Gynecological Endocrinology[JOURNAL]
Sun
200 papers
European society of gynecology (ESG) position paper on the proposed terminology change from PCOS to PMOS.
Castelo-Branco C, Vujovic S, Genazzani AD … +10 more , Brincat M, Meczekalski B, Stute P, Genazzani AR, Brichant G, Orvieto R, Vasaraudze I, Yoldemir T, Daniilidis A, on the behalf of the ESG Board
Gynecol Endocrinol · 2026 Dec · PMID 42367168 · Publisher ↗
BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder whose terminology inadequately reflects its systemic nature. The proposed renaming to polyendocrine metabolic ovary syndrome (PMOS) aims to b...
BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder whose terminology inadequately reflects its systemic nature. The proposed renaming to polyendocrine metabolic ovary syndrome (PMOS) aims to better represent its pathophysiology. OBJECTIVE: To present the European Society of Gynaecology (ESG) position regarding the proposed terminology change and its implementation. METHODS: Expert consensus and narrative synthesis of current scientific evidence and international recommendations. RESULTS: ESG supports a structured, patient-centered transition strategy. Recommendations include prioritizing patient communication, implementing a gradual transition with prolonged dual terminology use, and integrating the new terminology systematically into scientific and educational frameworks. The importance of interdisciplinary clarity and the central role of gynecological endocrinology are emphasized. CONCLUSION: A phased and clearly communicated transition will enhance conceptual accuracy while preserving patient understanding, continuity of care, and clinical coordination.
Peripheral precocious puberty with unilateral ovarian agenesis in early childhood: a case report and review of literature.
Asanidze E, Vash-Margita A, Asanidze B … +4 more , Kharaishvili M, Chiokadze M, Jibladze A, Kristesashvili J
Gynecol Endocrinol · 2026 Dec · PMID 42360895 · Publisher ↗
Peripheral precocious puberty (PPP) is a rare condition in early childhood, particularly among girls under 3 years of age. One cause of PPP is functional ovarian cysts that secrete estrogen at levels sufficient to trigge...
Peripheral precocious puberty (PPP) is a rare condition in early childhood, particularly among girls under 3 years of age. One cause of PPP is functional ovarian cysts that secrete estrogen at levels sufficient to trigger the development of premature secondary sexual characteristics. Unilateral ovarian agenesis is an uncommon congenital anomaly. The coexistence of both conditions in a single patient is extremely rare and poses unique diagnostic and management challenges. We report the case of a 2-year and 10-month-old girl presenting with concurrent breast development, pubarche, and recurrent vaginal bleeding. Pelvic imaging revealed a cyst in the left ovary and agenesis of the right ovary. Laparoscopy confirmed absence of the right ovary and ipsilateral fallopian tube. Based on clinical, hormonal, and radiologic findings, a diagnosis of PPP due to a functional ovarian cyst was made. Given the rapid progression of symptoms, increase in cyst size, and concern for torsion, a short observation period of three months was followed by ovarian-preserving laparoscopic cystectomy. Histopathology confirmed a benign follicular cyst. Postoperatively, the patient experienced partial regression of pubertal signs and complete resolution of vaginal bleeding. This case highlights the importance of individualized decision-making in managing PPP,especially in the presence of congenital anomalies.
Transdermal versus oral hormone replacement therapy and bone mass density in Turner syndrome patients: a pilot study.
Widmann K, Hager M, Windischbauer LM … +2 more , Krysiak R, Ott J
Gynecol Endocrinol · 2026 Dec · PMID 42351362 · Publisher ↗
OBJECTIVE: Women with Turner syndrome (TS) are at increased risk of reduced bone mineral density (BMD) due to primary ovarian insufficiency. This study aimed to assess longitudinal changes in BMD in TS patients receiving...
