BMC Women's Health[JOURNAL]
Sun
200 papers
Oral L-ergothioneine supplementation in women with suboptimal ovarian reserve: a single-center, open-label, self-controlled pilot study of ovarian reserve markers, endocrine profiles, and reproductive aging-related symptoms.
Liu W, Guo C, Ding W … +4 more , Cao J, Ju H, Liu F, Xiao G
BMC Womens Health · 2026 Jun · PMID 42310611 · Full text
PURPOSE: To evaluate the efficacy and safety of oral L-ergothioneine (EGT) in improving ovarian reserve and clinical symptoms in women with suboptimal ovarian function. As a proof-of-concept study, we explored correlatio...
PURPOSE: To evaluate the efficacy and safety of oral L-ergothioneine (EGT) in improving ovarian reserve and clinical symptoms in women with suboptimal ovarian function. As a proof-of-concept study, we explored correlations between hormonal shifts and symptom amelioration. METHODS: This single-center, open-label trial enrolled 40 women (aged 35-45 years) experiencing age-related reproductive decline (baseline AMH: 1.0-3.0 ng/mL) and menstrual disorders. Participants received oral EGT (120 mg/day) for three consecutive menstrual cycles. The primary outcome was the change in serum AMH. Secondary outcomes included sex hormones (FSH, E2), antral follicle count, and validated questionnaires (KI, PSQI, SF-36) and an exploratory Menstrual Symptom Score. RESULTS: Thirty-six participants completed the intervention without product-related adverse events. EGT supplementation was associated with increases in core ovarian markers: mean AMH increased from 1.81 ± 0.72 to 2.46 ± 1.54 ng/mL (mean change + 0.65 ng/mL, 95% CI [0.14, 1.17], p = 0.018). Concurrently, basal FSH decreased (8.38 ± 2.83 to 7.05 ± 2.51 mIU/mL, mean change - 1.33, 95% CI [- 2.50, - 0.17]; p = 0.032, FDR-adjusted p = 0.048) and E2 increased (43.78 ± 18.87 to 63.46 ± 50.81 pg/mL; mean change + 19.69, 95% CI [3.99, 35.38]; p = 0.019, FDR-adjusted p = 0.048). Clinical assessments showed progressive reductions in KI (5.42 ± 3.66 to 1.90 ± 2.16, p < 0.0001) and PSQI scores (6.89 ± 1.82 to 5.50 ± 1.40, p < 0.0001), alongside improved menstrual and SF-36 scores (p < 0.001). Subgroup analysis stratified by baseline ovarian reserve showed a significant AMH increase in the low-reserve subgroup (p = 0.017) but not the high-reserve subgroup. Exploratory correlation analysis showed that ΔFSH was associated with improvements in sleep quality (ΔPSQI, r = 0.43, p < 0.05) and E2 increases (r = -0.46, p < 0.05), linking hormonal stabilization directly to systemic relief. CONCLUSION: In this open-label, single-arm pilot study, oral EGT supplementation was associated with increases in serum AMH and favorable shifts in the basal FSH/E2 profile, alongside improvements in reproductive aging-related and sleep symptoms. Because the design lacks a control group, these changes cannot be attributed to EGT alone and may partly reflect natural variation, regression to the mean, or placebo effects. These hypothesis-generating findings warrant confirmation in adequately powered, placebo-controlled trials. TRIAL REGISTRATION: ChiCTR2500104484; Prospectively registered on 2025-06-18.
Vaginal scrub-and-paint versus paint-only preparation in total laparoscopic hysterectomy: surgical site infection and postoperative spotting outcomes in a randomised controlled trial.
Somjit S, Ruengkhachorn I, Inthaphoe N … +5 more , Tapala S, Sangprasert R, Boonkarn S, Neungton C, Kuljarusnont S
BMC Womens Health · 2026 Jun · PMID 42310609 · Full text
BACKGROUND: No consensus exists regarding optimal vaginal preparation techniques for preventing surgical site infections (SSIs) in laparoscopic hysterectomy. This study aimed to compare SSI incidence between vaginal scru...
BACKGROUND: No consensus exists regarding optimal vaginal preparation techniques for preventing surgical site infections (SSIs) in laparoscopic hysterectomy. This study aimed to compare SSI incidence between vaginal scrub-and-paint and paint-only preparation methods. METHODS: Assessor-blinded randomised controlled trial in a tertiary care hospital in Thailand. Eligible patients scheduled to undergo total laparoscopic hysterectomy, without immunocompromised status, intraoperative injury to adjacent organs, or contraindication to chlorhexidine gluconate. Participants who provided informed consent were randomised to receive either vaginal scrub-and-paint preparation or paint-only preparation. Data on SSI risk factors, operative parameters, and postoperative outcomes were collected for 30 days post-surgery. Data are presented as numbers (percentages), or medians (interquartile ranges [IQRs]). Categorical and continuous variables were analysed using appropriate statistical tests, with P < 0.05 as the criterion for significance. RESULTS: Among 370 participants, median age was 46.5 years (IQR 43.0-51.0), median operative time was 160 min (IQR 125.0-198.75), and median blood loss was 50 mL (IQR 21.25-100.0). Median hospital stay was 2 days (IQR 2.0-2.0). Twenty-nine patients (7.8%) had malignancy. No SSIs occurred in either group. Thirteen patients (7%) in the scrub-and-paint group experienced vaginal spotting. CONCLUSIONS: Within the limitations of this prematurely discontinued trial and the absence of SSI events, both regimens appeared comparable regarding SSI, while scrub-and-paint was associated with more vaginal spotting. CLINICAL TRIAL REGISTRATION: The study was registered with the Thai Clinical Trials Registry (reference 20230418002) on April 18, 2023. https://www.thaiclinicaltrials.org/show/TCTR20230418002.
Disease characteristics, treatment, and overall survival outcomes of patients with locally advanced cervical cancer referred for radiation therapy in Johannesburg, South Africa: a 2-year retrospective study.
