BMC Women's Health[JOURNAL]
Sun
200 papers
Transition experiences of female youth leaving youth shelters: a descriptive phenomenological study.
Kim G, Kim E, Park J … +1 more , Noh D
BMC Womens Health · 2026 May · PMID 42169112 · Full text
BACKGROUND: Youths living in alternative care facilities in Korea must leave the facilities by the age of 18 or 25 years at the latest. They often face significant financial and psychological difficulties in securing sta...
BACKGROUND: Youths living in alternative care facilities in Korea must leave the facilities by the age of 18 or 25 years at the latest. They often face significant financial and psychological difficulties in securing stable housing and employment as they transition from out-of-home care to independence. This study aimed to explore the transition experiences of female youth after leaving youth shelters. METHODS: A descriptive phenomenological approach was used, and in-depth interviews were conducted with 10 female youth who had left youth shelters. The analysis yielded 18 formulated meanings, six theme clusters, and three overarching themes. RESULTS: Participants experienced significant financial and psychological challenges after leaving the shelters. Over time, however, they gradually overcame these difficulties by actively seeking support from organizations, accepting their circumstances, and developing improved impulse control and self-care. Ultimately, they expressed aspirations for a stable life, a normal family, and personal growth. CONCLUSIONS: The findings suggest the need for targeted programs focused on vocational training, financial education, and phased settlement allowances, with an emphasis on job placement services and financial literacy. Transitional housing should be located near previous shelters to preserve support networks. Gender-responsive policies are needed to address safety concerns by improving access to secure living environments. Aftercare services, including case management, mentoring, and long-term psychological support, are essential to address ongoing needs and past traumas.
Clinicopathological characteristics and prognostic analysis of synchronous endometrioid endometrial and ovarian carcinomas: a retrospective cohort study.
Bai Y, Li Q, Zhang S … +4 more , Wang W, Yao Q, Ji X, Zheng H
BMC Womens Health · 2026 May · PMID 42169062 · Full text
BACKGROUND: Synchronous endometrioid endometrial and ovarian carcinomas (SEEOCs) represent a small yet clinically significant entity of gynecological malignancies. Their clinicopathological correlations, immunohistochemi...
BACKGROUND: Synchronous endometrioid endometrial and ovarian carcinomas (SEEOCs) represent a small yet clinically significant entity of gynecological malignancies. Their clinicopathological correlations, immunohistochemical profiles, and prognosis have not been well established. METHODS: We conducted a retrospective analysis of 50 SEEOC cases identified among 1160 patients with endometrioid endometrial carcinoma at a single institution. Clinicopathological parameters, including immunohistochemical profiles, were evaluated. Progression-free survival (PFS) was analyzed, with Kaplan-Meier analysis performed to identify significant prognostic factors. RESULTS: Deficient mismatch repair (dMMR) was detected in 36.1% of SEEOC cases and mutant p53 expression in 13.2%. PD-L1 (22C3) positivity was observed in 63.0% cases, and HER2 expression in 75.0%. Factors associated with worse PFS included poor tumor differentiation, > 50% myometrial invasion, lymphovascular space invasion (LVSI), lymph node metastasis, and advanced 2023 FIGO stage. Kaplan-Meier pairwise comparisons revealed that patients with focal LVSI had a PFS comparable to that of patients with substantial LVSI. Five patients were classified as FIGO IA3 stage. All patients at IA3 stage were premenopausal, showed no MELF (microcystic, elongated, and fragmented) invasion pattern, and none had recurrence. CONCLUSIONS: These findings support the prognostic significance of poor tumor differentiation, > 50% myometrial invasion, LVSI, lymph node metastasis, and 2023 FIGO staging system in SEEOCs. The high rates of dMMR, HER2, and PD-L1 positivity in SEEOCs suggest potential for targeted therapies in future therapeutic strategies.
Development and validation of a nomogram for predicting the likelihood of undergoing surgical intervention in ruptured corpus luteum.
Chen L, Liang F, Xu W … +2 more , Zhao S, Zhong X
BMC Womens Health · 2026 May · PMID 42169045 · Full text
OBJECTIVE: To investigate clinical factors associated with surgical intervention in patients with ruptured corpus luteum (CL) and to develop a prediction model for estimating the likelihood of undergoing surgical interve...
OBJECTIVE: To investigate clinical factors associated with surgical intervention in patients with ruptured corpus luteum (CL) and to develop a prediction model for estimating the likelihood of undergoing surgical intervention. METHODS: This retrospective study enrolled 341 patients with ruptured CL, who were allocated to surgical (n = 106) or conservative (n = 235) group. Baseline demographic, laboratory, and imaging data were collected and compared. Multivariable logistic regression analysis was employed to identify independently associated factors, which were subsequently used to develop a nomogram prediction model. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) for discriminative ability, calibration curves for accuracy, and decision curve analysis (DCA) for clinical utility. RESULTS: Abdominal rebound tenderness (OR = 1.363, 95% CI: 1.078-1.724), lower admission hemoglobin level (OR = 0.891, 95% CI: 0.862-0.921), longer prothrombin time (OR = 1.445, 95% CI: 1.019-2.048), larger maximum CL cyst diameter (OR = 2.340, 95% CI: 1.821-3.006), and greater pelvic fluid depth (OR = 1.482, 95% CI: 1.154-1.903) were independent factors associated with undergoing surgical intervention. The nomogram demonstrated good discriminative ability (AUC = 0.884, 95% CI: 0.847-0.921), with a bias-corrected AUC of 0.876 after Bootstrap validation. The calibration curve indicated good agreement between predicted probabilities and actual observations. DCA showed a favorable net clinical benefit across a wide range of threshold probabilities. CONCLUSION: This study developed a nomogram incorporating five independent predictors: abdominal rebound tenderness, admission hemoglobin, prothrombin time, maximum corpus luteum cyst diameter, and pelvic fluid depth. Although internal validation demonstrated good discrimination (AUC = 0.884) and potential clinical utility, inherent treatment-selection bias renders this model strictly exploratory. Pending prospective external validation, it serves merely as a preliminary decision-support reference.
