BMC Women's Health[JOURNAL]
Sun
200 papers
Descriptive comparison of comprehensive HIV knowledge and condom non-use at last sexual intercourse among unmarried adolescent girls and young women in Nigeria.
Tomori MO, Ogunwemimo H, Adedini SA
BMC Womens Health · 2026 Jul · PMID 42401873 · Full text
INTRODUCTION: Across sub-Saharan Africa, and Nigeria in particular, young women and adolescent girls aged 15 to 24 continue to face a disproportionate risk of HIV - and a large part of that risk comes down to unprotected...
INTRODUCTION: Across sub-Saharan Africa, and Nigeria in particular, young women and adolescent girls aged 15 to 24 continue to face a disproportionate risk of HIV - and a large part of that risk comes down to unprotected sex. Knowing about HIV is widely assumed to lead to safer behaviour, yet the evidence that knowledge actually translates into condom use is far from straightforward. This study takes a closer look at that relationship, comparing comprehensive HIV knowledge and condom non-use among unmarried adolescent girls and young women (AGYW) in Nigeria across three points in time. METHODS: We drew on data from the Nigeria Demographic and Health Surveys conducted in 2008, 2013, and 2018. Condom non-use at last sexual intercourse - a standard DHS indicator - served as our measure of risky sexual behaviour. The analysis focused on sexually active unmarried women in two age groups: adolescent girls aged 15 to 19, and young women aged 20 to 24. We excluded participants with missing or unclear responses for the outcome variable or key covariates. Weighted descriptive statistics and survey-weighted binary logistic regression models were run separately for each age group and survey year, with all analyses accounting for the clustered, stratified sampling design of the NDHS. Stata 16.1 was used throughout. RESULTS: HIV knowledge improved over the study period, particularly among young women in the older age group, while trends in condom use followed a less predictable pattern. Among adolescent girls, comprehensive HIV knowledge was not meaningfully linked to condom use in 2008, but that association became statistically significant by 2013 and held through 2018. Importantly, though, condom non-use actually rose in 2018 even as knowledge levels reached their highest point - a clear sign that knowing is not the same as doing. Socioeconomic status and region of residence were both significantly associated with condom use. CONCLUSION: Comprehensive HIV knowledge among unmarried AGYW in Nigeria has grown, but it has not reliably translated into condom use. This gap between what young women know and what they are able to do points to barriers that go well beyond information - structural, social, and economic forces that shape the choices available to them. Closing that gap will require interventions that take those realities seriously.
The effect of cyberchondria on genital hygiene behaviors: a cross-sectional study.
Başaran F, Yalçin H
BMC Womens Health · 2026 Jul · PMID 42401865 · Full text
BACKGROUND: Cyberchondria may influence women's health-related behaviors by shaping how they search for and interpret online health information. This study aimed to examine the effect of cyberchondria levels on genital h...
BACKGROUND: Cyberchondria may influence women's health-related behaviors by shaping how they search for and interpret online health information. This study aimed to examine the effect of cyberchondria levels on genital hygiene behaviors in women of reproductive age. METHODS: This cross-sectional study was conducted with 366 women aged 15-49 years registered at a family health center. Data were collected using a Demographic Information Form, the Genital Hygiene Behaviors Scale (GHBS), and the Cyberchondria Severity Scale Short Form (CSS-12). Descriptive statistics, Student's t-test, ANOVA, Pearson correlation, and multiple linear regression analysis were used in the analysis of the data. RESULTS: The mean total GHBS score of the participants was 87.28 ± 10.20; the CSS-12 score was 32.19 ± 9.35. Regression analysis showed that the excessiveness and reassurance-seeking subdimensions of cyberchondria were significant positive predictors of genital hygiene behaviors, while the anxiety subdimension was a significant negative predictor (p < 0.001). Although the overall cyberchondria score showed a weak positive correlation with genital hygiene behaviors, it was determined that age may play a more significant role in explaining genital hygiene behaviors. CONCLUSIONS: Our findings indicate a limited association between cyberchondria and genital hygiene behaviors. However, they suggest that age and related life experiences may be more significant determinants of these behaviors. Genital hygiene behaviors are more influenced by sociodemographic factors such as education, income level, and access to hygiene education. Cyberchondria is not a strong predictor on its own and should be evaluated in conjunction with other individual factors.
Women's Autonomy in Health Care Decision-Making in Somalia: Evidence from a Multinomial Logistic Regression Analysis of the 2020 National Survey.
Yousuf HJ, Omer AA, Ahmed SA
BMC Womens Health · 2026 Jul · PMID 42401836 · Full text
BACKGROUND: Women's autonomy in healthcare decision-making is a key determinant of maternal and reproductive health outcomes in Somalia. This study examined the level of women's autonomy and its associated factors using...
BACKGROUND: Women's autonomy in healthcare decision-making is a key determinant of maternal and reproductive health outcomes in Somalia. This study examined the level of women's autonomy and its associated factors using nationally representative data. METHODS: A cross-sectional study was conducted using data from the 2020 Somalia Demographic and Health Survey, including 32,272 women aged 15-49 years. Data were analyzed using STATA version 17, accounting for sampling weights. Multinomial logistic regression was used, and results were reported as Relative Risk Ratios (RRRs) with 95% Confidence Intervals (CIs). RESULTS: Overall, 15.3% of women made healthcare decisions independently, 32.9% made decisions jointly, and 51.8% had decisions made by others. Older women aged 45-49 years were more likely to make independent decisions compared to those aged 15-19 (RRR = 1.93; 95% CI: 1.42-2.62). Urban residence was associated with higher autonomy (RRR = 1.17; 95% CI: 1.07-1.28). Women in the highest wealth quintile had a higher likelihood of independent decision-making compared to the lowest quintile (RRR = 2.68; 95% CI: 2.36-3.03). Higher maternal education was also significantly associated with increased autonomy. CONCLUSION: Women's autonomy in healthcare decision-making in Somalia remains limited and is associated with socio-demographic and economic factors. Interventions focusing on improving women's education, economic empowerment, and access to healthcare services may enhance autonomy and improve health outcomes.