Ayeni OA, Mmereki D, Mistry H … +9 more , Achilonu O, Kassick M, Swanson S, Chen WC, Joffe M, Ratshikana M, Rendle K, Grover S, Ramiah D
BMC Womens Health · 2026 Jun · PMID 42310589 · Full text
PURPOSE: We assessed the association between baseline patient characteristics, disease stage, and treatment-related factors and overall survival among women with locally advanced, non-metastatic cervical cancer in South...
PURPOSE: We assessed the association between baseline patient characteristics, disease stage, and treatment-related factors and overall survival among women with locally advanced, non-metastatic cervical cancer in South Africa. PATIENTS AND METHODS: We retrospectively analysed data from 642 women with 2018 International Federation of Gynaecology and Obstetrics (FIGO) stage IB3-IVA cervical cancer who were referred for and deemed eligible for radiotherapy at a public tertiary hospital in South Africa between January 2021 and December 2022. All women discussed at the multidisciplinary team (MDT) meeting were included, irrespective of whether treatment was ultimately initiated. Demographic and clinical characteristics, treatment timelines, and survival outcomes were assessed. Multivariable Cox proportional‑hazards models were used to identify factors associated with overall survival. RESULTS: Of the 642 women, 54.1% were aged < 50 years and 60.3% were living with HIV. The stage distribution was: IB3, 1.7%; II, 43.5%; III, 50.1%; and IVA, 4.7%. The median time to treatment initiation was ~4 months; the median overall treatment duration was 63 days. The 2-year overall survival rate was 57.2% and varied by stage (IB3 and II, 70.0%; III, 49.3%; IVA, 12.4%; p < 0.001). On multivariable Cox regression analysis, worse survival was independently associated with Eastern Cooperative Oncology Group performance status 2-4 [vs. 0 and 1; adjusted hazard ratio (aHR), 1.75], stage III (vs. IB3 and II; aHR, 1.46) stage IVA (vs. IB3 and II; aHR, 2.02), and receipt of radiotherapy alone (vs. chemoradiation; aHR, 1.96). A significant interaction between EQD2 and overall treatment duration was observed. Patients receiving EQD2 <80 with treatment duration <56 days was associated with worse overall survival (aHR 2.65). HIV status was not associated significantly with survival. CONCLUSIONS: Overall Survival in women with locally advanced cervical cancer in South Africa was associated with disease stage, baseline patient characteristics, and treatment-related factors. Interventions targeting timely delivery of standard of care may improve survival in this setting.
Adaptation and exploratory factor analysis of a PCOS-specific HRQoL questionnaire in a South Indian population.
Washington A, Shenoy HT, B P … +1 more , Kumar R
BMC Womens Health · 2026 Jun · PMID 42304331 · Full text
INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a multifaceted disorder with physical, emotional, and social implications. Culturally adapted tools for assessing Health-Related Quality of Life (HRQoL) in Indian women,...
INTRODUCTION: Polycystic Ovary Syndrome (PCOS) is a multifaceted disorder with physical, emotional, and social implications. Culturally adapted tools for assessing Health-Related Quality of Life (HRQoL) in Indian women, particularly those under 18 and over 45 years of age, need to be developed. This study aimed to culturally adapt the Nasiri-Amiri PCOS-specific HRQoL questionnaire for Malayalam-speaking women, evaluate its reliability and factor structure using exploratory factor analysis (EFA), and identify key HRQoL domains in this population. METHODS: Between July 2024 and December 2025, a 52-item Malayalam-adapted questionnaire was distributed to women aged 13-52 years, of whom 201 met the inclusion criteria. Reliability assessments were performed using Cronbach's alpha. The ability of the data to be factored was evaluated using the Kaiser-Meyer-Olkin test and Bartlett's Test of Sphericity. Maximum likelihood extraction with Equamax rotation was used for exploratory factor analysis, with factor retention guided by the root-mean-square residual. RESULTS: Strong internal consistency for the instrument (Cronbach's α = 0.818) and adequate sampling adequacy (KMO = 0.794; Bartlett's p < 0.001) were assessed for exploratory factor analysis (EFA), which provided eight clinically relevant HRQoL domains (29 items total). The domains identified in this study included hirsutism, skin disease, menstrual irregularities, physical/emotional burden, emotional inconsistency, body image, problems with self-care, and social support. The major contributors to impaired HRQoL were menstrual dysfunction and other visible symptoms. Within the study sample, women reported greater distress associated with their weight than their appearance. Paracetamol use was comparatively higher for self-medicated pain relief during menstruation. CONCLUSION: Extending the assessment beyond the conventional 18-45 year reproductive window reveals that the PCOS-related burden persists into adolescence and adulthood. The adapted Malayalam PCOS-HRQoL tool showed acceptable reliability, making it a useful measure of quality of life in women with PCOS in this population. Further confirmatory factor analysis and longitudinal studies are required to confirm these findings.
Self-reported menstrual-related physical and psychological symptoms and health-seeking behaviour among rural school-going adolescent girls in Bangladesh.
Basit A, Fatema K, Ullah MO … +2 more , Seddiky MA, Mithun M
BMC Womens Health · 2026 Jun · PMID 42304323 · Full text
BACKGROUND: Menstrual Hygiene Management (MHM) is recognized globally as a public health concern; however, it remains a neglected issue in Bangladesh, particularly in rural communities. This study examined the self-repor...
