BMC Women's Health最新文献

Background: Menopause can be seen as a complex phenomenon influenced by an individual's cultural norms, belief systems, and lifestyle choices. In conservative societies such as Saudi Arabia, some women silently struggle with menopause due to cultural taboos and social stigma, making their experiences invisible and lowering their quality of life. The aim of this study was to explore in-depth the knowledge, attitudes, and experiences of middle-aged Saudi women with menopause.

Methods: The study employed qualitative methods using semi-structured interviews with middle-aged women undergoing menopause in Saudi Arabia from February to May 2023. The interviews were conducted online in Arabic, recorded and transcribed verbatim. The data were analysed inductively using thematic analysis.

Results: A total of twenty-nine women, aged 40-64 years, were interviewed. Three key themes were identified: mixed emotions towards menopause; experiencing biopsychosocial changes; and adapting to the transition. Overall, most participants had mixed perspectives on menopause. Negative aspects included feelings of uncertainty and the loss of fertility while positive aspects included a sense of relief from menstruation and the newfound freedom to engage in religious activities at any time. Notably, during the interviews, many participants reconsidered their initial negative views and voiced predominantly positive perspectives. Several women reported inconvenient menopausal symptoms, such as hot flashes, night sweats, disturbed sleep, and fatigue. Concerns about being perceived as less attractive led many to keep their symptoms private, and societal expectations played a significant role in influencing how women managed these symptoms and sought help. Many women opted to seek information discreetly online rather than seeking support from others. Self-care practices were favoured for managing menopause, with medical care being undervalued or at times deemed unsatisfactory.

Conclusion: In Saudi Arabia, menopause is generally seen as a natural phase of life. Many women appreciate the positive aspects it brings, such as relief from menstrual pain and an enhanced ability to participate in religious practices. However, they also encounter challenges, including hot flashes and concerns about perceived decreases in attractiveness. A notable trend is the preference for self-care strategies over medical interventions or hormone replacement therapy (HRT). There is a need to raise awareness about menopausal symptoms to reduce negative perceptions and experiences and to develop health promotion and educational interventions to support and empower women during this transition. Future research with healthcare professionals would extend these findings.

Background: A low-fat vegan diet, supplemented with soybeans, has been shown effective in reducing postmenopausal hot flashes. This secondary analysis assessed the association of a plant-based index (PDI), healthful (hPDI), and unhealthful (uPDI), with changes in hot flashes in postmenopausal women.

Methods: Participants (n = 84) were randomly assigned to a low-fat vegan diet supplemented with soybeans (n = 42) or a control group (n = 42) for 12 weeks. Three-day dietary records were analyzed and PDI indices were calculated. A repeated measures analysis of variance (ANOVA) was used for statistical analysis.

Results: All three scores increased in the vegan group, compared with no change in the control group; the effect sizes were: PDI + 9.8 (95% CI + 5.8 to + 13.8; p < 0.001); hPDI + 10.9 (95% CI + 6.4 to + 15.3; p < 0.001); and uPDI + 3.6 (95% CI + 0.5 to + 6.6; p = 0.02). The change in all three scores negatively correlated with change in body weight (PDI: r=-0.48; p < 0.001; hPDI: r=-0.38; p = 0.002; and uPDI: r=-0.31; p = 0.01). The changes in PDI and uPDI were negatively associated with changes in severe hot flashes (r=-0.34; p = 0.009; and r=-0.43; p < 0.001, respectively), and associations remained significant after adjustment for changes in body mass index (r=-0.31; p = 0.02; and r=-0.41; p = 0.001, respectively).

Conclusions: These findings suggest that minimizing the consumption of animal products and oil may be an effective strategy to reduce hot flashes in postmenopausal women, and that categorization of plant foods as "healthful" or "unhealthful" may be unwarranted.

Trial registration: ClinicalTrials.gov, NCT04587154, registered on Oct 14, 2020.

Background: Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine concern among women of reproductive age. In Saudi Arabia, there is a lack of evidence to identify who is at higher risk of PCOS and what the potential risk factors are. Thus, this study aimed to investigate the associations of PCOS risk with demographic and socioeconomic characteristics, access to healthcare, health behaviors, and health status.

