Gynecologic Health Research Articles

Gynaecological Health Patterns and Motherhood Experiences of Female Professional Football Players

The aim of this paper is to explore the gynaecological health patterns, contraceptive use, body perception, and motherhood experiences of female professional football players. The participants were recruited via email using FIFPRO (Football Players Worldwide). Online questionnaires were completed by consenting participants. The mean age at menarche was 13.5 years with an average cycle length of 26 days, and a bleeding period of 5 days. Cycle irregularities were experienced by 30%, and menstrual symptoms by 74%. Half of the participants used contraceptives, 60% using hormonal contraceptives, primarily oral contraceptive pills (38%), followed by implants (20%). The body satisfaction score was normal but there was a high drive-for-thinness (DT) score. The motherhood rate was low (1%), with participants experiencing normal conception, vaginal delivery, return to training after 6 weeks, and return to competition after 12 weeks. Our findings are consistent with findings in other elite female athletes with cycle irregularities and a significant number of cycle-related symptoms. The majority of those using contraceptives preferred hormonal contraceptives, reflecting trends seen in other elite athletes. While body satisfaction scores were normal, there was a high DT score, similar to that observed in lean and weight-category sports. The motherhood rate was low, consistent with previous findings in professional football players and other elite athletes. This may be due to a lack of financial support during pregnancy and the post-partum period. FIFPRO and its affiliated unions are negotiating better contracts for female football players.

Association between adverse childhood experiences and menstruation-related symptoms among Japanese female workers: A cross-sectional study.

Menstruation-related symptoms are a common and serious health problem even without a specific diagnosis such as premenstrual dysphoric mood disorder (PMDD) or dysmenorrhea. Various adverse childhood experiences (ACEs) might be associated with menstruation-related symptoms, not only traditional traumatic events such as abuse, but also expanded ACEs such as childhood poverty, school bullying, or natural disasters. This study examined the association between expanded ACEs (ACEs for Japanese) and menstruation-related symptoms among Japanese working women. Data came from an online survey conducted in October 2023 that included women aged 20-44 working full-time, who have never been pregnant and are not currently using contraception. Menstruation-related symptoms severity was evaluated using the Menstrual Distress Questionnaire (MDQ) and the Premenstrual Dysphoric Disorder (PMDD) scale. The MDQ score of the premenstrual and menstrual phases were classified into four categories as menstrual symptoms severity of each phase. Logistic regression assessed the association between ACEs and each outcome, adjusting for covariates. The analysis included 2000 women. Premenstrual and menstrual symptoms severity increased with two or more ACEs. In the fully adjusted model, women with four or more ACEs significantly showed severe premenstrual symptoms (adjusted odds ratio [aOR]=2.81, 95%CI:2.12-3.72), and severe menstrual symptoms (aOR=3.03, 95%CI: 2.29-4.02). Four or more ACEs were associated with PMDD (aOR=5.61, 95%CI: 2.65-11.89). Childhood poverty and school bullying were also associated with menstruation-related symptoms severity, and natural disasters with PMDD. Expanded ACEs were associated with menstruation-related symptoms. The results suggested the importance of trauma-informed care in gynecology, obstetrics, and occupational health practice.

Gynecologic health care for LGBTQIA+ people.

Gender relations are a set of socially determined norms and rules that assign values, characteristics, and expectations to individuals based on their biological sex. These aspects also influence the clinician-patient relationship, since it has been for a long time based on cisheteronormativity. However, this attitude alienated the LGBTQIA+ community from health services. Global and specific gynecologic care needs to be offered to the LGBTQIA+ population, which has demands for sexual and reproductive health care. In this narrative review, we bring conceptual aspects, gender identity and expression, sexual history, screening for cancer and other care to the community.

