Seminars in reproductive medicine最新文献_第2页

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 : 2025-09-01 Epub 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":"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":"167-179"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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

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 : 2025-09-01 Epub 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":"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":"180-188"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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

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 : 2025-09-01 Epub 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":"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":"202-213"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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

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 : 2025-09-01 Epub 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":"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":"221-230"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","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

Endometriosis. 子宫内膜异位症。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-09-01 Epub Date: 2026-01-20 DOI: 10.1055/s-0045-1814078

Kathleen M Hoeger, Terhi T Piltonen

引用次数: 0

Endometriosis. 子宫内膜异位症。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-09-01 Epub Date: 2026-01-20 DOI: 10.1055/s-0045-1813025

Michael S Rogers, Megan Kennedy Burns

引用次数: 0

Noninvasive Imaging Diagnostics for Endometriosis. 子宫内膜异位症的无创影像诊断。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-09-01 Epub Date: 2026-01-20 DOI: 10.1055/s-0045-1813023

Marcela Caetano Vilela Lauar, Cinthia Callegari Barbisan, Silvia Leite, Marina Paula Andres, Mauricio Simões Abrão

引用次数: 0

Menopause/Aging. 更年期/老化。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-06-01 Epub Date: 2025-10-27 DOI: 10.1055/s-0045-1812085

Hanna Savolainen-Peltonen

引用次数: 0

Progestogens in Menopausal Hormone Therapy: A Double-Edged Sword. 绝经期激素治疗中的孕激素：一把双刃剑。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-06-01 Epub Date: 2025-05-16 DOI: 10.1055/s-0045-1809186

Olavi Ylikorkala, Johanna M Joensuu, Heli Siitonen, Tomi S Mikkola

{"title":"Progestogens in Menopausal Hormone Therapy: A Double-Edged Sword.","authors":"Olavi Ylikorkala, Johanna M Joensuu, Heli Siitonen, Tomi S Mikkola","doi":"10.1055/s-0045-1809186","DOIUrl":"10.1055/s-0045-1809186","url":null,"abstract":"Progestogens (norethisterone acetate, medroxyprogesterone acetate, dydrogesterone, micronized progesterone, levonorgestrel, drospirenone, and trimegestone) added to estrogen for endometrial protection are reviewed. They can be given orally or vaginally, norethisterone acetate can also be given transdermally, and levonorgestrel can be given through the intrauterine route. Sequential use of progestogens protects the endometrium if exposure lasts for at least 12 days/month; longer intervals are not safe. Continuous use of progestogens, whether oral, transdermal, or intrauterine, provides the most effective protection. Progestogen addition is accompanied with significant elevations in breast cancer risk, the largest drawback of progestogen use, and dydrogesterone, micronized progesterone, and a levonorgestrel intrauterine device may be safest in this regard. Progestogens also double deep vein thrombosis risk and diminish the positive effect of estrogen on colorectal cancer and vascular health. Recent data imply a neutral effect of progestogens in combination with estrogen on Alzheimer's disease risk, but the risk of vascular dementia is decreased. In conclusion, progestogens are a double-edged sword, effectively protecting the endometrium but causing several side effects and reducing many estrogen-induced benefits. With modern endometrial diagnostic tools, the safety of low-dose unopposed estrogen regimens should be assessed in a prospective controlled trial in women with an intact uterus.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"145-153"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086592","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 : 2025-06-01 Epub Date: 2025-08-01 DOI: 10.1055/s-0045-1810601

Susanna M Savukoski, Maarit Niinimäki

引用次数: 0