Current Opinion in Obstetrics & Gynecology最新文献

GLP-1 receptor agonists for weight loss for perimenopausal and postmenopausal women: current evidence.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-19 DOI: 10.1097/GCO.0000000000001015

Hana Mikdachi, Rebecca Dunsmoor-Su

引用次数: 0

Menopause and mental health.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-19 DOI: 10.1097/GCO.0000000000001014

Karen Horst, Nicole Cirino, Karen E Adams

{"title":"Menopause and mental health.","authors":"Karen Horst, Nicole Cirino, Karen E Adams","doi":"10.1097/GCO.0000000000001014","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001014","url":null,"abstract":"Purpose of review: This review discusses mental health changes commonly experienced by individuals during the menopause transition (MT). The pathophysiology of the MT, the chronology and type of mental health symptoms arising from this pathophysiology, and evidence-based options for treating midlife patients are discussed. This review concludes with treatment options to enable clinicians to more effectively counsel, recognize and treat symptoms during the MT.Recent findings: The MT begins earlier than previously understood with mood and cognitive issues as common initial mental health symptoms significantly impacting quality of life. These symptoms are due to profound changes in the brain's structure, connectivity, energy metabolism, and inflammation linked to perimenopausal hormone shifts. Hormone therapy, psychiatric medication, psychotherapy, and lifestyle adjustments all play a role in the management of mental health symptoms arising during the MT. Lack of both obstetrician and gynecologist and mental health clinician awareness can leave patients undertreated and vulnerable to nonevidence-based approaches.Summary: Patients in the MT are at increased risk for mental health issues, both preexisting and new onset. The OB/GYN clinician plays a key role in recognizing and addressing these conditions to improve health outcomes in midlife women.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460839","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

Subclinical hypothyroidism in pregnancy: an evolving and controversial landscape.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-19 DOI: 10.1097/GCO.0000000000001019

Laurel Aberle, Caroline T Nguyen

{"title":"Subclinical hypothyroidism in pregnancy: an evolving and controversial landscape.","authors":"Laurel Aberle, Caroline T Nguyen","doi":"10.1097/GCO.0000000000001019","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001019","url":null,"abstract":"Purpose of review: This review aims to elucidate the developments in subclinical hypothyroidism (SCH) in pregnancy effects, management, and treatment. While mostly focusing on recent research, landmark studies are briefly reviewed to highlight major developments since their publication.Recent findings: Research has continued to show an increased risk of adverse outcomes in pregnant women with SCH, with recent research showing an increased risk of both impaired glucose tolerance and hypertensive disorders of pregnancy. Research has continued to show unclear effects of SCH on neonatal outcomes, specifically in offsprings' intellectual development and ability. The benefit of treatment of SCH continues to be unclear; however, data suggest that treatment for thyroid stimulating hormone (TSH) 2.5-4 mU/l regardless of thyroid peroxidase antibodies status and TSH 4-10 mU/l in later pregnancy has not shown maternal or neonatal benefit.Summary: With varying guidelines and inconsistent research outcomes, it is not surprising that SCH practices differ widely. Further research, with uniform definitions and criteria of SCH, is needed to elucidate the optimal management and treatment of this common pregnancy condition. Additionally, further research specifically aimed at optimizing TSH in preconception and early pregnancy is needed.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460855","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

A review of menopause in transgender and gender diverse individuals.

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-14 DOI: 10.1097/GCO.0000000000001013

Carly E Kelley, Danit Ariel

{"title":"A review of menopause in transgender and gender diverse individuals.","authors":"Carly E Kelley, Danit Ariel","doi":"10.1097/GCO.0000000000001013","DOIUrl":"https://doi.org/10.1097/GCO.0000000000001013","url":null,"abstract":"Purpose of review: This review aims to provide a comprehensive overview of the specific challenges, health considerations, and healthcare needs of transgender and gender diverse (TGD) people navigating menopause, highlighting the intersection of gender identity, hormone treatment, and age-related changes.Recent findings: Research on menopause in TGD individuals is lacking, without guidelines to support clinical management. This is the first review of its type to summarize the described impact of the menopausal transition on TGD individuals, the potential long-term risks associated with both gender-affirming hormone therapy and the intersectionality with aging, and how these risks may impact hormone management and overall comprehensive care.Summary: By drawing on the shared principles of cisgender menopausal hormone therapy and gender-affirming hormone therapy, providers are well positioned to apply their expertise to support the TGD population during menopause. We recommend using shared decision-making, culturally competent care, and a strong understanding of the biological, personal, and social experiences of TGD people that do not necessarily conform to stereotypically ciswoman experiences.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460835","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

