BMC Women's Health[JOURNAL]
Sun
200 papers
Investigation of copper and oxidative stress levels in oral contraceptive users.
Serin Gurel H, Dogan C, Bozali K … +4 more , Egici MT, Guler EM, Vural F, Dayan A
BMC Womens Health · 2026 May · PMID 42087140 · Full text
OBJECTIVE: The aim of this study was to investigate the relationship between oxidative stress parameters [total oxidant status (TOS), total antioxidant status (TAS), thiol/disulfide homeostasis, ischemia-modified albumin...
OBJECTIVE: The aim of this study was to investigate the relationship between oxidative stress parameters [total oxidant status (TOS), total antioxidant status (TAS), thiol/disulfide homeostasis, ischemia-modified albumin (IMA)] and serum copper levels in women who use oral contraceptives (OCs) compared to those who do not. METHODS: This single-center, prospective case-control study included a total of 154 women aged 18 to 45 years (72 OC users and 82 non-users) who presented to the gynecology outpatient clinic of a tertiary care training and research hospital. After obtaining written informed consent, demographic data and information regarding OC use were collected. Venous blood samples were drawn and serum samples were stored at -80 °C until analysis. Serum levels of TOS, TAS, total thiol, native thiol, disulfide, IMA and copper were measured. A p-value of < 0.05 was considered statistically significant. RESULTS: In OC users, serum levels of copper, TOS, oxidative stress index (OSI), disulfide and IMA were significantly elevated, whereas TAS and native thiol levels were significantly reduced compared to non-users (p < 0.05). Serum copper levels showed a positive correlation with oxidative stress markers and a negative correlation with antioxidant capacity indicators. CONCLUSIONS: OC use is associated with increased serum copper levels, which in turn have a significant impact on oxidative stress biomarkers. These findings suggest that OC use elevates systemic oxidative stress while compromising antioxidant defense mechanisms. Moreover, elevated copper levels may independently contribute to oxidative stress regardless of OC use.
Depressive symptoms and associated factors among women preparing for pregnancy: a population-based study from the Seoul metropolitan preconception health management program.
Lee HJ, Shin W, Han JY … +3 more , Choi HZ, Kang J, Woo SY
BMC Womens Health · 2026 May · PMID 42087119 · Full text
BACKGROUND: Depressive symptoms during pregnancy and the postpartum period have been extensively studied; however, evidence regarding mental health in the preconception period remains limited. Women preparing for pregnan...
BACKGROUND: Depressive symptoms during pregnancy and the postpartum period have been extensively studied; however, evidence regarding mental health in the preconception period remains limited. Women preparing for pregnancy undergo physiological changes, lifestyle adjustments, and psychosocial transitions, and emotional vulnerability may be heightened by reproductive stressors, including infertility. Nevertheless, population-based studies examining depressive symptoms and their associated lifestyle and reproductive factors during the preconception period remain scarce. METHODS: This cross-sectional study included 14,004 women aged 20-45 years who participated in the Seoul Metropolitan Preconception Health Management Program between 2019 and 2021. Depressive symptoms were assessed using the Korean-validated Hospital Anxiety and Depression Scale-Depression subscale (HADS-D), with scores ≥ 11 indicating elevated risk. Sociodemographic, lifestyle, nutritional, menstrual, and reproductive factors were assessed. A multivariable logistic regression model was used to identify factors independently associated with depressive symptoms. RESULTS: Among the participants, 1,102 women (8.5%) exhibited elevated depressive symptoms. In a multivariable logistic regression model, depressive symptoms were independently associated with current smoking, passive smoking exposure, insomnia, binge eating, irregular menstruation, severe dysmenorrhea, infertility history, and previous pregnancy. Insomnia, binge eating, current smoking, and severe dysmenorrhea were each associated with more than twofold higher odds of depressive symptoms. In contrast, regular physical activity showed a clear dose-response association, with increasing physical activity level associated with progressively lower odds of depressive symptoms, whereas greater dysmenorrhea severity was associated with progressively higher proportions screening positive for depressive symptoms. Folic acid supplementation was also independently associated with reduced odds of depressive symptoms. CONCLUSIONS: Depressive symptoms were relatively common among women preparing for pregnancy and were closely associated with modifiable lifestyle factors, including smoking, sleep problems, and eating behaviors, as well as reproductive-related factors such as dysmenorrhea and infertility. These findings underscore the need to integrate systematic mental health screening and targeted lifestyle and reproductive health interventions into routine preconception and infertility care to improve women's psychological well-being and support healthier future pregnancies.
Women veterans' experiences of veteran-specific support services: an international scoping review.
Godier-McBard L, Hooks C, Buxton E … +3 more , Morgan L, Adams A, Fossey M
BMC Womens Health · 2026 May · PMID 42070028 · Full text
BACKGROUND: The growing proportion of women in veteran communities internationally highlights a rising need for veteran support services tailored to their unique experiences. Despite this, support services remain predomi...
BACKGROUND: The growing proportion of women in veteran communities internationally highlights a rising need for veteran support services tailored to their unique experiences. Despite this, support services remain predominantly designed for men, leading to underutilization and dissatisfaction among women veterans. This scoping review aimed to provide a comprehensive international review of the current state of knowledge regarding the experiences of women veterans in accessing and engaging with veteran-specific support services. METHODS: This study followed the Joanna Briggs Institute scoping review methodology. Five databases were searched for papers published from 2000 onwards. Studies reporting on barriers and/or facilitators to access and experiences of engaging with veteran-specific support services reported by women veterans were included. There were no limitations on study methodology or country of origin, and all publications reporting primary research were included. RESULTS: A total of 117 studies were included in the review. This research originated predominantly from the US (n = 109), with seven UK papers, and one Canadian. Eleven themes were identified across the literature, highlighting gendered barriers and facilitators of accessing veteran-specific support for women. Women veterans report feelings of discomfort, exclusion, and discrimination within veteran services, which are perceived as being set up and designed for men. Women report experiencing stigma in help-seeking compounded by a perception of feminine weakness experienced during military service. Some women didn't want to access services they saw as military-adjacent, due to gendered adverse experiences during military service, including discrimination, harassment, and sexual violence. A lack of identification with the term 'veteran' further hinders women's engagement with veteran-specific services. Enablers of access include care that is sensitive to women's needs, trauma-informed service user-provider relationships, and peer support. CONCLUSION: The reviewed evidence suggests women experience unique challenges and needs in accessing veteran-specific services. Support services should focus on developing care that is, culturally competent, trauma-informed and sensitive to the needs of women, to address gendered barriers to engagement. More research is needed to confirm these research findings outside of the US context, and incorporating an intersectional lens in future research will be essential for improving the support systems for women veterans internationally.
