BMC Women's Health[JOURNAL]
Sun
200 papers
First documented case of cervical stenosis resulting in pyometra and fallopian tube torsion.
Yigzaw KT, Addis NA, Shiferaw EA … +2 more , Zewudu AA, Tereda AK
BMC Womens Health · 2026 May · PMID 42121208 · Full text
INTRODUCTION: Cervical stenosis (CS) is a condition characterized by the narrowing of the cervical canal, which can lead to complications such as pyometra and fallopian tube torsion (FTT). The interplay of these conditio...
INTRODUCTION: Cervical stenosis (CS) is a condition characterized by the narrowing of the cervical canal, which can lead to complications such as pyometra and fallopian tube torsion (FTT). The interplay of these conditions is rarely documented in the literature. CASE PRESENTATION: A 60-year-old Ethiopian woman, with a history of recurrent genitourinary infections and 16 years post-menopausal, presented with sudden onset right-sided lower abdominal pain, nausea, and foul-smelling vaginal discharge. Physical examination revealed a mass consistent with a 14-week size uterus and tachycardia. Ultrasound showed an endometrial fluid collection and an enlarged right adnexal mass. Laparotomy confirmed a necrotic right fallopian tube after a 1080-degree torsion and evacuation of frank pus was performed due to an obstructed cervix. DISCUSSION: The case illustrates a rare association between CS, pyometra, and FTT. Pyometra requires both an endometrial infection and cervical obstruction for fluid accumulation, leading to significant abdominal symptoms. The effectiveness of imaging methods for diagnosing FTT is limited, necessitating surgical intervention for definitive management. CONCLUSION: This unique case highlights the importance of considering rare complications such as fallopian tube torsion in patients with pyometra due to cervical stenosis. Early diagnosis and intervention are crucial to prevent necrosis and ensure successful treatment outcomes.
The mediating role of self-awareness between quality of life and family functioning in girls with precocious puberty: a cross-sectional study.
Wu X, Yang F, Yin L … +4 more , Bi D, Sunzi K, Sun H, Yi X
BMC Womens Health · 2026 May · PMID 42121198 · Full text
OBJECTIVE: This study aims to investigate the mediating role of self-consciousness between the quality of life and family functioning in girls with precocious puberty. METHODS: A convenience sampling method was employed...
OBJECTIVE: This study aims to investigate the mediating role of self-consciousness between the quality of life and family functioning in girls with precocious puberty. METHODS: A convenience sampling method was employed to select 314 female children aged 8-12 years with precocious puberty who were receiving outpatient treatment at a tertiary hospital in Sichuan Province, China, between March 2022 and March 2023 for a questionnaire survey; The general data survey form, the generic core scale of children's quality of life, the Piers-Harris Children's Self-Concept Scale, and the Family Function Assessment Scale were used as research tools; Pearson was used for correlation analysis, and AMOS 26.0 was applied to construct the mediating effect model and test between family functioning and quality of life of precocious puberty girls' self-awareness. RESULTS: Family function (β = 0.270, P < 0.001) and self-awareness (β = 0.480, P < 0.001) had a positive predictive effect on the quality of life of precocious puberty girls, and self-awareness had a partially mediating effect between the quality of life of precocious puberty girls and their family function (β = 0.293, P < 0.001), and the mediating effect accounted for 52.04% of the total effect. CONCLUSION: Improving family functioning and self-awareness in girls with precocious puberty is closely related to improving their quality of life. Medical professionals should consider multidisciplinary association to help precocious puberty girls create a favorable family atmosphere and promote the girls to establish a positive sense of self in order to improve their quality of life.
Barriers to screening amongst first-degree female relatives of patients with breast cancer: a qualitative study.
Shi Y, Xu J, Zhang Q … +3 more , Ma Z, Yao S, Dong Y
BMC Womens Health · 2026 May · PMID 42121188 · Full text
PURPOSE: To explore the underlying reasons and external factors influencing non‑participation or willingness to undergo screening among female first‑degree relatives of breast cancer patients, and to provide a basis for...
PURPOSE: To explore the underlying reasons and external factors influencing non‑participation or willingness to undergo screening among female first‑degree relatives of breast cancer patients, and to provide a basis for developing intervention programs through qualitative interviews. METHODS: A descriptive qualitative design was adopted. From the perspective of the Health Ecological Model, semi‑structured in‑depth interviews were conducted with 18 female first‑degree relatives of breast cancer patients. Thematic analysis was used to analyze the interview data. RESULTS: Participants ranged in age from 25 to 67 years and included daughters, sisters, and mothers of patients. Three themes and seven sub‑themes were identified: Microsystem (Emotional and trust barriers, Perceived imbalance of risk and cost); Mesosystem (Lack of family support, Insufficient interpersonal and information support, Poor advice from healthcare professionals); Macrosystem (Insufficient policy coverage, Cultural taboos and fatalism). CONCLUSION: Female first‑degree relatives of breast cancer patients face multi‑level barriers to screening. Healthcare providers should implement targeted interventions addressing these factors to improve their screening behaviors.
HPV and Health-related Quality of Life Scale: Turkish validity and reliability study.
Cansızlar GA, Erensayın B, Satılmış İG
BMC Womens Health · 2026 May · PMID 42121152 · Full text
OBJECTIVE: This study aims to adapt the HPV and Health-Related Quality of Life Scale (HPV-RQOLS) into Turkish and evaluate its reliability and validity. METHODS: This methodological study employed a cross-sectional desig...