Prevalence of menstrual disturbances and associated factors among female medical students in Southeast Asia: a systematic review and meta-analysis.
Ky ND, Chi NDL, Lam PT … +6 more , Minh NN, Kien TT, Hieu NS, Hoang LV, Ha LTN, Anh NTH
BMC Womens Health · 2026 Jul · PMID 42399947 · Full text
BACKGROUND: Menstrual disturbances are common among female medical students and may affect academic functioning, well-being, and daily activities, especially in Southeast Asia. This systematic review and meta-analysis ai...
BACKGROUND: Menstrual disturbances are common among female medical students and may affect academic functioning, well-being, and daily activities, especially in Southeast Asia. This systematic review and meta-analysis aimed to estimate the prevalence of menstrual disturbances and synthesize associated factors among female medical students in Southeast Asia. METHODS: PubMed, Embase, Scopus, Google Scholar, manual searching, and citation tracking were searched for studies published from January 1, 2000 to May 6, 2026. Eligible studies were observational studies that reported the prevalence of menstrual disturbances and associated factors among female undergraduate medical students in Southeast Asia. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist for analytical cross-sectional studies. Random-effects meta-analyses were conducted for outcomes with sufficient data, while associated factors were synthesized narratively. RESULTS: 17 studies involving 7,080 participants from Vietnam, Thailand, Indonesia, and Malaysia were included. Dysmenorrhea was the most frequently reported outcome, with a pooled prevalence of 78.11% (95% CI: 67.07%-86.21%; I² = 97.9%). The pooled prevalence was 30.10% for irregular menstruation (95% CI: 18.54%-44.89%; I² = 98.0%), 39.60% for premenstrual syndrome/premenstrual dysphoric disorder (95% CI: 20.13%-63.05%; I² = 98.5%), and 22.58% for abnormal menstrual cycle duration (95% CI: 15.48%-31.72%; I² = 95.0%). Family history showed the most consistent positive association with menstrual disturbances, with aOR ranging from 1.47 to 3.76. Psychological distress, functional impairment, caffeine intake, limited rest, and low or irregular physical activity were also reported as potential correlates, although evidence was heterogeneous. However, extremely high heterogeneity (I² >95%) was observed across all pooled outcomes; these estimates should therefore be interpreted with caution. CONCLUSIONS: Menstrual disturbances are commonly reported among female medical students in Southeast Asia. However, the evidence is limited by cross-sectional designs, inconsistent outcome definitions, high heterogeneity, and frequent risk of bias. These findings should therefore be interpreted as exploratory rather than confirmatory. TRIAL REGISTRATION: PROSPERO CRD420251178169.
Association between cervical ectropion and high-grade cervical dysplasia in women of reproductive age.
Medina JY, Bendezú RM, Hernández NF … +6 more , Palomino LC, Bellido FC, Ramos VB, Nuñez CB, Centeno JP, Soto LY
BMC Womens Health · 2026 Jul · PMID 42399914 · Full text
BACKGROUND: Cervical ectropion is a common anatomical condition in women of reproductive age. Although often considered a physiological variant, its potential role as a factor associated with epithelial alterations remai...
BACKGROUND: Cervical ectropion is a common anatomical condition in women of reproductive age. Although often considered a physiological variant, its potential role as a factor associated with epithelial alterations remains under debate. Exposure of immature columnar epithelium in the transformation zone may facilitate the persistence of human papillomavirus (HPV) and other infectious agents. METHODS: We conducted an analytical case-control study (1:2 ratio) at a referral hospital in Ica, Peru. Cases were women with histologically confirmed high-grade cervical dysplasia (CIN2-3), while controls had consecutive negative cytology results (NILM). Cervical ectropion was assessed by standardized colposcopy. Hierarchical multivariate logistic regression was used to adjust for demographic, behavioral, and infectious factors. RESULTS: A total of 276 women were included (92 cases and 184 controls). Cervical ectropion was observed in 33.0% of cases and in 10.3% of controls (p < 0.001). In multivariate analysis, ectropion remained significantly associated with high-grade cervical dysplasia (adjusted OR = 3.86; 95% CI: 1.74-8.53; p < 0.001). Significant associations were also found with bacterial vaginosis (adjusted OR = 2.47; 95% CI: 1.04-5.86; p = 0.041) and with a history of multiple sexual partners (adjusted OR = 3.55; 95% CI: 1.53-8.20; p = 0.003). CONCLUSIONS: Cervical ectropion was significantly associated with high-grade cervical dysplasia after adjustment for measured covariates and may constitute a potential clinical marker of epithelial vulnerability. However, residual confounding related to unmeasured HPV infection cannot be excluded. These findings support the importance of systematic screening and colposcopic surveillance, particularly in resource-limited settings where molecular HPV testing is not widely available.
Association between combined oral contraceptive pills and depression in women with polyendocrine metabolic ovarian syndrome (formerly polycystic ovary syndrome): a comparative cross-sectional study.
Prommani P, Sophonsritsuk A, Saipanish R … +2 more , Anantaburana M, Tantanavipas S
BMC Womens Health · 2026 Jul · PMID 42393692 · Full text
BACKGROUND: The prevalence of depression among women with polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS), is high. Combined oral contraceptives (COCs) are widely recommended fo...