Association of sleep duration and quality with age at natural menopause: results from NHANES 2005-2018.
Xie Q, Zhu Y, Chen B … +5 more , Zhang Y, Zhao M, Lan Y, Quan X, Yang X
BMC Womens Health · 2026 May · PMID 42069588 · Full text
BACKGROUND: While sleep is closely related to menopause, existing research has primarily focused on the impact of menopause on sleep, leaving the influence of sleep patterns on the timing of menopause largely unexplored....
BACKGROUND: While sleep is closely related to menopause, existing research has primarily focused on the impact of menopause on sleep, leaving the influence of sleep patterns on the timing of menopause largely unexplored. This study aimed to investigate the associations of sleep duration and quality with age at natural menopause. METHODS: This study included women with complete data on sleep patterns and natural menopausal age from the National Health and Nutrition Examination Survey (NHANES) cycles 2005-2018. Logistic and linear regression models, progressively adjusted for demographic, lifestyle, and health-related covariates, were used to examine the relationships of sleep duration and quality with menopausal age, analyzed both as categorical (early/late menopause) and continuous variables. Restricted cubic splines were applied to assess nonlinear associations. Subgroup analyses and alternative menopausal age classifications were also performed. RESULTS: A total of 2,157 women were included. Compared with medium sleep duration (7-9 hours), short sleep duration (< 7 hours) was associated with higher odds of early menopause in the initial model (OR = 1.41, 95% CI: 1.08-1.84, p = 0.01), but this association was attenuated in the fully adjusted model. Restricted cubic spline analysis revealed a nonlinear U-shaped association between sleep duration and early menopause (p for nonlinearity = 0.04), and an inverted U-shaped association with natural menopausal age (p for nonlinearity < 0.01), both peaking around 7.5 hours. Poor sleep quality remained significantly associated with early menopause after full adjustment (OR = 1.30, 95% CI: 1.01-1.66), but not with late menopause. In subgroup analyses, short sleep duration showed a stronger association with early menopause in women with BMI ≥ 28 and those without hormone use. Interestingly, poor sleep quality was positively associated with late menopause among women with ≥ 3 live births and no history of oral contraceptive use. CONCLUSIONS: Short sleep duration and poor sleep quality may be associated with early menopause, with evidence of nonlinear relationships and subgroup heterogeneity. In certain populations, poor sleep quality may also be linked to later menopause. These findings highlight the complex role of sleep in reproductive aging, requiring prospective studies to clarify causal pathways.
Single-port laparoscopic lateral suspension with total versus subtotal hysterectomy for pelvic organ prolapse: a prospective comparative study.
Wu HM, Xu N, Li YH … +4 more , Luo ZG, Xiong R, Li M, Li MX
BMC Womens Health · 2026 May · PMID 42069567 · Full text
BACKGROUND: Laparoscopic lateral suspension (LLS) is an effective mesh-based repair for pelvic organ prolapse (POP), but the optimal concomitant hysterectomy strategy - total (TH) versus subtotal (STH) - remains undefine...
BACKGROUND: Laparoscopic lateral suspension (LLS) is an effective mesh-based repair for pelvic organ prolapse (POP), but the optimal concomitant hysterectomy strategy - total (TH) versus subtotal (STH) - remains undefined. We compared anatomic outcomes, patient-reported outcomes, and complication profiles of LLS combined with TH (LLSHR) versus LLS combined with STH (LLSHE) in a prospective cohort of women who made an informed choice between the two procedures. METHODS: In this prospective comparative study conducted at Chengdu Integrated TCM & Western Medicine Hospital between October 2021 and October 2024, 82 women with symptomatic POP-Q stage II or III uterovaginal prolapse were counseled regarding both hysterectomy options and self-selected into the LLSHR group (n = 41) or the LLSHE group (n = 41). The study was approved by the institutional review board (IRB 2021.XJS.019) and retrospectively registered in the Chinese Clinical Trial Registry (ChiCTR2600118158). Primary outcomes were POP-Q point C and PISQ-12 score at 12 months. Secondary outcomes included POP-Q points Ba and Bp, PFDI-20, PFIQ-7, operative parameters, and mesh-related complications through 24 months. RESULTS: All 82 participants completed surgery as planned. At 12 months, point C was significantly more negative in the LLSHE group than in the LLSHR group (- 5.1 ± 0.5 cm vs. -4.5 ± 0.6 cm; P < 0.001), indicating superior apical support with cervical preservation. The PISQ-12 score at 12 months was significantly higher (better) in the LLSHE group (37.5 [IQR 33.0-42.5] vs. 31.0 [27.0-34.0]; P < 0.001). PFDI-20 and PFIQ-7 improved substantially in both groups with no between-group difference at any time point (all P > 0.05). At 24 months, point C remained significantly more negative in the LLSHE group (- 4.8 ± 0.5 vs. -4.4 ± 0.6; P = 0.004), and the PISQ-12 advantage of LLSHE persisted (37.0 [34.0-43.0] vs. 31.5 [26.8-39.0]; P = 0.005). Mesh exposure was observed in 3 patients (9.4%) in the LLSHR group and none in the LLSHE group (P = 0.226). Operative time was significantly shorter in the LLSHE group (149.0 [143.0-165.0] min vs. 171.0 [150.0-186.0] min; P = 0.002). CONCLUSIONS: In women undergoing LLS for POP, STH was associated with superior apical support and better sexual function at both 12 and 24 months, with shorter operative time and a numerically lower rate of mesh exposure compared with TH. Given the non-randomized design, these findings should be interpreted as hypothesis-generating. Prospective randomized trials are warranted to confirm these associations. TRIAL REGISTRATION: ChiCTR2600118158; registered February 2, 2026, retrospectively registered.
