Current Opinion in Obstetrics & Gynecology最新文献

New management approaches for female sexual dysfunction. 女性性功能障碍的新管理方法。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-07-31 DOI: 10.1097/GCO.0000000000000984

Lori A Brotto, Melanie Altas

{"title":"New management approaches for female sexual dysfunction.","authors":"Lori A Brotto, Melanie Altas","doi":"10.1097/GCO.0000000000000984","DOIUrl":"10.1097/GCO.0000000000000984","url":null,"abstract":"Purpose of review: The goal of this paper is to review the most recent studies evaluating treatments for female sexual dysfunction (FSD), including distressing symptoms of desire, arousal, and orgasm disorder. We divide the sections into psychological and pharmacological.Recent findings: There is excellent evidence in favour of mindfulness, cognitive behavioural therapy, and psychoeducation for improving low sexual desire in women, and less evidence in support of these approaches to address other sexual dysfunctions in women. There are two US Food and Drug Administration (FDA) approved pharmacological treatments for low desire in premenopausal women that have modest benefits above placebo, and a significant proportion of users will experience side effects. Evidence also supports the use of transdermal testosterone for low desire in postmenopausal women.Summary: Sexual dysfunction in women is common and distressing, and there are a variety of psychological and pharmacological treatments. More research is needed to better understand the predictors of a positive treatment response in order to deliver more personalized care.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Unravelling the vaginal microbiome, impact on health and disease. 揭示阴道微生物群对健康和疾病的影响。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-07-15 DOI: 10.1097/GCO.0000000000000976

Erica L Plummer, Lenka A Vodstrcil, Catriona S Bradshaw

{"title":"Unravelling the vaginal microbiome, impact on health and disease.","authors":"Erica L Plummer, Lenka A Vodstrcil, Catriona S Bradshaw","doi":"10.1097/GCO.0000000000000976","DOIUrl":"10.1097/GCO.0000000000000976","url":null,"abstract":"Purpose of review: The vaginal microbiome has a fundamental role in supporting optimal vaginal, reproductive, and sexual health. Conversely, dysbiosis of the vaginal microbiome is linked to vaginal symptoms and adverse health outcomes. This review summarizes recent literature concerning the role of the vaginal microbiome in health and disease, with a focus on the most common vaginal dysbiosis, bacterial vaginosis.Recent findings: Molecular studies have expanded our understanding of the composition of the vaginal microbiome. Lactic acid-producing lactobacilli are an important component of host defences against pathogens, whereas a paucity of lactobacilli is associated with adverse sequelae. Bacterial vaginosis is characterized by low levels of lactobacilli and increased levels of nonoptimal anaerobes; however, the exact cause remains unclear. Furthermore, despite decades of research, bacterial vaginosis recurrence rates following standard treatment are unacceptably high. Strategies to improve bacterial vaginosis cure and promote an optimal lactobacilli-dominated vaginal microbiome are being investigated. Importantly, historical and emerging evidence supports the sexual transmission of bacterial vaginosis, which opens exciting opportunities for novel treatments that incorporate partners.Summary: A mechanistic and deeper understanding of the vaginal microbiome in health and disease is needed to inform ongoing development of therapeutics to improve bacterial vaginosis cure. Partner treatment holds promise for improving bacterial vaginosis cure.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Medical management of endometriosis. 子宫内膜异位症的药物治疗。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-17 DOI: 10.1097/GCO.0000000000000983

Anais Alonso, Kate Gunther, Sarah Maheux-Lacroix, Jason Abbott

{"title":"Medical management of endometriosis.","authors":"Anais Alonso, Kate Gunther, Sarah Maheux-Lacroix, Jason Abbott","doi":"10.1097/GCO.0000000000000983","DOIUrl":"10.1097/GCO.0000000000000983","url":null,"abstract":"Purpose of review: While laparoscopic surgery plays a key role in the management of endometriosis, symptoms commonly recur, and repeat surgery comes with increased risk. Medical management, including hormonal and nonhormonal treatment, is vital in managing painful symptoms. This review summarizes recent evidence regarding various medical management options available to treat pelvic pain associated with endometriosis.Recent findings: Efficacy of dienogest vs. combined oral contraceptive on pain associated with endometriosis: randomized clinical trial.Once daily oral relugolix combination therapy vs. placebo in patients with endometriosis-associated pain: two replicate phase 3, randomised, double-blind, studies (SPIRIT 1 and 2).A randomized, double-blind, placebo-controlled pilot study of the comparative effects of dienogest and the combined oral contraceptive pill in women with endometriosis.Two-year efficacy and safety of relugolix combination therapy in women with endometriosis-associated pain: SPIRIT open-label extension study.Summary: All symptomatic women with suspected endometriosis who are not desiring immediate fertility can be offered suppressive treatment to control symptoms and slow the progression of disease. First-line treatments include the combined oral contraceptive pill and progestogens. Second-line treatments include gonadotropin-releasing hormone agonists and antagonists but current guidelines recommend that these should be reserved for people whose symptoms fail to be controlled by first-line agents. The use of complementary and alternative medicines is also increasing in both volume and number of agents used.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005969","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}

