Menstruation Matters

Military service involves potential exposure to a range of physical, chemical, and biological hazards that could impact reproductive health. Females represent 20% of Australian Defence Force (ADF) members and, like many military services, the ADF is prioritizing their recruitment and retention. However, given that females have different physiology and anthropometry, specific female occupational research is essential. This systematic review aimed to retrieve and summarize the findings of research involving currently serving ADF personnel with outcomes relevant to male or female reproductive health or any aspect of female health. Reproductive and female health studies between January 2002 and April 2023 that included serving ADF members were identified through a systematic search of 5 scientific databases. Data were extracted and synthesized, alongside a risk of bias assessment following PRISMA-ScR guidelines. Overall, 8 studies relating to reproductive health and 14 studies related to female health were identified. Studies were methodologically heterogeneous: few studies were at low risk of bias and few covered the same health outcome, preventing pooling of data. Four studies of males concluded that deployment to the Middle East was not associated with risk of infertility or birth defects. Female reproductive health studies provided very limited data. Other female health research primarily covered musculoskeletal disorders and injuries from basic training. Studies of reproductive and female health in ADF members do not currently provide a cohesive or comprehensive body of evidence in either area. This review serves as a systematic map of the existing evidence to identify gaps and set future strategic research agendas. More high-quality longitudinal studies with sex-stratified analyses are urgently needed, as is a strategic focus on health outcomes that may affect military preparedness and fitness for deployment.

Japanese traditional (Kampo) medicines are often used for pregnant women in Japan. However, no comprehensive studies have been conducted regarding the self-reported use of these medicines during pregnancy. This study investigated the use of Kampo medicines during pregnancy in Japan using the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study). Questionnaires were distributed to pregnant women participating in the TMM BirThree Cohort Study (July 2013 to March 2017) at approximately 12 weeks (early pregnancy) and 26 weeks (middle pregnancy). We analysed Kampo medicines use over three periods: (1) 12 months before pregnancy diagnosis, (2) the period between pregnancy diagnosis and around Week 12 of pregnancy and (3) from around Week 12 of pregnancy. In total, 19 220 women were included in the analysis. The proportions using prescribed Kampo medicines were 4.1% before pregnancy diagnosis, 4.5% from diagnosis to Week 12% and 4.5% after Week 12 of pregnancy. The most frequently prescribed Kampo medicines were tokishakuyakusan (1.0%) before pregnancy diagnosis, shoseiryuto (1.3%) from diagnosis to Week 12 and shoseiryuto (1.5%) Post-week 12. Sixty of the pregnant women used Kampo medicines containing crude drugs, which should be administered cautiously during pregnancy. The proportion of Kampo medicines use before and during pregnancy was 4%-5%. Some pregnant women used Kampo medicines containing crude drugs that should be administered cautiously during pregnancy. Further research is required to determine the safety of Kampo medicines during pregnancy.

What About the Boys? The Importance of Including Boys and Young Men in Sexual and Reproductive Health Research

This thesis explores infertility in the ancient medical texts. Fertility was a topic of great interest to ancient medical writers and in the last 30 years their views have received considerable attention from modem scholars. Although the subject of infertility has been discussed within the wider context of fertility, there has been little work that focuses specifically on infertility. In fact, the only work that has begun to analyse infertility in any detail is Rebecca Flemming’s 2013 article ‘The Invention of Infertility in the Classical Greek World: Medicine, Divinity, and Gender’. Although Flemming’s work is a welcome addition to the scholarship, it is only the beginning, and Flemming herself highlights that more research is needed on this topic. The aim of this thesis, then, is to undertake a full-scale study of infertility focusing on the ancient texts. I intend to show that by approaching the ancient medical texts with the question ‘what do these texts tell us about infertility?’ instead of ‘what do these texts tell us about fertility?’ the answers, and therefore our understanding of infertility, are very different. The first half of the thesis outlines what infertility meant to the ancient medical writers by looking at factors such as the language of infertility, its perceived causes and its various treatments. The second half seeks to build on the first by analysing how responsibility for infertility was shared between the couple in both theory and practice. In the final two chapters, I explore how the apparent system of blame and protection associated with infertility is articulated by the Hippocratic authors. The focus of this thesis is the Hippocratic corpus, most of which dates from the fifth to fourth centuries BC. However, I also consider other ancient authors, particularly the biological works of Aristotle, in order to place the Hippocratic theories into a wider context. In addition, I will consider evidence beyond the ancient medical texts in order to examine possible alternative sources of advice and treatment available to an infertile couple.