Antibody-drug conjugates as targeted therapy for treating gynecologic cancers: update 2025. 抗体药物结合物作为治疗妇科癌症的靶向疗法：2025 年更新。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2024-11-04 DOI: 10.1097/GCO.0000000000001002

Jordyn Silverstein, Beth Karlan, Nasim Herrington, Gottfried Konecny

{"title":"Antibody-drug conjugates as targeted therapy for treating gynecologic cancers: update 2025.","authors":"Jordyn Silverstein, Beth Karlan, Nasim Herrington, Gottfried Konecny","doi":"10.1097/GCO.0000000000001002","DOIUrl":"10.1097/GCO.0000000000001002","url":null,"abstract":"Purpose of review: Provide the most up-to-date information on the dynamic landscape of antibody-drug conjugates (ADCs) in gynecologic cancers. We discuss the latest research that supports the approved ADCs and outline the ongoing trials and preliminary results that may lead to ADC approvals in the future. Current gaps in knowledge and areas for future research are discussed.Recent findings: ADCs are rapidly changing the landscape of gynecologic cancer care. Three ADCs are currently FDA approved and used routinely in clinical practice, with many more currently in clinical development. The most common ADC target is folate receptor alpha of which there are 8 different folate receptor targeting ADCs in development. Other targets under investigation include trophoblast cell surface antigen-2 (Trop-2), claudin-6 (CLDN6), cadherin-6 (CDH6), nectin-4, HER-2 and B7-H4. ADCs can cause new and unique adverse effects, including ocular toxicities and interstitial lung disease.Summary: ADCs offer the opportunity for a more effective and personalized treatment approach for gynecologic cancer patients. Side effects must be closely monitored, and preventive measures must be followed to maximize benefit and minimize toxicity. A better understanding of the role of target proteins as biomarkers to predict response to ADCs will be critical for successful clinical implementation of ADCs and further research in this area is necessary.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"5-15"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11676621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559516","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

Menopausal hormone therapy for breast cancer survivors. 乳腺癌幸存者的绝经激素治疗。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2024-10-18 DOI: 10.1097/GCO.0000000000001001

Annabelle Huguenin

{"title":"Menopausal hormone therapy for breast cancer survivors.","authors":"Annabelle Huguenin","doi":"10.1097/GCO.0000000000001001","DOIUrl":"10.1097/GCO.0000000000001001","url":null,"abstract":"Purpose of review: The global incidence of breast cancer continues to increase and increasing efficacy of treatments has improved overall prognosis and survival with a resulting requisite focus on improving quality of life after cancer. Treatment inevitably results in symptoms of menopause and these symptoms may be more severe after cancer treatment compared to natural menopause and may pose a potential risk of early treatment discontinuation. Consequently, the global burden of successfully managing these symptoms is significant.Recent findings: There is a discordance between randomized and observational data regarding the risk of systemic menopausal hormone therapy and breast cancer recurrence; hormone receptor status is significant to recurrence risk in this setting. The systemic absorption of local oestrogen is not a consistent surrogate marker for cancer recurrence and clinical data has not demonstrated a consistent increase in the risk of cancer recurrence with local therapy.Summary: Nonhormonal treatments remain first-line management of menopause symptoms in breast cancer survivors to minimize the risk of cancer recurrence. However, severe symptoms not responding to nonhormonal interventions require a multidisciplinary, patient-centred approach to discuss the evidence base for hormonal treatments.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"37-41"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481399","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

Updates in palliative care of gynecologic oncology patients. 妇科肿瘤患者姑息治疗的最新进展。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2024-10-08 DOI: 10.1097/GCO.0000000000001000