Effectiveness of pain neuroscience education in women with dysmenorrhea: controlled clinical trial.
Inkaya Ç, Çoban O
BMC Womens Health · 2026 May · PMID 42169005 · Full text
BACKGROUND: Dysmenorrhea is a highly prevalent gynecological condition that negatively affects menstrual pain experience, daily activities, and overall quality of life. Pain neuroscience education (PNE) is a non-pharmaco...
BACKGROUND: Dysmenorrhea is a highly prevalent gynecological condition that negatively affects menstrual pain experience, daily activities, and overall quality of life. Pain neuroscience education (PNE) is a non-pharmacological intervention designed to reshape maladaptive pain beliefs and promote a more adaptive understanding of pain mechanisms. This study aimed to examine the effects of PNE on pain beliefs, menstrual pain intensity, and the functional impact of dysmenorrhea among women reporting symptoms consistent with primary dysmenorrhea. METHODS: This prospective controlled clinical trial included 74 women aged ≥18 years who reported dysmenorrhea symptoms consistent with primary dysmenorrhea. Participants were allocated consecutively to either a PNE group (n = 37) or a control group (n = 37). The PNE group received three weekly online educational sessions, whereas the control group continued their routine activities without intervention. The primary outcomes were pain intensity assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ) and pain-related beliefs assessed using the Pain Beliefs Questionnaire (PBQ). The secondary exploratory outcome was functional impact assessed using the Scale for Assessing the Impact of Dysmenorrhea on Daily Life (SAIDDL). All outcomes were collected using standardized self-reported online questionnaires before the intervention and during the first menstrual cycle following the intervention. RESULTS: Compared with the control group, the PNE group showed greater reductions in sensory, affective, and total pain scores on the SF-MPQ. The PNE group also demonstrated greater improvement in psychological pain beliefs, while total PBQ findings were more modest and should be interpreted cautiously. Greater improvement in functional impact was also observed in the PNE group, as reflected by lower SAIDDL scores. CONCLUSION: PNE was associated with short-term improvements in self-reported pain intensity, psychological pain beliefs, and daily functioning in women with dysmenorrhea. These findings suggest that PNE may represent a promising complementary non-pharmacological approach. Future studies with randomized designs, larger samples, and longer follow-up periods are needed to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov NCT06732778, Registration date: September 12, 2024.
The Effect of Stress Urinary Incontinence on Kinesiophobia in Postmenopausal Women with Osteoporosis: A Cross-Sectional Study.
Oba P, Polat M
BMC Womens Health · 2026 May · PMID 42163274 · Full text
BACKGROUND: This study aimed to examine whether stress urinary incontinence (SUI) was associated with kinesiophobia in women with postmenopausal osteoporosis. METHODS: This cross-sectional study included 83 women diagnos...
BACKGROUND: This study aimed to examine whether stress urinary incontinence (SUI) was associated with kinesiophobia in women with postmenopausal osteoporosis. METHODS: This cross-sectional study included 83 women diagnosed with postmenopausal osteoporosis, including those with SUI (n = 47) and those without (n = 36). Participants' kinesiophobia level was evaluated using the Tampa Scale of Kinesiophobia (TSK), and their mood was assessed using the Hospital Anxiety and Depression Scale (HADS), which includes two subscales: the HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D). SUI severity was evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and the effect of SUI on quality of life was assessed via the Incontinence Quality of Life Scale (I-QOL). Independent-samples t-tests were used for between-group comparisons, Pearson correlation analyses were used to assess associations between variables, and hierarchical and multiple linear regression analyses were conducted. RESULTS: The groups are similar in age, bone mineral density, and HADS-A scores. The HADS-D (p = 0.004) and TSK (p = 0.032) scores are higher in the SUI group. A positive correlation is found between the ICIQ-SF and TSK scores (r = 0.59, p < 0.001). According to hierarchical multiple linear regression analysis, adding the SUI as variable to the model further increased the explained variance in the TSK score by 7.3% (p = 0.008). The ICIQ-SF score was associated with the TSK score (B = 0.52, p < 0.001). CONCLUSIONS: These findings support considering SUI as one of several clinically relevant factors in the evaluation of postmenopausal osteoporosis, particularly in relation to kinesiophobia and comprehensive patient assessment.
Relationship between childhood adversity and premenstrual syndrome: mediating role of alexithymia and psychological distress in medical students.
Kahriz MA, Bahri N, Kianimoghadam AS … +2 more , Arani AM, Riazi H
BMC Womens Health · 2026 May · PMID 42163214 · Full text
OBJECTIVE: This study was conducted to identify the psychological factors that predict the severity of Premenstrual Syndrome (PMS) among young women in 2025. METHODS: In this cross-sectional study, researchers selected 6...
