Disorders In Women Research Articles

Integrated Treatment of Depression and Moderate to Severe Alcohol Use Disorder in Women – A Pilot Study in Routine Addiction Care

Integrated Treatment of Depression and Moderate to Severe Alcohol Use Disorder in Women – A Pilot Study in Routine Addiction Care

The Menstrual Disorders in Women of Reproductive Age with Obesity

Introduction. In this article, the authors present the results of studies on reproductive health features in 25 women with obesity seeking medical help for infertility. Objective: to study the nature of menstrual disorders in women of childbearing age with obesity. Materials and methods. We have studied the features of reproductive health in 25 obese women seeking medical assistance for infertility in the Republican specialized scientific and practical centre of endocrinology in 2014–2015, who were included in the first study group. The second group consisted of 25 women with normal weight-for-stature values and without menstrual disorders. All the patients underwent the following tests, including complete blood count, blood biochemistry, radioimmunoassays of the blood hormones (prolactin, luteinizing hormone (LH), follicle stimulating hormone (FSH), insulin, estradiol, progesterone, free testosterone, thyroxine, anti-Műllerian hormone, dehydroepiandrostenedione, ultrasound of the uterus and ovaries with folliculometry on 11–14th days of the menstrual cycle. All patients underwent magnetic resonance imaging of the pituitary gland. Results. In the history of the patients in both groups, diseases of the upper respiratory tract and gastrointestinal diseases were most common among somatic pathology. Among gynecological diseases, in both groups the most frequent disorders were chronic urogenital infection, candida vaginitis and bacterial vaginosis. Emphasis is placed on the data about the presence of hormone-dependent proliferative diseases in women with overweight: cervical pseudoerosions, endocervicosis, uterine fibroids, a history of endometriosis. The analysis of biochemical parameters in the first study group found increased triglycerids levels < 1.7 mmol/L in 15 %, a decrease in high-density lipoprotein cholesterol < 1.2 mmol/l — in 12 % of women, increased levels of low-density lipoprotein cholesterol > 3.0 mmol/L — in 34 %. The first group of patients had low values of the average parameters of LH, FSH, free and total testosterone (normogonadotropic hypogonadism) against normoprolactinemia. The levels of adrenocorticotropic hormone, thyroid-stimulating hormone, free thyroxine, and cortisol were within normal limits. Folliculometry results showed a high incidence of follicular persistence, anovulatory disorders and follicular atresia. Conclusions. In young women with the metabolic syndrome, secondary amenorrhea prevails in the structure of menstrual dysfunction — 8 (32.0 %) cases. Hyperandrogenic anovulation following hyperinsulinemia underlies the menstrual dysfunction.

Skeletal Muscle Relaxants for the Treatment of Myofascial Pelvic Pain and High Tone Pelvic Floor Disorders in Women: A Scoping Review