Impact of Uterine Myomatosis on Reproductive Health: Experience in Lima, Peru, 2022

In Lima, Peru, during 2022, uterine myomatosis stood out as a significant challenge in the gynecological health of women of childbearing age. This condition, characterized by the development of benign tumors in the uterine muscle, showed a high prevalence in women over 40 years old. National studies revealed it accounted for up to 20% of benign tumors in this population and significantly affected quality of life, causing symptoms such as abnormal uterine bleeding, anemia, pelvic pain, and infertility. Peru's health system implemented hormonal and surgical treatments, with myomectomy and hysterectomy as primary options in advanced cases.Nursing staff played a crucial role, providing comprehensive care during the postoperative period, managing pain, and educating patients on self-care. The Nursing Care Process (NCP) was used to structure personalized and holistic care. Despite progress, barriers such as unequal access to services and late detection persisted. The importance of preventive strategies, multidisciplinary teams, and public policies ensuring equitable management of this condition was highlighted. Uterine myomatosis remained a significant health issue requiring continuous efforts for its effective management

Participatory longitudinal qualitative interview study to understand Autistic gynaecological and obstetric health: the Autism from menstruation to menopause study protocol

IntroductionAutism is a lifelong minority neurotype present from birth. There is a dearth of credible evidence to suggest gender variation in Autism prevalence, despite historical under-diagnosis of women. Autistic people...

Women with Complex Vascular Anomalies: Impact on Contraception, Pregnancy and Reproductive Health.

Literature is scarce regarding contraceptive and reproductive health in women with complex vascular anomalies (VA). To assess obstetrical, gynecological and reproductive health in this population. Female adult patients of childbearing age from the VA clinic of a single tertiary care centre in Canada have been recruited by retrospective chart review, and administered phone interviews. Of the 16 patients recruited (mean age 32.8 years old), 14 used oral contraceptive pills (OCP) and intrauterine devices, with 3 patients experiencing a worsening of their VA under OCP. Fifteen women had children, with 12 experiencing variable worsening of their VA that returned to baseline after delivery or nursing cessation. Three women had severe complications. Degree of complications was variable in each subsequent pregnancy. Contraception and pregnancy management in women should be individualized and coordinated with a VA referral centre.

Butyrate as a Potential Modulator in Gynecological Disease Progression.

This review investigates the therapeutic potential of butyrate, a short-chain fatty acid (SCFA) produced by gut microbiota, in the prevention and treatment of various gynecological diseases, including polycystic ovary syndrome (PCOS), endometriosis, and gynecologic cancers like cervical and ovarian cancer. These conditions often pose treatment challenges, with conventional therapies offering limited and temporary relief, significant side effects, and a risk of recurrence. Emerging evidence highlights butyrate's unique biological activities, particularly its role as a histone deacetylase (HDAC) inhibitor, which allows it to modulate gene expression, immune responses, and inflammation. In PCOS, butyrate aids in restoring hormonal balance, enhancing insulin sensitivity, and reducing chronic inflammation. For endometriosis, butyrate appears to suppress immune dysregulation and minimize lesion proliferation. Additionally, in cervical and ovarian cancers, butyrate demonstrates anticancer effects through mechanisms such as cell cycle arrest, apoptosis induction, and suppression of tumor progression. Dietary interventions, particularly high-fiber and Mediterranean diets, that increase butyrate production are proposed as complementary approaches, supporting natural microbiota modulation to enhance therapeutic outcomes. However, butyrate's short half-life limits its clinical application, spurring interest in butyrate analogs and probiotics to maintain stable levels and extend its benefits. This review consolidates current findings on butyrate's multifaceted impact across gynecological health, highlighting the potential for microbiota-centered therapies in advancing treatment strategies and improving women's reproductive health.

Psychotherapy in Treating Female Sexual Dysfunction.

This paper provides a summary of the biopsychosocial approach to the identification of female sexual dysfunction, with a particular focus on psychological, interpersonal, and sociocultural components. A summary of psychotherapeutic approaches to the management of female sexual dysfunction, for cases warranting a specialist referral, is provided. Approaches including sensate focus sex therapy, cognitive behavioral therapy, mindfulness-based approaches, and systematic desensitization are summarized. This information may support obstetric and gynecologic health care professionals in engaging in interdisciplinary care and in providing an informative and warm referral to patients who would benefit from psychotherapeutic approaches.

