Search Results (275)

Concerns about weight gain are commonly cited with combined oral contraceptive pill (COCP) use, yet it remains unclear whether perceived weight gain as a reason for discontinuation differs by body mass index (BMI). We analyzed data from the 2017–2019 National Survey of Family Growth (NSFG), including 3709 non-pregnant women aged 20–49 years who had ever used COCPs and had BMI calculated from self-reported height and weight. Trained NSFG staff interviewed participants on reasons for discontinuation and coded them into predefined categories, including weight gain. Discontinuation was examined by BMI category (underweight, normal weight, overweight, obesity) using survey-weighted logistic regression adjusted for demographic and socioeconomic covariates. Overall, 35.2% (95% CI 32.3–38.1%) of women reported discontinuing COCPs due to dissatisfaction, with 20.2% (95% CI 18.1–22.3%) citing side effects. Weight gain was reported by 7.0% (95% CI 5.6–8.4%) of ever-users, with higher prevalence among women with overweight (8.4%) and obesity (7.7%) compared with normal-weight women (5.5%). In adjusted analyses, women with overweight (aOR 1.76, p = 0.048) and obesity (aOR 1.68, p = 0.033) had higher odds of COCP discontinuation due to self-reported weight gain. These findings highlight the importance of addressing weight-related concerns during contraceptive counseling, particularly for women with higher BMI. Full article

The perception that hormonal contraception causes weight gain is a general belief that frequently hinders the initiation and continuation of effective family planning. This narrative review analyses data from Cochrane systematic reviews and recent pharmacogenomic studies to separate patient perception from metabolic reality. Analysis of high-quality data, including Cochrane systematic reviews, indicates that the association between Combined Hormonal Contraceptives (CHCs)—including oral pills, the transdermal patch, and the vaginal ring—and weight gain is not supported by consistent high-quality evidence. Placebo-controlled trials demonstrate that these methods are weight-neutral on average. Perceived weight increases in CHC users are likely mediated in part by fluid retention linked to the estrogenic stimulation of the Renin–Angiotensin–Aldosterone System (RAAS), rather than adipose tissue accumulation. Conversely, Depot Medroxyprogesterone Acetate (DMPA) represents a verified clinical risk for weight gain, showing a demonstrated clinical association with significant fat mass accumulation. Hypothesized biological mechanisms for this increase include hypothalamic appetite stimulation and glucocorticoid-like activity. The etonogestrel implant occupies a complex middle ground. While population-level data suggests weight neutrality, recent exploratory pharmacogenomic research has identified a specific variant in the Estrogen Receptor 1 (ESR1) gene. For the minority of women carrying this variant, the implant may trigger clinically significant weight gain, suggesting a biological basis for their subjective experience despite statistical evidence. Ultimately, the persistence of the weight gain concern is fueled by the nocebo effect and the misattribution of natural age-related weight trajectories to contraceptive use. Full article

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder, primarily characterized by reproductive dysfunction, insulin resistance (IR), and long-term metabolic complications. Current first-line pharmacological treatments, including oral contraceptives, anti-androgens, and insulin sensitizers, can alleviate clinical symptoms but often fail to fully address the underlying pathophysiology, and their long-term use is frequently limited by adverse effects. Natural products, owing to their multi-target regulatory properties and favorable safety profiles, have emerged a promising adjuvant therapeutic strategy. This review systematically summarizes how natural products exert beneficial effects through mechanisms such as improving metabolic homeostasis by enhancing insulin sensitivity and mitigating oxidative stress and chronic inflammation; restoring endocrine balance by modulating the hypothalamic–pituitary–gonadal axis to reduce hyperandrogenemia and promote ovulation; and utilizing emerging pathways including regulating gut microbiota homeostasis and epigenetic modifications as a novel avenue for PCOS drug development. Preclinical and clinical evidence collectively indicates that these agents hold significant translational potential to ameliorate metabolic disturbances and improve reproductive outcomes, providing a scientific foundation for future integrated intervention strategies in PCOS. Full article

