Gynecological Endocrinology最新文献

{"title":"Evaluation of the evidence-based practices for the management of PCOS in the Latin America context: the consensus of the Latin American Association of Gynecological Endocrinology (ALEG).","authors":"Poli Mara Spritzer, Germán Gonzalo Salazar Santos, Mónica Liliana Munevar Vega, Peter Chedraui, Susana Pilnik, Adriana Camero Lascano, Alejandra Belardo, Alejandra Elizalde Cremonte, Alejandra Vivas Ramírez, Alejandro Rosas Balán, Ana María Barragán, Angela María Gómez Quintero, Camila Andrea Camargo Rodríguez, Daniel Alejandro Buitrago, Germán Barón Castañeda, Guillermo Rossi, Inés de La Parra, Iván Darío Montes Suárez, Jorge Alejandro Michel Vergara, Lucas Bandeira Marchesan, Mariana Abril Barreto, Milagros Sánchez Torrejón, Selva Lima, Teresa de Jesús Ramos de Ferreira, Alejandro Manzur","doi":"10.1080/09513590.2025.2456578","DOIUrl":"10.1080/09513590.2025.2456578","url":null,"abstract":"<p><strong>Objectives: </strong>Polycystic Ovary Syndrome (PCOS) is a complex condition affecting approximately 1 in 10 women of reproductive age. However, limited data are available regarding the specific characteristics and needs of women with PCOS in Latin America. This consensus sought to evaluate the evidence-based practices for the management of PCOS for Latin American populations, consolidate regional insights, identify eventual gaps in implementation and identify key research opportunities.</p><p><strong>Methods: </strong>Using the Delphi strategy, experts from various Latin American countries selected and reviewed a subset of recommendations from the 2023 International Evidence-Based Guideline (EBG) for the Assessment and Management of PCOS. Virtual and in-person meetings facilitated discussions on the selected recommendations, followed by voting rounds to achieve consensus.</p><p><strong>Results: </strong>A total of 33 recommendations for PCOS diagnosis and treatment were evaluated. In the initial voting round, 25 recommendations achieved strong agreement (80%-100% support), while eight received less than 80% agreement. After further discussions on their relevance and potential to influence behavior change among health professionals and public health policies, the remaining recommendations achieved near-unanimous support in the second round.</p><p><strong>Conclusions: </strong>This consensus underscored evidence-based practices for PCOS diagnosis and treatment deemed appropriate for the Latin American context. It also highlighted implementation barriers such as cost and accessibility, while identifying opportunities for research to improve PCOS management and address regional challenges. These findings aim to enhance clinical care and inform public health strategies tailored to the needs of Latin American women living with PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2456578"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical treatment for adenomyosis: long term use of progestins.","authors":"Silvia Vannuccini, Francesco La Torre, Federico Toscano, Anna Rosa Speciale, Milo Giani, Dilruba Tureli, Virginia Manzi, Angela Gallone, Felice Petraglia","doi":"10.1080/09513590.2025.2511329","DOIUrl":"https://doi.org/10.1080/09513590.2025.2511329","url":null,"abstract":"<p><strong>Background: </strong>Adenomyosis is a uterine disorder causing menstruation-related symptoms such as dysmenorrhea, heavy menstrual bleeding (HMB) and dyspareunia. A long-term management of the disease is required. Hormonal drugs are the most used, including a variety of progestins, even though few data are available on their long-term use in adenomyosis.</p><p><strong>Objective: </strong>To evaluate the long-term efficacy of different progestins, including progestin-only pills (POP), for the management of adenomyosis-related symptoms.</p><p><strong>Methods: </strong>A total of 140 patients (18-45 years) with adenomyosis were treated with progestins for at least three years. The treatment groups included dienogest (2 mg, <i>n</i> = 71), levonorgestrel-releasing intrauterine device (52 mg, <i>n</i> = 25), desogestrel (75 mcg, <i>n</i> = 20), and drospirenone (4 mg, <i>n</i> = 24). Symptoms were assessed using the Visual Analogue Scale (VAS) for pain and the Pictorial Blood Assessment Chart (PBAC) method for bleeding.