Study Objective To review the evidence of muscle relaxants and non-injectable drugs with muscle relaxant properties for the treatment of chronic pelvic pain. This includes investigation of whether the concept of skeletal muscle relaxant use for lower back striated muscle strain is a valid construct to apply to the context and treatment of women with chronic pelvic pain due to myofascial and hypertonic muscular dysfunction. The clinical effectiveness, side effects, and toxicology risk of the investigated drugs were characterized. Design A scoping review was conducted in accordance with PRISMA-ScR guidelines and protocols. Online databases were searched using MeSH and subject terms. Articles reporting evidence on skeletal muscle relaxant use were reviewed by two independent reviewers with a third reviewer for any discrepancies. Setting Scoping review. Patients or Participants N/A. Interventions N/A. Measurements and Main Results Comparison studies have not shown any skeletal muscle relaxant to be superior. Skeletal muscle relaxants are divided into two categories: antispastic and antispasmodic agents. Antispastic agents reduce muscle hypertonicity and involuntary jerks associated with neurological disorders. Antispasmodic agents aim to treat striated muscle spasms from musculoskeletal conditions such as low back pain and myofascial pain. Cyclobenzaprine is heavily studied, with demonstrated effectiveness for isolated conditions. Intravaginal diazepam may be beneficial, while other drugs have limited investigation. Considerable knowledge gaps remain regarding appropriate use of these medications in the context of pelvic pain. Conclusion Scant high-quality data exist to support the use of skeletal muscle relaxants for chronic pelvic pain secondary to myofascial and hypertonic muscular dysfunction. Antispastic agents have limited evidence. Antispasmodic agent usage should be based on side-effect profile, patient preference, abuse potential, and possible drug interactions. Future prospective research on antispasmodic agents in women with myofascial dysfunction is necessary to define medication safety, route, dosage, and clinical outcomes. To review the evidence of muscle relaxants and non-injectable drugs with muscle relaxant properties for the treatment of chronic pelvic pain. This includes investigation of whether the concept of skeletal muscle relaxant use for lower back striated muscle strain is a valid construct to apply to the context and treatment of women with chronic pelvic pain due to myofascial and hypertonic muscular dysfunction. The clinical effectiveness, side effects, and toxicology risk of the investigated drugs were characterized. A scoping review was conducted in accordance with PRISMA-ScR guidelines and protocols. Online databases were searched using MeSH and subject terms. Articles reporting evidence on skeletal muscle relaxant use were reviewed by two independent reviewers with a third reviewer for any discrepancies. Scoping review. N/A. N/A. Comparison studies have not shown any skeletal muscle relaxant to be superior. Skeletal muscle relaxants are divided into two categories: antispastic and antispasmodic agents. Antispastic agents reduce muscle hypertonicity and involuntary jerks associated with neurological disorders. Antispasmodic agents aim to treat striated muscle spasms from musculoskeletal conditions such as low back pain and myofascial pain. Cyclobenzaprine is heavily studied, with demonstrated effectiveness for isolated conditions. Intravaginal diazepam may be beneficial, while other drugs have limited investigation. Considerable knowledge gaps remain regarding appropriate use of these medications in the context of pelvic pain. Scant high-quality data exist to support the use of skeletal muscle relaxants for chronic pelvic pain secondary to myofascial and hypertonic muscular dysfunction. Antispastic agents have limited evidence. Antispasmodic agent usage should be based on side-effect profile, patient preference, abuse potential, and possible drug interactions. Future prospective research on antispasmodic agents in women with myofascial dysfunction is necessary to define medication safety, route, dosage, and clinical outcomes.

Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment.

Nearly half of women in the United States report problems with sexual function. Many health care providers do not ask about sexual concerns during routine clinical encounters because of personal discomfort, lack of familiarity with treatment, or the belief that they lack adequate time to address this complex issue. This may be especially true for hypoactive sexual desire disorder (HSDD), the most commonly identified sexual problem among women. HSDD is characterized by a deficiency of sexual thoughts, feelings, or receptiveness to sexual stimulation that has been present for at least 6 months, causes personal distress, and is not due to another medical condition. This is an up-to-date overview of HSDD for clinicians, discussing its physiology, assessment, diagnosis, and treatment strategies. Although a definitive physiology of HSDD is still unknown, multiple hormones and neurotransmitters likely participate in a dual-control model to balance excitation and inhibition of sexual desire. For assessment and diagnosis, validated screening tools are discussed, and the importance of a biopsychosocial assessment is emphasized, with guidance on how this can be implemented in clinical encounters. The 2 recently approved medications for HSDD, flibanserin and bremelanotide, are reviewed as well as off-label treatments. Overall, HSDD represents a common yet likely underrecognized disorder that midwives and other health care providers who care for women across the life span are in a unique position to address.

Sexual Disorders in Women with Overactive Bladder and Urinary Stress Incontinence Compared to Controls: A Prospective Study.