BACKGROUND: Menstrual Hygiene Management (MHM) is recognized globally as a public health concern; however, it remains a neglected issue in Bangladesh, particularly in rural communities. This study examined the self-reported prevalence and perceived severity of menstruation-related physical and psychological symptoms, their association with menstrual irregularity, and health-seeking behaviour among rural school-going adolescent girls. METHODS: A cross-sectional mixed-methods study was conducted among 474 grade 9-10 school-going girls in rural Sylhet division, Bangladesh, between September and November, 2024. Participants reported menstrual cycle characteristics and self-rated the severity of their common physical and psychological symptoms as mild, moderate, or severe. Menstrual cycle regularity was assessed through self-report. Symptom prevalence and severity distributions were summarised descriptively by cycle regularity group. Chi-square tests examined associations between menstrual irregularity and symptom severity. Qualitative in-depth interviews (n = 29) were conducted with purposively selected participants to contextualise quantitative patterns within broader sociocultural and structural determinants. RESULTS: Of 474 participants, 111 (23.4%) reported irregular menstrual cycles. Abdominal pain or cramps (77.2%), fatigue or weakness (69.4%), and joint or muscle pain (48.5%) were the most prevalent physical symptoms. Irritability (73.4%), mood swings (64.1%), and anxiety (58.6%) were the most common psychological symptoms. Menstrual irregularity was significantly associated with higher symptom severity for both physical (χ²(2) = 157.81, p < 0.001) and psychological (χ²(2) = 100.85, p < 0.001) outcomes; 49.5% of irregular-cycle girls reported severe physical symptoms versus 3.9% of regular-cycle girls, and 27.0% reported severe psychological symptoms versus 3.0%. Qualitative findings revealed that these high symptom burdens were systematically normalised through cultural beliefs, intergenerational transmission of avoidance strategies, and stigma-mediated communication failures, resulting in very low rates of formal health-care seeking irrespective of symptom severity. CONCLUSIONS: This study demonstrates that menstrual symptom burden, both physical and psychological, is substantial among rural adolescent girls in Bangladesh and is disproportionately severe among those with irregular cycles. These findings highlight the importance of integrating symptom recognition, stigma reduction, and accessible care pathways into health initiatives for adolescents. Given the cross-sectional and self-reported design, the results should be interpreted as exploratory but indicative of an important area for targeted public health attention in rural contexts.
Chemotherapy-induced peripheral neuropathy and social interaction anxiety in breast cancer patients: a cross-sectional study.
Xu L, Fan J, Wang J … +4 more , Tang Y, Li N, Liu J, Zhang W
BMC Womens Health · 2026 Jun · PMID 42298568 · Full text
BACKGROUND: Breast cancer patients face numerous physical and psychological challenges. Social engagement and psychological adjustment are critical to the quality of life throughout the survival phase. Although chemother...
BACKGROUND: Breast cancer patients face numerous physical and psychological challenges. Social engagement and psychological adjustment are critical to the quality of life throughout the survival phase. Although chemotherapy-induced peripheral neuropathy and physical handicap are linked to social adjustment, the interplay between these factors in breast cancer patients is unclear. METHODS: This cross-sectional study was conducted between March and September 2025, recruiting 285 breast cancer patients from a Grade A tertiary hospital in central China. Recruitment was conducted using convenience sampling. Data were collected via a structured questionnaire comprising several sections: a demographic and clinical information questionnaire, Chemotherapy Induced Peripheral Neuropathy Assessment Tool、Quick Disabilities of the Arm, Shoulder and Hand Questionnaire、Social Interaction Anxiety Scale. Statistical analysis was performed using SPSS 27.0, including descriptive statistics, univariate analysis and correlation analysis. SPSS PROCESS macro models 4 and 7 were utilised to test the hypothesised pathways between variables. RESULTS: The majority of patients were aged between 40 and 60; the mean ± standard deviation for social interaction anxiety scores was 19.91 ± 13.35. Chemotherapy-induced peripheral neuropathy, as well as disabilities of the arm, shoulder and hand, were found to have a significant positive correlation with social interaction anxiety (all P < 0.05). The results of the mediation and moderation model indicated that disabilities of the arm, shoulder and hand mediated the relationship between chemotherapy-induced peripheral neuropathy and social interaction anxiety, with a significant indirect effect (95% CI: 0.003 to 0.025), accounting for 18.06% of the total effect. The association between chemotherapy-induced peripheral neuropathy and disabilities of the arm, shoulder and hand may be negatively modulated by the neutrophil-to-lymphocyte ratio (95% CI: -0.042 to -0.005). CONCLUSION: There is a direct link between chemotherapy-induced peripheral neuropathy and social interaction anxiety in breast cancer patients, with disabilities of the arm, shoulder and hand acting as a mediator. Focusing on the management of chemotherapy-induced peripheral neuropathy and disabilities of the arm, shoulder and hand may help this population achieve better psychosocial adaptation. Healthcare professionals should think about combining these elements into long-term health management for their patients. However, the negative moderating effect of neutrophil-to-lymphocyte ratio on the link between chemotherapy-induced peripheral neuropathy and disabilities of the arm, shoulder and hand is minor; more scientific research is needed to confirm its clinical significance.
Health-promoting lifestyle among women living in suburban areas of northeastern Iran: A cross-sectional study.
Rastgoo F, Davoudi N, Najafi S … +1 more , Talab HZ
BMC Womens Health · 2026 Jun · PMID 42298498 · Full text
INTRODUCTION: Women, especially in urban marginalized areas, face a set of challenges and limitations in the field of health promotion. Considering the key role of women in family and community health, and their vulnerab...
INTRODUCTION: Women, especially in urban marginalized areas, face a set of challenges and limitations in the field of health promotion. Considering the key role of women in family and community health, and their vulnerability in marginalized conditions, this study aimed to examine health-promoting lifestyle in women living in urban marginalized areas, to identify their needs and provide a foundation for designing evidence-based interventions and effective policies to improve women's health. METHODS: This cross-sectional, descriptive-analytical study was conducted in 2025 on 295 women living in a suburban area of Mashhad, northeastern Iran, using multi-stage sampling. After ethical approval and written informed consent, participants completed a demographic questionnaire and the Health-Promoting Lifestyle Profile II (HPLP-II), whose Persian version has confirmed validity and reliability in Iran (Cronbach's alpha = 0.82). Data were analyzed in SPSS version 25 using descriptive and analytical statistics including Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests with a significance level of p < 0.05. RESULTS: The mean age of the women was 37.25 ± 10.63 years and mean total health-promoting lifestyle score was 127.87 ± 26.91, with the highest mean score in the spiritual growth dimension (26.02 ± 5.58). Analyses showed a significant inverse relationship between age, number of children, BMI, and lifestyle score (P < 0.05), and lower lifestyle scores among women with chronic diseases such as hypertension and hyperlipidemia (P < 0.05). A significant increase in lifestyle score with higher family income (P < 0.05), and differences in mean lifestyle scores based on marital status and educational level (P < 0.05). DISCUSSION AND CONCLUSION: The findings indicate that the overall level of health-promoting lifestyle among women living in marginalized areas is moderate and associated with various individual and social factors. These findings suggest that improving women's health in such settings requires attention to both personal behaviors and broader economic and educational contexts. Further studies are recommended to design and assess interventions that effectively address these factors.
