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Introduction: Human papillomavirus (HPV) diagnosis has a considerable emotional and psychological impact on women. To evaluate the impairment this infection leads to regarding quality of life (QoL), several scales have been suggested, such as the human‐papillomavirus‐quality‐of‐life (HPV‐QoL) questionnaire. This has been validated for the Spanish population and measures the impact of HPV on health‐related‐quality‐of‐life (HR‐QoL). However, normative values are yet to be developed. Thus, the objective was to describe the population‐based norms of the HPV‐QoL for Spanish women aged 25–65 years and to test the questionnaire's construct validity. Material and Methods: This was a cross‐sectional nationwide multicenter study. Women from outpatient clinics in Spain aged 25–65 years, with a diagnosis of past or active HPV infection were recruited. The central tendency, dispersion, and percentiles were calculated for the total score and its dimensions for each age group. Construct validity was tested by analyzing age groups and their correlations with other related scales (12‐Item General Health Questionnaire [GHQ‐12], Female Sexual Function Index [FSFI], and Hospital Anxiety and Depression Scale [HADS]). Results: A total of 1352 women were included in the study. The norms showed moderate and significant coefficients of correlation with other related scales. Significant differences between age strata groups were found according to educational level, sexual dysfunction, sexual activity, mental deterioration, and severity of anxiety and depression symptoms (p < 0.001 in all cases). The total score differed significantly between the groups (p = 0.006). Significant differences in the contagiousness, health, and sexuality dimensions (p < 0.05) were found among the groups. It was seen that HPV infection impaired women's QoL. Dimensions within all test age groups (p < 0.001 in all cases) were significantly different, with the health dimension being the highest contributor to women's QoL impairment, whereas social well‐being was the main determinant of QoL. Conclusions: Population‐based norms for the novel HPV‐QoL questionnaire showed adequate validity and could be a useful tool for assessing the impact of QoL among women with HPV in Spain. [ABSTRACT FROM AUTHOR]

Simple Summary: In patients with early-stage endometrioid endometrial cancer, the presence of lymph vascular space involvement (LVSI) correlates with nodal metastases, shorter disease-free survival and overall survival. However, the effect of LVSI on recurrence patterns of these patients has been poorly studied, and the optimal adjuvant treatment remains unclear. Additionally, positive LVSI is indicative for nodal assessment, however, this parameter is usually not Known until a final pathology report. The main aim of our study was to analyze oncological outcomes and patterns of recurrence of these patients according to LVSI status, as well as to determine preoperative predictors of positive LVSI. We confirmed in a large multi-institutional cohort of patients (3546 participants), that positive LVSI is an independent prognostic factor for distant recurrences (HR 2.37) but not for local recurrence. In addition, deep myometrial invasion, high-grade tumors, cervical stroma invasion, and tumor diameter ≥ 2 cm are independent predictors of positive LVSI. The main aim is to compare oncological outcomes and patterns of recurrence of patients with early-stage endometrioid endometrial cancer according to lymphovascular space invasion (LVSI) status. The secondary objective is to determine preoperative predictors of LVSI. We performed a multicenter retrospective cohort study. A total of 3546 women diagnosed with postoperative early-stage (FIGO I-II, 2009) endometrioid endometrial cancer were included. Co-primary endpoints were disease-free survival (DFS), overall survival (OS), and pattern of recurrence. Cox proportional hazard models were used for time-to-event analysis. Univariate and multivariate logistical regression models were employed. Positive LVSI was identified in 528 patients (14.6%) and was an independent prognostic factor for DFS (HR 1.8), OS (HR 2.1) and distant recurrences (HR 2.37). Distant recurrences were more frequent in patients with positive LVSI (78.2% vs. 61.3%, p < 0.01). Deep myometrial invasion (OR 3.04), high-grade tumors (OR 2.54), cervical stroma invasion (OR 2.01), and tumor diameter ≥ 2 cm (OR 2.03) were independent predictors of LVSI. In conclusion, in these patients, LVSI is an independent risk factor for shorter DFS and OS, and distant recurrence, but not for local recurrence. Deep myometrial invasion, cervical stroma invasion, high-grade tumors, and a tumor diameter ≥ 2 cm are independent predictors of LVSI. [ABSTRACT FROM AUTHOR]

