Gynecological Endocrinology最新文献

Background: Abnormal uterine bleeding (AUB) impacts the quality of life of women globally. While international classifications and frameworks exist, there are still critical unmet needs in awareness, diagnosis, treatment, and patient support. To better understand these, the lived experiences of patients with AUB shared on social media can offer valuable insights.

Objective: To identify and analyze unmet needs in the management of AUB as expressed during social media discussions.

Methods: Using the social media listening tool Sprinklr Social (Sprinklr Inc.), public posts from X (X Corp.) related to AUB from seven countries (Brazil, China, India, Mexico, Pakistan, Saudi Arabia, Ukraine) over a 10-year period (2014-2024) were analyzed. Posts were categorized by topic, sentiment, and emotion; further analyses assessed patients' unmet needs and feelings.

Results: A total of 926 posts were included. Analysis revealed five critical unmet needs: lack of awareness and understanding (41.8%), impact on wellbeing (27.6%), diagnosis issues (10.9%), dissatisfaction with treatment options (9.7%), and undervalued impact and advocacy (8.6%). Posts about diagnosis and symptoms carried the most negative sentiments; many patients expressed frustration over delayed diagnoses and dissatisfaction with treatment options. Additionally, the emotional and psychological burden of AUB was a recurring theme, suggesting the need for more holistic care approaches.

Conclusions: Gaps in AUB management were identified, with strong emphasis on the need for better patient education, more effective diagnostic processes, and personalized treatment strategies. Incorporating patient voices during the development of treatment guidelines and healthcare policies is crucial for addressing these unmet needs and improving patient outcomes.

Inflammation exerts an essential role in gestational diabetes mellitus (GDM), but the relationship between peripheral blood inflammatory markers and GDM remains unclear. The purpose of this study was to explore the relationship between inflammatory markers and GDM in US adults. Data were extracted from the National Health and Nutrition Examination Survey. Five inflammatory markers were derived from complete blood count. Survey-weighted multivariable logistic regression models were used to assess the association between inflammatory markers and GDM. Restricted cubic splines and subgroup analyses were conducted to validate the stability of the results. Finally, a total of 2363 women aged 20-44 were included based on specific criteria, with 229 self-reported GDM cases (9.69%). The increased lymphocyte-monocyte ratio (LMR) was associated with the higher risk of GDM, aOR = 1.82 (CI:1.30-2.56). Compared with the lowest tertile, the highest tertile group of LMR showed a significantly increased risk of GDM, aOR = 2.24 (CI: 1.28-2.85). Conversely, the highest tertile group of systemic inflammation response index (SIRI) was negatively associated with GDM, aOR = 0.61 (95% CI: 0.40-0.94). And high platelet-lymphocyte ratio (PLR) levels are related to a lower risk of GDM. No non-linear relationships were observed. Furthermore, subgroup analysis revealed that the association between LMR, SIRI, and GDM remained consistent with the overall results. Our study indicated that LMR, PLR, and SIRI may be potential predictors of GDM. Further large-scale prospective study is needed to investigate the role of LMR, PLR and SIRI in GDM.

Nearly 50% of women with functional hypothalamic amenorrhea (FHA) reveal polycystic ovarian morphology (PCOM), a known risk factor for ovarian hyperstimulation syndrome. However, gonadotropin releasing hormone-agonist (GnRH-a) triggers are not recommended in FHA, since an inadequate endogenous surge in luteinizing hormone (LH) is expected. We aimed to challenge this concept and evaluated LH levels after GnRH stimulation in FHA-women with and without PCOM. In a retrospective cohort study, 82 women with FHA, who underwent a GnRH stimulation test, were included. Thirty-five women revealed PCOM (42.7%). Twenty minutes after GnRH stimulation, there was an increase of serum LH levels in FHA-PCOM (median basal: 2.7 mIU/mL, IQR 1.1-4.6 versus median stimulated: 13.5 mIU/mL, IQR 7.8-21.6, p < 0.001) and in FHA-nonPCOM patients (median basal: 2.5 mIU/mL, IQR 0.5-3.9 versus median stimulated: 5.7 mIU/mL, IQR 2.4-13.9, p < 0.001). Overall, positive correlations (p < 0.001) were found between basal and stimulated LH levels. In FHA-PCOM patients, 42.9% of patients revealed stimulated LH levels >15 mIU/mL, while this was the case in 19.1% of FHA-nonPCOM patients (p = 0.034). In women with FHA-PCOM, ovulation induction with a GnRH-a trigger might be feasible. Future research should focus on the prediction of an adequate response to GnRH triggers in the IVF setting.