BackgroundJapanese traditional (Kampo) medicines are commonly prescribed in clinical practice, with increasing evidence supporting their use during pregnancy. The efficacy and safety of Kampo medicines during pregnancy have increasingly been studied; however, evidence in support of these medicines is inadequate. Thus, we conducted a temporal trend analysis of Kampo medicine prescriptions to determine the Kampo medicines for which further safety evidence is required.MethodsAdministrative data from pregnant Japanese women who visited acute-care diagnosis procedure combination hospitals between January 1, 2014, and December 31, 2023, were used in this study. Therapeutic categories related to the Kyoto Encyclopedia of Genes and Genomes D numbers 5100 and 5200 were defined as target Kampo medicines. Annual prescription trends were calculated as proportions. Temporal trends in the proportion of prescriptions for each Kampo medicine were assessed using the Cochran–Armitage trend test. Statistical significance was set at p < 0.05.ResultsBetween 2014 and 2023, the proportion of Kampo medicine prescriptions increased significantly from 12.0% to 13.6% (p < 0.001). As of 2023, tokishakuyakusan (2.9%) was the most prescribed medication, followed by kakkonto (2.4%) and daikenchuto (2.0%). From 2014 to 2023, the proportions of tokishakuyakusan (3.3% to 2.9%) and kakkonto (2.4% to 2.4%) prescriptions showed no significant temporal changes (p = 0.07 and 0.36, respectively). In contrast, the proportion of daikenchuto prescriptions increased significantly from 0.8% to 2.0% (p < 0.001).ConclusionThe primary prescribed Kampo medicines were those with established safety evidence for use in pregnant women. The proportion of Kampo medicine prescriptions for pregnant women in Japan has increased over time, with tokishakuyakusan being the most prescribed during the study period.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40780-025-00515-5.