OBJECTIVE: This study aims to adapt the HPV and Health-Related Quality of Life Scale (HPV-RQOLS) into Turkish and evaluate its reliability and validity. METHODS: This methodological study employed a cross-sectional design and convenience sampling. A total of 150 women diagnosed with HPV who presented to a training and research hospital in Turkey between January and December 2023 were included. The inclusion criteria were age between 18 and 60 years, proficiency in Turkish, a confirmed HPV-positive diagnosis, and voluntary participation in the study. Data were collected using the Participant Diagnosis Form and the HPV and Health-Related Quality of Life Scale (HPV-QoL) and SF-12 Quality of Life Scale. Analyses included content and construct validity through Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), internal consistency, concurrent and convergent validity. RESULTS: The Confirmatory Factor Analysis conducted in this study demonstrated that the four-factor model of the original scale did not show an adequate fit to the data. In contrast, the three-factor structure of the Turkish version exhibited acceptable fit indices (χ²/df = 2.219, RMSEA = 0.080, GFI = 0.884, AGFI = 0.821, CFI = 0.957). The Turkish HPV-QoL scale was found to comprise three factors-general well-being, health, and sexuality-and this structure explained a statistically significant proportion of the variance (p < 0.01). The contagiousness dimension present in the original scale was removed in the Turkish adaptation based on insufficient factor loadings (< 0.40) and recommendations from the expert panel. Acceptable model fit and high internal consistency were confirmed (total α = 0.938; subscales: 0.807-0.881). The total Cronbach's alpha coefficient of the scale was 0.938, indicating high reliability. Test-retest analyses demonstrated the scale's stability over time (p < 0.05). Furthermore, correlation analysis with the SF-12 Quality of Life Scale revealed a moderate, positive, and statistically significant association (p < 0.05). CONCLUSIONS: The Turkish HPV-QoL scale is a valid and reliable instrument for assessing health-related quality of life in individuals diagnosed with HPV. Its use in clinical practice and research settings may contribute to a better understanding of the psychosocial and physical impacts of HPV on individuals and support the planning of targeted interventions.
Exploring addiction treatment experiences among Iranian women in residential medium-term center: a qualitative study.
Khazaee-Pool M, Taymoori P, Dolan K … +2 more , Ponnet K, Pashaei T
BMC Womens Health · 2026 May · PMID 42121139 · Full text
BACKGROUND: Residential medium-term centers are among the treatment facilities available for women with substance use disorders in Iran. This qualitative study aimed to explore the lived experiences of women undergoing t...
BACKGROUND: Residential medium-term centers are among the treatment facilities available for women with substance use disorders in Iran. This qualitative study aimed to explore the lived experiences of women undergoing treatment for substance use disorders at residential medium-term rehabilitation centers in Sanandaj, the capital city of Kurdistan Province in western Iran. MATERIALS AND METHODS: This qualitative study employed content analysis to explore the experiences of women undergoing residential treatment for substance use disorders. Seventeen women were purposively selected from a women-only rehabilitation center for participation in semi-structured interviews. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. RESULTS: Data analysis revealed two main categories related to the participants' experiences with substance use disorder treatment at residential medium-term care centers: (1) Inhibiting factors, including unsuitable family situations, economic hardship, structural barriers, physical and environmental obstacles, lack of continuity of care, and comorbid health conditions; and (2) Facilitating factors, such as a drug-free environment, a comprehensive treatment curriculum, peer support, and access to psychological services. CONCLUSION: Based on the findings of this study, it can be concluded that various factors influence the recovery and rehabilitation process of women with substance use disorders. Overall, increasing awareness of these factors and designing interventions tailored to address them may contribute to improving quality of life and promoting sustained abstinence among these individuals.
The effect of training provided according to the health promotion model on premenstrual symptoms, emotional eating behavior, and perceived stress.
Aydın CM, Karabulutlu Ö
BMC Womens Health · 2026 May · PMID 42121133 · Full text
AIM: This study aimed to determine the effect of training provided according to the health promotion model on premenstrual symptoms, emotional eating behavior, and perceived stress. METHODS: The study was conducted as a...
AIM: This study aimed to determine the effect of training provided according to the health promotion model on premenstrual symptoms, emotional eating behavior, and perceived stress. METHODS: The study was conducted as a pretest-posttest randomized controlled trial between October 2023 and April 2024 with second- and third-year nursing and midwifery students at the Faculty of Health Sciences of a university in eastern Turkey. In the first stage, when students who took the Premenstrual Syndrome Scale scored 50% or more of the total scale score (220), PMS was classified as "present." Participants who scored 110 or higher on the Premenstrual Syndrome Scale were divided into three groups based on their PMS score levels. An equal number of individuals from each PMS score group were assigned to the intervention and control groups. The study was conducted using an open-label design, and the analysts were blinded during the data analysis process. The sample consisted of 86 students with PMS (42 in the intervention group and 44 in the control group). Data were collected using the "Personal Information Form," "Nutritional Habits During the Premenstrual Period," "Premenstrual Syndrome Scale (PMSS)," "Healthy Lifestyle Behaviors Scale (HLBS-II)," "Emotional Eating Scale (EES)," and "Perceived Stress Scale (PSS)." The intervention group received a training program using the health promotion model and the Phillips 66 technique. The posttest was administered to the intervention and control groups in the 8th week. RESULTS: In the intervention group, statistically significant differences were found between the pretest and posttest in the consumption of milk and dairy products, refined grains, fast food, sweet foods, and packaged products (p < 0.05). The mean score of the intervention group in the posttest was lower than that of the control group in the total EES and PMSS scores, and the statistical difference was found to be significant (p < 0.05). No statistically significant difference was found between the groups in the pretest and posttest in terms of the total PSS and HLBS-II scores (p > 0.05). The group*time interaction of the total PMSS score was found to be statistically significant, while the total EES, PSS, and HLBS-II scores were found to be statistically insignificant (p > 0.05). In the intra-group comparison of the stress/distress subscale of the PSS, the mean score difference between the intervention and control groups was found to be statistically significant in favor of the control group (p = 0.045, d = 0.311). The group × time interaction for the fatigue (F = 5.813, p = 0.018, η²=0.065) and depressive thoughts (F = 8.926, p = 0.004, η²=0.096) subscales of the PMSS was found to be statistically significant. The group × time interaction for the total PMSS score was found to be statistically significant (F = 6.764, p = 0.011, η²=0.075). The group × time interaction for the EES score, as well as for the PSS and HLBS-II subscales and their total scores, was found to be statistically insignificant (p > 0.05). CONCLUSION: The training program led to positive changes in reducing PMS symptoms, and improving nutrition-related behaviors. This program did not prove to be effective over time in reducing emotional eating, alleviating perceived stress, or fostering healthy lifestyle behaviors; however, it did lead to positive changes in the scores. This training program is recommended within the scope of public health practices because it has been found useful in guiding toward a changeable lifestyle, identifying perceived barriers and benefits related to emotional eating behavior with PMS, and supporting healthy behaviors. TRIAL REGISTRATION: The protocol for this randomized controlled, open label, pretest-posttest design parallel-group clinical trial was registered on ClinicalTrials.gov on 2023/10/16 Registration No: NCT06105567; URL: https://clinicaltrials.gov/study/NCT06105567.
