Women

This study aimed to assess maternal health profiles related to diet, pregnancy, and breastfeeding practices among 437 mothers with children under 24 months in a rural village in Madagascar, and to examine their association with maternal educational attainment using interviews and anthropometric data. Bivariate statistical analyses were performed to explore associations between maternal education level and all studied variables. Multivariate analyses were also conducted but did not yield reliable results and are therefore not presented. The findings showed that higher maternal education was strongly associated with better socioeconomic conditions; improved access to essential resources like food, clean water, and healthcare facilities; and greater dietary diversity. More educated women reported consuming a wider range of foods, reflecting better nutritional quality and potential benefits for maternal health. In contrast, education level did not significantly affect pregnancy-related care or breastfeeding practices as recommended by the WHO. This suggests that while education enhances women’s ability to access and choose nutritious diets, broader cultural or systemic factors may shape maternal care behaviors. Women with higher educational attainment had greater access to diverse and sufficient diets, which may contribute to improved maternal nutritional status. Sustainable interventions aimed at improving women’s education and nutritional literacy are needed to support informed dietary choices and improve maternal and child health outcomes. Full article

Endometriosis is a chronic inflammatory disorder affecting about 190 million women of reproductive age worldwide. It represents a major health challenge due to its broad impact on physical, reproductive, and psychological well-being and is clinically characterized by pelvic pain, menstrual irregularities, and infertility. This narrative review synthesized current evidence on the relationship between adiposity, metabolic and inflammatory markers, and endometriosis from a biopsychosocial and intersectional perspective. A comprehensive search was conducted in PubMed, Scopus, and Web of Science for peer-reviewed studies published in English over the past decade.: Results pointed out that endometriosis significantly affects inflammatory activity within adipose tissue, especially in visceral adipose tissue. Studies also reported reduced adipocyte size and altered adipose tissue function. The endometriosis cytokine profile exhibited a pattern of systemic and tissue-specific inflammatory activation (i.e., elevated levels of interleukin-6 and monocyte chemoattractant protein-1). Sociodemographic factors (i.e., age, race/ethnicity, socioeconomic status, and educational level) also play a significant role in differences in symptomatology, disease course, and healthcare access. To sum up, endometriosis need to be considered as a multisystem condition related to metabolic, inflammatory, and psychosocial factors. It is necessary to adopt a biopsychosocial and intersectional perspective to improve diagnosis and support more equitable and personalized therapeutic approaches. Full article

Aromatherapy, the therapeutic use of essential oils, is increasingly recognized as a complementary approach to women’s mental health, particularly during hormonally sensitive life stages such as menstruation, pregnancy, postpartum, and menopause. Concerns about the side effects of pharmacological treatments during these periods have driven interest in non-pharmacologic interventions. This narrative review synthesizes current clinical evidence on the efficacy of aromatherapy in alleviating psychological distress in women. A comprehensive literature review between 2000 and 2025 across PubMed, Scopus, and Web of Science databases identified 47 studies focusing on essential oils for anxiety, depression, or stress in female populations. The most substantial evidence supports the use of lavender, bergamot, rose, chamomile, clary sage, and ylang-ylang, with inhalation and massage as the most frequently studied delivery methods. Outcomes include reductions in cortisol, heart rate, and subjective stress, along with improvements in mood and emotional regulation. Aromatherapy demonstrates particular promise in postpartum and perimenopausal care. However, methodological heterogeneity and variability in oil composition limit generalizability. Despite these challenges, the evidence suggests that aromatherapy may serve as a safe, low-cost adjunct for managing mood disorders and stress in women, particularly when integrated into personalized, holistic care strategies. Full article

