Gynecologic Health Research Articles

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.

Female 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. A 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. A 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. There 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.

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.

Influence of nursing intervention on patients with recurrent bacterial vaginosis treated with sucrose gel.

Bacterial vaginosis significantly affects gynecological health of women, and recurrence is common with a high prevalence in patients who received sucrose gel treatment. Evidence has found that nursing intervention has benefits in improving the rate of recurrence of gynecological diseases. The purpose of this study was to investigate the influence of nursing intervention on patients with recurrent bacterial vaginosis treated with sucrose gel. A total of 1096 patients with bacterial vaginosis were recruited and randomly divided into the intervention nursing group (n = 548) and the control group (n = 548) between May 2022 and October 2022. Patients with bacterial vaginosis in the nursing intervention group received the individualized nursing intervention program, while patients in the control group received routine nursing for vaginitis and follow-up. The clinical efficacy and the short form health survey MOS 36 items (SF-36) scale were used to evaluate the efficacy of nursing intervention efficacy in patients with vaginosis treated with sucrose gel. Our results indicate that the nursing intervention was associated with significant improvements in physical functioning, depression, mental health, bodily vitality pain, and symptoms related to bacterial vaginosis compared to the control group patients. The social functioning-36 score in the nursing intervention group was higher than that in the control group during the 6-month period. Nursing intervention significantly decreased the recurrence of bacterial vaginosis via improvement quality of life and psychological states. In conclusion, the data in this study indicate that the nursing intervention improves recurrent bacterial vaginosis and the quality of life of patients treated with sucrose gel.

Molecular Testing for Women’s Gynecologic Health: Real-World Impact on Health Care Costs

Molecular Testing for Women’s Gynecologic Health: Real-World Impact on Health Care Costs

Body image of postmenopausal women

Abstract: Body image is a multidimensional, subjective, and dynamically changing concept that includes personal perceptions and feelings towards one's body. Menopause is associated with significant changes in external appearance and physical functioning. Aim: The study aimed to determine how women of postmenopausal age assess their bodies and what factors influence this evaluation. Material and methods: The research was conducted in six randomly selected gynaecological and primary health care clinics in Lublin. A total of 510 women were included in the study. A diagnostic survey was used as the research method. The research tool was a questionnaire consisting of a self-constructed part (socio-demographic data) and a standardized Body Esteem Scale questionnaire (BES). Results: In all subscales (sexual attractiveness, body control, and physical fitness), average results were obtained, although the highest was about body weight control (M = 5.85±2.00) and the lowest was related to sexual attractiveness (M = 4.78±2.17). The values of all subscales were significantly differentiated by the subjective assessment of the participant's health status (p&lt;0.05). The values of sexual attractiveness were significantly related to the place of residence (p = 0.021) and the employment status of the participants (p = 0.030). The values of self-assessment of physical fitness were significant with the place of residence (p = 0.012) and the marital status of the participants (p&lt;0.001). Conclusion: Women in postmenopausal age perceive their bodies in all categories (sexual attractiveness, body weight control/body strength, physical fitness) at an average level, indicating the need for psychosocial support. Providing them with support with their self-acceptance, and perhaps lifestyle changes, may improve their self-esteem to their body image.

