Women's health reports (New Rochelle, N.Y.)最新文献

Background: Cervical cancer screening with a self-collected vaginal specimen for human papillomavirus (HPV) testing was approved by the U.S. Food and Drug Administration in May 2024, offering a potential solution to declining screening rates.

Objective: We aimed to assess acceptability of clinic-based vaginal specimen self-collection for HPV testing and to evaluate associations between participants' sociodemographics and their likelihood of choosing self-collection for future screening and the overall acceptability of using the Evalyn® brush device. We also evaluated associations between specific acceptability constructs and reported likelihood to use the device in the future and overall acceptability.

Methods: Following self-collection of a vaginal specimen, participants completed an electronic survey that measured constructs from the Theoretical Framework of Acceptability. Associations were assessed using logistic regressions. The study was conducted at a colposcopy clinic in the Gynecology department of a midwestern academic medical center in the United States from November 2022 through July 2023.

Results: Participants (n = 81) reported high likelihood (98% likely or very likely) of choosing in-home self-collection for future screening and unanimity on overall acceptability (100% acceptable or completely acceptable) of using the device. More affirmative responses to measures on instruction understandability, ease of device use, understanding the device is used for cervical cancer screening, and perceiving self-collection improves screening rates were associated with a higher likelihood to choose self-collection for future screenings and overall acceptability of the device (all p values <0.05).

Conclusion: Vaginal specimen self-collection for HPV testing was well-received in the studied population, with high acceptability and likelihood of uptake. Implementation efforts should provide user-friendly instructions and emphasize the benefits of self-collection for cervical cancer screening, particularly among people less likely to engage with clinician-collected speculum-based screening.

Objectives: Menopause affects sleep quality and contributes to depressive symptoms, but its precise impact on sleep remains unclear. To address this gap, we conducted detailed measurements of brain activity during sleep in pre- and postmenopausal women using a novel wearable sheet-type frontal electroencephalography (EEG) patch, Haru-1 (PGV Inc., Tokyo, Japan).

Methods: Hospitalized patients aged 30-50 years who had undergone bilateral salpingo-oophorectomy, as well as volunteer participants aged 40-60 years who underwent EEG monitoring at home, were enrolled in the study. EEG recordings were obtained during sleep. Participants were assessed for menopausal symptoms using the Simple Menopausal Index (SMI) and for depressive symptoms using the Quick Inventory of Depressive Symptomatology Japanese version (QIDS-J). Sleep parameters were calculated to investigate the relationships between menopause, menopausal symptoms, depressive symptoms, and sleep characteristics.

Results: A total of 174 participants were recruited, and data from 126 participants were included in the final analysis. Among 126 analyzed participants (mean age: 46.3 ± 7.3 years; 36 premenopausal, 90 postmenopausal), postmenopausal women had lower sleep efficiency (78% vs. 88%; p = 0.0065) and longer sleep onset latency (20 minutes vs. 8 minutes; p = 0.0203). The presence of menopausal symptoms (SMI ≥51) correlated with shorter deep sleep (9 minutes vs. 26 minutes; p = 0.0367), and depressive symptoms (QIDS-J ≥6) were associated with prolonged wake after sleep onset (56 minutes vs. 36 minutes; p = 0.0242).

Conclusions: Menopause was associated with reduced sleep efficiency and increased sleep onset latency. Detailed EEG analyses may contribute to a better understanding of the pathogenesis of menopausal symptoms and their impact on sleep.

Background: Premenstrual syndrome (PMS) is a common menstrual disorder that can significantly impact the physical, emotional, and social well-being of affected women. However, PMS remains a neglected problem in Afghanistan, with limited data on its prevalence and impact. This study aimed to determine the prevalence of PMS and the more severe premenstrual dysphoric disorder (PMDD) among female university students in Kabul, Afghanistan.

Methods: Researchers conducted a cross-sectional study from April to October 2021 at four universities in Kabul. They included a total of 310 female students aged 15-35 years. After data cleaning, 44 participants were removed and 266 participants remained. Data were collected using a validated screening tool for PMS and PMDD, along with information on participants' sociodemographic and lifestyle factors. Statistical analysis was performed to assess the findings.

Results: The study found that 88.8% of participants screened positive for either moderate to severe PMS (27.1%) or PMDD (61.7%). There was a significant association between lower educational attainment and higher rates of PMS/PMDD.

Conclusion: This study uncovered a high prevalence of PMS and PMDD among female university students in Kabul. These conditions significantly impact young Afghan women's health and well-being, but remain a neglected issue. Urgent action is needed to improve awareness, screening, and treatment access for premenstrual issues in Afghanistan.

Objective: To determine associations of childhood emotional and physical abuse and neglect with the incidence of menstrual irregularity, male pattern hair growth, and possible PCOS.

Design: Cross-sectional Study at University.

Subjects: 410 individuals, 18-45 years old.

Intervention: Survey.

