than healthy participants or men and women with other sexual disorders to report disgust for sexually contaminated items. This suggests a role for disgust in either the origin or the continuation of the disorder, van Overveld said.

What's tougher to say is exactly how the emotion plays into the dysfunction. The disgust could come first, triggering the pelvic muscle clampdown. Or perhaps initial sexual problems contribute to disgust with the process, van Overveld said. But disgust is an important defense mechanism, he said, and the pelvic-muscle tightening could be a reflex akin to vomiting.

Previous studies have found that disgust and arousal work in opposition to one another, with sexual arousal dampening disgust. The current study, published online Oct. 22 in the Journal of Sexual Medicine, also found that even in healthy women, more feelings of disgust were linked to fewer feelings of sexual arousal.

The findings shouldn't be taken as blaming women with vaginismus for their condition, van Overveld warned. For one thing, disgust is not easy to control. For another, women with vaginismus have been shown in previous research to have normal sex drives.

However, learning to deal with disgust could potentially help women with vaginismus lessen their condition, van Overveld said. Current experimental therapies have women gradually practice touching their own genitalia, diminishing negative emotions in a controlled way. It's a therapy similar to those used to cure phobias, such as fear of spiders.

"An important next step would be to look at the relationship between disgust and sexual arousal more closely," van Overveld said. "Can sexual intercourse indeed perhaps be interpreted as a delicate balance between disgust on the one hand and a state of sexual arousal on the other? If so, can we help women with lifelong vaginismus to shift this balance?"

More from LiveScience:

NEW YORK - More than one in five women with early-stage breast cancer in a new study said they were given too much responsibility for treatment-related decisions - and those patients were more likely to end up regretting the choices they made.

The findings don't mean women should not be fully informed about their treatment options, researchers said, but rather that doctors may need to find new strategies to communicate with patients, especially those who are less educated.

"Some women may feel overwhelmed or burdened by treatment choices, particularly if they are not also given the tools to understand and weigh the benefits and harms of these choices," researchers led by Jennifer Livaudais wrote in the Journal of General Internal Medicine.

Her team from the Mount Sinai School of Medicine in New York surveyed 368 women who had just had surgery for early-stage breast cancer at one of eight New York City hospitals, and again six months later.

The majority said they typically had trouble understanding medical information and less than one-third knew the possible benefits of surgery, radiation and chemotherapy, Livaudais and her colleagues found.

Lack of both "health literacy" and knowledge about treatment benefits was common among the 21 percent of women who said they had too much responsibility for decision-making - as well as among the seven percent who felt they didn't have enough responsibility.

Women who were poor, non-white or didn't finish high school were also more likely to feel that they had either too much or too little say in their treatment.

Close to two-thirds of women on both ends of the spectrum had some regret about their original treatment decisions six months down the line. That compared to one-third of women who originally said they had a "reasonable amount" of decision-making responsibility.

One in eight women will be diagnosed with breast cancer at some point in her life, according to the National Cancer Institute, with a higher risk among those with certain genetic mutations.

Dr. Steven Katz, who has studied cancer-related decision-making at the University of Michigan in Ann Arbor, said that compared to past years, doctors now have better ways to tailor treatment to individual patients. But that also means treatment options are based on more convoluted information.

"The treatments are linked in complicated ways, and the information that doctors draw on to make recommendations has increasingly become more and more complex," Katz, who wasn't involved in the new research, told Reuters Health.

He said that for patients trying to make the best treatment choices, the smartest thing they can do is have a team of doctors - an experienced surgeon, a medical oncologist, a radiation oncologist and a plastic surgeon - all working on their case and sharing ideas.

"Of course if they have strong preferences for retaining a breast and having radiation yes (or) no, those are really important decisions for a patient to think about," Katz said.

"There are very strong reasons to engage women at the very highest level regarding those values and preferences."

"The purpose (of the study) was not to say women shouldn't be provided with these treatment options, but that the information really needs to be tailored better," Livaudais, who is now at the University of California, San Francisco, told Reuters Health.