Analysis to assess menstrual poverty in vulnerable and non-vulnerable populations served in a public service in Brazil

Objective: this study aims to identify the factors influencing menstrual period management among vulnerable and non-vulnerable patients treated at the Emergency Department of a public hospital. Methods: the sample comprised patients who sought care at the Emergency Department of Santa Casa de São Paulo between July 2022 and August 2023. Participants were stratified by gender (women, trans men, or non-binary individuals who menstruate) and social vulnerability (homeless, living in non-permanent housing such as shelters, without fixed income, or earning less than the minimum wage). Inclusion criteria were women, trans men, or non-binary individuals who menstruate, aged 18 years or older, and those who signed the Informed Consent Form (ICF). Exclusion criteria were individuals not menstruating or unable to sign the informed consent. Statistical analysis was performed using the Chi-Square Test. Results: seventy (70) patients participated in this study, 34 of whom were classified as vulnerable and 36 as non-vulnerable. Key differences between the groups included hygiene practices during menstruation, frequency and ability to purchase menstrual products and medications, type of material used, duration of exposure to the material, and health conditions during menstruation. Similarities between the groups were observed in the most commonly used materials, contraceptive methods, menstrual flow volume, and experiences of embarrassment. Conclusion: the study reveals both differences and similarities between the groups. Understanding these factors allows for the proper management of the menstrual period in vulnerable patients, supporting the development of public policies aimed at improving gynecological health outcomes for these populations.

Vaginal Microbiome: Environmental, Biological, and Racial Influences on Gynecological Health Across the Lifespan.

The human vaginal microbiome (VMB) is a complex and unique ecosystem composed of various microorganisms, including bacteria, fungi, archaea, viruses, and candidate phyla radiation. A healthy VMB is often characterized by the presence of Lactobacillus species, which play a crucial role in protecting and maintaining homeostasis within the vaginal environment. When this balance is disrupted, the protection of the vaginal epithelium weakens, leading to a reduction in Lactobacillus species and an increased risk of various gynecological and reproductive health issues. However, this generalized description can lead to misconceptions and an incomplete understanding of vaginal health, as Lactobacillus is not always dominant across all ages and racialized groups. Therefore, this review provides a comprehensive analysis of the environmental, biological, and racial influences on the VMB at each stage of a woman's life, highlighting their implications for gynecological health and offering a holistic understanding of the VMB for all women.

Concordance analysis between Human Papillomavirus genotyping assay and PCR-reverse spot hybridization for the detection of Human Papillomavirus infection.

Introduction. Human papillomavirus (HPV), the predominant viral infection affecting the anogenital tract, is closely linked to the development of intraepithelial neoplasia and malignancies in the cervix and other anal regions. Currently, 15 high-risk HPVs (HR-HPVs) and 3 potential HR-HPV types have been recognized as contributors to cervical cancer. Consequently, it is imperative to conduct HR-HPV screening using suitable tests in order to identify precancerous lesions and prevent the development of cancer.Hypothesis. The Human papillomavirus genotyping (type 23) detection kit (PCR-reverse point hybridization method) is reliable for clinical testing.Aims. The objective of this research was to assess the concordance between the Human papillomavirus genotyping (type 23) detection kit (PCR-reverse point hybridization method) and the approved HPV test.Methodology. A sample of 781 women who received HPV genotype testing during cervical cancer screening consultations at the Department of Gynecology, Fujian Maternity and Child Health Hospital, was examined. Thirty-two cases were excluded for lacking histological results or showing signs of vulvar intraepithelial rheology, leaving 749 valid histological samples. Only 181 valid pathological specimens were available after excluding those without cervical biopsy or total hysterectomy. The consistency of the test results was assessed using the kappa (K) statistic, with CIN2+ serving as the benchmark for determining sensitivity and specificity. Statistical significance was defined as differences with P values <0.05 (two-tailed).Results. The human papillomavirus genotyping (type 23) detection kit (PCR-reverse point hybridization method) and the approved HPV test demonstrated a high level of concordance with a total kappa value of 0.969 (P<0.05). The overall concordance rate was found to be 98.720%. Using cervical intraepithelial neoplasia grade 2+ (CIN2+) as the reference standard, the human papillomavirus genotyping (type 23) detection kit (PCR-reverse point hybridization method) and the approved HPV test both showed 89.655% sensitivity (P>0.05), while the specificity values were 40.590 and 40.309%, respectively (P>0.05).Conclusion. The evaluated HPV test demonstrates comparable performance to other assays available during the same time frame and exhibits strong concordance in detecting the majority of HPV genotypes.