Women's experiences toward cervical cancer care at the initiation of care: a qualitative study closing the gap policy and implementation in Indonesia.
Pahria T, Haroen H, Agustina HR … +5 more , Sari CWM, Natasya W, Winarno GNA, Maulana S, Franciscus Pardosi J
BMC Womens Health · 2026 May · PMID 42120980 · Full text
INTRODUCTION: Cervical cancer remains a major public health concern in Indonesia despite ongoing national efforts toward elimination. While policy initiatives have expanded screening and treatment services, limited evide...
INTRODUCTION: Cervical cancer remains a major public health concern in Indonesia despite ongoing national efforts toward elimination. While policy initiatives have expanded screening and treatment services, limited evidence exists regarding women's lived experiences during the early stage of cervical cancer care. Understanding women's perspectives is essential to strengthening a national care strategy. OBJECTIVE: To explore women's experiences during the early stage of cervical cancer care in Indonesia, from symptom recognition and abnormal screening results to diagnosis and initiation of treatment. METHODS: A qualitative descriptive study was conducted in a national tertiary referral center in West Java, Indonesia. Eighteen women diagnosed with cervical cancer were recruited using purposive sampling to capture diverse clinical and experiential backgrounds. Data were collected through in-depth, semi-structured interviews between August and October 2025. Interviews were transcribed verbatim and analyzed using Braun and Clarke's thematic analysis framework. Trustworthiness was ensured through member checking, audit trails, and collaborative theme validation. RESULTS: Three themes emerged: (1) women's experiences in accessing care services, (2) difficulties and coping mechanisms, and (3) unmet informational and psychosocial needs. Participants described normalization of early symptoms, misinterpretation at primary care level, fragmented referrals, and inconsistent staging information, contributing to diagnostic uncertainty and emotional distress. Although national health financing covered treatment costs, indirect financial burdens persisted. Women actively sought simplified explanations through digital platforms to compensate for communication gaps. Many entered treatment with limited preparation and inadequate counseling regarding side effects. CONCLUSION: Initiation of care represents a critical bottleneck within Indonesia's cervical cancer elimination efforts. Strengthening early clinical recognition by healthcare providers, referral continuity, structured counseling, early palliative care integration, and digital navigation systems is essential to bridge the policy-implementation gap and support achievement of the WHO cervical cancer elimination target of treating 90% of women diagnosed with cervical disease.
Tracing the developmental arc of matrescence: a phenomenological study of urban Indian mothers.
Mazumdar K, Kour P
BMC Womens Health · 2026 May · PMID 42116124 · Full text
The transition into motherhood entails profound developmental shifts across biological, psychological, emotional, and identity domains, conceptualized as matrescence, a dynamic process with significant implications for m...
The transition into motherhood entails profound developmental shifts across biological, psychological, emotional, and identity domains, conceptualized as matrescence, a dynamic process with significant implications for maternal well-being. Although scholarship on matrescence has expanded, it remains largely Western-centered, with limited attention to non-Western contexts. Addressing this gap, the present study explores how urban Indian mothers experience and interpret matrescence across different stages of motherhood.Guided by a phenomenological framework, this qualitative study draws on in-depth semi-structured interviews with 25 urban Indian mothers representing diverse occupational and family contexts. Interviews focused on emotional, relational, bodily, and identity-related changes following childbirth. Data were analyzed using Interpretative Phenomenological Analysis (IPA) to examine how mothers construct meaning around their transition over time.Findings reveal matrescence as a layered, evolving process organized around two overarching themes: Personhood - encompassing cognitive, emotional, physical, and identity shifts and Meaning-making of matrescence, shaped through personal narratives and sociocultural constructions of motherhood. Participants described renegotiating selfhood while navigating gendered expectations, familial pressures, and idealized models of "good" motherhood, highlighting the emotional labor embedded in maternal adaptation.By foregrounding mothers' voices from a non-Western setting, this study contributes to scholarship on matrescence and maternal mental health by demonstrating how cultural context shapes psychological experience. The findings underscore the need for contextually grounded frameworks and culturally sensitive supports that recognize motherhood as a developmental transition rather than a fixed identity state. The study presents a culturally grounded spiral model of matrescence as a recursive process of embodied change, meaning-making, and sociocultural negotiation.
Menstrual hygiene management and social exclusion among women in Afghanistan: insights from a national survey.
Dadras O, Stanikzai MH, Ezadi Z … +3 more , Jafari M, Dadras F, Tawfiq E
BMC Womens Health · 2026 May · PMID 42116112 · Full text
BACKGROUND: In Afghanistan, little is known about menstrual hygiene management (MHM) and the social isolation women experience during menstruation. Drawing on the nationally representative 2022-23 Afghanistan Multiple In...
