BMC Women's Health[JOURNAL]
Sun
200 papers
Oncological and reproductive outcomes following fertility-preserving treatment in mismatch repair-deficient endometrial cancer or atypical endometrial hyperplasia.
Zhang T, Yang J, Cao D … +10 more , Yu M, Wu H, Xiang Y, Zhang X, Zong X, Zhang R, Jin X, Zhang K, Zheng J, Yang J
BMC Womens Health · 2026 May · PMID 42204524 · Full text
OBJECTIVE: To investigate oncological and reproductive outcomes in patients with mismatch repair-deficient (MMRd) endometrial endometrioid carcinoma (EEC) or atypical endometrial hyperplasia (AEH) undergoing fertility-pr...
OBJECTIVE: To investigate oncological and reproductive outcomes in patients with mismatch repair-deficient (MMRd) endometrial endometrioid carcinoma (EEC) or atypical endometrial hyperplasia (AEH) undergoing fertility-preserving treatment to inform clinical management of this molecular subtype. METHODS: Clinical and pathological data from 14 patients with MMRd EEC or AEH who received fertility-preserving treatment at Peking Union Medical College Hospital from January 2020 to December 2023 were retrospectively analyzed. RESULTS: The mean age at diagnosis of the patients was 33.6 ± 4.2 years. Loss of MLH1/PMS2 expression was the most common immunohistochemical abnormality, followed by loss of MSH6, MSH2/MSH6, and PMS2 expression. Among the 12 patients who underwent germline genetic testing, pathogenic/likely pathogenic germline variants in MMR genes were identified in three patients. During the follow-up period (median 34.5 months, range 26-117 months), seven patients achieved complete remission (CR), with a median time to CR of 8 months. The recurrence rate among these patients was 57.1%, and the median time to recurrence was 11 months. Nine patients underwent surgery after treatment failure or recurrence, with postoperative pathology revealing histologic upgrading and/or metastasis in eight patients. Two patients successfully conceived through assisted reproductive technology and achieved live births. CONCLUSION: Patients with MMRd EEC or AEH undergoing fertility-preserving treatment demonstrated relatively low remission rates, high recurrence rates, and suboptimal reproductive outcomes. Careful risk assessment and close surveillance for recurrence are warranted for patients desiring fertility.
AWhen screams go unheard: covert violence, women victims, and social denial.
Saedi Z, Norouzi Aliabad F, Taheri E … +1 more , Azmoude E
BMC Womens Health · 2026 May · PMID 42204516 · Full text
BACKGROUND: Covert violence-defined as a pattern of subtle, intentionally hidden, and socially camouflaged abusive behaviors that systematically erode a victim's reality, autonomy, and self-worth-remains a critically und...
BACKGROUND: Covert violence-defined as a pattern of subtle, intentionally hidden, and socially camouflaged abusive behaviors that systematically erode a victim's reality, autonomy, and self-worth-remains a critically understudied dimension of gender-based violence. Distinct from overt psychological aggression, covert violence operates through tactics such as gaslighting, micro-invalidations, coercive control, and economic manipulation, often evading detection while inflicting profound harm. This scoping review systematically maps the evidence on its manifestations, psychosocial impacts, and the mechanisms of institutional and cultural denial that compound women's victimization. METHODS: Following Arksey & O'Malley's framework and PRISMA-ScR guidelines, we conducted systematic searches across five databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL) for English-language studies published between 1992 and 2025. The search strategy prioritized terms specific to covert violence (e.g., "covert abuse," "invisible violence," "subtle psychological aggression") alongside related concepts. From 1,325 identified records, 43 resources met inclusion criteria after rigorous screening. Data were extracted into a structured table cataloging study characteristics (design, population, abuse type, key findings) and synthesized thematically. RESULT: Covert violence emerges as a complex and multifaceted phenomenon characterized by systemic psychological, emotional, and economic abuse that deeply undermines women's autonomy, mental health, and social functioning. Key manifestations include gaslighting, coercive control, financial restriction, and relational manipulation, which lead to severe mental health outcomes-such as anxiety, depression, and PTSD-as well as physical health deterioration and social isolation. Despite its profound impact, covert violence remains largely invisible and underrecognized due to social denial, cultural minimization, and institutional shortcomings. Barriers to disclosure and support include the absence of physical evidence, fear of retaliation, stigma, and fragmented service systems. Importantly, covert violence frequently intersects with and precedes overt physical abuse, underscoring its role in sustaining cycles of control. Addressing covert violence requires urgent legal reforms to recognize non-physical abuse, trauma-informed training for professionals, integrated support services, and public health initiatives aimed at shifting societal attitudes. CONCLUSIONS: Our analysis reveals covert violence as a widespread and deeply embedded issue sustained by structural indifference and epistemic injustice. To effectively address this problem, multi-level interventions are needed, including the legal recognition of non-physical abuse, specialized training for frontline responders, and public campaigns that challenge the normalization of covert harm. Future research should prioritize longitudinal designs, cross-cultural comparisons, and the evaluation of integrated intervention models, with particular attention to marginalized populations.
Dynamics of facial skin microbiota in female college students during menstruation: comparative analysis between regular and irregular menstrual cycles with identification of phase-specific microbiota.
Liu H, Wang J, Li F … +6 more , Yang W, Zheng Y, Yin Y, Wei Q, Hong G, Liu Z
BMC Womens Health · 2026 May · PMID 42192555 · Full text
Previous studies demonstrate that many women experience menstrual cycle-related skin symptoms during their periods. While the exacerbation of skin conditions during menstruation is well-documented, the underlying biologi...