Methods: This cross-sectional study was conducted among women in all different regions of Saudi Arabia to assess PCOS risk and related factors. Ethical approval was obtained, and data collectors distributed anonymous, self-administered questionnaires through social media platforms, with informed consent from participants. Sociodemographic characteristics, health behaviors, and perceived stress were measured, with stress assessed using the Arabic version of Cohen's Perceived Stress Scale. Data management and analyses included statistical description, bivariate analysis, and multinomial logistic regression analyses using SPSS, with significance set at p < 0.05.

Results: The majority were younger than 30 years old, single, educated, urban residents, employed or students, and non-smokers. Most participants reported no chronic illnesses, with an average stress level of 19.71 (± 6.68). Concerning the risk of PCOS, 41.3% were at low risk, 33.3% were at suspected risk, 2.9% were at high risk, and 22.5% were diagnosed with PCOS. Factors associated with PCOS risk included age, region of residence, income, weight status, smoking status, presence of chronic conditions, medication and herbal remedy use, and perceived stress. Adjusted findings indicated that younger age, lower income, and higher stress levels were linked to an increased risk of PCOS, while chronic conditions were significantly associated with PCOS diagnosis rates.

Conclusion: The study suggested the need for tailored interventions addressing lifestyle, stress, and comorbid disease management to reduce the risk of PCOS and improve women's health outcomes.

Background: Cervical cancer is a leading cause of morbidity and mortality among women globally. The condition is both preventable and treatable yet remains a leading cause of cancer death in Ghana. This study aims to explore the unique experiences of women living with cervical cancer with a focus on the challenges and coping strategies.

Methods: The study employed a qualitative approach with an exploratory, descriptive design. This study was conducted among women with cervical cancer aged 18 years and above who have been diagnosed with the disease for at least 3 months. A total of 16 participants were purposively sampled based on the eligibility criteria and individually interviewed using a semi-structured guide. The six-step technique for qualitative analysis by Braun and Clarke guided data analysis.

Results: Most participants resorted to self-medication, over-the-counter drugs and herbal preparations as a first line of defense against the disease. The presence of cervical cancer affected participants' physical and mental well-being. Other challenges included financial burden and frequent equipment breakdowns which affected patients' treatment. Participants adopted different coping strategies such as taking blood tonic, increased rest and sleep, spiritual prayers and recreational activities. Family members, friends, the church and health workers provided support in the area of finance, advice, meal preparation and house chores, prayers and counseling to participants.

Conclusions: Cervical cancer affects the quality of life of many women and their significant others. The condition puts a lot of financial burden on its victims and there is the need for a system to reduce the burden on patients. It is recommended that the treatment of cervical cancer should be covered by the National Health Insurance Scheme to ease the financial burden on patients. There is a need for expansion of access to cervical cancer treatment across the country to reduce patients' burden and relieve the pressure on the few pieces of equipment at the current treatment centres.

Background: Conservative surgery for adenomyosis has been shown to be effective. However, risk factors for postoperative recurrence have yet to be clarified. In this study, we aimed to determine the recurrence rate after conservative surgery for adenomyosis and identify the risk factors for recurrence.

Methods: This retrospective study was conducted in a tertiary hospital. Patients who underwent conservative surgery for adenomyosis between January 2013 and April 2023 were identified. Eligible patients were assigned to either the recurrent or non-recurrent group. Continuous and categorical variables were compared between the two groups using the Mann-Whitney U test or chi-squared test. Risk factors for recurrence were identified by Cox proportional risk analysis.

Results: Data for 133 eligible patients who underwent conservative surgery for adenomyosis were analyzed. The mean follow-up duration was 52 months. The recurrence rate after conservative surgery was 39.1% (52/133). Cox proportional risk analysis identified adenomyosis involving the posterior uterine wall (hazard ratio [HR] 6.505, P = 0.018), two or more adenomyotic lesions (HR 6.310, P = 0.030), laparotomy (HR 2.490, P = 0.029), and concomitant endometriosis (HR 2.313, P = 0.036) to be risk factors for recurrence after conservative surgery. Postoperative combined progestogen therapy (HR 0.126, P < 0.001) or treatment with a gonadotropin-releasing hormone agonist (GnRHa) (HR 0.237, P = 0.004) prevented recurrence of adenomyosis.

