Women, Volume 3, Issue 3 (September 2023) – 8 articles

This study aimed to examine female recreational (FRC) athletes’ knowledge of the menstrual cycle and their perception of how each phase affects their performance, mood, and sleep. One hundred and sixty-four (n = 164) FRC athletes completed an online survey. The questionnaire employed was based on previously validated questionnaires and consisted of three different sections: (a) knowledge about the menstrual cycle, (b) menstrual cycle symptoms, and (c) menstrual cycle and performance. The results indicated that 70.1% of the surveyed FRC athletes were not knowledgeable regarding the phases of the menstrual cycle, with 55.5% being ignorant of the specific hormones released during the cycle. Furthermore, 37.8% perceived that their performance was sometimes affected during the early follicular phase, with the main symptoms being physical fatigue (17.9%) and a more irritable mood (25.9%). In addition, 19.5% of the FRC athletes reported sleeping disturbances, and 20.4% described changes in sleep quality during menstruation. Lastly, 11.9% of the FRC athletes reported suffering from a combination of mood swings, sleeping problems, bloating or stomach issues, breast tenderness, headaches, and fatigue prior to menstruation. The results of this study provide valuable insights into how FRC athletes experience the menstrual cycle, which can help RC athletes and trainers better understand their needs and support them in achieving optimal performance. Full article

Fluctuating hormone levels during the menstrual cycle and major reproductive cycle stages have been linked to mood changes, mental health conditions, and an increased likelihood of psychotic episodes. This knowledge could potentially be used for the predictive modeling of exacerbations and mood deterioration through the collection and analysis of data from wearables and apps. A literature search for a narrative review has been conducted using selected keywords in Pubmed, Embase and Google Scholar. Based on published data, it can be seen that hormonal changes affect the severity of symptoms in several mental health conditions, including depression, PMDD, PTSD, bipolar disorder and schizophrenia. The influence of FSH, LH, testosterone, and other hormone precursors has also been investigated, but there is less information available regarding their impact. E2 levels have been measured as a treatment–response biomarker and have demonstrated significant predictive ability for treatment responder groups. On the other hand, FSH has been demonstrated to be helpful in predicting treatment non-responder groups in schizophrenia. Monitoring reproductive hormones in combination with wearables or digital solutions has the potential to predict mood changes more effectively. Precise and frequent hormone measurements might prove to be more effective than relying on absolute threshold levels. Further research is needed to validate the utility and precision of hormone use in the field of mental health. Full article

Inv(9) is one of the most common chromosomal variants and is generally considered to be a variant of no clinical significance. We describe a case of a 35-year-old woman with a normal baseline fertility workup who presented to a university-affiliated fertility clinic after eight months of attempting conception. She underwent a rapid decline in anti-Mullerian hormone (AMH) from 10.0 ng/mL to 0.5 mg/mL and cycle day 3 (CD3) antral follicle count (AFC) from 58 to 4 total follicles during 18 months of follow-up. Her karyotype demonstrated a reportedly benign 46XX, Inv(9)(p11q13) variant. During follow-up and fertility treatment, she achieved pregnancy three times, but they all ended in chemical pregnancies. A systematic review of the literature identified 24 publications evaluating the association between infertility or recurrent pregnancy loss (RPL) and Inv(9). We report the prevalence of Inv(9) in women with infertility and the prevalence of infertility or RPL in women with Inv(9) mutation. Although Inv(9) has previously been considered to be a normal variant, several publications support the possible correlation between Inv(9) with reproductive failure. There has been limited literature regarding this association, and future studies should consider higher-resolution genomic detection methods to identify Inv(9)-related chromosomal rearrangements in couples presenting with infertility. Full article

Knowledge of the contributing factors of infertility is essential to optimizing the reproductive health of the population. Magazines are a major source of informational health messages; this study quantitatively and inductively examined the information in Japanese fertility-related magazine articles on modifiable lifestyle and risk factors associated with fertility. We conducted a content analysis in two major fertility-related magazines published between 2014 and 2020 that individuals attempting to conceive were likely to read. We also identified evidence-based lifestyle factors associated with reduced fertility after reviewing the scientific literature. In total, 76 lifestyle factors were mentioned in the magazine articles. A total of 9 of these 10 evidence-based lifestyle risk factors were among the 20 factors most frequently mentioned. Thus, the evidence-based lifestyle factors were well-discussed, but the articles focused heavily on nutritional factors. Health check-ups were not covered as extensively as nutrition and diet, although physical examination can uncover physiological causes of infertility. Some lifestyle factors in the articles had not been sufficiently scientifically examined. Too many recommendations were given in the magazine articles. This may induce a feeling of being overwhelmed in readers. The publishers of magazines should provide balanced information, consider prioritizing lifestyle factors by conclusive scientific evidence, and disseminate accurate information. Full article