OBJECTIVE: Women with Turner syndrome (TS) are at increased risk of reduced bone mineral density (BMD) due to primary ovarian insufficiency. This study aimed to assess longitudinal changes in BMD in TS patients receiving oral or transdermal hormone replacement therapy (HRT) and to identify factors associated with bone density decline. METHODS: This retrospective pilot study included 40 TS patients treated with oral or transdermal estradiol. The median age was 22 years in both the transdermal (20-30) and oral (20-27) groups. Median BMI was 23.1 (21.1-25.5) and 25.4 (22.1-29.1), respectively. Dual-energy X-ray absorptiometry (DEXA) of the lumbar spine and femoral neck was performed at baseline and follow-up. The primary outcome was the -score at both sites. Univariable and multivariable logistic regression analyses were used to identify factors associated with declining -scores. RESULTS: At baseline, 38.3% of patients had osteopenia, and 3.3% had osteoporosis. During follow-up, a decline in -scores at at-least one skeletal site was observed in 47.5% of patients. No significant differences were found between oral and transdermal estradiol therapy regarding absolute -scores, -score changes, or the proportion of patients with declining -scores (all > 0.05). In multivariable analysis, lower vitamin D levels at follow-up were independently associated with declining -scores. CONCLUSIONS: In TS patients, the route of estradiol administration did not significantly affect long-term BMD outcomes. Despite HRT, a substantial proportion of patients experienced bone loss. Vitamin D status has emerged as the most relevant modifiable factor associated with declining BMD, highlighting the need for bone health management beyond HRT.
Elevated ESR2 and BRCA1 gene expression in adenomyosis associated with endometrial cancer: a pilot study.
La Torre F, Nardi E, Bonechi F … +8 more , Vannuccini S, Sorbi F, Fambrini M, Castiglione F, Zannoni GF, Morandi A, Reis FM, Petraglia F
Gynecol Endocrinol · 2026 Dec · PMID 42329179 · Publisher ↗
BACKGROUND: Adenomyosis is a benign uterine disease that has been associated with endometrial proliferative disorders. Adenomyosis and endometrial cancer (EC) are sex-steroid-dependent conditions that may coexist, but th...
BACKGROUND: Adenomyosis is a benign uterine disease that has been associated with endometrial proliferative disorders. Adenomyosis and endometrial cancer (EC) are sex-steroid-dependent conditions that may coexist, but their estrogen receptor (ER) and progesterone receptor (PR) signaling landscape is poorly defined. OBJECTIVE: The present multicenter study aimed to characterize the expression of estrogen / plus the coregulators , , ) and progesterone ( plus , and ) receptor pathway-related genes in hysterectomy specimens of patients with adenomyosis and coexisting EC. METHODS: Specimens from three groups of patients ( = 10 per group) referred to two tertiary hospitals were studied: adenomyosis plus EC (Group 1), only adenomyosis (Group 2), and only EC (Group 3). Gene expression was assessed by droplet digital PCR using a compartment-matched design. Analysis was compartment-specific, and no cross-compartment comparisons were performed. RESULTS: Compared with isolated adenomyosis, adenomyotic lesions from uteri with coexisting EC showed higher ( = 0.0082) and ( = 0.0007) expression, with no differences in , , or . PR-related gene expression (, , and ) did not differ between adenomyosis groups. CONCLUSION: Although preliminary, the present findings indicate that adenomyosis coexisting with EC is characterized by elevated expression of and , suggesting an enriched ER-related microenvironment that may be relevant to local estrogen responsiveness.
Progestin therapy in premenopausal women with incidental meningioma-a narrative review and recommendations for women's health specialists.
Pluchino N, Vibert J, Roth M … +4 more , Gobrecht U, Pape J, Weidlinger S, Merki-Feld G
Gynecol Endocrinol · 2026 Dec · PMID 42323841 · Publisher ↗
OBJECTIVE: To review recent evidence on the association between progestin exposure and meningioma risk and to propose practical recommendations for hormonal management in women requiring progestin therapy. METHODS: A nar...