BackgroundTraditional Chinese medicine (TCM) in China and Kampo medicine in Japan are representative forms of traditional medicine in East Asia, in which mineral medicines constitute an indispensable source of therapeutic agents. Due to concerns about toxicity and safety, the frequency of mineral medicine use in modern times has declined compared with historical practice. Existing research on mineral medicines in traditional medicine has predominantly focused on toxicity and safety issues in an international context, overviews of historical mineral medicines in Japan, or records of specific mineral medicines in single ancient medical texts in China. However, there is a lack of comparative studies spanning multiple countries, historical periods, and a wide range of historical medical literature.MethodsThis study utilized modern computational techniques and a self-constructed database, the Chinese–Japanese Traditional Medical Literature Corpus. Based on the medical history of China and Japan, 56 representative historical medical texts from the period 219–1863 were selected, from which data on mineral medicines were extracted. The methods of prescription metrology and data mining were applied to analyze the co-occurring medicines in prescriptions containing mineral medicines, while word frequency statistics were used to examine the conditions treated by these medicines. Data cleaning, statistical analysis, and visualization were performed using Microsoft Excel and Python scripts.ResultsThe “Prescription” category of historical medical texts is the primary source of mineral medicine data for both countries. A total of 106 mineral medicines were recorded in Chinese historical texts, compared with 100 in Japanese historical texts, with 97 mineral medicines shared between the two. Based on a cation-based classification system, the mineral medicines documented in the historical texts of China and Japan were divided into 16 categories; all 16 were found in Chinese texts, while Japanese texts contained 14 categories. The top three categories of mineral medicines by number of occurrences were the same in both countries, though their ranking order differed slightly. For pharmacological analysis, mercury- and mercury-compound-based mineral medicines (hereafter referred to as mercury-based mineral medicines) were selected due to their high toxicity and high number of occurrences. Historical Chinese texts recorded 189 medical conditions treated with mercury-based mineral medicines or compound prescriptions containing them, while Japanese texts recorded 98 such conditions, with two conditions unique to Japan. Six conditions were identified as core conditions strongly associated with mercury-based mineral medicines in both countries. Historical Chinese texts documented 257 co-occurring medicines with mercury-based mineral medicines, while Japanese texts recorded 240, with 17 species unique to Japan. Twelve co-occurring medicines were identified as core drugs strongly paired with mercury-based mineral medicines in both countries. Gypsum was selected for further pharmacological analysis, as it is included in both modern authoritative pharmacopoeias and ranks just below salt in number of occurrences in historical texts of both countries. Historical Chinese texts documented 429 co-occurring medicines with gypsum, while Japanese texts recorded 168. The core medicines strongly paired with gypsum showed minimal differences between the two countries. The top five conditions most strongly associated with gypsum, in terms of number of occurrences, were the same in both Chinese and Japanese historical texts, although their ranking varied slightly. Compared with the indications recorded in modern pharmacopoeias and medical literature of both countries, the descriptions of gypsum-related core conditions in historical texts were more diverse and detailed.ConclusionThe classification of historical medical texts in this study is based on the characteristics of their content. The types of historical texts serving as data sources for mineral medicines are similar in China and Japan, and the recorded mineral medicine species, compound types, and frequently recorded varieties also show a high degree of similarity, indicating that Kampo medicine in Japan extensively absorbed the theoretical foundations of mineral medicines from TCM. However, the higher number of occurrences of sodium compound–based mineral medicines in Japan, as well as the differences in the occurrence probabilities of commonly recorded mineral medicines between the two countries, to some extent reflect the localization tendencies of mineral medicine use in Kampo medicine. Mercury-based mineral medicines and gypsum documented in historical Chinese and Japanese medical texts showed minimal differences in associated conditions and co-occurring medicines. Many mercury-based mineral medicines shared generalizable features, highlighting the research significance and value of distinguishing mineral medicines by compound type to reveal overarching pharmacological trends. The comparison of gypsum’s principal therapeutic indications between historical and modern records revealed a clear trend toward a narrower application scope for mineral medicines in the modern era. From the perspective of preserving and inheriting traditional mineral medicine knowledge, a large amount of mineral medicine knowledge in historical Chinese and Japanese medical texts remains to be explored. Furthermore, research supported by objective data—such as analyses of the pharmacological effects of co-occurring medicines related to mineral medicines and studies on the associations between these co-occurring medicines and their related conditions—remains urgently needed.

Traditional Japanese medicines inhibit compound action potentials in the frog sciatic nerve

Research Priorities to Support Women Veterans' Reproductive Health and Health Care Within a Learning Health Care System.

See related article, pages 1973–1979. The lack of effective and widely applicable pharmacological treatments for ischemic stroke patients may explain a growing interest in traditional medicines, for which extensive observational and anecdotal experience has accumulated over the past thousand years. The World Health Organization (WHO) defines traditional medicine as “health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being”.1 Unlike Western medicine, which focuses on disease, traditional medicine takes the approach that the body provides external clues to an internal imbalance that can be addressed by interventions such as herbs and acupuncture (holistic treatment approach).2 According to a 2003 WHO report,1 traditional medicine is very popular in all developing countries, and its use is rapidly increasing in industrialized countries. For example, traditional herbal preparations account for 30% to 50% of the total medicinal consumption in China. In Europe, North America and other industrialized regions, over 50% of the population have used traditional medicine at least once. The global market for herbal medicines currently stands at over US $60 billion annually and is growing steadily.1 In recent years, several reviews have been published on the effect and potential benefits of traditional Eastern medicine in stroke.3–7 It has been suggested that some herbal medicines, or their products, may improve microcirculation in the brain,4,8 protect against ischemic reperfusion injury,8,9 possess neuroprotective properties3,4 and inhibit apoptosis,10 thus justifying their use in ischemic stroke patients. However, unlike industrially manufactured pharmacological drugs used in Western medicine, the active (potent) components of herbal medicines often have not been specified and measured precisely, although there have been recent attempts to regulate dosages and use of …

