BMC Women's Health最新文献

Background: This study investigates the social impact of menstrual stigma in Spain. Whilst menstruation is a biological process, it is shaped by cultural norms that influence how it is perceived, experienced, and managed.

Methods: A nationwide cross-sectional mixed-methods survey was conducted with 4,028 participants aged 14 years and older. Quantitative items were analysed using descriptive statistics, while qualitative open-ended responses were thematically analysed through a constructivist lens to explore social perceptions, behavioural responses, and institutional dynamics related to menstruation.

Results: Menstruation affects participation in everyday activities, particularly those involving physical exposure such as sports, swimming, or wearing certain types of clothing. While some respondents reported avoiding activities due to physical symptoms, others cited anxiety, fear of leakage, or social discomfort, reflecting internalised stigma. In professional and educational settings, participants described presenteeism, reluctance to take leave, and a sense of pressure to minimise or conceal menstrual needs. Experiences of exclusion, whether from religious rituals, traditional roles, or interpersonal interactions, were also reported. Despite these challenges, the study highlights the positive role of supportive social environments. Solidarity, peer empathy, and institutional flexibility were identified as protective factors that help counter the effects of stigma. However, gaps in menstrual education and limited integration of menstrual health in clinical contexts continue to pose barriers to well-being and equity.

Conclusion: The findings underscore the need to recognise menstruation as a relevant factor in public health, education, and workplace inclusion. Addressing menstrual stigma requires structural attention and a shift from individual responsibility to collective and institutional support.

Background: Lymphocytic mastopathy (also known as diabetic mastopathy, fibrotic mastopathy, or sclerosing lymphocytic lobulitis) is a rare benign fibroinflammatory breast disease that clinically and radiologically mimics breast carcinoma. It is most commonly associated with long-standing diabetes mellitus and autoimmune disorders.

Case presentation: We report the case of a 63-year-old woman with a 6-month history of a gradually enlarging, painless right breast lump. The patient was a known type 2 diabetic for 15 years on oral hypoglycaemic agents. Mammography and ultrasonography revealed an ill-defined hypoechoic lesion with marked posterior acoustic shadowing (BIRADS IV). Core needle biopsy was inconclusive. Excision biopsy demonstrated dense keloid-like fibrosis with periductal and perilobular lymphocytic infiltration without atypia, consistent with lymphocytic mastopathy.

Conclusion: Awareness of lymphocytic mastopathy is essential to prevent misdiagnosis as malignancy and avoid unwarranted surgical interventions. Although rare in non-insulin dependent diabetics, this condition should be included in the differential diagnosis of breast lump that mimic carcinoma on clinical examination and imaging.

Background: Self-collection of HPV DNA samples is recommended as a cervical cancer screening method in areas with high barriers to clinical examination, such as Ethiopia. Self-collected sample adequacy in clinical settings is high compared to clinician collection, but less is known about self-collected sample adequacy in community settings. We evaluated sample adequacy differences when samples were taken at women's homes, a local health post, or a primary care health center in rural Ethiopia.

Methods: Women either self-collected vaginal samples for HPV DNA at home (Arm 1, n = 100), at a health post (Arm 2, n = 100), or at a health center (Arm 3, n = 200). Women received identical sample collection kits and illustrated instruction pamphlets; all samples were treated the same way once collected. HPV DNA testing was performed using Ampfire Multiplex High-Risk HPV (Atila, Mountain View, California).

Results: Thirty-two (8%) of the 399 samples were inadequate (negative β-globin gene). Sample inadequacy frequency was highest in Arm 1-Home (15%) compared to Arm 2-Health Post (7%) and Arm 3-Health Center (5%) (p < 0.05)). Arm 1 had significantly higher odds of inadequacy than Arm 3 (aOR: 2.8, 95% CI 1.2-6.8, p = 0.02) when adjusted for age, education, and marital status. There was no difference in adequacy between Arms 2 and 3. HPV prevalence was lowest in Arm 1 (6%) and significantly higher in Arms 2 and 3 (20.4% and 15.9%, respectively, p = 0.02). More women in Arm 2 reported positive views of self-sampling, and fewer reported embarrassment when using the self-test compared to Arm 1.

