International Journal of Women's Health最新文献

{"title":"Global Burden of Secondhand Smoke-Attributable ER-Negative Breast Cancer and Exploratory Immune-Metabolic Mediation Using Mendelian Randomization.","authors":"Defu Yang, Feng Shang, Xinying Ma, Haibo Zhang, Xue Ren, Xianqing Luan, Jianjing Wang, Ying Li, Tong Wu, Dongyang Lv, Ying Yan, Jing Liu, Ying Xu","doi":"10.2147/IJWH.S612541","DOIUrl":"10.2147/IJWH.S612541","url":null,"abstract":"<p><strong>Background: </strong>The global burden of breast cancer attributable to secondhand smoke (SHS) and its potential biological pathways, particularly for estrogen receptor (ER)-negative disease, remain incompletely characterized. This study aimed to evaluate temporal trends in SHS-attributable breast cancer burden and to explore whether immune and metabolic traits may represent candidate pathways linking SHS exposure with ER-negative breast cancer.</p><p><strong>Methods: </strong>We analyzed the Global Burden of Disease 1990-2021 data to estimate temporal trends in SHS-attributable breast cancer burden using Joinpoint regression, Bayesian age-period-cohort modeling, decomposition analysis, and autoregressive integrated moving average forecasting to 2050. Two-sample Mendelian randomization (MR) was performed using 36-38 single-nucleotide polymorphism instruments for exposure to tobacco smoke outside the home. Exploratory two-step MR mediation analyses screened 637 serum metabolites and 731 immune phenotypes using the product-of-coefficients approach.</p><p><strong>Results: </strong>Globally, absolute SHS-attributable breast cancer deaths increased from 4,949 in 1990 to 7,518 in 2021, and disability-adjusted life years (DALYs) increased from 1.74×10<sup>5</sup> to 2.57×10<sup>5</sup>. In contrast, age-standardized death and DALY rates declined, with estimated annual percentage changes of -1.31% and -1.22% per year, respectively. Marked disparities were observed across Socio-Demographic Index regions. Projection analyses suggested a plateau around 2030, followed by widening uncertainty. Decomposition analysis indicated that population growth and population aging were major contributors to the increasing absolute burden. In MR analysis, genetically proxied SHS exposure outside the home showed a nominal positive association with ER-negative breast cancer in the inverse variance-weighted model (β = 0.9976; odds ratio = 2.71; 95% confidence interval = 1.08-6.82), although alternative MR estimators showed wider and less consistent estimates. Exploratory two-step MR identified lipid- and energy-related metabolites, including 10-nonadecenoate, eicosenoate, 3-hydroxybutyrate, and dihomo-linoleate 20:2n6, as candidate metabolic signals. A myeloid antigen-presentation phenotype, HLA-DR on CD33dim HLA-DR+ CD11b- cells, was also prioritized as a potential immune-related signal. However, the indirect-effect estimates were imprecise and should be interpreted as exploratory rather than confirmatory evidence of mediation.</p><p><strong>Conclusion: </strong>The age-standardized burden of SHS-attributable breast cancer has declined globally, whereas absolute deaths and DALYs have increased due to demographic growth and aging, with persistent SDI-linked disparities. MR analyses provided suggestive genetic-instrument evidence linking SHS exposure outside the home with ER-negative breast cancer, and exploratory mediation analyses prioritized lipid metabolism, ke","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"612541"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874131","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":"Global Burden of Tuberculosis and Drug-Resistant Subtypes Among Women of Childbearing Age from 1990 to 2021, with Projections to 2030.","authors":"Jiawang Chen, Xiaozhen Peng, Yixiang Zheng, Ruochan Chen","doi":"10.2147/IJWH.S624782","DOIUrl":"10.2147/IJWH.S624782","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) poses a major threat to women of childbearing age (WCBA, 15-49 years), yet comprehensive global burden analyses remain limited. This study provides a comprehensive global spatiotemporal analysis of TB and drug-resistant subtypes among WCBA.</p><p><strong>Methods: </strong>Using Global Burden of Disease Study 2021 data, we assessed the global incidence and disability-adjusted life years (DALYs) of TB and drug-resistant subtypes among WCBA from 1990 to 2021, and projected trends to 2030 using Bayesian age-period-cohort models.</p><p><strong>Results: </strong>In 2021, an estimated 1.99 million WCBA developed TB globally. The age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) declined for overall TB and drug-susceptible TB (DS-TB), but increased for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). The large relative increases in XDR-TB should be interpreted cautiously because baseline estimates were very small and case definitions, testing capacity, and surveillance changed over time. The TB burden showed substantial geographic heterogeneity, with the highest age-standardized rates concentrated in Sub-Saharan Africa. Age-specific patterns showed higher ASIRs in younger populations, whereas ASDRs increased with age. Among the four GBD-attributable exposures included in the comparative analysis, high body-mass index had the largest modeled TB-related DALY rate in 2021. This restricted comparison should not be interpreted as ranking all established TB determinants. Projections suggest that overall TB incidence will decline, whereas the modeled XDR-TB ASIR may continue to rise through 2030 globally.