Introduction and Hypothesis Female urinary incontinence (UI) has a negative impact on sexual function and sexual quality of life (QoL) in women. But there is still no consensus on the type of UI or the prevalence of sexual dysfunction (SD). The aim of the study was to evaluate sexual disorders in women with overactive bladder (OAB) compared to patients with urinary stress incontinence (SUI) and healthy controls. Materials and Methods 106 women presenting to a urogynecological outpatient clinic (referral clinic) were investigated using standardized questionnaires and the Female Sexual Function Index (FSFI-d). All 65 incontinent women underwent a full urodynamic examination; the controls (31) were non-incontinent women in the same age range who came for routine check-ups or minor disorders not involving micturition or pelvic floor function. Women with mixed urinary incontinence, a history of previous medical or surgical treatment for UI, recurrent urinary tract infections, previous radiation therapy or pelvic organ prolapse of more than stage 2 on the Pelvic Organ Prolapse Quantification (POP-Q) system were excluded. Results 100 questionnaires could be evaluated (94.3%). Thirty-four women had urinary stress incontinence, 35 had OAB, 31 were controls. Mean age was 56 years, with no significant differences between groups. The scores of the questionnaire ranged from 2 to 35.1 points. The median score of OAB patients was significantly lower (17.6) than the median score of the controls (26.5; p = 0,004). The stress-incontinent women had a score of 21.95, which was lower than that of the controls but statistically non-significant (p = 0.051). In all subdomains, the OAB patients had lower scores than the stress-incontinent women and significantly lower values than the control group. Most striking was the impairment of “sexual interest in the last 4 weeks”. The figure for “none or almost no sexual activity” was 80% for the OAB group, 64.7% for the group of stress-incontinent women and 48% for the control group. Incontinence during intercourse was reported by one OAB patient and 4 stress-incontinent women but did not occur in the control group. Conclusions There is a high prevalence of SD in women with urinary incontinence. Patients with OAB reported a greater negative impact on sexual function and had significantly lower scores for the FSFI questionnaire than patients with stress incontinence or controls.

Prevalence and Associated Factors of Common Mental Disorders in Women: A Systematic Review.

Objectives: To identify the prevalence and factors associated with common mental disorders in adult women. Methods: Searches were carried out in the PubMed, Web of Science, Science Direct, Scopus, Cinahl, Google Scholar and Open Gray databases. The study protocol was registered with PROSPERO under number CRD42020168231. Cross-sectional studies showing the prevalence of common mental disorders in women over 18 years were included. Studies with men, children and pregnant women of another age group and with other mental disorders and other types of studies were excluded. The Joanna Briggs Institute checklist was used to assess the risk of bias. Results: Nineteen studies were included in this review. The prevalence of CMD ranged from 9.6% to 69.3%. The main associated factors were unemployment, indebtedness, low income, being a housewife, smoking, low education, poor self-rated health, being single, divorced or widowed. The risk of bias in the studies was classified as low and moderate. Conclusion: This review revealed a variable prevalence rate of CMD in adult women. Public policies are needed to create strategies to prevent the mental illness of these women.

Association between Non-Medical Cannabis Use and Anxiety Disorders in Women

Introduction: Non-medical cannabis use and anxiety disorders are highly prevalent among Canadian women; however, the direction of this assocation remains controversial. The objective of this article is to provide an evidencebased update regarding the effect of non-medical cannabis on anxiety symptoms in women. Methods: A literature search was conducted using PsychINFO and MEDLINE for articles related to cannabis and marijuana use among women with anxiety or anxiety disorders. Only English language literature from 2010 to 2020 was reviewed. Studies including patients under the age of 18 and studies addressing medical cannabis were excluded. Four studies met our inclusion criteria for this review. Results: Cannabis use and anxiety disorders are both highly prevalent among young women. Other substance use in addition to cannabis is frequently reported by women. Reasons for cannabis use by women with anxiety differed from those of men. Findings did not show a direct association between cannabis use and anxiety symptoms. Women who used cannabis did not report higher rates of anxiety nor did anxiety predict the onset of cannabis use. Conclusion: There is no evidence to indicate that non-medical cannabis use worsens anxiety symptoms among women. Further studies should focus on reducing potential confounding factors and developing a reliable method of quantifying cannabis use in order to determine the direction of the interaction between cannabis and anxiety disorders among women.

Prevalence of Post-traumatic Stress Disorder in Women with Normal Vaginal Delivery and Those with Caesarian Section

: Childbirth causes intense emotional arousal that may cause traumatic psychological symptoms in some women. This study investigated the prevalence of post-traumatic stress disorder (PTSD) in women with normal vaginal delivery and those with caesarian section. This was a cross-sectional study conducted in selected health centers affiliated to Shiraz University of Medical Sciences in 2018. The samples included 714 patients (328 vaginal deliveries and 386 cesarean deliveries). Sampling was performed using the convenience sampling method in two cluster stages after selecting the clinic. Mothers were determined to be traumatic in their delivery according to criterion A in the Diagnostic and Statistical Manual of Mental Disorders Version DSM-IV (with four questions). Then, a demographics checklist and a stress disorder questionnaire were filled out for all the mothers after a traumatic delivery through interviews. The prevalence of postpartum stress disorder was higher in the cesarean section group (10.8%) than in the normal vaginal delivery group (10%), but this difference was not significant (P = 0.275). Although the prevalence of PTSD between the two groups was not significant, the prevalence of PTSD was significantly higher in this study than in reports from other countries. This highlights the need for targeted interventions to reduce this disorder.