OBJECTIVE: This study was conducted to identify the psychological factors that predict the severity of Premenstrual Syndrome (PMS) among young women in 2025. METHODS: In this cross-sectional study, researchers selected 673 female medical students through convenience sampling. They collected data using the Childhood Trauma Questionnaire (CTQ), the Premenstrual Symptoms Screening Tool (PSST), the Toronto Alexithymia Scale (TAS-20), the Kessler Psychological Distress Scale (K10), and a demographic questionnaire. They analyzed the data using Structural Equation Modeling (SEM) in Amos and SPSS (Version 26). RESULTS: The SEM model showed a good fit. PMS severity had significant positive relationships with psychological distress (B = 0.64, p < 0.001), childhood adversity (B = 0.262, p < 0.01), and alexithymia (B = 0.35, p < 0.001). A moderate positive correlation existed between alexithymia and PMS severity (r = 0.409, p = 0.01). CONCLUSION: Childhood adversity, alexithymia, and psychological distress significantly predict PMS severity. These findings highlight the importance of a biopsychosocial approach. We suggest that doctors, especially gynecologists, should consider these psychological factors when assessing and treating patients with PMS.
Medicine and motherhood: a cross-sectional survey of the experiences of women doctors in the Republic of Ireland.
Biju S, Madden C, O'Connor P … +7 more , Byrne D, Humphries N, Fitzgibbon S, Finnegan J, O'Donoghue K, Jeffrey G, Lydon S
BMC Womens Health · 2026 May · PMID 42163205 · Full text
BACKGROUND: Women doctors may face challenges in their pursuit of motherhood, including a higher likelihood of delayed childbearing and infertility. The psychological and financial sequelae of their experiences around fe...
BACKGROUND: Women doctors may face challenges in their pursuit of motherhood, including a higher likelihood of delayed childbearing and infertility. The psychological and financial sequelae of their experiences around fertility, pregnancy, and motherhood have the potential to impact both the individual doctor and healthcare systems. However, most research on these topics is focused on North America. Given differences in medical training and healthcare systems, laws, and cultures across regions, this study sought to examine women doctors' experiences of fertility, family planning, pregnancy, and motherhood in an EU Member State, the Republic of Ireland (ROI). METHODS: A cross-sectional survey of women doctors working in any speciality in the ROI who were either pregnant, had one or more children in the previous 18 years, or had experienced infertility and/or accessed fertility treatments, was conducted. Women doctors answered questions regarding fertility and family planning, pregnancy, and motherhood. The analysis considered the relationship between their experiences and medical specialty and grade. Hierarchical regressions assessed the relationship between respondents' experiences and burnout, work-life balance, and career satisfaction. RESULTS: Data were provided by 776 women. Some positive experiences, such as high rates of breastfeeding, were evidenced. However, challenges were identified. Family considerations strongly influenced specialty choice, the incidence of self-reported infertility appeared high, maternity leave was perceived as a burden to colleagues, and women in senior grades took shorter maternity leaves. General Practice appeared as a family-friendly career choice compared to other specialities. Our analysis suggested some association between burnout and both respondent age and age of child(ren); work-life balance and grade, having a teenage child, and pregnancy complications; and career satisfaction and grade and the age of child(ren). CONCLUSIONS: This research identified important issues. A perception of burdening colleagues by taking maternity leave, potentially higher rates of infertility, and the substantive challenges of balancing work and home must be addressed. As the number of women in medicine increases, and the impact of doctor shortages is felt in the ROI, addressing these challenges is crucial to improve retention of women doctors and ensure that medicine remains an attractive career path.
Menstrual product preference and factors associated with use of freely-distributed reusable products among secondary students in Uganda: a longitudinal study.
Mugenyi L, Kyasanku R, Bakanoma R … +14 more , Ndekezi D, Nelson KA, Thomas KA, Lagony S, Tumuhimbise A, Namara J, Kembabazi N, Mpaji A, Nakalema S, Tanton C, Tembo M, Kyegombe N, Weiss HA, Torondel-Lopez B
BMC Womens Health · 2026 May · PMID 42163186 · Full text
INTRODUCTION: Access to menstrual products is a key factor for improving menstrual health, but there is limited research on the facilitators and barriers to their uptake and use. We describe menstrual product use, and fa...
INTRODUCTION: Access to menstrual products is a key factor for improving menstrual health, but there is limited research on the facilitators and barriers to their uptake and use. We describe menstrual product use, and factors associated with use of freely-distributed reusable pads and menstrual cups among female students in Ugandan secondary schools. METHODS: We analysed one-year follow-up data nested within a cluster-randomised trial evaluating the effectiveness of a multi-component menstrual health intervention among female students in 60 schools. The intervention included provision of five reusable pads and an optional menstrual cup, with training. We used random-effects logistic regression to identify factors associated with reported use of each product type at last menstrual period (LMP) at endline. We conducted focus group discussions and in-depth interviews among students and caregivers to explore product preferences, using thematic analysis. RESULTS: We analysed data from 2622 post-menarche participants present at both baseline and endline (mean age 15.6 years). Of these, 1683 (64.2%) used more than one type of menstrual product at LMP and 2203 (84.0%) used disposable pads at LMP, at endline. Among 1221/1302 (93.8%) intervention arm participants who received menstrual pads, and 613 (47.1%) who received a menstrual cup, 845 (69.2%) and 156 (25.4%) respectively reported using these products at LMP at endline. Reusable pad use was associated with older age, lower socioeconomic status, being a day scholar, prior use of reusable pads, and having higher menstrual self-efficacy at baseline. Use of a menstrual cup was associated with older age and being of non-Muganda ethnicity. Qualitative findings showed that knowledge, perceptions, affordability, prior familiarity, ease of use, comfort, peer influence, social stigma, and access to private washing facilities played key roles in product preference among the students. CONCLUSION: In this setting, participants used more than one product during a single menstrual period and preferred disposable pads when provided with free reusable products, due to challenges including washing and drying, social stigma, and discomfort. Provision of menstrual products needs to address both uptake and sustained use by considering individual preferences, cultural acceptability, sustainability, comfort, and environmental factors. TRIAL REGISTRATION: ISRCTN 45461276; 16/09/2021.