OBJECTIVE: To review recent evidence on the association between progestin exposure and meningioma risk and to propose practical recommendations for hormonal management in women requiring progestin therapy. METHODS: A narrative review of studies published between 2015 and 2025 evaluating the relationship between exogenous progestins and meningioma development, growth, or progression was performed. Evidence regarding different progestin compounds, cumulative exposure, reversibility after discontinuation, and implications for gynecologic practice was analyzed. RESULTS: Meningiomas account for more than one-third of intracranial tumors and occur two to three times more frequently in women, supporting a potential hormonal influence mediated by progesterone receptors, which are expressed in most tumors. The increasing use of MRI has led to more frequent detection of incidental meningiomas in premenopausal women using progestins for contraception or gynecologic conditions such as endometriosis and heavy menstrual bleeding. Consistent associations with increased meningioma risk were observed for high-dose or prolonged exposure to cyproterone acetate, chlormadinone acetate, nomegestrol acetate, and medroxyprogesterone acetate. Risk appeared to increase with cumulative exposure and decrease after treatment discontinuation. Evidence for other progestins, including desogestrel, dienogest, levonorgestrel, and the levonorgestrel-releasing intrauterine system, remains limited and less conclusive. CONCLUSIONS: Women's health specialists should systematically assess a history of meningioma before prescribing progestins. In patients with incidental meningioma, discontinuation of high-risk progestins should be considered, followed by MRI reassessment within 3-6 months. When hormonal treatment remains necessary, the lowest effective dose and regular neuro-oncologic monitoring are recommended. Increased awareness and individualized counseling are essential to optimize hormonal management in women at risk of meningioma.
Inter-rater reliability and clinical utility of the modified ferriman-gallwey scale in routine practice.
Chongaroonngamsang I, Matemanosak P, Suwanrath C … +3 more , Peeyananjarassri K, Khwankaew N, Geater A
Gynecol Endocrinol · 2026 Dec · PMID 42319915 · Publisher ↗
OBJECTIVES: To evaluate the reliability and clinical utility of the modified Ferriman-Gallwey (mFG) score in routine practice when applied by clinicians with differing experience and by patients for self-assessment. METH...
OBJECTIVES: To evaluate the reliability and clinical utility of the modified Ferriman-Gallwey (mFG) score in routine practice when applied by clinicians with differing experience and by patients for self-assessment. METHODS: In this cross-sectional reliability study, 43 reproductive-aged women were assessed for hirsutism. Three clinicians (reproductive endocrinologist, general gynecologist, and resident) independently scored participants using the mFG scale, and patients self-graded their hirsutism. Inter-rater reliability was examined using intraclass correlation coefficients (ICC) and weighted kappa statistics by body area. Clinical agreement was assessed with Bland-Altman limits of agreement (LOA). RESULTS: Inter-rater reliability was good (ICC = 0.649), higher between experienced clinicians (ICC = 0.723) and lower when the resident was included (ICC = 0.588). Weighted kappa ranged from 0.118 to 0.832 (highest for chin, lowest for upper back). Bland-Altman analysis showed substantial disagreement: experienced pair bias -0.74 (LOA -6.94 to + 5.46) and less-experienced pair bias + 0.44 (LOA -7.22 to + 8.11). Patient self-scoring showed poor agreement with clinician scoring (ICC = 0.20). CONCLUSIONS: Although clinician scoring demonstrated good statistical reliability, inter-rater differences remained clinically meaningful, with LOA exceeding diagnostic thresholds for hirsutism. Greater experience improved agreement but did not eliminate variability. Patient self-scoring showed low agreement with experts and tended to overestimate severity; however, it may function as a high-sensitivity screening adjunct rather than a substitute for clinician assessment.
Expression of Concern: Insulin Sensitiser Agents Alone and in Co-Treatment with r-FSH for Ovulation Induction in PCOS Women.
Gynecol Endocrinol · 2026 Dec · PMID 42304764 · Publisher ↗
Abstract loading — click title to view on PubMed.
Association between GLM7 and female infertility: a cross-sectional analysis of NHANES 2013-2018.
Dong T, Gao J, Wang X
Gynecol Endocrinol · 2026 Dec · PMID 42257240 · Publisher ↗
OBJECTIVE: Female infertility is a common reproductive disorder influenced by metabolic dysfunction. The glycolipid metabolism 7 factors (GLM7) is a composite metabolic index integrating age, BMI, glucose, insulin, and l...