Genitourinary syndrome of menopause (GSM), which includes vulvovaginal atrophy (VVA) and other bothersome genitourinary symptoms, affects over half of postmenopausal women and has a considerable impact on quality of life. This study aimed to evaluate the efficacy and safety of an injectable combination of hyaluronic acid and amino acids for treating GSM-related symptoms. In this prospective, multicenter study, 84 women aged 46–60 with moderate to severe VVA confirmed by gynecological examination received three intradermal treatments at 21-day intervals, targeting the vestibule, introitus, lower vaginal wall, and labia majora. Symptom severity was assessed using a visual analog scale (VAS), while tolerability and satisfaction were evaluated via a five-point Likert scale. Quality of life was measured using the Satisfaction With Life Scale (SWLS). Assessments were conducted at baseline, after each injection, and at 3- and 6-month follow-up visits. After three months, significant improvements were noted in vaginal dryness, itching, burning, and dyspareunia (all p < 0.001). Patient satisfaction increased from 59.0% to 80.7%, and SWLS scores rose from 4.57 ± 1.76 to 6.53 ± 1.10, reflecting enhanced quality of life. The treatment was well tolerated and demonstrated a favorable safety profile. These findings suggest that this injectable formulation may represent an effective, non-hormonal option for women with VVA, particularly those who are not candidates for hormone therapy. Full article

Cervical cancer remains the main etiology of high morbidity and mortality among women in developing world despite the screening plans. In South Africa, screening policies are low. Attitude, knowledge, and practices (AKP) play a pivotal role in diagnosis, prevention and screening. The review explores AKP towards cervical cancer and screening including global and regional burden, and determinants of screening uptake. Previous empirical studies identifying factors influencing adherence to screening services were identified. Studies from 2020–2025 were searched using PubMed and Google databases. Identified terms and topics were combined using Boolean Operators and PRISMA guidelines. Keywords were “attitudes”, “knowledge”, “practice”, “current cervical cancer screening”, AND “South Africa”, “global”, “regional”, “burden”, “cervical cancer”, “screening uptake determinants ” and “cervical cancer screening”, “factors influencing adherence”, and “cervical cancer screening”, “practices and pap smear tests”, “strengths”, “limitations”, “future research”, AND (“cervical cancer screening”). Key findings: many women know cervical cancer or Pap smears but lack detailed knowledge about risk factors and screening protocols, actual Pap smear uptake is low. Fear of outcome of procedure, pain, or embarrassment are primary barriers, and lack of service access. A multidisciplinary approach involving healthcare providers, government and non-governmental organizations is crucial in addressing gaps in cervical cancer screening. Full article

African American (AA) women often experience earlier onset and more severe menopause symptoms, especially vasomotor symptoms (VMSs) like hot flashes, compared to other groups. However, limited research has examined the effectiveness and acceptability of menopause treatments in this population. This scoping review synthesized evidence on pharmacological (e.g., hormone replacement therapy [HRT], SSRIs, venlafaxine, nitroglycerin) and holistic (e.g., dietary changes, physical activity [PA], supplementation) approaches for managing menopause symptoms in AA women. Using Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was conducted, guided by the PCC framework. Four databases (CINAHL, PsycInfo, PubMed, Scopus) were searched for English-language studies (2010–2025) involving AA women aged 40–65. Eligible studies included RCTs and observational designs with ≥10% AA participants. Data were charted and synthesized descriptively. Fourteen U.S.-based studies (11–53% AA representation) were included. Pharmacological treatments—especially HRT and SSRIs—were effective for VMSs and mood symptoms. Holistic approaches showed mixed outcomes; PA and magnesium offered modest benefit, while phytoestrogens sometimes worsened memory. Race-specific results were rarely reported. Effective pharmacological options exist, but evidence tailored to AA women is lacking. Future research must ensure greater AA representation and culturally responsive approaches to menopause care. Full article

This study discusses the challenges encountered in breast cancer screening coverage in Brazil. The aim was to verify mammography coverage in Brazil. A cross-sectional study was carried out using data provided by the Ministry of Health verifying the following information: method of detection, analysis of coverage, clinical and sociodemographic variables of breast cancer. We observed significant differences in the number of mammograms performed between Brazilian regions and between levels of education, which may be determining factors for adherence to the examination, as well as differences related to the collection period analyzed. Raising awareness among the population about the importance of mammography and training health professionals are fundamental to increasing coverage. It is necessary to invest in awareness-raising strategies and in a health care network prepared to welcome women with suspicious signs and symptoms, ensuring investigation and treatment. Full article