Same-day long-acting reversible contraceptive (LARC) placement: a systematic review of the benefits and barriers in the United States.
Lozano-Ortega G, Kennedy AR, Crespi S … +1 more , Patel VP
BMC Womens Health · 2026 May · PMID 42157240 · Full text
BACKGROUND: Increasing same-day placement rates of long-acting reversible contraceptives (LARCs) for individuals who are medically eligible and desire to do so is a key component of contraceptive access. The objective of...
BACKGROUND: Increasing same-day placement rates of long-acting reversible contraceptives (LARCs) for individuals who are medically eligible and desire to do so is a key component of contraceptive access. The objective of this literature review was to characterize data on the effectiveness and economic impact of programs aimed at increasing same-day LARC placement in the United States (US). METHODS: A systematic literature review was conducted January 2023 to identify relevant literature from 2012 onwards using Medline, EMBASE, and CINAHL databases. Studies reporting rates of same-day LARC placement, economic benefits related to specific programs or policies, or factors affecting access to same-day LARC placement were included. Key recommendations, including actionable insights to improve access to same-day LARC, were summarized. RESULTS: Thirty-three publications, representing 31 unique studies investigating same-day LARC placement across 21 states were included. Seven studies evaluated outcomes pre- and post-implementation of programs for same-day LARC placement, and all reported an increase in the rate of same-day LARC placements post-program implementation. Two studies estimated cost savings (USD) associated with same-day LARC placement, one estimated savings of $2,117 per adolescent per year when compared to requiring a second visit, and the second estimated savings of approximately $80 million through an assumed statewide scale-up of the evaluated program. Actionable insights to promote same-day LARC placement included staff and provider training, streamlining pregnancy and screening requirements, increasing LARC availability, and providing financial assistance. CONCLUSIONS: Programs for increasing same-day LARC placement were associated with increases in same-day LARC uptake and cost savings.
A digital self-care intervention for psychological distress associated with premenstrual syndrome: a fully online controlled trial using alternating allocation.
Ikeda Y, Egawa M, Ohsuga T … +5 more , Nakatani E, Tsuyuki K, Takahashi Y, Nakayama T, Mandai M
BMC Womens Health · 2026 May · PMID 42157172 · Full text
BACKGROUND: Premenstrual syndrome (PMS) is associated with significant psychological distress and productivity loss in women. This study aimed to evaluate whether a low-intensity digital intervention-comprising a symptom...
BACKGROUND: Premenstrual syndrome (PMS) is associated with significant psychological distress and productivity loss in women. This study aimed to evaluate whether a low-intensity digital intervention-comprising a symptom-tracking smartphone application and standardized informational emails-could reduce the psychological burden of PMS among women who self-identified as experiencing PMS. METHODS: We conducted a fully internet-based, open-label, parallel-group, nonrandomized controlled trial using centrally administered alternating allocation among women aged 18 years or older in Japan who self-identified as experiencing PMS. Participants were allocated alternately to either a 3-month intervention group (daily symptom tracking using a smartphone app and twice-weekly informational emails) or a waitlist control group. The primary outcome was the between-group difference in change scores on the psychological subscale of the Japanese version of the PMS-Impact Scale, measured from baseline to 3 months. Analyses were conducted per protocol. RESULTS: A total of 419 women were enrolled and assigned to either the intervention group (n = 210) or the waitlist control group (n = 209). Of these, 355 participants were included in the per-protocol analysis. The intervention group showed greater improvement in self-reported psychological distress than the waitlist control group. The between-group difference in change score, defined as intervention minus control, was - 1.37 points (95% CI, - 2.47 to - 0.27; p = 0.015). CONCLUSIONS: A simple, scalable digital intervention was associated with greater improvement in self-reported psychological distress among women who self-identified as experiencing PMS. These findings suggest that accessible, non-clinician-led tools may have potential as a self-management strategy for PMS, although causal interpretation is limited by the nonrandomized design. TRIAL REGISTRATION: This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on September 26, 2022. TRIAL REGISTRATION NUMBER: UMIN000048422.
Prevalence and associated factors of menstrual irregularities among reproductive-age women attending KAAH hospital, Hargeisa, Somaliland: a cross-sectional study.
Adam R, Hassan A, Gideon P
BMC Womens Health · 2026 May · PMID 42152058 · Full text
BACKGROUND: Menstrual irregularities are defined as cycles shorter than 21 days, longer than 35 days, or varying more than 7 days, impacting 5-30% of reproductive-age women globally. In Somaliland, sociocultural taboos,...