BackgroundJapanese traditional (Kampo) medicines containing ephedra may be used to treat colds during pregnancy. There are reports that ephedrine, a component of ephedra, has a risk of teratogenicity; however, the evidence remains equivocal.ObjectiveThis study aimed to evaluate the risk of major congenital malformations (MCMs) associated with exposure to Kampo medicines containing ephedra during the first trimester of pregnancy using the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study).MethodsTo 23,730 mother–infant pairs who participated in the TMM BirThree Cohort Study from July 2013 to March 2017, questionnaires in early and middle pregnancy were distributed approximately at weeks 12 and 26 of pregnancy, respectively. Infants' risk of MCMs in women who used Kampo medicines containing ephedra or acetaminophen during the first trimester was assessed, and the odds ratios (ORs) were estimated with unadjusted and adjusted analyses.ResultsAmong 20,879 women, acetaminophen and Kampo medicines containing ephedra were used in 665 (3.19%) and 376 (1.80%) women, respectively, in the first trimester. Among the infants born to the mothers who used acetaminophen or Kampo medicine containing ephedra during the first trimester, 11 (1.65%) and 8 (2.13%), respectively, had overall MCMs. OR of overall MCMs was higher in women who used Kampo medicines containing ephedra than in those who used acetaminophen in the first trimester (adjusted OR, 1.45; 95% confidence interval (CIs), 0.57–3.71); however, the difference was not statistically significant.ConclusionsIn this study, there was no statistically significant association between the use of Kampo medicines containing ephedra during the first trimester of pregnancy and the risk of MCMs. Although some point estimates of ORs exceeded 1.00, the absolute magnitude of any increased risks would be low.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40801-023-00411-0.

Traditional Japanese (Kampo) medicine has been widely applied in general medicine in Japan. In 2001, the model core curriculum for Japanese medical education was revised to include Kampo medicine. Since 2007, all 80 Japanese medical schools have incorporated it within their programs. However, postgraduate training or instruction of Kampo medicine has not been recognized as a goal for the clinical training of junior residents by Japan's Ministry of Health, Labour and Welfare; little is known about postgraduate Kampo medicine education. This exploratory study investigated attitudes about Kampo medicine among junior residents in Japanese postgraduate training programs. A questionnaire survey was administered to junior residents at five institutions in the Tohoku area of Japan. Questions evaluated residents' experiences of prescribing Kampo medicines and their expectations for postgraduate Kampo education and training. As a result, 121 residents responded (response rate = 74%). About 96% of participants had previously received Kampo medicine education at their pre-graduate medical schools and 64% had prescribed Kampo medications. Specifically, daikenchuto was prescribed to prevent ileus and constipation after abdominal surgery and yokukansan was prescribed to treat delirium in the elderly. Residents received on-the-job instruction by attending doctors. Over 70% of participants indicated that there was a need for postgraduate Kampo medicine education opportunities and expected lectures and instruction on how to use it to treat common diseases. In conclusion, we have revealed that junior residents require Kampo medicine education in Japanese postgraduate training programs. The programs for comprehensive pre-graduate and postgraduate Kampo education are expected.

Vancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p = .0003). Administration of probiotics (p = .0065) and Kampo medicines with probiotics (p = .0002), especially of the Kampo medicine hochuekkito (p = .0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p = 0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

The effects of 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) and two Chinese traditional (Kampo) medicines, Dai-saiko-to and Saiko-ka-ryukotsu-borei-to on spontaneous soft tissue (heart and tongue) mineralization in DBA/2NCrj mice were studied. These agents were given orally for 4 weeks to DBA/2NCrj mice. After 2 weeks of administration in the heart, 0.006 and 0.03% (w/v) HEBP decreased calcium content by 90 and 30%, respectively, while 0.27 and 2.7 mg/ml Dai-saiko-to reduced calcium content by 30 and 45%, respectively. Saiko-ka-ryukotsu-borei-to (0.27 mg/ml) reduced both calcium and phosphorus content by 50 and 35%, respectively. However, their inhibitory effects on the heart were not observed after 4 weeks of administration. The compounds delayed the onset of increases of bulk calcium and phosphorus content. In the tongue, at 4 weeks, 0.006 and 0.03% (w/v) HEBP reduced calcium content by 30 and 45%, respectively, while two Kampo medicines (at both concentrations used) significantly reduced the content of calcium (by 27-79%) and phosphorus (by 24-32%). These results strongly suggest that two Kampo medicines as well as HEBP may be useful in preventing and curing soft tissue calcification.