Effectiveness of community-based health education intervention on knowledge, attitudes, and controlling behaviors related to intimate partner violence in Hadiya Zone, Central Ethiopia: a cluster randomized controlled trial.
Agde ZD, Tirore LL, Abdissa HG … +5 more , Abageda M, Agafari GB, Magnus JH, Assefa N, Wordofa MA
BMC Womens Health · 2026 May · PMID 42067864 · Full text
BACKGROUND: In Ethiopia, a substantial proportion of women experience physical, psychological, or sexual violence perpetrated by their husbands or intimate partners. There is limited evidence on interventions aiming to i...
BACKGROUND: In Ethiopia, a substantial proportion of women experience physical, psychological, or sexual violence perpetrated by their husbands or intimate partners. There is limited evidence on interventions aiming to improve awareness, alter attitudes, and control behavior related to IPV in Ethiopia. Therefore, this study aimed to evaluate the effectiveness of community-based health education (CBHE) targeting couples on knowledge, attitudes, and controlling behavior among women in Hadiya zone, central Ethiopia. METHODS: A community-based, parallel-group, two-arm cluster randomized controlled trial design was employed to evaluate the effect of a CBHE intervention on knowledge, attitude, and controlling behavior related to IPV in Hadiya zone, central Ethiopia. A total of 432 women (216 in the intervention groups and 216 in the control groups) were involved in the study. The intervention was provided for couples over a period of six consecutive months. Generalized Estimating Equation (GEE) and difference-in-difference analysis were conducted to evaluate the effectiveness of the intervention on the outcomes. RESULTS: About 94.4% of the mothers in the intervention groups and 95% of the women in the control groups were available for intention-to-treat analysis at the end of the intervention. Women in the intervention groups were about 5 times more likely to have good knowledge of IPV than those in the control groups (AOR = 4.8; 95% CI 2.9-7.9). Mothers in the intervention were 70% less likely to have a supportive attitude towards wife-beating compared to mothers in the control group (AOR = 0.3; 95% CI 0.2, 0.5). Likewise, mothers in the intervention groups were 60% less likely to justify controlling behavior from their husbands compared to those in the control groups (AOR = 0.4; 95% CI 0.3, 0.7). CONCLUSIONS: This study highlights that CBHE intervention led to a significant improvement in participants' knowledge of IPV against women. It also resulted in a marked reduction in the acceptance of wife-beating and justification of controlling behaviors. These findings provide strong evidence to support the broader scale-up of this intervention. TRIAL REGISTRATION: This trial was recorded in the ClinicalTrials.gov registry with the identifier NCT05856214 on May 4, 2023.
Paraclitoral cystic lesions after female genital mutilation: a clinicopathologic evaluation from Mogadishu.
Toplu Mİ, Hassan HB, Abdullahi IM … +4 more , Aydoğdu BD, Özkan Y, Abdi MA, Aktürk E
BMC Womens Health · 2026 May · PMID 42067839 · Full text
BACKGROUND: Female genital mutilation/cutting (FGM/C) is associated with long-term gynecologic complications, including delayed paraclitoral cystic lesions. However, the clinicopathologic spectrum and postoperative outco...
BACKGROUND: Female genital mutilation/cutting (FGM/C) is associated with long-term gynecologic complications, including delayed paraclitoral cystic lesions. However, the clinicopathologic spectrum and postoperative outcomes of these lesions remain insufficiently characterized, particularly in high-prevalence settings. METHODS: This single-center retrospective clinicopathologic study included women with a history of FGM/C who underwent surgical excision of paraclitoral lesions between January 2017 and March 2025. Clinical presentation, surgical management, histopathological findings, and postoperative outcomes were analyzed. Comparative analyses were performed between epidermoid and non-epidermoid lesions. RESULTS: A total of 146 patients were included. The mean age was 28.9 ± 13.2 years. The most common presenting symptom was pain (58.9%), and pain was present in 86.3% overall. Histopathology revealed predominantly epidermoid cysts (84.2%), followed by traumatic neuroma (8.9%) and other benign lesions. Parity was significantly associated with histopathologic subtype (p = 0.020), with non-epidermoid lesions more common in women with parity > 3. All patients underwent complete en bloc excision, and no intraoperative complications were documented in the available operative records. Among patients with available follow-up, postoperative pain improvement was documented in 89.7%, and no recurrence was documented among patients with available 6-month follow-up. CONCLUSION: Paraclitoral lesions following FGM/C are predominantly epidermoid cysts but may also include other pathologies, such as traumatic neuroma. Surgical excision was associated with favorable early documented outcomes among patients with available follow-up; however, interpretation of functional recovery and recurrence remains limited by nonstandardized retrospective outcome assessment and incomplete follow-up. These findings contribute additional clinicopathologic data to a limited evidence base and highlight the need for prospective studies with standardized follow-up.
The value of posterior colpotomy first technique on the vaginal length during total abdominal hysterectomy.
Farid MN, Hammad BM, Saad H … +3 more , Abdelfattah AA, Maged AM, Soliman MR
BMC Womens Health · 2026 May · PMID 42063059 · Full text
OBJECTIVE: To investigate the role of posterior colpotomy first technique in preserving vaginal length and support with total abdominal hysterectomy (TAH). MATERIALS AND METHODS: Eighty women candidate for TAH for benign...