BACKGROUND: Menstrual irregularities are defined as cycles shorter than 21 days, longer than 35 days, or varying more than 7 days, impacting 5-30% of reproductive-age women globally. In Somaliland, sociocultural taboos, restricted access to sanitary products, and inadequate health infrastructure worsen underreporting and unmet needs. This study determined the prevalence and characteristics of irregular menstruation among reproductive-age women who visited KAAH Hospital, Hargeisa. METHODS: A cross-sectional hospital-based study design enrolled 288 women aged 15-49 years, who were attending the hospital from March-May 2025, via convenience sampling. A standardized questionnaire captured sociodemographic data, menstrual history, lifestyle, psychosocial measures (Perceived Stress Scale, Generalized Anxiety Disorder-7), and medical history (PCOS, thyroid). Hormonal assays (prolactin, TSH, LH, and FSH) were examined in specific instances. Bivariate analysis (chi-square tests) identified variables associated with irregular menstruation at a significance level of p < 0.05. RESULTS: The frequency of irregular menstruation was 85.76% (247/288). Notable correlations were discovered with age (peak 25-29 years; p < 0.001), income <$100 (p = 0.021), hormonal imbalances (e.g., 24.61% low LH; p = 0.003), stress (p = 0.041), anxiety (p = 0.040), an unhealthy diet (66.26%; p < 0.001), and less than seven hours of sleep per night (71.95%; p < 0.001). Among the subgroup of laboratory results (n = 65), low gonadotropins (LH was 24.61% low) and thyroid problems (18.46% elevated TSH) suggested ovarian disturbances, possibly subclinical PCOS. CONCLUSION: In Somaliland, high incidence indicates the need for urgent integrated screening for hormonal, psychosocial, and lifestyle risks. Education, nutrition, and FGM/C mitigation are SDG 3/5-aligned treatments that could promote reproductive equity by preventing infertility, metabolic risks, and inequities.
Protection from "any kind of risk" - a qualitative study exploring young women's experiences of safer sex in Canada.
Kennedy VL, Ford-Gilboe M, Zylak C … +5 more , Webster F, Berman H, Rabie C, Rude H, Newman-Fogel S
BMC Womens Health · 2026 May · PMID 42152030 · Full text
BACKGROUND: The safe sex discourse primarily focuses on reducing biological risks associated with sexual activities. As a public health concept, risk often neglects structural factors, like gender and access to appropria...
BACKGROUND: The safe sex discourse primarily focuses on reducing biological risks associated with sexual activities. As a public health concept, risk often neglects structural factors, like gender and access to appropriate care and support, while reinforcing individual blame. Adopting a narrow understanding of safe sex can limit the effectiveness of efforts to promote safer sexual behaviors. While literature on the more nuanced concept of safer sex offers valuable insights, how young women experience safer sex is not well understood. To address this gap, this study was undertaken to explore young women's experiences, priorities, and needs related to their sexual health. METHODS: A feminist participatory methodology guided this 2-phase qualitative study. In Phase 1 individual semi-structured interviews were conducted to explore participants' needs, priorities, and experiences related to their sexual health (n = 16). Phase 2 allowed for collaboration between young women as they discussed the structural contexts of their lives that influenced their meanings and experiences related to sexual health drawing on arts-based methods from photovoice (n = 5). RESULTS: A purposive sample of 16 young women was recruited for this study. Eligible participants were aged 16 to 21 years, identified as women, could participate in an English interview and were living in Canada. Participants were invited to engage in the research process in ways that emphasized their co-creation of knowledge, including by contributing to the interpretation and refinement of findings. Braun and Clarke's reflexive thematic analysis (RTA) was used to guide analysis. In RTA, diverse sources of knowledge (theory and literature; participants' stories; the researcher's lived and professional experiences) are valuable in knowledge production. Findings emphasize the importance of safety, boundaries, and pleasure, while recognizing factors that contribute to unsafe sex. CONCLUSION: The findings from this study call for moving beyond public health's risk-focused, individualistic discourse, which often ignores systemic barriers and pleasure, and reinforces self-blame. These findings call for a redefinition of safer sex to include emotional and mental safety, not just physical protection.
Navigating cervical cancer care in Maputo: a mixed-methods analysis of socioeconomic inequities in patient pathways and health system barriers.
Azevedo-Fernandes F, Chilundo B
BMC Womens Health · 2026 May · PMID 42152017 · Full text
BACKGROUND: Cervical cancer is largely preventable and curable when detected early, yet late diagnosis remains common in sub-Saharan Africa. In Mozambique, diagnostic pathways are multi-step and may fail through weak ref...
BACKGROUND: Cervical cancer is largely preventable and curable when detected early, yet late diagnosis remains common in sub-Saharan Africa. In Mozambique, diagnostic pathways are multi-step and may fail through weak referral continuity, administrative bottlenecks, and delayed diagnostic confirmation. Evidence is limited on where delays accumulate and whether constraints are socially patterned. METHODS: We conducted an explanatory sequential mixed-methods study among 165 women with histologically confirmed cervical cancer receiving care at Maputo Central Hospital, the national tertiary referral facility in Maputo Province, Mozambique. Structured questionnaires and medical record abstraction were used to characterise diagnostic pathways and to examine prolonged symptom-to-diagnosis delay (≥ 180 days) across household wealth quintiles using multivariable regression models. Subsequently, in-depth interviews with a purposive subsample of 20 women were analysed using Tanahashi's coverage framework and the Model of Pathways to Treatment. Quantitative and qualitative findings were integrated through joint display analysis and mechanism-oriented meta-inference to elucidate how socioeconomic position shaped diagnostic delay. RESULTS: Diagnostic delay was common, and care pathways were complex across wealth groups. Nearly two-thirds of women experienced prolonged delay, with no independent association with household wealth after adjustment. Prolonged delay was associated with higher navigation burden, reflected in multiple pre-diagnosis visits, and greater distance to primary care. Borrowing money to seek care was socially patterned. Qualitative findings indicated that early delays reflected symptom normalization, whereas post-entry diagnostic delays were driven by system-level navigation failures, including unclear referrals, repeated returns, administrative breakdowns, and service disruptions affecting women across socioeconomic strata. CONCLUSIONS: Among women who successfully reached tertiary oncology care in Maputo, prolonged diagnostic delays appeared to reflect shared health-system constraints within referral and diagnostic pathways rather than marked socioeconomic exclusion after entry into formal care. Strengthening referral continuity, diagnostic coordination, and effective coverage across primary and secondary care levels may help reduce delays more equitably and narrow gaps in diagnostic completion within the public referral system. Because the study population was limited to women who successfully accessed tertiary services, these findings may underestimate socioeconomic inequities occurring earlier in the pathway, including barriers to initial access and referral completion.