She recommended doctors ask each patient how much responsibility she feels comfortable taking going into treatment.

"Some patients prefer… for the information to be presented in simpler terms, or for the physician to recommend something to them," Livaudais said.

NEW YORK - Despite a widespread belief that sex during the later stages of pregnancy can jumpstart labor, a new study from Malaysia found no differences in the timing of delivery between women who had sex near term and those who abstained.

"We are a little disappointed that we did not find an association," said Dr. Tan Peng Chiong, an obstetrics and gynecology professor at the University of Malaya, and one of the authors of the study. "It would have been nice for couples to have something safe, effective and perhaps even fun that they could use themselves to help go into labor a little earlier if (they) wanted."

Tan said that many women believe intercourse can induce labor, and scientists have proposed plausible biological explanations for why it might help.

For one, semen contains a hormonelike substance called prostaglandin, which is used in synthetic form to induce labor.

Breast stimulation is also thought to hasten labor and orgasm can trigger uterine contractions.

Tan said the belief also probably came from "the deep seated folk perception that intercourse in pregnancy may be unsafe and may cause pregnancy expulsion or miscarriage despite fairly replete evidence to the contrary."

But few studies have ever investigated whether sex really can initiate labor, and the small amount of existing evidence was inconclusive, Tan and his colleagues write in the obstetrics and gynecology journal BJOG.

So they set out to see whether advising women to have sex during the final weeks of pregnancy could help them avoid an induction.

"Labor induction for prolonged pregnancy is common and many women are also tempted for a variety of personal reasons to trigger labor off in the very latter stages of pregnancy," he said.

The researchers invited more than 1,100 women to participate, all of whom were 35 to 38 weeks pregnant (the typical pregnancy lasts 40 weeks) and none of whom had had sex in the previous six weeks.

Roughly half of the women were advised by a physician to have sex frequently as a means of safely expediting labor.

The other half were told that sex was safe during pregnancy, but that its effects on labor were unknown.

The researchers then tracked the women to determine how long their pregnancies lasted and whether they required any medical intervention to start labor.

They found that about 85 percent of the women who were encouraged to have sex did follow the doctor's advice, while 80 percent of women in the other group also had sex.

Women in the group advised to have sex also had it more frequently for the remaining duration of their pregnancies - three times versus two.

But the rates of induced labor were similar in both groups: 22 percent of those advised to have sex and 20.8 percent of the other group had inductions, a difference so small it is likely to have been driven by chance.

Pregnancy also lasted an average of 39 weeks for both groups.

Dr. Jonathan Schaffir, an associate professor of obstetrics and gynecology at The Ohio State University College of Medicine who has studied obstetrical folklore, said the findings offer good support for the idea that sex won't induce labor.

Earlier research had relied primarily on surveys of women about their sexual experiences during pregnancy, but this study was "the first attempt to really randomize the experience, for some to have sex and some to not, which is a very hard thing to do," he said.

Schaffir wouldn't advise his patients to have sex for the express purpose of going into labor, he added, but the study did indicate that there aren't any hazards to it.

"Even though this study did not show any increase in the rate of labor or a decrease in the rate of induction, it helped to cement the idea that having sex is probably safe if you want it," he told Reuters Health.

Tan said the results show that pregnancy evolved to be resistant to disruption.

"Human pregnancy has to be robust to a little adventure like intercourse and unfortunately for our purpose, it seems pretty robust to the very end," he said.

NEW YORK - U.S. abortions fell 5 percent during the Great Recession in the biggest one-year decrease in at least a decade, according to government figures released Wednesday.

The reason for the decline wasn't clear, but some experts said it may be due to better use of birth control during tough economic times. Their theory is that some women believe they can't afford to get pregnant.

"They stick to straight and narrow ... and they are more careful about birth control," said Elizabeth Ananat, a Duke University assistant professor of public policy and economics who has researched abortions.

While many states have aggressively restricted access to abortion, most of those laws were adopted in the past two years and are not believed to have played a role in the decline.