Differential Methylation and Co-Methylation Analysis Reveals Functional Targets of Major Depressive Disorder in Women

Major depressive disorder (MDD) is the most common mental health disorder, twice more prevalent in women than in men. It is strongly associated with dementia, cardiovascular disease, and increased mortality. Epigenetic factors, including DNA methylation (DNAm), play an important role in the etiology of MDD. However, sex-specificity has not been explored.

International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women.

Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD).Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD.Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method.Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up.Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male formulations can be used cautiously with dosing appropriate for women. Patients should be assessed for signs of androgen excess and total testosterone levels monitored to maintain concentrations in the physiologic premenopausal range. Compounded products cannot be recommended because of the lack of efficacy and safety data.Clinical Implications: This clinical practice guideline provides standards for safely prescribing testosterone to women with HSDD, including identification of appropriate patients, dosing, and monitoring.Strengths & Limitations: This evidence-based guideline builds on a recently published comprehensive meta-analysis and the Global Position Statement endorsed by numerous societies. The limitation is that testosterone therapy is not approved for women by most regulatory agencies, thereby making prescribing and proper dosing challenging.Conclusion: Despite substantial evidence regarding safety, efficacy, and clinical use, access to testosterone therapy for the treatment of HSDD in women remains a significant unmet need.

The Serological Basis of the Correlation between Iron Deficiency Anemia and Thyroid Disorders in Women: A Community Based Study

Objectives: Iron Deficiency Anemia (IDA), a global public health problem may have an inimical effect on thyroid function, especially in women and children. This study was conducted to inspect the correlation between IDA and thyroid disorders in women of Bangladesh.
 Methods: A cross-sectional study was conducted among 452 women of different age groups in particular regions of Bangladesh presenting anemic symptoms and were confirmed anemic after testing of serum hemoglobin levels less than 12 g/dL. To identify the correlation between iron deficiency anemia and thyroid disorders; serum samples were tested quantitatively through standardized methods considering serum iron, total iron-binding capacity (TIBC), ferritin, thyroid-stimulating hormone (TSH), free thyroxin (FT4), and vitamin D levels as parameters. Post clinical diagnosis statistical analysis, graphical presentations of the complex clinical data was generated using advanced computer programming language and bio-analytical tools. 
 Results: A positive correlation between hypothyroidism and IDA in women was discovered in this study as 24.69% of patients with IDA from 0-60 years were found suffering from hypothyroidism simultaneously; with the highest percentage (38.46%) amongst the 31-40 years of age and 26% of iron-deficient females of reproductive age (15-49 years) were suffering from hypothyroidism. Moreover, the association between congenital hypothyroidism and IDA was noticed in 50% of cases above all.
 Conclusion: Hypothyroidism was found quite common among the women of different age groups who were previously reported with acute to chronic anemia symptoms due to iron deficiency.

Clinical Presentation and Evaluation of Pelvic Venous Disorders in Women

The term pelvic venous disorders (PeVD) describes a group of related clinical entities with overlapping clinical presentations that were previously characterized by separate imprecise syndromic terminology. The clinical manifestations of PeVD may variously include chronic pelvic pain; pelvic origin extrapelvic lower extremity and genital varices; lower extremity pain and swelling; and left flank pain and hematuria. This manuscript focuses on the primary manifestations of PeVD in women - chronic pelvic pain and pelvic origin lower extremity and vulvar varices - and will review the underlying pathophysiology and related complicating factors (such as maladaptive pain responses) to explain the variety of clinical presentations.

FDA Decisions on Measures of Hypoactive Sexual Desire Disorder in Women: A History, With Grounds to Consider Clinical Judgment.

