BMJ Sexual & Reproductive Health最新文献

Clinically unjustified and outdated restrictions on contragestives mean that fertility services are failing women in Britain.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-04-07 DOI: 10.1136/bmjsrh-2024-202604

Paula Baraitser, Patricia A Lohr, Sally Sheldon

引用次数: 0

Improving the environmental and financial impact of intrauterine contraception.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-04-07 DOI: 10.1136/bmjsrh-2024-202688

Catherine Zoe Mercer Stace, Georgina Forbes

引用次数: 0

The emerging role of progesterone receptor modulators in breast physiology, cancer prevention and treatment.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-04-04 DOI: 10.1136/bmjsrh-2024-202662

Abigail Liberty, Alison Edelman, Sarah Margaret Bernhardt

{"title":"The emerging role of progesterone receptor modulators in breast physiology, cancer prevention and treatment.","authors":"Abigail Liberty, Alison Edelman, Sarah Margaret Bernhardt","doi":"10.1136/bmjsrh-2024-202662","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202662","url":null,"abstract":"Background: Progesterone is critical for cyclic breast changes and breast cancer carcinogenesis. The commercially available progesterone receptor modulators (PRMs), ulipristal acetate (UPA) and mifepristone, have been utilised for their antiprogestogen effect in gynaecology. Administration of these medicines appears to induce favourable cellular and radiographic changes in the breast.Methods: This is a narrative review of the basic science, translational and clinical trials utilising UPA and mifepristone for breast health. It integrates historical and recent trials from around the world.Results: PRMs have shown promise in decreasing molecular markers of carcinogenesis in BRCA1 carriers. Outside of genetic cancer risk, PRMs decrease background parenchymal enhancement on breast magnetic resonance imaging and could be developed as a personalised protocol for breast cancer screening. Although there was limited efficacy of antiprogestogens in progression-free survival for people with breast cancer, there may be a role as neoadjuvant therapy prior to surgical resection.Conclusions: UPA and mifepristone have the potential to revolutionise breast cancer prevention, screening and treatment. As protocols emerge, gynaecologists will be on the front lines as regards both identifying patients who may benefit from these medications and serving as interdisciplinary support in accessing these medicines.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787711","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

Postpartum contraception audiovisual animations: contrasting priorities across different global settings. 产后避孕视听动画：全球不同环境下的优先事项对比。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-04-01 DOI: 10.1136/bmjsrh-2025-202754

Annette Thwaites, Katie Lightly

引用次数: 0

Research and development of emergency contraception over five decades.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-03-26 DOI: 10.1136/bmjsrh-2024-202616

Raymond Hang Wun Li, Pak Chung Ho, Anna Glasier

引用次数: 0

Fifty years of BMJ SRH: a US perspective on achievements in sexual and reproductive health.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-03-26 DOI: 10.1136/bmjsrh-2024-202560

Stephanie Irene Amaya, Paul D Blumenthal

引用次数: 0

Experiences of stigma amongst healthcare professionals working in abortion care: a global survey.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-03-15 DOI: 10.1136/bmjsrh-2024-202468

Louise Bury, Roger Ingham, Suzanna Bright, Lesley Hoggart

{"title":"Experiences of stigma amongst healthcare professionals working in abortion care: a global survey.","authors":"Louise Bury, Roger Ingham, Suzanna Bright, Lesley Hoggart","doi":"10.1136/bmjsrh-2024-202468","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202468","url":null,"abstract":"Introduction: Abortion-related stigma negatively affects healthcare professionals providing abortion care, threatening workforce well-being and service provision. This global study, part of the Royal College of Obstetricians and Gynaecologists' 'Making Abortion Safe' Project, explored healthcare providers' experiences of abortion stigma, its drivers and mitigating factors.Methods: A global online survey was distributed to healthcare professionals trained to provide abortion and post-abortion care (PAC) through 16 partner organisations over a 6-week period in 2021. The Abortion Provider Stigma Scale (APSS) was adapted, and linear regression modelling was used to examine the relationships between demographic variables, attitudes towards abortion, workplace burnout and total APSS scores.Results: In 1674 providers from 77 countries, stigma was universally experienced. Higher stigma levels were associated with countries with restrictive abortion laws; working in non-governmental organisation settings; and providing first- and second-trimester abortions compared with only PAC. A large majority (84%) of providers reported feeling burnout to some degree, with a strong correlation between APSS scores and workplace burnout. Providers exposed to both values clarification and attitude transformation (VCAT) training and other support workshops reported more positive attitudes and lower stigma compared with those with only VCAT or no training.Conclusions: Legal reform is needed to reduce stigma for providers as part of broader initiatives on women's reproductive rights in general. Meanwhile, ongoing support at the organisational level, alongside addressing stigmatising values and attitudes, can help create positive workplaces and resilient providers. Mainstreaming and integrating abortion services into public health systems would also help normalise abortion care.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633540","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

Experiences of abortion in the UK Armed Forces: a cross-sectional survey.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-02-25 DOI: 10.1136/bmjsrh-2024-202513