Previous studies demonstrate that many women experience menstrual cycle-related skin symptoms during their periods. While the exacerbation of skin conditions during menstruation is well-documented, the underlying biological mechanisms remain incompletely understood. Although an association between skin microbiota and the menstrual cycle have been proposed, to gain clearer insights into this change, we finally enrolled 95 subjects and implemented one-to-one matching in the present study. Facial skin microbial samples were collected from female college students during both menstrual and intermenstrual periods, followed by 16 S rRNA gene sequencing. The facial skin microbiome shifted with menstrual cycle regularity, primarily driven by the irregular menstrual group. Proteobacteria predominated over Firmicutes, Actinobacteria, and Bacteroidetes across all samples. At the genus level, Sphingomonas, Bradyrhizobium, Streptococcus, and Corynebacterium were most abundant. However, Firmicutes and Actinobacteria increased significantly in the irregular menstrual group, with Acinetobacter, Haemophilus, Streptococcus, and Corynebacterium exhibiting peak abundance in this group. Multiclass random forest analysis distinguished irregular menstrual samples from all others, achieving an area under the curve (AUC) of 0.82 using bacterial OTUs; Aeromonas caviae (OTU_423025) and Sphingomonadaceae (OTU_4391560) were identified as the model's most important OTUs. Reduced intra-kingdom interactions were observed in subjects with irregular cycles. Notably, in the irregular menstrual group, three co-occurring OTUs including Streptococcus (OTU_523025), Gemellaceae (OTU_858896), and Staphylococcus (OTU_4345285) were lost. Furthermore, PICRUSt2 analysis predicted upregulation of genes involved in fatty acid, carbohydrate metabolism and signal transduction (e.g., K01462, K01104, K17686) and downregulation of transport (K01991) and antioxidant related genes (K00799) in the irregular menstrual cycle group. The study indicates that irregular menstruation is accompanied by alterations in the structure of the skin microbial community, with such structural changes primarily occurring during the menstrual phase. Additionally, distinctive features of the facial skin microbiota were observed in the Irregular-Menstrual group.
The mind, body, sexuality triangle in the postmenopausal period: evaluation of menopausal attitude, depression, and sexual life quality.
Şahin S, Aydın EI, Dikmen R … +1 more , Ünsal A
BMC Womens Health · 2026 May · PMID 42192511 · Full text
BACKGROUND: This study investigates the attitudes of postmenopausal women toward menopause and various related factors and assesses levels of depression and quality of sexual life. METHODS: This cross-sectional study was...
BACKGROUND: This study investigates the attitudes of postmenopausal women toward menopause and various related factors and assesses levels of depression and quality of sexual life. METHODS: This cross-sectional study was conducted between March and December 2023 in a public hospital in Turkey with a total of 160 menopausal women. Data were collected through face-to-face interviews using structured questionnaires. Menopause Attitude Assessment Scale (MAAS), Beck Depression Inventory (BDI) and Sexual Quality of Life Questionnaire were used as data collection tools. RESULTS: The study group's ages ranged from 42 to 75, with a mean age of 54.76 ± 5.42 years. Their scores on the MAAS varied from 6 to 48, averaging 26.71 ± 8.14. Women with mild menopausal symptoms tended to hold more positive attitudes toward menopause. No significant correlation was found between the BDI and the MAAS scores (r = -0.129; p = 0.104). However, a positive correlation emerged between positive menopausal attitudes and higher sexual quality of life (r = 0.287; p = 0.001). In multivariable analysis, Beck Depression Inventory scores (β = 0.285, p < 0.001) and quality of sexual life scores (β = - 0.271, p < 0.001) were found to be independently associated with MAAS scores. CONCLUSION: This study suggests that menopausal attitudes in postmenopausal women may be associated with sexual quality of life and depression levels. However, causal inferences cannot be made due to the cross-sectional design.
Use of external breast prostheses, associated factors and relationship with selected quality of life aspects among post-mastectomy women in Sri Lanka: a cross-sectional study.
Perera CD, Perera DN, Pitigala UD … +1 more , Arambepola C
BMC Womens Health · 2026 May · PMID 42192508 · Full text
BACKGROUND: Despite advancements, over 60% of women undergo mastectomy as primary treatment following breast cancer, which could impact their quality of life (QOL). In this regard, external breast prostheses (EBP) have s...
BACKGROUND: Despite advancements, over 60% of women undergo mastectomy as primary treatment following breast cancer, which could impact their quality of life (QOL). In this regard, external breast prostheses (EBP) have shown potential to improve post-mastectomy QOL globally, but the evidence is limited in South Asia. This study assessed the use of EBP, factors associated with its current use and relationship with selected aspects of QOL among post-mastectomy women in Sri Lanka. METHODS: A cross-sectional study was conducted among 158 non-metastasized post-mastectomy breast cancer patients attending outpatient clinics at the National Cancer Institute, Maharagama. Following systematic random sampling, an interviewer-administered questionnaire collected data on socio-demographic characteristics, EBP use, perceived barriers and QOL aspects. RESULTS: The response rate was 94.9%. The current EBP use was 58.9% (n = 93), which was primarily intended to mimic natural breast tissue. More than 75% of them expressed satisfaction with its application at work, social events and outdoor shopping. Higher monthly income and educational status, non-urban living, non-Buddhists, being employed and ≥ 18 months since surgery were associated with current EBP use, however, younger age (18-60 years) (adjusted odds ratio = 2.4; 95% CI: 1.2, 4.9) and being single (adjusted OR = 3.2; 95% CI: 1.1, 9.5) were the only factors significantly associated with their current EBP use after adjusting for confounders. The EBP non-users consisted of 59 (37.3%) who had never used EBP and six (3.8%) who had used previously but now discontinued. Barriers to ever use of EBP included a lack of awareness (78.0%) and accessibility (61.0%), socio-cultural inappropriateness (55.9%), and feeling embarrassed (45.8%) and stigmatised (44.1%) to use. Compared with non-users, current EBP users reported higher satisfaction with the individual QOL aspects (p<0.01). CONCLUSIONS: EBP use, driven by younger age and being single, was relatively high in post-mastectomy patients, while continued use was significantly associated with improved QOL in some critical aspects. The findings highlight the importance of incorporating informal EBP supply channels into rehabilitation programs to ensure sustainability, while concurrently addressing barriers among never/discontinued users through enhanced awareness and stigma reduction via patient-support groups.
