BMC Women's Health最新文献

{"title":"Advances in the diagnosis and treatment of primary malignant melanoma of the vagina- a case presentation and systematic review.","authors":"Chengbin Lu, Die Fan, Yu Xiong, Xiaoxia Jiang, Jiangsha Li, Ping Yang, Yuanlong Shi, Hongmei Li, Zheng Li","doi":"10.1186/s12905-025-03980-0","DOIUrl":"10.1186/s12905-025-03980-0","url":null,"abstract":"<p><strong>Background: </strong>Primary Vaginal Melanoma (PVM) is a rare and highly aggressive malignancy, accounting for only 0.3-0.8% of all female melanomas, with an extremely poor prognosis.</p><p><strong>Objectives: </strong>This study aims to present the diagnostic process, surgical management, and postoperative chemotherapy options in a patient initially diagnosed with vaginal neuroendocrine carcinoma, later confirmed to have PVM. Additionally, we provide a systematic review to enhance awareness of PVM, reduce misdiagnosis, and improve early detection.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted, and a case report was analyzed.</p><p><strong>Results: </strong>A total of 89 publications were reviewed, summarizing the various treatment strategies and survival outcomes for PVM. In the reported case, postoperative pathology confirmed the diagnosis of PVM, differentiating it from primary vaginal neuroendocrine carcinoma. The treatment involved partial vaginal excision and removal of lesions from the posterior vaginal wall, followed by adjuvant chemotherapy with temozolomide and cisplatin.</p><p><strong>Conclusion: </strong>PVM is highly malignant with a poor prognosis, and surgical resection remains the primary treatment modality; however, its efficacy is limited. While chemotherapy may benefit some patients, the five-year survival rate ranging from 5 to 25%. Therefore, the development of novel therapeutic strategies is crucial. Recent advancements in immunotherapy and targeted therapies targeting BRAF/KIT mutations show promise, but standardized diagnostic and treatment protocols are still lacking. Future multicenter, long-term studies are needed to develop individualized treatment plans based on molecular profiling, providing an evidence-based approach to optimize diagnostic strategies and improve survival rates.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"444"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate partner violence and mental health outcomes among ever-married women in Mozambique.","authors":"Marifa Muchemwa, Million Phiri, Marcus Hollington, Tholene Sodi","doi":"10.1186/s12905-025-03990-y","DOIUrl":"10.1186/s12905-025-03990-y","url":null,"abstract":"<p><strong>Background: </strong>Intimate partner violence (IPV) is linked to adverse mental health outcomes. Despite its widespread prevalence and devastating consequences, the mental health impacts of IPV remain understudied in Mozambique. We examined the association between IPV and mental health outcomes among ever-married women in Mozambique.</p><p><strong>Methods: </strong>This study adopted a cross-sectional design based on the most recent Mozambique Demographic and Health Survey (MDHS) conducted in 2022-23. The sample comprised of 3,957 ever-married women aged between 15 and 49 years. The outcome variable for our study is mental health outcomes specifically focusing on depressive and anxiety symptoms. The main independent variable is IPV, focusing on three forms: physical, sexual and emotional violence each measured as a binary variable (yes/no). A multivariate analysis using binary logistic regression was performed between IPV and mental health outcomes while controlling for other independent variables. Adjusted odds ratios (aOR) and their corresponding 95% confidence intervals (95% CI) were reported. All analyses were weighted to account for complex survey design.</p><p><strong>Results: </strong>The prevalence of depressive symptoms was 11.5% (95% CI: 9.7-13.5) while that of anxiety symptoms was 29.9% (95% CI: 27.5-32.4). Ever-married women who experienced physical violence had significantly higher odds of depressive symptoms (aOR = 1.52, 95% CI: 1.01-2.30). Emotional violence was significantly associated with both depressive symptoms (aOR = 3.10; 95% CI: 2.08-4.61) and anxiety symptoms (aOR = 1.60; 95% CI: 1.22-2.11).</p><p><strong>Conclusion: </strong>The findings highlight the need to integrate mental health services into IPV prevention and response programmes in Mozambique. Incorporating routine mental health screening within IPV services could enable early identification and timely support for victims.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"447"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of female condom utilisation among women of reproductive age (15-49 years) in Rakai district, Uganda: a cross-sectional study.","authors":"Ahumuza Shannon, Nwanna Uchechukwu Kevin, Mojeed Akorede Gbadamosi","doi":"10.1186/s12905-025-03977-9","DOIUrl":"10.1186/s12905-025-03977-9","url":null,"abstract":"<p><strong>Background: </strong>The female condom serves as a dual protective device, preventing the spread of HIV/AIDS, unintended pregnancies and other sexually transmitted infections (STIS). When it comes to sexual protection and contraception, the female condom is an essential tool for women's empowerment. Females are more susceptible than males to acquiring STIs due to their biological makeup. Females are particularly vulnerable to sexual abuse following substance use. The uptake of female condoms has been a significant challenge in Uganda, and their uptake remains low. Limited research exists on the subject of female condom use in Uganda; hence, this study was undertaken and used the Health Belief Model to investigate the prevalence and factors associated with the use of female condoms among women of reproductive age in Rakai district, Uganda.