BMC Women's Health[JOURNAL]
Sun
200 papers
Partial autoamputation of an ovary following adnexal torsion with preserved ovarian function in a reproductive-age woman: a case report and literature review.
Hayashi K, Tsuyoshi H, Nakamori A … +5 more , Watanabe M, Hayashi Y, Hattori Y, Orisaka M, Yoshida Y
BMC Womens Health · 2026 Jun · PMID 42271369 · Full text
BACKGROUND: Ovarian autoamputation is a rare consequence of adnexal torsion. Preoperative diagnosis is challenging, and ovarian and tubal function on the affected side is rarely preserved once autoamputation has occurred...
BACKGROUND: Ovarian autoamputation is a rare consequence of adnexal torsion. Preoperative diagnosis is challenging, and ovarian and tubal function on the affected side is rarely preserved once autoamputation has occurred. CASE: A 29-year-old woman with a known benign-appearing left ovarian tumor presented with acute lower abdominal pain. Imaging studies suggested torsion of the ovarian tumor pedicle, and emergency laparoscopic surgery was performed. Intraoperatively, a necrotic, fist-sized mass consistent with an autoamputated ovarian tumor was identified in the pouch of Douglas, while the remaining ovary and fallopian tube were preserved. Histopathological examination revealed hemorrhagic infarction and necrosis of the tumor, with residual ovarian stroma containing follicles. Postoperative follow-up demonstrated normal follicular development and resumption of ovulatory function, confirming preserved ovarian function on the affected side. CONCLUSION: Unlike previous reports of ovarian autoamputation, this rare case of partial ovarian autoamputation suggests that spontaneous detachment of necrotic tissue does not inevitably result in the complete loss of ipsilateral ovarian function. However, in reproductive-age women, early surgical intervention should be strongly considered when adnexal torsion is suspected, even in the absence of definitive imaging findings, to maximize the potential for preserving ovarian function.
Effect of pelvic floor muscle training with or without dynamic neuromuscular stabilization-based breathing on menstrual pain and symptoms of primary dysmenorrhea: a randomized controlled trial.
Yakıt Yeşilyurt S, Birinci Olgun T, Dağ Y … +4 more , Dönmez EN, Aytekin İ, Erkanlı ME, Budak A
BMC Womens Health · 2026 Jun · PMID 42271328 · Full text
BACKGROUND: Breathing exercises may modulate dysmenorrhea by enhancing relaxation and eliciting analgesic effects. This study investigated the effects of Pelvic Floor Muscle Training (PFMT) with or without Dynamic Neurom...
BACKGROUND: Breathing exercises may modulate dysmenorrhea by enhancing relaxation and eliciting analgesic effects. This study investigated the effects of Pelvic Floor Muscle Training (PFMT) with or without Dynamic Neuromuscular Stabilization (DNS)-based breathing exercises on menstrual symptoms, pain, and quality of life in primary dysmenorrhea (PD). METHODS: Sixty-six women with PD were randomly assigned to one of three groups: PFMT combined with DNS-based breathing exercises (PFMT + DNS Group), PFMT alone (PFMT Group), or no intervention (Control Group) (once a week for 4 weeks). Outcomes were assessed using the Menstrual Symptom Questionnaire (MSQ), the McGill Pain Questionnaire (MPQ), and the Short Form-36 (SF-36) at baseline, post-treatment, and the 3-month follow-up. RESULTS: Both intervention groups showed significant improvements in MSQ subscales and MPQ scores from baseline to post-treatment (P < 0.05). Significant group × time interactions were observed for somatic complaints (P = 0.020, η² = 0.088), pain symptoms (P = 0.001, η² = 0.173), coping methods (P = 0.001, η² = 0.195), and total MSQ score (P = 0.001, η² = 0.198), and MPQ (P = 0.001, η² = 0.270). These improvements were maintained at the 3-month follow-up. Between-group comparisons showed significantly greater reductions in MPQ scores in both intervention groups than in control group, with no significant difference between PFMT and PFMT + DNS. No significant between-group differences were found for SF-36 subscales. CONCLUSIONS: A four-week PFMT significantly reduced menstrual symptoms and pain, with effects sustained at 3 months. However, adding DNS-based breathing exercises did not provide any additional benefits. TRIAL REGISTRATION: ClinicalTrials.gov, Trial registration: NCT06615258, Registration date: 26 September 2024.
Climate change and health: gender and social inequalities in contexts of urban vulnerability among women.
Terra MF, Lachtim SAF, de Mello Abdalla FT … +6 more , Travassos LRFC, Ribeiro DC, Fernandes LOM, Pereira NCH, Silva LS, da Silva Araújo HM
BMC Womens Health · 2026 Jun · PMID 42265715 · Full text
BACKGROUND: Climate change represents a global challenge with unequal impacts on vulnerable populations, particularly women living in vulnerable urban contexts. This study examines, from the perspective of women residing...
BACKGROUND: Climate change represents a global challenge with unequal impacts on vulnerable populations, particularly women living in vulnerable urban contexts. This study examines, from the perspective of women residing in an urban occupation within the metropolitan region of São Paulo, how climate change exacerbates social and gender inequalities, affecting living conditions and health. METHODS: This qualitative study was guided by Emancipatory Action Research and conducted in the Lélia Gonzalez occupation, linked to the Homeless Workers' Movement (MTST), in Santo André (São Paulo, Brazil), between March and August 2025. Thirteen women participated, including both cisgender and transgender individuals. Data were generated through six emancipatory workshops and a complementary questionnaire, supported by audio recordings, full transcription, and field notes. Data were analyzed using open coding and the development of emergent categories, interpreted through the Social Determination of Health framework and the 4 S principles: sustainability, security, solidarity, and sovereignty. RESULTS: Participants associated climate change with everyday experiences such as extreme heat, flooding, respiratory diseases, food insecurity, and precarious housing conditions. These phenomena were perceived as intensifying gender inequalities, increasing work and care burdens, exacerbating situations of violence, and reinforcing processes of social exclusion. CONCLUSIONS: Climate change deepens social and gender inequalities, directly affecting the health and daily lives of women in vulnerable urban settings. Emancipatory Action Research was a useful approach for articulating experiences, fostering critical reflection, and supporting collective action. The findings highlight the relevance of gender-sensitive, intersectoral public policies guided by the principles of sustainability, sovereignty, solidarity, and security, particularly in such contexts. DESCRITORES: Mudanças Climáticas; Equidade de Gênero; Vulnerabilidade em Saúde; Saúde; Mulheres; Desigualdades de Saúde. DESCRIPTORS: Climate Change; Gender Equity; Health Vulnerability; Health; Women; Health Inequalities. DESCRIPTORES: Cambio climático; Equidad de Género; Vulnerabilidad in Salud; Salud; Mujeres; Inequidades in Salud.