Higher education and employment are two key components of women’s empowerment. However, many women fail to continue their studies or work after marriage, which can significantly reduce their empowerment potential, especially in countries with stark gender inequality such as in Bangladesh. In this study, our objective was to explore the individual, household and community factors associated with post-marriage education and employment among Bangladeshi women using data from the latest Bangladesh Demographic and Health Survey (BDHS 2017–18). Data were analysed using multivariate logistic regression methods. The results of the study show that a large proportion of the participants did not continue their studies (42.1%) or work (72.5%) after marriage, while only 3% of the participants studied and about 29.0% worked for more than 5 years after marriage. The most important factors associated with continuing to study after marriage include having access to a mobile phone (OR = 1.89, 95% CI = 1.62, 2.19), the husband’s number of years of education (OR = 1.11, 95% CI = 1.08, 1.15), a higher household wealth index (OR = 1.27–4.31) and improved toilet facilities (OR = 1.36, 1.12, 1.65). Conversely, the number of children (OR = 0.69, 95% CI = 0.65, 0.73), living in rural areas (OR = 0.78, 95% CI = 0.68, 0.88) and residing in certain divisions are negatively associated with continuing to study after marriage. Women with a mobile phone (OR = 1.47, 95% CI = 1.06, 2.03) are more likely to continue working after marriage, while those with larger spousal age differences (OR = 0.33, 95% CI = 0.19, 0.58) and those living in the Chittagong division (OR = 0.53, 95% CI = 0.30, 0.96) are less likely to do so. The study indicates that a large proportion of Bangladeshi women do not continue their education or work after marriage. These findings underscore the significance of empowering women and addressing sociodemographic issues to promote education and work opportunities after marriage. Full article

An estimated 4–8% of all women, and 16–25% of women with migraine, have menstrual migraine (MM), which causes considerable disability, but is underdiagnosed and undertreated. We investigated the burden of disease, health-care seeking behavior, and treatment practices among women with MM, using social media. In 12 days, 6246 women answered an online survey, allowing for diagnosis of MM by the International Classification of Headache Disorders third edition (ICHD-3). In total, 47% had MM, 21% had non-menstrual migraine (nMM), and 15% had probable menstrual migraine (pMM). Among women with MM, 61% had missed out on school/work and 69% on family, leisure, or social activities in the last 3 months. Fifty-four percent had consulted a health-care practitioner about their MM, of whom thirty-seven percent had received information about medical treatment of MM. A total of 85% used medicine in connection with MM, either over-the-counter medication only (57%), prescription medication only (24%), or both. Social media offers an efficient and less expensive recruitment platform for population-based studies on MM and is a useful tool to raise public awareness about MM. Moreover, this study confirms the significant impact of MM on women’s everyday lives and the challenges it poses to their regular activities. Full article

The vaccination of pregnant women against influenza and COVID-19 may reduce the risk of severe illness in both the women of this population and their babies. Although the risks of non-vaccination are more serious than the side effects, maternal immunization is still the least-used method of prevention due to a lack of information leading to concerns about the safety and efficacy of vaccines, resulting in a low prevalence rate among pregnant individuals. Our study investigates vaccination coverage and the knowledge, attitudes and perceptions of COVID-19 in pregnant women at a university hospital. A questionnaire was created with the following three scores: a vaccination propensity score, a knowledge score and a hesitancy score. The first observation in the results was the very low number of immunized women (only 4.7% received their first dose). The main barrier towards vaccination was found to be fear of adverse events. We noticed a low percentage of influenza and diphtheria tetanus pertussis vaccination compared to other studies. Vaccination propensity was higher when healthcare workers educated their patients. As immunization is a crucial part of public health policy, measuring coverage to identify gaps and monitor trends, especially for individuals considered at high risk, and developing new strategies in order to increase awareness of vaccination during pregnancy is particularly timely and relevant. Full article

The human papillomavirus (HPV) vaccine prevents cancer and is highly effective; however, the uptake has been low in the United States of America (USA) and among the most vulnerable populations. A recent Center for Disease Control (CDC) report highlighted that approximately 13,000 new cases of cervical cancer are diagnosed each year in the USA. Although cervical cancer is considered treatable, especially when detected early, in the USA, approximately 4000 women die every year of cervical cancer. However, little is known about access and awareness among women in the USA. The objective of this article is to focus on the role played by clinical pharmacists in bringing awareness about the HPV vaccine. It offers recommendations to enhance the administration of the HPV vaccine. This rapid literature review revealed two significant themes: Disparities in healthcare access to the HPV vaccine among women and clinical roles in empowering women to access the HPV vaccine. This rapid review emphasizes the need for future research in enhancing awareness about HPV as a viable strategy for women. As an integral part of the healthcare team, pharmacists can significantly improve awareness and administer the HPV vaccine, yielding enhanced outcomes and cancer prevention. Full article