Designing CITOBOT: A Portable Device for Cervical Cancer Screening Using Human-Centered Design, Smart Prototyping, and Artificial Intelligence

Cervical cancer remains a leading cause of mortality in its invasive stages, presenting a significant global public health challenge, particularly in low- and middle-income countries. Despite technological advancements that have improved the quality of cervical images captured during visual inspections, several challenges persist. This article presents key findings from the CITOBOT-COL translational research project, a large-scale initiative focused on designing CITOBOT as a portable cervical cancer screening device. We detail the comprehensive technological development of CITOBOT, guided by a human-centered design approach, smart prototyping, and the integration of AI. Over four design iterations, we developed and refined CITOBOT v4, a portable device. Prototypes were validated through focus groups and testing by experts in cervical cancer prevention, gynecology, nursing, software, artificial intelligence, computer engineering, and public health, utilizing various anatomical models at the Simulated Hospital Laboratory of Pontificia Universidad Javeriana Cali, Colombia. Additionally, we developed AI algorithms using the Inception V3 network, optimized with Transfer Learning and Fine Tuning, for cervical image classification and offline-operating software that guides the physician through the examination and provides a risk assessment for cervical cancer. Feedback was crucial in assessing and refining the device's functionality, focusing on capturing high-quality cervical images. The development of CITOBOT v4 highlights the importance of fostering innovation in resource-limited settings, offering an effective solution to improve cervical cancer screening and potentially save lives in vulnerable communities.

OCCURRENCE OF HUMAN PAPILLOMAVIRUS (HPV) IN WOMEN OF LGBTQIA+ COMMUNITY TREATED IN MANAUS, AMAZONAS

Human papillomavirus (HPV) is a significant etiological factor for several types of cancer, including cervical carcinoma, with 80% of cases of cervical cancer occurring in Latin America. In Brazil, cervical carcinoma is the third most prevalent cancer among women, and the northern region and the state of Amazonas have the highest incidence in the country. However, not all women benefit from cervical cancer screening measures. Most women in the LGBTQIA+ community do not seek gynecological health services since they often face barriers related to female homosexuality when accesing sexual health services. Using PCR, this study perfomed the molecular detection and genotyping of HPV in thirty-six patients (20 homosexual and 16 bisexual women) from Manaus, Amazonas, Brazil. Samples of the cervical epithelium were taken during the preventive examination and genotyping was perfomed to detect HPV 16, 18, 31 and 58. Of the thirty-six patients analyzed in this study, 88% of bisexual women (n=14) and 60% of homosexual women (n=12) tested positive for HPV. The HPV 18 genotype was the most frequent among the findings. The results indicate that homosexual and bisexual women are more vulnerable to HPV infections due to the lack of more specific gynecological care directed to this group, which includes the lack of training of professionals to deal with the particularities of this population group. Therefore, more HPV screening studies for LGBTQIA+ women and improved training for specialized health professionals are needed.

Gynecological health care services utilization and violence among female sex workers in Togo in 2021

BackgroundFemale Sex Workers (FSW) in Sub Saharan Africa face multiple challenges increasing their vulnerability to poor health, particularly poor sexual and reproductive (SRH) health outcomes and violence. The aim of this study was to assess the use of gynecology health care services and factors associated with its use as well as experiences of violence among FSW in Togo.MethodA cross-sectional study was carried out in 2021 among FSW in two cities of Togo. A snowball sampling method was used and initial seeds were identified in each site in collaboration with FSW non-governmental organizations. A logistic regression was performed to identify factors associated with the use of a SRH service and violence.ResultsA total of 447 FSW with a median age of 30 [IQR: (24–38)] participated in this study and 43.4% of them had reached at least secondary school. Among them, 29.1% reported having been to a gynecological consultation over the previous year. Factors associated with a gynecological consultation included: living in the Lomé capital city (aOR = 0.35, 95%CI 0.22–0.54), and an experience of condom breakage or slippage (aOR = 2.00; 95%CI 1.19–2.64). The majority reported at least one lifetime pregnancy (87.9%), 39.8% reported ever having an unintended pregnancy and 67.6% of them ever had an abortion. Finally, 61.1% indicated being victims of physical, sexual, or emotional violence in the previous six months. Sex workers living in Lomé (aOR = 1.78; 95%CI 1.16–2.73); a history of abortion (aOR = 1.53; 95%CI 1.03–2.31) and having more than 15 clients per week (aOR = 4.87; 95% CI 1.99–11.94), were more likely to experience violence.ConclusionThere is an under-utilization of health care services among FSW in Togo in addition to overall poor sexual and reproductive health outcomes with a high prevalence of gender-based violence. Those results highlight the importance of continued advocacy for the integration of SRH care with HIV prevention services geared toward FSW as well as a holistic approach to SRH care with innovative ways to prevent violence.