In 2000, the FDA began issuing advice about treatments for hypoactive sexual desire disorder (HSDD) in women. How its recommendations have evolved has not been reviewed. Its consistent preference for self-rating by patients over evaluation by an examining clinician has not been addressed. Recount the changes in FDA's proposals about patient-reported outcomes and diagnostics. Compare the value of patient-reported measures and clinical interviews. Historical review is based on draft guidances, publications, meetings, and prescribing information. The FDA has avoided clinician input into diagnosis and evaluation of the severity of HSDD in women. It abandoned its initial (2000) insistence on counts of satisfying sexual events to define efficacy in favor of symptom-related scales to evaluate desire and distress with daily self-ratings. By 2015, the FDA accepted the self-rated Female Sexual Function Index-Desire Domain (FSFI-D) to measure desire and the most relevant item of the Female Sexual Distress Scale-Revised (FSDS-R) to measure distress; retrospection for both is one month. TheFDA rejected the one clinician-rated broad measure of HSDD, the Sexual Interest and Desire Inventory (SIDI-F), although well-validated and treatment-sensitive. Since 2005, the FDA has accepted the Decreased Sexual Desire Screener (DSDS) to diagnose HSDD by non-expert clinicians using self-ratings and exploring them in more depth in a clinical interview. FDA's decisions on how to measure HSDD in women may have stabilized on accepting 2 co-primary measures: the FSFI-D and the FSDS-R item on bother about low desire, and on accepting the DSDS for diagnosis. FDA's rejection of clinician ratings of severity through interviews in clinical trials seems unsound because interviews can give broader assessments than (brief) self-ratings, although the agency's logic was to avoid diagnostic controversies and help avoid overcommercialization. Semistructured clinical interviews for diagnosis (DSDS) and severity-rating (SIDI-F) are well validated and are recommended for clinical practice. Pyke RE. FDA Decisions on Measures of Hypoactive Sexual Desire Disorder in Women: A History, With Grounds to Consider Clinical Judgment. Sex Med Rev 2021;9:186-193.

A Comparative Study of the Frequency of Post-Traumatic Stress Disorder in Women Undergoing Normal Vaginal Delivery and Cesarean Section

Introduction and Objective: Childbirth may be a stressful event for some women and trauma that some of them experienced during childbirth can cause Post-Traumatic Stress Disorder (PTSD). The aim of this study was to compare the frequency of PTSD among women with Normal Vaginal Delivery (NVD) and cesarean section (C-Section).

Body Image Disorder in Women Treated for Uterine Cancer

Body Image Disorder in Women Treated for Uterine Cancer

PDB1 Type 1 Diabetes Is Associated with Urinary System and Genital TRACT Disorders in Women

Type 1 diabetes can lead to different complications including macro- and microvascular disorders, and osteoporosis. However, only limited data on the association between type 1 diabetes (T1D) and urinary system and genital tract disorders was published. The aim of this work was to estimate this association among women with T1D treated in gynecological practices in Germany. This retrospective cross-sectional study included women aged 16 years or older with T1D diagnosis between January 2015 and December 2018 from 268 gynecological practices in Germany (IMS Disease Analyzer database). T1D patients were 1:5 matched with patients without diabetes by age, and physician. The main outcome of the study was the prevalence of different urinary system, breast, pelvic organ and genital tract disorders documented between the first T1D diagnosis documentation between and the last outpatient visit. Multivariate logistic regression models were fitted with all study disorders as dependent variables, and T1D as impact variable. In each model, the effect of T1d on the defined disorder was adjusted for all other study disorders. The present study included 1,357 women with and 1,357 women without T1D (mean age 45.6 years). T1D was significantly associated with acute vulvitis (OR: 2.12 (95% CI: 1.56-2.90), other specified urinary incontinence (OR: 1.64 (95% CI: 1.19-2.26), acute cystitis (OR: 1.46 (95% CI: 1.10-1.95), and absent, scanty and rare menstruation (OR: 1.37 (95% CI: 1.13-1.67). These findings may have implications for the future care of women with T1D. First, the focus should not only be on diabetes management but also on recognizing and treating additional comorbidities including urinary system and genital tract disorders. Further studies are required to investigate the association between T1D and increased risk of urinary system and genital tract disorders.

Yoga for Substance Use Disorder in Women: A Systematic Review.