OBJECTIVE: Female infertility is a common reproductive disorder influenced by metabolic dysfunction. The glycolipid metabolism 7 factors (GLM7) is a composite metabolic index integrating age, BMI, glucose, insulin, and lipid profiles. This study aimed to examine its association with female infertility in a nationally representative population. METHODS: Data from 1,405 female participants aged 18-45 years from the 2013-2018 cycles of the National Health and Nutrition Examination Survey were analyzed. We used survey-weighted logistic regression models and restricted cubic splines to assess the association between GLM7 and infertility. Receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracy. RESULTS: A total of 167 participants (11.9%) reported infertility. After full adjustment, higher GLM7 levels were independently associated with increased odds of infertility (odds ratio (OR) = 1.401, 95% CI: 1.028-1.909, = 0.034). A positive linear association was observed, with a potential plateau effect at GLM7 ≈ 6.98. GLM7 showed modest discriminative ability (AUC = 0.596, 95%CI: 0.552-0.639). CONCLUSIONS: GLM7 was positively associated with female infertility. As a multidimensional metabolic indicator, GLM7 may provide complementary information for reproductive health research. However, its modest discriminative performance suggests limited value as a standalone screening tool, warranting further validation in longitudinal and clinical studies.
From 'polycystic ovary syndrome' to 'polyendocrine metabolic ovarian syndrome': why terminology matters.
Chedraui P, Nappi RE
Gynecol Endocrinol · 2026 Dec · PMID 42228625 · Publisher ↗
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The associations of sleep parameters with sexual quality of life among postmenopausal women.
Koc Kulaksiz G, Yoldemir T
Gynecol Endocrinol · 2026 Dec · PMID 42192589 · Publisher ↗
OBJECTIVE: Aging and menopause negatively affect women's sexual quality of life, and midlife women often report sleep difficulties. The aim of the present study was to investigate the relationship between sleep quality a...
OBJECTIVE: Aging and menopause negatively affect women's sexual quality of life, and midlife women often report sleep difficulties. The aim of the present study was to investigate the relationship between sleep quality and sexual quality of life in postmenopausal women. METHODS: A total of 303 postmenopausal women attending the Gynecology and Menopause Clinics of a university-affiliated training hospital completed the sexual quality of life questionnaire-female (SQoL-F) and the Pittsburgh sleep quality index (PSQI). SQOL-F and PSQI scores were compared by time since menopause, educational level, and age in decades. Correlations between SQoL-F and PSQI domain scores were analyzed. RESULTS: One hundred thirteen women (37.3%) had good sexual quality of life (SQoL-F > 84). SQoL-F and PSQI domain scores did not differ by time since menopause. Sexual and relationship satisfaction were higher among women aged 40-49 years, while other SQoL-F domains showed similar scores across age groups. PSQI domains were also comparable between age categories. Demographic characteristics did not differ between women with good versus poor sleep quality. Correlations between SQoL-F and PSQI domains were negligible to low, including total scores. The correlations reported are unadjusted. The Spearman rho values between the four domains of SQoL-F and seven domains of PSQI ranged between -0.181 and 0.033 (95% CI: -0.281 to 0.129), -0.144 and 0.026 (95% CI: -0.256 to 0.173), -0.159 and 0.043 (95% CI: -0.270 to 0.170), -0.087 and 0.009 (95% CI: -0.207 to 0.140), respectively. CONCLUSION: Younger and better-educated postmenopausal women showed a better overall sexual quality of life. No meaningful association was found between sleep parameters and sexual outcomes.
Restoring ovulation in functional hypothalamic amenorrhea: impact of polycystic ovarian morphology on hormonal response to pulsatile GnRH.
Boegl M, Kasper I, Dewailly D … +3 more , Mayrhofer D, Hager M, Ott J
Gynecol Endocrinol · 2026 Dec · PMID 42176250 · Publisher ↗
OBJECTIVE: Up to 50% of women with functional hypothalamic amenorrhea (FHA) exhibit polycystic ovarian morphology (PCOM) on ultrasound. We aimed to compare the hormonal response to ovulation induction with pulsatile GnRH...
