Seminars in reproductive medicine最新文献

Female Adipose Tissue Sex Steroid Biosynthesis. 女性脂肪组织性类固醇生物合成。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-10-03 DOI: 10.1055/s-0045-1811952

Natalia Hetemäki, Tomi S Mikkola, Hanna Savolainen-Peltonen

{"title":"Female Adipose Tissue Sex Steroid Biosynthesis.","authors":"Natalia Hetemäki, Tomi S Mikkola, Hanna Savolainen-Peltonen","doi":"10.1055/s-0045-1811952","DOIUrl":"https://doi.org/10.1055/s-0045-1811952","url":null,"abstract":"Estrogens, including estradiol and estrone, and androgens, including testosterone, are locally produced in adipose tissue throughout a woman's lifespan. Already in fertile-aged women, subcutaneous and visceral adipose tissue produce notable amounts of estrogens despite ongoing ovarian estrogen synthesis. After menopause, adipose tissue becomes the most important producer of estrogens. A decrease in circulating estrogen concentrations coincides with a relative increase in the amount of visceral adipose tissue and an increased risk for metabolic disorders. Furthermore, local adipose tissue biosynthesis of sex steroids may regulate the distribution of adipose tissue between the subcutaneous and visceral depots. Further studies are needed to characterize the relation of local adipose tissue sex steroid milieu to local and circulating markers of adipose tissue and metabolic dysfunction. This can shed more light on the increasing adiposity and metabolic burden associated with menopause. Here, we discuss the roles estrogens and androgens play in adipose tissue distribution and function before and after menopause, and highlight the role of local sex steroid biosynthesis, or intracrinology, in determining local tissue sex steroid environments.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reproductive History and Cardio-Metabolic Risk in the Postmenopausal Age. 绝经后年龄的生殖史和心脏代谢风险。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-09-30 DOI: 10.1055/s-0045-1811965

Laura Cucinella, Anna Odone, Rossella E Nappi

引用次数: 0

Hormonal Contraception in Perimenopause: What to Consider to Guide the Choice. 围绝经期激素避孕：应考虑哪些因素来指导选择。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-09-19 DOI: 10.1055/s-0045-1811951

Tiziana Fidecicchi, Marta Caretto, Giulia Chen, Davide Simi, Maria M Montt Guevara, Andrea Giannini, Stefano Luisi, Tommaso Simoncini

{"title":"Hormonal Contraception in Perimenopause: What to Consider to Guide the Choice.","authors":"Tiziana Fidecicchi, Marta Caretto, Giulia Chen, Davide Simi, Maria M Montt Guevara, Andrea Giannini, Stefano Luisi, Tommaso Simoncini","doi":"10.1055/s-0045-1811951","DOIUrl":"https://doi.org/10.1055/s-0045-1811951","url":null,"abstract":"Perimenopausal women have specific needs when it comes to contraception. Although fertility rates generally decrease after age 40, pregnancy is still possible and may be associated with a higher risk of obstetric and fetal complications. Moreover, women may experience bothersome symptoms during perimenopause due to anovulatory cycles and fluctuating estrogen levels, such as abnormal uterine bleeding, vasomotor symptoms, migraines, and mood disorders. Additionally, age increases the risk of the most common side effects of well-known contraceptives, particularly those containing estrogen. For this reason, contraception counseling during perimenopause should be tailored to the woman's characteristics. It should include three steps: evaluating the woman's needs and symptoms; evaluating the potential benefits of the chosen method; evaluating risk factors that may contraindicate certain choices. No contraceptive method is contraindicated solely based on age. Among combined hormonal contraceptives, if no contraindication exists, natural estrogens should be preferred after 40 years old. On the other hand, progestin-only methods can also be safely used in the presence of cardiovascular risk factors. This review will address the main reasons why a woman may need an HC method and how to make a tailored and informed choice.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of Menopausal Symptoms When Hormone Therapy Is Contraindicated. 激素治疗禁忌时更年期症状的治疗。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-09-02 DOI: 10.1055/s-0045-1811192