Associations between physical activity, sleep patterns and diet quality and menstrual health symptoms in midlife: evidence from the 1970 British Cohort Study.
Abdullayev K, Mitchell JJ, Blodgett JM
BMC Womens Health · 2026 May · PMID 42192416 · Full text
BACKGROUND: Menstrual health symptoms, including painful periods, heavy bleeding, and premenstrual syndrome (PMS), are prevalent in midlife women and may be influenced by lifestyle factors. Identifying modifiable health...
BACKGROUND: Menstrual health symptoms, including painful periods, heavy bleeding, and premenstrual syndrome (PMS), are prevalent in midlife women and may be influenced by lifestyle factors. Identifying modifiable health behaviours associated with these symptoms could inform non-pharmacological interventions. This study examined the associations between diet quality, physical activity, and sleep patterns with menstrual health symptoms in midlife women using data from the 1970 British Cohort Study. METHODS: Participants (N = 2,109) were drawn from the age 46 sweep of the 1970 British Cohort Study, a birth cohort of individuals born within a single week. Dietary data was collected using the 24-hour Oxford WebQ questionnaire and a Mediterranean diet score was derived as an indicator of diet quality. Physical activity (total time and moderate-vigorous physical activity) and sleep patterns (duration, efficiency, regularity) were measured via thigh-worn accelerometers for a 7-day wear period. Quartiles were derived for each continuous exposure, with the healthiest quartile as the reference group. Binary menstrual health outcomes (heavy periods, painful periods, PMS) were self-reported. Binomial logistic regression models estimated associations between individual lifestyle factors and each menstrual symptom, adjusting for irregular menstrual bleeding, contraception use, body mass index (BMI), education, endometriosis diagnosis, smoking status and cohabiting status. RESULTS: Approximately half of participants reported experiencing painful periods (44.1%), heavy periods (51.8%) or PMS (49.5%). Participants in the lowest quartile of diet quality had reduced odds of experiencing PMS symptoms (adjusted OR: 0.75, 95% confidence interval (CI): 0.57, 0.98)). There was no significant association between total physical activity and any of the menstrual symptoms in adjusted models, however, those in the lowest quartile of moderate-vigorous physical activity had 1.35 (1.01, 1.80) times higher odds of having painful periods and 1.33 (0.99, 1.79) times higher odds of having heavy periods in adjusted models. There were no associations with PMS and any physical activity variable. Those in the lowest sleep regularity quartile had 1.43 (1.08,1.91) higher odds of experiencing painful periods, 1.34 (1.00,1.79) higher odds of heavy periods and 1.33 (1.01,1.76) higher odds of PMS in adjusted models. Lowest levels of sleep efficiency showed 1.41 (1.07,1.84) higher odds of painful periods in unadjusted models. Sleep duration was not associated with any menstrual health outcomes. CONCLUSIONS: Findings suggest that specific lifestyle behaviours, such as moderate-vigorous physical activity and sleep regularity, are associated with lower risk of painful periods, with further evidence indicating sleep regularity is also associated with heavy periods and PMS. Future research should explore potential causal relationships and intervention strategies to improve menstrual health through lifestyle modifications.
Comparison of conventional multiport laparoscopy, single-port laparoscopy, and vNOTES for the management of large adnexal masses (≥ 10 cm): a retrospective cohort study.
Gungorduk K, Biton E, Uyar BS … +4 more , Ergu BN, Ustuntas S, Karaoz F, Gulseren V
BMC Womens Health · 2026 May · PMID 42192414 · Full text
OBJECTIVE: We compared the surgical outcomes and quality of recovery of conventional multiport laparoscopy (CML), Single-port laparoscopy (SPL), and vaginal natural orifice transluminal endoscopic surgery (vNOTES) for ma...
OBJECTIVE: We compared the surgical outcomes and quality of recovery of conventional multiport laparoscopy (CML), Single-port laparoscopy (SPL), and vaginal natural orifice transluminal endoscopic surgery (vNOTES) for managing large adnexal masses. METHODS: This multicenter, retrospective cohort study included 87 patients who underwent salpingo-oophorectomy for benign adnexal masses ≥ 10 cm between January 2020 and December 2025 (CML: n = 38, SPL: n = 26, vNOTES: n = 23). The evaluated parameters included surgical timing (port setup, total operation, and specimen removal times), early postoperative pain using the Visual Analog Scale (VAS) and Faces Pain Scale Revised (FPS-R), and overall quality of recovery using the QoR-40 questionnaire at 24 h postoperatively. The secondary outcomes included cosmetic scar satisfaction and sexual function. RESULTS: CML demonstrated the shortest port setup time (2.5 ± 0.5 min) and total operation time (61.0 ± 14.7 min) among the groups. In contrast, vNOTES and SPL provided significantly faster specimen removal times than CML (6.1 ± 1.8 min and 6.6 ± 1.3 min vs. 9.3 ± 2.2 min, respectively; P < 0.001). The vNOTES group reported significantly lower VAS and FPS-R scores across all early postoperative time points (6, 12, and 24 h) and achieved the highest overall QoR-40 score (153.5 ± 9.7, P = 0.004). Multivariate logistic regression identified the vNOTES approach as the only independent predictor of excellent recovery (QoR-40 ≥ 150) (odds ratio [OR]: 1.8, 95% confidence interval [CI]: 1.1-3.1, P = 0.012). No significant differences were observed in terms of estimated blood loss, intraoperative complications, or long-term sexual function among the three groups. CONCLUSION: CML, SPL, and vNOTES are safe and effective minimally invasive approaches for large adnexal masses. While CML is the fastest overall, vNOTES appeared to offer benefits including efficient specimen extraction, reduced postoperative pain, and enhanced quality of recovery. Given the retrospective design, the modest sample size, and the patient-preference-based allocation, these findings should be considered hypothesis-generating and confirmed in adequately powered prospective studies.
Health-related quality of life among working-age women with breast cancer in Croatia: a population-referenced cross-sectional study.