OBJECTIVE: To investigate the role of posterior colpotomy first technique in preserving vaginal length and support with total abdominal hysterectomy (TAH). MATERIALS AND METHODS: Eighty women candidate for TAH for benign lesion were randomly assigned to either classical technique (40 women) or posterior colpotomy first technique (40 women). The primary outcome parameter was the total vaginal length and shortening measured 3 months after the procedure. RESULTS: The operative time was significantly longer in the posterior colpotomy group compared to classic group (106.28 ± 8.3 vs. 95.18 ± 18.35 min, P < 0.001). Total vaginal shortening was significantly lower in the posterior colpotomy group compared to classic group (0.99 ± 0.3 vs. 2.4 ± 0.8, P < 0.001). The number of women with postoperative dyspareunia was significantly lower in the posterior colpotomy group compared to classic group (4/40 (10%) vs. 8/40 (20%), P = 0.011). The female sexual function index score was significantly higher in the posterior colpotomy group compared to classic group (28.5 ± 2.5 vs. 24.19 ± 1.76, P = 0.038). CONCLUSION: The posterior colpotomy first technique is associated with less shortening of the total vaginal length, less occurrence of dyspareunia, and higher female sexual function index score compared to the classic approach for TAH.
Pre-rupture diagnosis and conservative surgery for ovarian ectopic pregnancy hidden by an endometrioma, guided by the transvaginal ultrasound "sliding organ sign": a case report and literature review.
Wei S, Liu W, Liu S … +1 more , Chen H
BMC Womens Health · 2026 Apr · PMID 42063054 · Full text
BACKGROUND: Ovarian ectopic pregnancy (OEP) is a rare and life-threatening condition that is typically diagnosed post-rupture. Its diagnosis and management become more complex when it is concurrent with ovarian endometri...
BACKGROUND: Ovarian ectopic pregnancy (OEP) is a rare and life-threatening condition that is typically diagnosed post-rupture. Its diagnosis and management become more complex when it is concurrent with ovarian endometrioma, as the latter may mask the clinical and radiological features of OEP. CASE PRESENTATION: We report the case of a 28-year-old woman (gravida 2, para 1) who presented with 44 days of amenorrhoea and lower abdominal pain. Transvaginal ultrasound (TVS) revealed an empty uterus, a complex right adnexal mass containing a yolk sac (with synchronous movement with the ovary and a negative "sliding organ sign", raising a strong suspicion of ovarian ectopic pregnancy), and a separate "ground-glass" cystic lesion (consistent with an endometrioma). Corpus luteum blood flow signals were detected in the left ovary. The patient's preoperative haemoglobin concentration was 128 g/L. Diagnostic laparoscopy confirmed a right ovarian pregnancy co-existing with an ipsilateral endometrioma. Both lesions were excised laparoscopically while preserving the ovary. Haemostasis was achieved by primary suturing supplemented with minimal bipolar coagulation to preserve ovarian function. The patient recovered well; her postoperative haemoglobin concentration was 122 g/L, and her menses resumed at 6 weeks post-operatively, which confirmed preserved ovarian function. CONCLUSIONS: This case reaffirms a fundamental clinical principle: any reproductive-age woman with a positive pregnancy test, an empty uterus, and an adnexal mass should be presumed to have an ectopic pregnancy, prompting immediate surgical evaluation. In our patient, this principle alone mandated surgery. The transvaginal ultrasound findings (a yolk sac and a negative "sliding organ sign") did not change the need for surgery, but they provided critical preoperative localization of the gestational sac to the ovary. This allowed us to anticipate an ovarian pregnancy, obtain specific consent for ovary-conserving surgery, and plan a suture-dominant haemostatic strategy. To our knowledge, this is the first reported case of pre-rupture diagnosis of an ovarian ectopic pregnancy masked by an endometrioma using these sonographic signs. Clinicians must prioritize the clinical triad; when available, meticulous ultrasound adds precision for fertility preservation.
Patients' knowledge of and experience with Enhanced Recovery After Surgery (ERAS)-guided surgery: a qualitative study.
Ibadin S, Rana B, Smith C … +2 more , Nelson G, Sauro KM
BMC Womens Health · 2026 Apr · PMID 42063045 · Full text
BACKGROUND: Implementing Enhanced Recovery After Surgery (ERAS) guidelines can improve post-operative outcomes and recovery. Patient partnership in care is a core tenet of ERAS, but there is little evidence exploring pat...
BACKGROUND: Implementing Enhanced Recovery After Surgery (ERAS) guidelines can improve post-operative outcomes and recovery. Patient partnership in care is a core tenet of ERAS, but there is little evidence exploring patients' perceived knowledge of and experience with ERAS guideline recommended care. The objective is to understand patients' knowledge of and experience with Enhanced Recovery After Surgery (ERAS)-guided surgeries. METHODS: Using an interpretive descriptive approach, one-on-one interviews were conducted with patients who had undergone an ERAS-guided surgery in Alberta, Canada. The semi-structure interviews were facilitated by a trained qualitative researcher. The audio recordings were transcribed verbatim and were analyzed using framework analysis. RESULTS: Seventeen interviews were conducted among females with a mean age of 59.1 years, who mostly had gynecologic or breast surgery. Knowledge of ERAS guidelines was minimal, but when probed about the ERAS care elements many patients expressed receiving ERAS compliant care. Four main themes emerged from the data: (1) patient awareness and education about ERAS guidelines, (2) patient experience with ERAS elements, (3) perception of the quality of care, and (4) patient informed strategies for improving surgical care. CONCLUSIONS: This study identified an opportunity to improve awareness of ERAS guidelines and ERAS recommended care. Patients expressed a desire to be better informed about the processes of care and to be more active members of the care team.
Evaluation of endometrium by transvaginal ultrasound and baseline factors as a predictor for endometrial abnormalities in asymptomatic postmenopausal women.
