BMJ Sexual & Reproductive Health最新文献_第5页

Efficacy and safety of emergency contraception interventions: a systematic review and Bayesian network meta-analysis. 紧急避孕措施的有效性和安全性：一项系统综述和贝叶斯网络荟萃分析。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2025-202892

Yazhen Zhang, Xuening Zhang, Yidan Chen, Juan Zhang, Qinglong Zhang, Hui Jin

{"title":"Efficacy and safety of emergency contraception interventions: a systematic review and Bayesian network meta-analysis.","authors":"Yazhen Zhang, Xuening Zhang, Yidan Chen, Juan Zhang, Qinglong Zhang, Hui Jin","doi":"10.1136/bmjsrh-2025-202892","DOIUrl":"10.1136/bmjsrh-2025-202892","url":null,"abstract":"Objective: To assess the efficacy and safety of emergency contraception (EC) interventions.Methods: Literature published until 28 December 2024 was retrieved from nine databases. Randomised controlled trials (RCTs) evaluating the efficacy of copper or levonorgestrel intrauterine devices (Cu-IUDs or LNG-IUDs), oral levonorgestrel (LNG), mifepristone (MFP), ulipristal acetate (UPA) and oral EC plus cyclooxygenase inhibitor (COX) were considered eligible. A Bayesian network meta-analysis was conducted to evaluate the relative risk (RR) with a 95% credible interval (CrI) for efficacy and adverse events. Evidence certainty was graded using the CINeMA GRADE application. Pairwise meta-analyses, robustness analyses and Bayesian meta-regressions were conducted to verify the reliability of the results.Results: Of 17 244 studies, 92 involving 37 260 women were included. With robustness verified, the Cu-IUD was the most effective EC treatment. No significant differences in EC efficacy were observed between LNG-IUD and all other treatments, but with low- or very-low-certainty evidence. With acceptable adverse events, co-treatment with LNG and COX (LNG-COX) was more efficacious than single-dose (RR=0.112, 95%CrI: 0.005, 0.686) or double-dose LNG (RR=0.095, 95%CrI: 0.004, 0.605) with high certainty. MFP (25 mg) and UPA had comparable EC efficacy (RR=0.782, 95%CrI: 0.425, 1.433), whereas MFP tended to induce advancement of the subsequent menstrual period.Conclusions: Although the efficacy of LNG-COX was confirmed by high-certainty evidence, large-scale validation trials are required before it can be recommended clinically. Owing to within-study bias and imprecision, large RCTs are strongly recommended to assess the efficacy of ECs for interventions without direct comparisons.Trial registration number: CRD42024627671.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"218-226"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494765","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

Preconception care for men: a scoping review of knowledge, behaviours and interventions. 男性孕前护理：知识、行为和干预措施的范围审查。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2025-202975

Gabriella Citra, Yuyu Sumiya, Gessica Augustin, Daichi Suzuki, Shuxian Liu, Maria Lohan, Hitomi Suzuki, Naoko Arata, Asako Mito, Erika Ota

{"title":"Preconception care for men: a scoping review of knowledge, behaviours and interventions.","authors":"Gabriella Citra, Yuyu Sumiya, Gessica Augustin, Daichi Suzuki, Shuxian Liu, Maria Lohan, Hitomi Suzuki, Naoko Arata, Asako Mito, Erika Ota","doi":"10.1136/bmjsrh-2025-202975","DOIUrl":"10.1136/bmjsrh-2025-202975","url":null,"abstract":"Aim: This scoping review mapped quantitative evidence on men's preconception care (PCC) focusing on: (1) knowledge, (2) behaviours and attitudes, (3) reproductive intentions and (4) outcomes of educational or counselling interventions. The review also sought to identify evidence gaps and inform future policies and practices to enhance male engagement in reproductive health.Methods: Quantitative studies involving men aged ≥18 years from high- and upper-middle-income countries were included. Studies focusing on couples, non-English-language publications, qualitative research, reviews and commentaries were excluded. Quantitative designs were prioritised to map measurable determinants and outcomes of engagement in PCC. Searches were conducted across seven databases in September 2025, following the PRISMA-ScR framework. No critical appraisal was performed, consistent with scoping review methodology.Results: Fourteen studies (n=18 733 men) were included, most of which were observational. Findings indicated low fertility awareness, inconsistent engagement in preconception behaviours, and minimal use of supplements or healthcare services. Differences were noted by age, education and fatherhood status. One intervention improved knowledge but did not address systemic barriers.Conclusions: Men remain underrepresented in PCC. Gender-transformative, system-level reforms integrating men into primary care, health education and public messaging are needed. Future research should test context-specific, equity-oriented interventions to promote inclusive PCC for all.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"209-217"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009016","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