Laura Maria Niskanen, Henna Johanna Kärkkäinen, Marjo Tiina Tuppurainen

{"title":"Treatment of Menopausal Symptoms When Hormone Therapy Is Contraindicated.","authors":"Laura Maria Niskanen, Henna Johanna Kärkkäinen, Marjo Tiina Tuppurainen","doi":"10.1055/s-0045-1811192","DOIUrl":"https://doi.org/10.1055/s-0045-1811192","url":null,"abstract":"Menopausal symptoms, particularly vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM), significantly affect women's quality of life (QoL). While menopausal hormone therapy (MHT) is the most effective treatment, contraindications such as estrogen-sensitive cancers and thromboembolic conditions limit its use for many women. This review explores alternative nonhormonal treatments, including pharmacological options like selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, gabapentin, clonidine, and neurokinin receptor antagonists (e.g., fezolinetant), alongside nonpharmacological approaches such as lifestyle modifications, cognitive-behavioral therapy, and acupuncture. These alternatives, though less effective than MHT, provide critical options for women unable to use hormonal therapies. Emerging treatments like fezolinetant demonstrate promise in reducing VMS by addressing the underlying pathophysiology, but safety concerns, such as hepatotoxicity, require ongoing monitoring. GSM management includes therapies such as vaginal estrogens, prasterone, and ospemifene, with tailored approaches necessary for cancer survivors. Emphasis is placed on individualized care, better patient education, and continued research into the safety and efficacy of these therapies to improve the QoL for postmenopausal women.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endometriosis and Fertility: Where Do We Draw the Line? 子宫内膜异位症与生育：界限在哪里？

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-08-25 DOI: 10.1055/s-0045-1811510

Natalie E Rivera, Sadikah Behbehani

引用次数: 0

More than the Lesion: Unraveling the Complexities of Endometriosis-Associated Pain. 不仅仅是病变：解开子宫内膜异位症相关疼痛的复杂性。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-08-25 DOI: 10.1055/s-0045-1811206

Maria C Alzamora-Schmatz, Ashley Gubbels

{"title":"More than the Lesion: Unraveling the Complexities of Endometriosis-Associated Pain.","authors":"Maria C Alzamora-Schmatz, Ashley Gubbels","doi":"10.1055/s-0045-1811206","DOIUrl":"https://doi.org/10.1055/s-0045-1811206","url":null,"abstract":"Endometriosis is a chronic, estrogen-dependent inflammatory disorder characterized by ectopic endometrium-like tissue, leading to debilitating pain and reduced quality of life. Pain is the hallmark of endometriosis, with individuals experiencing dysmenorrhea, dysuria, dyschezia, dyspareunia, and chronic pelvic pain. However, pain does not always correlate with the severity or location of the lesions, which suggests additional factors are involved in the generation of endometriosis-associated pain. The underlying mechanisms are multifactorial, involving peripheral and central sensitization, inflammation, aberrant innervation, immune dysregulation, and hormonally influenced processes. Additionally, many individuals with endometriosis experience comorbid pain syndromes, including pelvic floor dysfunction (PFD), irritable bowel syndrome, interstitial cystitis, abdomino-pelvic myalgia, and vulvar vestibulodynia. These conditions share overlapping pathophysiological mechanisms, such as cross-sensitization of pelvic organs and maladaptive neuroplastic changes, further amplifying pain perception. Despite advances in understanding these mechanisms, current treatment strategies remain inadequate, with hormonal suppression and surgical intervention providing variable relief. A comprehensive, multimodal approach targeting neuroinflammatory pathways, PFD, and central sensitization may be essential for improving pain management. Further research is needed to refine therapeutic strategies and develop targeted interventions for this challenging condition.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breaking Down Barriers: Improving Access to Quality Endometriosis Care. 打破障碍：提高获得高质量子宫内膜异位症护理的机会。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-08-07 DOI: 10.1055/s-0045-1811188

Nathalia Nieto Rey, Jorge D Lopez I, Angélica M Quintero M, Luis F Sanabria P, Juan Diego Villegas-Echeverri