Pelvic Müllerian duct cyst with coexisting endometriosis: a case report.
Feng W, Cao C, Qiang G … +4 more , Liu L, Yu K, Xv Y, Ji Z
BMC Womens Health · 2026 May · PMID 42151970 · Full text
BACKGROUND: Müllerian duct cyst (MDC) is an uncommon congenital lesion arising from incomplete regression of the paramesonephric duct. It typically presents as a midline pelvic cystic lesion and is often asymptomatic, ma...
BACKGROUND: Müllerian duct cyst (MDC) is an uncommon congenital lesion arising from incomplete regression of the paramesonephric duct. It typically presents as a midline pelvic cystic lesion and is often asymptomatic, making preoperative diagnosis challenging. CASE PRESENTATION: We report the case of a 37-year-old woman who was admitted in 2024 for evaluation of an incidentally discovered pelvic cystic lesion. Pelvic magnetic resonance imaging (MRI) revealed a well-circumscribed, non-enhancing posterior pelvic cystic lesion. Laparoscopic resection of the cyst was performed, and intraoperatively, dense adhesions were noted between the cyst, the posterior uterine wall, and the posterior peritoneum. Histopathological examination confirmed the diagnosis of MDC and revealed coexisting endometriosis in the adherent posterior peritoneum. CONCLUSIONS: This case highlights the importance of considering MDC in the differential diagnosis of pelvic cystic lesions in women, as well as the potential coexistence of endometriosis.
Comparison of the effect of calcium and vitamin B1 supplementations on menstrual distress symptoms: a randomized, triple-blind, controlled trial.
Adeli M, Fallah-Karimi S, Khalilzadeh-Farsangi Z … +1 more , Kabirian M
BMC Womens Health · 2026 May · PMID 42151944 · Full text
BACKGROUND: Menstrual distress is a prevalent condition that considerably compromises the well-being and daily functioning of women across the globe. While both calcium and vitamin B1 have demonstrated promise in influen...
BACKGROUND: Menstrual distress is a prevalent condition that considerably compromises the well-being and daily functioning of women across the globe. While both calcium and vitamin B1 have demonstrated promise in influencing pain pathways and neurological function, their relative effectiveness in mitigating menstrual distress remains inadequately explored. This study was therefore designed to directly compare the therapeutic impact of calcium and vitamin B1 supplementation on the severity of this condition. METHODS: A triple-blind, randomized, placebo-controlled clinical trial was conducted in Iran in 2024. One hundred and twenty-three university students experiencing mild to moderate menstrual distress were randomly allocated into three groups: a calcium group (n=40), a vitamin B1 group (n=37), and a placebo group (n=46). Over a two-month period, all participants received 60 identically encapsulated, coded supplements. The primary outcome, the severity of menstrual distress, was evaluated using the Moos Menstrual Distress Questionnaire (MMDQ) during the menstrual cycle preceding and following the two-month intervention. Statistical analyses, performed in SPSS version 26, included Chi-square, ANOVA, and Tukey's tests, with a significance threshold set at p < 0.05. RESULTS: Following the intervention, both supplementation groups exhibited a marked and statistically significant reduction in overall symptom severity-including pain, concentration difficulties, behavioral changes, and negative affect-compared to the placebo group (p 0<0.001). A notable between-group difference emerged specifically in the pain domain, where the reduction in pain intensity was significantly greater in the calcium group than in the vitamin B1 group (4.13 ± 0.4 vs. 2.6 ± 0.9, P = 0.042). CONCLUSIONS: The findings indicate that both calcium and vitamin B1 are effective interventions for reducing the multifaceted symptoms of menstrual distress. However, calcium demonstrated superior efficacy specifically for alleviating menstrual pain compared to vitamin B1. These results support the inclusion of these specific nutritional supplements in clinical management strategies to ameliorate menstrual distress.
Cold-knife conization versus loop electrosurgical excision for cervical adenocarcinoma in situ: a retrospective cohort study.
Abudurehemu S, Wang X, Wang J … +2 more , Liu T, Chen M
BMC Womens Health · 2026 May · PMID 42143293 · Full text
OBJECTIVE: The purpose of this study was to compare the efficacy of cold-knife conization (CKC) and loop electrosurgical excision procedure (LEEP) in treating cervical adenocarcinoma in situ (AIS) and identify relevant r...