The relationship between the vaginal and vulvar microbiomes and lichen sclerosus symptoms in post-menopausal women

Lichen sclerosus is a chronic inflammatory condition of unknown etiology that affects the genital and extragenital skin, which can lead to sexual dysfunction and has been associated with vulvar cancer. The vaginal microbiome has a critical role in gynecologic health, but little is known about the microbiome in lichen sclerosus. This study investigated the vaginal and vulvar microbiomes of 27 post-menopausal women with lichen sclerosus. The most abundant genera detected in the vaginal microbiome were Lactobacillus, Gardnerella, and Anaerococcus, while Lactobacillus, Anaerococcus, and Staphylococcus were the most abundant in the vulvar microbiome. The vaginal samples clustered into two main groups, Lactobacillus dominant (n = 6, > 50% microbiome Lactobacillus) and polymicrobial (n = 21) with no dominant genus. The vulvar samples were mainly polymicrobial (n = 25). Actinomyces, Anaerococcus, and Ezakiella in the vaginal microbiome and Actinomyces and Ezakiella in the vulvar microbiome were significantly associated with lichen sclerosus symptoms (adjusted p < 0.05). In this population of post-menopausal women with lichen sclerosus the majority have diverse, non-Lactobacillus dominant microbiomes, which is considered less optimal for gynecologic health based on studies of pre-menopausal women. Actinomyces, Ezakiella, and Anaerococcus were associated with lichen sclerosus symptoms. Understanding the role of these bacteria in lichen sclerosus pathogenesis will be an essential future investigation.

Effectiveness of Telehealth in Obstetric and Gynecologic Care: A Systematic Review of Health Outcomes.

Telehealth applications are growing in the fields of obstetrics andgynecology. Strong scientific analysis and clinical recommendations are necessary for these innovative advancements. The purpose of this study was to conduct a thorough evaluation of how telehealth interventions can enhance obstetric and gynecologic health outcomes. Using pre-established inclusion and exclusion criteria, we searched the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 968 pertinent research articles were found in these databases, and Endnote software checked them for duplication. Only fifty-two of these articles were deemed relevant after a thorough text examination. Every study that was included had its risk of bias evaluated using the Newcastle-Ottawa Scale (NOS). Overall, telehealth interventions enhanced breastfeeding and smoking cessation obstetric outcomes. While preserving mother and fetal outcomes, telehealth interventions reduced the requirement for high-risk obstetric monitoring office visits. According to one study, women with gestational hypertension had lower rates of preeclampsia diagnoses. For continued use of injectable and oral contraceptives, telehealth treatments proved successful; one text-based study discovered higher rates of oral contraception after six months. When medication abortion services were provided via telehealth, access to early abortion was enhanced, and clinical outcomes were comparable to those of in-person care. Few studies have indicated the value of telehealth in improving the notification of test results for sexually transmitted infections and in improving the symptoms of urine incontinence with app-based interventions. Early availability of medical abortion services, breastfeeding, perinatal smoking cessation, telehealth therapies, and high-risk obstetrics schedule optimization were all linked to better obstetric outcomes. More carefully planned research is required to look at these and other interventions in order to produce data that can guide choices regarding the integration of more recent telehealth technology into obstetrics and gynecology practices.