Main outcome measures: A questionnaire was administered to students, faculty, and staff at a regional State University of New York (SUNY) campus. Data on sociodemographic factors, menstrual dysfunction (irregularity, male pattern hair growth, and PCOS), and experiences of childhood abuse and neglect were collected.

Results: Participants were sub-grouped into those with menstrual irregularity (MI: defined as >35 days between one period's beginning and the next, or ≤8 cycles/year, or absent periods altogether), or male pattern hair growth (MHG: defined as excess hair on the upper lip, chin, chest, abdomen, buttocks, or back), both (MI+MHG), or those who did have neither (Unaffected). Family income status yielded some association with the presence of MI, MHG, or MI+MHG. There were significant correlations between individuals reporting MI, MHG, and MI+MHG and reported experiences of feeling loved by their caregiver (p value = 0.0029988), experiencing verbal abuse (p value = 0.0000004293), experiencing physical neglect (p value = 0.030228), feeling emotionally disconnected from their caregiver (p value = 0.0006138), and not having a peaceful home (p value = 0.00005760630462), vis-à-vis Unaffected individuals. Almost all respondents with a prior diagnosis of PCOS (97.6%) reported MI and/or MHG.

Conclusions: All childhood experiences of abuse and neglect, except the loss of a parent, were significantly associated with features suggestive of PCOS. Larger, unbiased population studies across different demographics, are needed.

Objective: Intimate partner violence (IPV) significantly affects women's health, but the lack of control groups in past studies hinders identifying high-risk populations and establishing evidence-based interventions. This study examines the link between IPV and women's mental health outcomes.

Methods: A nationwide database was used in this case-control study. The study targeted adult women aged 18-64 in 2019 and employed a case-control study design with a total sample size of 71,512 participants. Data were sourced from the Ministry of Health enrollment files, cause of death statistics, and outpatient and inpatient claims data. Chi-square tests were used to analyze the association between IPV with mental health outcomes and personal characteristics. Additionally, conditional logistic regression models were applied to investigate the impact of IPV on women's mental health outcomes.

Results: Compared with nonvictims, women who experienced IPV had significantly lower socioeconomic status and were at higher risk for various mental health outcomes. These included bipolar disorder (adjusted odds ratio [OR] = 5.91, 95% confidence interval [CI]: 4.16-8.38), alcohol and substance abuse (adjusted OR = 4.84, 95% CI: 2.88-8.14), depression (adjusted OR = 4.67, 95% CI: 3.91-5.58), schizophrenia (adjusted OR = 2.37, 95% CI: 1.80-3.12), and anxiety (adjusted OR = 2.36, 95% CI: 1.98-2.81).

Conclusions: This study identified several mental disorders highly associated with IPV among adult women, with particular emphasis on bipolar disorder, alcohol and substance abuse, and depression. Insights into high-risk mental health disorders will help clinical staff be alert to IPV and provide a reference for policy planning of IPV counseling and intervention.

Background: Measuring quantitative menstrual cycle hormones at home may help women better understand their postpartum and perimenopause fertility transitions, but these quantitative fertility monitors require validation.

Materials and methods: This study included 16 North American women, aged 28-51, during either the postpartum (n = 8, cycles = 18) or perimenopause (n = 8, cycles = 35) fertility transitions testing daily first-morning urine testing with both the Mira Monitor and ClearBlue Fertility Monitor (CBFM) along with menstrual cycle parameter tracking. The main outcome measures were a rise in estrone-3-glucuronide (E₁3G) and luteinizing hormone (LH) urine hormone values from the Mira monitor correlated to low, high, or peak values on the CBFM.

Results: Both in the postpartum and perimenopause transitions, the identification of the day of ovulation based on the LH surge on the Mira and CBFM monitors was highly correlated (R = 0.94 and 0.83, p < 0.001). The E₁3G levels on the Mira monitor were significantly higher for a CBFM reading of "High" compared with "Low" for both the postpartum and perimenopausal cycles (all p < 0.001). Similarly, the LH levels on the Mira monitor were significantly higher for a CBFM reading of "Peak" (LH surge) compared with "High" for both the postpartum and perimenopausal cycles (all p < 0.001).

Conclusions: The LH surge and levels of E₁3G in urine identified on the quantitative Mira fertility monitor strongly correlate to the LH surge and the shift from low to high on the CBFM during the postpartum and perimenopause transitions.

Objectives: Cervical cancer screening rates fall below national goals. At-home self-sampled tests for human papillomavirus (HPV) may improve screening rates. This study assesses the acceptability of self-sampled HPV testing with respect to motivating factors and preference among average-risk patients (undergoing routine screening) and high-risk patients (receiving follow-up care after abnormal screening results).

Materials and methods: This cross-sectional study sample consisted of 46 participants (female, ages 30-65), including average-risk (n = 35) and high-risk (n = 11) patients, who had already received clinician-collected cervical cancer screening. Participants completed a self-sampled HPV test and a survey. Motivators included cervical cancer screening facilitators, sexual history, health care factors, and feelings during self-sampled test. We analyzed the relationships between these constructs and test modality preference for their next cervical cancer screening (i.e., self-sampled HPV testing at home vs. other preference).