Duplančić V, Bobinac A, Vončina L … +4 more , Hraste K, Vuger AT, Šeparović R, Vrdoljak E
BMC Womens Health · 2026 May · PMID 42192412 · Full text
BACKGROUND: Health-related quality of life (HRQoL) is a key outcome in breast cancer survivorship, yet population-referenced data for working-age women, a group facing distinct social and functional challenges, in Centra...
BACKGROUND: Health-related quality of life (HRQoL) is a key outcome in breast cancer survivorship, yet population-referenced data for working-age women, a group facing distinct social and functional challenges, in Central and Eastern Europe remain scarce. We aimed to quantify HRQoL among Croatian working-age women with breast cancer and to benchmark patient-reported outcomes against national female population norms. METHODS: We conducted a multicentre cross-sectional study in 2024 at two tertiary oncology centres in Croatia. Women aged 18-65 years attending outpatient breast cancer care completed the EQ-5D-5 L (dimensions, EQ-VAS and utility index) and the EORTC QLQ-BR23. EQ-5D-5 L utilities were calculated using the Slovenian value set and compared with age-stratified Croatian female population norms (2022). Group differences were analysed using appropriate non-parametric tests. RESULTS: In total, 271 women participated, with 233 included in EQ-5D-5 L analyses. Mean EQ-5D-5 L utility was substantially lower among patients than in the general female population (0.76 vs. 0.91), accompanied by lower EQ-VAS scores (66.2 vs. 84.0). Problems were most frequently reported in pain/discomfort and anxiety/depression. HRQoL declined with age (utility 0.82 to 0.70; p = 0.03) and was significantly lower in women with metastatic disease compared with non-metastatic disease (0.70 vs. 0.77; p = 0.03). Disease-specific assessment revealed pronounced impairments in future perspective and sexual functioning/enjoyment, alongside notable symptom burden related to systemic therapy side effects and arm and breast symptoms. CONCLUSION: Working-age women with breast cancer in Croatia experience clinically meaningful reductions in HRQoL compared with national population norms, with higher burden among older women and those with metastatic disease. These findings highlight substantial unmet survivorship care needs and support the integration of routine patient-reported outcome monitoring into oncology follow-up, alongside targeted symptom management, psychosocial support, rehabilitation and sexual health care.
The help-seeking experiences of adolescents and youth with endometriosis: a systematic review and thematic synthesis.
Meagher S, Frayne J, Renshaw-Todd J … +1 more , Ohan J
BMC Womens Health · 2026 May · PMID 42192401 · Full text
BACKGROUND: Obtaining a diagnosis of endometriosis is often a long and involved journey. Little specific information exists about this journey for young people. This qualitative systematic review and thematic synthesis a...
BACKGROUND: Obtaining a diagnosis of endometriosis is often a long and involved journey. Little specific information exists about this journey for young people. This qualitative systematic review and thematic synthesis aimed to describe help-seeking experiences for young people who have been diagnosed with endometriosis, with attention to their needs, priorities, and relationships. METHODS: A systematic search was conducted of MEDLINE, Embase, PsycINFO, CINAHL, SocINDEX, Google Scholar, and ProQuest Dissertations and Theses on 18/12/2024. This combined the term "endometriosis" with variants of the concept "help-seeking". Eligible articles reported the first-person perspectives of young people aged 10-24 years who were diagnosed with endometriosis. Quality assessment was conducted using the QualSyst tool. Thematic synthesis was used to construct themes. RESULTS: A total of 5,287 unique titles were assessed. 29 qualitative or mixed-methods studies (reported in 35 articles) met inclusion. Five analytical themes were generated: (1) Distinguishing 'normal' from 'abnormal' menstruation is difficult for young people, (2) Young people anticipate unhelpful responses, (3) Healthcare encounters aren't tailored to young people, (4) Invalidation has disruptive consequences, and (5) Young people need acknowledgment and resources. CONCLUSIONS: Validating relationships and age-relevant information and resources are needed to improve the help-seeking experiences of young people with endometriosis. Healthcare professionals must also ensure services are tailored to young people's life stage and concerns. TRIAL REGISTRATION: Prospero ID CRD42024575314.
Prevalence and determinants of undernutrition among lactating mothers in Jimma Town, Ethiopia: a community-based cross-sectional study using Bayesian logistic regressionmodel.
Marine BT, Haile YA, Tesfaye YZ … +3 more , Geleta EG, Ashenafi N, Zewde MG
BMC Womens Health · 2026 May · PMID 42192382 · Full text
BACKGROUND: Undernutrition among lactating mothers remains a major public health concern, particularly in low-resource settings such as Ethiopia. Adequate maternal nutrition during lactation is essential for the health a...
BACKGROUND: Undernutrition among lactating mothers remains a major public health concern, particularly in low-resource settings such as Ethiopia. Adequate maternal nutrition during lactation is essential for the health and wellbeing of both mothers and their children. Bayesian logistic regression was employed in this study because it provides robust parameter estimation under uncertainty and allows the incorporation of prior information. This study aimed to assess the prevalence of undernutrition and identify its associated factors among lactating mothers in Jimma Town, Oromia Region, Ethiopia. METHODS: A community-based cross-sectional study was conducted from March 20 to April 25, 2024, among lactating mothers residing in Jimma Town. A total of 423 participants were selected using systematic random sampling. Data were collected using a pretested interviewer-administered questionnaire. Data were entered into EpiData version 3.1 and analyzed using R software. Bayesian logistic regression was implemented using Markov Chain Monte Carlo simulation, and posterior adjusted odds ratios (AORs) with 95% credible intervals (CrIs) were estimated to identify factors associated with undernutrition. RESULTS: The prevalence of undernutrition among lactating mothers was 21.5% (95% CrI: 17.6%-25.4%). Factors associated with higher odds of undernutrition included low dietary diversity (OR = 2.62, 95% CrI: 1.37-4.60), maternal age 15-25 years (OR = 4.33, 95% CrI: 2.85-6.38), meal frequency fewer than three times per day (OR = 5.44, 95% CrI: 3.67-7.96), and practicing food taboos (OR = 6.39, 95% CrI: 4.32-9.39). Protective factors included maternal employment (OR = 0.42, 95% CrI: 0.21-0.76), monthly income ≥ 6000 ETB (OR = 0.12, 95% CrI: 0.05-0.24), family size fewer than five members (OR = 0.47, 95% CrI: 0.29-0.70), receiving nutritional counseling (OR = 0.59, 95% CrI: 0.30-0.99), attending antenatal care visits (OR = 0.27, 95% CrI: 0.12-0.53), birth interval of at least two years (OR = 0.02, 95% CrI: 0.003-0.07), and breastfeeding frequency fewer than six times per day (OR = 0.03, 95% CrI: 0.008-0.055). These extreme protective estimates should be interpreted cautiously due to the cross-sectional study design and the potential influence of sparse data or residual confounding. CONCLUSION: Nearly one in every five lactating mothers in Jimma Town is undernourished. Undernutrition was significantly associated with multiple factors, including the mother's age, family size, employment status, monthly income, dietary diversity, nutritional counseling, breastfeeding frequency, birth interval, antenatal care visits, frequency of meals, and the practice of food taboos. These findings highlight the urgent need for comprehensive, targeted nutrition interventions and educational programs that address not only dietary habits but also broader determinants such as family planning, maternal education, economic empowerment, and access to health services.
