International Journal of Women's Health最新文献

{"title":"Practical Guidance on the Use of Vaginal Laser Therapy: Focus on Genitourinary Syndrome and Other Symptoms.","authors":"Victoria Kershaw, Swati Jha","doi":"10.2147/IJWH.S446903","DOIUrl":"https://doi.org/10.2147/IJWH.S446903","url":null,"abstract":"<p><p>Genitourinary syndrome of the menopause (GSM) is a chronic, often progressive condition, characterised by symptoms relating to oestrogen deficiency including; vaginal dryness, burning, itching, dyspareunia, dysuria, urinary urgency and recurrent urinary tract infections. GSM affects up to 70% of breast cancer survivors with a tendency to particularly severe symptoms, owing to the effects of iatrogenic menopause and endocrine therapy. Patients and clinicians can be reluctant to replace oestrogen vaginally due to fear of cancer recurrence. Vaginal laser is a novel therapy, which may become a valuable nonhormonal alternative in GSM treatment. There are currently 6 published studies regarding Erbium:YAG laser treatment for GSM, 41 studies regarding CO2 laser treatment for GSM and 28 studies regarding vaginal laser treatment for GSM in breast cancer survivors. Number of participants ranges from 12 to 645. The majority of studies describe a course of 3 treatments, but some report outcomes after 5. Significant improvements were reported in vaginal dryness, burning, dyspareunia, itch, Vaginal Health Index Scores (VHIS), Quality of Life, and FSFI (Female Sexual Function Index). Most studies reported outcomes at short-term follow-up from 30 days to 12 months post-treatment. Few studies report longer-term outcomes with conflicting results. Whilst some studies suggest improvements are sustained up to 24 months, others report a drop-off in symptom improvement at 12-18 months. Patient satisfaction ranged from 52% to 90% and deteriorated with increasing time post-procedure in one study. The findings in this review must be validated in robust randomised sham-controlled trials of adequate power. There remain a number of unanswered questions in terms of which laser medium to use, optimal device settings, ideal interval between treatments, pre-treatment vaginal preparation, as well as safety and efficacy of repeated treatments long term. These issues could be addressed most efficiently with a mandatory registry of vaginal laser procedures.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1909-1938"},"PeriodicalIF":2.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Readiness, Beliefs, and Practices Regarding Menstruation Among Women in Saudi Arabia.","authors":"Helalah Alenizy, Nouran Aleyeidi, Reema Almutairi, Leen Khosyfan, Raghad Bedaiwi, Leen Alowaidah, Hissah Alrushud, Khawla Alfadda, Lujain A Alshamekh, Najd Al Anazi, Shuruq Alshammari, Amal Alzahrani, Hanin Alomar","doi":"10.2147/IJWH.S490728","DOIUrl":"10.2147/IJWH.S490728","url":null,"abstract":"<p><strong>Background: </strong>Menstruation is a natural process that occurs monthly in women. Although menstruation is a fundamental aspect of women's lives, their readiness for and beliefs about menstruation vary. Moreover, their practices during menstruation can be influenced by various factors, including age, education level, mother's education, and field of specialty. This study aimed to explore menstruation-related readiness, beliefs, and practices among women who had experienced menstruation in Saudi Arabia. In addition, the study aimed to evaluate the factors affecting these women's readiness, beliefs, and practices regarding menstruation.</p><p><strong>Patients and methods: </strong>This cross-sectional online questionnaire-based study included 3471 women of different ages who had experienced menstruation. The participants were selected using convenience sampling from all regions of Saudi Arabia. The questionnaire was distributed between late December 2022 and March 2023 and included questions on demographics and menstruation-related readiness, beliefs, and practices.</p><p><strong>Results: </strong>Of the 3471 participants, 1627 (46.8%) were well prepared for menstruation. In addition, most of the study participants (80.2%) had positive beliefs about menstruation. However, the participants' menstrual practices varied. Over half of the participants (63%) used painkillers and approximately half (54.4%) used herbal medicine during menstruation.