Abortions have been dropping slightly over much of the past decade. But before this latest report, they seemed to have leveled off.

The new data from the Centers for Disease Control and Prevention found that both the number and rate of abortions fell 5 percent in 2009, the most recent statistics available from most states.

Nearly all states report abortion numbers to the federal government, but it's voluntary. A few states — including California, which has the largest population and largest number of abortion providers — don't send in data. Experts believe there are more than 1 million abortions performed nationwide each year, but because of the incomplete reporting, the CDC had reports of about 785,000 in 2009.

For the sake of consistency, the CDC focused on the numbers from 43 states and two cities — those that have been sending in data without interruption for at least 10 years. The researchers found that abortions per 1,000 women of child-bearing age fell from about 16 in 2008 to roughly 15 in 2009. That translates to nearly 38,000 fewer abortions in one year.

Mississippi had the lowest abortion rate, at 4 per 1,000 women of child-bearing age. The state also had only a couple of abortion providers, and has the nation's highest teen birth rate. New York was highest, with abortion rates roughly eight times higher than Mississippi's. New York is second only to California in number of abortion providers.

Nationally since 2000, the number of reported abortions has dropped overall by about 6 percent and the abortion rate has fallen 7 percent, but the figures essentially leveled off for a few of those years.

By all accounts, contraception is playing a role in lowering the numbers.

Some cite a government study released earlier this year suggesting that about 60 percent of teenage girls who have sex use the most effective kinds of contraception, including the pill and patch. That's up from the mid-1990s, when fewer than half were using the best kinds.

Experts also pointed to the growing use of IUDs. The IUD, or intrauterine device, is a T-shaped plastic sperm-killer that a doctor inserts into a woman's uterus. A Guttmacher Institute study earlier this year showed that IUD use among sexually active women on birth control rose from under 3 percent in 2002 to more than 8 percent in 2009.

IUDs essentially prevent "user error," said Rachel Jones, a Guttmacher researcher.

Ananat said another factor for the abortion decline may be the growing use of the morning-after pill, a form of emergency contraception that has been increasingly easier to get. It came onto the market in 1999 and in 2006 was approved for non-prescription sale to women 18 and older. In 2009 the age was lowered to 17.

Underlying all this may be the economy, which was in recession from December 2007 until June 2009. But well afterward, polls have shown most Americans remained worried about anemic hiring, a depressed housing market and other problems.

You might think a bad economy would lead to more abortions by women who are struggling. However, John Santelli, a Columbia University professor of population and family health, said: "The economy seems to be having a fundamental effect on pregnancies, not abortions."

More findings from the CDC report:

• The majority of abortions are performed by the eighth week of pregnancy, when the fetus is about the size of a lima bean.
• White women had the lowest abortion rate, at about 8.5 abortions per 1,000 women of child-bearing age; the rate for black women was about four times that. The rate for Hispanic women was about 19 per 1,000. 
• About 85 percent of those who got abortions were unmarried. 
• The CDC identified 12 abortion-related deaths in 2009. 

Doctors are misinformed about which women can receive one type of birth control, a new study suggests.

Researchers surveyed health care providers at family planning clinics in Colorado and Iowa, finding that only about half of the providers said they considered Paraguard and Mirena, types of intrauterine devices (IUDs), safe and reliable for preventing pregnancy in women who had just had babies.

In addition, about 30 percent of respondents said these IUDs were not safe for women who had just had abortions.

These views conflict with new recommendations from the American College of Obstetrics and Gynecology, which said last year that almost all women, including those who have recently had a baby or abortion, can safely receive IUDs.

Moreover, health care providers at family planning clinics are likely more informed about IUD use than the average doctor. Therefore, the misconceptions among doctors in general could be even more widespread, said study researcher Claire Brindis, a director of the Bixby Center for Global Reproductive Health at the University of California, San Francisco.

For patients, the message is: know the facts about IUDs, Brindis said. Women should discuss their level of comfort with inserting IUDs with their doctors, and those women who want this kind of birth control should find a doctor who is willing to perform the procedure.