Wang Z, Yan Z, Wu D … +3 more , Wang M, Meng Y, Li M
BMC Womens Health · 2026 May · PMID 42063014 · Full text
OBJECTIVE: The cut-off value of endometrial thickness (ET) in asymptomatic postmenopausal women, beyond which intervention is required, is still debated. This study aimed to provide a clinical decision support tool to gu...
OBJECTIVE: The cut-off value of endometrial thickness (ET) in asymptomatic postmenopausal women, beyond which intervention is required, is still debated. This study aimed to provide a clinical decision support tool to guide the management of asymptomatic postmenopausal women with incidentally detected endometrial thickening. METHODS: A retrospective observational study was conducted involving 280 asymptomatic postmenopausal women with ET > 5 mm who underwent hysteroscopy or dilation and curettage. Participants were stratified by menopausal duration and history of endocrine therapy for breast cancer. We analysed associations between ET, transvaginal ultrasound (TVUS) features, baseline characteristics and pathological outcomes. Based on univariate and multivariate analyses, we developed a prediction model to help predict endometrial lesions. RESULTS: The pathological negativity rate was 35.36% among the whole cohort. We propose two candidate diagnostic thresholds for ET in asymptomatic postmenopausal women: a lower cut-off of 7 mm suggestive of any endometrial pathology (primary outcome), and a higher cut-off of 9.5 mm warranting suspicion for clinically significant pathology, including atypical endometrial hyperplasia (AEH) and endometrial cancer (EC) (secondary outcome). Our findings indicate a statistically significant difference in ET between healthy women within 5 years of menopause and those beyond 5 years. Nevertheless, no such significant disparity was observed in women with endometrial lesions. No significant difference was observed in ET between the overall population and patients receiving postoperative endocrine therapy for breast cancer. Using the presence or absence of endometrial lesions as the outcome, a prediction model was established. The model incorporates age, height, TVUS vessel pattern, and echogenicity. It provides a more holistic risk assessment tool than relying on a single millimetre measurement. CONCLUSION: Adopting a 7 mm candidate cut-off for intervention could spare over one‑third of asymptomatic women from unnecessary invasive procedures. Risk assessment should integrate TVUS morphological features with clinical factors, not merely rely on a single ET measurement. External validation in diverse populations is required before clinical implementation.
Effects of extracorporeal shockwave therapy on pain and pelvic floor function in women with pelvic floor myofascial pain: a retrospective cohort analysis.
Wu YC, Ding DC
BMC Womens Health · 2026 Apr · PMID 42062986 · Full text
BACKGROUND: Pelvic floor myofascial pain (PFMP) is a common cause of chronic pelvic pain. We aimed to explore whether the application of extracorporeal shockwave therapy (ESWT) is associated with reductions in pain inten...
BACKGROUND: Pelvic floor myofascial pain (PFMP) is a common cause of chronic pelvic pain. We aimed to explore whether the application of extracorporeal shockwave therapy (ESWT) is associated with reductions in pain intensity and pelvic floor dysfunction scores among patients with PFMP. METHODS: We conducted a retrospective cohort study of 20 female patients with PFMP treated with ESWT between July 2022 and February 2024. All participants underwent a baseline assessment, which included a comprehensive medical history, physical examination, and symptom evaluation using the Visual Analogue Scale (VAS) and the Pelvic Floor Disability Inventory-20 (PFDI-20). ESWT was administered perineally in lithotomy position once weekly for four consecutive weeks, with 2,000 impulses delivered per session. Changes in VAS, PFDI-20, and its subscales (POPDI-6, CRADI-8, UDI-6) were analyzed using paired statistical comparisons. RESULTS: The median age of the patients was 55 years (interquartile range, IQR, 47.5–63.0). After 4 weeks of ESWT, the median VAS score decreased significantly from 7.0 to 2.0 (p < 0.01). The median PFDI-20 score decreased from 33.0 to 26.5 (p < 0.01). Subscale analysis revealed significant reductions in POPDI-6 (from 11.0 to 8.0, p < 0.01), CRADI-8 (from 13.0 to 10.0, p < 0.05), and UDI-6 (from 10.0 to 9.0, p < 0.01). Effect sizes for pre–post changes ranged from r = − 0.54 to − 0.88, with 95% bootstrap confidence intervals reported for all outcomes. CONCLUSION: ESWT is associated with decreased pain intensity and reduced pelvic floor dysfunction scores in patients with PFMP. However, short-term, within-patient change remains the dominant interpretative frame. As such, ESWT is described as associated with symptom reductions rather than implying effectiveness. These preliminary, within-patient findings warrant confirmation in larger, controlled prospective studies.
Hysteroscopic myomectomy for FIGO type 3 uterine fibroids with diameter not less than 5 cm: a retrospective, single-center study of eighteen cases.
Liu Y, Wu W, Jin J … +5 more , Zou Q, Xing Q, Wang J, Cao W, Du X
BMC Womens Health · 2026 May · PMID 42062866 · Full text
BACKGROUND: Hysteroscopic myomectomy is a preferred treatment for women requiring future fertility. While it was difficult to manage large submucosal fibroids or deep intramural invasion myomas with hysteroscopic approac...