Conclusions: Collecting self-samples at home yielded more inadequate samples than collecting at a health center; however, self-samples collected at the health post were not significantly different from those collected at the health center. In rural areas, self-sampling at locations proximal to women's residences but providing privacy may increase screening campaigns' success. While more work is needed to confirm this finding, home sampling may miss women who should be referred for diagnostic testing.

Background: Hysterectomy is one of commonly performed gynaecological surgeries. Even though it is effective for treating benign conditions, it can compromise ovarian function by disrupting blood supply, potentially leading to earlier menopause and altered sexual wellbeing. Total abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) are two widely used approaches; however, their long-term impact on ovarian reserve and sexual function remains debated. Internationally, the Female Sexual Function Index (FSFI) is used as a validated tool to measure sexual health, yet no Sinhala version exists. Through this study, we aimed to compare sexual function and ovarian reserve following TAH and TLH, while also developing and validating a Sinhala version of the FSFI.

Methods: Conducted in two phases, the first involved the development and validation of a Sinhala version of the FSFI in normal volunteers. The second was a prospective non-randomised cohort study at Teaching Hospital Peradeniya, including 81 patients. Ovarian reserve was assessed with Follicle-stimulating hormone (FSH) and Estradiol (E2) levels before surgery and six months later. Sexual function was measured using the validated Sinhala FSFI at the same time points. Data were analysed using SPSS version 21, with adjusted analyses performed to account for baseline sexual function and selected sociodemographic factors.

Results: Both groups showed an increase in FSH (TAH: 6.57 to 7.73 mIU/mL; TLH: 5.89 to 6.96 mIU/mL, both p < 0.001) and a reduction in E2 (TAH: 184.05 to 157.20 pmol/L, p = 0.012; TLH: 163.60 to 122.17 pmol/L, p < 0.001). FSFI scores declined in both groups (TAH: 25.77 to 24.46, p = 0.001; TLH: 22.87 to 21.14, p < 0.001). Although baseline and unadjusted follow-up FSFI scores differed between groups, the magnitude of decline was similar (ΔFSFI: TAH - 1.30 vs. TLH - 1.72, p = 0.507). After adjustment for covariates, surgical approach was not independently associated with postoperative sexual function. Hormonal changes were not significantly associated with FSFI outcomes.

Conclusion: Both approaches were associated with comparable reductions in ovarian reserve and sexual function over a six-months period. Neither approach showed a clear advantage, highlighting the importance of preoperative counselling and individualized surgical planning to ensure that women are aware of potential hormonal and sexual health changes after surgery.

Background: Lifestyle and health behaviors affect a woman's overall health, including reproductive health. Leading a health-promoting lifestyle is crucial for optimizing conditions for conception, embryo and fetal development, and minimizing risks for both mother and child.

Methods: This cross-sectional study examined the relationship between women's knowledge of health-promoting behaviors and their engagement in such behaviors during the pregnancy planning period. A diagnostic survey was conducted using an original questionnaire and the Health Behavior Inventory by Zygfryd Juczynski. The study included 100 women attending preconception visits at obstetrics and gynecology clinics between March and May 2024.

Results: Most respondents (64%) agreed that health-promoting behaviors during the preconception period influence pregnancy success. The most common behaviors included giving up stimulants (86%), visiting a gynecologist (83%), and supplementing folic acid (81%). The least common were completed (29%) or planned (9%) vaccinations. Women were primarily motivated by the desire to increase their chances of conception (38%) and ensure the health of their child (20%). The majority (65%) demonstrated an average level of knowledge regarding recommended health behaviors. Knowledge and behavior intensity were influenced by sociodemographic factors such as age, education, residence, and marital status. A significant relationship was found between knowledge level and engagement in health-promoting activities - women with greater knowledge were more likely to adopt behaviors supporting reproductive health.