</p><p><strong>Results: </strong>Dienogest significantly reduced dysmenorrhea, dyspareunia, and HMB, with efficacy maintained over three years in most patients. However, after the first year 49% of patients required a switch to other treatments due to side effects or contraception need. The levonorgestrel-releasing intrauterine device also effectively managed HMB and pain, with 15% of patients switching treatment due to side effects. Both drospirenone and desogestrel improved HMB and dysmenorrhea, but desogestrel had a higher discontinuation rate due to reduced long-term efficacy. Norethisterone acetate was used as a second-line treatment in cases of intolerance or inadequate response.</p><p><strong>Conclusion: </strong>Progestins are effective for the long-term management of adenomyosis symptoms. The flexibility in switching between different progestins or routes of administration may help in optimizing outcomes.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2511329"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A different approach to PCOS: evaluation of spermiogram results in male patients with a family history of PCOS.","authors":"Mujde Can Ibanoglu, Ayse Gizem Yildiz, Ozde Beren Tatar, Berna Seckin, Tufan Cicek, Yaprak Engin-Ustun","doi":"10.1080/09513590.2025.2501694","DOIUrl":"https://doi.org/10.1080/09513590.2025.2501694","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the possible influence of a family history of PCOS on male reproductive health by comparing the spermiogram parameters of patients diagnosed with a first-degree relative with PCOS with those of a control group without such a family history.</p><p><strong>Methods: </strong>This prospective study included 51 male participants aged 19-39 years, 25 of whom had a first-degree relative diagnosed with PCOS, while 26 formed the control group. Semen samples were collected and analyzed according to the World Health Organization (WHO) 2021 guidelines.</p><p><strong>Results: </strong>In this study, the spermiogram results of 51 patients aged between 19 and 39 years with a mean age of 31.50 ± 4.80 years were analyzed. The median sperm concentration (0.6 vs. 11.1 million/ml; <i>p</i> = 0.024) was significantly lower in the study group and the median total progressive motile sperm concentration (3.7 vs. 3.0 million/ml; <i>p</i> = 0.010) was significantly lower in the control group. Comorbidities were more common in the study group, including hair loss (64%; <i>p</i> < 0.001) and gynecomastia (25%; <i>p</i> = 0.008). Robust regression analysis revealed that semen concentration was significantly higher in subjects with dyslipidemia (+95.973 million/ml; <i>p</i> < 0.001), as was sperm motility (+49.081 units; <i>p</i> < 0.001) and TPMSC (+74.028 million/ml; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Men with family history of PCOS have distinct reproductive and metabolic features, including lower median sperm concentration and higher incidence of alopecia and gynecomastia. Dyslipidemia significantly predicted improved sperm concentration and motility.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2501694"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications for the use of menopausal hormone therapy after cancer: on what data should we rely on?","authors":"Angelo Cagnacci, Marco Gambacciani, Stefano Lello, Anna M Paoletti","doi":"10.1080/09513590.2025.2477504","DOIUrl":"https://doi.org/10.1080/09513590.2025.2477504","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2477504"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signs and symptoms of vulvovaginal atrophy (VVA) in clinical practice - the possible involvement of thyroid autoimmunity in genitourinary syndrome of menopause (GSM).","authors":"Laura Cucinella, Federica Barbagallo, Mariacristina Erroi, Chiara Procaccianti, Ellis Martini, Lara Tiranini, Giorgia E Parrotta, Greta Monne, Giulia M Colombo, Aldo Calogero, Rossella E Nappi","doi":"10.1080/09513590.2025.2458705","DOIUrl":"10.1080/09513590.2025.2458705","url":null,"abstract":"<p><strong>Background: </strong>Thyroid autoimmune disorders (ADs) are common in midlife women and can impact various aspects of health, including sexual function. The effect of thyroid autoimmunity on the clinical manifestations of vulvovaginal atrophy (VVA) remains unclear.</p><p><strong>Objective: </strong>To explore the relationship between thyroid ADs and VVA signs and symptoms in a sample of postmenopausal women.