</p><p><strong>Conclusion: </strong>This study found that less than half of the participants were ready for menarche. In contrast, most participants displayed positive beliefs concerning menstruation. In terms of practices, the women exhibited certain dietary restrictions during their menstrual period and predominantly favored herbal remedies for pain relief over conventional painkillers. Implementing awareness campaigns and incorporating school education on menstrual readiness and hygiene is needed.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1875-1887"},"PeriodicalIF":2.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Intrauterine Device Migration: Uterine Penetration and Bladder Involvement with Secondary Stones 3 Years Post-Insertion.","authors":"ZhiLong Chen, Zhong Lv, YunFeng Shi","doi":"10.2147/IJWH.S492865","DOIUrl":"10.2147/IJWH.S492865","url":null,"abstract":"<p><strong>Background: </strong>Intrauterine devices (IUDs) are among the most popular contraceptive methods globally due to their convenience and cost-effectiveness. However, improper placement can lead to complications such as device migration and uterine perforation, with increased risk observed when IUDs are implanted within four to six weeks postpartum. Typically, patients are asymptomatic or experience mild lower abdominal discomfort or minor abnormal vaginal bleeding following IUD displacement. Advances in diagnostic techniques have resulted in an increased reporting of uterine perforations due to IUD migration. Although rare, secondary stone formation following IUD perforation has been noted. In 2023, cases of IUD perforation were reported in women with a history of multiple cesarean sections and in a young woman without detailed marital history.</p><p><strong>Prior presentation: </strong>The 43-year-old patient, who had an IUD inserted three years prior, exhibited symptoms of frequent urination and painful urination unrelieved by anti-infective and analgesic treatments. The patient underwent cystotomy for foreign body removal, which revealed the IUD had perforated the uterus and bladder, with both arms of the device invaded into bladder wall and covered with concentric stone layers. Complete removal of the IUD and surrounding stones, followed by suturing and postoperative anti-infection analgesic treatment, led to significant symptom improvement.</p><p><strong>Conclusion: </strong>This case underscores the importance of regular IUD check-ups to prevent uterine perforation and the necessity of considering IUD migration in patients presenting with lower urinary tract symptoms without routine IUD examination. While self-examination by the patient through the strings in the vagina is possible, imaging studies are also indispensable. Surgery has proven to be an effective solution for such complications, but cystoscopy is not always the best option, and the decision to perform open surgery should be based on the patient's perforation and the condition of the surrounding tissues. This paper emphasizes the need for vigilance and proper clinical management.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1903-1907"},"PeriodicalIF":2.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Pathways Between Breast Cancer and Cardiovascular Disease Through Mediator Factors: A Two-Step Mendelian Randomization Analysis.","authors":"Weilin Lu, Kaiming Li, Haisi Wu, Jinyu Li, Yan Ding, Xiaolin Li, Zhipeng Liu, Huae Xu, Yinxing Zhu","doi":"10.2147/IJWH.S483139","DOIUrl":"10.2147/IJWH.S483139","url":null,"abstract":"<p><strong>Background: </strong>The causal relationship of breast cancer (BC) with cardiovascular disease (CVD) and the underlying mediating pathways remains elusive. Our study endeavors to investigate the causal association between BC and CVD, with a focus on identifying potential metabolic mediators and elucidating their mediation effects in this causality.</p><p><strong>Methods: </strong>In this study, we conducted two-sample Mendelian randomization (MR) to estimate the causal effect of BC (overall BC, ER+ BC, ER- BC) from the Breast Cancer Association Consortium (BCAC) on CVD including coronary heart disease (CHD), hypertensive heart disease (HHD), ischaemic heart disease (IHD), and heart failure (HF) from the FinnGen consortium. Then, we used two-step MR to evaluate 18 metabolic mediators of the association and calculate the mediated proportions.