Conclusions: Women planning pregnancy show awareness of the impact of health-promoting behaviors on pregnancy outcomes and child health, which is reflected in their actions. However, the predominance of average knowledge levels indicates a need for further education, particularly in less commonly addressed areas.

Background: Multiple myeloma (MM) is a common malignant tumor of the blood system, on the other hand, the incidence of fallopian tube cancer is low, accounting for only 0.1%~1.8% of gynecological malignant tumors. It is extremely rare for these two diseases to occur together. In this paper, we present a case of primary fallopian tube cancer that was discovered and metastasized to the ovary during chemotherapy for MM, and we review the literature.

Case presentation: The patient was 69 years old and had been postmenopausal for 19 years. She was admitted to the hospital due to abnormal vaginal discharge lasting for one week. She had a history of MM for 5 years and had just completed 13 courses of treatment with daretuzumab. Doppler ultrasound and pelvic computed tomography(CT) revealed tubal and ovarian lesions with a high probability of malignancy. Laparoscopic exploration was performed, and frozen pathology confirmed the presence of malignant tumors originating from the right adnexa. The bilateral fallopian tubes and ovaries were removed. Postoperative paraffin pathology showed right fallopian tube cancer with ovarian metastasis. Following the surgery, the patient received three sessions of hyperthermic intraperitoneal therapy and one session of carboplatin and paclitaxel chemotherapy. Currently, the patient is in a generally stable condition and is awaiting the second round of chemotherapy.

Conclusion: The coexistence of MM and primary fallopian tube carcinoma is an extremely rare occurrence. When a pelvic mass is detected in patients with multiple myeloma, it is important to consider the possibility of a second primary tumor in addition to myeloma metastasis. Managing patients with this dual malignancy presents a significant challenge for clinicians. Treatment plans should be developed through multidisciplinary collaboration, taking into account the severity of the disease and the patient's physical condition. Close monitoring is necessary during the perioperative period, as these patients are susceptible to infection and kidney damage. It is advisable for patients and their children to undergo genetic testing in order to implement appropriate preventive measures.

Background: Women's ability to refuse unwanted sex is a fundamental dimension of gender equality and a key determinant of overall well-being. Despite its importance, there is limited evidence on the prevalence and factors influencing this ability in Tanzania. This study therefore aimed to investigate the prevalence and determinants of women's ability to refuse sex among reproductive-age women in the country.

Method: This study analyzed secondary data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS), using a weighted sample of 9,090 women aged 15-49. Descriptive statistics summarized socio-demographic characteristics, while binary logistic regression identified factors associated with women's ability to refuse sex. Both unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals were reported, with statistical significance set at p < 0.05.

Results: The study found that 69.6% of Tanzanian women of reproductive age had the ability to refuse sex (95% CI: 68.5%-70.4%). After adjusting for confounders, women's ability to refuse sex was associated with their education, primary (aOR = 1.354, p < 0.001), secondary (aOR = 1.74, p < 0.001), higher (aOR = 2.253, p = 0.024), and their partners' education, secondary (aOR = 1.269, p = 0.015), higher (aOR = 1.756, p = 0.009). Wealth (aOR = 1.241, p = 0.017), awareness of sexually transmitted infections (aOR = 1.368, p < 0.001), prior HIV testing (aOR = 1.714, p < 0.001), media access, low (aOR = 1.273, p < 0.001), medium (aOR = 1.612, p < 0.001), high (aOR = 1.954, p < 0.001), and contraceptive use, calendar-based (aOR = 1.311, p < 0.001) or other methods (aOR = 1.525, p < 0.001), were also positively associated. Women from Unguja (aOR = 0.425, p < 0.001) and Pemba (aOR = 0.376, p = 0.004) were less likely to refuse sex.

Conclusion: The study found that a majority of Tanzanian women have the ability to refuse sex and that the ability to refuse sex is significantly linked to education, economic status, partner's education, access to media, STI awareness, HIV testing, and contraceptive use. However, women in Unguja and Pemba had lower ability to refuse sex compared to those in mainland urban areas. The findings highlight the need for targeted interventions to address regional disparities and promote equitable access to resources that support women's ability to refuse sex.