Combined oral contraceptive pills (COCPs) are commonly used by reproductive-aged women with overweight or obesity, but their metabolic effects remain understudied. This pilot study examined the feasibility of recruiting and retaining women with overweight or obesity initiating COCPs and evaluated changes in body weight, body composition, energy intake (EI), eating behaviors, and cardiometabolic markers. Premenopausal women aged 18–40 years with a body mass index between 25 and 45 kg/m² initiating COCPs (n = 10) or using nonhormonal contraception (NHC; n = 10) were followed for six months. Outcome measures included body weight, body composition, EI, eating behavior questionnaires, ecological momentary assessment of appetite and satiety, and fasting laboratory measures. There were no between-group differences in changes in weight, EI, or appetite. Binge-eating severity decreased in COCP users and increased in NHC users, though the within-group change in COCP users was not statistically significant. Exploratory analyses demonstrated increases in hemoglobin A1c and triglycerides among COCP users compared to NHC users, while bioavailable testosterone decreased in COCP users only. This study demonstrates high retention and feasibility among women with overweight/obesity undergoing intensive dietary and metabolic monitoring. Although weight outcomes were similar between groups, these preliminary findings identify potential metabolic signals warranting confirmation in adequately powered studies. Full article

Objective: To assess the relationship between adherence to various plant-based diets, as measured by overall, healthy, and unhealthy plant-based diet indices (PDI, hPDI, uPDI), and ovarian cancer risk. Methods: We obtained data on 1031 cases of ovarian cancer and 2411 controls from a case-control study conducted in Italy. PDI, hPDI, and uPDI were calculated using data from a validated food frequency questionnaire. We used logistic regression to calculate the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) of ovarian cancer for PDI, hPDI, and uPDI, adjusting for several possible confounders. Results: PDI and hPDI were inversely related to ovarian cancer risk (OR = 0.70 for the fourth compared to the first quartile, 95% CI: 0.55–0.89, and OR = 0.67, 95% CI: 0.53–0.84, respectively). On the other hand, a higher uPDI was related to a higher risk of ovarian cancer (OR = 1.78, 95% CI: 1.40–2.28). The estimates for a 5-point increment in the indices were 0.88 (95% CI: 0.81–0.95) for PDI, 0.90 (95% CI: 0.83–0.96) for hPDI, and 1.15 (95% CI: 1.07–1.23) for uPDI. Consistent associations for the three indices were observed across strata of age, family history of breast/ovarian cancer, educational level, parity, oral contraceptives use, and menopausal status. Conclusions: Plant-based diets favorably influence ovarian cancer risk; plant-based diets characterized by a high intake of unhealthy plant foods are linked to an increased risk. Promoting diets rich in healthy plant foods could support the reduction of ovarian cancer risk. Full article

This study aims to describe oral contraceptive knowledge among adolescents and young women, and to examine individuals’ characteristics associated with oral contraceptive knowledge. A cross-sectional survey was administered using an online panel. Females aged 16 to 24 were recruited. Oral contraceptive knowledge was measured using nine items with six domains, including oral contraceptive use, efficacy, indication, mechanism of action, risks, and side effects. A summated score was created, with a score of 9 indicating highest level of knowledge. Multivariable regression was used to examine significant socio-demographics and clinical characteristics. Among the 700 included responses, largest proportion of respondents were White (45.43%) and were covered by public insurance (43.14%). A total of 446 (63.71%) respondents expressed at least slight interest in using over-the-counter oral contraceptives. Overall, the mean score of knowledge was 4.08 out of 9. Most did not correctly answer questions about side effects, the mechanism of action and appropriate use. Similar patterns were observed among those who were interested in over-the-counter oral contraceptives (mean = 4.11). Adolescents and young women had a low level of oral contraceptive knowledge. With a high proportion of individuals interested in over-the-counter oral contraceptives, additional information support is needed to support informed contraception choice and use. Full article