For many women, IUDs may be more effective at preventing pregnancy than are birth control pills. A study published in May in the New England Journal of Medicine found that women who used birth control pills, skin patches or vaginal rings were 20 times more likely to get pregnant over a three-year period than women who used IUDs or implants.

The devices do carry risks, however; women who currently have pelvic infections or get them frequently should not use the devices. ParaGard, which is a copper, hormone-free device, has been associated with heavy bleeding, severe cramping and vaginal inflammation. Mirena, which releases small amounts of a synthetic progestin hormone, may be associated with hormonal side effects, such as acne, weight gain or mood changes. Neither device protects against sexually transmitted infections.

But some doctors may have concerns that an IUD could tear the uterus of a woman who has just had a baby or an abortion ; the latest science does not support these worries, however, Brindis said. Changes since the devices first appeared may contribute to the misunderstanding, she said. Doctors who received their medical training many years ago may be less informed about today's IUDs, or may associate IUDs with the stigma attached to the devices in the 1970s, when one IUD called the Dalkon Shield was linked with bacterial infections of the uterus, Brindis said.

In the new study, Brindis and colleagues analyzed information from 273 doctors, doctor's assistants, nurse practitioners, certified nurse midwives and registered nurses. Participants filled out surveys in 2010 and 2012. During that period, family planning agencies had pushed to increase education about IUDs among health care providers in Iowa and Colorado, where they survey occurred.

That education has helped somewhat — the percentage of doctors who said IUDs were safe and reliable for postpartum women increased from 37 percent to 50 percent over the two-year period. But there is still a lot of room for improvement, Brindis said.

"We still have a long way to go to have a wide acceptance," Brindis said. IUDs are often considered a "last resort" for birth control, but there is no need to view them this way, she said.

For a woman with insurance, an IUD costs about $500 — more expensive than a single payment for birth control pills. But over the long-term, an IUD that lasts five or 10 years can cost less than many months of pill prescriptions, Brindis said.

The study was presented this week at the American Public Health Association meeting in San Francisco. It was conducted in collaboration with Ashley Philliber and colleagues at Philliber Research Associates, an independent research and evaluation firm in Accord, N.Y.

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NEW YORK - Women suffering symptoms of a heart attack are more likely than their male counterparts to dial 911 - but there's a lot of room for improvement for men and women, alike, a new study finds. 

It's estimated that more than 1 million Americans suffer a heart attack each year, and about half of them die.

To boost your odds of survival, experts say you should call 911 at the first signs of possible heart attack symptoms - which include pain or a squeezing sensation in the chest; trouble breathing; pain in the arms, shoulders and neck; dizziness or lightheadedness; and nausea or vomiting.

"I think you should have a low threshold for calling," lead researcher Dr. Jonathan D. Newman of Columbia University Medical Center in New York told Reuters Health. "Rather than ‘watching and waiting.'"

In the new study, Newman and his colleagues looked at how often New Yorkers with heart symptoms called 911. They found that among 184 heart attack sufferers, women were more likely than men to call: 57 percent did, versus 28 percent.

But both men and women typically failed to dial 911 for symptoms of unstable angina - unexplained chest pain that doesn't go away with rest, or may even get worse. The pain is caused by reduced blood flow to the heart, and it could signal an impending heart attack.

The findings, reported in The American Journal of Cardiology, are based on 476 patients who either arrived at the Columbia ER or were transferred to the hospital from a nearby center.

Overall, 61 percent ended up being diagnosed with unstable angina, and 39 percent with a heart attack.

Among 292 people with unstable angina in the new study, only 15 percent of women and 13 percent of men called 911.

It's not clear how everyone else got to medical attention - whether they hopped on the subway or hailed a cab, according to.

But the bottom line, he said, is that anyone with possible heart attack or unstable angina symptoms should call. Getting treatment quickly is key, he noted. And if you call an ambulance, paramedics can begin your treatment en route to the hospital.

ATYPICAL SYMPTOMS

It's unclear why female heart attack victims appear more likely to call 911, Newman said.