Chronotype score is associated with testosterone levels and estradiol-to-testosterone ratio in young adult Saudi women: a cross-sectional study.
Sumayli RI, Al Lahaf BH, Dhamiri MY … +5 more , Mahmoud MH, Balkhtb RM, Jeraiby MA, Mjery YA, Kaabi YA
BMC Womens Health · 2026 Jun · PMID 42265569 · Full text
BACKGROUND: Chronotype reflects individual preference for sleep-wake timing and is closely linked to circadian rhythm regulation. Greater eveningness tendency has been associated with adverse metabolic and endocrine outc...
BACKGROUND: Chronotype reflects individual preference for sleep-wake timing and is closely linked to circadian rhythm regulation. Greater eveningness tendency has been associated with adverse metabolic and endocrine outcomes; however, evidence regarding its relationship with reproductive hormones in women remains limited, particularly in Saudi Arabia. This study aimed to investigate the association between chronotype score and gonadal hormone profiles in young adult Saudi women. METHODS: In this cross-sectional study, 58 healthy Saudi female university students aged 18-23 years were recruited at Jazan University between September and October 2025. Blood samples were collected during the early follicular phase of the menstrual cycle (days 2-5). Chronotype was assessed using the Reduced Morningness-Eveningness Questionnaire (rMEQ). Serum estradiol and testosterone concentrations were measured using chemiluminescent immunoassays. Associations between rMEQ score and hormonal parameters were evaluated using Spearman's rank correlation and partial Spearman correlation analyses. RESULTS: rMEQ score was negatively correlated with testosterone concentrations (ρ = -0.344, P = 0.008) and positively correlated with the estradiol-to-testosterone (E2/T) ratio (ρ = 0.338, P = 0.009), indicating that greater eveningness tendency was associated with a relatively more androgenic hormonal profile. These associations remained significant after adjustment for age, body mass index, and menstrual cycle day. No significant association was observed between rMEQ score and estradiol concentrations (ρ = 0.017, P = 0.897). CONCLUSIONS: Lower rMEQ scores, indicating greater eveningness tendency, were associated with higher testosterone concentrations and a reduced E2/T ratio in healthy young Saudi women, suggesting a relatively more androgenic hormonal profile. These findings indicate that variation in chronotype may be linked to differences in reproductive hormone balance and may have implications for women's reproductive and metabolic health.
The effectiveness of psychosocial interventions on physiological symptoms of menopause: a systematic review and meta-analysis.
Robinson K, Hardy R, Melville M … +3 more , Saidel S, Desai R, Spector A
BMC Womens Health · 2026 Jun · PMID 42252432 · Full text
BACKGROUND: Menopause is a transitional life stage marked by the end of menstruation, during which approximately 80-90% of women experience persistent symptoms such as vasomotor symptoms, musculoskeletal pain, fatigue, a...
BACKGROUND: Menopause is a transitional life stage marked by the end of menstruation, during which approximately 80-90% of women experience persistent symptoms such as vasomotor symptoms, musculoskeletal pain, fatigue, and sleep disturbance. While menopausal hormone therapy is effective for some symptoms, non-pharmacological psychosocial interventions are increasingly recommended as alternatives or adjuncts. This review evaluates the efficacy of psychosocial interventions for managing physiological menopausal symptoms. METHODS: Six databases were systematically searched from inception to October 2024 for randomised controlled trials evaluating psychosocial interventions for menopausal women with physiological symptoms. Outcomes were grouped into nine categories, including sleep quality, insomnia, pain, fatigue, urogenital symptoms, sexual functioning, and vasomotor symptoms (classified as frequency, bothersomeness, and severity). Primary analyses used post-intervention data, with sensitivity analyses based on change scores. Effect sizes were expressed as Hedges' g. The protocol was preregistered on PROSPERO, CRD42024572869. RESULTS: 28 randomised controlled trials involving 2,887 women were included, of which 24 were included in the meta-analysis and four synthesised narratively. Psychosocial interventions produced medium-to-large reductions in the bothersomeness of hot flushes and night sweats at short-term follow-up (Hedges' g = - 0.60 to - 0.87) and medium-term follow-up (g = - 0.50 to - 0.77), while effects on symptom frequency and severity were smaller. Significant improvements were observed in sleep quality (short-term: g = - 0.77 to - 1.04; medium-term: g = - 0.46) and insomnia (short-term: g = - 1.77 to - 2.48; medium-term: g = - 1.56 to - 1.79). Psychosocial interventions did not demonstrate improvements on sexual functioning or urogenital symptoms. Intervention dose varied across studies, and retention rates were high (mean = 86.7%), indicating good feasibility. CONCLUSION: Psychosocial interventions, particularly cognitive behavioural therapy, were associated with improvements in menopausal symptoms, with the strongest and most consistent effects observed for vasomotor symptom bothersomeness and sleep outcomes. These findings support psychosocial approaches as valuable non-pharmacological options, either alone or alongside pharmacological treatments. Future research should focus on tailoring interventions to individual needs, assessing whether benefits are maintained long-term, and examining whether effectiveness varies across different stages of menopause.
