BMC Women's Health最新文献

Objectives: To compare the differences in clinical characteristics between different types of abdominal wall endometriosis (AWE) according to the invasive levels of tissue mass.

Methods: 122 patients, who had undergone resection of AWE lesions at our hospital from January 2011 to January 2023, were retrospectively analyzed. The patients were divided into three types according to their deepest level of lesion invasion. Type I designated invasion of skin and subcutaneous tissue; type II, of the fascial rectus abdominis; and type III, of the muscle and/or peritoneum. The general conditions, clinical manifestations, auxiliary examinations, surgical and postoperative conditions, and recurrence, were classified, compared, and analyzed.

Results: Of the 122 patients, type I patients accounted for 23.0%, type II patients for 45.1%, and type III for 31.9%. With respect to group comparisons, we observed that as the location of the mass deepened, the size of the mass increased (P < 0.001), the rate of concurrent pelvic endometriosis increased (0%, 7.2%, 10.3%, respectively), the rate of multiple lesions became elevated (3.6%, 10.9%, 15.4%, respectively), the rate of mesh implantation increased (P = 0.0012), and the risk of drainage placement (P = 0.0012) was enhanced, the length of postoperative hospital stay (P = 0.0042) was lengthened, the number of postoperative fever cases (3.6%, 3.6%, 15.4%, respectively) increased. With a median follow-up time of 93 months, only 2 cases, including 1 case in type I and 1 case in type II, were diagnosed as recurrence. Rates were not statistically significant by the different groups.

Conclusion: The different types of AWE have an impact on surgical results, but no impact on the chance of recurrence. Type III AWE carries more severe clinical manifestations, larger lesion size, longer operative time, higher necessity of mesh implantation, and longer postoperative recovery process. Complete resection of AWE lesion is the main therapeutically approach and shows relatively low long-term recurrency rate.

Background: Concentrations of female sex hormones fluctuate during the menstrual cycle (MC), while hormonal contraceptives (HC) generally suppress hypothalamic-pituitary-ovarian axis function resulting in lower concentrations of endogenous estradiol (E2) and progesterone (P4). Little attention has been paid to changes in androgen concentrations during MC and HC phases. Therefore, the aim of this study was to investigate changes in androgen concentrations over the MC and HC phases.

Methods: The study was a cross-sectional analysis across MC and HC phases using four time points. E2, P4, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (tT), free testosterone (fT), sex hormone-binding globulin (SHBG), dehydroepiandrosterone (DHEA) and its sulfate (DHEA-S) were analyzed from the serum of healthy, physically active, naturally menstruating (NM = 36), hormonal intrauterine device using (IUD = 12) and combined HCs using (CHC = 25) females.

Results: In NM, concentrations of tT (β = 0.16, p = 0.050), fT (β = 1.85, p < 0.001) and DHEA (β = 5.29, p = 0.045) were significantly higher at ovulatory phase and concentrations of DHEA-S at the mid-follicular phase (β = 0.32, p = 0.012) compared to bleeding. In IUD, tT concentrations fluctuated significantly being highest at mid-cycle (β = 0.34, p = 0.001) compared to the sample defined as measurement 1 (based on bleeding and/or hormonal concentrations). In CHC, concentrations of E2, P4, tT, fT, DHEA, and DHEA-S remained unchanged between the HC phases.

Conclusions: Since the endogenous hormonal milieu, including androgens, may affect female physiology, considering the fluctuation in androgen levels over the MC and HC phases may be of importance in physiological research.

Objective: This study aimed to examine the relationship between mothers' perceptions of respectful maternity care and their parental self-confidence levels.

Method: This descriptive cross-sectional study was conducted online using the snowball sampling method with 425 mothers who had a baby aged 0-1 year and experienced a normal birth.

Results: The mean age of the mothers was 28.32 ± 5.46 years. Mothers reported high levels of respectful maternity care perception. Variables such as place of birth, birth experience, medical interventions during birth, and receiving support during childbirth significantly influenced respectful maternity care perception. Additionally, a weak but positive correlation was found between respectful maternity care perception and parental self-confidence levels.

Conclusion: These findings emphasize that respectful maternity care plays a key role in strengthening mothers' confidence in their parenting abilities. Enhancing supportive, non-interventionist, and positive birth environments may therefore contribute to improved maternal outcomes and a more empowering childbirth experience.

Background: Breastfeeding (BF) is a global practice essential for infant nutrition and maternal-child bonding. However, breastfeeding-related musculoskeletal pain (BFMP) is a common yet under-researched condition that may impair functional ability and contribute to early weaning. Although BFMP has been investigated in several populations, limited evidence exists regarding its prevalence, associations, and functional impact among lactating mothers in Arabic-speaking countries.