Psychological distress and dyadic trust in Italian women awaiting colposcopy after positive cervical cancer screening: a cross-sectional study.
Bevilacqua F, Robba E, Berchialla P … +9 more , Preti M, Malandrone F, Pollano B, Barbierato I, Bami Z, Gallio N, Marozio L, Ostacoli L, Carletto S
BMC Womens Health · 2026 Jun · PMID 42289681 · Full text
BACKGROUND: Screening programs have substantially reduced cervical cancer incidence and mortality, yet abnormal results can generate considerable psychological distress even before a diagnosis is confirmed. Interpersonal...
BACKGROUND: Screening programs have substantially reduced cervical cancer incidence and mortality, yet abnormal results can generate considerable psychological distress even before a diagnosis is confirmed. Interpersonal resources such as dyadic trust-the expectation of reliability and support within intimate relationships-may buffer distress, but their role in the colposcopy context is understudied. Examining both individual and relational predictors of emotional well-being may inform targeted psychosocial interventions and improve patient-centered care in cervical cancer screening. OBJECTIVES: To estimate the prevalence of depression, anxiety, and stress among Italian women referred for their first colposcopy after a positive cervical cancer screening result, and to identify associated sociodemographic, clinical, and interpersonal factors, with particular focus on dyadic trust. MATERIALS AND METHODS: This cross-sectional observational study was conducted from June 2022 to March 2024 at the Lower Genital Tract Clinic of the University of Torino, Italy. Women undergoing their first colposcopy after a positive cytology and/or human papillomavirus (HPV) DNA test within the "Prevenzione Serena" screening program completed three questionnaires at their appointment: a sociodemographic and clinical form, the Depression Anxiety Stress Scales-21 (DASS-21), and the Dyadic Trust Scale (DTS). Multivariable logistic regression models assessed associations between participant characteristics and psychological outcomes. Exploratory nomograms were developed to estimate individual risk probabilities; these were not internally validated and should not be used for clinical prediction. RESULTS: A total of 573 women participated (median age 36 years). Most were single (61%), university-educated (53%), employed (82%), and HPV-unvaccinated (83%). Mild to extremely severe symptoms of stress, depression, and anxiety were reported by 70%, 41%, and 31% of respondents, respectively. In multivariable analysis, higher dyadic trust was associated with lower risk of depression (OR 0.66, 95%CI 0.51-0.85), anxiety (OR 0.53, 95%CI 0.31-0.91) and stress (OR 0.46, 95%CI 0.25-0.85). Lower educational level was associated with higher risk of depression (OR 1.64, 95%CI 1.02-2.64), as HPV vaccination (OR 1.87, 95%CI 1.02-3.41). Younger age was associated with higher risk of anxiety (OR 1.88, 95%CI 1.25-2.86) and stress (OR 4, 95%CI 1.92-8.33) for 16-year increase. Exploratory nomograms allowed individualized risk estimation. CONCLUSIONS: Psychological distress-particularly stress-is common among women awaiting colposcopy after a positive screening result. Younger age, lower education, HPV vaccination status, and lower dyadic trust identify those at elevated risk. Integrating risk-stratified psychosocial support, enhancing relational coping, and tailoring communication may improve emotional outcomes. Prospective studies should clarify causal pathways and evaluate partner-inclusive interventions.
Mental health, coping strategies and help-seeking behaviours among women petty traders in Nsukka, Enugu State, Nigeria: a cross-sectional survey.
Anosike C, Njoku GO, Isiogugu NO … +6 more , Ogbene CP, Odoabuchi MU, Nnaji AG, Nwobodo CJ, Neboh WC, Obeh LH
BMC Womens Health · 2026 Jun · PMID 42288874 · Full text
BACKGROUND: In Nigeria, women petty traders often face significant socio-economic stressors that potentially affect their mental health. Despite these challenges, mental health remains under-researched in informal econom...
BACKGROUND: In Nigeria, women petty traders often face significant socio-economic stressors that potentially affect their mental health. Despite these challenges, mental health remains under-researched in informal economic sectors in developing countries. Therefore, this study examined the mental health status, coping strategies, and help-seeking behaviours of women petty traders in Nsukka, Enugu State. METHODS: A cross-sectional survey was conducted among 331 women petty traders at Ogige Market in Nsukka. Respondents were recruited through multi-stage sampling. Data were collected using interviewer-administered structured questionnaires, including a Patient Health questionnaire, a Generalized Anxiety Disorder Scale, a Coping Orientation to Problems Experienced Inventory, and a General Help-seeking Questionnaire. The data obtained were analyzed using descriptive and inferential statistics. P < 0.05 was considered to be statistically significant. RESULTS: A total of 331 women participated in the survey. The prevalence of moderate to severe anxiety and depression was 22.9% and 27.4%, respectively, with most women utilizing emotion-focused coping strategies (29.35 ± 7.29). Additionally, the level of anxiety had a weak positive relationship with emotion-focused coping (r = 0.144, p = 0.008) and avoidant coping (r = 0.294, p < 0.001). A moderate positive correlation exists between the level of depression and avoidant coping (r = 0.307, p < 0.001). More than half of the respondents had the intention to seek help from intimate partners (n = 203, 61.3%), parents (n = 211, 63.7%), and family members (n = 182, 55.0%). More than half of the respondents were unlikely to seek help from mental health professionals (n = 186, 56.2%) and phone helplines (n = 197, 59.5%). CONCLUSIONS: A considerable proportion of women petty traders had moderate to severe anxiety and depression. The women were more inclined to seek emotional support from informal close social networks. The findings underscore the need to strengthen mental health support systems and promote accessible, socio-culturally and economically sensitive interventions that encourage the use of adaptive coping strategies and professional help among women petty traders.