BACKGROUND: The prevalence of depression among women with polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS), is high. Combined oral contraceptives (COCs) are widely recommended for the treatment of women with PMOS, potentially reducing stress related to managing PMOS symptoms and improving body image. However, concerns exist regarding a potential association between COC use and depression. Given these conflicting effects, the present study aimed to evaluate the relationship of COCs on depression and its associated factors in Thai women with PMOS, compared with non-COC users. METHODS: A comparative cross-sectional study was conducted among 96 participants (48 COC users and 48 non-COC users) diagnosed with PMOS using the Rotterdam criteria. Depression was assessed using the Thai version of the Patient Health Questionnaire-9 (PHQ-9). Group comparisons of depression prevalence were analysed using the chi-square test. Predictive factors and interaction analyses were performed using multivariable and Firth's logistic regression, expressed as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The prevalence of depression was 37.50% of COC users and 35.42% of non-COC users, with no statistically significant association observed (p-value = 0.832). COC use was not associated with depression. Low testosterone levels were the crucial variables associated with depression among women with PMOS (OR 4.38, 95% CI: 1.45-13.28; p = 0.009), remaining significant after adjustment for age (OR 5.98, 95% CI: 1.83-19.52; p = 0.003). These associations did not affect the interaction of COC use. CONCLUSIONS: Depression is highly prevalent among women with PMOS, with prevalence similar between COC users and non-users. Routine screening is recommended for early detection and timely management, regardless of the treatment approach or COC use. Low testosterone levels may be associated with depression in women with PMOS. However, the findings should be interpreted with caution owing to limited statistical power. Larger prospective studies are required to clarify the association between COC use, androgen imbalance, and depression in women with PMOS.
Correction: Expression and clinical significance of CCN5 and the oestrogen receptor in advanced breast cancer.
Zhou G, Qu W, Yang L … +2 more , Huang A, Gui X
BMC Womens Health · 2026 Jul · PMID 42393664 · Full text
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Early-life exposures and risk of multiple gynecological diseases: evidence from a large community-based study of 272,706 women.
Jiang J, Fu Y, Chen Y … +7 more , Liu H, Sun Z, Yin Y, Liu Y, Li D, Wan Z, Shuai P
BMC Womens Health · 2026 Jul · PMID 42393656 · Full text
BACKGROUND: Early-life exposures may influence long-term reproductive health, but comprehensive population-based evidence remains limited. This study aimed to evaluate the associations between six early-life factors (lon...
BACKGROUND: Early-life exposures may influence long-term reproductive health, but comprehensive population-based evidence remains limited. This study aimed to evaluate the associations between six early-life factors (long-term/recurrent antibiotic use [LRAU], birth weight, multiple birth, breastfeeding, age at menarche and maternal smoking around birth) and the risk of six major non-neoplastic gynecological diseases in adulthood. METHODS: This large observational association study used data from 272,706 women derived from the UK Biobank, a population-based cohort resource. Six gynecological disorders-uterine fibroids (UF), polycystic ovary syndrome (PCOS), endometriosis, genital prolapse, female infertility, and premenstrual syndrome (PMS)-were identified from hospital inpatient records, first occurrence records, and self-reports. Multivariable logistic regression was used as the primary analysis to estimate adjusted odds ratios (aORs), with Cox models as supplementary analyses. The primary adjusted model included age at recruitment, ethnicity, educational attainment, Townsend deprivation index, and smoking status. A Bonferroni-adjusted significance threshold of P < 0.0014 was applied. RESULTS: Among 272,706 women, the prevalence of the six non-neoplastic gynecological diseases ranged from 0.07% for PMS to 8.51% for UF. After Bonferroni correction, LRAU during early life was associated with higher odds of UF, PCOS, endometriosis, genital prolapse, and PMS. Earlier menarche was associated with higher odds of UF, PCOS, endometriosis, and genital prolapse. Maternal smoking around birth was associated with endometriosis, genital prolapse, and PMS. Not being breastfed as a baby was associated with endometriosis and PMS. Birth weight was associated with genital prolapse. Findings were generally consistent across Cox models and sensitivity analyses, although PMS estimates should be interpreted cautiously because of limited cases. CONCLUSIONS: These findings suggest associations between selected early-life factors and adult non-neoplastic gynecological diseases. Some exposures are potentially modifiable, whereas others are non-modifiable. Together, these factors may help identify individuals at higher risk and inform future studies on risk stratification, but their potential preventive implications require further causal validation.
Comparison of four imaging modalities for cesarean scar defect: a retrospective study.
Zhou X, Zhou M, Qiao H … +1 more , Wang X
BMC Womens Health · 2026 Jul · PMID 42393653 · Full text
BACKGROUND AND AIMS: We compared four imaging methods: transvaginal ultrasound(TVU), magnetic resonance imaging(MRI), saline contrast-enhanced MRI (SCE_MRI) and hysteroscopy combined with transabdominal ultrasound (HSC_T...