OBJECTIVE: Up to 50% of women with functional hypothalamic amenorrhea (FHA) exhibit polycystic ovarian morphology (PCOM) on ultrasound. We aimed to compare the hormonal response to ovulation induction with pulsatile GnRH therapy in FHA patients with and without PCOM. METHODS: In this single-center observational study, 41 patients with FHA underwent 3 months of pulsatile GnRH therapy to induce ovulation. Patients were categorized into a PCOM group ( = 24) and a non-PCOM group ( = 17). Serum levels of Anti-Muellerian-hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, sex hormone-binding globulin (SHBG), testosterone, and thyroid-stimulating hormone (TSH) were assessed at baseline and after 3 months of treatment. RESULTS: At baseline, median AMH levels were significantly higher in the PCOM group (6.21 ng/ml [IQR 4.03-8.87]) compared to the non-PCOM group (1.7 ng/ml [IQR 1.14-2.20]; < 0.001). After 3 months of pulsatile GnRH therapy, AMH levels significantly increased in the non-PCOM group (1.94 [IQR 1.39-2.49], < 0.001), whereas no significant change was observed in the PCOM group ( = 0.218). LH, FSH, and estradiol levels increased in both groups. Pulsatile GnRH therapy effectively induced ovulation (1 dominant follicle in each patient), irrespective of ovarian morphology. CONCLUSION: The significant AMH rise in women with FHA without PCOM likely reflects restored folliculogenesis. In contrast, the absence of an AMH rise in the PCOM group was expected, given their already elevated baseline levels. Importantly, these findings suggest that pulsatile GnRH therapy does not exacerbate AMH levels in most patients.
Variation in gestational outcomes among PCOS phenotypes in natural and art-conceived pregnancies.
Senthil P, Piserchio N, Potter K … +1 more , Ryznar R
Gynecol Endocrinol · 2026 Dec · PMID 42169609 · Publisher ↗
OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. While diagnostic criteria have historically varied, the Rotterdam criteria, established in 2003, are...
OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. While diagnostic criteria have historically varied, the Rotterdam criteria, established in 2003, are now the standard. This classification identifies four PCOS phenotypes based on the presence and/or absence of three key features: ovulatory dysfunction (OD), hyperandrogenism (HA), and polycystic ovarian morphology (PCOM). Despite phenotypic differences, current clinical guidelines treat PCOS as a homogeneous condition when assessing pregnancy risks. Therefore, this narrative review examines variations in gestational outcomes across PCOS phenotypes in both natural and assisted reproductive technology (ART)-conceived pregnancies. METHODS: A search of three databases (PubMed, Cochrane, and Google Scholar) using key terms identified 13 eligible retrospective and prospective studies reporting gestational outcomes in PCOS phenotypes. RESULTS: Findings indicate that phenotypes characterized by HA (A, B, and C) are at higher risk for preeclampsia, gestational diabetes, and miscarriage in natural pregnancies. However, in ART-conceived pregnancies, Phenotypes A and D exhibited higher risks of adverse outcomes, while Phenotypes A and C showed significantly lower live birth and cumulative live birth rates. CONCLUSION: These results reveal inconsistencies in pregnancy risks across phenotypes and conception methods, suggesting differences in the underlying mechanisms. The findings challenge the one-size-fits-all approach to pregnancy counseling in PCOS. Incorporating phenotype-specific risk stratification into clinical guidelines could enhance maternal and neonatal outcomes, particularly for high-risk phenotypes. Further research is needed to refine pregnancy care strategies tailored to individual PCOS phenotypes.
Outcome comparisons of controlled ovarian hyperstimulation protocols in adenomyosis patients: a real-world retrospective cohort study.
Wang Z, Yang J, Huang C … +1 more , Xu Y
Gynecol Endocrinol · 2026 Dec · PMID 42120313 · Publisher ↗
OBJECTIVE: To compare the efficacy of different COH protocols on pregnancy outcomes in adenomyosis patients. STUDY DESIGN: A real-world retrospective cohort study analyzed 1486 IVF-ET cycles in adenomyosis patients who r...