BACKGROUND: Hysteroscopic myomectomy is a preferred treatment for women requiring future fertility. While it was difficult to manage large submucosal fibroids or deep intramural invasion myomas with hysteroscopic approaches. We conducted this study to explore the feasibility of hysteroscopic removal of large sized (≥ 5 cm) FIGO type 3 fibroids with deep intramural invasion that are difficult to manage with one-step hysteroscopy by "downgrading" technique. METHODS: This retrospective study included of hysteroscopic myomectomy from February 2023 to September 2025 in an academic university hospital. The removal of large type 3 myomas was typically not less than 5 cm in maximum diameter. The clinical characteristics, details of the surgery and postoperative follow-up were collected for retrospective analysis. RESULTS: A total of eighteen patients were included. The primary maximum diameter of fibroids ranges from 5 to 9.5 cm (median size was 6.5 cm) and ten of them was 6 cm or larger. 77.8% cases scored above 6 according to the classification of the STEPW classifications. Mean hysteroscopic operating time was 41.7 min. The perfusion fluid deficit was between 300 and 2,500 mL. The lowest blood potassium levels ranged from 2.11 to 3.82 mmol/ml. The One-step Hysteroscopic resection was performed in sixteen cases, 88.9% of patients. One case had successfully removed the residual fibroid through another hysteroscopic surgery six weeks after surgery, and another patient refused to receive a reoperation. All patients exhibited stable vital signs intraoperatively and postoperatively. The menstruation was recovered in all patients after the procedure. After 3 to 34 months of follow-up, there was no evidence of the recurrence in all but one patient who lost to follow-up at 1 year postoperatively. Notably, three patient achieved pregnancy spontaneously and two of them successfully delivered a healthy baby. CONCLUSIONS: Hysteroscopic resection with "downgrading" technique is a potential alternative approach for women with large (≥ 5 cm) FIGO type 3 fibroids. However, careful execution in a proficient hysteroscopic center is essential.
Unfiltered chronic pain: Insights from women with color through a virtual photovoice study.
Rahman-Tahir R, Prophet J, Yazdani AT … +2 more , L Hassett A, Gentile R
BMC Womens Health · 2026 May · PMID 42062852 · Full text
Photovoice was utilized with two groups of women of color in Ann Arbor, Michigan (n = 20) living with chronic pain to foster critical dialog about their experiences. The study aimed to explore and understand their lived...
Photovoice was utilized with two groups of women of color in Ann Arbor, Michigan (n = 20) living with chronic pain to foster critical dialog about their experiences. The study aimed to explore and understand their lived experiences through collaborative engagement using a virtual Photovoice. The participants identified key themes, including pain, healing, self-care, overcoming obstacles, nature, and spirituality, which provided valuable insights into their journeys. Participant photographs and dialogues reveal how women of color navigate spaces where their pain is often misunderstood, while simultaneously alleviating pain and reclaiming dignity. To support holistic chronic pain management, systemic reforms must cover evidence-based complementary therapies, expand behavioral health access, fund community support groups, and mandate provider bias training co-designed by patients. These efforts should be guided by trauma-informed and interdisciplinary care models, supported by public awareness campaigns that validate the multidimensional reality of chronic pain and address structural barriers to wellness.
The characterization of patients with premature ovarian failure, endometriosis, and polycystic ovary syndrome in women attending comprehensive health centers in Urmia, Iran.
Fathi B, Ghasemnejad-Berenji H, Hashemi SS … +6 more , Sadeghpour S, Hosseini A, Alinejad V, Firooziyan S, Manafpour M, Bagheri M
BMC Womens Health · 2026 Apr · PMID 42057055 · Full text
BACKGROUND: Polycystic Ovary Syndrome (PCOS), Premature Ovarian Failure (POF)(menopause before age 40), and Endometriosis (EMs) are major challenges; early detection is vital for effective management, improved outcomes,...
BACKGROUND: Polycystic Ovary Syndrome (PCOS), Premature Ovarian Failure (POF)(menopause before age 40), and Endometriosis (EMs) are major challenges; early detection is vital for effective management, improved outcomes, and sustained health support for women. We aimed to characterize patients with POF, EMs, and PCOS in women attending comprehensive health centers in Urmia, Iran. METHODS: This health center-based study involved 373 women. Medical findings obtained from transvaginal sonography, along with clinical features, signs, symptoms, and biochemical analyses were employed to characterize the women with PCOS, POF, and EMs. RESULTS: The frequency of PCOS, POF, and EMs in the tested population were 17.69%, 0.8%, and 3.5%, respectively. Notable differences were identified among women with PCOS compared to healthy individuals regarding alcohol consumption, the place of residence, menstrual cramps, scale of dysmenorrhea-related pain, menstrual cycle, feeling of an abdominal mass, menstrual back pain, abortion, constipation, amenorrhea, hypomenorrhea, oligomenorrhea, ovarian cyst, abnormal pap smear, vaginal infection, diabetes, hormone therapy, primary infertility, acanthosis, acne, hirsutism, and alopecia. Severe dysmenorrhea-related pain and the sensation of an abdominal mass are key characteristics for effectively screening women with POF. Informative clinical characteristics for EMs include dysmenorrhea, severe dysmenorrhea-related pain, heavy menstrual bleeding, abdominal mass feeling, chronic pelvic discomfort, menstrual back pain, oligomenorrhea, ovarian cysts, primary infertility, acanthosis, and acne. CONCLUSIONS: The majority of women diagnosed with PCOS lived in rural areas. Healthcare systems should place a high priority on women’s health in rural regions, where scarce resources and accessibility issues frequently undermine well-being. It is crucial to emphasize early detection, reproductive health, mental wellness, and social support. Enhancing these services not only improves the quality of life for women but also fortifies community resilience and guarantees fair health opportunities for all rural inhabitants, both now and for future generations to prosper.
Absence of high-risk human papillomavirus in breast cancer tissues from young BRCA1/BRCA2-negative women.
Kaya E, Kahraman E, Arikan AE … +3 more , Tokat F, Uras C, Erkanlı S
BMC Womens Health · 2026 Apr · PMID 42057021 · Full text
BACKGROUND: Human papillomavirus (HPV) has been investigated as a potential risk factor in breast cancer, but the literature remains inconsistent. Although biological mechanisms involving HPV E6/E7 oncogene activity prov...