</p><p><strong>Conclusion: </strong>Reducing TB among WCBA requires improved access to rapid diagnosis, drug susceptibility testing, effective DR-TB treatment, and risk-based TB screening within reproductive and antenatal care, particularly in low-SDI and high-burden settings. Pregnancy- and postpartum-specific surveillance should also be strengthened, as these populations are not separately identifiable in GBD 2021.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"624782"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864691","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":"Effect of Disodium Etidronate on Bone Mineral Density in Postmenopausal Women: A Six-Month Prospective Study.","authors":"Weihan Kong, Li Wang, Huiyu Xue, Xin Feng","doi":"10.2147/IJWH.S586114","DOIUrl":"10.2147/IJWH.S586114","url":null,"abstract":"<p><strong>Background: </strong>Postmenopausal osteoporosis, characterized by rapid bone loss, raises fracture risk. Bisphosphonates are standard treatments. This study evaluates the 6-month efficacy of Disodium Etidronate, a first-generation bisphosphonate with a distinct mechanism, on bone mineral density (BMD) at the hip and lumbar spine in postmenopausal women, an area with limited data.</p><p><strong>Objective: </strong>This study aimed to assess the effect of a 6-month Disodium Etidronate course on BMD in postmenopausal women.</p><p><strong>Methods: </strong>A prospective cohort study enrolled 70 postmenopausal women. Participants received 60 mg of Disodium Etidronate orally once daily for six months. BMD at the femoral neck, trochanter, total hip, and lumbar spine (L1-L4) was measured via dual-energy X-ray absorptiometry (DXA) at baseline and post-treatment. Changes in BMD, site-specific differences, and influencing factors (age, BMI, calcium intake, exercise) were analyzed.</p><p><strong>Results: </strong>After treatment, BMD increased significantly at all sites (all P<0.001): femoral neck (0.70±0.15 to 0.75±0.13 g/cm²), trochanter (0.65±0.10 to 0.70±0.15 g/cm²), total hip (0.72±0.14 to 0.77±0.13 g/cm²), and lumbar spine L1-L4 (0.80±0.13 to 0.86±0.14 g/cm²). The lumbar spine increase exceeded the trochanter's (P=0.023). Age negatively correlated with BMD improvement (β=-0.25, P=0.001), while BMI (β=0.18, P=0.012), calcium intake (β=0.12, P=0.035), and exercise (β=0.15, P=0.021) showed positive correlations. Adverse reactions were mild (10% incidence).</p><p><strong>Conclusion: </strong>A six-month Disodium Etidronate regimen effectively increases BMD in postmenopausal women, with greater efficacy in the lumbar spine. Efficacy is influenced by age, BMI, calcium intake, and exercise. The treatment demonstrates good safety and tolerability.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"586114"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864729","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":"Laparoscopic Cervical Cerclage Band Erosion into the Rectal Lumen Complicated by Recto-Uterine Fistula: A Case Report.","authors":"Ziqian Tang, Qunzhi Zhang, Qi Li, Desheng Qi, Huan Chen","doi":"10.2147/IJWH.S629738","DOIUrl":"10.2147/IJWH.S629738","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic abdominal cervical cerclage (LACC) is a well-established intervention for cervical insufficiency. Long-term complications involving delayed band migration and erosion into adjacent viscera are exceptionally rare; the most frequently reported site is the urinary bladder. To the best of our knowledge, complete erosion into the intestinal lumen has not been previously reported. This report describes a case of complete cerclage band erosion into the rectal lumen, later complicated by recto-uterine fistula formation, and highlights the associated diagnostic and management challenges.</p><p><strong>Case: </strong>A 44-year-old asymptomatic woman with prior LACC presented for elective band removal. Preoperative evaluation, including pelvic ultrasound, was unrevealing. During laparoscopy, two cerclage bands were found entirely within the rectal lumen, necessitating unplanned rectal repair and diverting transverse colostomy. Three months later, pre-colostomy reversal imaging revealed a recto-uterine fistula. A multidisciplinary team recommended delayed surgical repair; the patient opted for conservative management.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this case represents the first report of complete transmural erosion of an LACC band into the rectum with subsequent recto-uterine fistula formation. This case demonstrates that cerclage removal in patients with complex surgical histories warrants careful preoperative planning and multidisciplinary preparedness. Given the extreme rarity of this complication, the decision regarding elective cerclage removal should be individualized.