Outcomes and experiences of women with complex health needs accessing a national specialist referral abortion service: a service evaluation. 有复杂健康需求的妇女获得国家专家转诊堕胎服务的结果和经验：一项服务评价。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2025-202939

Allison Tavender Farnworth, Terri Brosnan, Isabelle Parris-Sizer, Stephen Courtenay Robson

{"title":"Outcomes and experiences of women with complex health needs accessing a national specialist referral abortion service: a service evaluation.","authors":"Allison Tavender Farnworth, Terri Brosnan, Isabelle Parris-Sizer, Stephen Courtenay Robson","doi":"10.1136/bmjsrh-2025-202939","DOIUrl":"10.1136/bmjsrh-2025-202939","url":null,"abstract":"Background: National guidance emphasises the importance of offering women requesting abortion timely access to care and choices about abortion method. Women with complex health needs face particular challenges due to restrictions in where their procedure can be safely performed. In England, a specialised commissioned service operates, offering care in five National Health Service (NHS) centres.Methods: A service evaluation collecting clinical and patient-reported data from 277 women attending (a) an NHS specialist abortion service and (b) a local abortion service for low-risk women at the same NHS provider during 2023/2024 in the North East of England.Results: Clinical outcomes were similar between groups. Women accessing the specialist service had higher gestation at abortion (+14 days, 95% CI 6.0 to 22.0), waited longer between referral and procedure (+8.0 days, 95% CI 7.0 to 10.0), were less likely to have accessed their preferred abortion method (-37.4%, 95% CI -49.3 to-25.5), travelled for longer (+30.0 min, 95% CI 20.0 to 50.0), spent more money to access care (+£22.2, 95% CI 9.0 to 45.0) and were more likely to report financial hardship as a consequence (+27.6%, 95% CI 13.3 to 41.9). This group also rated their pre-hospital care lower and described specific challenges about their care.Conclusions: While specialised abortion services for women with complex health needs have improved opportunities to access safe care, differences remain in important elements of the service. This creates disparities in relation to timely access, experience and choice of abortion method. Streamlining referral mechanisms between providers may reduce delay and improve efficiency and consistency. Services should consider how to support women who need to travel to access care.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"167-175"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854394","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

Symptom profiles in the late reproductive stage, earlier premenopause and early perimenopause in the absence of vasomotor symptoms: a cross-sectional study. 在没有血管舒缩症状的生殖晚期、绝经前早期和围绝经期早期的症状概况：一项横断面研究。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2025-203075

Santina Bresolin, Rakibul M Islam, Molly Bond, Susan R Davis

{"title":"Symptom profiles in the late reproductive stage, earlier premenopause and early perimenopause in the absence of vasomotor symptoms: a cross-sectional study.","authors":"Santina Bresolin, Rakibul M Islam, Molly Bond, Susan R Davis","doi":"10.1136/bmjsrh-2025-203075","DOIUrl":"10.1136/bmjsrh-2025-203075","url":null,"abstract":"Background: Perimenopause is formally diagnosed by menstrual bleeding patterns. This study investigated whether symptoms in the late reproductive stage (LRS), characterised by changed menstrual flow, differ from earlier premenopause or from perimenopause in the absence of vasomotor symptoms (VMS).Methods: The Australian Women's Midlife Years Study (2023-2024) was a nationally representative cross-sectional study of 8096 women aged 40-69 years, who completed the Menopause-specific Quality of Life Questionnaire (MENQOL). The prevalence of moderate-to-severe symptoms in participants without VMS was analysed using generalised linear models with Gamma log link and modified Poisson regression with robust variance, respectively.Results: The analysis included 1039 respondents without VMS, of which 63.5% (n=660) had regular menses with no change in menstrual flow, 20.1% (n=209) had regular menses with changed flow, and 16.4% (n=170) were perimenopausal (cycle variation at least 7 days). Premenopausal participants with unchanged flow were less likely to report poor memory (adjusted prevalence ratio (aPR) 0.60, 95% CI 0.43 to 0.83, p=0.043), 'accomplishing less than used to' (aPR 0.65, 95% CI 0.50 to 0.85, p=0.014), 'feeling tired or worn out' (aPR 0.78, 95% CI 0.68 to 0.90, p=0.009) and bloating (aPR 0.63, 95% CI 0.49 to 0.80, p=0.004) compared with LRS participants. The other 18 individual MENQOL symptoms did not differ between premenopausal LRS and early perimenopause.Conclusions: Premenopausal women with regular menstrual cycles reporting changed menstrual flow but no VMS differ little from those without VMS and no change in menstrual flow. This indicates that change in flow alone is not a clear indicator of commencement of the menopause transition.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"192-199"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431024","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