Physical activity, sedentary behaviour, and anthropometric profiles in women with and without insulin resistance: a cross-sectional study.
Wiśniewska-Ślewicz K, Żak-Kowalska K, Kowalski S … +5 more , Moskal A, Tęcza E, Khorram-Manesh A, Al-Wathinani AM, Goniewicz M
BMC Womens Health · 2026 Jun · PMID 42251403 · Full text
BACKGROUND: Insulin resistance (IR) is a multifactorial metabolic condition influenced by lifestyle, body composition, and behavioral factors. Regular physical activity is known to improve insulin sensitivity, yet its as...
BACKGROUND: Insulin resistance (IR) is a multifactorial metabolic condition influenced by lifestyle, body composition, and behavioral factors. Regular physical activity is known to improve insulin sensitivity, yet its associations with anthropometric and socio-demographic variables remain incompletely understood, particularly among young women. METHODS: A total of 443 women aged 18-35 years participated in this cross-sectional study, including 301 with medically confirmed IR and 142 metabolically healthy controls. Anthropometric indices, Body Mass Index (BMI), Waist-Hip Ratio (WHR), Abdominal Volume Index (AVI), and Body Adiposity Index (BAI), were self-measured using standardized procedures. Physical activity was assessed via the Global Physical Activity Questionnaire (GPAQ), with total energy expenditure expressed as Metabolic Equivalent of Task (MET). Group comparisons were performed using Mann-Whitney U tests and Generalized Linear Models (GENLIN) with robust covariance estimation. RESULTS: Women with IR exhibited significantly higher BMI, WHR, AVI, and BAI values (all p < 0.001) and lower total physical activity (2,615 vs. 3,679 MET; p = 0.01) compared with controls. Sedentary behavior was more prevalent among IR participants (449 vs. 363 MET; p < 0.001). The observed differences were independent of anthropometric covariates. Socio-demographic factors showed nonlinear associations: lower and higher income levels, as well as rural residence, were linked to reduced activity in the IR group. Sleep duration showed no significant effect. CONCLUSIONS: Physical activity, independent of body composition, is a key determinant of metabolic health in women. The results highlight the need for targeted behavioral interventions promoting movement as a core therapeutic and preventive strategy in insulin resistance management.
The IDEA pilot trial: feasibility, acceptability, and preliminary efficacy of an online adaptation of an evidence-based intervention for campus sexual assault prevention.
Peitzmeier SM, Ashwell L, Adams MP … +2 more , Edwards K, Senn CY
BMC Womens Health · 2026 Jun · PMID 42237318 · Full text
BACKGROUND: Enhanced Assess, Acknowledge, Act (EAAA) is the only intervention shown in a randomized controlled trial to reduce sexual violence victimization against undergraduate women by 50%. EAAA is an in-person, small...
BACKGROUND: Enhanced Assess, Acknowledge, Act (EAAA) is the only intervention shown in a randomized controlled trial to reduce sexual violence victimization against undergraduate women by 50%. EAAA is an in-person, small-group intervention led by two trained peer facilitators over four three-hour sessions. Implementation cost and train-the-trainer complexities have led to limited uptake with relatively few institutions implementing the intervention, despite its efficacy. Adapting EAAA for online delivery would enable use of a centralized facilitator pool, dramatically cutting cost and complexity for institutions who wish to implement it and enabling scale-up of a singularly effective primary prevention intervention. The aim of the current study was to adapt and pilot EAAA for online delivery and assess the feasibility, acceptability, and potential efficacy of the adapted intervention. METHODS: Using the ADAPT-ITT framework for systematic intervention adaptation, we created Internet-Delivered EAAA (IDEA), which uses an innovative hybrid online/in-person delivery mode whereby pairs of women are together in person, and then facilitators live-facilitate the intervention to a group of up to 8 pairs via videoconferencing. The adaptation process included an initial pilot or "theater" test (n = 8) with direct observation by experts, an expert focus group to offer suggestions on refining the intervention, and a one-armed pilot trial (n = 65). Primary outcomes were feasibility (recruitment and retention), acceptability (participant ratings on post-session surveys and feedback provided in participant focus groups), and preliminary indicators of efficacy (increases in self-defense self-efficacy and ability to detect risk in coercive situations, decreases in rape myth acceptance, as well as reports of using skills learned in the intervention to decrease sexual assault risk). RESULTS: IDEA was delivered successfully with strong recruitment (90% of target) and retention (84%). Participants found the intervention acceptable with high mean enjoyment (8.2 out of 10) and willingness to recommend the training to others (8.5 out of 10). Preliminary indicators of potential efficacy showed that the program significantly increased self-defense self-efficacy and perceived risk of acquaintance rape, while significantly reducing acceptance of rape myths and beliefs about female precipitation of rape. CONCLUSIONS: IDEA had high feasibility and acceptability, and promising indicators of potential efficacy, comparable to historical data from the in-person EAAA efficacy trial. TRIAL REGISTRATION: NCT04797741. Registered March 10, 2021.
Associated factors of undernutrition among women of reproductive age living with HIV in Mahama Refugee Camp, Rwanda.
Nwanna UK, Suubi R, Archibong OV
BMC Womens Health · 2026 Jun · PMID 42231369 · Full text
INTRODUCTION: Low dietary diversity in low- and middle-income countries (LMICs) usually results from households basing their diets on a small number of food groups beyond their staple foods. Numerous studies have demonst...