Results: Few participants experienced negative feelings during self-sampled HPV testing (uncomfortable: 20%; anxious: 22%; and unpleasant: 15%). Overall, 57% of participants would prefer to complete a self-sampled HPV test at home for their next cervical cancer screening compared with other test options. Test modality preference for their next cervical cancer screening did not differ for average- versus high-risk patients, and it did not vary by any of the motivating factors we assessed (all p > 0.05).

Conclusions: Acceptability of self-sampled HPV testing at home is high, with little difference in attitudes observed across patient characteristics. These findings demonstrate that self-sampled HPV testing may be an effective tool for increasing cervical cancer screening, even among high-risk patients who have previously had abnormal screening results.

Background: Pregnant women have been identified as a special adult population that is particularly vulnerable to oral diseases. The aims of this study were (1) to determine the prevalence of oral disease risk factors and (2) to examine the association between having a dental visit in the last 12 months and obvious tooth decay among a sample of pregnant women with low income.

Methods: This cross-sectional study analyzed the outcomes of oral health risk assessments for 554 pregnant women in a municipal hospital in the Bronx, New York. Descriptive statistical analyses were performed to examine the characteristics of the study population. Simple and multivariable logistic regression analyses were conducted to examine the association between having a dental visit in the last 12 months and obvious tooth decay.

Results: Overall, 28.2% of participants had a dental visit in the last 12 months and 87.7% had dental insurance. Over half of individuals reported frequent consumption of sugary beverages (52.2%). Nearly 30% of the participants showed signs of obvious tooth decay. There was no statistically significant association between last dental visit and obvious tooth decay (odds ratio = 1.02, 95% confidence interval [0.67-1.56]).

Conclusions: The high prevalence of unmet oral health needs despite widespread dental insurance coverage in this study sample suggests other barriers to oral health care beyond insurance coverage. The findings from this study underscore the complexity of oral disease and the potential role that targeted, interprofessional efforts can have on the promotion of oral health in vulnerable pregnant women.

Introduction: Women are historically underrepresented as grand rounds speakers in US medical schools regardless of department. We hypothesized that the representation of women as grand rounds speakers would increase after the widespread adoption of virtual grand rounds during the COVID-19 pandemic.

Methods: We reviewed publicly available or individually provided grand round speaker lists for 2019, 2021, and 2022 from representative medical departments, surgical departments, and basic science departments of our local institution and the top 10 academic medical schools based on their national ranking according to the 2022 Blue Ridge Institute for Medical Research Rankings of NIH Funding. Speaker gender was determined based on name and publicly available biographies.

Results: In total, we identified 1995 speaking engagements from 10 institutions. All but six talks delivered post-COVID-19 pandemic were in hybrid or virtual-only format compared to exclusively in-person sessions pre-COVID-19 pandemic. Before the COVID-19 pandemic, women accounted for 37.3% of invited speakers compared to 45.5% post-COVID. This increase in the representation of women as grand rounds speakers was consistent across all academic ranks and most departments.

Conclusions: We propose that departments, particularly those with fewer women at baseline, should continue to offer at least some virtual grand rounds opportunities throughout the year with a goal of increasing the diversity of speakers and improving the access of their faculty to women speakers.

Background: Although female sexual dysfunction (FSD) and low sexual self-efficacy are common in patients with interstitial cystitis/bladder pain syndrome (IC/BPS), existing measures of these constructs do not fully capture unique challenges faced by patients with IC/BPS, such as managing sex-related symptom exacerbations, experiencing rewarding sexual activity, and maintaining intimate relationships. To address the lack of tailored measurement of FSD and sexual self-efficacy in patients with IC/BPS, we aimed to adapt the Painful Intercourse Self-Efficacy Scale-Interstitial Cystitis (PISES-IC) for this population.

Method: To form the PISES-IC, we added three items to the pain self-efficacy subscale of the PISES, each informed directly by qualitative interviews with patients with IC/BPS and literature review of patient-reported sexual experiences in IC/BPS. Utilizing baseline data of 71 female participants involved in a clinical trial for IC/BPS (NCT#04275297), we assessed the validity and reliability of the newly adapted PISES-IC.

Results: Results indicate that the PISES-IC is indeed a valid and reliable measure of sexual self-efficacy in the IC/BPS population and that the items informed by IC/BPS patient experiences (self-efficacy related to pain flares, rewarding sexual activity, and interference with romantic relationships) may be particularly related to FSD in patients with IC/BPS.

Conclusions: The PISES-IC captures aspects of sexual experiences of patients with IC/BPS that are not assessed by other existing measures. The PISES-IC can be utilized in research and clinical settings to inform patient care and to further understand sexual experiences of IC/BPS patients.