Victoria Elizabeth Kinkaid, Ruth Guest, Antony Willman, Kate King

{"title":"Experiences of abortion in the UK Armed Forces: a cross-sectional survey.","authors":"Victoria Elizabeth Kinkaid, Ruth Guest, Antony Willman, Kate King","doi":"10.1136/bmjsrh-2024-202513","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202513","url":null,"abstract":"Background: Abortion is a common pregnancy outcome; in the UK one in three women will have an abortion by age 45 years. Despite women making up 11.7% of the UK Armed Forces (UKAF), anecdotal voices from patient groups and clinicians highlight their gender-specific health needs not being addressed by the UKAF. There is a worldwide absence of literature and policy on abortion care in the AF, including rates and experiences. This survey addresses the paucity of data on abortion experiences in UK servicewomen to ensure the UKAF is providing the best possible care for them.Methods: A REDCap survey was circulated among UK servicewomen via email and social media networks, and snowball distribution was utilised to widen participation. Quantitative data were used for descriptive statistics and qualitative data were analysed iteratively by the authors, with regular meetings to agree on themes.Results: A total of 427 servicewomen responded: 124 (29%) declared they previously had an abortion, with 102 (23.9%) being in service. Twelve (11.8%) of these abortions were required when on deployment. Four key themes emerged: 'Trust in information holders', 'Influencers, barriers and access', 'Systemic lack of awareness' and 'Life in the military'.Conclusions: This is the first study to collect data on UK servicewomen's experience around abortion care, and highlights a complex interplay of factors which may influence abortion care decisions. Stigma and judgement were pervasive threads running through all themes, negatively impacting UKAF women. Evidence-based policies and information on abortion are recommended for both servicepeople and healthcare professionals to facilitate access to abortion and begin to destigmatise it in the AF.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499301","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

Early medical abortion before missed menses: a prospective observational study of outcomes of abortion at less than 30 days from last menstrual period.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-02-23 DOI: 10.1136/bmjsrh-2024-202534

Elizabeth April Wheate, John Joseph Reynolds-Wright, Sharon T Cameron

{"title":"Early medical abortion before missed menses: a prospective observational study of outcomes of abortion at less than 30 days from last menstrual period.","authors":"Elizabeth April Wheate, John Joseph Reynolds-Wright, Sharon T Cameron","doi":"10.1136/bmjsrh-2024-202534","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202534","url":null,"abstract":"Introduction: High-sensitivity urine pregnancy tests can detect pregnancy before missed menses. The widespread availability of these tests, alongside improvements in abortion access in many settings, may mean more women present for abortion at a very early stage of pregnancy. We aimed to examine the outcome of early medical abortion (EMA) in pregnancies less than 30 days from last menstrual period (LMP).Methods: This study analysed prospectively collected data on patients at less than 30 days from LMP seeking abortion at a single service in Edinburgh, UK between March 2020 and December 2023. We determined the effectiveness, outcomes of the pregnancy (complete abortion, ongoing pregnancy, incomplete abortion) and serious complications among those seeking EMA at this gestation.Results: Of 13 565 patients seeking abortion, 78 (0.6%) presented with a self-reported positive home pregnancy test and less than 30 days from LMP. Some 63/78 patients (81%) proceeded to EMA with mifepristone followed by misoprostol. Of this group, 31/63 (49%) had a pre-abortion ultrasound. Complete abortion occurred in 58/63 (92%, 95% CI 82% to 97%), 4/63 (6%) had an ongoing pregnancy and 1 (1%) had a surgical evacuation for incomplete abortion. There were no serious complications.Conclusions: Only a very small percentage of patients present for abortion before a missed period. Nevertheless, EMA at this stage is safe and effective. There may be a higher rate of ongoing pregnancy, and so those patients wishing to proceed to EMA should be advised of the importance of confirming success in line with local protocols.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482228","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

Understanding patient experiences during gynaecological procedures: a qualitative exploratory study.

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-02-12 DOI: 10.1136/bmjsrh-2024-202588

Deepti Divya Gopisetty, India Rogers-Shepp, Elisa Padron, Megha Shankar, Kate A Shaw

{"title":"Understanding patient experiences during gynaecological procedures: a qualitative exploratory study.","authors":"Deepti Divya Gopisetty, India Rogers-Shepp, Elisa Padron, Megha Shankar, Kate A Shaw","doi":"10.1136/bmjsrh-2024-202588","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202588","url":null,"abstract":"Background: Pain with gynaecological clinic-based procedures is common and undertreated. Prior research has focused on interventions for reducing pain and anxiety with analgesics, yet there remain gaps in understanding the myriad of facilitators and barriers to a person's positive experience. We aimed to start to address these gaps by exploring factors that influence a person's experience during gynaecological procedures beyond quantitative measures of pain.Methods: A qualitative thematic analysis approach was used for this exploratory study. Through convenience sampling, we recruited 15 participants with gynaecological procedural experience with intrauterine device (IUD) insertions, surgical abortions, colposcopies and/or endometrial biopsies. We conducted in-depth, semi-structured 1:1 interviews that explored participants' experience of the procedure. We then used a mixed inductive and deductive approach for development of a codebook and thematic analysis based on the Person-Centered Care Framework for Reproductive Health Equity (PCFRHE).Results: Four themes fundamental to understanding how patients process procedural experiences were identified: (1) Balancing preparation and anxiety, (2) Variable rapport with clinicians, (3) Self-advocacy and autonomy and (4) Clinician responsiveness to pain.Conclusions: Person-centred care in an inclusive, trauma-responsive environment is essential for improving gynaecological procedural experience. Ensuring patient access to pre- and post-visit information and offering multiple options to increase comfort are tangible actions clinicians can take to improve patient experience. This study underscores the importance of person-centred care in gynaecological procedures, emphasising better preprocedural education and support.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405676","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