BACKGROUND AND AIMS: We compared four imaging methods: transvaginal ultrasound(TVU), magnetic resonance imaging(MRI), saline contrast-enhanced MRI (SCE_MRI) and hysteroscopy combined with transabdominal ultrasound (HSC_TAU) for evaluating cesarean scar defect(CSD) morphology and clinical correlations. METHODS: Sixty-one women with prior cesarean delivery and prolonged menstrual bleeding underwent all four imaging modalities within days 7-14 of a single menstrual cycle. We measured CSD length, width, depth, and residual myometrial thickness (TRM), and compared detection rates and severity classification, and the linear regression between CSD length and menstrual bleeding duration. RESULTS: HSC_TAU detected CSD in 100% of patients, compared to 94% for TVU, 97% for MRI, and 97% for SCE_MRI. HSC_TAU measured longer CSD length (median 15.4 mm) than TVU (6.5 mm), MRI (8.0 mm), and SCE_MRI (8.2 mm) (P < 0.001). TVU measured thicker TRM (median 2.7 mm) than HSC_TAU (2.0 mm), MRI (2.0 mm), and SCE_MRI (1.8 mm) (P < 0.001). Using TRM < 2.5 mm as the threshold for severe CSD, TVU identified only 43% of cases as severe, while HSC_TAU, MRI, and SCE_MRI identified 66-77%. The linear regression analysis revealed a significant association between HSC_TAU-measured CSD length and menstrual bleeding duration (regression coefficient β = 0.24, 95% CI: 0.08-0.30, R² = 0.14, p = 0.003). CONCLUSION: HSC_TAU offers high detection rate and reliable TRM measurement. TVU tends to underestimate CSD size and overestimate TRM, which may lead to underdiagnosis of severe cases. We suggest using TVU for initial screening and HSC_TAU for preoperative evaluation in symptomatic patients.
Barriers to accessing cervical cancer prevention services among out-of-school young women in Ibadan.
Sangoniyi OO, Dairo MD
BMC Womens Health · 2026 Jul · PMID 42393649 · Full text
BACKGROUND: Cervical cancer accounts for an estimated 604,127 cases and 341,831 deaths. 84% of cervical cancer morbidities and 88% of cervical cancer-related mortality in such areas are attributed to women in developing...
BACKGROUND: Cervical cancer accounts for an estimated 604,127 cases and 341,831 deaths. 84% of cervical cancer morbidities and 88% of cervical cancer-related mortality in such areas are attributed to women in developing countries. Out-of-school young women are a vulnerable and underserved population in public health, having limited access to health education and prevention services. This study aims to identify the willingness and barriers to accessing cervical cancer prevention services which is key to developing strategies that enhance the uptake among out-of-school young women. METHODS: In a community-based cross-sectional study among 356 out-of-school young women aged 15-24 years in Ibadan North Local Government Area, eligible respondents were selected using a multistage sampling technique. Data was collected using structured questionnaires and analysed with SPSS version 27. RESULTS: Most respondents (n = 224, 62.9%) were aged 15-19 years, with the mean age being 18.9 ± 2.42, and unemployed (n = 327, 91.9%). Main barriers to accessing cervical cancer prevention services include lack of awareness of the strategy (HPV vaccine (n = 302/356, 84.8%, Pap Smear - 306/356, 86%), absence of services centre (HPV vaccination centre - n = 115/356, 32.3%, Pap smear screening centre - 115, 32.3% and HPV test - n = 89, 25%), fear of positive result (HPV test - 104/356, 29.2%) and high cost of screening (HPV test - 303/356, 85.1%). CONCLUSION: Low knowledge, high cost, lack of awareness of services and fear of positive results significantly impede access to cervical cancer preventive services. Educational campaigns to increase awareness and uptake of cervical cancer prevention services are recommended.
The relationship between different hormone receptors in breast cancer patients and ovarian response before chemotherapy; a retrospective cohort study.
Yahyaei A, Kashi S, Hasani F … +3 more , Vesali S, Hoseini S, Ghaffari F
BMC Womens Health · 2026 Jul · PMID 42387472 · Full text
BACKGROUND: This study intended to investigate the relationship between the hormone receptors (including estrogen and progesterone receptors (ER/PR), and human epidermal growth factor receptor-2 (HER2) or triple-negative...
BACKGROUND: This study intended to investigate the relationship between the hormone receptors (including estrogen and progesterone receptors (ER/PR), and human epidermal growth factor receptor-2 (HER2) or triple-negative breast cancer (TNBC)) status of BC patients and their response to ovarian stimulation before chemotherapy. METHODS: This is a retrospective cohort study. All patients with pathologically confirmed BC who underwent fertility preservation elected for oocyte or embryo cryopreservation were included in the study. All patients were stratified according to the immunohistochemically expression of receptors. We divided the patients into the exposure groups of ER+ (n = 89)/ ER- (n = 39), PR+ (n = 85)/ PR- (n = 43), HER2+ (n = 46)/ HER2- (n = 82), TNBC (n = 27)/ non-TNBC (n = 101), and Ki67 < 20% (n = 36)/ Ki67 ≥ 20% (n = 74). The primary outcome was total oocytes retrieved. RESULTS: In total, 128 patients with BC were enrolled in this study. Based on the patients' baseline characteristics, as well as the ovarian stimulation cycle parameters and their outcomes, no significant differences were observed among patients according to hormone receptor status. The HER2 + group exhibited a significantly higher number of dominant follicles on the trigger day than the HER2- group (p = 0.035); however, no significant differences were noted regarding oocyte count and maturity. CONCLUSIONS: The findings of the current study show that the determinants of BC prognosis, such as ER, PR, TNBC, and Ki67 status, have no effect on patients' responses to ovarian stimulation. Nevertheless, despite achieving an acceptable number of dominant follicles on the day of trigger, HER2 + status can affect the number of retrieved oocytes, particularly the number of mature oocytes.
The association between dietary acid load and endometriosis: a case-control study.
Noormohammadi M, Ghoreishy SM, Ghasemisedaghat S … +6 more , Hashemi Javaheri FS, Eslamian G, Kazemi SN, Rashidkhani B, Taheripanah R, Nouri M
BMC Womens Health · 2026 Jul · PMID 42387353 · Full text
BACKGROUND: Endometriosis is a chronic inflammatory disorder that affects 5-15% of women of reproductive age. It is characterized by severe symptoms, including dysmenorrhea and non-cyclic pelvic pain, which can substanti...