OBJECTIVE: To compare the efficacy of different COH protocols on pregnancy outcomes in adenomyosis patients. STUDY DESIGN: A real-world retrospective cohort study analyzed 1486 IVF-ET cycles in adenomyosis patients who received COH regimens between 2018 and 2021. Pregnancy outcomes were compared among patients under different COH protocols. RESULTS: The short-acting long protocol achieved the highest live birth (47.92%) and cumulative clinical pregnancy (68.84%) rates. The antagonist protocol showed lower fresh-cycle pregnancy (36.63% vs. 52.10%, = 0.036), live birth (21.78% vs. 36.55%, = 0.009), and cumulative clinical pregnancy rates (39.31% vs. 53.29%, < 0.001) compared to the long/ultra-long protocol. Multivariable logistic regression confirmed that the COH protocol was an independent predictor of both clinical pregnancy (Wald ² = 8.127, = 0.043) and cumulative clinical pregnancy (Wald ² = 40.344, < 0.001). In patients <35 years with a normal ovarian reserve (anti-Müllerian hormone ≥ 1.2 ng/mL), live birth rates and cumulative clinical pregnancy rates were similar between the antagonist protocol and long/ultra-long protocols (27.59% vs. 44.94%, = 0.098; 63.83% vs. 63.87%, = 0.995), with significantly less gonadotropin used in the antagonist protocol. CONCLUSIONS: In adenomyosis patients, the long/ultra-long provided better fresh-cycle outcomes. While the antagonist protocol had lower overall pregnancy rates, it preserved cumulative pregnancy rates in young patients with normal ovarian reserves and reduced gonadotropin exposure.
Association of regional fat distribution indicators with infertility in women: insights from the 2013-2018 NHANES.
Chen L, Mu F, He T … +1 more , Wang F
Gynecol Endocrinol · 2026 Dec · PMID 42104773 · Publisher ↗
BACKGROUND: Female infertility is multifactorial, with adiposity and regional fat distribution hypothesized as contributors, though evidence using detailed fat measures is limited. This study aims to examine the associat...
BACKGROUND: Female infertility is multifactorial, with adiposity and regional fat distribution hypothesized as contributors, though evidence using detailed fat measures is limited. This study aims to examine the association between fat distribution indicators and female infertility in a nationally representative sample. METHODS: This retrospective cross-sectional study analyzed NHANES 2013-2018 data from 2,531 women aged 20-45. Infertility was defined by self-reported difficulty conceiving ≥ 12 months or seeking fertility care. Exposures included body mass index (BMI) and DXA-based measures: total percent fat (TPF), android percent fat (APF), gynoid percent fat (GPF), android fat/gynoid fat ratio (AGR), visceral fat/total fat (VPF), subcutaneous fat/total fat (SPF), and visceral fat/subcutaneous fat ratio (VSR). Multivariable logistic regression was used to assess associations, and sensitivity analyses were performed to evaluate robustness. RESULTS: In multivariable-adjusted models, TPF, APF, AGR, and BMI were modestly associated with higher odds of infertility (TPF: OR = 1.02, 95%CI: 1.00-1.05; APF: OR = 1.03, 95%CI: 1.01-1.04; AGR: OR = 1.02, 95%CI: 1.01-1.03; BMI: OR = 1.02, 95%CI: 1.01-1.04). Smooth curve fitting suggested a generally monotonic positive pattern for these associations. Associations were broadly similar across subgroups, although some subgroup interactions were observed. CONCLUSION: In this analysis, TPF, APF, AGR, and BMI showed modest associations with infertility, which should not be interpreted causally. Although associations were generally consistent across subgroups, subgroup-specific heterogeneity cannot be excluded.
Inflammatory markers mediate the association of the Zhejiang University index with gestational diabetes mellitus: data from NHANES 2007-2020.
Ye M, Wu H, Shan F … +4 more , Zhou H, Yu J, Wu Y, Hao T
Gynecol Endocrinol · 2026 Dec · PMID 42101192 · Publisher ↗
BACKGROUND: Gestational diabetes mellitus (GDM) threatens maternal and infant health, yet early prediction is challenging. The Zhejiang University (ZJU) index, reflecting insulin resistance and hepatic lipid metabolism,...
BACKGROUND: Gestational diabetes mellitus (GDM) threatens maternal and infant health, yet early prediction is challenging. The Zhejiang University (ZJU) index, reflecting insulin resistance and hepatic lipid metabolism, predicts metabolic diseases, but its role in GDM across multiethnic populations is unclear. METHODS: This study analyzed NHANES 2007-2020 data from US women aged 20-45. Weighted logistic regression, restricted cubic spline (RCS), subgroup, and ROC analyses assessed ZJU index and GDM. Mediation analysis evaluated inflammatory ratios. Sensitivity analysis excluded women with chronic diseases or medication use. RESULTS: Among 2240 women, 10% had GDM. Higher ZJU index was linearly associated with increased GDM risk; highest quartile had over twice the odds (OR = 2.25, 95% CI: 1.10-3.41). ZJU index outperformed BMI, FPG, ALT, AST (AUC = 0.718). PHR and LHR partially mediated the association. Sensitivity analysis confirmed robustness. CONCLUSION: ZJU index is a strong, independent predictor of GDM, outperforming traditional markers. HDL‑related inflammatory markers partially mediate this association, suggesting immunometabolic pathways. Further studies are needed for validation in broader populations.
