Seminars in reproductive medicine最新文献_第3页

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 : 2025-06-01 Epub Date: 2025-09-30 DOI: 10.1055/s-0045-1811965

Laura Cucinella, Anna Odone, Rossella E Nappi

引用次数: 0

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 : 2025-06-01 Epub 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":"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":"106-124"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","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

Introduction to Hanna Savolainen-Peltonen, MD, PhD. Hanna Savolainen-Peltonen医学博士简介

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-0045-1812086

Kathleen M Hoeger, Terhi T Piltonen

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 : 2025-06-01 Epub 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":"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":"134-144"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","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

Menopause and Body Composition: A Complex Field. 更年期和身体组成：一个复杂的领域。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-06-01 Epub Date: 2025-06-09 DOI: 10.1055/s-0045-1809531

Hanna-Kaarina Juppi, Jari E Karppinen, Eija K Laakkonen

{"title":"Menopause and Body Composition: A Complex Field.","authors":"Hanna-Kaarina Juppi, Jari E Karppinen, Eija K Laakkonen","doi":"10.1055/s-0045-1809531","DOIUrl":"10.1055/s-0045-1809531","url":null,"abstract":"Given that menopause affects about half of the world's midlife population, it is crucial to understand its impact beyond traditional menopausal symptomology. For instance, many women, while transitioning through menopause, experience profound changes in body composition. These changes may contribute to postmenopausal reductions in metabolic health. This narrative review explores the influence of menopause on skeletal muscle and adipose tissue, highlighting the decline in muscle mass and strength and the gain and redistribution of adipose tissue, particularly the increase in visceral adiposity. Although menopausal changes in body composition are seemingly extensively studied, the longitudinal studies are not that common, and the precise mechanisms driving body composition changes remain unclear, with uncertainties surrounding the roles of hormonal shifts compared with regular aging, energy balance, and lifestyle factors. Notably, it remains debated whether menopause or estrogen meaningfully influences resting energy expenditure. The review also considers the potential mitigating effects of menopausal hormone therapy and regular exercise. Understanding these changes is essential for developing effective strategies to support women's health during and after menopause.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"85-105"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258870","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 : 2025-06-01 Epub 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":"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":"154-162"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","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

Fertility Challenges Facing Women with Early-Stage Endometrial Cancer. 早期子宫内膜癌妇女面临的生育挑战。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-06-06 DOI: 10.1055/s-0045-1809532

Kirsten Tryde Macklon

引用次数: 0

Fertility-Sparing Treatment in Young Women Diagnosed with Endometrial Cancer: Review of Safety, Pregnancy Outcomes, and Current Recommendations. 诊断为子宫内膜癌的年轻女性保留生育能力的治疗：安全性、妊娠结局和当前建议的回顾。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-05-02 DOI: 10.1055/s-0045-1809041

Anna Mathilde Yde, Signe Frahm Bjørn, Kirsten Louise Tryde Macklon

{"title":"Fertility-Sparing Treatment in Young Women Diagnosed with Endometrial Cancer: Review of Safety, Pregnancy Outcomes, and Current Recommendations.","authors":"Anna Mathilde Yde, Signe Frahm Bjørn, Kirsten Louise Tryde Macklon","doi":"10.1055/s-0045-1809041","DOIUrl":"10.1055/s-0045-1809041","url":null,"abstract":"With the rising incidence of endometrial cancer, including among young women, and the trend of increasing age among first-time mothers, the need for safe and effective fertility-sparing treatments for endometrial cancer and atypical endometrial hyperplasia has become crucial. Focusing on studies from the past decade, this review synthesizes findings on the safety and outcomes of fertility-sparing treatments for endometrial cancer and atypical endometrial hyperplasia and provides an overview of current treatment recommendations. Fertility-sparing treatment, including hysteroscopic tumor resection followed by hormonal therapy with oral progestins and/or the insertion of a levonorgestrel-releasing intrauterine device, can be offered to a selected group of women of reproductive age who wish to preserve their ability to become pregnant in the future. The safety of conservative treatment for women diagnosed with Stage 1A, Grade 1 endometrial cancer without myometrial invasion is high; however, current evidence on the safety of this treatment for women with Grade 1, Stage 2 endometrial cancer is limited. Even though the success rate in terms of pregnancies and deliveries is high, it is not as high as in the general population, and women should be informed of the potential need for assisted reproductive technology.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"47-53"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051338","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