BACKGROUND: Endometriosis is a chronic inflammatory disorder that affects 5-15% of women of reproductive age. It is characterized by severe symptoms, including dysmenorrhea and non-cyclic pelvic pain, which can substantially impair quality of life. Although diet is a major modifiable risk factor for many chronic diseases, its potential role in endometriosis has received limited attention. This study aimed to investigate the association between Dietary Acid Load (DAL) and the odds of endometriosis among Iranian women. METHODS: This hospital-based case-control study was conducted in Tehran, Iran, between February to September 2021. Participants included women diagnosed with endometriosis and healthy controls, all of whom were evaluated by a gynecologist who was blinded to the study object. Dietary intake was assessed using a validated 168-item food frequency questionnaire (FFQ). DAL was estimated using Two indices: Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP). Logistic regression models were used to investigate the association between DAL and odds of endometriosis. RESULTS: A total of 105 women with endometriosis and 208 healthy controls were included in the study. The results showed that each one-unit increase in PRAL and NEAP was associated with an 8%, and 4% increase in the odds of endometriosis, respectively. CONCLUSION: Higher DAL was associated with increased odd of endometriosis. These findings suggest that reducing the consumption of acid-producing foods may help lower the risk of endometriosis. Further prospective studies are warranted to confirm these findings and clarify the underlying mechanisms.
The profiles of vaginal microbiota in fertile and infertile Thai women.
Li J, Apinuthirunchot T, Chaithongwongwatthana S … +6 more , Chanchaem P, Sawaswong V, Jitvaropas R, Payungporn S, Kaur H, Jaisamrarn U
BMC Womens Health · 2026 Jun · PMID 42381049 · Full text
BACKGROUND: Vaginal microbiota dysbiosis has been associated with female reproductive health and infertility. This study aimed to compare vaginal microbiota profiles according to fertility and ovarian induction status am...
BACKGROUND: Vaginal microbiota dysbiosis has been associated with female reproductive health and infertility. This study aimed to compare vaginal microbiota profiles according to fertility and ovarian induction status among Thai women. METHODS: In this cross-sectional study, vaginal samples were collected from Thai reproductive-aged women during their periovulatory period. The 16 S rRNA gene was amplified and sequenced to ascertain the composition of the vaginal microbiota among 92 women (30 fertile and 62 infertile women). Vaginal microbiota profiles at the phylum and genus levels were compared among fertile women, infertile women before ovulation induction, and infertile women after ovulation induction. RESULTS: The dominant vaginal microbial phyla across all groups were Firmicutes, Actinobacteria, Bacteroidetes, and Fusobacteria. Lactobacillus was the predominant genus across all groups. However, exploratory differential abundance analyses identified several differentially enriched taxa across fertile, infertile (pre-ovulation induction), and infertile (post-ovulation induction) groups. No significant differences in alpha or beta diversity were observed between groups. CONCLUSION: Our findings did not demonstrate significant differences in overall vaginal microbial diversity between fertile and infertile Thai women. However, exploratory differential abundance analyses identified several taxa that may warrant further investigation. Larger prospective studies are needed to better clarify the potential role of vaginal microbiota in reproductive health and infertility.
Association of platelets and platelet-related parameters (PLT/MPV/PLR) in endometriosis: a meta-analysis.
Qiu J, Li J, Wang A … +1 more , Lin K
BMC Womens Health · 2026 Jun · PMID 42380851 · Full text
BACKGROUND: Endometriosis (EMS) is a prevalent gynecological condition, and its diagnosis remains challenging. Hematological indicators such as platelet count (PLT), mean platelet volume (MPV), and platelet-to-lymphocyte...
BACKGROUND: Endometriosis (EMS) is a prevalent gynecological condition, and its diagnosis remains challenging. Hematological indicators such as platelet count (PLT), mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) have recently received attention for their potential diagnostic value in EMS. OBJECTIVE: To assess the association of PLT, MPV, and PLR in EMS by a meta-analysis. METHODS: We systematically searched Embase, PubMed, Cochrane Library, and Web of Science up to June 2025 for studies on the association of platelet-related parameters (PLT, MPV, and PLR) with EMS. Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for PLT, MPV, and PLR using a random-effects model. All statistical analyses were performed using Stata16.0. RESULTS: Nineteen studies with 5675 subjects were included. Overall pooled analyses showed no statistically significant differences in PLT (SMD 0.35 [- 0.02, 0.71], I²=97.6%, P = 0.063) and PLR (SMD 0.24 [- 0.16, 0.64], I²=96.6%, P = 0.224) between EMS and non-EMS populations. However, MPV was significantly elevated in EMS compared with non-EMS populations (SMD 0.30 [0.09, 0.52], I²=82.7%, P = 0.006). Subgroup analyses by control group type revealed context-dependent associations. Compared with benign gynecological conditions (e.g., ovarian cysts, uterine fibroids), EMS showed significantly elevated PLT (SMD 0.20 [0.01, 0.38], I²=53.7%, P = 0.042) and PLR (SMD 0.33 [0.22, 0.43], I²=0.0%, P < 0.01). PLT was significantly lower in EMS than in ovarian cancer (SMD - 0.56 [- 0.81, - 0.32], I²=0.0%, P < 0.001). MPV was significantly elevated in EMS compared with healthy individuals (SMD 0.46 [0.11, 0.81], I²=84.7%, P = 0.010), whereas no significant difference was observed between EMS and other benign gynecological conditions (SMD 0.04 [- 0.10, 0.19], I²=0.0%, P = 0.547). CONCLUSION: MPV shows potential as an adjunctive marker for EMS, while PLT and PLR have limited independent diagnostic value but may be useful in specific clinical contexts.