</p><p><strong>Methods: </strong>This cross-sectional study used a multistage random sampling method with a sample size of 125 women. Data were gathered using an interviewer-administered questionnaire and assessed with the Health Belief Model against the outcome variable, which was Female Condom utilisation. Log-binomial regression model analysis was done using SPSS version 25.</p><p><strong>Results: </strong>The prevalence of utilising female condoms was 34%. The socio-demographic variables of the respondents that influenced FC utilisation were age (26-35 years) (aPR: 0.84, CI: 0.76-0.93, p < 0.001) and Monthly income (200,000-500,000 Ugx) (aPR: 0.14, CI: 0.03-0.74, p = 0.021). Also, perceived severity (aPR: 2.9, CI: 1.14-7.35, p = 0.026) and perceived benefits (aPR: 6.6, CI: 1.19-36.70, p = 0.031) were significantly associated with the outcome variable. Our significance level was 0.05 with a 95% confidence interval.</p><p><strong>Conclusions: </strong>The prevalence of utilisation of female condoms was low; age, religion, marital status, monthly income, perceived severity and benefits were the predictors of female condom use among women of reproductive age. Therefore, health education and awareness should be carried out at the community level to increase the sensitisation of female condoms by emphasising the importance of their use in preventing HIV/AIDS, STIs, and unintended pregnancies.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"436"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis in para-aortic lymph nodes without any pelvic endometriosis: the first case report, sequencing analysis and literature review.","authors":"Yu Chen, Chunyan Hao, Qing Zhang, Qiuli Teng, Xiaoming Zhang, Guowei Tao, Lijie Wang","doi":"10.1186/s12905-025-03964-0","DOIUrl":"10.1186/s12905-025-03964-0","url":null,"abstract":"","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"443"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the numbers: sexual life in women with gynecological cancer.","authors":"Zehra Acar, Asibe Özkan","doi":"10.1186/s12905-025-03967-x","DOIUrl":"10.1186/s12905-025-03967-x","url":null,"abstract":"<p><strong>Background: </strong>Sexual problems are among the most common challenges faced by women with gynecological cancer, as cancer symptoms and treatments often negatively impact their sexual health.</p><p><strong>Aim: </strong>This mixed-methods study was conducted to determine the sexual life experiences of women having gynecological cancer treatment.</p><p><strong>Methods: </strong>The study was carried out between February and June 2024 in the gynecologic oncology department of a city hospital with 14 women who were not in the period of menopause, diagnosed with cancer for the first time, and were sexually active. A personal information form, the Female Sexual Distress Scale-Revised (FSDS-R), and a semi-structured interview form were used as data collection tools. The analysis of qualitative data was carried out using conventional content analysis.</p><p><strong>Results: </strong>The mean age of the women was 38.21 ± 4.40 and the mean FSDS-R score was 18.71 ± 7.18. It was observed that gynecological cancer diagnosis and treatment negatively affected daily living activities, emotional states, body image, and sexual lives of women. The experiences of the participants were grouped into four main and ten sub-themes. The main themes are: \"Feelings related to cancer diagnosis\", \"The effects of cancer diagnosis and treatment on life\", \"The effects of cancer on body image/perception of femininity\", \"Sexual life\".</p><p><strong>Conclusion: </strong>This study highlights the profound impact of gynecological cancer and its treatment on women's sexual health and overall quality of life. Women face multidimensional challenges encompassing emotional, physical, relational and sexual domains. These findings underline the importance of incorporating comprehensive psychosocial care including sexual counseling into the standard management of gynecological cancer.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"442"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and awareness of breast cancer symptoms, risk factors, and screening barriers among women in Kuwait: a cross-sectional study.","authors":"Khalda AlMutawah, Ghalia Taqi, Sara Radhwan, Asma AlMutairi, Atyab AlHussainan, Mariam Faraj, Anwar H AlBaloul","doi":"10.1186/s12905-025-03994-8","DOIUrl":"10.1186/s12905-025-03994-8","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most diagnosed cancer globally and the second leading cause of cancer-related mortality across all demographics. In Kuwait, the incidence is 50 cases per 100,000 person-years. Delayed detection, often linked to limited awareness of breast cancer symptoms and risk factors, contributes significantly to morbidity and mortality. This study aimed to assess breast cancer knowledge, awareness of symptoms and risk factors, and perceived barriers to screening among women in Kuwait.