Despite the many benefits for both the mother and fetus of physical activity during pregnancy, only 12.7–37.8% of pregnant persons in the United States achieve the recommended 150 min of moderate-intensity physical activity per week. While many variables influence physical activity participation during pregnancy, social support has been associated with physical activity participation in various populations. Originally used in the study of criminology, the social support theory has been applied in recent evidence as a method of promoting physical activity and other healthy behaviors. Recent literature suggests that social support and co-participation are interpersonal facilitators of participation in physical activity. Therefore, we propose an integrated model through a combination of social support and co-participation in physical activity to increase physical activity during pregnancy: the SsCo-PAP Model. The practical advantage of this combination is that both social support and co-participation emphasize social connectedness to facilitate physical activity. We recommend that the model be utilized by clinicians to educate, encourage, and support their patients to be physically active during their pregnancy. Future research should analyze the feasibility and effectiveness of using the SsCo-PAP Model in clinical practice. Full article

Mastectomy, while a life-saving intervention for breast cancer, often leads to profound psychological and emotional challenges for affected women. Feelings of loss altered body image, and anxiety about recurrence can significantly impact mental well-being. This study aimed to explore and describe the experiences of women after mastectomy at Mankweng Tertiary Hospital in Limpopo Province, South Africa. In this study, a qualitative phenomenological design was used. Data were collected through semi-structured in-depth interviews with women who had undergone mastectomy. Fifteen participants were purposively sampled, and thematic analysis was used to identify key patterns and meanings in their narratives. The findings revealed that the participants initially described feelings of being ‘disabled’, incomplete, and anxious about cancer recurrence or their ability to perform maternal functions such as breastfeeding. However, over time, many developed resilience and acceptance, seeing surgery as a life-saving measure and an opportunity for renewal. The adjustment of women after mastectomy is a complicated emotional transition from crisis and loss to adjustment and empowerment. The results identify the need for holistic psychosocial support that combines counseling, peer networks, and education for their family members addressing their emotional healing, body image, and social reintegration. Full article

To improve shared decision-making about the potential risks and benefits of hormone therapy (HT), it is crucial to understand the joint effects of menopausal age and HT use on hypertension onset. This study examines the combined and individual effects of age at menopause and HT on hypertension onset in U.S. women based on their hysterectomy and oophorectomy history. This population-based, cross-sectional study included 4776 postmenopausal women with and without hysterectomy and oophorectomy history from the 2011–2020 National Health and Nutrition Examination Survey (NHANES). Age at hypertension onset was defined as the time scale at which a respondent was diagnosed with hypertension following the menopause onset. The weighted prevalence of hypertension was 40.0% (95% CI 38.2–41.8%) overall, highest in those who had an oophorectomy with or without hysterectomy (51.6%), followed by those with hysterectomy alone (45.3%), then in those with an intact uterus and ovaries (33.7%), p < 0.0001. Among women with an intact uterus and ovaries, those who experienced menopause before age 45 and used HT had a comparable risk of hypertension (aHR = 1.34, 95% CI: 0.81–2.22) to women who experienced menopause between ages 45 and 54 and did not use HT. Conversely, women who experienced menopause before age 45 and did not use HT showed a significantly increased risk of hypertension (aHR = 1.68, 95% CI: 1.27–2.22). The findings suggest that the absence of ovaries, with or without a uterus, HT use, and age at menopause are associated with the likelihood of hypertension development. This study highlights the need for personalized management and decision-making to reduce the risk of hypertension and cardiovascular disease in peri- and postmenopausal women. Full article