Abortion exceptionalism in research governance: why naming the problem matters. 研究治理中的堕胎例外论：为什么指出问题很重要。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2026-203263

Nicola Boydell, John Joseph Reynolds-Wright, Marie Larsson, Jacqueline Quinn, Sharon Cameron, Jeni Harden

引用次数: 0

Effect of hormonal contraception in individuals with anxiety and mood (affective) disorders: a rapid review. 激素避孕对焦虑和情绪（情感性）障碍患者的影响：快速回顾。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2026-203256

Alexandra-Andreea Ciritel, Benjamin Boxer, Anna Kelly, Jaqueline Quinn, Kate Foster, Rebecca Strauss

{"title":"Effect of hormonal contraception in individuals with anxiety and mood (affective) disorders: a rapid review.","authors":"Alexandra-Andreea Ciritel, Benjamin Boxer, Anna Kelly, Jaqueline Quinn, Kate Foster, Rebecca Strauss","doi":"10.1136/bmjsrh-2026-203256","DOIUrl":"10.1136/bmjsrh-2026-203256","url":null,"abstract":"Background: Psychological side effects are a frequent reason for discontinuation of hormonal contraception (HC), yet women with pre-existing mental health (MH) conditions are often excluded from studies despite their prevalence and needs.Objectives: To examine the effects of HC used for pregnancy prevention on anxiety and mood (affective) symptoms in women with established MH disorders.Methods: MEDLINE, Embase and Cochrane CENTRAL were systematically searched for English-language studies published between 2015 and 2025. Randomised controlled trials, cohort and cross-sectional studies evaluating any HC type in women with clinically diagnosed or self-reported anxiety or mood (affective) disorders were included. Studies assessing HC for therapeutic indications were excluded. Screening and data extraction followed Cochrane Rapid Review guidance. Due to heterogeneity in study designs and outcomes, findings were narratively synthesised by contraceptive type and population (adult, adolescent, postpartum).Results: Ten studies met inclusion criteria. HC use did not consistently worsen anxiety or mood symptoms in women with pre-existing MH disorders. Combined oral contraceptives (COCs) showed largely neutral effects, with some studies reporting increased mood symptoms, while progestogen-only methods and levonorgestrel intrauterine devices were associated with stable or improved symptoms. Negative associations were less pronounced in women with existing disorders than in those without prior MH conditions.Conclusions: HC appears generally safe for women with established anxiety or mood (affective) disorders. Symptoms were largely stable or modestly improved, with adverse effects reported more often with COCs, particularly among adolescents and first-time users. Individualised contraceptive counselling is recommended.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"200-208"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204242","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

Implementing a point-of-care test for β-human chorionic gonadotropin testing within an abortion service. 在人工流产服务中实施β-人绒毛膜促性腺激素的即时检测。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2025-203072

Jacqueline Quinn, John Joseph Reynolds-Wright, Karen McCabe, Seonaid Boyle, Gordon Marr, Sharon T Cameron

引用次数: 0

Establishing research priorities in abortion care: the importance of a UK-wide partnership approach. 在堕胎护理中建立研究优先事项：全英国伙伴关系方法的重要性。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2026-203354

Patricia A Lohr

引用次数: 0

Contraception use in women with intellectual disability: a retrospective cohort study. 智力残疾妇女的避孕使用：一项回顾性队列研究。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-07-10 DOI: 10.1136/bmjsrh-2025-202938