</p><p><strong>Methods: </strong>Cross-sectional study including postmenopausal women not using systemic hormone therapy. VVA signs were assessed using the vaginal health index (VHI) and vulvar health index (VuHI); VVA symptoms were rated on a four-point severity scale.</p><p><strong>Results: </strong>Among 112 women enrolled, 28 had thyroid ADs. A significantly higher percentage of women with thyroid ADs showed vaginal atrophy (75 vs. 45.2%, <i>p</i> < .05). A greater proportion of women with thyroid ADs exhibited vulvar atrophy or both vaginal and vulvar atrophy, though these differences were not statistically significant. Women with thyroid ADs reported significantly higher scores for dryness, burning/itching, irritation/inflammation, and dyspareunia compared to those without it. A higher percentage of women with thyroid ADs experienced severe dyspareunia (45 vs. 20.6%, <i>p</i> < .05), severe burning/itching (33.3 vs. 9.1%, <i>p</i> < .05), and severe stress urinary incontinence (17.9 vs. 3.6%, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>This study suggests that thyroid ADs may contribute to genital aging, with an apparent greater involvement in vaginal signs of atrophy. Women with thyroid ADs reported more severe VVA symptoms, but specific symptomatological clusters should be investigated in larger samples. Our data support the need to explore further the role of thyroid disorders in VVA.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2458705"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/09513590.2025.2464492","DOIUrl":"10.1080/09513590.2025.2464492","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2464492"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early gestational diabetes mellitus risk predictor using neural network with NearMiss.","authors":"Min Zhao, Xiaojie Su, Lihong Huang","doi":"10.1080/09513590.2025.2470317","DOIUrl":"10.1080/09513590.2025.2470317","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is globally recognized as a significant pregnancy-related condition, contributing to complex complications for both mothers and infants. Traditional glucose tolerance tests lack the ability to identify the risk of GDM in early pregnancy, hindering effective prevention and timely intervention during the initial stages.</p><p><strong>Objective: </strong>The primary objective of this study is to pinpoint potential risk factors for GDM and develop an early GDM risk prediction model using neural networks to facilitate GDM screening in early pregnancy.</p><p><strong>Methods: </strong>Initially, we employed statistical tests and models, including univariate and multivariate logistic regression, to identify 14 potential risk factors. Subsequently, we applied various resampling techniques alongside a multi-layer perceptron (MLP). Finally, we evaluated and compared the classification performances of the constructed models using various metric indicators.</p><p><strong>Results: </strong>As a result, we identified several factors in early pregnancy significantly associated with GDM (<i>p</i> < 0.05), including BMI, age of menarche, age, higher education, folic acid supplementation, family history of diabetes mellitus, HGB, WBC, PLT, Scr, HBsAg, ALT, ALB, and TBIL. Employing the multivariate logistic model as the baseline achieved an accuracy and AUC of 0.777. In comparison, the MLP-based model using NearMiss exhibited strong predictive performance, achieving scores of 0.943 in AUC and 0.884 in accuracy.</p><p><strong>Conclusions: </strong>In this study, we proposed an innovative interpretable early GDM risk prediction model based on MLP. This model is designed to offer assistance in estimating the risk of GDM in early pregnancy, enabling proactive prevention and timely intervention.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2470317"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can menopausal hormone therapy be considered in postmenopausal women who are older than 60 years?","authors":"Panagiotis Anagnostis, Julia K Bosdou, Thomas Georgiou, Dimitrios G Goulis","doi":"10.1080/09513590.2025.2468957","DOIUrl":"https://doi.org/10.1080/09513590.2025.2468957","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2468957"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the mechanism of action of berberine combined with Jianpi Yishen Huazhuo formulation in treating obese polycystic ovary syndrome by activating PI3K/AKT signaling pathway.","authors":"Xiaojing Zhang, Dejiang Ji, Yan Zhang, Cuizhong Du, Lijun Liang, Aqsa Ahmad, Yahong Feng, Gaxi Ye","doi":"10.1080/09513590.2025.2462068","DOIUrl":"10.1080/09513590.2025.2462068","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the effects and potential mechanisms of berberine in conjunction with Jianpi Yishen Huazhuo formulation (JPYSHZF) on obese rats that serve as a model for polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>Letrozole combined with high-fat diet (HFD) was used to establish an overweight PCOS rat model. After successful modeling, each intervention group was monitored for 28 d. An oral glucose tolerance test (OGTT) is performed to assess glucose metabolism. