BMJ Sexual & Reproductive Health最新文献

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Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006-2010 versus 2017-2019. 随着伴侣获得长效可逆避孕药具(LARC)机会的增加,男性永久避孕的变化:2006-2010 年与 2017-2019 年全国家庭增长调查的分析。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-16 DOI: 10.1136/bmjsrh-2024-202372
Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw
{"title":"Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006-2010 versus 2017-2019.","authors":"Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw","doi":"10.1136/bmjsrh-2024-202372","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202372","url":null,"abstract":"<p><strong>Objective: </strong>Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.</p><p><strong>Study design: </strong>We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006-2010 (early) and 2017-2019 (recent) waves.</p><p><strong>Results: </strong>We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.</p><p><strong>Conclusion: </strong>Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626010","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
Double dosing ulipristal acetate emergency contraception for individuals with obesity: a randomised crossover trial. 针对肥胖症患者的双剂量醋酸乌利司他紧急避孕药:随机交叉试验。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-14 DOI: 10.1136/bmjsrh-2024-202401
Alison Edelman, Jon D Hennebold, Kise Bond, Jeong Y Lim, Ganesh Cherala, Steven W Blue, Shawn P Kraft, David W Erikson, David Archer, Jeffery Jensen
{"title":"Double dosing ulipristal acetate emergency contraception for individuals with obesity: a randomised crossover trial.","authors":"Alison Edelman, Jon D Hennebold, Kise Bond, Jeong Y Lim, Ganesh Cherala, Steven W Blue, Shawn P Kraft, David W Erikson, David Archer, Jeffery Jensen","doi":"10.1136/bmjsrh-2024-202401","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202401","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether increasing the dose of ulipristal acetate (UPA)-containing emergency contraception (EC) improves pharmacodynamic outcomes in individuals with obesity.</p><p><strong>Study design: </strong>We enrolled healthy, regularly-cycling, confirmed ovulatory, reproductive-age individuals with body mass index (BMI) >30 kg/m<sup>2</sup> and weight >80 kg in a randomised crossover study. We monitored participants with transvaginal ultrasound and blood sampling for progesterone, luteinising hormone (LH), and estradiol every other day until a dominant follicle measuring >15 mm was visualised. At that point, participants received either oral UPA EC 30 mg or 60 mg and returned for daily monitoring up to 7 days. After a no treatment washout cycle, participants returned for a second monitored cycle and received the other UPA dose. Our primary outcome was the proportion of subjects with no follicle rupture 5 days post-dosing (yes/no). For reference, we also enrolled a control group with BMI <25 kg/m<sup>2</sup> and weight <80 kg who received UPA EC 30 mg during a single cycle. We also obtained blood samples for pharmacokinetic parameters for UPA and its active metabolite, <i>N</i>-monodemethyl-UPA (NDM-UPA) as an optional substudy.</p><p><strong>Results: </strong>We enrolled a total of 52 participants with BMI >30 kg/m<sup>2</sup> and 12 controls, with the following cycles completed: 12 controls, 49 UPA 30 mg, and 46 UPA 60 mg. The entire cohort demographics were a mean (SD) age of 29.8 (3.4) years and BMI by group: controls 22.5 (1.4) kg/m<sup>2</sup>, group 1 37.9 (6.7) kg/m<sup>2</sup>, and group 2 39.3 (5.4) kg/m<sup>2</sup>. All 12 (100%) of controls had a delay of at least 5 days for follicle rupture. Among the high BMI group, dosing groups (UPA EC 30 mg vs 60 mg) were similar in the proportion of cycles without follicle rupture over 5 days post-UPA dosing (UPA 30 mg: 47/49 (96%), UPA 60 mg: 42/46 (91%), Fisher's exact test p=0.43). However, after excluding cycles where dosing occurred too late (after LH surge), a delay of at least 5 days occurred in all participants at both doses. The 60 mg UPA dose resulted in a twofold increase in maximum observed concentration and the area under the curve of both UPA and NDM-UPA levels compared with 30 mg.</p><p><strong>Conclusion: </strong>A standard 30 mg dose of UPA is sufficient to delay ovulation regardless of BMI or weight. Results of our study do not support dose adjustment for body size.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615921","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
Self-performed Rh typing: a cross-sectional study. 自行进行的 Rh 分型:一项横断面研究。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-14 DOI: 10.1136/bmjsrh-2024-202349
Divya Dethier, Mary Tschann, Meliza Roman, John J Chen, Reni Soon, Bliss Kaneshiro