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"629738"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857203","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":"Prognostic Significance of the Ki-67 Index with an Optimal Cut-off Value of 32.5% in Uterine Sarcoma and Uterine Carcinosarcoma: A Retrospective Cohort Study.","authors":"Piaopiao Ye, Fang Wang, Xinyue Dai, Xiaoli Hu, Yuanqiu Wang","doi":"10.2147/IJWH.S595101","DOIUrl":"10.2147/IJWH.S595101","url":null,"abstract":"<p><strong>Objective: </strong>Uterine sarcomas and uterine carcinosarcomas are rare heterogeneous malignancies with poor prognosis. Though carcinosarcomas have been pathologically reclassified as dedifferentiated endometrial carcinomas, their highly aggressive clinical behavior merits combined analysis with uterine sarcomas. This study aimed to investigate the prognostic value of Ki-67 proliferation index in major histologic subtypes and identify an optimal cut-off value for risk stratification.</p><p><strong>Materials and methods: </strong>We retrospectively enrolled 86 surgically treated primary uterine sarcoma and carcinosarcoma patients (2006-2019). Ki-67 labeling index was detected via immunohistochemistry. The optimal cut-off value for Ki-67 was determined using receiver operating characteristic (ROC) curve analysis. Overall survival (OS) and progression-free survival (PFS) were evaluated via Kaplan-Meier curves and Cox regression.</p><p><strong>Results: </strong>The optimal Ki-67 cut-off value was 32.5%. High Ki-67 expression (≥32.5%) was significantly associated with older age (P=0.001), postmenopausal status (P=0.002), and aggressive histological subtypes 0.760 (P<0.001). High Ki-67 group had worse 3-year PFS (18.5% vs 76.4%) (range, 22-73) and 3-year OS (25.5% vs 85.4%). Multivariate analysis confirmed high Ki-67 as an independent prognostic factor for poorer PFS and OS (P < 0.001). Larger tumor size (P < 0.001), postmenopausal status (PFS: P = 0.001; OS: P = 0.002), and high-risk histological type (P < 0.001) also remained significant. Notably, the 32.5% cut-off applies across major histological subtypes.</p><p><strong>Conclusion: </strong>Ki-67 index serves as an independent biomarker for uterine sarcoma and carcinosarcoma. The 32.5% cut-off effectively divide patients into low- and high-risk groups, with the latter demonstrating significantly inferior survival outcomes.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"595101"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864681","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":"Machine Learning-Based Prediction of Antepartum Depression Symptoms: A Prospective Cohort Study.","authors":"Hongyan Xie, Shengnan Cong, Shiqian Ni, Jingjing Han, Xiaoqing Sun, Rong Zhu, Tingting Zhang, Meng Yao Wang, Yaxuan Wu, Aixia Zhang","doi":"10.2147/IJWH.S599295","DOIUrl":"10.2147/IJWH.S599295","url":null,"abstract":"<p><strong>Background: </strong>Antepartum depression is a common mental health issue. This study aimed to develop a tool to predict antepartum depression risk and contribute to improving the screening rate of antepartum depression.</p><p><strong>Methods: </strong>This study used a prospective design, including a total of 1,701 mid-pregnancy women, who were followed up until late pregnancy. We comprehensively incorporate predictors from biological, psychological, demography, and obstetrics. Several machine learning algorithms (logistic regression, random forest, support vector machine and extreme gradient boosting) were used to predict antepartum depression. Predictive variables were screened using the least absolute shrinkage and selection operator (LASSO). The models were built based on 70% of the training set and evaluated on the remaining 30% test set using metrics such as accuracy, precision, sensitivity, specificity, F1 score, and area under the receiver operating characteristic curve (AUC). We also ranked the importance of the variables.</p><p><strong>Results: </strong>LASSO was used to select the nine variables (out of a total of 42). The importance ranking of the nine variables is as follows: psychological resilience, rumination, stress, social support, body image satisfaction during pregnancy, preparation for neonatal parenting, low-density lipoprotein cholesterol, work status and relationship with parents. The logistic regression achieved 68% accuracy, 25.6% precision, 68.7% sensitivity, 68.4% specificity, 37.3% F1-score, and 76% AUC in the test set. The random forest achieved 66.1% accuracy, 24.1% precision, 68.5% sensitivity, 65.7% specificity, 35.6% F1-score, and 75.4% AUC in the test set. The support vector machine achieved 65.1% accuracy, 23% precision, 65.7% sensitivity, 65.1% specificity, 34.1% F1-score, and 70.1% AUC in the test set. The extreme gradient boosting achieved 86.8% accuracy, 57.8% precision, 15.7% sensitivity, 98.1% specificity, 24.7% F1-score, and 71.8% AUC in the test set.