Poor satisfaction with one’s body is associated with obesity and emotional eating (EmE), especially in women. To improve behavioral obesity treatments, this study aimed to identify the effects of targeting the mediators of the body satisfaction–EmE relationship to improve weight-reduction outcomes. Women with Class II obesity (body mass index [BMI] of 35–39.9 kg/m²) were randomized into 6-month treatments targeting either increased physical activity and self-regulation (TARGETED group, n = 44) or standard weight management education (STANDARD group, n = 33). Improvements over 6 months in EmE, body satisfaction, mood, eating-related self-efficacy and self-regulation, and physical activity, and in weight over 6, 12, and 24 months, were significantly greater in the TARGETED group. Mood and eating-related self-efficacy mediated the body satisfaction–EmE relationship at baseline and the group–EmE change relationship. In the consideration of the treatment targets, increased physical activity predicted reduced EmE, mediated by mood change, and increased self-regulation predicted reduced EmE, mediated by self-efficacy change. Reduced EmE predicted weight losses. This research (a) identified psychological/behavioral mediators of the body satisfaction–EmE relationship; (b) ascertained methods associated with the improvement of those variables, their correlates, and interrelations; and (c) confirmed the viability of the indicated behavioral targets on EmE within a community-based obesity treatment. Given the identified associations with short- and longer-term weight losses, treatments were effectively informed. Full article

This study examined the consistency between clinical criteria, assigned priority level, and waiting time for elective hysterectomy, assessing whether higher priority translates into faster surgical access. We conducted a retrospective cohort study including 846 women who underwent the procedure between January 2018 and January 2024 at a public hospital in São Paulo, Brazil. The median waiting time was 6 months (IQR: 3–10), with wide variability ranging from 0.5 to 53 months. All components of the clinical score were associated with higher priority levels, demonstrating adequate discriminative ability to identify patients at greater clinical risk. However, assigned priority was not associated with shorter waiting times. Criteria reflecting greater clinical vulnerability, including duration of symptoms (β = +2.50 months), age (β = +1.00), and cardiovascular disease (β = +1.00), were paradoxically associated with longer waiting times, whereas anemia was the only factor associated with reduced waiting time (β = −1.00). These findings reveal a marked discrepancy between formal prioritization and actual surgical scheduling, underscoring the need for more objective and equity-oriented criteria in the management of surgical waiting lists. Full article

Adverse pregnancy outcomes (APOs) such as prematurity, low birth weight, stillbirth, and birth defects remain significant global health challenges. While many risk factors are known, APOs encompass a wide range of outcomes with diverse, sometimes poorly understood etiologies. Pregnancy-related acute kidney injury (PR-AKI) and liver injury are particularly associated with increased maternal and fetal mortality. This study investigated the association between hematological parameters, kidney and liver injury markers and adverse pregnancy outcomes. This cross-sectional study involved 714 pregnant women aged 18–40 years, conducted between August 2021 and August 2022. Maternal blood samples were collected before and after delivery to compare hematological parameters. Kidney and liver injury markers were measured using standard methods. The study analysed the association of these parameters with adverse pregnancy outcomes. The median age of participants was 24 years (Q1, Q3: 21, 26). Women with adverse pregnancy outcomes had statistically significant serum creatinine levels [0.52 mg/dL (0.45, 0.58)] compared to those without [0.50 mg/dL (0.44, 0.56)], although the difference was not clinically significant. Elevated Aspartate Transaminase (AST) levels (>90th percentile) were statistically associated with adverse pregnancy outcomes. Pairwise comparisons with Bonferroni corrections revealed significant differences in Hemoglobin (Hb), White Blood Cell (WBC), Red Blood Cell (RBC), platelet, and Packed Cell Volume (PCV) levels before and after delivery (p < 0.05) in both groups. Elevated AST levels, but not other hematological or biochemical parameters, were independently associated with adverse pregnancy outcomes, whereas creatinine differences lacked clinical impact. Full article