OBJECTIVE: The purpose of this study was to compare the efficacy of cold-knife conization (CKC) and loop electrosurgical excision procedure (LEEP) in treating cervical adenocarcinoma in situ (AIS) and identify relevant risk factors within a recent cohort from a tertiary hospital in China. METHODS: We conducted a retrospective chart review of patients who underwent a conization procedure with a preoperative or postoperative diagnosis of AIS of the cervix from January 2021 to July 2024. Clinicopathological data and follow-up results were collected, with recurrence-free survival (RFS) as the primary endpoint. RESULTS: Among the 251 patients included, 161 (64.14%) underwent LEEP and 90 (35.86%) underwent CKC as primary treatment. Overall, 29.9% (75/251) underwent eventual hysterectomy. Median follow-up was 36 months. The positive margin rate was lower in the CKC group than in the LEEP group (16.7% vs. 31.7%, P < 0.001). Multivariate analysis showed that LEEP (aOR 2.28, 95% CI 1.13-4.58, P = 0.021), TZ type 2 or 3 (aOR 2.00, 95% CI 1.12-3.58, P = 0.019), and AIS with concurrent HSIL (aOR 2.07, 95% CI 1.13-3.78, P = 0.018) were independently associated with positive margins. Greater cone depth was associated with lower risk (per 1 mm increase: aOR 0.73, 95% CI 0.55-0.97, P = 0.031) when conization type was excluded due to collinearity. Among patients who underwent hysterectomy, positive conization margin was the only predictor of residual disease (aOR 9.12, 95% CI 1.07-77.8, P = 0.043). Kaplan-Meier analysis showed a significant difference in RFS among the three groups (P = 0.018), but pairwise comparison did not reveal a significant difference between the LEEP and CKC groups (P = 0.109). CONCLUSIONS: In this retrospective cohort, CKC achieved lower positive margin rates than LEEP for AIS. However, short-term RFS did not differ significantly between the two techniques, suggesting that margin status alone may not fully predict oncologic outcomes. Positive margin was a predictor of residual disease at hysterectomy, but this finding requires validation. For fertility-seeking patients, CKC is preferred to optimize margins, though LEEP may be acceptable when CKC is not feasible.
Giant endometrioma of the canal of nuck mimicking a vulvar mass: a rare case and narrative review.
Aldakhil LO
BMC Womens Health · 2026 May · PMID 42135814 · Full text
BACKGROUND: Endometriosis of the canal of Nuck is an extremely rare manifestation of extrapelvic endometriosis that may mimic common groin pathologies such as inguinal hernia or hydrocele, often leading to diagnostic dif...
BACKGROUND: Endometriosis of the canal of Nuck is an extremely rare manifestation of extrapelvic endometriosis that may mimic common groin pathologies such as inguinal hernia or hydrocele, often leading to diagnostic difficulty and delayed recognition. CASE PRESENTATION: We report the case of a 29-year-old nulliparous woman who presented with a gradually enlarging painless swelling in the right vulvar region over eight months. Physical examination revealed a large cystic mass measuring approximately 15 × 10 cm involving the right vulva and inguinal area with displacement of the clitoris and vaginal introitus. Ultrasonography demonstrated a well-defined cystic lesion with internal echoes, while magnetic resonance imaging revealed a hemorrhagic cystic lesion along the course of the canal of Nuck without peritoneal communication. Surgical exploration identified a cystic mass adjacent to the round ligament containing characteristic "chocolate-like" fluid. Complete excision of the lesion was performed. Histopathological examination confirmed endometrioma of the canal of Nuck. The postoperative course was uneventful, and the patient remained asymptomatic with no evidence of recurrence during a 3-year follow-up. CONCLUSION: Although rare, canal of Nuck endometriosis should be considered in the differential diagnosis of inguinal or vulvar masses in women of reproductive age. Early recognition, appropriate imaging and complete surgical excision allow accurate diagnosis and excellent outcomes. This case highlights an unusually large presentation and emphasises the diagnostic challenges associated with atypical clinical features.
Genital inflammation screening for predicting sexually transmitted infections and bacterial vaginosis: an updated cost analysis from the GIFT study in Madagascar, South Africa, and Zimbabwe.
Smith E, Harimanana A, Mwaturura T … +8 more , Raharimanga V, Gamana TM, Gill K, Harding-Esch E, Crucitti T, Masson L, Passmore JA, Sinanovic E
BMC Womens Health · 2026 May · PMID 42135706 · Full text
BACKGROUND: Sexually transmitted infections (STIs) and bacterial vaginosis (BV) are significant public health issues, particularly in sub-Saharan Africa, and are associated with genital inflammation and increased HIV acq...
BACKGROUND: Sexually transmitted infections (STIs) and bacterial vaginosis (BV) are significant public health issues, particularly in sub-Saharan Africa, and are associated with genital inflammation and increased HIV acquisition risk. A substantial proportion of these infections are asymptomatic, limiting the effectiveness of syndromic management. The Genital InFlammation Test (GIFT), a novel rapid point-of-care (POC) test, was developed to detect elevated inflammatory biomarkers associated with genital inflammation. The first-in-field prototype of the GIFT device was evaluated in a multicenter observational study conducted in South Africa, Zimbabwe, and Madagascar. This study updates prior cost estimates using a hypothetical GIFT prototype in South Africa and extends the analysis to routine family planning services in Madagascar, and Zimbabwe. METHODS: A provider-perspective, combining a top-down and bottom-up costing approach, was conducted at device evaluation observational study sites in Madagascar, South Africa, and Zimbabwe (n = 1 per country). Economic costs, including capital and recurrent expenditures, were collected through facility records, interviews, and self-reported provider timesheets to determine the incremental cost of integrating GIFT screening into family planning consultations. Research-related costs were excluded. A probabilistic sensitivity analysis using Monte Carlo simulation was performed to address parameter uncertainty, particularly around GIFT's estimated market price of US$5.00. RESULTS: The incremental cost per woman screened with GIFT was estimated to be US $6.46 (95% CI: US $1.98 - US $12.22) in Madagascar, US $9.05 (95% CI: US $3.78 - US $15.83) in South Africa, and US $8.28 (95% CI: US $3.04 - US $16.52) in Zimbabwe, slightly higher than previous estimates for South Africa (US $3.53 - US$ 5.32). Recurrent costs (personnel, supplies, and overheads) constituted more than 98% of this cost, with the GIFT device being the primary cost driver. CONCLUSIONS: Updated costs suggest slightly higher implementation costs than previous estimates. This analysis suggests that the affordability and potential scale-up of GIFT and other novel POC screening tools will depend heavily on their final market price. These findings provide essential economic evidence to inform further analyses on cost-effectiveness, affordability, and optimal integration of GIFT into routine sexual and reproductive healthcare services in low- and middle-income countries.