Promising Drug Delivery System for Cervical Cancer – A Future Approach

There is evidence that peptide targeting can be applied in cervical cancer therapy and for diagnosis involving the use of molecular imaging, hence developing peptide probes for this disease. Cervical cancer, which also has a high possibility of being prevented, is among the common tumors affecting women globally. Despite the occurrence being reduced greatly by screening, the illness remains fatal and its claims many lives annually, especially in the developing nations. In exercising such a perspective, specific public health efforts known to encourage physical activity, proper diet, and early detection of cervical cancer must begin to be taken seriously. When combined, doctors, health officers, and lawmakers could speed up the global deployment of such programs. California’s American Cancer Society, the present review enlists a host of pharmaceutical goods available in the market. This perspective of present-day research and manufacturing is devoted to the development of various types of nanocarriers for possible utilization in medication transport. Thus, overall cancer mortality appears to be not substantially different, though cancer incidence rates for both sexes are 50% lower in impoverished countries when compared to affluent nations. At the moment, there are new peptide probes that are developed solely for cervical cancer-perfectly suitable for targeting peptides applicable in therapeutic and diagnostic imaging. M13KE phage dodecapeptide (12-mer) peptide library was screened for recognition of human immunodeficiency virus type 1 (HIV-1) by immunofluorescence and flow cytometry; the S7 clone was identified as most suitable. A disease that affects many women is gynecologic health problems, and cervical cancer is the leading presenting complaint experienced regularly. Among these studies, QSAR, drug-likeness, PCA, dynamic cross-correlation matrix, molecular docking, molecular dynamics and quantum calculation properties can be listed. In the first literature survey, after identifying the potent antibacterial and anticancer activity of the molecule apigenin, some other promising derivatives were identified and more research has been carried out on them, focusing on their synthesized derivatives as inhibitors of DNA polymerase theta and cervical cancer caused by human papillomavirus. The results were streamlined by the use of in-silico molecular docking, which showed that all Apigenin derivatives and the targeted proteins had potential energy-binding relationships. Further validation is essential because this study used in-silico computational methodologies and produced excellent results. Applying in-silico molecular docking made the data more comprehensible, which showed the possible energy bindings of the targeted proteins and all the Apigenin variants. Due to the fact that this work utilized in-silico computational methods and obtained significant results, further validation is required. Hence, the present wet-lab experiments coupled with both in-vitro and in-vivo conditions, additional validation of the results.

Coronavirus impact on female reproductive system of fertile age: Short-term and delayed consequences

Introduction: Even though the COVID-19 pandemic has come to an end, several short-term and delayed consequences of coronavirus infection remain insufficiently studied, which determines the relevance of this study. The study aims to analyse the impact of coronavirus infection on the course of pregnancy and reproductive health of females of fertile age in different periods according to the data of medical institutions of Turkestan city.Methods: The following research methods were used in the study: bibliographic, discrete statistics, cluster, and frequency analysis.Results: In this study, 301 cases of pregnancy of females diagnosed with coronavirus infection of different severity were statistically analysed. The study examined several aspects related to the study group including duration of hospitalisation, number of previous pregnancies and deliveries, complications of pregnancy and delivery occurring on COVID-19, haematological parameters, and oxygen saturation levels of pregnant females. The main clinical features of pregnancies with COVID-19 were identified. Thus, the result of the study was an analysis of the presented statistical sample and a comprehensive review of the current literature on the short-term and delayed effects of coronavirus infection on the female reproductive system.Conclusions: The results obtained are of significant practical importance for specialists in obstetrics, gynaecology, reproductology and public health because they can serve as a basis for the development of effective clinical recommendations and strategies for managing the reproductive health of females who have undergone coronavirus infection

Causal Relationship Between Mood Swing and Gynecological Disorders: A Mendelian Randomization Study.

Gynecological disorders are a wide range of health problems affecting the female reproductive system, which poses substantial health challenges worldwide. Increasing number of observational studies have associated mood instability to common female diseases, but the underlying causal relationship remains unclear. In this work, Mendelian randomization (MR) analysis was applied to explore the genetically predicted causal relationship of mood swings and several prevalent gynecological disorders. Instrumental variables (IVs) of mood swings were selected from UK Biobank (UKB), with 204,412 cases and 247,207 controls being incorporated. The genetic variants for female disorders were obtained from genome-wide association studies (GWASs) and FinnGen consortium. To avoid biases caused by racial difference, only European population was included here. Five strong analytical methodologies were used to increase the validity of the results, the most substantial of which was the inverse variance weighting (IVW) method. Pleiotropy, sensitivity, and heterogeneity were assessed to strengthen the findings. We found mood swings was significantly positively associated with risk of endometrial cancer (OR= 2.60 [95% CI= 1.36, 4.95], P= 0.0037), cervical cancer (OR= 1.01[95% CI= 1.00,1.02], P= 0.0213) and endometriosis (OR= 2.58 [95% CI= 1.18, 5.60], P= 0.0170) by IVW method. However, there was no causal relationship between mood swing and ovarian cancer. No pleiotropy and heterogeneity existed and sensitivity tests were passed. This study reveals that mood swing may serve as a genetically predicted causal risk factor for endometrial cancer, cervical cancer, and endometriosis in the European population, while no such association was observed for ovarian cancer. These findings make up for observational research's inherent limitations and may improve patient outcomes in the field of gynecological health. However, the study's focus on European populations may limit the applicability of these results globally.

Equitable Care for Patients With Disabilities: Considerations for the Gynecologic Health Care Professional.

Equitable Care for Patients With Disabilities: Considerations for the Gynecologic Health Care Professional.