Teresa Khoo, Daniel Karlin, Christopher Pietras

{"title":"Updates in palliative care of gynecologic oncology patients.","authors":"Teresa Khoo, Daniel Karlin, Christopher Pietras","doi":"10.1097/GCO.0000000000001000","DOIUrl":"10.1097/GCO.0000000000001000","url":null,"abstract":"Purpose of review: This review assesses the impact of early integration of palliative care and the disparities that exist among patients with gynecologic malignancies. It also highlights the recent advances in symptom management, goals of care communication, and end of life care.Recent findings: Although palliative care has been utilized earlier, there are still barriers to its integration both nationally and worldwide, manifesting as predominantly late hospice referrals and aggressive care at the end of life. However, there are increasing efforts to promote earlier integration and discussion around goals of care through multidisciplinary approaches. Apart from symptom burdens, patients with gynecologic malignancies experience financial toxicity that impact various aspects of their lives, leading to potentially harmful choices to mitigate costs. A growing area of interest in palliative care is the realm of psychedelic-assisted therapy, which has shown benefits in treating advanced cancer patients with depression.Summary: While significant strides have been made in incorporating palliative care earlier, continued research in palliative care is needed to address symptomatic and psychosocial suffering worldwide.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900561","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

Prevention of gynecological cancers: cervical cancer screening in Turkey: a role model for the world. 预防妇科癌症：土耳其的子宫颈癌筛查：世界的榜样。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2024-12-06 DOI: 10.1097/GCO.0000000000000998

Utku Akgör, Bilal Esat Temiz, Murat Gültekin

{"title":"Prevention of gynecological cancers: cervical cancer screening in Turkey: a role model for the world.","authors":"Utku Akgör, Bilal Esat Temiz, Murat Gültekin","doi":"10.1097/GCO.0000000000000998","DOIUrl":"https://doi.org/10.1097/GCO.0000000000000998","url":null,"abstract":"Purpose of review: This review examines Turkey's cervical cancer screening programme, highlighting its evolution from a cytology-based approach to a more effective HPV-based strategy. The review is timely given the global push to reduce cervical cancer incidence through improved screening practices, and it positions Turkey's programme as a potential model for other countries facing similar public health challenges.Recent findings: Recent advances in cervical cancer screening in Turkey include the nationwide introduction of HPV DNA testing, centralized laboratory systems and innovative management software. The programme has significantly improved screening coverage and early detection rates, particularly in underserved communities. However, challenges remain in areas such as training healthcare workers, raising awareness of HPV vaccination, and integrating self-sampling methods into the screening process.Summary: The Turkish experience demonstrates that a well organized HPV-based cervical cancer screening programme can overcome significant cultural and logistical barriers and lead to improved public health outcomes. Future efforts should focus on refining triage strategies, exploring new molecular tests, and expanding the use of self-sampling to further improve the effectiveness of cervical cancer prevention efforts worldwide.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":"37 1","pages":"30-36"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923492","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

Current opinions: updates on the changing landscape in the management of cervical cancer. 最新意见：有关子宫颈癌管理的最新情况。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2024-09-26 DOI: 10.1097/GCO.0000000000000999

Puja S Venkat, Alexandra H Smick, Ritu Salani

{"title":"Current opinions: updates on the changing landscape in the management of cervical cancer.","authors":"Puja S Venkat, Alexandra H Smick, Ritu Salani","doi":"10.1097/GCO.0000000000000999","DOIUrl":"10.1097/GCO.0000000000000999","url":null,"abstract":"Purpose of review: To review the recent updates in the management of cervical cancer across all stages of the disease.Recent findings: After decades of minor advances, the landscape in cervical cancer is now rapidly changing. Recent studies have reported across the cervical cancer spectrum and on different therapeutic modalities. First, less radical surgery in the assessment and management of patients with early-stage, low-risk disease has been shown to be a safe option with reduced morbidity. The role of checkpoint inhibitor therapy in combination with chemotherapy and radiation has demonstrated improved survival outcomes, moving immunotherapy to earlier lines of therapy. The options for systemic therapy continue to include checkpoint inhibitors as well as treatment with antibody drug conjugates (ADCs) in the recurrent setting. Additional research continues to focus on targeting biomarkers in this disease.Summary: In this paper, we will review the practice-changing trials impacting early stage, locally advanced, and recurrent cervical cancer patients. Despite advances, the limited survival for these patients continues to highlight the need for access to preventive healthcare (vaccine/cytology) and clinical trials to continue to make advances.","PeriodicalId":55194,"journal":{"name":"Current Opinion in Obstetrics & Gynecology","volume":" ","pages":"16-21"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900557","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

Editorial introductions. 编辑介绍。

IF 2.2 4区医学

Current Opinion in Obstetrics & Gynecology Pub Date : 2025-02-01 Epub Date: 2025-01-02 DOI: 10.1097/GCO.0000000000001006

引用次数: 0