BACKGROUND: In Afghanistan, little is known about menstrual hygiene management (MHM) and the social isolation women experience during menstruation. Drawing on the nationally representative 2022-23 Afghanistan Multiple Indicator Cluster Survey (MICS), we quantified the prevalence of appropriate MHM and menstrual-related social exclusion and examined their sociodemographic drivers. METHODS: We conducted a cross-sectional analysis of 40,330 women aged 15-49 years who responded to questions on MHM, corresponding to those who had menstruated in the past year preceding the survey. "Appropriate MHM" was defined as the use of a sanitary pad, tampon, or clean cloth, plus access to a private space for changing or washing. "Social exclusion" captured any missed social activities, work, or schooling due to menstruation. Survey-weighted logistic regression models estimated adjusted odds ratios (AORs) for both outcomes, including interaction and stratified analyses by place of residence. RESULTS: Overall, 86.0% of women met criteria for appropriate MHM, yet 30.2% reported menstrual-related social exclusion. Provincial estimates of appropriate MHM varied widely (49.4% in Jawzjan to 98.5% in Khost), and social exclusion ranged from 2.7% (Ghor) to 79.0% (Faryab). After adjustment, women in rural areas (AOR: 1.91, 95%CI: 1.53-2.37), those with internet access (AOR: 1.50; 1.19-1.90), and those from the richest wealth quintile (AOR: 1.66; 1.22-2.26) had significantly higher odds of appropriate MHM. Never-married women had lower odds of appropriate MHM (AOR 0.86; 0.75-0.97). The odds of social exclusion were lower in women aged 18-24 (AOR: 0.87; 0.78-0.96), 25-34 (AOR: 0.79; 0.70-0.89), and 35-49 (AOR: 0.86; 0.76-0.98). However, mobile-phone ownership was associated with higher odds of social exclusion (AOR: 1.20; 1.08-1.33). A significant interaction by residence (p < 0.001) indicated that lack of adequate MHM was associated with higher odds of social exclusion among urban women (AOR: 1.46; 1.07-2.00), whereas in rural areas it was associated with lower odds (AOR: 0.68; 0.56-0.82). CONCLUSION: Although the majority of Afghan women report appropriate MHM, nearly one-third still experience social exclusion during menstruation. Policy efforts should prioritize low-tech, community-based approaches to address menstrual health challenges, particularly among unmarried and economically disadvantaged women, while considering digital platforms as complementary tools for subgroups with existing access.
Management and outcomes of fertility preservation in rare Cowden syndrome-associated endometrial carcinoma: a case series.
Huang Y, Wang B, Jiang P … +7 more , Liao J, Shao W, Xiao Y, Liu J, Ye X, Chai Z, Wang C
BMC Womens Health · 2026 May · PMID 42116069 · Full text
BACKGROUND: Cowden syndrome-associated endometrial carcinoma (CS-EC) is rare, and data on fertility-preserving treatment for young patients remain limited. This series describes the diagnosis and management of three pati...
BACKGROUND: Cowden syndrome-associated endometrial carcinoma (CS-EC) is rare, and data on fertility-preserving treatment for young patients remain limited. This series describes the diagnosis and management of three patients with CS-EC who underwent fertility-sparing treatment. We also report the subsequent pregnancy outcome for one of these individuals. These cases provide a clinical reference for the individualized management of such patients. CASE PRESENTATION: Three patients (aged 29, 31, and 28 years) with germline Phosphatase and tensin homolog (PTEN) pathogenic variants and stage IA endometrial carcinoma underwent individualized fertility-sparing treatment. Case 1 (PTEN p.R189Qfs*9) failed levonorgestrel-releasing intrauterine system (LNG-IUS) treatment at 19 months. Eight cycles of GnRH agonist (GnRH-a) plus letrozole (LE) subsequently induced a complete response. A recurrence was successfully managed with twelve additional cycles of this regimen. Case 2 (PTEN p.R173C) attained remission after six months of megestrol acetate (MA). Case 3 (PTEN p.R335*) responded to MA over nine months, then developed complex mucinous papillary metaplasia during LNG-IUS maintenance, which resolved with ethinylestradiol/cyproterone acetate (EE/CPA). She subsequently conceived and delivered a live birth through Intracytoplasmic sperm injection (ICSI). During the follow-up period, all patients were administered maintenance therapy using a LNG-IUD. CONCLUSIONS: Fertility-sparing therapy may serve as a potentially feasible option for highly selected patients with stage IA CS-EC, and could lead to relatively favorable pregnancy outcomes. The clinical feasibility of this strategy relies heavily on strict patient selection, timely molecular diagnosis, and standardized continuous multidisciplinary management.
Impact of female genital mutilation on sexual function and psychosocial wellbeing among Somali women: a cross-sectional study.
Erkok U, Barut A, Saglik B … +5 more , Hassan HB, Guner G, Kablan G, Ertok C, Omer Z
BMC Womens Health · 2026 May · PMID 42116011 · Full text
BACKGROUND: Female Genital Mutilation (FGM) is associated with significant physical, psychological, and sexual health consequences. This study sought to examine the impact of FGM on sexual function and psychosocial well-...
BACKGROUND: Female Genital Mutilation (FGM) is associated with significant physical, psychological, and sexual health consequences. This study sought to examine the impact of FGM on sexual function and psychosocial well-being among women in Somalia compared to those without FGM. METHODS: A total of 753 women were consecutively enrolled, including 707 with FGM and 46 without. Data collected included age, type of FGM (Types I-IV), decision-maker, and setting of the procedure. Participants completed the Female Sexual Function Index (FSFI) and the Brief Symptom Inventory-18 (BSI-18) to evaluate sexual function and psychosocial well-being. RESULTS: The prevalence of FGM was 93.9%, with Type II being the most common (47.1%), followed by Type III (28.1%), Type I (18.9%), and Type IV (5.9%). Mothers were the primary decision-makers in 60.0% of cases. Sexual dysfunction was significantly more prevalent among women with FGM (64.6%) compared to those without (34.8%) (p < 0.001). The incidence of dysfunction increased with FGM severity: Type I (52.2%), Type II (60.2%), Type III (74.9%), and Type IV (90.5%) (p < 0.001). Women with FGM demonstrated significantly decreased sexual desire, arousal, lubrication, orgasm, satisfaction, and higher pain, anxiety, depression, and somatization (p < 0.001). Regression analysis revealed a strong inverse association between FGM and all domains of sexual and psychological health, with odds ratios increasing with the FGM type (Type I: OR = 2.1; Type II: OR = 2.8; Type III: OR = 5.6; Type IV: OR = 17.8). CONCLUSION: Our findings suggest that women in FGM experience significantly greater psychosexual and psychosocial impairments compared to their non-FGM counterparts.