</p><p><strong>Conclusion: </strong>The antepartum depression risk prediction model developed in this study has moderate discriminative ability, which helps achieve early identification and classification management of risk, and provides a basis for targeted interventions.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"599295"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857246","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":"Rapid Intrauterine Fetal Death Caused by <i>Listeria monocytogenes</i> in Mid-Pregnancy: A Case Report and Literature Review.","authors":"Wenwan Sun, Jiaxin Liu, Haiyan Sun, Xue Cui","doi":"10.2147/IJWH.S623923","DOIUrl":"10.2147/IJWH.S623923","url":null,"abstract":"<p><strong>Background: </strong><i>Listeria monocytogenes</i> (LM) is a foodborne Gram-positive bacillus capable of growth at refrigeration temperatures. Pregnancy-associated infection may cause placental invasion and fetal loss despite mild or nonspecific maternal symptoms. Intrinsic lack of cephalosporin activity can delay effective treatment when listeriosis is not suspected.</p><p><strong>Case presentation: </strong>A 34-year-old primigravida at 22+6 weeks presented after 8 hours of fever and 6 hours of lower abdominal pain. Marked leukocytosis, neutrophilia, elevated C-reactive protein, fetal tachycardia, uterine contractions, and abnormal amniotic echogenicity suggested intra-amniotic infection. Ceftriaxone was started for fever of undetermined origin; intrauterine fetal death occurred 8 hours after admission. Cultures of throat swab, ear swab, and perianal secretion specimens obtained from the delivered fetus all yielded <i>L. monocytogenes</i>, and placental histopathology showed stage III, grade II acute chorioamnionitis. After fetal delivery, treatment was changed to intravenous ampicillin, with resolution of fever and inflammatory abnormalities. Refrigerated Arctic shrimp consumed 2 weeks earlier was considered a suspected, unconfirmed exposure.</p><p><strong>Conclusion: </strong>In febrile pregnant patients, the combination of fetal tachycardia, uterine activity, a marked inflammatory response, and no alternative infection source should prompt early consideration of listeriosis and LM-active empirical therapy after cultures are obtained. Dietary exposure history, appropriate specimen collection, and awareness of cephalosporin noncoverage are central to management and prevention.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"623923"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856987","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":"The Quantification Paradox in Gynecologic Color Doppler Ultrasound: From Spectral Indices to Microvascular Imaging and Artificial Intelligence.","authors":"Yeping Zhang, Juan Shi, Aihong Wang","doi":"10.2147/IJWH.S631732","DOIUrl":"10.2147/IJWH.S631732","url":null,"abstract":"<p><p>Color Doppler ultrasound has long promised to convert tumor vascularity into an objective and reproducible measure for differentiating benign from malignant gynecologic disease. The historical record is more complicated. Quantitative spectral indices such as the resistance index, pulsatility index and peak systolic velocity were repeatedly proposed as objective discriminators, but their cutoffs did not become stable clinical standards. What entered major adnexal-mass systems was instead a coarse visual color score, used within structured multivariable frameworks such as the International Ovarian Tumor Analysis models and the Ovarian-Adnexal Reporting and Data System. New technologies-superb microvascular imaging, contrast-enhanced ultrasound, radiomics and deep learning-now reopen the old ambition of vascular quantification. This narrative review reorganizes gynecologic Doppler literature around measurement rather than disease category. It proposes that a major limiting problem may have been reproducibility, not signal content. High-resolution vascular features are more likely to become clinically useful when operator, machine, acquisition and population variance are controlled. The practical agenda for Doppler innovation should therefore prioritize standardized acquisition, reproducibility reporting, calibration, external validation and task-specific deployment over another isolated high-AUC or high-resolution vascular biomarker. Literature was identified through PubMed/MEDLINE searches (inception to 31 May 2026) combining gynecologic ultrasound with Doppler, O-RADS/IOTA, SMI, CEUS, radiomics, artificial intelligence and reproducibility; citation chaining was also used, with gynecologic evidence prioritized.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"631732"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857022","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":"Sociocultural and Structural Determinants Affecting Women's Health Among Female Sex Workers in Cameroon: A Qualitative Pilot Study.","authors":"Simon Manga, Madeleine Simeni, Claudette Sirri Che, Florence Manjuh, Kathleen Nulah, Holly Lynn Horan","doi":"10.2147/IJWH.S632375","DOIUrl":"10.2147/IJWH.S632375","url":null,"abstract":"<p><strong>Purpose: </strong>Female sex workers (FSWs) face significant sociocultural and structural determinants that adversely affect their health and wellbeing. This qualitative pilot study explored the lived experiences, health behaviors, and underlying social determinants shaping women's health among FSWs, using the PEN-3 cultural framework to inform contextually relevant interventions.