BACKGROUND: Human papillomavirus (HPV) has been investigated as a potential risk factor in breast cancer, but the literature remains inconsistent. Although biological mechanisms involving HPV E6/E7 oncogene activity provide biological plausibility for viral involvement, reproducible evidence in breast tumors is lacking. This study aimed to determine whether high-risk HPV is detectable or transcriptionally active in breast cancer tissues from young women negative for BRCA1/BRCA2 mutations. METHODS: This retrospective, single-center study included women younger than 50 years with confirmed BRCA1/BRCA2-negative breast cancer. Formalin-fixed, paraffin-embedded tumor specimens were analyzed for high-risk HPV DNA using a PCR-based assay targeting HPV-16, HPV-18, and pooled high-risk genotypes. A subset of tumors with sufficient residual FFPE material and laboratory acceptance for FFPE-based RNA testing also underwent high-risk HPV E6/E7 mRNA analysis to assess transcriptional activity. RESULTS: Ninety women contributed 91 breast cancer specimens. Demographic, reproductive, and pathological features were consistent with typical early-onset breast cancer. High-risk HPV DNA was not detected in any tumor specimen. All mRNA analyses were also negative, indicating absence of transcriptionally active viral oncogene expression. CONCLUSIONS: High-risk HPV was neither detectable nor transcriptionally active in breast cancer tissues from young BRCA1/BRCA2-negative women. These findings do not support a role for high-risk HPV in breast carcinogenesis in this population.
Long-term effects of ospemifene on densitometric and bone metabolism biomarkers in postmenopausal women reporting Vulvar and Vaginal Atrophy (VVA).
Maffei S, Formica A, Corsini D … +1 more , Franchini M
BMC Womens Health · 2026 Apr · PMID 42050600 · Full text
Ospemifene (OSP), a Selective Estrogen Receptor Modulator (SERM), is recommended for treating vulvovaginal atrophy (VVA) in postmenopausal women (PMW). Previous 12 mm data suggested that OSP therapy had beneficial effect...
Ospemifene (OSP), a Selective Estrogen Receptor Modulator (SERM), is recommended for treating vulvovaginal atrophy (VVA) in postmenopausal women (PMW). Previous 12 mm data suggested that OSP therapy had beneficial effects on bone mineral and biochemical markers in a similar VVA population.Objective This real-life study sought to evaluate the long-term effects (24 mm) of Ospemifene therapy on bone metabolism and mineral parameters compared with a control group.Methods PMW aged 40–64 years with VVA symptoms and a baseline bone health assessment were included in the study. A total of 72 subjects treated with Ospemifene 60 mg/day (OSPG) were compared with a control group (CG, n = 49) over 24 months. Bone mineral density (BMD) at the femoral neck, total femur, and lumbar spine was assessed by DEXA, and biochemical markers of bone metabolism were measured in blood samples at baseline and 24 months.Results In the control group, BMD and T-scores significantly decreased at the femoral neck (-0,029; -0,26) and lumbar spine (-0,049; -0,32). In contrast, the OSPG showed no significant decline in BMD at any measured site (+ 0,005; +0,005;+0,009). The CG also exhibited a significant increase in bone turnover markers (BAP: +2.7; OC: +4.2). Conversely, the OSPG demonstrated significant reductions in bone alkaline phosphatase (BAP: -2.5) and osteocalcin (OC: -2.8), biomarkers of bone formation.Conclusions Long-term ospemifene treatment effectively preserves bone health at all sites, counteracting the expected menopause-associated bone loss and protecting against bone density reduction in healthy PMW with VVA.
Perioperative inflammatory response as a determinant of post-myomectomy intrauterine adhesion formation.
Wang X, Li F, Zhang W … +2 more , Zhong W, Shen J
BMC Womens Health · 2026 Apr · PMID 42050576 · Full text
BACKGROUND: Intrauterine adhesions (IUAs), or Asherman's syndrome, are a common complication of intrauterine surgery (e.g. hysteroscopic myomectomy) that can lead to menstrual disturbances and infertility. Excessive post...
BACKGROUND: Intrauterine adhesions (IUAs), or Asherman's syndrome, are a common complication of intrauterine surgery (e.g. hysteroscopic myomectomy) that can lead to menstrual disturbances and infertility. Excessive postoperative inflammation is thought to drive adhesion formation, but the predictive value of specific inflammatory biomarkers remains unclear. METHODS: We performed a prospective observational study of 150 women (age 19-45) undergoing hysteroscopic submucosal fibroid resection. Serum C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were measured at three timepoints: preoperatively, 48 h postoperatively, and 3 months postoperatively. IUAs were assessed at 12 weeks via second-look hysteroscopy and graded by American Fertility Society criteria. RESULTS: Of 135 patients who completed follow-up, 40 (30.8%) developed IUAs (20 mild, 12 moderate, 8 severe). Baseline characteristics were similar between those who developed IUAs and those who did not, except that FIGO type II fibroids were more frequent in the IUA group (20.0% vs. 8.4%, p = 0.04). IL-6 and CRP levels rose markedly after surgery in patients who developed adhesions, whereas increases in the no-IUA group were modest. By 48 h postoperatively, mean IL-6 was ~ 7 pg/mL higher in the IUA group than in no-IUA (23.0 vs. 15.8 pg/mL, p < 0.001), and CRP was ~ 2.4 mg/L higher (8.5 vs. 6.1 mg/L, p < 0.001). These differences persisted at 3 months (IL-6 18.2 vs. 14.2 pg/mL; CRP 6.4 vs. 5.1 mg/L; both p < 0.001), indicating a prolonged inflammatory response. TNF-α rose modestly postoperatively in both groups and was significantly higher in the IUA group at 48 h (13.0 vs. 10.0 pg/mL, p < 0.001) and 3 months (11.5 vs. 9.4 pg/mL, p = 0.01). IL-6 showed the strongest correlation with adhesion severity (Spearman ρ ≈ 0.5, p < 0.001) and was an independent predictor of moderate-to-severe IUA risk (adjusted odds ratio [OR] 1.25 per 1 pg/mL, 95% confidence interval [CI] 1.11-1.42). CRP was also an independent predictor (OR 1.32 per 1 mg/L, 95% CI 1.08-1.61, p = 0.006), whereas TNF-α did not retain significance in multivariate analysis. In a model adjusting for surgical factors (fibroid type, operative time), IL-6 and CRP remained significant predictors (adjusted OR 1.22, 95% CI 1.09-1.39 and OR 1.29, 95% CI 1.06-1.57, respectively). Women with type II fibroids had higher odds of developing moderate/severe adhesions (OR ~ 2.8, 95% CI 1.1-7.3). ROC analysis demonstrated that IL-6 had the highest discriminative ability for clinically significant IUAs (area under curve [AUC] ≈ 0.80), outperforming CRP (AUC ≈ 0.72) and TNF-α (AUC ≈ 0.65). At an optimal 48-hour IL-6 cutoff of ~ 20 pg/mL, sensitivity for predicting moderate/severe adhesions was ~ 81% and specificity ~ 74%, while a CRP cutoff of ~ 7 mg/L yielded ~ 75% sensitivity and 65% specificity. CONCLUSIONS: Perioperative elevations in IL-6 and CRP are strongly associated with IUA formation after hysteroscopic myomectomy, and dynamic changes in these markers offer predictive value. Early post-surgical IL-6 and CRP measurements may help identify high-risk patients and support risk-stratified postoperative surveillance or prophylactic interventions.