{"title":"Breaking Down Barriers: Improving Access to Quality Endometriosis Care.","authors":"Nathalia Nieto Rey, Jorge D Lopez I, Angélica M Quintero M, Luis F Sanabria P, Juan Diego Villegas-Echeverri","doi":"10.1055/s-0045-1811188","DOIUrl":"https://doi.org/10.1055/s-0045-1811188","url":null,"abstract":"Endometriosis affects an estimated 200 million women globally, yet significant barriers hinder access to timely and appropriate care. These barriers encompass various aspects, including societal normalization of menstrual pain, leading to delayed diagnosis and misinterpretation of symptoms as \"normal\" period pain. This normalization, coupled with the stigma surrounding menstrual health, often results in the dismissal of symptoms by both individuals and healthcare providers. Furthermore, access is often limited by socioeconomic factors and healthcare disparities, making specialized treatments financially prohibitive for many. There is an urgent need for a multi-pronged approach to improve access to quality endometriosis care. This includes increased education and awareness for patients, healthcare providers, and the public to destigmatize the condition and promote early recognition of symptoms. Additionally, addressing healthcare system reforms and socioeconomic disparities is essential to ensuring equitable access to effective diagnostic tools and treatment options for all affected individuals. Further research is crucial to better understand the underlying mechanisms of the disease, improve diagnostic tools, and develop more effective treatments.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Long-term Health Effects of Early Menopause. 早期绝经对健康的长期影响。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-08-01 DOI: 10.1055/s-0045-1810601

Susanna M Savukoski, Maarit Niinimäki

引用次数: 0

Endometrioma: Contemporary Approach to Diagnosis and Management. 子宫内膜瘤：当代诊断和治疗方法。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-08-01 DOI: 10.1055/s-0045-1810430

Megan Billow, Shobha Sridhar, Gabrielle Mintz

{"title":"Endometrioma: Contemporary Approach to Diagnosis and Management.","authors":"Megan Billow, Shobha Sridhar, Gabrielle Mintz","doi":"10.1055/s-0045-1810430","DOIUrl":"https://doi.org/10.1055/s-0045-1810430","url":null,"abstract":"Endometriomas affect up to 44% of women with endometriosis and are associated with chronic pelvic pain, infertility, and reduced ovarian reserve. Diagnosis and management are clinically challenging, requiring a nuanced understanding of imaging, clinical presentation, and patient goals. This review offers a comprehensive overview of the diagnosis and management of ovarian endometrioma, with a focus on clinical presentation, advanced diagnostic imaging, and treatment strategies. It addresses the complex balance between symptom relief, disease progression, fertility preservation, and long-term ovarian function, while also exploring emerging innovations in care. Endometriomas are often associated with significant pelvic pathology, including deep endometriosis and adenomyosis. Advanced imaging modalities, such as transvaginal ultrasound and magnetic resonance imaging, have significantly improved diagnostic accuracy. Management strategies range from surveillance in asymptomatic patients to medical therapy for symptom control. Surgical options of laparoscopic cystectomy remain the gold standard for patients with pain, infertility, or concerning imaging findings, but do carry the risk of affecting ovarian reserve. Emerging evidence suggests that conservative surgical techniques and postoperative hormonal therapy may reduce recurrence rates. Endometriomas represent a complex gynecological condition requiring individualized management strategies. Future research should focus on biomarkers for diagnosis and recurrence prediction, refining noninvasive diagnostic tools, and optimizing surgical techniques to minimize ovarian damage.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Understanding of Endometriosis Pathophysiology and Future Perspectives. 子宫内膜异位症病理生理学的当前认识和未来展望。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-07-30 DOI: 10.1055/s-0045-1810431

Megan L Falsetta, Emanuelle Chrysilla

{"title":"Current Understanding of Endometriosis Pathophysiology and Future Perspectives.","authors":"Megan L Falsetta, Emanuelle Chrysilla","doi":"10.1055/s-0045-1810431","DOIUrl":"https://doi.org/10.1055/s-0045-1810431","url":null,"abstract":"Endometriosis-the growth of uterine-like tissue outside the uterus-is a devastating disease that severely reduces the quality of life of those affected, resulting in missed days from school and work due to intractable pelvic pain. While endometriosis was first recognized over 100 years ago, we still do not fully understand the mechanisms of the disease, and most treatments address the symptoms of pain and discomfort but do not prevent lesion growth or disease progression. Endometriosis is a significant cause of infertility; 50% of patients seeking fertility care have endometriosis. Definitive diagnosis typically requires histological examination of excised lesional tissue, necessitating surgical excision of lesions. Therefore, many patients have a significant diagnosis delay-up to 11 years following the first onset of symptoms. While modern research technologies hold the potential to vastly improve diagnosis and treatment, women's health, particularly genitopelvic health, is understudied and underfunded. Here, we summarize what is currently known about the mechanism and ongoing efforts to develop new biomarkers and therapies that target the root causes of disease.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0