</p><p><strong>Methodology: </strong>We conducted a qualitative phenomenological study with 30 FSWs recruited through purposive and snowball sampling in Douala (n=20) and Kribi (n=10). In-depth, semi-structured interviews were conducted in English, French, or Pidgin and transcribed verbatim. Data were analyzed using thematic analysis in NVivo, guided by the PEN-3 framework, incorporating both deductive and inductive coding approaches.</p><p><strong>Results: </strong>Participants included three types of FSWs: street-based FSWs (n=17), VIP-based sex workers (n=7), and female exotic dancers (n=6). Findings revealed a complex interplay of economic survival, stigma, and structural vulnerability. Economic pressures drove high client volumes and engagement in risky sexual practices, including condomless sex for higher pay. Participants reported widespread exposure to violence, harassment, and exploitation, including from uniform officers, compounded by the illegality of sex work. Stigma and marginalization contributed to maladaptive coping behaviors such as substance use. Despite limited engagement in formal health-promoting behaviors, notable resilience was evident through peer solidarity and informal financial support systems. Significant gaps in sexual and reproductive health knowledge were identified, with reliance on unsafe methods for pregnancy prevention and frequent use of abortion services. Community-based organizations provided HIV-related services but did not comprehensively address broader health needs.</p><p><strong>Conclusion: </strong>FSWs' health outcomes are shaped by intersecting sociocultural and structural determinants, including economic vulnerability, stigma, and criminalization. Addressing these challenges requires multi-level, woman-centered interventions that integrate sexual and reproductive health services with economic empowerment, stigma reduction, and policy reform. Improving FSWs' health is critical not only for equity but also for broader public health impact.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"632375"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857030","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":"Integrated Strategy Combining Real-World Data Mining, Network Pharmacology, and Molecular Docking to Decipher the Mechanism of Action of a Core Herbal Combination for Menopausal Syndrome.","authors":"E Zhang, Yaxue Xu, Ping Chen, Jiuxian Li, Xiaodan Zhang","doi":"10.2147/IJWH.S597832","DOIUrl":"10.2147/IJWH.S597832","url":null,"abstract":"<p><strong>Background: </strong>Menopausal syndrome (MPS) affects most peri- and post-menopausal women, and the multi-target nature of traditional herbal therapy makes its mechanism of action difficult to characterize with conventional methods.</p><p><strong>Objective: </strong>This study aims to elucidate the treatment strategy and molecular basis of Professor Zhang Xiaodan's herbal therapy for menopausal syndrome (MPS) through an integrated approach combining clinical data mining, network pharmacology, and molecular docking.</p><p><strong>Methods: </strong>A total of 158 clinical prescriptions (January 2024-January 2025) were analyzed. Core herbal combinations were identified via association rule mining and hierarchical clustering and subsequently validated through expert review. Bioactive compounds were retrieved from TCMSP, while disease-related targets were sourced from GeneCards, OMIM, DrugBank, and TTD. Protein-protein interaction (PPI) networks were constructed and analyzed, and functional enrichment was performed using R. Molecular docking simulations validating key interactions.</p><p><strong>Results: </strong>Analysis of 142 herbs (2,212 applications) revealed Licorice, Scutellaria, and Glehnia as the most frequent. Herbs were primarily cold-natured, sweet-bitter, and targeted lung/liver/kidney meridians. Data mining revealed 48 high-frequency herb pairs and three major clusters, from which an 8-herb core formula was derived. Network analysis identified 252 active compounds, 195 overlapping targets, and 10 core targets, including MAPK1, ESR1, and TP53. Enrichment analysis highlighted pathways related to lipid metabolism, AGE-RAGE signaling, and PI3K-AKT signaling. Molecular docking demonstrated strong binding affinities, notably between luteolin and MAPK1.</p><p><strong>Conclusion: </strong>Professor Zhang's treatment strategy emphasizes nourishing yin and blood, clearing heat, and regulating qi. The core formula likely exerts therapeutic effects via multi-target mechanisms involving ESR1 and TP53 through key signaling pathways, offering a mechanistic explanation for its clinical efficacy against MPS.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"597832"},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864667","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}