Gestational diabetes mellitus (GDM) affects 9-25% of pregnancies. Undiagnosed or poorly managed GDM is associated with both short- and long-term complications in the fetus and mother. The pathogenesis of GDM is complex and has not yet been fully elucidated. Several biomarkers found in maternal serum have the potential for the early diagnosis of GDM. The aim of this narrative review was to explore novel biomarkers that have not been comprehensively described in previous reviews. We believe these biomarkers may allow for the detection of GDM in the early stages of pregnancy, enabling timely proper treatment and potentially preventing complications for both the mother and the fetus.

Objective: Endometriosis is an estrogen-dependent disease wherein isoflavones interact with estrogen receptors. Daidzein-rich isoflavone aglycones (DRIAs) have been shown to inhibit cell proliferation and aromatase activity in vitro and in vivo. This study aims to investigate the effects of DRIAs on the enzymes involved in estrogen metabolism in endometriosis.

Study design: Stromal cells isolated from ovarian endometriomas (OESCs) were cultured with DRIAs. Ovarian endometrioma (OE) specimens were obtained from patients who were treated with or without DRIAs. The gene expressions involved in estrogen metabolism and 17β-hydroxysteroid dehydrogenase (HSD17β) 1 activity were analyzed using RT-PCR and thin layer chromatography, respectively.

Results: HSD17β1 expression in OE specimens was evaluated using immunohistochemical staining. DRIA treatment significantly suppressed HSD17β1 expression and elevated estrogen sulfotransferase (EST) levels in OESCs; however, no differences were observed in HSD17β2, HSD17β7, HSD17β12, and steroid sulfatase (STS) levels. HSD17β1 enzyme activity was inhibited by DRIAs. Furthermore, immunohistochemical analysis confirmed that HSD17β1 expression was suppressed in the OE specimens of patients undergoing treatment with DRIAs.

Conclusions: DRIA treatment could suppress abnormal estrogen production via EST stimulation as well as the inhibition of aromatase and HSD17β1 activities, suggesting therapeutic potential in endometriosis that needs to be confirmed by our ongoing clinical trial. ay.

Background: Endometriosis is a chronic condition affecting physical health, emotional well-being, and socioeconomic stability. While pain is a well-recognized determinant of health-related quality of life (HR-QoL), the role of pain experience over employment status remains underexplored. Objective: To determine among women with endometriosis whether employment status independently contributes to HR-QoL, beyond clinical symptoms. Methods: This cross-sectional study was conducted at the University Hospital of Geneva. Women with a confirmed diagnosis of endometriosis were included. Employment status was categorized as full-time employment (>80%), part-time employment (≤80%), voluntary unemployment, and involuntary unemployment. HR-QoL was measured using the Endometriosis Health Profile-30 (EHP-30). Results: A total of 324 patients were included (mean age 32 ± 7.2 years); 78.2% had deep infiltrating endometriosis, and 34.5% reported prior surgery. Regarding employment, 63.2% were employed (51.5% full-time, 11.7% part-time), while 36.7% were unemployed, including 26.2% by choice. Full-time and part-time employment were linked to lower EHP-30 pain scores, with part-time employment showing a stronger association (β = -34.48, 95% CI: -58.00 to -10.88, p = 0.006) than full-time employment (β = -20.57, 95% CI: -40.70 to -0.43, p = 0.046). Unemployed women actively seeking work exhibited worse HR-QoL, particularly in social support (β  = 34.95, 95% CI: 1.89 to 70.80, p = 0.048) and overall HR-QoL burden (β  = 168.27, 95% CI: 30.60 to 205.91, p = 0.019). Conclusion: Employment status is an independent predictor of HR-QoL in women with endometriosis. Beyond pain, professional identity and social integration play key roles in endometriosis burden.