INTRODUCTION: Low dietary diversity in low- and middle-income countries (LMICs) usually results from households basing their diets on a small number of food groups beyond their staple foods. Numerous studies have demonstrated that among people in both developed and developing nations, dietary diversity is a reliable indicator of dietary quality. Humanitarian crises over the past few decades have altered the patterns of food consumption in refugee camps, where the prevalence of food insecurity has significantly grown, resulting in undernutrition and chronic diseases. Therefore, our study determined the factors associated with undernutrition among women of reproductive age living with HIV in Mahama refugee camp, Rwanda. METHODS: Using a cross-sectional design, our study examined the association between undernutrition (outcome) and household diversity scores, access to kitchen gardens, and chronic illness. The study was conducted at the Mahama refugee camp, which was home to 58,248 people. Yemane's algorithm was used to recruit a sample size of 170 women of reproductive age living with HIV for this study, while utilizing a random sampling technique. Anthropometric measurements (BMI and MUAC) of the respondents were examined; SPSS version 25 was used for data analysis. RESULTS: According to this study, the majority of women in the refugee camp ate grains (98%) and pulses (86%). The majority had a 68% medium diversity score. Additionally, access to kitchen garden (AOR = 0.391, p = 0.014, 95% CI = 0.185-0.825), dietary scores of highest (AOR = 0.039, p = 0.001, 95% CI = 0.033-0.475) and medium (AOR = 0.125, p = 0.002, 95% CI = 0.006-0.242) were found to be significantly associated with lower odds of undernourishment in the camp. Though not statistically significant, having any other chronic illness was associated with a higher risk of undernourishment (AOR = 2.359, p = 0.102, 95% CI = 0.843-6.602). CONCLUSIONS: Grains, legumes, fruits, seeds, nuts, and vegetables made up the majority of the food consumed by the 170 sampled women refugees. The risk of undernutrition was also significantly reduced in women who had access to kitchen gardens and showed high and medium dietary scores; a tendency was also observed for the risk of undernutrition to increase in respondents with extra chronic conditions. To enhance dietary scores and promote fair access to the kitchen garden, comprehensive healthcare interventions should be implemented in the camp.
Menstrual hygiene management knowledge, practices, and prevalent restrictions among women of the reproductive age in Bheemdatta Municipality of Sudurpashchim Province Nepal: a mixed-methods study.
Pandey A, Paudel A, Myia SD
BMC Womens Health · 2026 Jun · PMID 42231293 · Full text
BACKGROUND: Menstrual hygiene management (MHM) is a fundamental aspect of women's health, yet it remains inadequately addressed in many low- and middle-income countries, including Nepal. This study aimed to assess knowle...
BACKGROUND: Menstrual hygiene management (MHM) is a fundamental aspect of women's health, yet it remains inadequately addressed in many low- and middle-income countries, including Nepal. This study aimed to assess knowledge, practices, and prevalent menstrual restrictions among women of reproductive age in Bheemdatta Municipality, Sudurpashchim Province, Nepal. METHODS: A community-based concurrent mixed-method study was conducted among 161 women aged 15-49 years selected through multistage stratified sampling. Quantitative data were collected using a semi-structured questionnaire through face-to-face interviews and analyzed using SPSS version 22. Qualitative data from nine interviews (three IDIs and six KIIs) were thematically analyzed using NVivo 10 to substantiate the quantitative findings. RESULTS: Of the total participants, 94% had good knowledge of menstruation, and 90% recognized it as a physiological process. However, only 12% demonstrated good MHM practices, 64% had fair, and 24% had poor practices. Around 60% used sanitary pads, 24% alternated between pads and cloths, and 17% used cloths exclusively. Qualitative findings highlighted key barriers including financial constraints, limited access to sanitary products, inadequate water and disposal facilities, and deep-rooted socio-cultural taboos. Despite improved awareness, women reported facing restrictions during menstruation-most commonly avoiding temples (93%), cooking (74%), eating nutritious food (48%) and using bathroom (12%). CONCLUSION: Although knowledge about menstruation was high, its translation into hygienic practices remains inadequate due to economic, infrastructural, and socio-cultural beliefs and restrictions. Interventions should prioritize behavioral change communication, subsidized menstrual products, and community engagement to dismantle harmful taboos and promote safe and dignified menstrual hygiene management.
Investigation of the effect of TNF-α levels on infertility duration and infertility characteristics in endometriosis patients presenting with infertility complaints.
Özuyar Şimşek G, Uzunlar Ö, Özen S … +3 more , Çandar T, Sancı M, Duman ED
BMC Womens Health · 2026 Jun · PMID 42226212 · Full text
BACKGROUND: Endometriosis is a chronic inflammatory disorder frequently associated with infertility. Tumor necrosis factor-alpha (TNF-α) is involved in inflammatory pathways; however, the clinical relevance of serum TNF-...
BACKGROUND: Endometriosis is a chronic inflammatory disorder frequently associated with infertility. Tumor necrosis factor-alpha (TNF-α) is involved in inflammatory pathways; however, the clinical relevance of serum TNF-α in relation to infertility duration and ovarian reserve remains uncertain. METHODS: This prospective comparative study included 70 infertile women aged 20-37 years: 35 women with clinically and/or radiologically diagnosed endometriosis and 35 age-matched infertile controls with unexplained infertility and no clinical or imaging evidence of endometriosis. Serum TNF-α was measured using enzyme-linked immunosorbent assay. Hormonal parameters, including anti-Müllerian hormone (AMH), were obtained from third-day menstrual-cycle samples retrieved from clinical records. Associations between TNF-α, infertility duration, AMH, and clinical characteristics were evaluated. Exploratory adjusted analyses were performed for log-transformed TNF-α and AMH. RESULTS: Serum TNF-α levels were higher in the endometriosis group than in controls (median [IQR], 235.49 [124.33-390.31] vs. 64.58 [58.91-76.52] ng/L; p < 0.001). AMH levels were lower in the endometriosis group in unadjusted analysis (2.05 [1.67-3.41] vs. 3.30 [2.26-3.66] ng/mL; p = 0.029). After adjustment for age, BMI, smoking status, and previous surgical history, endometriosis group status remained associated with log-transformed TNF-α (β = 1.386, 95% CI 1.114 to 1.657; p < 0.001), whereas the association with AMH was attenuated (β=-0.824, 95% CI -1.817 to 0.169; p = 0.102). TNF-α was not associated with infertility duration or AMH within the endometriosis group. CONCLUSIONS: Serum TNF-α was elevated in infertile women with clinically and/or radiologically diagnosed endometriosis but was not associated with infertility duration, AMH, or selected clinical characteristics. The high discriminatory performance observed in ROC analysis should be interpreted as exploratory because of the modest sample size, clinical/radiologic case definition, potential selection bias, and lack of external validation. Serum TNF-α may reflect systemic inflammatory activity rather than infertility severity or ovarian reserve impairment.