A randomized controlled trial on the effect of Gushukang on bone mineral density in perimenopausal and postmenopausal women.
Liu L, Ruan X, Gu M … +8 more , Li Y, Yang Y, Cheng J, Jiang L, Wang Z, Zhang M, Liu A, Mueck AO
Gynecol Endocrinol · 2026 Dec · PMID 42033017 · Publisher ↗
OBJECTIVE: To study the effect of the traditional Chinese medicine Gushukang on bone mineral density (BMD) in perimenopausal and postmenopausal women. METHODS: In this randomized trial, 156 women were assigned to three g...
OBJECTIVE: To study the effect of the traditional Chinese medicine Gushukang on bone mineral density (BMD) in perimenopausal and postmenopausal women. METHODS: In this randomized trial, 156 women were assigned to three groups ( = 52 each): hormone therapy (HT), Chinese medicine (CM, Gushukang capsules), or combination therapy. Interventions lasted 6 months. Height, weight, and BMD were measured, and blood samples were taken to assess FSH, LH, E2, , AST, ALT, BUN, and CRE levels before and after treatment. Changes in these indicators were compared. RESULTS: Of the 156 participants, 142 completed the study (HT: 49, CM: 42, combination: 51). The median ages (Q1, Q3) of the three groups were 51.00 (47.00, 53.50), 53.00 (49.00, 57.00), and 51.00 (45.25, 54.00) years, respectively, with no significant difference. Pretreatment BMD values (mg/cm³) were 115.10 (102.90, 118.80), 107.40 (88.50, 114.65), and 113.25 (100.20, 118.98) for the HT, CM, and combination groups, respectively. After 6 months of treatment, the combination group showed a significant increase in BMD after treatment compared with before treatment ( < 0.01). In the hormone therapy and combination groups, FSH and LH levels decreased significantly, while E2 levels increased significantly after treatment ( < 0.05), whereas no significant differences in these indicators were observed in the Chinese medicine group. No significant differences in liver or kidney function were found in any of the three groups before and after treatment. CONCLUSION: Both Gushukang and menopausal hormone therapy for 6 months can increase BMD in perimenopausal and postmenopausal women; however, combination therapy yields superior results.
Drawbacks in dopaminergic neurotransmission: compromising sexual performance.
Armeni A, Nappi RE, Chedraui P
Gynecol Endocrinol · 2026 Dec · PMID 42028668 · Publisher ↗
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Continuous estetrol/drospirenone regimen for the treatment of endometriosis-related pain: preliminary results.
Dell'Aquila M, Della Corte L, Kafetzis D … +3 more , Bifulco G, Di Carlo C, Giampaolino P
Gynecol Endocrinol · 2026 Dec · PMID 42018156 · Publisher ↗
PURPOSE: Endometriosis is a chronic inflammatory condition that causes significant physical and psychological distress. This study aimed to evaluate the therapeutic efficacy and safety of a combined oral contraceptive co...
PURPOSE: Endometriosis is a chronic inflammatory condition that causes significant physical and psychological distress. This study aimed to evaluate the therapeutic efficacy and safety of a combined oral contraceptive containing estetrol (E4, 14 mg) and drospirenone (DRSP, 3 mg) in managing endometriosis-related pain. MATERIALS AND METHODS: A retrospective cohort study was carried out at the Endometriosis Center, Federico II University Hospital, Naples, from January 2024 to November 2024. Forty patients with diagnosis of endometriosis and significant pain symptoms (VAS > 6) were included and received E4/DRSP under a continuous regimen for 6 months. Chronic pelvic pain, dyspareunia, dysmenorrhea, and patient quality of life were assessed at baseline, after 3 and 6 months. In the group of patients with endometrioma, reduction in size was evaluated. RESULTS: E4/DRSP significantly reduced chronic pelvic pain and dyspareunia. Dysmenorrhea was resolved entirely due to amenorrhea induction. Endometriomas decreased in size by 30% on average after 6 months. Adverse effects were mild and occurred in 13/40 of patients (32.5%). CONCLUSION: E4/DRSP demonstrated efficacy and tolerability for managing endometriosis-related pain, offering a promising option for long-term treatment. Further research is needed to confirm its impact on lesion regression and disease progression.