Family planning service quality and contraceptive discontinuation among short-acting contraceptive users in Indonesia: a survival analysis of the 2017 Indonesia demographic health survey.
Susanti L, Utarini A, Wilopo SA
BMC Womens Health · 2026 Jun · PMID 42288868 · Full text
BACKGROUND: Contraceptive discontinuation rates in Indonesia are higher among short-acting contraceptive users. The quality of family planning services was suspected to be the cause. The Indonesian Demographic Health Sur...
BACKGROUND: Contraceptive discontinuation rates in Indonesia are higher among short-acting contraceptive users. The quality of family planning services was suspected to be the cause. The Indonesian Demographic Health Survey (IDHS) assesses family planning, discontinuation rates, and factors related to family planning. This study aimed to analyze short-acting contraceptive discontinuation and the quality of family planning services using The IDHS 2017 data. METHODS: This research analyzes data from the 2017 IDHS of women aged 15-49 years who had been using contraception in the last five years preceding the survey. Data on contraceptive discontinuation rates, reasons for discontinuation, contraceptive methods, sources of family planning services, caregivers, contraceptive decision makers, and contraceptive payment methods were extracted from the survey. Family planning service quality was assessed through the method information index (MII) from the 2017 IDHS. Survival analysis and the Cox proportional hazard model were used to analyze family planning service quality and contraceptive discontinuation. RESULTS: The overall contraceptive discontinuation rate for short-acting contraceptive method (pills, injectable) in Indonesia was 43.6%. The complete MII or informed choice rate was 30%. Episodes with complete MII discontinue earlier than those incomplete. Approximately 60% of the discontinuations involved the use of injectables, but pill users discontinued earlier. The main reason for discontinuation is side effects. The Cox proportional hazard model revealed several variables that were significantly associated: complete MII (Hazard Ratio or HR 1.1), the use of a pill (HR 2.9) or an injectable contraceptive (HR 2.8), switching to other methods (HR 7.5), switching to long-acting reversible contraception (LARC) (HR 6,9), the use of other service sources (HR 2.0), age ≤ 29 years (HR 1.4), and age 30-34 years (HR 1.2). CONCLUSIONS: The number of contraceptive discontinuation episodes in Indonesia was quite high, with few informed choices, although those with informed choices discontinued earlier. It is possible that those with informed choice acknowledge the contraceptive side effects and then choose to discontinue. Considering those who discontinue and switch to other methods, it is crucial to improve the quality of counseling with the aim of making optimal informed choices.
A womb with rheum: providers' knowledge and educational needs in caring for women with rheumatic diseases.
He L, Arenas GA, Karani R … +3 more , Faison M, Dade A, Edens C
BMC Womens Health · 2026 Jun · PMID 42288838 · Full text
BACKGROUND: Patients with rheumatic diseases have unique reproductive health needs. Recent guidelines have been established by various soceities on this topic. However, the education received by women's health providers...
BACKGROUND: Patients with rheumatic diseases have unique reproductive health needs. Recent guidelines have been established by various soceities on this topic. However, the education received by women's health providers pertaining to the recognition and management of common rheumatic diseases in patients of childbearing age is not well-defined. This study aims to assess knowledge gaps, specify aspects of care with greatest uncertainty, and assess current resources used by women's health providers in the management of their patients with rheumatic disease. METHODS: An electronic survey was distributed nationally to physicians and allied health professionals who care for reproductive age women. The survey scored participants on their correct responses and confidence ratings in three sections: (1) patients presenting with a new rheumatic disease, (2) contraception in those with a known rheumatic diagnosis, and (3) preconception/antepartum rheumatology medication management. Participants were also asked about resource utilization. Survey questions and scenarios were based on American College of Obstetrics and Gynecology Committee Opinions and the American College of Rheumatology Guidelines for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Data were captured using RedCap© and analyzed using descriptive statistics. RESULTS: The survey was completed by 200 participants with majority being academic obstetricians and gynecologists. Respondents scored the lowest in recognizing new rheumatic disease presentations in peri-and post-partum periods (28.7%, 95% CI: 25.9-31.6%). Contraception counseling was the area of highest accuracy (57.5%, 95% CI: 54.2-60.8%) and confidence (44.6%, 95% CI: 41.7-47.5%), although areas for contraceptive knowledge expansion exist. Approximately 70% of respondents identified online resources as their main resource used in clinical practice and would prefer more information to be provided as a website, published guidelines, or Smartphone application. CONCLUSIONS: Women's health providers lack educational opportunities to improve knowledge and confidence in managing reproductive-aged patients with rheumatic disease. Recognizing new disease presentations and antepartum medication management were identified as topics with the largest knowledge gaps. Collaborative resources are needed to fill educational needs.
Factors of the reproductive life plan for married and employed Japanese women considering having children.
Angerhofer S, Yoshida M, Atogami F … +3 more , Nakamura Y, Takeishi Y, Yoshizawa T
BMC Womens Health · 2026 Jun · PMID 42286637 · Full text
BACKGROUND: Women's delayed childbearing results in negative effects on maternal health and may restrict women from achieving their reproductive goals. By the age of 30 years, Japanese women are typically in the process...
BACKGROUND: Women's delayed childbearing results in negative effects on maternal health and may restrict women from achieving their reproductive goals. By the age of 30 years, Japanese women are typically in the process of acquiring a more autonomous and fulfilling work status. Conversely, this is also the time when women experience a decline in fertility. Therefore, it is necessary to explore how reproductive and career visions affect intentions and behaviors toward the Reproductive Life Plan (RLP) to build support for achieving their reproductive goals. The objective of this study was to examine the associations between RLP and the reproductive and career visions of employed, married, and childless Japanese women in their 30s. METHODS: We administered a questionnaire comprising 29 items on RLP (i.e., pregnancy timing considerations and attitudes favoring pregnancy delay), reproductive and career visions, and participants' demographics. A multi-logistic regression analysis was used to explore the factors influencing "absence of pregnancy timing consideration" and "attitude favoring pregnancy delay." RESULTS: Approximately half of the participants had completed a university education, most of them were in non-management positions, and 36.1% were working 40 h or more per week. The average number of desired children was 1.7 ± 0.6. The factor "absence of pregnancy timing consideration" was associated with education, marriage duration, infertility concerns, self-perceived pregnancy probability, the number of desired children, and the intention to return to work after delivery. "Attitude favoring pregnancy delay" was associated with infertility concerns, scores of fertility knowledge, the interval between the ideal age for the first pregnancy and current age, the number of desired children, and working more than 40 h per week. CONCLUSION: Absence of pregnancy timing consideration" and "Attitude favoring pregnancy delay" were associated with different factors. Developing support systems for RLP, including the development of reproductive and career visions, will help prevent delayed childbearing among employed, married, and childless Japanese women in their 30s.