Glycolytic reprogramming in endometriosis: molecular mechanisms, immune modulation, and non-hormonal therapeutic opportunities.
Guo L, Liu L, Geng Y … +2 more , Zhang B, Zhao S
BMC Womens Health · 2026 May · PMID 42186039 · Full text
Endometriosis is a chronic gynecological disorder characterized by ectopic tissue growth and significant morbidity, yet current hormonal and surgical treatments often fail to prevent recurrence or entail severe side effe...
Endometriosis is a chronic gynecological disorder characterized by ectopic tissue growth and significant morbidity, yet current hormonal and surgical treatments often fail to prevent recurrence or entail severe side effects. Increasing evidence highlights metabolic reprogramming, specifically aerobic glycolysis (the Warburg effect), as a fundamental driver of endometriotic lesion pathogenesis. This narrative review synthesizes current research on the regulatory mechanisms and therapeutic potential of targeting glycolytic dysregulation in endometriosis. We examine the aberrant upregulation of rate-limiting enzymes, including hexokinase 2 (HK2), 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3), and pyruvate kinase M2 (PKM2), driven by signaling axes such as ALKBH5-HK2, PAK5-PKM2, and S1PR4/mTOR. The review further elucidates how enhanced glycolytic flux and lactate accumulation promote cell proliferation, invasion, and epithelial-mesenchymal transition (EMT) while orchestrating an immunosuppressive microenvironment via M2 macrophage polarization and histone lactylation. Furthermore, we evaluate emerging non-hormonal therapeutic strategies, including specific glycolysis inhibitors and natural compounds, and discuss the utility of immune-metabolic gene signatures for non-invasive diagnosis. Highlighting these metabolic vulnerabilities offers promising avenues for precision medicine to improve clinical management and patient outcomes in endometriosis.
Clinical and diagnostic evaluation of flank pain in female patients: a retrospective cohort study of 3350 patients.
Baba D, Çalışkan A, Balık AY … +2 more , Başaran E, Taşkıran AT
BMC Womens Health · 2026 May · PMID 42186022 · Full text
BACKGROUND/OBJECTIVES: This study aimed to determine the distribution of confirmed urological diagnoses in female patients presenting with flank pain and to evaluate the diagnostic performance of clinical, laboratory, an...
BACKGROUND/OBJECTIVES: This study aimed to determine the distribution of confirmed urological diagnoses in female patients presenting with flank pain and to evaluate the diagnostic performance of clinical, laboratory, and imaging parameters in identifying urological pathology. METHODS: This retrospective cohort study included 3350 female patients (18-65 years) who presented with flank pain at the urology outpatient clinic of Düzce University Hospital between January 2020 and September 2024. Patients were categorized into two groups based on the presence (Group 1, n = 1831) or absence (Group 2, n = 1519) of a confirmed urological diagnosis. Serum creatinine, urinary white blood cells (WBCs), urinary red blood cells (RBCs), and clinical and imaging findings were analyzed. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed to assess diagnostic performance. RESULTS: A confirmed urological diagnosis was identified in 54.7% of patients, with urinary tract infection (27.8%) and urolithiasis (19.8%) being the most frequently documented conditions. Urinary WBC levels demonstrated higher diagnostic performance than serum creatinine (AUC: 0.82 vs. 0.76). In multivariable analysis excluding imaging-derived variables, urinary WBC levels (OR: 3.12, 95% CI: 2.64-3.68, p = 0.01) and serum creatinine (OR: 2.08, 95% CI: 1.72-2.51, p = 0.03) were significantly associated with confirmed urological diagnoses. Combined models incorporating laboratory and clinical parameters showed improved discriminative performance (AUC up to 0.86). Imaging findings, including hydronephrosis and urinary stones, were more frequently observed in patients with confirmed urological diagnoses (p = 0.01). CONCLUSIONS: Urological conditions constitute a substantial proportion of flank pain presentations in female patients evaluated in a urology outpatient setting. While laboratory and imaging findings provide useful diagnostic information, no single parameter alone is sufficient for accurate differentiation, and a combined clinical and diagnostic approach is required.
Impact of prehabilitation on quality of life and mental health in patients awaiting cytoreductive surgery for ovarian cancer or suspected adnexal tumors.
Zębalski MA, Szostek P, Szpiech J … +2 more , Krzywon A, Nowosielski K
BMC Womens Health · 2026 May · PMID 42185882 · Full text
BACKGROUND: Preoperative psychological distress and impaired quality of life are common in patients awaiting surgery for ovarian cancer or adnexal masses. We aimed to assess whether a multimodal prehabilitation program i...