{"title":"Self-performed Rh typing: a cross-sectional study.","authors":"Divya Dethier, Mary Tschann, Meliza Roman, John J Chen, Reni Soon, Bliss Kaneshiro","doi":"10.1136/bmjsrh-2024-202349","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202349","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether patients are capable and willing to self-administer and interpret an EldonCard test to determine their Rh status.</p><p><strong>Methods: </strong>This was a cross-sectional study in Honolulu, HI, USA of pregnancy-capable people aged 14-50 years who did not know their blood type and had never used an EldonCard. Participants independently completed EldonCard testing, determined their Rh type and answered a survey on feasibility and acceptability. Separately, a blinded clinician recorded their interpretation of the participant's EldonCard. When available, we obtained blood type from the electronic health record (EHR). We measured Rh type agreement between participant, clinician and EHR, as well as participant comfort and acceptability of testing.</p><p><strong>Results: </strong>Of the 330 total participants, 288 (87.3%) completed testing. Patients and clinicians had 94.0% agreement in their interpretation of the EldonCard for Rh status. Patient interpretation had 83.5% agreement with EHR while clinician and EHR had 92.3% agreement. Sensitivity of EldonCard interpretation by patient and clinician was 100%. Specificity was 83.2% for patients and 92.2% for clinicians. Two patients (of 117) had Rh-negative blood type in the EHR. The vast majority of participants found the EldonCard testing easy (94.4%) and felt comfortable doing the testing (93.7%). Participants with lower education levels felt less confident (p=0.003) and less comfortable with testing (p=0.038); however, their ability to interpret results was similar to others (p=0.051).</p><p><strong>Conclusions: </strong>Patient-performed Rh typing via the EldonCard is an effective and acceptable option for patients, and could be used as a primary screening test for Rh status.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615946","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
Seeking support for abortion online: a qualitative study of women's experiences. 在网上寻求堕胎支持:对妇女经历的定性研究。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2023-202083
Rachel Victoria Wilson-Lowe, Carrie Purcell, Ruth Lewis, Lisa McDaid
{"title":"Seeking support for abortion online: a qualitative study of women's experiences.","authors":"Rachel Victoria Wilson-Lowe, Carrie Purcell, Ruth Lewis, Lisa McDaid","doi":"10.1136/bmjsrh-2023-202083","DOIUrl":"10.1136/bmjsrh-2023-202083","url":null,"abstract":"<p><strong>Introduction: </strong>Social support can mitigate the impact of stress and stigma before or after an abortion. However, stigma anticipation can limit access to in-person support. Informal online spaces can offer opportunities to address unmet support needs including supplementing in-person support lacking within stigmatised contexts. While earlier studies have explored content of posts comprising personal accounts of abortion, little is known about the nuances of how and to what end online spaces are navigated.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted remotely (online or by telephone) with 23 women living in Scotland (aged 20-54 years) recruited through social media and online advertisements. Reflexive thematic analysis was supported by NVivo12 software.</p><p><strong>Results: </strong>Key themes: obtaining support that was unavailable from in-person networks; preparation for abortion; reducing feelings of isolation. The majority of participants independently searched online for accounts of abortion, with only three receiving any signposting to specific resources. Without guidance, finding relevant, supportive content was not straightforward. The search process was additionally complicated by the prevalence of abortion stigma online, which generated an additional burden at a potentially challenging time. Those who received direction towards particular resources reported primarily positive online experiences.</p><p><strong>Conclusions: </strong>While online content could address perceived in-person support gaps, the process of finding supportive content without guidance can be complex. Online searching may also expose women to stigmatising material and interactions. Signposting by abortion services towards well-moderated and trustworthy online resources could be constructive in limiting exposure to stigma and misinformation, while allowing those seeking it to access better support.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139711521","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}
引用次数: 0
Changes in fertility intention among married Chinese couples with two children during COVID-19: a cross-sectional study. COVID-19 期间中国已婚二孩夫妇生育意愿的变化:一项横断面研究。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2022-201759
Ni Ning, Xiangmin Tan, Ying Li, Jingfei Tang, Lisa Lommel, Mei Sun