Dysregulated endometrial podocalyxin and LIF expression in women with ovarian endometrioma.
Karakelleoğlu G, Karadağ C
Gynecol Endocrinol · 2026 Dec · PMID 42015488 · Publisher ↗
OBJECTIVE: To investigate whether ovarian endometrioma is associated with disruption of the endocrine-regulated transition between the anti-adhesive modulator podocalyxin (PCX) and the adhesive modulator leukemia inhibit...
OBJECTIVE: To investigate whether ovarian endometrioma is associated with disruption of the endocrine-regulated transition between the anti-adhesive modulator podocalyxin (PCX) and the adhesive modulator leukemia inhibitory factor (LIF) in the endometrium. METHODS: This cross-sectional study included 42 women (32 infertile, 10 fertile controls). Among infertile participants, 17 had ovarian endometrioma (EOC), seven had non-endometriotic cysts, and eight had prior infertility treatment failure. Endometrial tissue obtained via laparoscopy or hysteroscopy was analyzed in 30 women with mid- or late-luteal endometrium. PCX mRNA, PCX protein, and LIF mRNA levels were assessed using qRT-PCR and ELISA. RESULTS: LIF mRNA expression was significantly lower in the EOC group compared to all other groups (p < 0.001), while PCX mRNA and protein levels were higher (p < 0.001). Progesterone levels negatively correlated with PCX mRNA (r = -0.48, = 0.007) and protein (r = -0.45, = 0.012). LIF expression showed strong negative correlations with PCX mRNA (r = -0.81) and protein (r = -0.82) (p < 0.001). No associations were found with cyst characteristics. CONCLUSION: Ovarian endometrioma is associated with disruption of the PCX-LIF transition, suggesting impaired endometrial progesterone responsiveness.
Identification of key genes in recurrent pregnancy loss related to obesity.
Mi H, Zhao L, Guo J
Gynecol Endocrinol · 2026 Dec · PMID 42013197 · Publisher ↗
OBJECTIVE: The underlying mechanism of recurrent pregnancy loss (RPL) is still not fully understood. We aimed to identify the key genes involved in the process by which obesity influences RPL. METHODS: RPL and obesity da...
OBJECTIVE: The underlying mechanism of recurrent pregnancy loss (RPL) is still not fully understood. We aimed to identify the key genes involved in the process by which obesity influences RPL. METHODS: RPL and obesity data were retrieved from the GEO database. The differentially expressed genes (DEGs) between disease and normal samples among RPL and obesity were selected. Through intersecting the above DEGs, important DEGs were obtained. GO and KEGG analyses were used to analyze the function of these important genes. Two algorithms (LASSO and SVM) and receiver operator characteristic (ROC) analysis were used to optimize the DEGs. Furthermore, the immune infiltration and single gene enrichment analysis were performed to explore the correlations between key biomarkers and immune cells. RESULTS: A total of 1857 RPL-related DEGs and 2880 obesity-related DEGs were selected, respectively. Through intersecting the above two parts of DEGs, 100 important genes were obtained, which were involved in immune response processes such as the EGFR tyrosine kinase inhibitor resistance JAK-STAT signaling pathway, and T cell receptor signaling pathway. Through LASSO, SVM, and ROC analyses, five down-regulated optimal genes in RPL were finally considered as biomarkers in obesity-related RPL: GIPR, KRTAP4-11, NFU1, OPN4, and PRMT7. The five biomarkers showed effective diagnostic ability in RPL, with AUC above 0.8. Furthermore, eosinophils, CD56 bright natural killer cells, and monocytes were significantly correlated with the five biomarkers. CONCLUSION: This study identified five effectively diagnostic genes and explored their correlations with immune cells, providing indications for the following development of diagnostic tools and potential mechanism exploration.
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