Dysmenorrhea patients' experience with work productivity impact and treatment in Japan.
Hiraike O, Goto D, Uchiyama M … +2 more , Takahashi S, Osuga Y
BMC Womens Health · 2026 Jun · PMID 42286607 · Full text
BACKGROUND: Nearly 50% of Japanese women report impaired work performance due to menstrual symptoms. Our objectives were to describe the real-world experiences of patients living with dysmenorrhea with a focus on work pr...
BACKGROUND: Nearly 50% of Japanese women report impaired work performance due to menstrual symptoms. Our objectives were to describe the real-world experiences of patients living with dysmenorrhea with a focus on work productivity and its association with treatments. Our exploratory objective was to understand the coping methods for menstrual pain in Japanese women. METHODS: Using an anonymized database consisting of linked Japanese health insurance claims and Work Productivity and Activity Impairment Questionnaire - General Health (WPAI-GH) responses for women aged between 18 and 50 years, we conducted descriptive analyses of work productivity impact among patients with dysmenorrhea, other chronic diseases and individuals without medical records. Analysis of work productivity impact was conducted per dysmenorrhea treatment. The analyses were descriptive and unadjusted thus the generalizability and external validity of differences between conditions and treatments are limited. RESULTS: Among 9,235 individuals in the employer-sponsored insurance claims database, 956 (10.4%) had diagnosed dysmenorrhea. The unadjusted mean WPAI-GH scores for the dysmenorrhea patient population demonstrated absenteeism at 2.5 ± 0.3% (mean ± standard error) and presenteeism at 26.8 ± 0.9%, similar to groups with mental disorders, headaches, or low back pain. Dysmenorrhea patients receiving low-dose estrogen progestin, also known as combined oral contraceptives, was the largest treatment group and had the lowest mean absenteeism and presenteeism scores among treatment groups in this unadjusted descriptive analysis. In 5,471 respondents who responded on coping methods for menstrual pain, 2,250 (41.1%) used over-the-counter medications, while 329 (6.0%) sought medical care. CONCLUSION: The productivity impact observed in patients with dysmenorrhea was substantial and found to be similar to that of patient groups with major chronic conditions such as mental disorders, headaches, and low back pain. We further found that dysmenorrhea patients' productivity outcomes varied across treatment groups. Whilst prospective studies with adjustment for confounding factors are needed to establish the generalizability of differences between treatment- and condition-based subgroups, our findings underscore the need for greater awareness of dysmenorrhea as a condition that deserves medical attention, and timely medical care may help reduce the burden and improve the quality of life.
Magnitude and determinants of double burden of malnutrition among married women in Africa: a multi-country analysis from 25 countries.
Ejigu BA, Tiruneh FN
BMC Womens Health · 2026 Jun · PMID 42286597 · Full text
INTRODUCTION: The Double Burden of Malnutrition among women in Africa is a pressing public health issue. However, there is a lack of comprehensive evidence on this phenomenon and its determinants. This study aims to brid...
INTRODUCTION: The Double Burden of Malnutrition among women in Africa is a pressing public health issue. However, there is a lack of comprehensive evidence on this phenomenon and its determinants. This study aims to bridge this gap by exploring the determinants of the double burden of malnutrition, with a particular focus on women's decision-making power. METHODS: This study analyzed data come from DHS datasets from 25 African countries. The analysis included 114,101 married non-pregnant women. Nutritional status was assessed using BMI. We conducted chi-squared tests for bivariate analysis and multilevel baseline category logit models for multivariable analysis. Results were presented as relative risk ratio (RRR) with their respective 95% confidence intervals. RESULTS: This study found that 11.4% of women were underweight and 17.2% were overweight or obese. Socio-demographic factors such as residence, age, education, wealth status, and decision-making power were significantly associated with malnutrition. Rural residence and younger age groups were associated with higher underweight prevalence, while older age groups and urban residence exhibited increased overweight and obesity risks. Higher education and wealth quantile, health insurance, and economic decision making power were associated with higher overweight and obesity while breastfeeding was found to reduce the risk of obesity and obesity. CONCLUSION: This study uncovers malnutrition challenges among women residing in 25 African countries. Addressing malnutrition requires diverse strategies, including food security, healthcare enhancement, encouraging breastfeeding with adequate support, implementing culturally sensitive interventions that acknowledge and integrate cultural beliefs and practices concerning nutrition and body image and empowering women.
Postmenopausal vulvar hemangioma: diagnostic insights from a low-resource setting.
Posite CM, Batista M, Atwine R … +3 more , Mohamed MS, Kato C, Ssenkumba B
BMC Womens Health · 2026 Jun · PMID 42277817 · Full text
BACKGROUND: Vulvar hemangiomas are rare in adults, particularly among postmenopausal women, often leading to clinical misdiagnosis. In resource-constrained settings, the lack of advanced imaging and immunohistochemistry...