Comparative effectiveness of hormonal therapies for preventing recurrence in endometriosis: a real-world retrospective cohort study with risk factor analysis.
Chen Z, Zheng Y
BMC Womens Health · 2026 Jun · PMID 42380844 · Full text
BACKGROUND: Endometriosis is a common chronic disease in women of reproductive age, and long-term postoperative medical management is a key strategy for preventing recurrence. Currently used clinical medications include...
BACKGROUND: Endometriosis is a common chronic disease in women of reproductive age, and long-term postoperative medical management is a key strategy for preventing recurrence. Currently used clinical medications include dienogest (DNG), GnRH agonists (GnRH-a), combined oral contraceptives (COC), and the levonorgestrel-releasing intrauterine system (LNG-IUS). However, comparative effectiveness of different hormonal therapies for preventing recurrence in real-world clinical practice and the basis for individualised patient selection remain insufficient. OBJECTIVE: To systematically evaluate the efficacy and safety of DNG, GnRH-a, COC, and LNG-IUS in preventing postoperative recurrence of ovarian endometriomas; to analyse independent risk factors for postoperative recurrence, providing evidence-based support for individualised clinical treatment decisions. METHODS: A retrospective cohort study design was adopted. A total of 167 patients who underwent laparoscopic cystectomy at our hospital between January 2020 and January 2022, had a postoperative pathological diagnosis, and received sequential GnRH-a maintenance therapy were enrolled. According to the sequential maintenance regimen, patients were divided into three groups: GnRH-a + DNG group (n = 61), GnRH-a + COC group (n = 64), and GnRH-a + LNG-IUS group (n = 42). The primary outcome was the recurrence rate within 3 years after surgery. Secondary outcomes included menstrual bleeding profiles, recurrent cyst diameter, and adverse drug reactions. Cumulative recurrence rates were calculated using the Kaplan‑Meier method, and intergroup comparisons were performed using the log‑rank test. Multivariate logistic regression analysis was used to identify independent risk factors for postoperative recurrence. RESULTS: There were no statistically significant differences in baseline data among the three groups (P > 0.05), indicating comparability. The 3‑year cumulative recurrence rate in the GnRH-a + DNG group was 19.67% (12/61), significantly lower than that in the GnRH-a + LNG-IUS group (45.24%, 19/42; P = 0.003). The recurrence rate in the GnRH-a + DNG group was also lower than that in the GnRH-a + COC group (34.38%, 22/64), although this difference did not reach statistical significance (P = 0.053). No significant differences were observed among the three groups in mean daily menstrual blood loss, incidence of dysmenorrhoea, or menstrual cycle length (P > 0.05). However, the incidence of spotting in the LNG-IUS group (52.38%) was significantly higher than that in the DNG group (24.59%) and the COC group (12.50%, P < 0.001). There were no statistically significant differences in the total incidence of adverse drug reactions (13.11%, 14.06%, 11.90%) or recurrent cyst diameter among the groups (P > 0.05). Multivariate logistic regression analysis suggested that higher dysmenorrhea VAS score (OR = 1.376), history of pelvic procedures (OR = 1.483), and r-AFS stage IV (OR = 2.676) were independent risk factors for postoperative recurrence (all P < 0.05), while older age at surgery was a protective factor (OR = 0.891) (P < 0.05). CONCLUSION: Among sequential GnRH-a maintenance regimens, DNG was associated with a lower recurrence rate than LNG-IUS in preventing 3‑year recurrence after laparoscopic cystectomy in this cohort. Although the recurrence rate in the DNG group was lower than that in the COC group, the difference did not reach statistical significance, indicating only a trend toward superiority. All three regimens have a favourable overall safety profile, but the LNG-IUS group has a higher incidence of spotting. Severe dysmenorrhoea, previous pelvic operation history, and r-AFS stage IV are independent risk factors for postoperative recurrence, whereas older age at surgery has a protective effect.
Performance of the cervical cancer screening program in Souss-Massa, Morocco: evidence for strategic transition toward HPV testing.
Amaoui B, Belkadi C, Dlhane M … +7 more , Amrani M, Ammari A, Safini F, Khazraji YC, Benider A, Abaoui S, Semghouli S
BMC Womens Health · 2026 Jul · PMID 42380837 · Full text
BACKGROUND: Cervical cancer remains a major public health concern in Morocco. Since 2012, the national program for early detection, based on visual inspection with acetic acid (VIA), has targeted women aged 30 to 49 year...
BACKGROUND: Cervical cancer remains a major public health concern in Morocco. Since 2012, the national program for early detection, based on visual inspection with acetic acid (VIA), has targeted women aged 30 to 49 years. This study assesses the program's performance in the Souss-Massa region in 2024, focusing on screening coverage, diagnostic quality, and therapeutic management. METHODS: A retrospective descriptive analysis was conducted across six provinces using routinely collected indicators: coverage of cervical screening by visual inspection with acetic acid (VIA), referral rate, colposcopy completion, treatment uptake, and histopathology outcomes. Data completeness was assessed, and adjusted coverage estimates were computed to correct under-reporting using proportional imputation. Analyses used both raw and adjusted data, with 95% confidence intervals (CI) and appropriate non-parametric or categorical tests. RESULTS: In 2024, 31,034 women were screened (crude coverage 7.07% [95% CI 6.99-7.15]). After under-reporting was adjusted for using proportional imputation - an exploratory correction given that 70% of the data was missing - the regional coverage was estimated at 28.85% (95% CI: 28.60-29.10). However, this figure should be treated as an illustrative estimate rather than a definitive programme indicator. Overall, 1,975 women were referred (referral rate 5.52% [95% CI 5.28-5.76]), 1,615 underwent colposcopy (completion 81.77% [95% CI 79.92-83.62]), and 330 cervical abnormalities were diagnosed (300 CIN1; 30 CIN2+), including 33 histologically confirmed CIN2 + when pathology was available. The CIN2 + detection rate was 1.04 per 1,000 women screened. Treatment uptake among women with diagnosed lesions was 44.85% [95% CI 39.33-50.37], with marked inter-provincial disparities. Only 0.58% of screened women were migrants. Statistically significant differences were observed between provinces for multiple indicators. However, these differences suggest an association with structural and organisational factors rather than indicating a causal relationship. CONCLUSION: Program performance in Souss-Massa remains below WHO-recommended thresholds for both coverage and treatment. Strengthening medicalization and workforce capacity, improving digital data systems, and piloting a transition to primary HPV testing - including self-sampling and a test-and-treat approach - are key priorities to improve equity and detection performance.