Association of obstructive sleep apnea with postoperative outcomes after breast reconstruction.
Li Y, Feng H, He L … +3 more , Yang W, Xie H, Mo R
BMC Womens Health · 2026 May · PMID 42106757 · Full text
BACKGROUND: Obstructive sleep apnea (OSA) is prevalent among breast reconstruction patients, yet its impact on surgical outcomes remains inadequately characterized. This study assessed associations between OSA and postop...
BACKGROUND: Obstructive sleep apnea (OSA) is prevalent among breast reconstruction patients, yet its impact on surgical outcomes remains inadequately characterized. This study assessed associations between OSA and postoperative complications, length of stay, and inpatient costs among patients undergoing breast reconstruction. METHODS: We performed a retrospective population-based study using the National Inpatient Sample from 2016 to 2022. Breast reconstruction hospitalizations were identified using ICD-10-PCS procedure codes, and OSA was identified using the ICD-10-CM diagnosis code G47.33. National estimates were generated using HCUP discharge weights, and the complex survey design of the NIS was accounted for in all analyses. Multivariable logistic regression was used to analyze binary postoperative complications. LOS and inpatient costs were summarized as median (interquartile range [IQR]) and compared using the Wilcoxon rank-sum test because of non-normal distributions. A prespecified two-sided P value < 0.001 was considered statistically significant. RESULTS: Based on weighted national estimates, 177,435 adult breast reconstruction hospitalizations were included, of which 7,865 (4.4%) involved patients with OSA. In multivariable-adjusted analyses, OSA was associated with increased odds of respiratory failure (adjusted odds ratio [aOR], 2.705; 95% confidence interval [CI], 2.089-3.504), heart failure (aOR, 2.282; 95% CI, 1.862-2.796), and thrombocytopenia (aOR, 1.552; 95% CI, 1.219-1.976) (all P < 0.001). OSA was also associated with lower odds of seroma (aOR, 0.555; 95% CI, 0.468-0.659). Compared with patients without OSA, those with OSA had a longer LOS (median, 3 [IQR, 2-4] vs. 2 [IQR, 1-3] days; P < 0.001) and higher inpatient costs (median, $99,066 [IQR, $64,118-$144,249] vs. $91,965 [IQR, $60,160-$139,225]; P < 0.001). In subgroup analyses, the associations with respiratory failure, heart failure, and seroma remained directionally consistent across autologous and implant-based reconstruction. CONCLUSIONS: OSA is independently associated with increased cardiopulmonary complications, thrombocytopenia, prolonged hospitalization, and elevated costs in breast reconstruction patients. These findings support routine preoperative OSA screening and optimized perioperative management.
Analysis of factors influencing the missed diagnosis of cervical precancerous lesions by colposcopy.
Yuan L, Wang H, Xu Z … +2 more , Liu K, Lan S
BMC Womens Health · 2026 May · PMID 42106698 · Full text
OBJECTIVE: We aimed to explore the factors that influence the missed diagnosis of cervical precancerous lesions by colposcopy. METHODS: This retrospective cohort study included 448 patients with cervical precancerous les...
OBJECTIVE: We aimed to explore the factors that influence the missed diagnosis of cervical precancerous lesions by colposcopy. METHODS: This retrospective cohort study included 448 patients with cervical precancerous lesions who underwent colposcopy and cervical biopsy between January 1, 2022, and October 13, 2024. Univariate and multivariate logistic regression analyses were performed to identify factors associated with missed diagnosis, with colposcopic findings compared against histopathological results as the gold standard. RESULTS: Compared to histopathological results (gold standard), the accuracy rate of colposcopy was 65.63% (294/448). Univariate logistic regression analysis showed that insufficient colposcopic diagnosis was significantly correlated with age ≥40 years (χ2=15.632, p<0.001), absence of postcoital vaginal bleeding (χ²=5.734, p=0.01), low-grade abnormalities in liquid-based cytology (χ²=9.809, p=0.002), non-HPV16 infection (χ2=7.204, p=0.007), lesions located in the cervical canal (χ²=23.914, p<0.001), history of cervical conization (χ2=7.182, p=0.007), and colposcopic features including no or thin acetowhite epithelium (χ²=225.559, p<0.001), absence of mosaic (χ2=45.925, p<0.001), absence of punctate blood vessels (χ²=36.041, p<0.001), and positive iodine test (χ2=35.794, p<0.001). Multivariate logistic regression analysis identified age ≥40 years (OR=0.468, 95% CI: 0.287~0.761, p=0.002), absence of postcoital vaginal bleeding (OR=2.132, 95% CI: 1.077~4.222, p=0.030), low-grade abnormalities in TCT results (OR=2.584, 95% CI: 1.527~4.372, p<0.001), non-HPV16 infection (OR=0.545, 95% CI: 0.358~0.832, p=0.005), and lesions localized to the cervical canal (OR=0.042, 95% CI: 0.005~0.338, p=0.003) as independent risk factors for missed diagnosis. The highest missed diagnosis rate (67.9%) was observed in patients aged ≥55 years with low-grade TCT abnormalities (n=53), which should be interpreted with caution as exploratory data; in contrast, the missed diagnosis rate was 20.0% in patients aged <25 years with HPV16 positivity (n=15). CONCLUSION: Age over 40, absence of postcoital vaginal bleeding, low-grade abnormality in TCT results, non-HPV16 infection, and lesions in the cervical canal are independent risk factors for cervical precancerous lesions detected through colposcopy. However, the findings must be interpreted cautiously because they were based on a retrospective study and the study had a short follow-up.
Women's reasoning and experience in the cervical cancer screening programme when offered a self-sampling HPV test: a qualitative content analysis.
Hellsten C, Magnusson L, Borgfeldt C
BMC Womens Health · 2026 May · PMID 42106661 · Full text
BACKGROUND: Our aim was to explore the reasoning and experiences of women when offered a self-sampling HPV test. METHODS: This study implemented a qualitative study design and content analysis using an inductive approach...