BACKGROUND: Vulvar hemangiomas are rare in adults, particularly among postmenopausal women, often leading to clinical misdiagnosis. In resource-constrained settings, the lack of advanced imaging and immunohistochemistry (IHC) necessitates a heavy reliance on histopathological evaluation. This report highlights the importance of including benign vascular tumors in the differential diagnosis of adult vulvar masses to ensure accurate management. CASE PRESENTATION: A 62-year-old postmenopausal woman presented with a two-month history of a painless, firm, non-pulsatile mass on the left labia majora measuring 1.2 × 0.7 × 0.5 cm. Given the lesion's mobility and the absence of high-flow features or regional lymphadenopathy, an excisional biopsy was performed to achieve both diagnosis and therapy. Although the absence of preoperative imaging limited the initial assessment of vascular flow, meticulous histopathological examination revealed a well-circumscribed dermal proliferation of bland, variably sized vascular channels associated with a reactive lymphoplasmacytic infiltrate. A diagnosis of vulvar hemangioma was established via meticulous morphological assessment, successfully excluding malignancy despite the lack of IHC. CONCLUSION: This report contributes to the limited literature on geriatric vulvar hemangiomas by demonstrating that a de novo presentation in a postmenopausal woman can be definitively managed without advanced diagnostic technology. It establishes that in low-resource settings, meticulous hematoxylin and eosin-based morphological assessment is a robust standard for excluding malignancy, thereby preventing over-treatment and ensuring cost-effectively successful surgical outcomes.
Young women with (pre)malignant cervical disease in northern Netherlands: what characterises them - A population-based cohort study.
Dieleman M, Vermeulen KM, Siebers AG … +6 more , Wisman BA, Schuuring E, Esajas MD, Brandenbarg D, Maass SWMC, de Bock GH
BMC Womens Health · 2026 Jun · PMID 42277809 · Full text
BACKGROUND: Little is known on (pre)malignant cervical disease in women below the age of population-based screening (PBS). The aim of this study was to evaluate the occurrence of (pre)malignant cervical disease and relat...
BACKGROUND: Little is known on (pre)malignant cervical disease in women below the age of population-based screening (PBS). The aim of this study was to evaluate the occurrence of (pre)malignant cervical disease and related sociodemographic characteristics in women who are tested and/or referred by the GP before reaching the eligible age (30 years) for participation in the first round of PBS for cervical cancer in the northern Netherlands. METHODS: A linkage was performed between the Lifelines cohort (N = 88439 women) and the Dutch nationwide pathology databank (Palga). Data on cervical test records and sociodemographics such as socio-economic status and smoking status were retrieved and analysed. RESULTS: A cervical test record before the first round of PBS was reported for 6301 women. Cervical intra-epithelial neoplasia grade 2 or higher (CIN2+) was diagnosed in 198 (3.1%) women. CIN2 + was associated with low educational level (adjusted odds ratio (aOR) 1.7, 95% confidence interval (CI) 1.1-2.4), ex-smoking (aOR 1.8, 95%CI 1.2-2.9) and current smoking (aOR 2.7, 95%CI 1.9-3.8). CONCLUSIONS: Within women tested and/or referred by the GP before the eligible age for the Dutch cervical cancer PBS, 3.1% was diagnosed with CIN2+. Higher odds of CIN2 + for women with a low educational level and women who (used to) smoke should be taken along in clinical decision making towards testing and referral.
Menstrual vulnerability to acute systemic stress: evidence from 884 women after COVID-19 infection.
Jiang X, Han R, Yang X
BMC Womens Health · 2026 Jun · PMID 42277801 · Full text
BACKGROUND: Menstrual function is sensitive to inflammatory, endocrine, and psychosocial stressors that may transiently disrupt the hypothalamic-pituitary-ovarian axis. Although menstrual disturbances have been reported...
BACKGROUND: Menstrual function is sensitive to inflammatory, endocrine, and psychosocial stressors that may transiently disrupt the hypothalamic-pituitary-ovarian axis. Although menstrual disturbances have been reported during the coronavirus disease 2019 (COVID-19) pandemic, large real-world data from Asian populations remain limited. We aimed to describe menstrual changes reported after COVID-19 infection and to identify potential vulnerability factors. METHODS: We conducted a retrospective cross-sectional survey using an electronic questionnaire among reproductive-aged women who had experienced at least one menstrual cycle following laboratory-confirmed or self-tested COVID-19 infection between January and March 2023. Participants reported menstrual characteristics before and after infection. Multivariable logistic regression analyses were performed adjusting for age, age of menarche, abnormal uterine bleeding (AUB)-related disease, pre-existing menstrual irregularity, vaccination status, and fever. RESULTS: Among 884 participants, 662 (74.9%) reported at least one menstrual change after infection. Alterations most commonly involved cycle length (421/884, 47.6%), menstrual flow (369/884, 41.7%), and duration (261/884, 29.5%). Women with pre-existing irregular cycles were more likely to report post-infection changes than those with regular cycles. In adjusted analyses, pre-existing menstrual irregularity remained independently associated with reporting menstrual changes (adjusted OR 1.51, 95% CI 1.12-2.03). CONCLUSIONS: Menstrual disturbances were frequently reported following COVID-19 infection and showed substantial interindividual variability. These findings suggest that menstrual function may be vulnerable to acute systemic stress. Because the study was cross-sectional and based on self-reported outcomes, the findings should be interpreted as associative rather than causal and may have been influenced by recall or selection bias. Prospective longitudinal studies are warranted.
Deep infiltrating endometriosis presenting as acute abdomen with extremely elevated tumor markers: a cancer-mimicking case.
Ma X, Ye JS, Liu Z … +1 more , Geng QL
BMC Womens Health · 2026 Jun · PMID 42277797 · Full text
BACKGROUND: Deep infiltrating endometriosis (DIE) is a rare and severe subtype of endometriosis that can cause marked distortion of pelvic anatomy. Diagnosis becomes particularly challenging when it presents as an acute...