BACKGROUND: Preoperative psychological distress and impaired quality of life are common in patients awaiting surgery for ovarian cancer or adnexal masses. We aimed to assess whether a multimodal prehabilitation program including physical exercise, nutritional support, and psychological counseling could improve quality of life and reduce anxiety and depression prior to surgery. METHODS: In this prospective single-centre study, 145 patients were enrolled from May 2021 to May 2024 at a gynecologic oncology centre in Katowice, Poland. Baseline and post-intervention assessments included the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Hospital Anxiety and Depression Scale (HADS). The prehabilitation program lasted on average 21.1 ± 16.7 days and combined physical exercise, nutritional support, and psychological counseling. RESULTS: After completion of prehabilitation, global health status/quality of life scores improved modestly but significantly (mean change ~2.5 points; p = 0.045). Mean HADS scores declined for anxiety (p = 0.003) and for depression (p = 0.028), indicating reductions in psychological distress. CONCLUSIONS: Participation in a structured prehabilitation program was associated with improvements in overall quality of life and reductions in anxiety and depression in women awaiting gynecologic oncologic surgery, although the magnitude of these changes was modest. Notably, these improvements were observed despite the substantial psychological burden typically experienced during the preoperative period. These findings support incorporation of prehabilitation into standard preoperative care to better prepare patients both physically and mentally.
The lived experiences of female only-child caregivers in transnational settings.
Dang Z, Basch CE
BMC Womens Health · 2026 May · PMID 42185864 · Full text
BACKGROUND: China's One-Child Policy created only-child daughters solely responsible for aging parents. For those abroad, caregiving is further complicated by distance, immigration rules, and cultural expectations. Littl...
BACKGROUND: China's One-Child Policy created only-child daughters solely responsible for aging parents. For those abroad, caregiving is further complicated by distance, immigration rules, and cultural expectations. Little is known about how these women manage cross-border caregiving. OBJECTIVES: This study examines the experiences of only-child Chinese daughters in the United States as they care for aging parents across borders. METHODS: Guided by the Meaning-Making Model, we conducted semi-structured interviews with 60 married, only-child daughters aged 30-45. Each had provided remote care for at least one year. Data were analyzed using reflexive thematic analysis. RESULTS: Three central findings emerged. First, caregivers redefined what it means to be present, capable, and filial, compensating for physical distance with increased attentiveness, emotional availability, and reciprocal support. Second, these women experienced and managed conflicting emotions, balancing their personal goals with deeply held filial expectations. Third, uncertainty and anticipatory grief strongly influenced their decisions on traveling, career advancement, citizenship choices, and care arrangements, highlighting how planning for future needs is an ongoing, emotionally charged process. CONCLUSIONS: Transnational caregiving among only-child Chinese daughters is both emotionally complex and shaped by cultural expectations. This study introduces anticipatory caregiving to describe the future-oriented emotional and logistical work that defines long-distance care. These insights show that transnational caregiving is not just a set of tasks. It is a unique psychological and cultural experience that demands new, tailored support.
Self-reported physical activity intensity and training volume are not related to menstrual health among recreationally active Swiss females.
Kubica C, Zimmermann S, Nigg CR
BMC Womens Health · 2026 May · PMID 42178530 · Full text
BACKGROUND: Menstrual cycle (MC) symptoms and disorders are common among females, with higher prevalence rates observed in competitive athletes. However, many women are physically active at recreational levels and might...
BACKGROUND: Menstrual cycle (MC) symptoms and disorders are common among females, with higher prevalence rates observed in competitive athletes. However, many women are physically active at recreational levels and might be also affected by MC health issues. To date, little is known about how physical activity intensity and training volume impact MC health in this broader, under-researched group. Therefore, this study aimed to analyze the association of physical activity and menstrual health among active Swiss females of reproductive age. METHODS: Between May and June 2023, we conducted a cross-sectional online survey among females (≥ 18 years) who were neither pregnant nor using hormonal contraceptives. Self-reported data on MC health, including premenstrual syndrome (PMS), oligomenorrhea, and secondary amenorrhea, were collected. Binary logistic regressions were used to assess the associations between leisure-time physical activity, overall training volume, and MC health. RESULTS: A total of 719 females were included (mean age = 29.2 ± 8.2 years; BMI = 22.5 ± 3 kg/m; moderate to vigorous physical activity = 367 ± 296 min/week; mean training volume = 4.8 ± 4 h/week; average MC length = 29.4 ± 8.9 days). The prevalence rates were 15.9% for PMS, 17.8% for oligomenorrhea, and 2.9% for secondary amenorrhea. No associations of physical activity and training volume were observed for PMS and secondary amenorrhea. Higher levels of light physical activity were associated with a greater prevalence of oligomenorrhea (OR = 1.028, 95% CI: 1.005 - 1.053). The association was small in magnitude and model fit (R < 0.2). CONCLUSION: Our findings suggest no clinically relevant association between MC health and physical activity as well as training volume in recreationally active females. Longitudinal research is needed to verify these results and inform guidelines to support menstrual health among active females.
Health outcomes of victim-survivors accessing specialist domestic abuse services: the role of abuse experience, vulnerabilities and sociodemographic characteristics.
Bunce A, Davies E, Barbosa EC
BMC Womens Health · 2026 May · PMID 42177560 · Full text
BACKGROUND: Domestic abuse (DA) is a public health problem with wide-ranging impacts for victim-survivors and services responding to it. The purpose of the current study was to explore relationships between victim-surviv...