PCOS combined with obesity aggravates the metabolic and immune abnormality in females.
Chen ML, Zhang SP, Yang J … +11 more , Qin PF, Liu JQ, Su N, Sun YL, Gu L, Yang ZX, Chen J, Gu XZ, Zhou P, Zhang D, Li Q
BMC Womens Health · 2026 Apr · PMID 42050527 · Full text
INTRODUCTION: Polycystic ovary syndrome (PCOS) appears to be closely correlated with obesity; however, no studies have compared the difference between PC-Ob (PCOS plus obesity), obesity-only, and PCOS-only patients at a...
INTRODUCTION: Polycystic ovary syndrome (PCOS) appears to be closely correlated with obesity; however, no studies have compared the difference between PC-Ob (PCOS plus obesity), obesity-only, and PCOS-only patients at a multi-omics level. In the present study, we aimed to explore this through sEV proteomics and metabolomics on female plasma. METHODS: We recruited 79 females based on BMI, AMH, LH, T, P, Fasting insulin, and HOMA-IR; next, we categorized them into four groups: 20 Control (Ctr), 21 PCOS, 19 Obesity (Ob), and 19 PCOS with Obesity (PC-Ob) and collected plasma samples. Next, we randomly sent 10 from each group for quantitative sEV proteomics and untargeted metabolomics on female plasma. RESULTS: There were significant changes in multiple metabolites and proteins between each of three patient (PCOS, Ob, and PC-Ob) groups and Ctr group. Particularly, compared with PCOS or Ob group, PC-Ob group have more DEPs (differentially-expressed proteins) and MLDs (metabolites with level difference), and the proteins are largely involved in immunity and metabolism. Cross-omics associations analysis showed that two immunity and metabolism-related DEPs, A2M and BCHE, changes in high correlation with multiple lipids between the upper four groups. DISCUSSION: Our findings showed that females with both PCOS and obesity have significantly increased abnormalities in immunity and metabolism.
Prevalence and correlates of physical, emotional, sexual, and technology-facilitated gender-based violence among a national sample of adolescent and adult women living with HIV in Zambia.
Peltzer K, Pengpid S
BMC Womens Health · 2026 Apr · PMID 42050521 · Full text
BACKGROUND: The study’s objective was to assess the prevalence and correlates of physical, emotional, sexual, and technology-facilitated intimate partner violence (IPV) as well as poly-victimization among a national samp...
BACKGROUND: The study’s objective was to assess the prevalence and correlates of physical, emotional, sexual, and technology-facilitated intimate partner violence (IPV) as well as poly-victimization among a national sample of adolescent and adult women living with HIV (WLHIV) in Zambia in 2024. METHODS: Data from 1,063 WLHIV between the ages of 15 and 49 who took part in the 2024 Zambia Demographic and Health Survey and responded to the domestic violence and mental health module were examined. Logistic regressions were used to estimate predictors of physical, emotional, sexual, and technology-facilitated IPV as well as poly-victimization. RESULTS: More than one in four women (28.8%) had exposure to physical violence, followed by emotional violence (24.6%), sexual violence (9.4%) and technology-based violence (6.0%). Exposure to any IPV was 40.8% and 20.1% had poly-victimization (2–4 types of IPV). In adjusted logistic regression analysis being widowed, divorced, or separated were associated with physical IPV, emotional IPV, and poly-victimization. Internet use and urban residence were associated with technology-based IPV. Screened depression and/or anxiety disorders and/or on medication for depression or anxiety was associated with emotional IPV, technology-facilitated IPV, and poly-victimization. Suicidal ideation was associated with physical IPV. Being ashamed of HIV was associated with emotional IPV, sexual IPV technology-facilitated IPV, and poly-victimization. HIV disclosure was inversely associated with technology-facilitated violence. Current tobacco use was negatively and current alcohol use was positively associated with physical IPV. A supportive attitude towards wife beating was associated with sexual IPV and poly-victimization. Experiencing controlling behaviour and having a husband or partner who is often drunk were highly associated with physical IPV, emotional IPV, sexual IPV and poly-victimization. CONCLUSION: More than one in four WLHIV (28.8%) had exposure to physical violence, followed by emotional violence (24.6%), sexual violence (9.4%) and technology-based violence (6.0%). Exposure to any IPV was 40.8% and 20.1% had poly-victimization (2-4 types of IPV). In addition, the survey identified the multifaceted nature of physical, emotional, sexual, and technology-facilitated IPV, highlighting contributing individual-level, relationship-level, and community/societal-level factors. Findings underscore the need for an integrated policy response to IPV among WLHIV in Zambia.
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