Correlation between spinopelvic alignment and uterine dimensions in primary dysmenorrhea: A case-control study

Background. The high prevalence of primary dysmenorrhea (PD) among young females has prompted interest in exploring its multifactorial causes. One area of investigation is the relationship between musculoskeletal posture and gynecological health. Purpose. To examine the potential correlation between spinopelvic alignment and uterine dimensions in females with and without PD. Methods. This case-control observational study included 40 females with regular menstrual cycles, divided into two groups: 20 with PD (study group) and 20 without PD (control group). Spinopelvic alignment parameters, including thoracic kyphosis, lumbar lordosis, pelvic tilt, and pelvic torsion, were assessed using a 4D formetric device. Uterine dimensions, including corpus length and width, as well as cervix length and width, were measured by ultrasonography. Results. No significant correlations were found between the spinopelvic alignment and uterine dimensions in the study group with PD (p &gt; 0.05). However, in the control group without PD, there were significant moderate negative correlations between uterine corpus width and thoracic kyphotic angle (p &lt; 0.05), as well as between cervix length and pelvic tilt (p &lt; 0.05). Conclusion. In females with PD, there are no significant correlations between spinopelvic alignment and uterine dimensions. In contrast, in females without dysmenorrhea, there are significant correlations between uterine corpus width and thoracic kyphotic angle, and between cervix length and pelvic tilt.

Association of parity with the timing and type of menopause: A longitudinal cohort study.

We investigated the time-varying association between parity and timing of natural menopause, surgical menopause, and premenopausal hysterectomy among 23,728 women aged 40-65 years at enrollment in the Alberta's Tomorrow Project cohort study (2000-2022), using flexible parametric survival analysis. Overall, natural menopause was most common by study end (57.2%), followed by premenopausal hysterectomy (11.4%) and surgical menopause (5.3%). Risks of natural menopause before age 50 years were elevated for 0 births (adjusted hazard ratio at age 45: 1.33, 95% CI 1.18-1.49) and 1 birth (age 45: 1.21, 1.07-1.38), but similar for ≥3 births (age 45: 0.95, 0.85-1.06), compared to 2 births (reference). Elevated risks of surgical menopause before age 45 years for 0 births (age 40: 1.37, 1.09-1.69) and 1 birth (age 40: 1.11, 0.85-1.45) attenuated when excluding women with past infertility or recurrent pregnancy loss, and reduced risks were observed over time for ≥3 births (age 50: 0.84, 0.75-0.94). Risks of premenopausal hysterectomy were lower before age 50 years for 0 births (age 45: 0.82, 0.76-0.88) but elevated after age 40 years for ≥3 births (age 50: 1.25, 1.08-1.45). These complex associations necessitate additional research on the sociobiological impacts of childbearing on gynecologic health.

The Impact of Obesity on Gynecological Health: A Comprehensive Overview

The Impact of Obesity on Gynecological Health: A Comprehensive Overview

Reproductive and Gynecologic Health Among Highly Vulnerable Hairstylists of Color

Reproductive and Gynecologic Health Among Highly Vulnerable Hairstylists of Color

A comprehensive analysis of contraceptive safety: Implications for gynecological health and education levels

The use of contraceptives is essential for lowering the net reproduction rate and stabilizing population growth. Developing countries are characterized by high birth rates and rapid population growth. With lower contraceptive usage rates among eligible couples and resistance towards family planning methods, achieving population stabilization seems challenging. Therefore, this study aims to study the effects of various contraceptive methods on gynecological health and their safety profiles, The present observational study, was conducted in Department Obstetrics and Gynaecology at tertiary health care centre, Panjab, India. A total of 450 women were evaluated with the help of a pre-designed and pre-tested questionnaire to address knowledge, awareness, and perception of contraception among the rural and urban population in Punjab. The data were collected and analysed.All the participants were known to the traditional contraception and only few were aware about the modern contraception. Participants preferred tubal ligation (43.78%) over vasectomy (75.78%) and rarely considered hysterectomy (1.11%). Most knew about male condoms (99.56%) but fewer about female condoms (0.44%). Among the participants, 59.78% were aware of contraception side effects. Regarding condom use, opinions were divided, with 48.67% in favor and 51.33% against. Educated individuals were aware of contraception but not its major side effects. Therefore, we suggest investigating social, cultural, and knowledge aspects to improve understanding.

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.