BACKGROUND: Domestic abuse (DA) is a public health problem with wide-ranging impacts for victim-survivors and services responding to it. The purpose of the current study was to explore relationships between victim-survivors' experiences of abuse, additional needs/vulnerabilities and sociodemographic characteristics, and physical and mental health outcomes and health care help-seeking behaviours following DA. METHODS: Secondary analysis was conducted using Women's Aid Federation of England's (Women's Aid) case management and outcomes measurement system, On Track, the largest national dataset on DA. To understand the relationship between abuse types (physical, sexual, emotional, financial, coercive control, technology-facilitated abuse (tech abuse) and threats to kill), needs/vulnerabilities (disability; offending, drug and alcohol-related support needs; pregnancy, recourse to public funds and accessing by-and-for services) and health outcomes (perpetrator caused harm to or loss of unborn child, attempted strangulation, self-harm (disclosed), feeling depressed or suicidal, injury requiring GP treatment and injury requiring Accident and Emergency (A&E) treatment), we used a series of logistic regression models, controlling for potentially confounding variables (including accommodation status, sexual orientation and ethnicity). Stakeholders from Women's Aid and five other third sector organisations input into the study design and interpretation of results. RESULTS: Ninety-six percent of victim-survivors accessing DA services (n = 77,785) were female. Almost half (41.24%) had felt depressed/suicidal, while 5.59% disclosed having self-harmed. Almost one quarter (23.41%) had suffered a strangulation attempt, and 2.54% had suffered harm to or loss of their unborn child caused by the perpetrator. Just under 10% had an injury requiring A&E treatment and slightly less (7.33%) had an injury requiring GP treatment. Associations with the type of abuse varied by health outcome, for example physical abuse followed by threats to kill were most strongly associated with attempted strangulation and injuries requiring GP and A&E treatment, whilst tech abuse was most strongly associated with self-harm and feeling depressed/suicidal. Vulnerabilities/needs were more consistently associated with health outcomes, with those with a disability; drug, alcohol or offending support needs, or living in temporary/unstable accommodation more likely to experience negative outcomes across the board, and almost all needs/vulnerabilities being associated with adverse mental health outcomes (with the exception of pregnancy and accessing specialist by-and-for services, which appeared to have a protective effect). CONCLUSIONS: Our findings highlight the almost inevitable harms to mental health for victim-survivors of DA, the dangers of non-physical types of abuse such as threats to kill and tech abuse and the heightened risk of attempted strangulation. These findings have particularly important and timely implications for the training of health care professionals. Alongside improvements in health care settings, health care professionals, specialist support workers, researchers and policymakers must continue to explore more integrative and collaborative ways of working to further improve the response to DA and intervene before irreversible damage is done.
Effects of centralized multidisciplinary surgical endometriosis care: a retrospective 3-year follow-up cohort study.
Koivurova S, Makelä-Kaikkonen J, Laru J … +5 more , Ohtonen P, Uimari O, Niinimäki M, Rautio T, Terho A
BMC Womens Health · 2026 May · PMID 42177522 · Full text
BACKGROUND: We aimed to study the impact of centralizing surgical endometriosis care, including possible improvements in patient outcome. METHODS: This study is a single tertiary centre retrospective cohort study with a...
BACKGROUND: We aimed to study the impact of centralizing surgical endometriosis care, including possible improvements in patient outcome. METHODS: This study is a single tertiary centre retrospective cohort study with a 3-year postoperative follow-up conducted at the University hospital district of Oulu, Finland. The cohorts consisted of 215 women operated before centralization (January 2013 - June 2016) and 246 women operated after centralization (July 2016 - December 2019). Background, intraoperative and postoperative 3-year data were collected from hospital records. NRS and EHP-30 questionnaires were sent to patients to study long-term patient outcome. Comparisons were made between the two time periods. Main outcome measures were rates of referrals from secondary to tertiary level hospital, changes in diagnostics, implementation of multidisciplinary approach and patient access to specialized endometriosis care. Data were analysed via SPSS version 28.0 using independent samples t-test or Mann-Whitney U-test and Chi-squared test or Fisher's exact test. Multivariable adjusted models were used to control for possible confounding factors when comparing the two time periods. RESULTS: After centralization, referrals from secondary level hospitals tripled (4.6% vs. 12.6%, p = 0.003). Preoperative endometriosis diagnosis using MRI increased (24.2% vs. 48.8%, p < 0.001) and complex surgery was more often planned and performed by a multidisciplinary team (3.3% vs. 18.3%, p < 0.001; 8.8% vs. 18.4%, p = 0.008). A slight non-significant reduction in complication risk was detected after centralization (aOR 0.95, 95% CI 0.50-1.78). Hormonal treatment was more common pre- and postoperatively (35.8% vs. 52.7%, p = 0.002; 47.9% vs. 69.9%, p < 0.001). Postoperative follow-up at tertiary level hospital was longer (8.2 mo vs. 12.2 mo, p = 0.002). CONCLUSIONS: Centralization of endometriosis surgery was achieved in terms of increased number of referrals. Multidisciplinary approach was implemented more often in diagnostics, preoperative counselling and surgery. Preoperative and postoperative hormonal treatments were conducted more thoroughly. Postoperative specialized care surveillance was increased after centralization allowing chronically symptomatic patients a better access to an individualized treatment plan.
Diagnostic performance of systemic inflammatory and nutritional indices and their association with clinicopathological features in endometrial cancer: a retrospective study.
Gül Aydın Ş, Yüksek Ş, Güzel M … +2 more , Çopuroğlu M, Toyganözü HC
BMC Womens Health · 2026 May · PMID 42177465 · Full text
BACKGROUND: Systemic inflammatory and nutritional indices derived from routine blood tests have been widely investigated as prognostic markers; however, their diagnostic value in differentiating benign endometrial diseas...