Conclusion: Adenomyosis continues to have a relatively high long-term recurrence rate after conservative surgery. Patients with adenomyosis involving the posterior wall of the uterus, those with two or more adenomyotic lesions, and those with concomitant endometriosis are at high risk for recurrence after conservative surgery. Postoperative progestogen or GnRHa therapy may reduce the risk of recurrence of adenomyosis. Considering the retrospective nature of this study and its small sample size, larger prospective studies are needed to confirm its findings.

Background: The burden of pediatric HIV/AIDS, mother-to-child transmission rate, and unintended pregnancy among HIV-positive women remain high in sub-Saharan Africa, including Ethiopia. Provision of contraceptives is an undeniable strategy to overcome the risks. However, pooled data to provide informed decisions on modern contraceptive use among HIV-positive women attending ART clinics in Ethiopia are meager. Hence, this review aimed to estimate the magnitude of modern contraception, and revisable long act contraceptives methods (RLCM) use and associated factors among HIV positive ART clinic attending women.

Methods: A systematic review and meta-analysis was conducted using PubMed, Google, Cochrane library, Web of Science, Google Scholar, and Scopus database. A funnel plot and Egger's regression test were used to assess publication bias. Heterogeneity of studies was assessed using I-square statistics and the Joanna Briggs Institute (JBI) quality assessment tool was applied to ensure the quality of the included articles. We employed a random-effect model to pool the national utilization of modern contraceptives and the effect size of associated factors. We conducted sub-group analysis by regions to control heterogeneity and to detect variation.

Results: A total of 21 studies were included in the meta-analysis. The magnitude of pooled utilization of modern contraceptive and RLCM was 60% [95% CI: 52-68] and 11%, [95% CI: 8-14], respectively. In the random effect model, young women [OR = 2.36, 95% CI: 1.78-3.13], attending secondary school and above [AOR = 1.34, 95% CI: 1.06-1.69], having two or more live children [AOR = 1.84, 95% CI: 1.46-2.34], discussion with a husband [AOR = 2.92, 95% CI: 2.39-3.57], CD4 > 250cells/mm³ [AOR = 1.59, 95% CI: 1.08-2.33], and using HAART [AOR = 1.71, 95% CI: 1.35-2.15] increased odds of modern contraceptive methods utilization.

Conclusion: Overall the utilization of RLCM among modern contraceptive users HIV positive women is low. Therefore, to improve the uptake of RLCM among modern contraceptive users HIV positive women, policymakers and program designers need to take into account age and educational levels of women and programs which enhance reproductive health consultation habit between couples. Moreover, integration of family planning services to ART clinics needs to be strengthened.

Background: The use of immediate postpartum intrauterine contraceptive devices during the postpartum period supports women's need for spacing births and prevents them from unplanned pregnancies. However, in developing countries, utilization of immediate postpartum contraceptives is low. This increases the risk of maternal morbidity, maternal mortality, preterm birth, child mortality, low birth weight, and small gestational age in subsequent pregnancy with interpregnancy interval.

Objective: To assess immediate postpartum intrauterine contraceptive device utilization and the associated factors among women who gave birth in Hospitals in West Wolegga Zone in 2020.

Methods and materials: An institutional-based cross-sectional study was conducted in public hospitals in the West Wolegga Zone from 1 April 2020 to 30 April 2020 among 290 postpartum women. The sample size was proportionally allocated to six hospitals by considering their monthly delivery. Study subjects were taken by systematic sampling technique (Kth=N/n =1025/290=3.53), thus every 4th woman who gave birth in the hospital was recruited in each hospital until the total sample size for this study was obtained. Bivariable and multivariable logistic regression was used to assess the association of independent variables with immediate postpartum intrauterine device utilization. A significance level of 0.05 was used to assess the statistical significance of the study's associations.