Comparison of two menopausal hormone therapy regimens in managing menopausal symptoms: a retrospective study.
Yu Y, Lv M, Fu Y
BMC Womens Health · 2026 Jun · PMID 42226203 · Full text
BACKGROUND: Femoston (estradiol/dydrogesterone) and Climen (estradiol valerate/cyproterone acetate) are two widely prescribed sequential menopausal hormone therapy (MHT) regimens that differ in estrogen formulation, prog...
BACKGROUND: Femoston (estradiol/dydrogesterone) and Climen (estradiol valerate/cyproterone acetate) are two widely prescribed sequential menopausal hormone therapy (MHT) regimens that differ in estrogen formulation, progestogen component, and sequential pattern. Head-to-head comparative data on their clinical efficacy and safety remain scarce. METHODS: This single-center retrospective study enrolled 80 perimenopausal and early postmenopausal women who received Femoston (n = 42) or Climen (n = 38) for six consecutive treatment cycles between January 2022 and January 2025. The primary outcome was post-treatment Kupperman Menopausal Index (KMI) score assessed by multivariable linear regression. Secondary outcomes included individual symptom response rates, serum sex hormone levels, lipid profile, hepatic enzymes, fasting plasma glucose, endometrial thickness, and adverse events. RESULTS: Both regimens produced substantial reductions in KMI scores from baseline (Femoston: 26.90 ± 5.72 to 10.48 ± 3.72; Climen: 27.53 ± 6.08 to 11.74 ± 4.12; both P < 0.001). After multivariable adjustment, treatment group was not independently associated with post-treatment KMI score (β = 0.58, 95% CI: -0.82 to 1.98, P = 0.412). Response rates for hot flashes/sweating, insomnia, and mood symptoms were comparably high between groups (all P > 0.05). Both regimens significantly suppressed FSH and LH and elevated E₂. Regarding lipid profiles, Femoston significantly increased HDL-C (P = 0.001) whereas Climen did not (P = 0.402); Climen significantly increased TG (P = 0.048) whereas Femoston did not (P = 0.583). After Benjamini-Hochberg correction, the between-group difference in HDL-C remained significant (adjusted P = 0.024). No clinically significant changes in hepatic enzymes, fasting glucose, or endometrial thickness were observed in either group, and no serious adverse events occurred. CONCLUSIONS: Femoston and Climen provide comparable short-term menopausal symptom relief. The more favorable lipid profile with Femoston, particularly its HDL-C benefit, may inform individualized regimen selection, especially in women without indications for antiandrogenic therapy. Prospective studies with longer follow-up are warranted to evaluate hard cardiovascular endpoints.
Effects of a high-intensity functional exercise program on menopausal symptoms, physical performance, and dual-task performance in postmenopausal women: a randomized controlled trial.
Gözütok NH, Eyuboglu F
BMC Womens Health · 2026 Jun · PMID 42226147 · Full text
BACKGROUND: This study aims to examine the effects of a high-intensity functional exercise program on menopausal symptoms, physical performance, and dual-task performance in postmenopausal women. METHODS: The study inclu...
BACKGROUND: This study aims to examine the effects of a high-intensity functional exercise program on menopausal symptoms, physical performance, and dual-task performance in postmenopausal women. METHODS: The study included 40 postmenopausal women aged 50-65. Participants were randomized into two groups: a high-intensity functional exercise (HIFE) group and a control group. Participants' physical performance was assessed using a short physical performance battery (SPPB), and dual-task performance was assessed using simultaneous cognitive tasks during a 4-meter walk and a 30-second sit-to-stand test. The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms, and the Menopause-Specific Quality of Life Scale (MSQOL) was used to assess health-related quality of life. Assessments were conducted at the beginning of the training and at the end of 8 weeks. RESULTS: The HIFE group demonstrated significantly greater improvements in SPPB total score, including 4-meter walk and chair sit-to-stand performance, compared with the control group (p < 0.05, d = 1.97). In addition, significant improvements were observed in dual-task performance in the HIFE group compared with the control group (p < 0.05). Large effect sizes were observed for the 30-second sit-to-stand test (d = 2.36) and the 4-meter walk test (d = 2.76). Significant improvements were also observed in somatic and psychological subparameters and total MRS scores, as well as in all MSQOL subparameters except sexual problems (p < 0.05). No significant differences were observed between the groups in SPPB balance, MRS urogenital symptoms, or MSQOL sexual problems (p > 0.05). CONCLUSIONS: The study found that the HIFE program increased physical performance, reduced dual-task costs, and decreased somatic and psychological symptoms in postmenopausal women, while also improving health-related quality of life. Our study demonstrated that HIFE is an effective exercise modality for improving physical performance, reducing menopausal symptoms, and enhancing cognitive-motor performance in postmenopausal women. CLINICAL TRIAL REGISTRATION: NCT07471620, Registration date: 10/03/2026.
Health belief model-based determinants of women's participation in cervical cancer screening: a case-control study from Southeastern Turkey.
Acar U, Barlas F, Beyazgul B … +1 more , Koruk I
BMC Womens Health · 2026 May · PMID 42216173 · Full text
BACKGROUND: In line with the World Health Organization's elimination targets, HPV‑DNA-based cervical cancer screening is the standard; however, screening uptake remains suboptimal in many settings. To assess, in a centre...