</p><p><strong>Results: </strong>Genetically predicted ER+ BC was causally associated with an increased risk of CVD including CHD (OR = 1.034, 95% CI: 1.004-1.065, p = 0.026), HHD (OR = 1.061, 95% CI: 1.002-1.124, p = 0.041), IHD (OR = 1.034, 95% CI: 1.007-1.062, p=0.013), and HF (OR = 1.055, 95% CI: 1.013-1.099, p = 0.010), while no causality was observed for overall BC and ER- BC. Furthermore, high-density lipoprotein cholesterol (HDL-C) was identified as a mediator of the association between ER+BC and CVD, including CHD (with 15.2% proportion)) and IHD (with 15.5% proportion), respectively.</p><p><strong>Conclusion: </strong>This study elucidates the potential causal impact of ER+ BC on subsequent risk of CVD, including CHD, HHD, IHD, and HF. We also outline the metabolic mediator HDL-C as a priority target for preventive measures to reduce excessive risk of CVD among patients diagnosed with ER+BC.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1889-1902"},"PeriodicalIF":2.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic Female Genitourinary Fistula in Uganda: Etiology, Twelve-Year Trends, and Risk Factors for Development Following Cesarean Section.","authors":"Onesmus Byamukama, Christopher Tarnay, Brenda Ainomugisha, Leevan Tibaijuka, Rogers Kajabwangu, Paul Kato Kalyebara, Henry Mark Lugobe, Verena Geissbuehler, Musa Kayondo","doi":"10.2147/IJWH.S473024","DOIUrl":"https://doi.org/10.2147/IJWH.S473024","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the magnitude and trend of the iatrogenic genitourinary fistula in Uganda, and the risk factors for development following the Cesarean Section (CS).</p><p><strong>Methods: </strong>A retrospective review of charts of women with a confirmed diagnosis of genitourinary fistula at four regional fistula repair sites in Uganda between 2010 and 2021 was conducted. A fistula was classified as iatrogenic if it was; ureteric, vesico-cervical, vesico-uterine, or vaginal vault fistula that followed an obstetric or gynecological surgery. The annual proportions for the ischemic and iatrogenic fistula over the study period were compared. A sub group analysis of women with genitourinary fistula delivered by CS was done to determine the factors associated with iatrogenic fistula. Multivariable log binomial regression was performed to determine the independent risk factors.</p><p><strong>Results: </strong>There were 521 women who presented with genito-urinary fistula of which, 169 (32.4%) were iatrogenic. Most of the iatrogenic fistulae followed CS (71%). The proportions of iatrogenic fistulae increased from 8/52 (9.6%) in 2010 to 38/88 (43.2%) in 2020. The risk factors for iatrogenic fistula following CS were; Grand-multiparity (OR = 5.8; 95% CI: 2.1-15.4), Repeat CS (OR = 4.1; 95% CI: 1.8-9.3), CS performed by an intern doctor (OR = 4.8; 95% CI: 1.5-15.5) and CS done at a Health Centre IV (OR = 4.5; 95% CI: 1.2-16.7).</p><p><strong>Conclusion: </strong>The magnitude of the iatrogenic genitourinary fistula in Uganda is high and most follow CS. There is an observed rising trend in iatrogenic fistula. The risk factors for iatrogenic fistula following CS are grandmultiparity, repeat CS, CS performed by intern doctors and CS performed at lower health facilities. There is a need for continuous training and supervision of lower cadre doctors involved in CS to reduce on the rising trend of iatrogenic fistula.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1865-1873"},"PeriodicalIF":2.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Composite Dietary Antioxidant Index and Endometriosis from NHANES 2001-2006: A Cross-Sectional Study.","authors":"Xiaoping Xu, Han Wu, Yang Liu","doi":"10.2147/IJWH.S483870","DOIUrl":"https://doi.org/10.2147/IJWH.S483870","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between Composite Dietary Antioxidant Index (CDAI) and the risk of endometriosis in American women.