BACKGROUND: Our aim was to explore the reasoning and experiences of women when offered a self-sampling HPV test. METHODS: This study implemented a qualitative study design and content analysis using an inductive approach. Data consisted of written narratives collected through open-ended questions from a total of 173 women. Women were included if they had been offered a self-sampling device since September 2021 and were southern Sweden residents. To achieve purposive sampling with maximum variation, attenders adhering to the screening programme, nonattenders (absent for at least two screening rounds), and women with cervical dysplasia were recruited. RESULTS: The content analysis generated seven categories: (1) unpleasant experience with a vaginal examination; (2) gratefulness and acceptability of self-sampling; (3) varied perception of one's capacity to perform self-sampling; (4) preference for cervical sampling by healthcare professionals; (5) anxiety and fear concerning a potential or detected HPV infection; (6) different risk assessments for acquiring an HPV infection; and (7) negative impact on mental well-being due to cervical dysplasia. The overarching theme became "the HPV self-sampling reduced practical and emotional barriers to attending the cervical cancer screening programme, but test results may create anxiety." CONCLUSIONS: Most women valued HPV self-sampling, although their confidence in performing it varied. Self-sampling can reduce the emotional and practical barriers to participation in cervical cancer screening. However, anxiety about cervical dysplasia or following a positive HPV test was noted, highlighting the need for healthcare professionals to provide personalised information to alleviate negative emotions.
Clinical outcomes of pelvic floor muscle training, electrical stimulation, and magnetic stimulation in women with postpartum stress urinary incontinence: a retrospective cohort study.
Qi Y, Sun C, Luo L … +1 more , Wang C
BMC Womens Health · 2026 May · PMID 42104361 · Full text
BACKGROUND: Postpartum stress urinary incontinence (PSUI) commonly impairs quality of life in postpartum women. Pelvic floor muscle training (PFMT), as a primary foundational treatment, faces challenges such as inadequat...
BACKGROUND: Postpartum stress urinary incontinence (PSUI) commonly impairs quality of life in postpartum women. Pelvic floor muscle training (PFMT), as a primary foundational treatment, faces challenges such as inadequate adherence and significant individual differences in efficacy. Electrical stimulation (ES) and magnetic stimulation (MS), as passive pelvic floor rehabilitation techniques, are often used in conjunction with PFMT in clinical settings. However, there is a lack of systematic retrospective cohort study evidence comparing the efficacy, safety, and adherence of these three methods. OBJECTIVE: Compare the effects of the three intervention strategies: PFMT, PFMT combined with ES, and PFMT combined with MS, on the recovery of pelvic floor function and the improvement of clinical symptoms in patients with PSUI. METHODS: This retrospective study enrolled patients with PSUI who received systematic treatment at our hospital's plastic surgery department between June 2020 and June 2025. Patients were divided based on their treatment regimens: PF (receiving PFMT guidance), ES (receiving PFMT combined with outpatient ES therapy), and MS (receiving PFMT combined with outpatient MS therapy). A total of 102 patients (n = 34) were ultimately included. All patients received a 12-week course of systematic rehabilitation treatment. Primary indicators were objective measures: the amount of urine leakage during a 1-hour pad test, pelvic floor muscle strength (modified Oxford grading), and urodynamic parameters (maximum urethral closure pressure [MUCP], abdominal pressure leak point pressure [LPP]). Secondary indicators included the overall clinical response rate, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scores, Incontinence Quality of Life Questionnaire (I-QOL) scores, and the incidence of adverse events. RESULTS: Baseline characteristics were balanced among the three groups (P > 0.05). After 12 weeks of treatment, the urine leakage volume in all three groups decreased compared to the baseline (P < 0.001). Specifically, the urine leakage volume after MS and ES treatments was lower than after PF treatment (P < 0.01). In terms of pelvic floor muscle strength, both MS and ES treatments resulted in higher Oxford grades compared to PF (P < 0.001). Regarding urodynamic parameters, both MS and ES treatments showed higher MUCP and LPP values than PF (P < 0.001) with MS higher than ES (P < 0.05). In terms of clinical overall effectiveness, PF had a rate of 73.5% (25/34), ES had a rate of 91.2% (31/34), and MS had a rate of 94.1% (32/34). Both ES and MS had higher rates compared to PF (P < 0.05). Both MS and ES showed lower ICIQ-SF scores (P < 0.01) and higher I-QOL scores (P < 0.001) than PF. Moreover, MS had higher I-QOL scores than ES (P = 0.008). CONCLUSION: In this non-randomized study, PFMT combined with ES or MS was associated with greater improvements than PFMT alone, and MS showed more favorable urodynamic and quality-of-life changes. Causal superiority cannot be determined.
Effects of short-term resistance training plus whole-body neuromuscular electrical stimulation on blood cardiometabolic biomarkers in sedentary middle-aged women: a parallel-group, randomized trial.
Aizava PVS, de Salles Painelli V, de Paula Silva L … +6 more , Orlandi EB, Pavanello A, Cosialls AMH, Barbão KEG, Valdés-Badilla P, Branco BHM
BMC Womens Health · 2026 May · PMID 42104318 · Full text
BACKGROUND: Middle-aged women are disproportionately affected by cardiometabolic deterioration during the menopausal transition. Resistance training (RT) is an established countermeasure, and whole-body neuromuscular ele...