Worldwide, health care systems are increasingly highlighting the importance of traditional medicines. The World Health Organization (WHO) plans to introduce traditional medicine into the international classification of diseases (ICD) for the first time since it started in 1900. Kampo medicine is a traditional Asian medical system that is unique in many ways. Kampo was transferred from the ancient Han Chinese dynasty and uniquely developed in Japan, especially during the Edo period (1603–1867). The theoretical understanding and the use of the abdominal examination “Fukushin” to assess the patient's constitutional state are particular to Kampo. After the Meiji restoration in 1867, Japan's new government accepted only Western medicine from Europe and founded one medical licensure system. The result was suppression of acquired wisdom and insights with marginalization of practitioners until 1976. At that time, the Japanese Medical Association promoted its coverage by Japan's National Health Insurance program by physicians who were trained in Western medicine. And now, all of Japan's 80 medical schools teach Kampo medicine. As a result, roughly 90% of physicians use Kampo medicine in their daily practice. This is a very unique model of integration of traditional medicine and modern biomedicine. To better understand the promise of this integration, this special issue features Kampo medicine in the context of modern biomedicine. Many provocative articles are included in this special issue. To begin, K. Katayama et al. address the current situation of Kampo use in the National Health Care program. The authors analyzed 67,113,579 health care claim records and found that only 1.34% represented Kampo prescriptions. This suggests that a very small portion of conventional practice includes Kampo treatment even though many physicians use Kampo. H. Okamoto et al. present us with a case series of patients with refractory glossodynia. Among 39 patients, 69.2% of patients reported a beneficial effect. This is one of the examples in which Kampo treatment is effective even for the difficult cases in the Western biomedicine. K. Ogawa et al. show the usefulness of daiobotanpito for the treatment of acute diverticulitis. Y. Tanaka and T. Sakiyama report the case series of the usefulness of the Kampo treatment for pediatric emotional and behavioral disorders which were also refractory to the modern biomedicine. M. A. Bahar et al. reported that goshajinkigan prevents paclitaxel induced peripheral neuropathy without interfering with the anticancer action of paclitaxel in the basic research. Kampo medicines are often used for the purpose of the reduction of the side effects of chemotherapy for malignancies. K. Watanabe et al. report the potentially preventive effect of diabetic complications. Goshajinkigan is often used for the neuropathy from diabetes mellitus. Additionally, this Kampo medicine may be beneficial for the blood glucose control. K. Katayama et al. report a computer-based diagnostic way of Kampo patient patterns termed “Sho.” This represents a promising blend of modern technology for a new world of traditional medicine in the future. Y.-C. P. Arai et al. reported about Fukushin, Kampo's unique diagnostic procedure. Certain Fukushin findings are related to the anxiety-depression levels. T. Namiki et al. report that cytosine-adenine (CA) repeat polymorphism of the estrogen receptor β gene can be the predictive biomarker of the effectiveness of Kampo medicine for the treatment of the climacteric syndrome. T. Yoshino et al. and H. Tokunaga et al. describe hie (cold sensation) and hiesho (cold disorder). Hie and hiesho are very important concepts in Kampo treatment. T. Yoshino et al. characterized hie and hiesho. H. Tokunaga et al. characterized the differences of male hie, female hie with menstruation, and female hie after menopause by data mining method. To conclude, S. Yakubo et al. summarize the history and pattern diagnosis of Kampo medicine. Together, these articles represent the promise and challenges present in the scientific understanding of Japan's herbal medicine tradition. We hope these articles help the readers to understand and appreciate the potential power of Kampo medicine outside of Japan. We invite you to explore Kampo. Kenji Watanabe Gregory A. Plotnikoff Takeshi Sakiyama Heidrun Reissenweber-Hewel

Availability of Male and Female Sexual Health and Fertility Information on National Cancer Institute–Designated Cancer Center Websites