Background: Obesity-related polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with infertility and metabolic dysfunction. While bone morphogenetic protein-15 (BMP-15) plays a recognized role in ovarian function, its specific impact on infertility in obese PCOS patients remains unclear Objective: This study aimed to investigate the influence of BMP-15, NOD-like receptor protein 3 (NLRP3), and interleukin-18 (IL-18) on infertility in this population and to evaluate their predictive clinical value. Methods: Clinical data from 185 obese PCOS patients were retrospectively analyzed. Univariate and logistic regression analyses identified infertility-related factors. Results: Results showed an infertility rate of 34.43%, with significant differences in BMP-15, NLRP3, IL-18, Morisky Medication Adherence Scale (MMAS-8), and Connor-Davidson Resilience Scale (CD-RISC) scores between infertility and non-infertility groups. NLRP3, IL-18, and MMAS-8 emerged as risk factors, while BMP-15 and CD-RISC were protective.In an obese PCOS mouse model, BMP-15 administration improved metabolic parameters, restored hormonal balance, reduced ovarian inflammation, and preserved fertility. Conclusion: These findings suggest that BMP-15 plays a protective role in PCOS-related infertility by modulating metabolic and inflammatory pathways. BMP-15 may serve as a valuable biomarker and therapeutic target for early identification and intervention in obese PCOS patients at risk of infertility.

Polycystic ovarian syndrome (PCOS) is a major endocrine disorder that affects women of reproductive age. This study evaluated global disease burden trends (1990-2021) and projected future trajectories to 2050 to inform public health strategies. Using Global Burden of Disease 2021 data, we analyzed PCOS prevalence, incidence, and disability-adjusted life years (DALYs) and correlations with the sociodemographic index (SDI). Trends were assessed via the estimated annual percentage change, and future burden was projected using a Bayesian age-period-cohort model. From 1990 to 2021, global PCOS prevalence among reproductive - age women rose 89.55% to 69.47 million. Incident cases increased 55.90% to 2.30 million, and DALYs surged 87.70% to 607.76 thousand. Regions with rising SDI, particularly South, East, and Southeast Asia, saw the steepest increases in age-standardized rates. The incidence rose most sharply in the 10-19 age group, while the prevalence and DALYs peaked in the 15-49 age group. Projections indicate a continued increase in PCOS burden until 2050. PCOS poses a serious public health challenge, particularly in the medium-SDI regions. This escalating burden underscores the need for targeted interventions, particularly for adolescents and young women, to mitigate its long-term health impacts. Policymakers and clinicians must prioritize PCOS management to address its increasing global prevalence and associated disabilities.

Objectives: Premature ovarian insufficiency (POI) is a serious condition that affects women worldwide, In recent years, the number of research publications on POI has increased over the last decades because of the advancement of cutting-edge research in gynecology and the deepening of disciplinary interactions. At the same time, there is a more urgent need to systematically analyze and review existing studies to generalize the research paradigm and disciplinary structure of the field under technological changes.

Materials and methods: We selected the top 100 most cited papers in the Web of Science (WOS) SCI-Expanded database. Knowledge graphs were constructed through the VOS viewer, Cite Space, and Scimago Graphica software, and then relevant information retrieved from the literature was edited using Excel to assess research priorities and trends in the field.

Results: A total of 53 periodicals from 34 different nations and regions published the 100 most-cited publications between 1999 and 2024. The Journal of Clinical Endocrinology & Metabolism published the majority of the papers, while The Lancet had the highest average number of citations per piece. The United States of America produced the highest contribution in terms of publications, with China and France closely trailing after. In terms of total publications, Erasmus MC, Shanghai Jiao Tong University, and Shandong University each contributed the highest number of papers. The main categories were obstetrics and gynecology, endocrinology and metabolism, and reproductive biology. The top five keywords were: failure, women, ANTI-MULLERIAN HORMONE, NATURAL MENOPAUSE, and AGE. The study of HERITAGE AND GENETICS, CARDIOVASCULAR DISEASES, and CELL BIOLOGY AND IMMUNOGENETICS is becoming more and more popular in POI, as shown by cluster analysis.

Conclusions: Bibliometric analysis enables POI researchers to efficiently and visibly pinpoint the cutting-edge areas and focal points of their study. Potential topics of future study may include genetic and molecular biological pathways, cardiovascular pathology, and immunology.