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":"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":"https://doi.org/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":"https://doi.org/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":"https://doi.org/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":"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":"Effect of light fasting diet therapy on lipid metabolism and sex hormone levels in patients with polycystic ovary syndrome combined with infertility.","authors":"Xiaomei Jiang, Yongfeng Wang, Hong Tang, Jin Ma, Heyue Li","doi":"10.1080/09513590.2025.2458084","DOIUrl":"https://doi.org/10.1080/09513590.2025.2458084","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of light fasting diet therapy, including flaxseed powder supplementation, on lipid metabolism and sex hormone levels in patients with polycystic ovary syndrome (PCOS) combined with infertility.</p><p><strong>Methods: </strong>A total of 104 PCOS patients with combined infertility were divided into the control group (<i>n</i> = 52) and intervention group (<i>n</i> = 52) using a random number table method. Over a two-month study period, the control group received light fasting diet therapy with rice flour as a placebo, while the intervention group received light fasting diet therapy supplemented with flaxseed powder. Differences in general clinical data, anthropometric indicators, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), fasting plasma glucose (FPG), fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)) were compared between the two groups.</p><p><strong>Results: </strong>After treatment, both groups showed significant reductions in FSH, LH, E2, and P levels compared to baseline (<i>p</i> < .05). In the intervention group, the mean FINS and HOMA-IR levels were significantly lower than those in the control group following 2 months of treatment (<i>p</i> < .05). Furthermore, TC, TG, and LDL-C levels were significantly reduced in the intervention group compared to the control group (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>Light fasting diet therapy, especially with flaxseed powder, improves obesity, lipid, and glucose metabolism disorders in PCOS patients with infertility. However, longitudinal studies are needed to better understand these associations and assess long-term effects before considering this intervention as a standard clinical recommendation for PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2458084"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058867","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":"https://doi.org/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}

{"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":"A rare deleterious missense mutation in the <i>AXIN2</i> gene in Chinese women with polycystic ovary syndrome.","authors":"Ying Zhang, Yu Chen, Fa-Ying Liu, Jing-Wen Fu, Xian-Xian Liu, Jun Tan, Ou-Ping Huang, Yang Zou","doi":"10.1080/09513590.2025.2463545","DOIUrl":"https://doi.org/10.1080/09513590.2025.2463545","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is an endocrine disorders and characterized by polycystic ovary morphology and oligomenorrhea, affecting fertility and health condition of female around the world. The causative factors of PCOS are complex, and genetic structure remains a long-standing medical challenge in genetics. Previous genome-wide association study (GWAS) showed that Wing-less-related integration site (Wnt) signaling is the most affected pathway among PCOS-related risk genes, and genetic mutations in the Wnt/β-catenin signaling may lead to abnormal development of PCOS.</p><p><strong>Objective: </strong>To explore the possibility of axis inhibitor-2 (<i>AXIN2</i>) variants in Chinese women with PCOS and assess their pathogenicities.</p><p><strong>Methods: </strong>A total of 365 Chinese women with PCOS and 905 women without PCOS as control were recruited from Jiangxi Provincial Maternal and Child Health Hospital, All of the 11 exons and flanking regions of the <i>AXIN2</i> gene were amplified by polymerase chain reaction (PCR), the potential variants were analyzed by Sanger sequencing. The evolutionary conservation analysis of the identified Axin-2 mutant was analyzed among 15 vertebrates from <i>human</i> to <i>zebrafish</i>. The protein structure change was analyzed between the wild-type and mutation-type. The pathogenicity of <i>AXIN2</i> variant was further analyzed in silico.</p><p><strong>Results: </strong>We totally identified 7 genetic variants of <i>AXIN2</i> in this study, including 4 synonymous and 3 missense. Among them, we find a rare deleterious missense variant [p.R714W (c.2140C > T)]. The allele frequencies of this variant were 0.82% and 0.17% in PCOS cases and matched controls, respectively. And it was ranging from 7.89e-5 to 1.47e-4 in public databases. Fisher's exact test indicated that the allele frequencies in PCOS were <i>p <</i> 0.05 compared to both the controls and the databases. Especially, the mutant amino acid site is highly conserved in vertebrates, while the mutation changed the 714th arginine to tryptophan resulting in significant change in the protein structural of Axin-2.</p><p><strong>Conclusion: </strong>In this study, we identified a rare deleterious missense <i>AXIN2</i> mutation [p.R714W (c.2140C > T)] in Chinese women with PCOS, and this mutant is probably pathogenic. This study may provide a new perspective on revealing the genetic variation of PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2463545"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255594","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}