BACKGROUND: Middle-aged women are disproportionately affected by cardiometabolic deterioration during the menopausal transition. Resistance training (RT) is an established countermeasure, and whole-body neuromuscular electrical stimulation (WB-NMES) may enhance its physiological effects. However, whether short-term RT combined with WB-NMES further improves blood cardiometabolic biomarkers in this population remains unknown. METHODS: In this parallel-group, randomized trial, 23 sedentary middle-aged women (47 ± 6 y, 86.3 ± 15.7 kg, 1.61 ± 0.06 m, 33.2 ± 6.0 kg∙m) were allocated to six weeks of RT combined with WB-NMES (RT + WB-NMES; n = 11) or RT alone (RT; n = 12), performing two supervised sessions per week. Primary outcomes were blood biomarkers related to cardiometabolic risk (total cholesterol, LDL-c, HDL-c, VLDL-c, triglycerides, fasting glucose, liver enzymes, and C-reactive protein). Secondary outcomes comprised anthropometric measures, body composition, and physical fitness. RESULTS: No significant Group × Time interaction was identified for any blood biomarker. A significant main effect of Time was observed for LDL-c (P = 0.002) and total cholesterol (P = 0.001), with post-hoc analyses revealing significant within-group reductions exclusively in the RT + WB-NMES group (LDL-c: P = 0.041, ES = - 1.13; total cholesterol: P = 0.026, ES = - 0.91). No significant Group × Time interaction was found for any anthropometric, body composition, or most physical fitness variables. Lumbar traction strength improved significantly within the RT + WB-NMES group (P = 0.029, ES = 0.99) but not in RT alone (P = 0.569, ES = 0.53). CONCLUSIONS: Six weeks of RT combined with WB-NMES accelerated reductions in LDL-c and total cholesterol in sedentary middle-aged women, although statistical superiority over RT alone was not demonstrated. These preliminary findings support the cardiometabolic relevance of short-term RT + WB-NMES, though larger trials are required. TRIAL REGISTRATION: U111113186998 https://ensaiosclinicos.gov.br/rg/RBR6zx5zcz . Registered on 10/09/2025.
Effects of gallic acid on cyclophosphamide-induced experimental ovarian injury in rats.
Koyun Alvuroğlu E, Öztürk Okatan D, Şahin E … +1 more , Alver A
BMC Womens Health · 2026 May · PMID 42098761 · Full text
BACKGROUND: The potential harmful effects of cancer treatments on reproductive function have now been clearly recognized. Exposure to chemotherapy is considered a risk factor for premature ovarian failure and causes infe...
BACKGROUND: The potential harmful effects of cancer treatments on reproductive function have now been clearly recognized. Exposure to chemotherapy is considered a risk factor for premature ovarian failure and causes infertility. This study investigated the prophylactic effects of gallic acid (GA) against cyclophosphamide (CP)-induced ovarian damage in rats. METHODS: Thirty-two adult female Sprague Dawley rats were randomly assigned into four groups (control, CP, GA, and CP + GA). No procedure was applied to the control group. The CP group received 150 mg/kg CP via the intraperitoneal (i.p.) route on day 7 of the experiment. The GA group received 20 mg/kg GA daily for seven days from day 1 of the experiment via oral gavage. The CP + GA received 20 mg/kg GA daily for seven days from day 1 of the experiment via oral gavage and 150 mg/kg i.p. CA on day 7 of the experiment. All rats were sacrificed on day 8. Sections taken from the ovaries were stained using hematoxylin-eosin, Masson's trichrome, Periodic Acid-Schiff, and the TUNEL method. Histopathological examination of ovarian tissues and follicle counting were performed. Glutathione peroxidase (GPX), superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), tissue anti-müllerian hormone (AMH), and serum AMH levels were examined during biochemical investigation. RESULTS: Follicular cell degeneration increased significantly in the CP group compared to the control and GA groups (p < 0.001 for both). Follicular cell degeneration in the CP + GA group was significantly lower than in the CP group (p = 0.003), but higher than in the control and GA groups (p = 0.005, p = 0.015 and p = 0.029, respectively). The GA and control groups exhibited similar morphologies. The apoptotic index was higher in the CP group than in the control and CP + GA groups (p = 0.032 and p = 0.032, respectively). Primordial follıcle cell numbers decreased significantly in the CP group compared to the control and CP + GA groups (p = 0.015 and p = 0.029, respectively). Unilaminar primary follicle cell numbers were lower and atretic cell numbers were higher in the CP group than in the control and GA groups (p < 0.001 and p = 0.008, respectively). The numbers of unilaminar primary follicles were lower in the CP + GA group than in the control group (p = 0.009), while atretic follicle numbers were higher than in the control and GA groups (p < 0.001 for both). Atretic follicle numbers were also higher in the CP + GA group than in the control and GA (p = 0.009 and p = 0.008, respectively). MDA levels were higher in the CP than in the control and GA groups (p = 0,003 and p = 0.001, respectively). MDA levels in the CP + GA decreased compared to the CP group (p = 0.002). SOD activity decreased in the CP group compared to the control, CP + GA, and GA groups (p = 0.003, p = 0.006 and p = 0.038, respectively). Tissue CAT activity was lower in the CP group than in the control group (p = 0.038). Tissue CAT activity increased in the CP + GA group compared to the control and CP groups (p < 0.001 for both). Tissue CAT activity also increased in the GA group compared to the control and CP groups (p = 0.001 for both). Tissue AMH was lower in the CP group compared to the control group (p = 0.015), while serum AMH was higher in the GA group than in the other groups (p = 0.003, p = 0.003, and p = 0.022, respectively). No intergroup difference was observed in GPX levels. CONCLUSIONS: GA can be effective in preventing follicle cell damage caused by CP in the ovary.
A repeated cross-sectional analysis of routine leucorrhea test results in women from Jianyang City, Western China (2022-2024) and exploration of the significance of health screening.
Zhang T, Zhang H, Wei Y … +1 more , Wang D
BMC Womens Health · 2026 May · PMID 42098750 · Full text
OBJECTIVE: To examine temporal trends in routine leucorrhea test results and associated pathogen findings among women participating in sustained cervical and breast cancer screening programs in a county-level city of wes...