</p><p><strong>Methods: </strong>The study adopted a cross-sectional design, incorporating 3862 women aged over 20 years, selected from the National Health and Nutrition Examination Survey (NHANES) dataset from 2001 to 2006. Six dietary antioxidants were taken into account in calculating CDAI. Endometriosis was determined based on self-report. To evaluate the association between CDAI and the risk of endometriosis, we employed models with multivariable logistic variables. For subgroup assessment in relation to CDAI, a stratified multivariate logistic regression model was utilized.</p><p><strong>Results: </strong>Among all participants, 273 participants (7.1%) were found to exhibit endometriosis. The preliminary analysis showed a reverse association between CDAI and the likelihood of endometriosis (odds ratio [OR] = 0.95; 95% confidence interval [CI]: 0.92~0.98). Upon full adjustment within the multivariable logistic regression, the ORs (95% CI) for endometriosis prevalence per unit increase in CDAI were estimated to be 0.96 (0.93~1). When the CDAI levels were divided into quartiles, it was found that the ORs for endometriosis with CDAI levels in Q2 (-2.131-0.023), Q3 (0.023-2.650), and Q4 (2.650-42.854) were 0.74 (0.52, 1.05), 0.76 (0.53, 1.1), and 0.53 (0.36, 0.79), respectively, compared to those with CDAI levels in Q1 (-7.151--2.131). We evaluated the association between CDAI and endometriosis using subgroups stratified by age, race/ethnicity, education level, body mass index (BMI), oral contraceptive, and menopausal status, revealing a substantial negative relationship.</p><p><strong>Conclusion: </strong>In this cross-sectional study, increasing CDAI was proportionally associated with a reduced risk of endometriosis among American women, suggesting a diet high in antioxidants may play an important role in reducing the risk of endometriosis. The findings of NHANES data spanning 2001 to 2006 suggest that promoting antioxidant-rich diets could be an important prevention strategy for endometriosis.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1845-1854"},"PeriodicalIF":2.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Retroperitoneal Ectopic Pregnancy and Review of Literature.","authors":"Liqun Xia, Tongyun Qi, Jianhua Qian","doi":"10.2147/IJWH.S486185","DOIUrl":"https://doi.org/10.2147/IJWH.S486185","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal ectopic pregnancy (REP) is a rare form of ectopic pregnancy, in which fertilised eggs are implanted in the retroperitoneal cavity. Due to its atypical location and non-specific symptoms, REP is often misdiagnosed, leading to delayed treatment. This condition poses serious risks owing to its proximity to the retroperitoneal blood vessels. Limited research and lack of specific guidelines make the management of REP challenging.</p><p><strong>Case report and literature review: </strong>A 47-year-old woman with REP was initially misdiagnosed as having acute gastroenteritis due to severe abdominal pain and gastrointestinal symptoms. She had amenorrhoea and significant lower abdominal pain, but no vaginal bleeding. After 35 days of amenorrhoea, the patient's serum beta-human chorionic gonadotropin (β-hCG) level was 16111.94 mIU/mL. Imaging revealed no intrauterine gestational sac; however, a mass was detected in the left adnexal area. Emergency laparoscopy identified a 3.0 cm ectopic mass in the retroperitoneal space, adjacent to the lower edge of the left broad ligament and near critical structures, with surface rupture and bleeding. The mass was surgically removed, and the patient's β-hCG levels returned to normal 33 days post-surgery. In addition, we reviewed previously published English literature on REP, highlighting its characteristics, pathogenesis, diagnosis, and treatment with the aim of improving the understanding and management of the condition.</p><p><strong>Conclusion: </strong>REP is difficult to diagnose because of its rarity and nonspecific symptoms. Early diagnosis relies on serum β-hCG testing, ultrasonography, and radiological examination. When β-hCG is elevated and no gestational sac is found within the uterus or at common ectopic sites, REP should be considered. Surgical resection is the primary treatment for this condition.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"16 ","pages":"1855-1864"},"PeriodicalIF":2.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}