BACKGROUND: In line with the World Health Organization's elimination targets, HPV‑DNA-based cervical cancer screening is the standard; however, screening uptake remains suboptimal in many settings. To assess, in a centre implementing Türkiye's national cancer screening standards, the relationship between women's screening status and a Health Belief Model (HBM)-based, 19‑item attitude scale; and to provide clear, practice‑oriented findings on screening behaviour. METHODS: In a case-control design, women aged 30-65 years were studied (November-December 2024). A total of 210 participants (1:1 screened vs. not screened) were included. The HBM‑based scale and sociodemographic variables were administered. Chi‑square tests were used for categorical variables and Mann-Whitney U tests for continuous variables. Scale scores were dichotomised at the median (low/high), and unadjusted odds ratios (ORs) were calculated from 2 × 2 tables; multivariable logistic regression was additionally used to estimate adjusted odds ratios (aORs) controlling for age, education, marital status, employment, and perceived income (two-sided p < 0.05). RESULTS: Scale scores were significantly higher among women who had undergone screening [median (IQR)]: perceived severity 22(4) (p < 0.001, r = 0.339), perceived susceptibility 12(7) (p < 0.001, r = 0.314), perceived barriers/self-efficacy 17(3) (p < 0.001, r = 0.355), perceived benefits 19(4) (p = 0.03, r = 0.176), and total score 71(9) (p < 0.001, r = 0.483). Women with low scores had higher odds of not being screened: severity OR = 3.04, susceptibility OR = 3.33, barriers/self‑efficacy OR = 2.86, total score OR = 4.41 (all p < 0.001); benefits OR = 1.17 (not significant, p = 0.68). Associations remained significant after adjustment for sociodemographic characteristics: low total HBM score aOR = 4.50 (2.46-8.26, p < 0.001); low perceived severity aOR = 3.73, low perceived susceptibility aOR = 4.92, low perceived barriers/self-efficacy aOR = 3.10 (all p < 0.01). CONCLUSION: The HBM‑based attitude scale indicates that perceived threat (severity, susceptibility) and barriers/self‑efficacy are strongly associated with women's screening behaviour; the total belief score discriminates better than individual subscales. Findings support culturally sensitive communication and service arrangements focused on reducing barriers and enhancing self‑efficacy to improve screening participation.
Vitamin D deficiency and pain severity in endometriosis: a phenotype-based retrospective observational study.
Baglar I, Sanlikan F, Keles E … +3 more , Sasmaz A, Soylu KK, Api M
BMC Womens Health · 2026 May · PMID 42210340 · Full text
OBJECTIVE: To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and pain severity in women with surgically and histopathologically confirmed endometriosis, and to assess whether this association...
OBJECTIVE: To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and pain severity in women with surgically and histopathologically confirmed endometriosis, and to assess whether this association differs between ovarian endometrioma (OE) and deep infiltrating endometriosis (DIE) phenotypes. METHODS: This retrospective observational analytical study included 427 women with surgically confirmed endometriosis. Patients were classified according to dominant phenotype as OE (n=231) or DIE (n=196). Serum 25(OH)D levels were categorized as deficient (<20 ng/mL), insufficient (20-30 ng/mL), and sufficient (≥30 ng/mL). Pain severity-including dysmenorrhea, chronic pelvic pain, and dyspareunia-was assessed using the Visual Analog Scale (VAS). Multivariable linear regression analyses were performed to examine the association between vitamin D levels and pain scores, adjusting for age, body mass index, and seasonal variation. RESULTS: Serum 25(OH)D levels were inversely associated with all pain parameters (p<0.001). Patients with vitamin D deficiency had higher median VAS scores compared to those with sufficient levels [7.0 (6.0-8.0) vs 4.0 (3.0-5.0), p<0.001]. In multivariable analyses, lower 25(OH)D levels remained significantly associated with higher pain severity (β = -0.28, p<0.001). A significant interaction between vitamin D levels and disease phenotype was observed (interaction p=0.004), suggesting that the association between lower vitamin D levels and higher pain scores was more pronounced in patients with the DIE phenotype compared to those with OE. A threshold value of 18.5 ng/mL demonstrated 74% sensitivity for identifying patients with severe pain (VAS ≥7). CONCLUSION: Lower serum vitamin D levels are significantly associated with greater pain severity in women with endometriosis, with a stronger association observed in the DIE phenotype. However, given the retrospective and cross-sectional nature of the analysis, causality cannot be inferred. Prospective studies are needed to further clarify these associations and their potential clinical implications.
Postmenopausal bladder endometriosis without exogenous estrogen: a case report and literature review.
Wu N, He Y, Jia Y … +1 more , Wang G
BMC Womens Health · 2026 May · PMID 42210311 · Full text
BACKGROUND: Endometriosis is a common estrogen-dependent disorder that typically affects women of reproductive age and generally resolves following menopause. This report describes a rare case of postmenopausal bladder e...
BACKGROUND: Endometriosis is a common estrogen-dependent disorder that typically affects women of reproductive age and generally resolves following menopause. This report describes a rare case of postmenopausal bladder endometriosis (BE) occurring in a woman with a normal body mass index and no history of exogenous estrogen use. CASE PRESENTATION: A postmenopausal woman with a normal body mass index and no history of estrogen replacement therapy presented with dysuria. Clinical examination and imaging suggested bladder endometriosis. The patient underwent laparoscopic partial cystectomy with total hysterectomy and bilateral salpingo-oophorectomy. Postoperative histopathology confirmed the diagnosis of endometriosis. CONCLUSIONS: This case demonstrates that BE can occur in postmenopausal women in the absence of exogenous estrogen or obesity. The coexistence of liver cirrhosis, associated with impaired estrogen metabolism, and diabetes, characterized by chronic inflammation, may synergistically contribute to a pro-inflammatory microenvironment that sustains local estrogen activity, enabling lesion persistence. Clinicians should consider such systemic factors in non-obese postmenopausal women presenting with symptoms suggestive of endometriosis.