This systematic review aimed to identify psychosocial risk factors associated with the development of complicated perinatal grief in adult women who experienced pregnancy loss. Following PRISMA guidelines, comprehensive searches were conducted in Web of Science, PubMed, Scopus, and PsycINFO databases, covering 1990–2024. A total of 34 quantitative studies comprising 7872 participants were included, mainly using cross-sectional and longitudinal designs. Findings indicate that complicated perinatal grief is a multifactorial condition influenced by personal variables (absence of living children, history of depression or PTSD, advanced maternal age, low education and income), obstetric factors (later gestational loss, multiple pregnancies, stillbirth, or neonatal death), and psychosocial factors (low social support, relationship conflict, violence, ostracism, and limited psychological care). Negative cognitions, rumination, and maladaptive coping strategies were also linked to prolonged symptoms of depression, anxiety, and post-traumatic stress. The review concludes that complicated perinatal grief is a multidimensional phenomenon determined by psychological, social, cultural, and medical factors and highlights the need to understand perinatal loss as a profoundly significant experience that affects women’s identity, relationships, and mental health. This evidence highlights the importance of emphasizing the identified risk factors that can lead to complicated grief. Full article

Women in vulnerable living situations with schizophrenia face intersecting challenges, including migration-related trauma, caregiving burdens, and systemic barriers such as cultural dislocation, limited healthcare access, and stigma. These factors heighten vulnerability compared with men and contribute to delayed diagnoses, poor treatment adherence, and adverse outcomes. Advances in artificial intelligence (AI) and digital tools offer potential support, though they should be regarded as complementary rather than stand-alone solutions. This review synthesizes literature on gender-specific care for women with schizophrenia, examining clinical, social, and reproductive needs alongside the impact of migration and psychosocial adversity. Emerging models, including women-focused psychiatric units, perinatal services, and community therapeutic spaces, illustrate holistic approaches that integrate the medical, psychological, and social dimensions of care. Digital interventions, such as smartphone applications, mobile health tools, and digital participation strategies, are considered supportive extensions that offer opportunities to improve access, reduce costs, and enhance continuity of care. Despite this promise, digital tools remain under-validated for women in precarious contexts. Ethical challenges, including algorithmic bias, data privacy risks, and the exclusion of undocumented or marginalized groups, further constrain equitable implementation. This review aims to articulate conceptual linkages among gender, migration, and digital innovation in schizophrenia care, identifying thematic patterns, ethical tensions, and structural limitations in the existing literature. The synthesis provides a foundation for future hypothesis development and interdisciplinary research to advance inclusive and equity-driven mental health interventions. Full article

Stress urinary incontinence (SUI) is the most common subtype of female urinary incontinence, affecting up to one in four women and markedly reducing quality of life. Its pathophysiology primarily involves impaired suburethral and paraurethral support, resulting in decreased tissue stiffness and urethral hypermobility. Conventional imaging provides anatomical detail but is limited in its ability to assess pelvic floor biomechanics. This narrative review summarizes current evidence on strain elastography (SE) as a functional imaging modality in urogynecology, with emphasis on evaluating suburethral tissue stiffness in women with SUI. A narrative review was performed using PubMed (2000–2025). Primary searches (“strain elastography” AND “female stress urinary incontinence”; “stress incontinence” AND “elastography”) yielded 19 records, of which 12 were included after screening. Owing to the limited number of SE-specific studies, the review was expanded to include shear wave elastography research, key guidelines, and biomechanical literature on pelvic floor ultrasound in adult women with SUI. SE provides a non-invasive, real-time method for assessing tissue stiffness, bridging the longstanding gap between anatomical and biomechanical evaluation. Current evidence supports SE as a feasible and promising diagnostic adjunct for the functional assessment of SUI in women. Full article

