BMC Women's Health最新文献

Background: Cervical cancer (CC) is a public health burden, particularly in low-and middle-income countries, but can be prevented by screening for Human Papillomavirus (HPV). Nevertheless, positive test results may have psychological and sexual impacts for women. This study aimed to assess the impact of HPV test results on anxiety and sexual dysfunction in Cameroonian women.

Methods: This prospective cohort study conducted from 2020 to 2022 in Cameroon, included women previously enrolled in the 3T-Approach trial. Participants underwent a same-day consultation, organized as follows: HPV screening, triage of HPV-positive women and treatment by thermal ablation or Large Loop Excision of the Transformation Zone (LLETZ), if necessary. They completed anxiety (STAI) and sexual function (ASEX) questionnaires at 1, 6, and 12 months post-screening.

Results: Among 273 women included in the study, 220 (80.6%) completed all time points. Upon inclusion, 24.5% were HPV-positive, of which 46.3% underwent treatment. Anxiety levels did not significantly differ by HPV status. Higher sexual dysfunction prevalence was observed in HPV-positive women at all intervals. Between 1 and 12 months HPV-positive women showed an increase in their mean sexual dysfunction score (+ 4.5, 95% CI: 0.5 to 8.4), which was not seen in HPV-negative women. This disparity persisted even after adjusting for socio-demographic factors.

Conclusion: HPV test results did not significantly impact anxiety levels in women in Cameroon. Nevertheless, HPV-positive women reported higher sexual dysfunction at one-year post-screening compared to HPV-negative women. Further research should focus on investigating the factors affecting sexual dysfunction, in order to propose strategies to maintain women's well-being without compromising screening rates.

Trial registration: The protocol of the 3TApproach study was registered under ClinicalTrials.gov, (identifier NCT03757299) on 28, November, 2018.

Introduction: Endometriosis, characterized by the presence of endometrial-like tissue outside the uterus is one of the major causes of chronic pelvic pain in women which jeopardize the daily life. This study aims to describe the socio-demographic and clinical characteristics of women with endometriosis in Bangladesh.

Methods: A cross-sectional study was conducted at Chattogram Medical College Hospital, Bangladesh, from January to December 2023 including women aged 16-55 years who were clinically diagnosed with endometriosis. Data on socio-demographics, menstrual history, and clinical presentations were collected through interviews and physical examinations. Pain severity was assessed using a visual analogue scale (VAS).

Results: A total of 396 women with endometriosis were included, with a mean age of 29.9 ± 8.1 (SD) years. Dysmenorrhea (92.6%) was the predominant clinical presentation, followed by non-menstrual pelvic pain (64.5%) and dyspareunia (50%). Pain severity in majority of the patients was moderate, with a mean VAS score of 5.1 (SD 1.9). Other symptoms included polyuria (40.9%), dysuria (26.5%), diarrhea (14%), and constipation (7.5%). Deeply infiltrative endometriosis was identified in 16.4% of participants.

Conclusions: In conclusion, our study suggests that endometriosis patients in Bangladesh often present with typical symptoms, experiencing moderate pelvic pain, thus offering valuable real-world clinical insights into the disease's epidemiology and characteristics.

Background: Endometriosis is a chronic, estrogen-dependent condition affecting 10% of reproductive-aged women, often associated with infertility and chronic pelvic pain. Recent evidence suggests that gut microbiota dysbiosis and alterations in the estrobolome, defined as the collection of bacterial genes involved in estrogen metabolism, may play a role in the pathogenesis of endometriosis and infertility.

Methods: This systematic review was registered with PROSPERO (ID: CRD42024627464). A comprehensive search was conducted across PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, ClinicalTrials.gov, and grey literature sources up to December 2024, without a lower date limit. The search included terms such as "estrobolome," "endometriosis," "infertility," and "estrogen metabolism". Original articles and clinical trials investigating the role of the estrobolome in endometriosis pathogenesis and infertility were included. Abstract-only studies, reviews, and non-English articles were excluded.