Objective: To evaluate the effectiveness of a pharmacist-led educational intervention in reducing premenstrual syndrome (PMS) symptoms and improving self-care practices. Methods: A mixed-design study was conducted in community pharmacies in Spain between January and June 2025. First, a cross-sectional analysis determined PMS prevalence. Second, a longitudinal pre-post study was performed with women suffering from PMS. The intervention involved personalized guidance and an evidence-based educational infographic. Primary outcomes included symptom severity (measured by a numeric rating scale) and quality of life. Results: 350 women participated in the study. The mean age of participants was 23.7 ± 6.3 years (range: 17–51 years). At the six-month follow-up, the PMS group showed a significant reduction in mean pain intensity (from 6.86 to 3.26; p < 0.001) and a smaller reduction in the control group (from 4.82 to 2.88; p < 0.001), alongside improvements in irritability, insomnia, and fatigue. The proportion of women reporting a negative impact on quality of life decreased from 97.0% to 60.8% (p < 0.001). Oral contraceptive use was identified as a protective factor (OR: 0.33; 95% CI: 0.17–0.65). Conclusions: Educational interventions led by community pharmacists are effective in significantly alleviating PMS symptoms and enhancing women’s quality of life. Practice Implications: Community pharmacists are strategically positioned to identify women with PMS and provide evidence-based education. Implementing structured protocols and visual tools in pharmacies can optimize symptom management and promote self-care. Full article

Background/Objectives: Cervical cancer remains a major cause of morbidity and mortality among women worldwide, marked by stark geographic and socioeconomic disparities. Preventable via HPV vaccination and screening, progress toward elimination varies widely across and within countries. This narrative review synthesizes the epidemiology, including incidence, mortality, survival, and stage distribution, as well as risk factors and the coverage/equity of HPV screening and vaccination programs. Methods: Comprehensive searches were performed in PubMed, Web of Science, Scopus, and Google Scholar (no date restrictions; English only). Included were original epidemiological studies, systematic reviews, meta-analyses, and international reports on burden, risk factors, or prevention indicators. Data were qualitatively synthesized into three themes: epidemiological patterns, risk factors, and screening/prevention programs. Results: Persistent high-risk HPV infection causes nearly all cervical cancers, predominantly HPV16/18, with regional variation in other types. Strong co-factors include HIV immunosuppression, early sexual debut, multiple partners, high parity, long-term oral contraceptive use, and smoking. Inequalities in incidence, late diagnosis, and survival are driven by socioeconomic disadvantages, low education, rural residence, and poor health system access. Screening ranges from cytology/VIA to primary HPV testing, but coverage is low and inequitable in high-burden settings. HPV vaccination has expanded yet faces major gaps in low- and middle-income countries. Conclusions: Cervical cancer burden concentrates in low-resource and marginalized populations. Global elimination demands accelerated, equitable scale-up of HPV vaccination and screening, alongside health system strengthening and barrier reduction. Full article

Polycystic Ovary Syndrome (PCOS) is characterized by a self-perpetuating vicious cycle between insulin resistance (IR) and hyperandrogenism (HA). While lifestyle management remains the internationally recommended first-line treatment, current clinical management, primarily relying on combined oral contraceptives and metformin, offers symptomatic relief or “masking” of the phenotype but fails to adequately disrupt this core pathophysiological loop, while also carrying potential intergenerational safety concerns. This review systematically evaluates the paradigm shift toward mechanism-based precision medicine. First, we analyze emerging precision-targeted therapies that intervene in specific pathological nodes: (1) metabolic regulators (e.g., GLP-1RAs, SGLT2i, and brown adipose tissue (BAT) activators) that target systemic glucotoxicity and the novel “BAT-Ovarian axis”; (2) neuroendocrine modulators (e.g., NK3R antagonists) that act as negative modulators of the hyperactive GnRH pulse generator; and (3) innovative androgen synthesis inhibitors (e.g., Artemisinins) that utilize a degradation-at-source mechanism. Complementing these, we explore the strategic value of Natural Products through the lens of “Network Pharmacology”, highlighting their ability to restore systemic homeostasis via multi-target modulation. Finally, we address critical translational challenges, specifically the need to establish long-term reproductive and offspring safety, providing a roadmap for developing true disease-modifying treatments for PCOS. Distinct from reviews limited to isolated therapeutic modalities, this article uniquely bridges current clinical management with emerging organ-specific precision targets and natural product networks. Full article