Fertility Following Fertility-Sparing Surgery for Borderline Ovarian Tumors. 边缘性卵巢肿瘤保留生育能力手术后的生育能力。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-07-23 DOI: 10.1055/s-0045-1810420

Stefan Cosyns, Michel De Vos

{"title":"Fertility Following Fertility-Sparing Surgery for Borderline Ovarian Tumors.","authors":"Stefan Cosyns, Michel De Vos","doi":"10.1055/s-0045-1810420","DOIUrl":"10.1055/s-0045-1810420","url":null,"abstract":"Borderline ovarian tumors (BOTs) are commonly diagnosed in women of reproductive age, raising concerns about the impact of surgical management on fertility. This review explores the role of fertility-sparing surgery (FSS) and fertility preservation (FP) strategies in young women diagnosed with BOTs. While FSS carries a slightly higher risk of recurrence compared to bilateral salpingo-oophorectomy, there is growing evidence supporting the safety of FSS, with no adverse effects on 10-year overall survival. In light of this, recent multidisciplinary guidelines recommend FSS for BOT at all stages. A significant proportion of women with BOTs report infertility prior to diagnosis, suggesting a possible pathophysiological link between reduced reproductive fitness and the development of BOT. The potential association between ovarian stimulation (OS) and an increased risk of BOT remains controversial, with current evidence failing to establish a definitive causal link. For women with recurrent stage I BOT and no evidence of peritoneal disease on imaging, OS followed by oocyte retrieval is a viable option before definitive surgery. Notably, a history of BOT does not significantly affect pregnancy outcomes following IVF. FP counseling is essential to tailor treatment plans that address both oncological and reproductive needs in patients undergoing FSS for BOT.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"23-31"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699389","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

After Radical Trachelectomy: Reproductive and Obstetrical Outcomes of Fertility-Sparing Surgery for Cervical Cancer. 根治性气管切除术后：保留生育能力的宫颈癌手术的生殖和产科结果。

IF 1.4 3区医学

Seminars in reproductive medicine Pub Date : 2025-03-01 Epub Date: 2025-04-17 DOI: 10.1055/s-0045-1808092

Sinor Soltanizadeh, Mikkel Rosendahl, Ligita Paskeviciute Frøding, Signe Frahm Bjørn, Berit Jul Mosgaard, Claus Høgdall

{"title":"After Radical Trachelectomy: Reproductive and Obstetrical Outcomes of Fertility-Sparing Surgery for Cervical Cancer.","authors":"Sinor Soltanizadeh, Mikkel Rosendahl, Ligita Paskeviciute Frøding, Signe Frahm Bjørn, Berit Jul Mosgaard, Claus Høgdall","doi":"10.1055/s-0045-1808092","DOIUrl":"10.1055/s-0045-1808092","url":null,"abstract":"Radical trachelectomy has become an accepted fertility-sparing treatment for patients with early-stage cervical cancer. Despite its oncological safety, radical trachelectomy is associated with persistent sexual dysfunction and voiding issues, complicating long-term quality of life. Fertility outcomes demonstrate overall pregnancy rates ranging from 25.7-73%, with less radical procedures such as conization and simple trachelectomy reporting higher pregnancy rates compared with radical trachelectomy. Assisted reproductive treatments might be necessary due to complications such as cervical stenosis. During pregnancy, there is an elevated risk of miscarriage, preterm delivery, and premature rupture of membranes due to cervical shortening. However, less radical fertility-sparing procedures such as conization and simple trachelectomy demonstrate lower preterm delivery rates. Prophylactic cerclage, as well as close monitoring of cervical length during pregnancy, is essential, and cesarean section remains the recommended method of delivery. Recent studies suggest that less radical fertility-sparing procedures may provide comparable oncological safety while reducing complications, highlighting the need to reevaluate surgical approaches. This review provides an overview of reproductive and obstetrical outcomes in patients after treatment for early-stage cervical cancer with trachelectomy. This review additionally emphasizes the need for further research to refine fertility-sparing strategies.","PeriodicalId":21661,"journal":{"name":"Seminars in reproductive medicine","volume":" ","pages":"11-15"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028402","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