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 490 employed women aged 18 years and older across Kuwait. A structured questionnaire was used to assess participants' awareness of breast cancer symptoms and risk factors, as well as barriers to screening. Composite scores were developed for symptom awareness, risk factor knowledge, and screening barriers. Multiple linear regression was used to identify demographic predictors associated with each score.</p><p><strong>Results: </strong>The median participant age was 35 years, with 66.1% holding a bachelor's degree. Higher education levels were significantly associated with greater BC sign identification (p = 0.013 for bachelor's degree; p = 0.009 for postgraduate degree). Participants with a family history of breast cancer demonstrated significantly greater knowledge of both BC signs and risk factors (p < 0.001). The most recognised symptom was a breast lump or thickening (72.0%). The most frequently cited barrier to screening was concern about pain or discomfort (57.8%).</p><p><strong>Conclusion: </strong>While women in Kuwait have moderate awareness of key breast cancer symptoms and risk factors, knowledge gaps and screening barriers persist, particularly regarding lesser-known warning signs and screening apprehension. Public health strategies should prioritise targeted education initiatives, including workplace wellness programs and culturally tailored awareness campaigns, to improve early detection and reduce the breast cancer burden in the region.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"448"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared and distinct molecular pathways in eutopic endometrium of endometriosis and adenomyosis patients: a transcriptomic study in Chinese women.","authors":"Juncui Bao, Xin Jiang, Yu Liu, Liping Zeng, Ruinan Xu, Qicai Hu, Shuai Cheng Li, Changzhong Li, Hui Du, Ruifang Wu, Wenkui Dai","doi":"10.1186/s12905-025-03959-x","DOIUrl":"10.1186/s12905-025-03959-x","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis (EMs) and adenomyosis (AD) are prevalent gynecological disorders with overlapping symptoms but potentially distinct pathophysiology. This study was to understand different gene expression patterns of eutopic endometrium between EMs and AD in Chinese populations.</p><p><strong>Methods: </strong>This study investigated transcriptomic profiles of eutopic endometrium in Chinese women with EMs (n = 25), AD (n = 22), and controls (n = 18) to identify shared and disease-specific gene expression patterns.</p><p><strong>Results: </strong>RNA sequencing and bioinformatic analyses revealed 370 differentially expressed genes (DEGs) between EMs and controls, as well as 309 DEGs between AD and controls. Both conditions showed significant downregulation of immune-related pathways compared to controls, though with disease-specific immune signatures. We identified 115 shared DEGs between EMs and AD, primarily involved in inflammatory processes, while disease-specific DEGs highlighted unique pathophysiological mechanisms: antibacterial responses in EMs and neutrophil activation in AD. Direct comparison between EMs and AD revealed 46 DEGs, with EMs-upregulated genes enriched in mucosal immunity. In addition, EMs-enriched pathways included oxidative phosphorylation, ribosome biogenesis, and arachidonic acid metabolism, while AD-enriched pathways involved Wnt signaling and epithelial proliferation.</p><p><strong>Conclusions: </strong>This study identified shared inflammatory processes of eutopic endometrium for EMs and AD in a Chinese population. EMs-enriched and AD-enriched pathways also inform distinct diagnostic and therapeutic strategies between EMs and AD.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"435"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between imaging-derived fat distribution and stress urinary incontinence: a cross-sectional study in US adult women.","authors":"Jun Zhang, Yucong Zhang, Sheng Xin, Jiaquan Mao, Adilijiang Aibibuli, Hui Cheng, Xiaming Liu, Wen Song, Xiaodong Song","doi":"10.1186/s12905-025-03998-4","DOIUrl":"10.1186/s12905-025-03998-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between android-to-gynoid fat ratio (A/G ratio) and stress urinary incontinence (SUI) in US adult women.</p><p><strong>Methods: </strong>The study employed data from the National Health and Nutrition Examination Survey (NHANES) database, encompassing the 2005-2006 and 2011-2018 cycles. We utilized multivariable-adjusted logistic regression models to examine the independent effect of the A/G ratio on SUI. Additionally, refined subgroup analyses were conducted to assess the impact of effect modifiers, along with sophisticated smooth curve fitting methods to delve into the potential non-linear relationship between the A/G ratio and SUI.