BACKGROUND: Systemic inflammatory and nutritional indices derived from routine blood tests have been widely investigated as prognostic markers; however, their diagnostic value in differentiating benign endometrial disease from endometrial cancer (EC) remains insufficiently defined. This study aimed to evaluate the diagnostic performance of inflammatory and nutritional indices and to explore their associations with clinicopathological features in EC. METHODS: This retrospective observational study included 270 patients who underwent surgical evaluation for endometrial pathology. The cohort comprised 135 patients with histopathologically confirmed endometrial cancer and 135 patients with benign endometrial conditions. Preoperative inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and prognostic nutritional index (PNI), were calculated. Clinicopathological characteristics and immunohistochemical findings were recorded. Multivariable logistic regression analysis was performed to identify independent predictors of malignancy. RESULTS: All inflammatory indices and PNI were significantly higher in the malignant group (all p < 0.001). In multivariable analysis, age, body mass index, haemoglobin level, SII (OR = 1.004, 95% CI 1.001-1.007; p = 0.018), and PNI (OR = 1.380, 95% CI 1.228-1.550; p < 0.001) emerged as independent predictors of malignancy. Receiver operating characteristic (ROC) analysis showed that PNI had limited discriminative ability (area under the curve [AUC] = 0.620, 95% CI 0.554-0.687), with a cut-off value of 52.0 (sensitivity 69.6%, specificity 50.4%). Within the malignant cohort, lower PNI values were significantly associated with adverse clinicopathological features, including deep myometrial invasion, cervical stromal invasion, lymph node metastasis, higher tumour grade, serous histology, and abnormal p53 expression. CONCLUSIONS: Systemic inflammatory and nutritional indices may provide complementary information in the evaluation of endometrial pathology. While SII appears to be associated with malignancy risk, PNI primarily reflects tumour aggressiveness rather than diagnostic discrimination. These readily available biomarkers may support preoperative risk stratification, particularly in patients with inconclusive imaging or biopsy results, where additional risk stratification may help guide the urgency or extent of surgical planning; however, further prospective studies are required to confirm their clinical utility.
Causal effects of oral microbiome traits on female reproductive diseases: a two-sample Mendelian randomization study.
Xing X, Meng W, Chen W … +3 more , Shi X, Wei D, Lu Q
BMC Womens Health · 2026 May · PMID 42174554 · Full text
OBJECTIVE: Female reproductive diseases (FRDs) impose a substantial health burden. Observational studies suggest links between oral dysbiosis and systemic conditions, but whether oral microbial traits causally influence...
OBJECTIVE: Female reproductive diseases (FRDs) impose a substantial health burden. Observational studies suggest links between oral dysbiosis and systemic conditions, but whether oral microbial traits causally influence FRDs remains unclear. We used two-sample Mendelian randomization (MR) to evaluate potential causal effects of genetically predicted oral microbiome traits on FRDs. METHODS: Genome-wide association study (GWAS) summary statistics for 44 salivary microbial traits were obtained from a publicly available oral microbiome GWAS based on the Danish ADDITION-PRO cohort (16 S rRNA profiling; European ancestry; n = 610). Outcome GWAS summary statistics for six FRDs were obtained from FinnGen (R12). The inverse-variance weighted (IVW) method was the primary analysis, complemented by MR-Egger, weighted median, and weighted mode. Sensitivity analyses included Cochran's Q, MR-Egger intercept, MR-PRESSO, leave-one-out, and Steiger directionality tests. Multiple testing for primary IVW analyses was addressed using Benjamini-Hochberg false discovery rate (FDR) correction. RESULTS: In primary IVW analyses, several oral taxa showed nominal associations (P < 0.05) with uterine leiomyoma (class Bacilli: OR = 1.0303, 95% CI 1.0012-1.0602; genus Veillonella: OR = 1.0291, 95% CI 1.0075-1.0512) and tubal infertility (family Veillonellaceae: OR = 0.8640, 95% CI 0.7824-0.9541; genus Veillonella: OR = 0.8900, 95% CI 0.8167-0.9699). However, none of these associations remained statistically significant after Benjamini-Hochberg FDR correction for the primary IVW analyses (all q > 0.05). In sensitivity analyses, MR-PRESSO outlier correction suggested a nominal association between Rothia mucilaginosa and uterine leiomyoma (OR = 1.0228, 95% CI 1.0069-1.0391; P = 0.0202). Overall, sensitivity analyses and Steiger directionality tests did not indicate that the main signals were driven by strong directional pleiotropy or reverse causation. CONCLUSION: This two-sample MR study provides suggestive, exploratory genetic evidence that specific oral microbiome traits may be linked to uterine leiomyoma and tubal infertility, but the evidence did not remain statistically significant after multiple-testing correction. Larger oral microbiome GWAS, independent outcome datasets, and functional studies are needed to validate these signals and clarify biological mechanisms.
Belonging to self: Flint women meeting needs, securing safety and finding voice.
Hailemariam M, Bustos TE, Ataro B … +9 more , Nguyen C, Jefferson BL, Saddler S, Spencer B, Miller R, Richie F, Brown G, White JM, Johnson JE
BMC Womens Health · 2026 May · PMID 42174547 · Full text
BACKGROUND: Belonging is a fundamental human need that influences health and well-being. Women's ability to belong to themselves is affected by structural disinvestment, environmental injustice, poverty and chronic preca...
BACKGROUND: Belonging is a fundamental human need that influences health and well-being. Women's ability to belong to themselves is affected by structural disinvestment, environmental injustice, poverty and chronic precarity. Guided by the belongingness framework, this study explores solutions of women in the Flint area to increase "belonging to self," which encompasses basic needs, services, safety and autonomy. METHODS: Using a community-based participatory research approach, we interviewed 100 women and community representatives. In-depth interviews (Fall 2017-Spring 2018) explored strengths, needs, aspirations, and solutions. A team of community-academic pairs analyzed the data. RESULTS: Four interrelated themes emerged: Basic Needs, Services, Safety, and Autonomy. (1) Basic Needs included gaps in food, water, and housing, disproportionately affecting women with mental health or substance use challenges, domestic violence survivors, and pregnant women. (2) Services revealed deficits in childcare, maternal support, education, employment, healthcare, and transportation, often compounded by distrust and bureaucratic barriers. (3) Safety encompassed physical and emotional vulnerabilities limiting daily life. (4) Autonomy reflected the interplay of personal agency, relational dynamics, and structural constraints. Across themes, participants proposed community-rooted, trauma-informed solutions-including 24-hour childcare, mentorship, community gardens, skill-building, and peer support-to enhance well-being, equity, and women's ability to belong to themselves. CONCLUSION: Complex and interconnected factors shape women's experiences of belonging to oneself. Themes of basic needs, access to services, safety, and autonomy can frame pathways to health and wellbeing for women in challenging contexts. Despite limited access to opportunity, women shared collective strategies for survival, support, and reimagining their futures.
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