Association between abdominal surgical incision type and midline intraperitoneal adhesion occurrence, findings from laparoscopic evaluation in a low-resource setting; a retrospective cohort of laparoscopic evaluations.
Imaralu JO, Olalere H, Nathaniel MB … +5 more , Olatunji OF, Adewole A, Odugbemi OO, Okojie N, Imaralu EI
BMC Womens Health · 2026 May · PMID 42210275 · Full text
BACKGROUND: Abdominal incisions are mostly done in the umbilical or suprapubic regions, typically in the midline, to prevent visceral and vascular injury, by taking advantage of the greater distance between these incisio...
BACKGROUND: Abdominal incisions are mostly done in the umbilical or suprapubic regions, typically in the midline, to prevent visceral and vascular injury, by taking advantage of the greater distance between these incision sites and the intraabdominal structures. Unfortunately, adhesions often form at the peritoneal surfaces of these sites, making repeat surgical access, a daunting task. The study aimed to determine the relationship between surgical incision type and the occurrence, location, spread and severity of peritoneal adhesions. METHODS: A Retrospective cohort study, involving laparoscopic evaluation of 296 patients. Laparoscopic entry was with the aid of a Veress needle in all cases, while insufflation was done with carbon dioxide using a pre-set pressure of 15mmHg for all diagnostic and 18-20mmHg, for all the operative procedures. The reported adhesions were scored using the Peritoneal Adhesion Index (PAI) score. RESULTS: The prevalence of adhesion was 96/296 (32.4%) of laparoscopies, with majority 80/96 (83.3%) in the midline region. Over half of the adhesions were attached to the anterior abdominal wall. Previous peritoneal surgery (p = 0.004, ARR = 40.27, 16.47-64.77), was the main association with adhesion formation. This factor was also the main predictor of adhesion location within the midline regions (p < 0.001, ARR = 10.28, 3.11-34.58) this finding, was irrespective of surgical involvement of uterus or adnexa (p = 0.997). No association was, however, found between the risk of adhesion attachment to the anterior abdominal wall and presence of adhesion in the midline (p = 0.999) or individual midline regions; epigastric (p = 0.778), umbilical (p = 0.345), suprapubic (p = 0.999). Exploratory laparotomy (PAI = 10.80 ± 2.86), myomectomy (PAI = 10.89 ± 3.71) and salpingectomy (PAI = 11.00 ± 5.66) had more severe adhesions, while appendicectomy (PAI = 6.17 ± 3.74) and caesarean section (PAI = 7.47 ± 3.34) the least. Adhesion occurrence (p = 0.883), midline adhesion (p = 0.997) or anterior abdominal wall attachment (p = 0.327) were, however, not significantly associated with incision type. CONCLUSION: Previous peritoneal surgery, irrespective of uterine or adnexal involvement, was associated with increased risk for adhesion formation. The incision type and the depth of surgery, were, however, not significantly associated with adhesion formation, adhesion location or attachment to the anterior abdominal wall, suggesting an interplay of other operative surgical considerations.
Carbon dioxide laser combined with photodynamic therapy versus photodynamic therapy alone for vaginal intraepithelial neoplasia: a multicenter retrospective comparative cohort study.
Hong H, Hu X, Yu Z … +4 more , Zhang X, Zhou Y, Wang X, Chen Z
BMC Womens Health · 2026 May · PMID 42204715 · Full text
BACKGROUND: Vaginal intraepithelial neoplasia (VaIN) is a premalignant condition characterized by a high risk of persistence and recurrence, and no universally accepted standard treatment has been established. Photodynam...
BACKGROUND: Vaginal intraepithelial neoplasia (VaIN) is a premalignant condition characterized by a high risk of persistence and recurrence, and no universally accepted standard treatment has been established. Photodynamic therapy (PDT) is a minimally invasive treatment option for VaIN, but its efficacy may be limited in some patients. We aimed to evaluate whether the addition of carbon dioxide (CO₂) laser ablation to PDT could improve the efficacy and safety of treatment for VaIN. METHODS: This multicenter retrospective comparative study included patients with VaIN treated at the First Affiliated Hospital of the University of Science and Technology of China and the First Affiliated Hospital of Bengbu Medical University between December 2018 and August 2024. Patients were assigned to the PDT plus CO₂ laser group or the PDT-alone group according to the treatment they actually received. All patients were followed for 12 months. The primary clinical outcome was complete remission (CR) at each follow-up endpoint. Secondary outcomes included HPV clearance among patients who were HPV-positive at baseline, cumulative recurrence, progression, and safety outcomes. RESULTS: A total of 146 patients were included, of whom 78 received PDT plus CO₂ laser and 68 received PDT alone. In the PDT-alone group, the CR rates at 3, 6, and 12 months were 70.6%, 63.2%, and 66.2%, respectively, compared with 70.5%, 85.9%, and 88.5% in the PDT plus CO₂ laser group. No significant between-group difference was observed at 3 months (P = 0.992), whereas the combination group showed significantly higher CR rates at 6 and 12 months (P = 0.002 and P = 0.001, respectively). Among patients who were HPV-positive at baseline, HPV clearance rates at 3, 6, and 12 months were 40.3%, 45.2%, and 50.0% in the PDT-alone group, compared with 67.6%, 66.2%, and 83.1% in the PDT plus CO₂ laser group, respectively. Cumulative recurrence by 12 months occurred in 6 patients (8.8%) in the PDT-alone group and 2 patients (2.6%) in the PDT plus CO₂ laser group. CONCLUSIONS: In this multicenter retrospective comparative cohort study, CO₂ laser combined with PDT was associated with higher complete remission rates and greater HPV clearance than PDT alone in patients with VaIN. The combined approach may improve lesion control and was associated with a numerically lower cumulative recurrence rate within 12 months, although recurrence-related findings should be interpreted cautiously because of the small number of events. The treatment appeared generally tolerable based on available retrospective safety records. Further prospective studies are warranted to confirm these findings. TRIAL REGISTRATION: Not applicable. This study was a multicenter retrospective comparative cohort study and was not prospectively registered.