Methods: A cross-sectional study utilized an online questionnaire developed in Microsoft Forms and distributed via different social media platforms through convenience and snowball sampling. Eligible participants included Arabic-speaking non-pregnant mothers aged 18 years or older who had been breastfeeding for at least one month. The questionnaire, adapted from validated tools, underwent expert review and pilot testing for the BF characteristics and infant/toddler characteristics. Additionally, pain severity (using the Numeric Rating Scale), and functional limitations (Neck Disability Index, Oswestry Disability Index, and DASH) were assessed. SPSS program, version 27 was used to analyze data using binary logistic regression, Spearman rho, and chi-square tests to identify associations between BFMP and related variables.

Results: Out of 471 participants (mean age = 31.3 ± 5.6 years), 81.7% reported BFMP, with the back (40.4%) and upper extremities (36.8%) being the most affected areas chosen. Higher maternal age, longer feeding duration and frequent sessions were linked to increased pain (p < 0.05). Moreover, Use of ergonomic support during BF was associated with lower pain scores (p = 0.01). Functional limitations were significantly associated with pain severity (p < 0.001). Furthermore, Psychological distress and a tendency toward early weaning were significantly higher among those with severe pain (p < 0.01).

Conclusions: Breastfeeding- related musculoskeletal pain (BFMP) is highly prevalent among lactating mothers in Arabic-speaking countries and significantly affects functional capacity and breastfeeding (BF) sustainability. These findings underscore the need for targeted ergonomic education and early multidisciplinary intervention including physical therapy (PT) and occupational therapy (OT) to support maternal health and prolong successful BF.

Background: Postmenopausal women are at increased risk of developing cardiovascular, muscular, and metabolic dysfunction due to hormonal changes associated with aging. Citrulline, a non-essential amino acid and precursor to nitric oxide, has gained interest as a potential dietary supplement for improving vascular health, muscle function, and metabolic parameters in this population.

Objective: This systematic review aims to evaluate the effects of citrulline supplementation, administered directly or via watermelon products, on cardiovascular, muscular, and metabolic outcomes in postmenopausal women.

Methods: A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus databases to identify randomized controlled trials (RCTs) investigating citrulline supplementation in postmenopausal women. Studies were included if they reported outcomes related to blood pressure, arterial stiffness, endothelial function, muscle strength or mass, metabolic parameters, and safety. Study quality was assessed using the Cochrane Risk of Bias Tool 2. Due to heterogeneity in study designs and reported outcomes, results were synthesized narratively.

Results: Twelve RCTs involving 360 postmenopausal women were included. all conducted in the United States, with study durations ranging from 4 to 8 weeks and participant ages between 50 and 75 years. Seven studies reported blood pressure outcomes, with most showing reductions in systolic blood pressure and mean arterial pressure. Five studies examined arterial stiffness, with mixed findings on pulse wave velocity and augmentation index. Four studies assessed endothelial function, two of which demonstrated significant improvements in flow-mediated dilation. Muscle function outcomes were investigated in two studies, suggesting improvements only when citrulline was combined with resistance training. Six studies assessed metabolic parameters, with no consistent effects observed on body weight, glucose, insulin, or lipid profiles. Across all studies, no adverse effects related to citrulline supplementation were reported.

Conclusion: Citrulline supplementation may offer benefits for blood pressure regulation (up to 9 mmHg SBP reduction in some studies) in hypertensive postmenopausal women, but evidence for arterial stiffness, endothelial function, and metabolic outcomes remains inconsistent. Further large-scale studies are needed before clinical recommendations can be made.

Background: Endometriosis is a chronic condition affecting women of reproductive age and often associated with pain, impaired fertility, and reduced quality of life. Management requires long-term strategies, with medical treatment preferred over repeated surgery. Treatment selection must balance efficacy, cost, patient preference, and safety. Dienogest is a progestin shown to be effective, but real-world data in Thai women remain limited. This study aimed to evaluate the efficacy and safety of dienogest in this population.

Methods: This single-arm, real-world prospective observational study was conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand from April 2024 to May 2025. Women with endometriosis received dienogest once daily for 24 weeks. Baseline symptoms, endometriosis-associated pain, and satisfaction were assessed using a visual analog scale (VAS). Follow-up visits were scheduled at 12 and 24 weeks, with reassessment of pain symptoms, satisfaction, and adverse events.