Adjunct vaginal lactic acid with single-dose metronidazole for bacterial vaginosis: a randomized controlled trial.
Pichailuck C, Kamolvit W, Phoonthong S … +4 more , Aneklap P, Neungton C, Nitayanon P, Tansirichaiya S
BMC Womens Health · 2026 Jun · PMID 42380834 · Full text
BACKGROUND: Bacterial vaginosis (BV) is a common cause of vaginal dysbiosis in women worldwide, often complicated by biofilm-associated recurrence. This randomized controlled trial aimed to evaluate whether adding a 7-da...
BACKGROUND: Bacterial vaginosis (BV) is a common cause of vaginal dysbiosis in women worldwide, often complicated by biofilm-associated recurrence. This randomized controlled trial aimed to evaluate whether adding a 7-day course of vaginal lactic acid to a single-dose oral metronidazole improves early ecological restoration and clinical outcomes compared with metronidazole alone. METHODS: An open-label, randomized controlled trial was conducted at the Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, from December 2023 to January 2026. Women aged 18-50 years with symptomatic BV (Amsel criteria) were randomized (1:1) to receive oral metronidazole 2 g single-dose (MET) or metronidazole plus 7-day vaginal lactic acid 5 g daily (METLAC). The primary outcome was quantitative recovery of vaginal Lactobacillus at 10-14 days, assessed by 16S rRNA gene qPCR. Secondary outcomes included clinical cure, symptom resolution, and recurrence. RESULTS: A total of 110 women were enrolled and randomized. Three participants were lost to follow-up, leaving 107 for the clinical analysis (MET n = 53; METLAC n = 54). Primary qPCR analysis was available for 101 participants. At 10-14 days, Lactobacillus 16S rRNA gene copy numbers increased significantly from baseline in both groups (p < 0.01). While the between-group difference in absolute Lactobacillus recovery was not statistically significant, the METLAC group demonstrated a numerically greater mean recovery and a higher proportion of microbiological responders (51.9% vs. 44.9%). Secondarily, at one week, the participant-reported clinical cure rate was 100% (54/54) in the METLAC group compared with 75.5% (40/53) in the MET group (absolute difference 24.5%; p < 0.001). Resolution of malodorous discharge was also significantly faster in the METLAC group. Recurrence rates at six months were 31.4% in the METLAC group and 21.6% in the MET group. CONCLUSIONS: Adjunct vaginal lactic acid added to single-dose oral metronidazole did not significantly improve early vaginal Lactobacillus recovery or reduce 6-month bacterial vaginosis recurrence. However, women receiving adjunct therapy experienced a significantly higher one-week clinical cure rate and faster malodor relief, with only mild and tolerable vaginal irritation. These findings suggest that adjunctive vaginal lactic acid provides a feasible short-term symptomatic treatment option in resource-limited Southeast Asian settings, although its role in improving long-term microbiological outcomes remains uncertain. TRIALS REGISTRATION: Thai Clinical Trials Registry, TCTR20231106004 Registered on 6 November 2023.
Association between metal mixture exposure and the risk of POI: a case control study.
Wang L, Wang Q, Sun J … +5 more , Huang Y, Zhang Q, Wei L, Yin S, Lai D
BMC Womens Health · 2026 Jun · PMID 42374441 · Full text
BACKGROUND: The adverse impacts of homeostasis disturbance of plasma trace elements on female reproduction, including premature ovarian insufficiency (POI), have received increasing attention recently, yet limited eviden...