Yunhe Huang, Peiwen Liao, Preeyaporn Srasuebkul, Pramudie Gunaratne, Julian Trollor

{"title":"Contraception use in women with intellectual disability: a retrospective cohort study.","authors":"Yunhe Huang, Peiwen Liao, Preeyaporn Srasuebkul, Pramudie Gunaratne, Julian Trollor","doi":"10.1136/bmjsrh-2025-202938","DOIUrl":"10.1136/bmjsrh-2025-202938","url":null,"abstract":"Introduction: Women with intellectual disability often have limited knowledge and decision-making input regarding their contraception use. This study aimed to examine and compare the prevalence of any and specific contraceptive use in women with intellectual disability and matched comparators.Methods: This was a retrospective, population-based, cohort study of women with intellectual disability and matched comparators aged 15-49 years in New South Wales, Australia in 2001-2018 using linked administrative datasets. Outcomes included overall and annual prevalence of any and specific contraceptive use calculated using person-years. We used a generalised linear model to examine the association between intellectual disability status and any contraceptive use.Results: Women with intellectual disability were slightly more likely to use contraception overall (26.8% vs 23.9%), with different patterns of prevalence by age. The contraceptive pill accounted for 48.9% of overall contraceptive use in women with intellectual disability and 58.1% in comparators. Contraceptive injection showed increased prevalence in women with intellectual disability (20.4% vs 4.8%), while hormonal intrauterine device use showed decreased prevalence (11.2% vs 18.3%). Annual prevalence graphs showed a larger increase in contraceptive implant use in women with intellectual disability over time. The model showed a significant association between intellectual disability and any contraception use after controlling for covariates (relative rate 1.15, 95% CI 1.12 to 1.17).Conclusions: The tendency towards contraceptives that require minimal active management may reduce opportunities for decision-making involvement. We recommend the development of better information and support for women with intellectual disability to enable access to a wider range of contraceptive options and achieve greater agency in reproductive health.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"176-183"},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854429","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

Young people's sexual wellbeing: a systematic review of qualitative studies. 年轻人的性幸福：定性研究的系统回顾。

IF 3.2 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2026-06-23 DOI: 10.1136/bmjsrh-2025-203161

Raquel Bosó Pérez, Jennifer Littlejohn, Malachi Willis, Ruth Lewis, Kirstin R Mitchell

{"title":"Young people's sexual wellbeing: a systematic review of qualitative studies.","authors":"Raquel Bosó Pérez, Jennifer Littlejohn, Malachi Willis, Ruth Lewis, Kirstin R Mitchell","doi":"10.1136/bmjsrh-2025-203161","DOIUrl":"https://doi.org/10.1136/bmjsrh-2025-203161","url":null,"abstract":"Background: Young people's adverse sexual experiences contribute to a significant global mental health burden and detract from their quality of life. Sexual wellbeing connects sexual and mental health and can offer a novel perspective on drivers and impacts of young people's sexual behaviour. It is a promising means through which to shift public health focus from risk to aspects of sex relevant to broader wellbeing.Methods: This systematic review aimed to characterise sexual wellbeing for adolescents and emerging adults (aged 16-24 years). We searched four databases for peer-reviewed qualitative literature on young people's accounts relevant to sexual wellbeing published between 1988 and 2025. We intensity sampled and thematically synthesised studies against Mitchell et al's Sexual Wellbeing Conceptual Framework. PROSPERO registration: CRD42022315593.Results: We thematically synthesised 93 papers, representing 3152 participants across 25 countries. Our synthesis characterises youth sexual wellbeing as feeling: congruence between one's sexual thoughts, feelings, values, behaviours and emerging identities; driven by curiosity or desire; capable of advocating for one's wants and boundaries; able to authentically express oneself; deserving of care, respect and support; and expectant of a positive sexual future. Women, sexual and gender minorities, sexual violence survivors, youth with disabilities or health conditions, and those in deprived or sexually conservative communities report additional barriers to wellbeing.Conclusions: This first-ever review of youth sexual wellbeing underscores its significance during this life stage, and outlines similarities and differences compared with adults. The findings demand a stronger focus on young people's priorities for sexual wellbeing to support their healthy development.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307165","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