It has been suggested that yoga may be an effective adjunct intervention in the management of substance use disorders (SUD). Additionally, women with SUD require different treatment approaches than men. The objective of this study was to critically evaluate the evidence for the effectiveness of yoga, specifically for women, as part of treatment for SUD. Nine electronic databases were searched from inception to January 2020. Randomized controlled trials (RCT) that evaluated any type of yoga, including yoga as a component of mindfulness-based treatment, against any type of control in individuals with any type of addiction were eligible. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist and Statement, methodological quality was appraised using Physiotherapy Evidence Database (PE Dro) criteria. Ten RC Ts (eight mixed-gender and two female-focused) met the eligibility criteria. Most of these RCTs were small to medium-sized, with various methodological and analytical flaws and deficits. The types of addictions included in these studies were alcohol, drug, and nicotine addiction. Most RCTs suggested that various types of yoga, primarily Hatha Yoga and its components, led to favorable or equivalent results for SUD as an adjunct to control or treatment-as-usual interventions. There are limited results on the impact of yoga for SUD specifically focused on women and their unique needs. Although the results of mixed-gender articles are encouraging, large RCTs with gender-specific subanalyses are required to better determine the benefits specific to women incorporating yoga for SUD.

Perinatal Mood and Anxiety Disorders in Women Undergoing Medically Assisted Reproduction

Background: Women taking advantage of medically assisted reproduction (MAR) techniques may differ from spontaneously conceiving women (nonMAR) in risk of depression and/or anxiety. We aimed to investigate possible differences between MAR and nonMAR through the use of the Edinburgh Postnatal Depression Scale in a sample of Italian-speaking women at their third trimester of pregnancy. Methods: We administered the Edinburgh Postnatal Depression Scale (EPDS) to two groups of pregnant women, MAR and nonMAR, at the third trimester of pregnancy (T0), one month after delivery (T1), and three months after delivery (T2) from February 2013 to December 2019. EPDS total scores cutoffs were ≥9 for risk of depression, 9–11 mild depression, ≥12 major depression, and the EPDS-3A cluster ≥4 was a proxy for anxiety. Results: Included were 1303 nonMAR women and 92 MAR, an expected disproportion. NonMAR and MAR women did not differ on depression or anxiety at any assessment timepoint. MAR women were older than nonMAR, consumed more alcohol and medical drugs, and displayed more complications during pregnancy. Scoring over the threshold on depression risk was associated with foreign nationality, unemployment, psychiatric history of the patient, family or partner, psychiatric problems in past pregnancies, hyperemesis, premenstrual syndrome (PMS), and stressful life events in the last year at baseline, and, for some of them, at other timepoints. In contrast, MAR past or current was associated with having suprathreshold depression at the first-month postpartum follow-up. Conclusions: Taken together, our data show that women opting for MAR do not differ from spontaneously conceiving women regarding psychiatric outcomes but do differ on some sociodemographic and clinical variables.

Yoga for Substance Use Disorder in Women: A Systematic Review

To critically evaluate the evidence for the effectiveness of yoga, specifically for women, as part of treatment for substance use disorder (SUD).

Opioid Use Disorder in Women and the Implications for Treatment.

Objective:The opioid epidemic continues to evolve and impact all groups of people. Moreover, there are concerning trends among women. The aim of this article is to provide a review of opioid use disorder in women and the implications for treatment.Methods:A nonsystematic review of the literature as conducted to examine: (1) the epidemiology of opioid-related hospitalizations and deaths of women; (2) co-occurring pain, anxiety disorders, and trauma among women with opioid use disorder; (3) evidence for opioid agonist treatment of pregnant women with opioid use disorder; and (4) implications for treatment of women with opioid use disorder and next steps for research and practice.Results:The current opioid epidemic has produced important differences by sex and gender with increased rates of use and overdose deaths in women. Significant mental health concerns for women include co-occurring psychiatric disorders and suicide. Expanding medication treatment for perinatal opioid use disorder is crucial. While effective treatments exist for opioid use disorder, they are often not accessible, and a minority of patients are treated.Conclusions:The end to the opioid epidemic will require innovative multi-systemic solutions. There are significant practice gaps in preventing rising death rates among women by opioid overdose, treating co-occurring psychiatric disorders and pain, and treating perinatal women with opioid use disorder and their infants. Research on sex and gender differences, and the intersection with race/ethnicity and US region, is critically needed and should include treatment implementation studies to achieve wider access for women to effective prevention, early intervention, and treatment.