Determining the relationship between gynecologic cancer awareness and health literacy among women of reproductive age: a descriptive study.

To determine the relationship between gynecologic cancer awareness and health literacy among women of reproductive age. This study was conducted in a descriptive design and involved 510 women. Data collection utilized the "Personal Information Form", "Gynecologic Cancer Awareness Scale (GCAS)" and "Health Literacy Scale (HLS)", gathered. Pearson correlation and linear regression analyses, independent samples t-test, one-way analysis of variance and post hoc analyses were employed for data analysis. Effect sizes were calculated using eta-squared (η2) coefficients. The mean total score of women on the GCAS was 154.42 ± 18.27, while the mean total score on the HLS was 57.07 ± 7.86. Significant differences were observed in women's GCAS total scores concerning age, perceived income status, and history of gynecological examination, whereas significant differences were noted in HLS total scores concerning age, educational status, marital status, and perceived income status. A weak positive correlation was detected betwixt women's GCAS and HLS total scores. It was determined that 20.8% of the total variation in gynecologic cancer awareness level was explained by health literacy. Women exhibit an above-average level of awareness regarding gynecologic cancers. Health literacy level contributes to an increase in gynecologic cancer awareness.

Ethics in the provision of obstetric and gynecologic health care for non-binary and transgender individuals.

Transgender and non-binary individuals often face bias and a lack of awareness, knowledge, and sensitivity from healthcare professionals. This article aims to raise awareness of the concepts of medical ethics among OBGYNs, so they will be better able to approach complex ethical situations in a clear and structured way when providing obstetric and gynecologic health care for transgender and gender-diverse patients.

Society for endocrinology guideline for understanding, diagnosing and treating female hypogonadism.

Female hypogonadism (FH) is a relatively common endocrine disorder in women of premenopausal age, but there are significant uncertainties and wide variation in its management. Most current guidelines are monospecialty and only address premature ovarian insufficiency (POI); some allude to management in very brief and general terms, and most rely upon the extrapolation of evidence from the studies relating to physiological estrogen deficiency in postmenopausal women. The Society for Endocrinology commissioned new guidance to provide all care providers with a multidisciplinary perspective on managing patients with all forms of FH. It has been compiled using expertise from Endocrinology, Primary Care, Gynaecology and Reproductive Health practices, with contributions from expert patients and a patient support group, to help clinicians best manage FH resulting from both POI and hypothalamo-pituitary disorders, whether organic or functional.

Empowering Young Roma Women in matters of health and primary care: an innovative training program

Abstract Background Roma communities are rather diverse groups with different level of knowledge, beliefs and motivations in relation to their health. Raising awareness and self-efficacy of these individuals is a challenging field in the EU public health agenda. Objectives To address this challenge, the program entitled “Empowering Young Roma Women in matters of health, prevention and human rights: a new methodological approach” was developed with the aim to empower Roma women in terms of health and prevention topics pilot testing different educational methods. A two-step co-design approach was performed to determine the training content, tools, methods. The training was implemented in 5 areas throughout Greece (Volos, Chalkida, Thiva, Agia Varvara, Zefyri) in Jan-Oct 2023, including 3 phases: a. Train-the-trainers, b. Training the Roma women and c. Training evaluation. Results The educational material developed for health and prevention included 4 units (gynaecological health issues, vaccinations, smoking and nutrition). Each unit consisted of a theoretical background to develop the material, a presentation for future trainers, a presentation for trainees, a brochure, and a poster. For the training a new methodological approach was tested i.e. a health professional or Roma women (after being trained) to deliver the training. In total, 548 pre-post questionnaires were collected. Most trainees, understood the content of the training, acquired new knowledge and found the information interesting and possible to include in their daily life. 80% trainees expressed their satisfaction with the overall presentation. Regarding knowledge improvement based on the type of trainer only a slightly greater degree of improvement was observed for Roma trainers. Conclusions It is crucial to develop culturally appropriate health interventions by directly working with communities, to understand their particular needs, and to ensure they receive the information needed to make informed decisions. Key messages • Maintaining and promoting health is a decisive factor of social inclusion. • Tailor-made training of ethnic minorities shall be an integral part of the EU public health agenda.