BACKGROUND: The adverse impacts of homeostasis disturbance of plasma trace elements on female reproduction, including premature ovarian insufficiency (POI), have received increasing attention recently, yet limited evidence has been reported so far. POI significantly affects women's quality of life and poses risks such as infertility and cardiovascular disease, necessitating the exploration of alternative risk factors. METHODS: The metals studied included Iron (Fe), Zinc (Zn), Selenium (Se), Cobalt (Co), Magnesium (Mg), Strontium (Sr), Lithium (Li), Copper (Cu), Aluminum (Al), Chromium (Cr), Manganese (Mn), Arsenium (As), Titanium (Ti), Vanadium (V), and Iodine (I) in POI patients (n = 30) and controls (n = 31). Using a case-control design, we employed logistic regression and Bayesian Kernel Machine Regression (BKMR) analyses to evaluate the relationship between individual and combined plasma metal exposures and the risk of developing POI. RESULTS: Mn levels were higher in the POI group (median [IQR]: 2.20 [1.58-2.81] µg/L) compared to controls (1.44 [1.04-2.57] µg/L; p = 0.050). Similarly, V levels were significantly elevated in the POI group (mean ± SD: 1.19 ± 0.32 µg/L) versus controls (1.00 ± 0.38 µg/L; p = 0.049). Logistic regression indicated that higher Co levels were associated with a 98% reduced risk of POI (OR: 0.02; 95% CI: 0.00-0.72; p = 0.032), while higher Cu and V levels were associated with increased POI risk (Cu: OR: 1.01; 95% CI: 1.00-1.01; p = 0.032; V: OR: 8.65; 95% CI: 1.09-68.98; p = 0.042). Meanwhile, the RCS analysis revealed that higher plasma Mn levels were associated with an increased risk of POI (P non-linear = 0.041). Using BKMR, we evaluated the joint and individual effects of four metals-Mn, Co, Cu, and V-on POI risk and observed a joint risk effect on POI when all four metals were at or above their 55th percentiles. In particular, Mn had a significant effect on POI risk, with its effect size increasing as the concentrations of the other three metals rose from their 25th to 75th percentiles, and remained significant when the other metals were fixed at their 75th percentiles. Notably, Co showed inverse associations with Mn-Cu-V exposure. Moreover, no significant interactions were observed between Mn and Co, Cu, or V in their association with POI risk. CONCLUSIONS: Key findings revealed positive associations between plasma metal levels with POI risk in both single-metal and mixture analyses, highlighting manganese as a potential correlative biomarker for POI.
Benign hemorrhagic mesenteric cyst mimicking peritoneal dissemination in early-stage ovarian clear cell carcinoma: a case report.
Huang X, Liu X, Dai H … +1 more , Xu M
BMC Womens Health · 2026 Jun · PMID 42374388 · Full text
BACKGROUND: Ovarian clear cell carcinoma (OCCC) is a distinct subtype of epithelial ovarian cancer with characteristic biological behavior and clinical features. Accurate preoperative staging is essential for guiding opt...
BACKGROUND: Ovarian clear cell carcinoma (OCCC) is a distinct subtype of epithelial ovarian cancer with characteristic biological behavior and clinical features. Accurate preoperative staging is essential for guiding optimal management; however, imaging findings may occasionally be misleading. CASE PRESENTATION: We report the case of a 58-year-old postmenopausal woman with OCCC who was clinically suspected to have advanced disease because of a large abdominopelvic tumor, mesenteric abnormalities on contrast-enhanced CT, and an elevated serum CA125 level. These findings raised concern for peritoneal dissemination and extraovarian involvement. However, intraoperative exploration identified a discrete hemorrhagic lesion within the mesentery rather than diffuse malignant seeding. Final histopathological examination confirmed early-stage OCCC, while the mesenteric lesion was identified as a benign hemorrhagic cyst. At the most recent clinical evaluation, 12 months after surgery, the patient remained disease-free. CONCLUSIONS: This case highlights a potential diagnostic pitfall in which benign extraovarian lesions may mimic metastatic disease, potentially leading to overstaging. It underscores the importance of integrating imaging findings with intraoperative evaluation and histopathological confirmation to ensure accurate staging and appropriate clinical management.
Bridging the service gap: health facility challenges in HPV vaccine uptake in rural Uganda.
Evarist MR, Kibonire RA
BMC Womens Health · 2026 Jun · PMID 42366344 · Full text
BACKGROUND: Cervical cancer remains a major cause of morbidity and mortality among women in Uganda. Although the Human Papillomavirus (HPV) vaccine is highly effective in preventing cervical cancer, completion of the rec...
BACKGROUND: Cervical cancer remains a major cause of morbidity and mortality among women in Uganda. Although the Human Papillomavirus (HPV) vaccine is highly effective in preventing cervical cancer, completion of the recommended two-dose schedule remains low, particularly in rural settings. Rukiga District was selected for this study due to persistently low HPV second-dose (HPV2) completion rates compared with national targets. This study assessed health facility-level barriers influencing HPV vaccine completion among adolescent girls aged 9-14 years in rural Uganda. METHODS: A mixed-methods cross-sectional study was conducted between June and September 2022 in selected Health Centre II (HC II), Health Centre III (HC III), and Health Centre IV (HC IV) facilities in Rukiga District. A household survey involving 292 caregivers of eligible adolescent girls was conducted using systematic random sampling. The primary outcome was completion of the two-dose HPV vaccination schedule (HPV2). Quantitative data were analysed using logistic regression to identify factors associated with vaccine completion. In addition, 21 key informant interviews involving 11 healthcare workers and 10 Village Health Team (VHT) members were conducted and analysed thematically to explore contextual barriers affecting HPV vaccine uptake and completion. RESULTS: The HPV vaccine completion rate was 23.49%, indicating low coverage. In multivariable analysis, vaccine stock-outs and cold-chain challenges (adjusted odds ratio [AOR] = 1.75, 95% confidence interval [CI]: 1.04-2.93; p = 0.004) and understaffing of healthcare workers (AOR = 1.97, 95% CI: 1.05-3.68; p = 0.006) were the only statistically significant predictors of HPV vaccine completion. Although limited healthcare worker knowledge (AOR = 0.94, 95% CI: 0.70-1.24) and absence of government programmes targeting out-of-school girls (AOR = 0.97, 95% CI: 0.73-1.29) were not statistically significant in the adjusted model, qualitative findings highlighted them as important contextual barriers. Additional challenges identified included weak outreach systems, transportation constraints, misconceptions about HPV vaccination, and limited community awareness. CONCLUSION: HPV vaccine completion in rural Uganda remains low and is strongly influenced by health system constraints, particularly vaccine supply-chain disruptions and human resource shortages. Strengthening vaccine logistics, improving staffing levels, enhancing healthcare worker capacity, and expanding outreach strategies targeting underserved populations are essential for improving vaccine completion and achieving national immunisation targets.
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