引用次数: 0

Providing adolescent-friendly sexually transmitted infection screening and treatment services. 提供适合青少年的性传播感染筛查和治疗服务。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI: 10.1097/GCO.0000000000000978

Julie C Friedman, Bianca Cannon, Nichole Tyson, Melissa Kang

{"title":"Providing adolescent-friendly sexually transmitted infection screening and treatment services.","authors":"Julie C Friedman, Bianca Cannon, Nichole Tyson, Melissa Kang","doi":"10.1097/GCO.0000000000000978","DOIUrl":"10.1097/GCO.0000000000000978","url":null,"abstract":"Purpose of review: There are high rates of sexually transmitted infections (STIs) worldwide. Adolescents and young adults (AYA) ages 15-24 years remain one of the populations that is most vulnerable to STIs. The goal of this review is to summarize recent international updates in adolescent STI screening and treatment.Recent findings: Normalizing sexual history taking and STI testing, and advocating for adolescents to receive comprehensive sexuality education improves stigma surrounding sexual health. The global rise in syphilis is pervasive and includes high rates of infection among AYA and women of reproductive age - universal screening may be indicated depending on local epidemiology. Gonococcal antimicrobial resistance remains a significant public health concern worldwide, thus judicious use of antimicrobials and reporting cases of resistance is crucial. Sexual health services are increasingly using virtual platforms, which may be an effective strategy for STI testing and treatment among AYA.Summary: Specific areas of focus to address the STI epidemic among AYA include reducing stigma surrounding sexual health, screening, and treatment of STIs, especially with the global rise in syphilis and high rates of gonorrhea resistance, in addition to increased use of telehealth services as effective education and intervention strategies.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Enhancing equity in cervical screening - initiatives to increase screening participation. 加强宫颈癌筛查的公平性--提高筛查参与率的举措。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-07-22 DOI: 10.1097/GCO.0000000000000979

Telma Costa, Deborah Bateson, Yin Ling Woo

{"title":"Enhancing equity in cervical screening - initiatives to increase screening participation.","authors":"Telma Costa, Deborah Bateson, Yin Ling Woo","doi":"10.1097/GCO.0000000000000979","DOIUrl":"10.1097/GCO.0000000000000979","url":null,"abstract":"Purpose of review: Cervical cancer can be eliminated as a public health problem through a three-pillar approach including high coverage of human papillomavirus (HPV) vaccination and HPV-based cervical screening, and treatment of precancers and invasive cancers. However, access inequities prevent many women and people with a cervix benefitting from these life-saving advances. This review focuses on evidence-based interventions that can improve equity and scale-up of cervical screening.Recent findings: The transition from conventional cytology to HPV screening provides multiple opportunities to address equity and a multipronged approach can be used to identify priority groups, understand barriers and develop tailored solutions. There are proven financing mechanisms, tools, technologies and screening delivery methods to overcome screening barriers in different settings. This includes self-sampling interventions, point-of-care testing, health service integration, consumer-led co-design processes and digital screening registries.Summary: To achieve cervical cancer elimination globally, cervical screening must be delivered in an inclusive, culturally safe and context-appropriate manner. There are multiple tools and strategies that can be implemented to improve participation of never- and under-screened groups, and to enhance equity in cervical screening.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Expanding access to postpartum contraception. 扩大产后避孕的覆盖面。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.1097/GCO.0000000000000982