Microneedle (MN) technologies have emerged as a groundbreaking platform for transdermal and intradermal drug delivery, offering a minimally invasive alternative to oral and parenteral routes. Unlike passive transdermal systems, MNs allow the permeation of hydrophilic macromolecules, such as peptides, proteins, and vaccines, by penetrating the stratum corneum barrier without causing pain or tissue damage, unlike hypodermic needles. Recent advances in materials science, microfabrication, and biomedical engineering have enabled the development of various MN types, including solid, coated, dissolving, hollow, hydrogel-forming, and hybrid designs. Each type has unique mechanisms, fabrication techniques, and pharmacokinetic profiles, providing customized solutions for a range of therapeutic applications. The integration of 3D printing technologies and stimulus-responsive polymers into MN systems has enabled patches that combine drug delivery with real-time physiological sensing. Over the years, MN applications have grown beyond vaccines to include the delivery of insulin, anticancer agents, contraceptives, and various cosmeceutical ingredients, highlighting the versatility of this platform. Despite this progress, broader clinical and commercial adoption is still limited by issues such as scalable and reliable manufacturing, patient acceptance, and meeting regulatory expectations. Overcoming these barriers will require coordinated efforts across engineering, clinical research, and regulatory science. This review thoroughly summarizes MN technologies, beginning with their classification and drug-delivery mechanisms, and then explores innovations, therapeutic uses, and translational challenges. It concludes with a critical analysis of clinical case studies and a future outlook for global healthcare. By comparing technological progress with regulatory and commercial hurdles, this article highlights the opportunities and limitations of MN systems as a next-generation drug-delivery platform. Full article

Background and Objectives: There is a lack of information on the dietary intake of long-term combined oral contraceptive users (COC-users) in relation to their body composition. The aim of the pilot study was to determine the food consumption of young women using COCs for >6 months and its relationship to body composition compared to non-users. Materials and Methods: A total of 45 healthy women (21.8 ± 1.7 years) were divided into COC non-users (n = 19) and users of a low (≤20 μg) ethinylestradiol (EE) dose (n = 18) and a medium (30–35 μg) EE dose (n = 8). Anthropometric data, body composition, physical activity levels, three-consecutive-days of dietary records, and serum concentrations of calcium, magnesium, and vitamin D were assessed. Statistical methods included chi-squared, Fisher’s exact test, t-test, Mann–Whitney U test, Spearman’s correlation, and multiple linear regression. Results: There were no differences between COC-users and non-users in terms of physical activity, intake of micronutrients, body mass index, body fat percentage (BF%), or bone mineral density (BMD). COC-users consumed a higher percentage of energy from fats (p = 0.02) and had higher serum vitamin D levels (p < 0.01). BF% was negatively associated with BMD (coefficient −0.008; p = 0.027). Conclusions: The use of COCs for ˃6 months is not associated with FM or BMD, regardless of dietary differences. Further attention should be paid to possible associations between COCs use, dietary habits, and body composition (including BMD). Full article