Results: Five studies were analyzed, highlighting gut dysbiosis, estrobolome alterations, and immunological factors in endometriosis and infertile patients. Some investigations reported dysregulated or increased β-glucuronidase activity, suggesting a potential link between microbial estrogen metabolism and disease pathophysiology. These microbial and enzymatic alterations were accompanied by elevated inflammatory cytokines and persistent activation of immune cells, possibly contributing to local and systemic estrogen stimulation and lesion progression.

Conclusions: Our analysis emphasizes how disruptions in estrogen-metabolizing bacterial pathways may contribute to the inflammatory and hormonal features observed in endometriosis and infertility. Given the associations observed, future studies should explore whether modulating the microbiota or estrogen metabolism can improve clinical outcomes in patients with endometriosis or infertility.

Purpose: Hiesho (cold hypersensitivity) is a common condition in Japan and other Asian countries, particularly among females, and has substantial health implications. Despite the high prevalence of Hiesho, the existing screening methods for this condition remain controversial and largely subjective. This study aimed to explore the potential of using the foot skin temperature-recovery rate after a cooling test as a quantitative biomarker for Hiesho.

Methods: Sixty-two young females underwent a cooling test, which was followed by foot-temperature measurements. The participants also completed the Terasawa Hiesho Questionnaire. Data analysis included receiver operating characteristic (ROC) curve evaluation and statistical tests to determine biomarker efficacy.

Results: Hiesho was identified in 31 participants. The Hiesho and non-Hiesho groups showed significant differences in temperature-recovery rates, particularly at specific foot regions and time intervals. The Aligned Rank Transform was used for post-hoc pairwise comparisons. At the medial metatarsal 15 min post-cooling, the values for the Hiesho and No-Hiesho groups differed significantly (p < 0.01, Cohen's d = 0.663, 95% confidence interval (CI), 0.231, [Formula: see text]). The ROC curve identified the temperature-recovery rate at the medial metatarsal at 15 min post-cooling as the most effective biomarker, with a suggested screening threshold of < 44.68% (area under the curve = 0.701, 95% CI: [0.572, 0.811]).

Conclusion: This study demonstrated significant differences in foot temperature-recovery rates between individuals with and without Hiesho, indicating its potential as a reliable biomarker. Despite these limitations, this approach offers a promising quantitative method for Hiesho assessment, and warrants further investigation.

Introduction: Female sex workers (FSWs) remain highly vulnerable to HIV, other sexually transmitted infections (STIs) and broader sexual and reproductive health challenges. Peer-led interventions are widely recommended, yet their specific contributions and implementation gaps are poorly synthesised. This scoping review mapped peer-education strategies used globally to promote sexual health among FSWs, with emphasis on intervention components, outcomes, and evidence gaps, including the role of peers.

Methods: This scoping review followed the Joanna Briggs Institute (JBI) manual and Arksey and O'Malley's methodological framework. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for peer-reviewed studies published between January 1993 and December 2023. The search used the keywords "sex worker," "sexual health," and "peer education." Eligible studies were required to focus on peer-led sexual health interventions among female sex workers (FSWs) and be published in English. The studies meeting these criteria were screened, charted, and narratively synthesized.

Results: Of 15,488 records, 31 studies from 16 countries (97% in low- and middle-income settings) were included. All incorporated peer-led components and consistently showed positive effects across three outcome domains: behavioural (increased consistent condom use and reduced high-risk behaviours in 23 studies), clinical/biomedical (higher HIV/STI testing, clinic referrals and, in several large-scale programmes, reduced HIV/STI incidence in 12 studies), and psychosocial & structural (improved knowledge, self-efficacy, mental health, human rights awareness and reduced violence in 11 studies). However, peer recruitment, training, supervision and compensation were described in detail in only a minority of studies, no study addressed ethical concerns including burnout, payment inequity and potential exploitation of peer educators.

Conclusion: Peer-led interventions are highly effective across behavioural, clinical/biomedical and psychosocial & structural domains among FSWs, primarily due to peers' unique ability to build trust and access hidden networks. To strengthen evidence and equity, future research must systematically document peer processes, evaluate comparative effectiveness, and proactively address ethical and sustainability challenges for peer educators themselves.