{"title":"Changes in fertility intention among married Chinese couples with two children during COVID-19: a cross-sectional study.","authors":"Ni Ning, Xiangmin Tan, Ying Li, Jingfei Tang, Lisa Lommel, Mei Sun","doi":"10.1136/bmjsrh-2022-201759","DOIUrl":"10.1136/bmjsrh-2022-201759","url":null,"abstract":"<p><strong>Background: </strong>A three-child policy was implemented in China to stimulate a rise in fertility levels and coincided with the COVID-19 pandemic. Data suggested that COVID-19 has a negative impact on fertility intention.</p><p><strong>Aim: </strong>To describe married couples' changes in intention to have a third child during the COVID-19 pandemic and determine factors associated with altered intentions.</p><p><strong>Methods: </strong>An online survey was conducted in October 2021, including sociodemographic characteristics, change of intention to have a third child after the COVID-19 pandemic outbreak, reasons for increased or decreased intention, and the Fertility Intention Scale (FIS). Bivariate and multivariable logistic regression were used to test the potential factors associated with changes in intention.</p><p><strong>Results: </strong>A total of 1308 participants provided responses. Following the COVID-19 outbreak, 35.8% of participants decreased their third-child intention, while 2.8% of participants increased their third-child intention. Males (aOR 1.90, 95% CI 1.42 to 2.54), youngsters (aOR 1.77, 95% CI 1.08 to 2.93) and those living in Estern China (aOR 2.12, 95% CI 1.13 to 3.98) were more likely to decrease their third-child intention. Perceived risk (aOR 1.07, 95% CI 1.03 to 1.10) and policy support (aOR 1.06, 95% CI 1.03 to 1.09) as measured on the FIS decreased couples' intention to have a third child. Social support (aOR 0.94, 95% CI 0.91 to 0.98) as measured on the scale protected participants from decreased intention.</p><p><strong>Conclusions: </strong>During severe public health emergencies, strong prevention and control policies, together with enhancing support from partners and healthcare professionals for women, are necessary to improve intentions to give birth.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140173800","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
French Parliament ratifies the inclusion in the French Constitution of "guaranteed freedom" for abortion: but does this really prevent future restrictions? 法国议会批准将堕胎 "保障自由 "写入法国宪法:但这真的能防止未来的限制吗?
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2024-202316
Philippe Faucher
{"title":"French Parliament ratifies the inclusion in the French Constitution of \"guaranteed freedom\" for abortion: but does this really prevent future restrictions?","authors":"Philippe Faucher","doi":"10.1136/bmjsrh-2024-202316","DOIUrl":"10.1136/bmjsrh-2024-202316","url":null,"abstract":"","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288202","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
Self-managed medication abortion trajectories: results from a prospective observational study in Argentina, Nigeria and Southeast Asia. 自我管理药物流产轨迹:来自阿根廷、尼日利亚和东南亚的一项前瞻性观察性研究的结果。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2023-201979
Elizabeth A Pleasants, Ruvani T Jayaweera, Ijeoma Egwuatu, Sybil Nmezi, Ika Ayu Kristianingrum, Ruth Zurbriggen, Belén Grosso, Chiara Bercu, Relebohile Motana, Caitlin Gerdts, Heidi Moseson
{"title":"Self-managed medication abortion trajectories: results from a prospective observational study in Argentina, Nigeria and Southeast Asia.","authors":"Elizabeth A Pleasants, Ruvani T Jayaweera, Ijeoma Egwuatu, Sybil Nmezi, Ika Ayu Kristianingrum, Ruth Zurbriggen, Belén Grosso, Chiara Bercu, Relebohile Motana, Caitlin Gerdts, Heidi Moseson","doi":"10.1136/bmjsrh-2023-201979","DOIUrl":"10.1136/bmjsrh-2023-201979","url":null,"abstract":"<p><strong>Objectives: </strong>Time is a crucial factor in abortion-seeking because options for care change with pregnancy duration, and most people prefer to access abortion care early in pregnancy. We aimed to collect data on the timing of steps in accompanied self-managed abortion-seeking experiences in legally restrictive settings.</p><p><strong>Methods: </strong>In this prospective, observational, cohort study we recruited callers from three abortion accompaniment groups in Argentina, Nigeria and a country in Southeast Asia. Participants completed a baseline survey before starting a self-managed medication abortion (SMA) and two follow-up surveys (approximately 1 and 3 weeks after taking medication). Primary outcomes of interest included: (1) time from abortion decision to contacting the hotline, (2) time from contacting the hotline to obtaining pills and (3) time from obtaining pills to taking the first dose. We explored relationships between participant characteristics and each of these outcomes and evaluated differences in overall abortion time using survival analyses.</p><p><strong>Results: </strong>Between July 31, 2019 and October 01, 2020 we enrolled 1352 eligible callers; 1148 provided data for this analysis. After deciding to have an abortion, participants took 12.2 days on average (95% CI: 11.6, 12.9) to start medications for abortion. On average, participants at later pregnancy durations progressed through the SMA process more quickly (<4 weeks: 20.9 days, 4 weeks: 11 days, 5-6 weeks: 10.1 days, 7-9 weeks, 10.4 days, 10+ weeks: 9.1 days; p<0.001).</p><p><strong>Conclusions: </strong>Overall, participants accessed accompaniment group support and started abortion regimens quickly and at relatively early pregnancy durations. SMA with accompaniment provided a time-efficient route for obtaining abortions.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71420843","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
Patient experiences of undergoing abortion with and without an ultrasound scan in Britain. 在英国,接受和未接受超声波扫描的人工流产患者的经历。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2023-202116