Background/Objectives: The most prevalent benign tumors in women are uterine fibroids. Most patients—more than half—do not exhibit any symptoms, but the most common clinical signs include irregular uterine bleeding, pelvic pain, gastrointestinal problems, increased frequency of urination, and, in some cases, infertility. Venous thromboembolism is a very rare consequence, especially when significant uterine fibroids are present. This syndrome usually develops because of pelvic vascular systems being compressed, which causes venous stasis. Pharmacological treatment, minimally invasive procedures, and surgical techniques are examples of therapy alternatives. The purpose of this study is to present, compare, and potentially elucidate the underlying mechanisms of VTE development in fibroids. Methods: we have synthesized findings from 24 documented instances of venous thromboembolism (VTE) linked to uterine fibroids. Results: the principal mechanism underlying thromboembolic events was identified as the mechanical compression of pelvic venous structures due to mass effect. Additionally, we recognized other pertinent risk factors, including oral contraceptive use, May-Thurner syndrome, myomatous erythrocytosis, and intravenous leiomyomatosis. None of the reviewed case reports provided evidence of confirmed inherited thrombophilia in the patients under investigation. The femoral and popliteal veins, primarily in the left leg, were most frequently impacted by thrombosis and the ensuing blockage. Imaging techniques confirmed that individuals suffered pulmonary embolisms in half of the cases. When the right treatment was given as soon as possible, most of VTEs had favorable outcome. In almost half of the cases examined, the patient had a hysterectomy. Since all symptoms were alleviated and the chance of additional thromboembolic consequences was reduced, this treatment strategy turned out to be the most successful. Conclusions: Clinicians should maintain a low threshold for venous imaging in women with large pelvic masses and unilateral limb symptoms. Despite being uncommon, VTE associated with UFs can cause serious morbidity. Mechanical venous compression is the main mechanism, which is often exacerbated by additional prothrombotic variables. Clinicians should maintain a low threshold for venous imaging in women with significant pelvic masses and unilateral limb symptoms, look for concurrent thrombophilia, and investigate early surgical consultation to address compressive etiologies when VTE is still unexplained. It would be simpler to ascertain the actual incidence and pinpoint risk variables that can be altered with standardized reporting of fibroid-associated VTE and prospective registries. Full article

Background/Objectives: Epithelial ovarian cancer (EOC) encompasses ovarian, fallopian tube and peritoneal malignancies. It is a deadly disease and is rarely cured when diagnosed at advanced stages. Early-stage disease is often curable, but clinicians and researchers have been stymied in their attempts to reliably screen for this disease, even in high-risk populations. Effective prevention of ovarian cancer is usually limited to the use of combined oral contraceptives and removal of the ovaries and fallopian tubes. Methods and Results: We aim to review the current guidelines and the evidence reported for both the early detection and prevention of ovarian cancer. Novel imaging techniques, biomarkers, and surgical advances will be discussed. Conclusions: This review will offer (a) an understanding of the epidemiology of EOC (b) analysis and a discussion of relevant molecular markers that might be exploited for more accurate early detection (c) medical and surgical methods to prevent ovarian cancer. Full article

Objectives: This study aims to evaluate the safety and tolerability of estetrol/drospirenone in adolescents. Methods: In this Phase 3 open-label study, postmenarchal adolescents (12–17 years) received estetrol (E4)/drospirenone (DRSP) 15 mg/3 mg orally for six cycles (24 active/4 placebo regimen). Safety was evaluated through adverse event (AE) reporting. Participants also recorded daily pill intake, bleeding/spotting, dysmenorrhea, and pain medication use in e-diaries. Descriptive statistics were used. Results: Of 112 enrolled participants, 105 received treatment (mean age: 15.2 years), and 84.8% were completers. No serious treatment-related AEs or safety concerns were observed. Nausea and dysmenorrhea (each 1.9%) were the most common treatment-related AEs. Over 71% of participants took all tablets in each cycle. The percentage of participants with unscheduled bleeding and/or spotting decreased from 45.8% (Cycle 1) to 14.5% (Cycle 5), and the number of days with unscheduled bleeding and/or spotting decreased from nine to six days per cycle. The scheduled bleeding and/or spotting rate ranged between 77.4% and 90.5%, with a duration decreasing from six to four days in Cycle 1 to Cycle 5. Absence of scheduled bleeding increased from 9.5% in Cycle 3 to 22.6% in Cycle 5. The proportion of participants reporting dysmenorrhea decreased by 34.8%, with a median visual analogue scale score dropping from 5.0 at baseline to 3.7 at Cycle 6. Pain medication use decreased from 63.9% to 31.6% in Cycle 6. Conclusions: The use of E4/DRSP in adolescents raised no safety concerns, was well tolerated, resulted in a clear and stable cyclic bleeding pattern, and reduced pain associated with dysmenorrhea. Full article