</p><p><strong>Results: </strong>Of the 6779 women participants with an average age of 40.812, 2565 (37.8%) self-reported SUI. A non-linear relationship between the A/G ratio and SUI has been detected, with the threshold (A/G ratio = 0.446). Above and below this threshold, the effect sizes and the 95% confidence intervals were 1.464 (0.775-2.766) and 10.308 (3.558-29.863), respectively. Subgroup analyses showed that the positive association was more pronounced among young women who were premenopausal, living alone, hypertensive and with normal or low body mass index (BMI).</p><p><strong>Conclusion: </strong>There was a non-linear relationship between the A/G ratio and SUI. In individuals with a lower A/G ratio, even small increases in the A/G ratio substantially elevated the risk of SUI. Results of this study indicate that A/G ratio, as a measure of fat distribution, is of great importance for clinicians in assessing SUI risk and timely intervening.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"439"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global and regional burden of polycystic ovary syndrome, 1990-2021: a systematic analysis of the global burden of disease study 2021.","authors":"Ou Chai, Xinyu Feng, Na Tang, Dongqing Cui, Huiyang Li, Wenyan Tian, Jinyue Fan, Yingmei Wang, Zhimin Hou","doi":"10.1186/s12905-025-03976-w","DOIUrl":"10.1186/s12905-025-03976-w","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS), characterized by chronic anovulation, hyperandrogenism, and insulin resistance, is one of the most common reproductive endocrinopathies. This study uses the updated Global Burden of Disease (GBD) database (1990-2021), which has a larger number of cases, to explore the global burden of PCOS in depth.</p><p><strong>Methods: </strong>This research leveraged the GBD 2021 dataset to examine the incidence, prevalence, years lived with disability (YLDs), and the corresponding age-standardized rate (ASR) of PCOS. The study used the estimated annual percentage change (EAPC) to assess the trends in the burden of PCOS over the period from 1990 to 2021. The association between the burden of PCOS and socio-demographic index (SDI) was then analysed, as well as the changing trends in the incidence and prevalence of PCOS in different age groups. Ultimately, the research prognosticated the disease burden linked to PCOS during the span from 2022 to 2031.</p><p><strong>Results: </strong>During the period spanning from 1990 to 2021, the quantity of incident cases, prevalent cases, and YLDs of PCOS gradually grew. The ASIR, ASPR, and ASYR increased most rapidly in Southeast Asia from 1990 to 2021. In addition, there were significant positive correlations between ASIR, ASPR and ASYR of PCOS and the SDI of 21 GBD regions (P < 0.05, |correlation (cor)| >0.3). Notably, the prevalence of PCOS among women in most age groups showed an upward trend over time. Finally, it was forecasted that between 2022 and 2031, there would be a rising trend in both the incidence and prevalence of PCOS.</p><p><strong>Conclusion: </strong>This study showed that the ASIR and ASPR of PCOS were increasing year by year, which suggested that we needed to strengthen the related research as well as the prevention and treatment work on PCOS.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"437"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine transverse diameter and risk of LNG-IUS malposition in adenomyosis patients: a threshold effect analysis from a retrospective cohort study.","authors":"Yin Lin, Junying Jiang, Hao Lin, Hong Yan, Ting Deng","doi":"10.1186/s12905-025-03997-5","DOIUrl":"10.1186/s12905-025-03997-5","url":null,"abstract":"<p><strong>Objective: </strong>The malposition of the levonorgestrel-releasing intrauterine system (LNG-IUS) can have a considerable impact on the treatment outcomes for patients with adenomyosis. This study was designed to explore the relationship between the transverse diameter of the uterus and the occurrence of LNG-IUS malposition.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled 99 adenomyosis patients treated at Fujian Maternity and Child Health Hospital between May 2021 and May 2023. Preoperative uterine transverse diameter was measured using transvaginal ultrasound examinations. We defined LNG-IUS malposition as either downward displacement or expulsion of the device. Data analysis employed Cox regression models with adjustments for relevant demographic, clinical, and laboratory variables.</p><p><strong>Results: </strong>Our analysis revealed a notable non-linear relationship between the transverse diameter of the uterus and subsequent risk of LNG-IUS malposition. We identified 5.4 cm as a significant clinical threshold; beyond this measurement, the risk increased substantially, with malposition hazard rising by 112% per additional centimeter (HR 2.12; 95% CI, 1.28-3.49; p = 0.003). Among the subgroup of patients suffering from severe dysmenorrhea (VAS ≥ 7), this association was considerably stronger, yielding a hazard ratio of 3.43 (95% CI, 1.32-8.89; p = 0.011).</p><p><strong>Conclusion: </strong>Patients with adenomyosis whose uterine transverse diameter exceeds 5.4 cm face a higher risk of LNG-IUS malposition. This measurement threshold provides clinicians a practical tool for assessing suitable candidates for LNG-IUS placement, which may lead to better outcomes in this patient group.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"446"},"PeriodicalIF":2.7,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}