Results: A total of 62 participants were included for analysis, with a mean age of 34.2 ± 7.2 years. Dysmenorrhoea was reported by 86.4% and chronic pelvic pain by 60.6% of participants. The mean overall endometriosis associated-pain VAS decreased significantly from 7.5 ± 1.6 at baseline to 2.8 ± 2.2 at 12 weeks and 1.9 ± 1.7 at 24 weeks (p < 0.001). Satisfaction scores were 7.5 ± 1.9 at 12 weeks and 8.1 ± 1.5 at 24 weeks with discontinuation rate of 3 out of 65 women (4.6%). At 12 weeks, common adverse events included acne (29.0%), depressed mood (16.1%), breast pain (14.5%), and headache (14.5%), while weight gain and hot flushes were less common. By 24 weeks, weight gain (26.7%) and acne (26.7%) were most frequently reported.

Conclusion: Dienogest was associated with reducing pain and good satisfaction in Thai women with endometriosis, with an acceptable safety profile. These findings support its use as a practical long-term management option.

Trial registration: ISRCTN registration approval number ISRCTN68041248 on 13 March 2024.

Background: Women with disabilities are susceptible to compounded discrimination based on gender and disability, which can constrain healthcare access and worsen health outcomes. Quantitative evidence on determinants of unmet healthcare needs in Women with disabilities remains limited. This study aimed to identify predictors of unmet healthcare needs among women with disabilities and to provide evidence to inform improvements in healthcare accessibility.

Methods: We conducted a cross-sectional analysis of 2873 Women with disabilities from the nationally representative 2023 Survey of People with Disabilities in Korea. Guided by Andersen's Behavioral Model of Health Services Use, we examined predisposing, enabling, and need factors associated with unmet healthcare needs using descriptive statistics, chi-square tests, and multivariable logistic regression.

Results: Among women with disabilities, the prevalence of unmet healthcare needs was 19.7%. The most common reasons were difficulty traveling to healthcare facilities (41.2%) and financial constraints (25.8%). In multivariable analysis, the odds of experiencing unmet healthcare needs were higher among those with lower household income, physical disabilities, severe disability, dependence in instrumental activities of daily living (IADL), poor self-rated health, experience of depression, difficulty using transportation, and inability to go out alone.

Conclusions: Women with disabilities experience high rates of unmet healthcare needs. Limitations in daily living due to physical disability, low socioeconomic status (SES), and mental health vulnerability emerged as major factors underlying unmet healthcare needs among women with disabilities. Integrated policies addressing financial barriers, healthcare accessibility, and women's health are needed to meet the unique needs of women with disabilities.

This study aimed to identify the spatial distribution and its associated factors of unmet need for family planning among women of reproductive age in administrative woredas of Ethiopia, using data from 8,716 married or in-union women in the 2016 Ethiopian Demographic and Health Survey. Spatial analyses, including autocorrelation, hotspot identification, and interpolation, were employed to examine geographical patterns, while a multilevel multinomial logistic regression model identified associated factors. The overall prevalence of unmet need was 21.04% (12.84% for spacing, 8.2% for limiting). Spatial analysis revealed that unmet need for limiting was dispersed, while spacing needs were randomly distributed. Key determinants included knowledge of family planning (spacing: aOR = 1.76, 95% CI:1.21-2.57; limiting: aOR = 2.45, 95% CI:1.41-4.23), having more than four living children (spacing: aOR = 1.40, 95% CI:1.05-1.86; limiting: aOR = 10.04, 95% CI:5.45-18.50), husband's employment (spacing: aOR = 0.44, 95% CI:0.28-0.71; limiting: aOR = 0.35, 95% CI:0.20-0.61), and the interaction of rural residency with husband's employment (spacing: aOR = 1.98, 95% CI:1.17-3.36; limiting: aOR = 2.42, 95% CI:1.28-4.55). The findings indicate that the prevalence of unmet need for family planning in Ethiopia's administrative woredas remains high, greater the acceptable standard defined by global benchmarks. Key factors include women's knowledge of family planning, the number of living children, the husband's occupation, and the contextual influence of rural residency. The spatial heterogeneity, particularly for limiting births, underscores the need for geographically targeted interventions. Therefore, national strategies and woreda-specific programs aimed at reducing unmet need must move beyond uniform approaches. They should prioritize enhancing comprehensive family planning education, addressing high-parity concerns, engaging male partners, and tailoring service delivery to mitigate the specific socio-contextual barriers prevalent in rural settings to ensure equitable access to family planning services across all administrative woredas.