Michelle Cooper, Kirsten Black, Sharon Cameron

{"title":"Expanding access to postpartum contraception.","authors":"Michelle Cooper, Kirsten Black, Sharon Cameron","doi":"10.1097/GCO.0000000000000982","DOIUrl":"10.1097/GCO.0000000000000982","url":null,"abstract":"Purpose of review: Women are particularly vulnerable to unintended pregnancy in the 12 months following a birth. Improving access to postpartum contraception within maternity settings can prevent unintended and closely spaced births, improving the health of mother and child. This review will summarize the recent research in postpartum contraception (PPC), building on existing knowledge and developments in this field.Recent findings: Current models of postpartum contraceptive provision may not adequately meet women's needs. The COVID-19 pandemic led to changes in postpartum contraceptive provision, with an increasing emphasis placed on maternity services. Antenatal contraceptive discussion is associated with increased postpartum contraceptive planning and uptake of methods after birth. Digital health interventions may be a useful tool to support information about contraception. The most effective long-acting reversible contraceptive (LARC) methods, such as the intrauterine device (IUD) and implant, can be challenging to provide in the maternity setting because of availability of trained providers. Postpartum IUD insertion remains relatively under-utilized, despite evidence supporting its safety, efficacy and cost-effectiveness.Summary: Antenatal information needs to be partnered with access to the full range of methods immediately after birth to reduce barriers to PPC uptake. Training and education of maternity providers is central to successful implementation of PPC services.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898966","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}

引用次数: 0

Editorial introduction. 编辑介绍。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI: 10.1097/GCO.0000000000000985

引用次数: 0

No test medical abortion - a review of the evidence on selective use of preabortion testing. 无检查药物流产--对选择性使用流产前检查证据的审查。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-12 DOI: 10.1097/GCO.0000000000000981

Amanda Cleeve, Emma Wallengren, Karin Brandell, Sabrina Lee, Margit Endler, John Reynolds-Wright

{"title":"No test medical abortion - a review of the evidence on selective use of preabortion testing.","authors":"Amanda Cleeve, Emma Wallengren, Karin Brandell, Sabrina Lee, Margit Endler, John Reynolds-Wright","doi":"10.1097/GCO.0000000000000981","DOIUrl":"10.1097/GCO.0000000000000981","url":null,"abstract":"Purpose of review: The last decade has seen a cascade of different telemedicine models for medical abortion (MA) being tested and implemented. Among these service delivery models is the 'no-test' MA model, in which care is provided remotely and eligibility for the MA is based on history alone. The purpose of this review is to provide an overview of the existing evidence for no-test MA.Recent findings: The evidence base for no-test MA relies heavily on cohort and noncomparative studies predominantly from high resource settings. Recent findings indicate that no-test MA is safe, effective, and highly acceptable. Diagnoses of ectopic pregnancy and underestimation of gestational age were rare. Identified advantages included shortening time to access MA and mitigating access barriers such as cost, and geographical barriers. Abortion seekers valued omitting the ultrasound citing reasons such as privacy concerns, costs, more flexibility, and control. The impacts of no-test MA on unscheduled postabortion contacts and visits and on contraceptive use were unclear due to limited evidence.Summary: No-test MA can be provided to complement other care pathways including those with some or no in-person care. Further research is needed to allow for widespread adoption of no-test MA and scale-up in a variety of contexts, including low-resource settings.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Ergonomic considerations for unique surgeon populations. 针对特殊外科医生群体的人体工学考虑因素。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-05-21 DOI: 10.1097/GCO.0000000000000968

Emily Olig, Gina Ranieri, Michelle Louie

{"title":"Ergonomic considerations for unique surgeon populations.","authors":"Emily Olig, Gina Ranieri, Michelle Louie","doi":"10.1097/GCO.0000000000000968","DOIUrl":"10.1097/GCO.0000000000000968","url":null,"abstract":"Purpose of review: Surgeons are rapidly diversifying as a population, introducing new ergonomic challenges. This review describes the challenges that are experienced by special populations of surgeons including small-handed surgeons, pregnant surgeons, and trainees, and evidence-based solutions to overcome them.Recent findings: Small-handed and female surgeons report more musculoskeletal complaints compared with their male counterparts. Pregnant surgeons frequently report development or worsening of musculoskeletal disorders such as carpal tunnel syndrome and low back pain. Trainees also report high rates of musculoskeletal complaints with minimal autonomy to alter their environment. Limited objective data exists regarding the ideal instruments currently available for special populations. Several small, randomized studies have proposed exercise regimens targeting the upper extremities and pregnancy-related pain syndromes with improvements in symptoms. Various methods of ergonomic education have been studied in trainees with improvements in operating room posture and performance.Summary: Limited objective data is available to recommend specific surgical instruments for high-risk surgeon populations. Beneficial exercise regimens have been described for musculoskeletal disorders commonly plaguing surgeons but have yet to be studied explicitly in small-handed or pregnant surgeons and trainees.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 endocrinology and infertility in 2024: promise and turmoil. 2024 年的生殖内分泌与不孕症：希望与动荡。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2024-08-01 Epub Date: 2024-06-27 DOI: 10.1097/GCO.0000000000000964

Ruben Alvero

引用次数: 0