Beyond education and contraceptive use: do caste, ethnicity, and religion influence fertility behaviour in Nepal? Evidence from six rounds of DHS.
Ghimire DR, Kc S
BMC Womens Health · 2026 May · PMID 42129769 · Full text
BACKGROUND: Nepal has experienced a substantial decline in fertility over the past three decades; however, notable heterogeneity persists across sociocultural groups. This study examines how constitutionally defined cast...
BACKGROUND: Nepal has experienced a substantial decline in fertility over the past three decades; however, notable heterogeneity persists across sociocultural groups. This study examines how constitutionally defined caste, ethnicity, and religion shape fertility behaviour after accounting for education, wealth, and structural determinants. By applying a repeated cross-sectional framework, the study provides new evidence on long-term patterns and shifting trajectories across population subgroups. METHODS: The study analysed data from six rounds of the Nepal Demographic and Health Survey (1996-2022), comprising currently married women aged 15-49. Separate analyses (individual period and pooled) were done for lifetime (15-49 years) and completed (40-49) fertility. A survey-adjusted Poisson regression model was used to estimate associations with the number of children ever born (CEB). Duration since marriage was included as the exposure variable to account for variation in reproductive risk time. A pooled interaction model (caste/ethnicity x survey year) assessed temporal changes in sociocultural fertility differentials. RESULTS: Women's educational attainment was the strongest and most consistent predictor of lower fertility, with women aged 40-49 with post-secondary education having substantially lower expected CEB than those with no schooling. Among women aged 15-49, wealth, met need for contraception, and urban residence were also associated with reduced fertility. Sociocultural differentials persisted after adjustment: Muslim women had higher expected CEB than Arya women across most survey years; Madheshi women exhibited rising fertility relative to Arya women in interaction models; Janjati women showed accelerated fertility decline; and the pooled effect for Dalit women was not statistically significant. CONCLUSION: Fertility heterogeneity in Nepal reflects the combined influence of sociocultural identity and structural conditions. While education is the key driver of fertility reduction, persistent differences among Muslim and Madheshi communities indicate the need for culturally tailored reproductive health strategies. Policies should prioritise universal completion of secondary education for girls, as well as equity-focused empowerment and family planning initiatives to address remaining disparities.
The genetic association of miR-34a-5p rs72631823 with the susceptibility to obstetric antiphospholipid syndrome.
Wang J, Huang Y, Wang R … +6 more , Li C, Lei L, Zhang Y, Zhao X, Qi X, Li M
BMC Womens Health · 2026 May · PMID 42129714 · Full text
BACKGROUND: Obstetric antiphospholipid syndrome (OAPS) is a complex autoimmune disorder affecting women. miR-34a-5p is upregulated in APS patients, yet the role of functional pre-miR-34a rs72631823 polymorphism in OAPS s...
BACKGROUND: Obstetric antiphospholipid syndrome (OAPS) is a complex autoimmune disorder affecting women. miR-34a-5p is upregulated in APS patients, yet the role of functional pre-miR-34a rs72631823 polymorphism in OAPS susceptibility and outcomes remains unexplored. METHODS: This case-control study collected 182 OAPS patients and 188 matched healthy pregnant women (confirmed aPL-negative). The rs72631823 polymorphism was genotyped by TaqMan method. Relative miR-34a-5p level was detected by RT-qPCR. Associations were assessed using Chi-square tests and multivariable logistic regression, presented by odds ratios (ORs) with 95% confidence intervals (CIs). The diagnostic value of miR-34a-5p was evaluated by a receiver operating characteristic (ROC) curve. Bioinformatics analysis of miR-34a-5p target genes was performed using miRDB, TargetScan, and ENCORI databases, followed by GO/KEGG enrichment analysis. RESULTS: rs72631823 AA genotype was independently correlated with increased OAPS risk (adjusted OR = 3.002, 95% CI = 1.189-7.581, P = 0.020), and exhibited a dose-dependent effect on miR-34a-5p expression. The rs72631823 was correlated with a higher risk of poor maternal (AA vs. GG: adjusted OR = 3.767, 95% CI = 1.419-10.003, P = 0.008) and infant outcomes (AA vs. GG: adjusted OR = 2.957, 95% CI = 1.059-8.258, P = 0.039). miR-34a-5p demonstrated promising discriminative ability for OAPS (AUC = 0.859, 95% CI = 0.821-0.897, sensitivity = 79.12%, specificity = 77.66%). Exploratory bioinformatics analysis suggested that miR-34a-5p targets were enriched in Wnt signaling, MAPK pathway, and vascular development. These computational findings provide a plausible biological context and generate hypotheses regarding its potential role in OAPS. CONCLUSION: miR-34a-5p rs72631823 polymorphism is associated with enhanced miR-34a-5p expression. This increased expression is associated with pro-inflammatory and pro-thrombotic pathways, correlating with an increased risk of OAPS susceptibility and predicting poor outcomes.
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