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of sex hormones and serum levels of gastrointestinal hormones in rats. Biochemical analyzers were used to assess blood lipid levels. The protein expression levels of p38, PI3K, GLUT4, and AKT in ovarian tissue were demonstrated using Western Blotting (WB). Real-time fluorescence quantitative PCR (RT-qPCR) was used to measure the mRNA expression levels of p38, PI3K, GLUT4 and AKT in the same tissue. The morphological changes of ovarian tissue were observed using Hematoxylin-eosin (HE).</p><p><strong>Results: </strong>Treatment with berberine in conjunction with JPYSHZF has been shown to reduce serum testosterone T and luteinizing hormone (LH) levels while increasing serum follicle-stimulating hormone (FSH) and E2 levels. This combination therapy also decreases the LH/FSH ratio and ameliorates polycystic ovary-like pathological changes in the ovaries of rats with PCOS. Additionally, this treatment decreases serum TC, TG, and LDL-c levels while increasing HDL-c levels. It also reduces levels of GLU and Ghrelin while enhancing levels of CCK, PYY, and GLP-1. Furthermore, the relative 6 of PI3K and AKT proteins, as well as the mRNA levels of PI3K, GLUT4, and AKT, were found to be increased.</p><p><strong>Conclusions: </strong>Berberine combined with JPYSHZF can improve the sex hormone levels, ovarian function, glucose and lipid metabolism levels, and gastrointestinal hormone levels in obese PCOS rats by activating the PI3K/AKT signaling pathway, thereby playing a role in treating obese PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2462068"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-specific reference ranges and variation of anti-mülerian hormone in healthy Chinese women of reproductive and perimenopausal age: a nationwide population-based prospective multicenter cross-sectional study.","authors":"Linli Hu, Hongyi Yang, Haining Luo, Yuexiang Zhang, Xiaohong Wang, Sanhua Wei, Qiongfang Wu, Ying Jiang, Xiaoyan Liang, Jianhui Chen, Yingpu Sun","doi":"10.1080/09513590.2024.2431230","DOIUrl":"10.1080/09513590.2024.2431230","url":null,"abstract":"<p><strong>Objective: </strong>To determine the variation of serum AMH levels in healthy Chinese women and establish AMH reference ranges accordingly.</p><p><strong>Methods: </strong>This prospective cross-sectional multicenter study was designed to enroll healthy Chinese women of reproductive age (20-39 years) and perimenopausal age (40-49 years) from five reproductive centers in different regions of China. The study began in May 2022 and finished in February 2023. Age-specific 2.5th-97.5th percentiles AMH reference ranges were established. Multivariable linear regressions were undertaken to analyze the association of serum AMH with different demographic and clinical variables, including antral follicle count (AFC).</p><p><strong>Results: </strong>1113 healthy Chinese women were enrolled, including 614 of premenopausal age and others of reproductive age. The AMH (ng/ml) reference ranges for Chinese women of reproductive age were 0.87-9.89 (20-24 years), 0.42-8.24 (25-29 years), 0.34-7.46 (30-34 years), and 0.28-5.66 (35-39 years). For perimenopausal women, their reference ranges were 0.12-4.63 (40-41 years), 0.01-4.12 (42-43 years), 0.01-2.65 (44-45 years), 0.01-1.90 (46-47 years), and 0.01-1.08 (48-49 years). The regression of AMH on AFC adjusted by age is Log10(AMH)=0.2594-0.0235*Age + 0.0632*AFC.</p><p><strong>Conclusions: </strong>This study established the age-specific serum AMH reference ranges for healthy Chinese women of reproductive and premenopausal age, and observed that the consistent decrease of AMH after 20 years accelerated around the beginning of perimenopause (40 years).</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2431230"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}