Results: In this study, the magnitude of the Immediate postpartum intrauterine contraceptive device utilization was 19.3%.factors like Early initiation of antenatal care [AOR=4.46 95% CI:1.84-10.78], Planning of future pregnancy [AOR=3.7(95% CI: 1.43-9.54)], Ever heard of the immediate postpartum intrauterine contraceptive device [AOR=2.67(95% CI: 1.08-6.58)] and Counseling about postpartum intrauterine contraceptive device [AOR=5.15(95% interval: 2.00-13.28] were associated with immediate postpartum intrauterine device utilizations.

Conclusion: The use of immediate postpartum intrauterine contraceptive devices is low compared to other studies conducted in Ethiopia. Age, early antenatal care initiation, pregnancy planning, hearing of the immediate postpartum intrauterine device immediately inserted after delivery, and counselling on the immediate postpartum intrauterine device were significantly associated with mothers' use of immediate postpartum intrauterine devices. Health Program directors should develop strategies to increase the use of immediate postpartum intrauterine contraceptive devices.

Introduction: Placenta is a vital organ with highly specialized functions. According to the Perinatal Section of the Pediatric Pathology Society, placental histopathological abnormalities are typically categorized into maternal vascular hypoperfusion, fetal thrombotic vasculopathy, and inflammatory lesions. This study aims to assess the placental histopathological abnormality results in relation to adverse obstetric outcomes and to investigate whether specific placental abnormalities are associated with particular adverse outcomes.

Methods: A retrospective cross-sectional study was conducted between January 2017 and January 2020 including all women who were admitted to Sultan Qaboos University Hospital with an adverse obstetric outcome who met the inclusion criteria, and whose placentas were sent for histopathological examination.

Results: A total of 191 women were included in the study. The most common adverse obstetric outcomes included preterm labor (25.1%), fetal growth restriction (FGR) (19.4%), preeclampsia and related complications (15%), placental abruption (14.1%), and chorioamnionitis (14%). 74% of women had abnormal placental findings. Among women with preterm labor, inflammatory lesions were present in 56.3% of cases (p = 0.006). Fetal thrombotic vasculopathy lesions were present in 13.5% of FGR cases (p = 0.037). In preeclampsia cases, maternal under perfusion lesions were present in 79% of cases (p = 0.013).

Conclusion: Placental histopathological examination is an important tool for assessing perinatal outcomes. Correlating placental findings with specific obstetrical conditions and adverse outcomes provides valuable information that can assist obstetricians in developing appropriate management plans for future pregnancies.

Background: Breast cancer is the most common cancer among females. Assessing self-screening practices for breast cancer patients is vital for developing targeted interventions. The current study aimed to assess self-screening practices for breast cancer and associated factors via the theory of planned behavior constructs among female students in Ethiopian universities.

Methods: A cross-sectional study design was conducted using the theory of planned behavior constructs. The data were collected from January 30, 2022, to February 30, 2022, in Ethiopia. A structured, self-administered questionnaire was used. The validity and reliability tests were checked to use the questionnaire in the main study through a pilot test. The data were collected through online Google Forms by distributing them to university students via Telegram groups, Imo, emails, and Facebook. The collected data were exported to SPSS version 26 for analysis. Bivariate analysis was used to identify the candidate variables for multiple logistic regression (P value < 0.02). Those variables with a P value less than 0.05 were considered significant predictors of breast cancer screening practices.

Results: A total of 418 female students participated in the study. The respondents were aged between 18 and 37 years. In the current study, 318 (76.1%; 95% CI: 72.0, 80.4) university students had good screening practices for breast cancer. Nonhealth-related departments (AOR = 1.95; 95% CI: 1.11, 3.44), having training in breast cancer self-examination (AOR = 1.87; 95% CI: 1.04, 3.35), having a good attitude (AOR = 1.96; 95% CI: 1.11, 3.47), having good behavioral control (AOR = 4.1; 95% CI: 2.18, 7.71), and having good behavioral intentions (AOR = 1.88; 95% CI: 1.09, 3.24) were associated with self-screening practices for breast cancer patients.

Conclusion: Designing a theory of planned behavior-based educational interventions improve self-screening practices for breast cancer among university female students. These insights could guide the development of future breast cancer awareness and prevention programs in university settings, with the goal of increasing early detection rates and lowering the risk of breast cancer. The study also serves as foundational information for designing future research using more advanced study design methods.