Women, he noted, are more likely than men to have so-called atypical heart attack symptoms - like unexplained shortness of breath, nausea or weakness. They're also more likely than men to have no chest pain at all.

Given that, you might expect women suffering a heart attack would call 911 less often than men, Newman pointed out. But that's not the case.

Newman's team did find that the gap between men and women was concentrated among people younger than 65. That is, relatively younger women were more likely than their male counterparts to call 911.

"We don't have a clear reason for that," Newman said.

He speculated that younger women might find symptoms like chest discomfort or breathlessness more alarming than older women do.

"Younger women may be less likely to see these symptoms as a part of aging," Newman said.

Since the patients were all New Yorkers, the figures may not be true of all Americans, according to Newman.

But, he and his colleagues write, the findings do suggest that people need more education on when to call 911.

"Heart attack symptoms can vary," Newman said. "It doesn't have to be the classic ‘clutching your chest in pain.'"

Snoring that begins during pregnancy may be a sign of breathing problems that put women at risk for high blood pressure, a potentially serious complication for the mother and baby, a new study says.

In the study, women who began snoring while pregnant were twice as likely to have pregnancy-induced high blood pressure, or preeclampsia, compared with pregnant women who did not snore.

The findings held even after the researchers took into account factors that could affect blood pressure, such as the mother's age, race, smoking habits and weight gain in pregnancy.

High blood pressure in pregnancy is linked with an increased risk of premature birth and smaller babies.

The study found only an association, and not a direct cause-effect link.

But if breathing problems during sleep do in fact increase blood pressure in pregnant women, the researchers estimate close to 19 percent of pregnancy-related high blood pressure cases, and 11 percent of preeclampsia cases, could be helped by treating snoring.

The new findings suggest that screening pregnant women could help identify those at risk for hypertensive disorders, said study researcher Louise O'Brien, an associate professor at the University of Michigan's Sleep Disorders Center.

A study published earlier this month found that babies born to women with sleep apnea were at increased risk for admission to the neonatal intensive care unit.

"If sleep apnea really is playing a role in these outcomes, then this is a clear opportunity that we can intervene and hopefully improve some of those pregnancy outcomes," O'Brien said.

Pregnancy, in fact any weight gain, is known to put people at risk for breathing problems during sleep, including snoring, the researchers said. Earlier studies have also linked breathing problems in sleep to an increased risk of high blood pressure in the general population.

In the new study, O'Brien and colleagues analyzed information from more than 1,700 pregnant women who were at least 28 weeks pregnant. Participants reported whether they snored or gasped for air during sleep, and when the breathing problems began.

Thirty-four percent of women reported snoring as frequently as three to four times a week, and 25 percent said their snoring started during pregnancy.

Among those whose snoring began during pregnancy, about 10 percent had pregnancy-related hypertension, compared with 4.5 percent of those who did not snore.

In addition, 13 percent of those whose snoring began during pregnancy had preeclampsia, compared with 8 percent of those who did not snore.

The researchers noted that the women reported their own snoring, which may not be entirely accurate.

Any pause or obstruction in breathing during sleep increases the activity of the nervous system, which in turn increases blood pressure, O'Brien said.

Breathing problems in sleep are also associated with increased inflammation, which is thought to play an important role in preeclampsia.

It's not known whether the women in the study who began snoring while pregnant also started having high blood pressure at the same time, O'Brien said.

In some sense, the new findings are the opposite of what one would expect — women who were snoring for a short time had a higher risk of high blood pressure than chronic snorers, O'Brien said. But it could be that chronic snorers have adapted to the condition, whereas women who start snoring during pregnancy experience a rise in blood pressure because snoring presents an extra challenge to their bodies, O'Brien said.

O'Brien and colleagues are now conducting a study to see if treating breathing problems with continuous positive airway pressure (CPAP) reduces high blood pressure in pregnant women.

The new study was published online Sept. 10 in the American Journal of Obstetrics and Gynecology. Preliminary results from the study were presented in 2009 at the Associated Professional Sleep Societies in Seattle.

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