Rebecca Blaylock, Patricia A Lohr, Lesley Hoggart, Pam Lowe
{"title":"Patient experiences of undergoing abortion with and without an ultrasound scan in Britain.","authors":"Rebecca Blaylock, Patricia A Lohr, Lesley Hoggart, Pam Lowe","doi":"10.1136/bmjsrh-2023-202116","DOIUrl":"10.1136/bmjsrh-2023-202116","url":null,"abstract":"<p><strong>Background: </strong>Routine ultrasound scanning to determine gestational age and pregnancy location has long been part of pre-abortion assessment in Britain, despite not being legally required or recommended in national clinical guidelines. To support implementation of fully telemedical abortion care (implemented in Britain in April 2020), the Royal College of Obstetricians and Gynaecologists (RCOG) issued clinical guidance for an 'as-indicated' approach to pre-abortion ultrasound, removing the need for a clinic visit. We aimed to understand patient experiences of ultrasound in abortion care by conducting a qualitative study with individuals who had abortions with and without an ultrasound scan.</p><p><strong>Methods: </strong>Between November 2021 and July 2022, we recruited patients who had a medical abortion at home without a pre-procedure ultrasound at 69 days' gestation or less at British Pregnancy Advisory Service (BPAS), and also had at least one other abortion with an ultrasound from any provider in Britain. We conducted interviews using a semi-structured interview guide to explore our participants' experiences and conducted reflexive thematic analysis.</p><p><strong>Results: </strong>We recruited 24 participants and included 19 interviews in our analysis. We developed three themes from our data. These were 'Ultrasound scans and their relationship with autonomy and decision-making', 'Intrusive and out of place: the ultrasound as an inappropriate technology' and 'Towards preference-centred, quality care'.</p><p><strong>Conclusions: </strong>Further research and user-testing of strategies to improve the scan experience should be undertaken. Patient testimonies on the negative impact of ultrasound scans in abortion care should reassure providers that omitting them according to patient preference is a positive step towards providing patient-centred care.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746146","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
Association between COVID-19 vaccination and menstruation: a state of the science review. 接种 COVID-19 疫苗与月经之间的关系:科学现状综述。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2024-202274
Laura A Payne, Lauren A Wise, Amelia K Wesselink, Siwen Wang, Stacey A Missmer, Alison Edelman
{"title":"Association between COVID-19 vaccination and menstruation: a state of the science review.","authors":"Laura A Payne, Lauren A Wise, Amelia K Wesselink, Siwen Wang, Stacey A Missmer, Alison Edelman","doi":"10.1136/bmjsrh-2024-202274","DOIUrl":"10.1136/bmjsrh-2024-202274","url":null,"abstract":"<p><strong>Introduction: </strong>Menstrual health is a key patient-reported outcome beyond its importance as a general indicator of health and fertility. However, menstrual function was not measured in the clinical trials of COVID-19 vaccines. The purpose of this review was to synthesise the existing literature on the relationship between COVID-19 vaccination and menstrual health outcomes.</p><p><strong>Methods: </strong>A PubMed search to 31 October 2023 identified a total of 53 publications: 11 prospective cohort studies, 11 retrospective cohort studies or registry-based cohort studies, and 31 cross-sectional or retrospective case-control studies.</p><p><strong>Results: </strong>Identified studies were generally at moderate-to-high risk of bias due to retrospective design, interviewer bias, and failure to include a non-vaccinated control group. Nonetheless, the bulk of the literature demonstrates that COVID-19 vaccine is associated with temporary changes in menstrual characteristics (cycle length and flow) and menstrual pain. Follicular phase (at the time of vaccination) is associated with greater increases in cycle length. Evidence suggests temporary post-vaccine menstrual changes in adolescents, abnormal vaginal bleeding in postmenopausal individuals, and a potential protective effect of using hormonal contraception.</p><p><strong>Conclusions: </strong>In this review we found evidence supporting an association between the COVID-19 vaccine and menstrual health outcomes. Given the importance of menstrual function to overall health, we recommend that all future vaccine trials include menstruation as a study outcome. Future vaccine studies should include rigorous assessment of the menstrual cycle as an outcome variable to limit sources of bias, identify biological mechanisms, and elucidate the impact of stress.</p>","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300007","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}
引用次数: 0
Preconception health risk factors documented in general practice electronic medical records. 全科电子病历中记录的孕前健康风险因素。
IF 3.4 3区 医学
BMJ Sexual & Reproductive Health Pub Date : 2024-07-12 DOI: 10.1136/bmjsrh-2023-202038
Nishadi Nethmini Withanage, Jessica R Botfield, Kirsten Black, Danielle Mazza
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