Endometriosis and chronic pelvic pain (CPP) impose substantial economic burden in New Zealand, yet no national cost-of-illness (COI) model currently exists. This study provides the first nationwide estimate using a modified World-Endometriosis-Research-Foundation (WERF) EndoCost protocol incorporating direct healthcare, productivity, and carer costs. An attribution correction model was applied to account for diagnostic overlap, assigning 43.4% of CPP cases to endometriosis. Attribution-adjusted annual per capita costs were INT 97,497 (NZD 174,130) for endometriosis and INT 33,262 (NZD 59,406) for CPP. Macroeconomic costs ranged from INT 12.7B to 17.7B (NZD 22.6B–31.7B) per annum, depending on prevalence. Productivity losses were the primary cost driver, accounting for 65% of endometriosis and 75% of CPP cost. The unattributed lifetime burden was INT 1.96M (NZD 3.50M) per person for endometriosis and INT 1.54M (NZD 2.74M) per person with CPP. This reflects total economic burden over a 34.5-year working lifespan, adjusted for labor-force participation. Diagnostic delays and health system inefficiencies such as poor healthcare access and suboptimal symptom management are likely to be the most significant modifiable contributor to this burden. Addressing this will require investment in healthcare provision and symptom management alongside equitable access to fertility care. Full article

Use of assisted reproductive technology (ART) to bear children has in recent years become widespread in Japan. While midwives are required to understand the experiences of individual women and provide ongoing support for them, implementing respectful care that meets the needs of women using ART remains challenging. This study therefore aimed to explore the specific care components expected of midwives for women with twin pregnancies after ART. A cross-sectional questionnaire survey was conducted through Google Forms on 273 women with twin pregnancies, of whom 85 had conceived twins through ART. Women were recruited through national multiple birth support groups and midwifery centers providing postnatal care. Data were collected from July 2021 to December 2022, and care expectations were rated on a 5-point Likert scale. Factor analysis was performed to identify care components, and reliability was evaluated using Cronbach’s alpha. Among the participants, 41.2% were between 36 and 40 years of age. Seven primary care factors were identified: comprehensive parenting support for twins, addressing concerns regarding the sudden death of twins, interdisciplinary medical collaboration, connecting women with twin pregnancies, understanding post-delivery physical pain, providing continuity before and after delivery, and supporting the development and well-being of the twins. The findings emphasize the importance of understanding individual ART histories and providing tailored care to respond appropriately to women’s needs during pregnancy, childbirth, and the postpartum period. The identified components provide an empirical foundation for integrating these perspectives into routine midwifery care and educational programs for women with ART-conceived twin pregnancies. Full article

Positive Body Image (PBI) has been conceptualized as a multidimensional construct encompassing acceptance, functionality appreciation, and self-care, yet little is known about the lived processes through which women move from self-criticism to reconciliation with their bodies. This study aimed to explore how women experience, construct, and sustain PBI in their everyday lives, and to identify the psychological and contextual factors that facilitate its development. Semi-structured interviews were conducted with ten women in Greece (ages 18–62) of diverse body sizes, educational backgrounds, and life circumstances, which were then analyzed using interpretative phenomenological analysis. Participants were recruited through convenience sampling and interviewed online between July and August 2025. Findings revealed three superordinate themes—(1) Catalysts of Realism and Self-Care, (2) From Rejection to Reconciliation, and (3) My Own Positive Body Image—comprising nine subthemes that together illustrated a developmental process of body acceptance and meaning-making. Findings revealed a trajectory from self-rejection to reconciliation, marked by shifts from external appearance to holistic embodiment, and from self-criticism to compassion, functionality appreciation, and intrinsic motivation. Participants described mindful self-care practices—particularly exercise and healthy eating—as acts of self-nurturing, supported by psychotherapy, positive social relationships, and turning points such as illness, aging, or personal maturation. These catalysts facilitated a reorientation of body image away from societal ideals and toward health, resilience, and existential meaning. The study contributes to understanding how women develop sustainable forms of PBI, highlighting the importance of self-compassion, supportive contexts, and body functionality. These insights have implications for interventions aiming to promote wellbeing, resilience, and healthier relationships with the body across the lifespan. Full article