BACKGROUND: Deep infiltrating endometriosis (DIE) is a rare and severe subtype of endometriosis that can cause marked distortion of pelvic anatomy. Diagnosis becomes particularly challenging when it presents as an acute abdomen with significantly elevated tumor marker levels. In this study, we describe a rare and deceptive presentation of acute abdomen caused by severe DIE that closely mimicked ovarian carcinoma. CASE PRESENTATION: A 42-year-old woman (gravida 1, para 1) was admitted with sudden-onset severe diffuse abdominal pain lasting 5 hours. Preoperative findings-including cancer antigen 125 and carbohydrate antigen 19-9 were both elevated to approximately 20-fold above the upper limit of normal, along with imaging results-strongly suggested a ruptured malignant ovarian tumor. Intraoperatively, the lesions were indistinguishable from advanced ovarian cancer, and a definitive diagnosis of deep infiltrating endometriosis (American Society for Reproductive Medicine score 178, Stage IV) was confirmed only through postoperative histopathological examination. Her postoperative recovery was unremarkable, with rapid symptomatic relief, and no recurrence was observed during follow-up. CONCLUSION(S): This case highlights that deep infiltrating endometriosis should be considered in patients presenting with acute abdomen, even when clinical and biochemical features strongly suggest pelvic malignancy. Furthermore, the emergency surgery for definitive diagnosis and radical resection also achieved excellent therapeutic outcomes.
Effect of different long-acting reversible contraceptive methods on female sexual function: a retrospective cohort study.
Ye S, Ma L, Huang Y … +4 more , Su B, Cao Y, Huang J, Zhu J
BMC Womens Health · 2026 Jun · PMID 42277791 · Full text
BACKGROUND: The impact of long-acting reversible contraception (LARC) on female sexual function remains a controversial and often overlooked issue. This study aimed to evaluate the effects of three common LARC methods on...
BACKGROUND: The impact of long-acting reversible contraception (LARC) on female sexual function remains a controversial and often overlooked issue. This study aimed to evaluate the effects of three common LARC methods on female sexual function. METHODS: This retrospective cohort study included 90 women, divided into three groups based on their chosen contraceptive: copper-containing intrauterine device (Cu-IUD, n = 30), levonorgestrel intrauterine system (LNG-IUS, n = 30), and the etonogestrel subcutaneous implant (Implanon, n = 30). Changes in sexual frequency and partner sexual satisfaction were recorded. Sexual function was assessed using the Female Sexual Function Index (FSFI) prior to insertion and at one, three, and six months post-insertion. Female sexual dysfunction (FSD) was defined as an FSFI total score of ≤ 19. Differences in these outcomes were compared among the three groups and across the different time points. RESULTS: The frequency of sexual activity at six months post-insertion was significantly higher than at one month (p < 0.001) and three months (p = 0.034). Cu-IUD users reported significantly better partner sexual satisfaction compared to LNG-IUS users (B=-2.267, p < 0.001) and Implanon users (B=-2.072, p < 0.001). LNG-IUS users had the lowest total FSFI scores at all assessed time points (p = 0.004), while Cu-IUD users scored highest in the desire and satisfaction domains (p < 0.001 and p = 0.003, respectively). Both Cu-IUD and Implanon users reported better outcomes in lubrication and orgasm compared to LNG-IUS users (p < 0.001 and p = 0.004, respectively). Implanon users scored highest in the pain domain (p = 0.002). No significant differences were observed in the arousal domain at six months. FSD was significantly associated with the type of LARC used, a history of abortion, and changes in the frequency of sexual activity. Specifically, LNG-IUS users had a higher probability of experiencing FSD than Implanon users (p = 0.023). A history of abortion (p = 0.005) and a decreased frequency of sexual activity (p < 0.001) were identified as independent risk factors for FSD. CONCLUSIONS: This study reveals that the LNG-IUS was associated with the poorest sexual function outcomes and a higher risk of FSD. Given the differences observed across various dimensions, clinicians can provide more personalized counseling when recommending contraceptive options. Additionally, dynamic follow-up for women using LARC is crucial, particularly within the first three months after insertion.
Gynecological laparoscopic surgery in Pokhara: four years' experience at Charak memorial hospital.
Palikhe B, Nepal K, Shrestha OK … +4 more , Tripathee M, Baral P, Shrestha A, Sharma P
BMC Womens Health · 2026 Jun · PMID 42271399 · Full text
BACKGROUND: Minimally invasive surgery (MIS) has transformed gynecological practice worldwide because of its advantages including reduced postoperative pain, shorter hospital stay, and faster recovery. However, evidence...
BACKGROUND: Minimally invasive surgery (MIS) has transformed gynecological practice worldwide because of its advantages including reduced postoperative pain, shorter hospital stay, and faster recovery. However, evidence regarding the implementation and outcomes of gynecological laparoscopy in low- and middle-income countries remains limited. This study aimed to evaluate the feasibility, safety, and perioperative outcomes of gynecological laparoscopic surgeries performed in a resource-constrained tertiary care center in Nepal. METHODS: A retrospective descriptive study with limited comparative analysis was conducted at Charak Memorial Hospital, Pokhara, Nepal. Medical records of patients undergoing gynecological laparoscopic surgery between 2019 and 2023 were reviewed. Primary outcomes included conversion to laparotomy and perioperative complication rates. Secondary outcomes included operative time, intraoperative blood loss, and duration of hospital stay. Complications were classified according to the Clavien-Dindo classification system. RESULTS: A total of 159 patients were planned for laparoscopic gynecological surgery during the study period. Among them, 153 procedures (96.2%) were completed laparoscopically, while 6 cases (3.8%) required conversion to laparotomy. The mean age of patients was 37.2 ± 12.1 years. Ovarian cystectomy was the most common procedure performed (62.1%), followed by total laparoscopic hysterectomy (26.8%). Histopathological examination of ovarian cystectomy specimens demonstrated predominantly benign lesions with no malignant pathology identified. Total laparoscopic hysterectomy had significantly longer operative time and greater intraoperative blood loss compared with other procedures (P < 0.001). Most patients (84.9%) were discharged within two days of surgery. The overall complication rate was 6.5%, with most complications classified as minor (Clavien-Dindo Grade I-II). Fever was the most common postoperative complication. One major complication involving pelvic vein thrombosis and one intraoperative urinary bladder injury were encountered. CONCLUSION: Gynecological laparoscopic surgery can be performed safely and feasibly in a resource-constrained setting with acceptable conversion and complication rates. Despite challenges related to resource limitations and the learning curve associated with MIS implementation, favorable perioperative outcomes were achieved. Further prospective and comparative studies are required to strengthen the evidence for wider adoption of minimally invasive gynecological surgery in similar low-resource settings.
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