Promoting cervical cancer screening participation among Chinese women from resource-limited settings: a multicenter qualitative study.
Wang H, Zhu Y, Zhang B … +3 more , Ding H, Yang Y, Qiao Y
BMC Womens Health · 2026 May · PMID 42204709 · Full text
BACKGROUND: This qualitative study aimed to explore the factors influencing participation in HPV-based cervical cancer screening among women from resource-limited settings areas in mainland China. METHODS: We conducted s...
BACKGROUND: This qualitative study aimed to explore the factors influencing participation in HPV-based cervical cancer screening among women from resource-limited settings areas in mainland China. METHODS: We conducted semi-structured interviews based on the health belief model among women from resource-limited settings areas in China. The sample population was stratified by age and screening status, and the interviewees were continually included until the data were saturated for every subgroup. Thematic content analysis was adopted in the inductive approach. RESULTS: Of the 23 participants, we summarized three themes: (1) organized screening has a significant promotion, (2) lack of knowledge leads to lower perceived susceptibility and benefits, and (3) life burden keeps women away from accessing cervical cancer screening services. CONCLUSION: To improve the coverage rate of cervical cancer screening, authority and attractive information, as well as a supportive community, are essential to bridge the knowledge gap and increase screening participation.
Serological detection of acute and chronic toxoplasmosis in infertile women in the north of Iran.
Montazeri M, Rostamkalai F, Fakhar M … +2 more , Peyvandi S, Zamaniyan M
BMC Womens Health · 2026 May · PMID 42204680 · Full text
BACKGROUND: Toxoplasma gondii (T. gondii) infection is a common parasitic disease worldwide and has been suggested as a potential factor affecting female fertility. This study aimed to determine the seroprevalence of ant...
BACKGROUND: Toxoplasma gondii (T. gondii) infection is a common parasitic disease worldwide and has been suggested as a potential factor affecting female fertility. This study aimed to determine the seroprevalence of anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M(IgM) antibodies among infertile women attending an in vitro fertilization (IVF) clinic in Mazandaran province in northern Iran and to investigate associations with demographic and clinical characteristics. METHODS: A descriptive cross-sectional survey was conducted on 130 infertile women referred to the IVF department at Imam Khomeini Hospital, Sari, from 2019 to 2020. Serum samples were collected and analyzed for anti-T. gondii IgG and IgM antibodies using enzyme-linked immunosorbent assay (ELISA). Demographic and clinical data were recorded. Statistical analysis was conducted using chi-square tests and binary logistic regression to compute adjusted odds ratios (ORs) and 95% confidence intervals (CIs), aiming to identify potential factors linked to T. gondii IgG and IgM seropositivity. A P-value of less than 0.05 was considered statistically significant. RESULTS: Anti-T. gondii IgG antibodies were detected in 52.3% (68/130) of participants, indicating past exposure, while IgM antibodies were found in 10% (13/130). No significant associations were observed between T. gondii seropositivity and variables such as age, residence, type of infertility, history of abortion, polycystic ovary syndrome, fibroma, or previous surgeries (P> 0.05). CONCLUSIONS: The study revealed a high seroprevalence of chronic T. gondii infection among infertile women infertile women at an IVF clinic in Mazandaran province, while only 10% showed IgM antibodies. No significant links were found between T. gondii seropositivity and various demographic or clinical factors, suggesting that the impact of T. gondii on female infertility may be less significant than previously thought. These findings suggest that while exposure to T. gondii is common in this population, it may not be a direct contributor to infertility in this context. Further research with larger sample sizes is warranted to clarify potential implications.
Menopause comfort scale: a scale development study.
Goke Arslan G, Aypar Akbag NN, Sanli Y … +1 more , Cinar Yucel S
BMC Womens Health · 2026 May · PMID 42204543 · Full text
BACKGROUND: Menopause is a transitional period. A large proportion of women experience severe menopausal symptoms, which affect their quality of daily life and comfort. Improving the well-being and comfort of women who a...
BACKGROUND: Menopause is a transitional period. A large proportion of women experience severe menopausal symptoms, which affect their quality of daily life and comfort. Improving the well-being and comfort of women who are affected physically, socio-culturally, psycho-spiritually, and environmentally during menopause is of extreme importance for nurses. The aim in conducting the present study was to develop the Menopause Comfort Scale to determine the comfort levels of menopausal women and to perform its validity and reliability study in Turkish. METHODS: In this descriptive, comparative, and methodological study, it was aimed to develop the Menopause Comfort Scale and to analyze its psychometric properties. In the sample, 423 women who met the inclusion criteria and volunteered to participate in the study were included. The Descriptive Information Form and the Menopause Comfort Scale were used to collect data. RESULTS: In this study, the Kaiser-Meyer-Olkin (KMO) coefficient was calculated as 0.782. The Bartlett's test of sphericity yielded the following result: χ² = 821.787 p = 0.000. As a result of the exploratory factor analysis, the 11 items were grouped under 4 factors with eigenvalues greater than 1.00. The overall scale explained 71.314% of the total (common) variance. The confirmatory factor analysis yielded the following: fit indices: (χ²/df = 1.34), Root Mean Square Error of Approximation (RMSEA): 0.04, Normed Fit Index (NFI): 0.93, Comparative Fit Index (CFI): 0.98 and Goodness of Fit Index (GFI): 0.96. The reliability coefficient of the scale was calculated as α = 0.814. CONCLUSIONS: In conclusion, the Menopause Comfort Scale developed in this study is a valid and reliable measurement tool, and it can be administered to assess the comfort levels of menopausal women in psychological, environmental, physical, and social dimensions.
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