OBJECTIVE: To examine temporal trends in routine leucorrhea test results and associated pathogen findings among women participating in sustained cervical and breast cancer screening programs in a county-level city of western China. METHODS: In this repeated cross-sectional screening study, routine leucorrhea test data were collected from women aged 35-64 years who participated in cervical and breast cancer screenings in Jianyang City, Sichuan Province, between January 2022 and December 2024 (12,156 cases in 2022, 13,824 cases in 2023, and 11,382 cases in 2024). Participants were stratified by age and region. Vaginal cleanliness and pathogens were assessed using the normal saline wet mount method. Statistical analyses were performed using SPSS 26.0, including trend analysis, linear regression, and stratified analyses to examine age-region interaction effects. RESULTS: Over the three-year period, the abnormal rate of routine leucorrhea tests (Grade III-IV) decreased from 34.21% to 30.00%, corresponding to an annual reduction of 6.5% (P < 0.001). Infection rates of Candida albicans, Trichomonas vaginalis, and clue cell positivity declined concurrently. The 51-55 age group had the highest baseline abnormal rate but showed the most pronounced decrease (5.40% points). Stratified analysis indicated that township perimenopausal women (51-55 years) experienced the steepest improvement (7.2% points) compared with urban counterparts (3.8% points, P < 0.01). The urban-rural gap narrowed by 3.90% points (P < 0.001). Following the 2023 township healthcare initiative, township abnormal rates declined more steeply than the pre-intervention trend would have predicted (difference of 3.10% points); given the cross-sectional design, this difference should be interpreted as a temporal association rather than causal attribution. CONCLUSION: Participation in a sustained, population-based screening program was temporally associated with a declining trend in abnormal leucorrhea findings among women aged 35-64 years in this county-level city of western China. Based on a preliminary linear trend estimate derived from three annual data points, the abnormal rate may decrease to approximately 26% by 2026 if current intervention intensity is maintained; this projection should be interpreted with caution given the limited time series. Because this is a repeated cross-sectional analysis, causal inference is not warranted. Targeted interventions for perimenopausal women and residents of township areas should be reinforced to optimize gynecological health services in western China.
Perceived quality of care of medical abortions in the public health system in Catalonia (Spain).
López-Gimeno E, Falguera Puig G, Martínez Bueno C … +4 more , García-Sierra R, Vicente-Hernández MM, Grau Galtés J, Cabedo-Ferreiro RM
BMC Womens Health · 2026 May · PMID 42092864 · Full text
BACKGROUND: In Spain, induced abortions are covered by the public health system. In the region of Catalonia, under the scope of Primary Care, the Sexual and Reproductive Health Care Units (ASSIR) attend to women who choo...
BACKGROUND: In Spain, induced abortions are covered by the public health system. In the region of Catalonia, under the scope of Primary Care, the Sexual and Reproductive Health Care Units (ASSIR) attend to women who choose to have a medical abortion (MA) up to 9.6 weeks of gestation. AIM: To determine the perception of the quality of care received by women who have undergone a MA in the ASSIR. METHODS: Multicentre cross-sectional study, in collaboration with all of Catalonia's ASSIR units. At the follow-up visit after the MA, the women completed the SERVPERF (SERVice-PERFormance) Perceived Quality Satisfaction Scale, validated in Spanish, to evaluate the quality of care received in the dimensions of health professionals, administrative staff, organization, information, clinical aspects, impact of the process, and satisfaction. RESULTS: Eight hundred and five (86.6%) women completed the SERVPERF MA questionnaire. The mean total SERVPERF score of participants' assessment of care was 96.68 (SD 15.6), with a maximum possible score of 130. The mean score per question across the entire scale was 3.72 (SD 0.6), with a maximum score of 5. The questions with the lowest scores were related to clinical aspects (pain, anxiety, bleeding), with a mean of 2.26 (SD 0.8), and the impact of the process (on life and family relationships), with a mean of 3.25 (SD 1). In contrast, satisfaction (I would use the service again or recommend it to a friend) obtained the highest mean score: 4.47 (0.8). Women who had previously had an abortion reported higher perceived quality (M = 98.54, SD = 14.52) than women without past abortions (M = 95.67, SD = 16.21), p = 0.013. CONCLUSION: The overall satisfaction score falls within a favourable range. The clinical aspects of pain, anxiety, and bleeding scored the lowest but did not correlate with a decrease in user satisfaction; participants would return to the center and recommend it to others.
BMI-dependent association between mammographic breast density and osteoporosis in postmenopausal women using automated density assessment.
Lee HS, Song SH, Park C … +3 more , Kim S, Youn YH, Youk JH
BMC Womens Health · 2026 May · PMID 42092860 · Full text
BACKGROUND: To evaluate the association between automatically measured mammographic breast density (MBD) and osteoporosis in postmenopausal women and determine whether this relationship differs across body mass index (BM...
BACKGROUND: To evaluate the association between automatically measured mammographic breast density (MBD) and osteoporosis in postmenopausal women and determine whether this relationship differs across body mass index (BMI). METHODS: This retrospective cross-sectional study included 7,143 postmenopausal women who underwent both digital mammography and dual-energy X-ray absorptiometry (DXA). MBD (%) was automatically quantified using the Laboratory for Individualized Breast Radiodensity Assessment (LIBRA). Osteoporosis was defined as a DXA T-score ≤ -2.5. BMI-dependent associations were evaluated using logistic regression with a BMI×MBD interaction (continuous model) and prespecified categorical analyses (median split). Discrimination (AUC) was compared between models with and without MBD. RESULTS: Osteoporosis was present in 12.8% (912/7143) of participants. In the continuous interaction model including age, BMI, MBD, and a BMI×MBD interaction, the BMI×MBD interaction was significant (P = 0.007). The estimated odds ratio (OR) for osteoporosis per 1% higher MBD was 0.989 (95% CI 0.981-0.997) at BMI 20, 0.976 (95% CI 0.964-0.989) at BMI 25, and 0.963 (95% CI 0.943-0.984) at BMI 30. In a prespecified median split (MBD < 25.3% vs. ≥ 25.3%), the absolute risk difference was larger in women with BMI ≥ 25 (9.28% vs. 4.59%). Adding MBD to an age + BMI model minimally changed AUC (0.682 to 0.684). CONCLUSION: Higher automated mammographic breast density was associated with lower odds of osteoporosis, and this inverse association was stronger at higher BMI. Although mammographic breast density added little incremental discrimination beyond age and BMI, these findings may provide biologically and epidemiologically relevant insight but do not support clinical decision-making based on mammographic breast density alone.
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