Women, Volume 5, Issue 1 (March 2025) – 4 articles

Perimenopause, the transitional phase leading up to menopause, affects millions of women worldwide, yet it remains poorly understood and under-addressed in healthcare. Despite the availability of treatment options like hormone replacement therapy (HRT) and non-hormonal alternatives, the awareness and utilization of these options vary significantly among women. Here, we conducted a cross-sectional survey with 1000 adults, both men and women, from the United States and Canada. We evaluated the perceived familiarity of participants with the timing, duration, and symptoms of perimenopause, as well as their satisfaction with their treatment options and communication with their healthcare providers. We found that, in general, women and older people were more likely to feel familiar with perimenopause, although the youngest age group surveyed also reported relatively high familiarity. We also found that there is a disconnect between people reporting high familiarity with perimenopause and its symptoms but overall middling and lower familiarity with the age and duration of onset and satisfaction with treatment options. Our results suggest further investigation into where people obtain their information concerning perimenopause, as well as into how knowledge of perimenopause may vary based on demographics. Full article

Black mothers with preterm infants face unique challenges during their stay in the NICU and after discharge. Racism-related barriers impact access to care for Black preterm infants. Understanding their experiences in caring for preterm infants is crucial to developing equity-focused interventions to address racism in the NICU and promote Black preterm infant health outcomes. The purpose of this scoping review is to shed light on Black mothers’ experiences of having a preterm infant. A search was conducted in CINAHL, Medline, Maternity and Infant Care, and Google Scholar. A total of 287 articles were retrieved and screened. Twelve (12) articles included in the final review were from the United States. The findings highlight the need to address racism among healthcare providers in the NICU through training and education. Gaps in understanding the experiences of Black parents with preterm infants from other Western contexts remain and require further research. Full article

Intrauterine devices (IUDs) are highly effective long-acting contraceptives. However, pain associated with insertion deters some women and impacts satisfaction. This systematic review critically evaluates the effectiveness of local anesthetics, misoprostol, nonsteroidal anti-inflammatory drugs (NSAIDs), and conscious sedation for managing pain associated with IUD insertion. A comprehensive database search including PubMed, Web of Science, Google Scholar, ClinicalTrials.gov, and ProQuest was conducted from inception to July 2023 for randomized controlled trials (RCTs). RCTs assessing interventions for IUD insertion pain were included. Case reports, non-randomized studies, and non-English papers were excluded. Two independent reviewers extracted data on pain outcomes and adverse effects. The risk of bias was assessed using Cochrane tools. Thirty-nine RCTs (n = 12,345 women) met the inclusion criteria. Topical lidocaine effectively reduced pain on consistent findings across multiple high-quality RCTs. Misoprostol pretreatment facilitated easier insertions through cervical ripening. However, evidence for NSAIDs was inconclusive, with some RCTs finding no additional benefits versus placebo. Results also remained unclear for nitrous oxide conscious sedation due to variability in protocols. Nulliparity predicted higher reported pain consistently. Lidocaine and misoprostol show promise for minimizing IUD insertion pain and difficulty. Further optimization is required to standardize conscious sedation and fully evaluate NSAIDs. Improving pain management may increase favorable experiences and uptake of this reliable method. Full article

Spontaneous rupture of the utero-ovarian vessels is an exceptionally rare but potentially life-threatening condition, especially in the case of non-pregnant women with a history of complex gynecological conditions. We report the case of a 45-year-old woman presenting with severe abdominal pain and hemoperitoneum, 15 years after surgical eradication of stage IV endometriosis. Diagnostic imaging revealed significant free fluid and vascular disruption near the uterus. Emergency laparotomy confirmed blood in the peritoneal cavity and identified a rupture of the left paracervical vessels. This case underscores the critical role of timely surgical intervention and the challenges of diagnosing spontaneous vascular rupture in the context of chronic conditions such as endometriosis and fibromyalgia. A review of the literature revealed very limited cases with similar presentations, emphasizing the rarity of such vascular events, although without active endometriotic lesions. This report highlights the importance of considering spontaneous vascular rupture in differential diagnoses for acute abdominal pain with hemoperitoneum. Advanced imaging and multidisciplinary management are pivotal in ensuring favorable outcomes. Full article