Objectives: To develop the population-based norms for the Cervantes-SF scale, which measures the impact of menopause on the health-related quality of life (HRQOL) of women in Spain.Methods: We used a sample obtained from representative studies of the Spanish population according to geographic density and autonomous community. This sample was composed of 5,237 non- institutionalized peri- and post-menopausal women, aged 40-75 years. Measures of central tendency, dispersion and percentiles were calculated for the total score and its dimensions, in 11 three-year age categories. Construct validity was analyzed based on a comparison with known groups to confirm the validity of the normative scales.Results: The norms show a monotonic gradient, with an incremental impact on HRQOL as age increases, as shown by an increase in the total score and each of the dimensions. Fifty percent of women showed that peri-/post-menopausal symptomatology interfered with HRQOL > 39 %, ranging from 25 % (40-44 years) to 47 % (72-75 years). The population norms showed significant differences between groups according to generic HRQOL, number of comorbidities, history of osteoporotic fracture, educational level, and presence of obesity.Conclusions: These results support the validity of the population-based norms for the Cervantes-SF scale, a valid instrument for measuring the impact of menopause on HRQOL in Spain. The norms obtained facilitate the interpretation of these scores in clinical practice, research, and health management. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to determine if the endometrial tumor volume (TV) measured by magnetic resonance imaging (MRI-TV) is associated with survival in endometrial cancer and lymph nodes metastases (LN+). Patients and methods: We evaluated the MRI imaging and records of 341 women with endometrial cancer and preoperative MRI from 2008 to 2018. The MRI-TV was calculated using the ellipsoid formula measuring three perpendicular tumor diameters. Tumor myometrial invasion was also analyzed. Results: Higher MRI-TV was associated with age ≥ 65y, non-endometrioid tumors, grade-3, deep-myometrial invasion, LN+ and advanced FIGO stage. There were 37 patients with LN+ (8.8%). Non-endometrioid tumors, deep-myometrial invasion, grade-3 and MRI-TV ≥ 10 cm3 were the factors associated with LN+. Using a receiver operating characteristic [ROC] curve, the MRI-TV cut-off for survival was 10 cm3 (area under curve [AUC] = 0.70; 95% CI: 0.61–0.73). 5 years disease-free (DFS) and overall survival (OS) was significantly lower in MRI-TV ≥ 10 cm3 (69.3% vs. 84.5%, and 75.4% vs. 96.1%, respectively). MRI-TV was considered an independent factor of DFS (HR: 2.20, 95% CI: 1.09–4.45, p = 0.029) and OS (HR: 3.88, 95% CI: 1.34–11.24, p = 0.012) in multivariate analysis. Conclusions: MRI-TV was associated with LN+, and MRI-TV ≥ 10 cm3 was an independent prognostic factor of lower DFS and OS. The MRI-TV can be auxiliary information to plan the surgery strategy and predict the adjuvant treatment in women with endometrial cancer. [ABSTRACT FROM AUTHOR]

Objective: To study the prevalence and epidemiological characteristics of women with vulvodynia. To assess the risk factors associated to the disease.Study Design: A cross-sectional study was made in which questionnaires were anonymously and confidentially distributed to Spanish women over 18 years of age between April 2016 and September 2017. The questionnaires were distributed by e-mail and through social networks, women's associations and specific websites. This type of questionnaire has been validated and used in many studies of this kind. The women answered questions referred to epidemiological aspects, demographic parameters, medical history, the presence of vulvodynia, associated factors, and comorbidities.Results: A total of 684 questionnaires were completed. The prevalence of vulvodynia was 6.6% (45 women). Thirteen percent (95 women) had experienced vulvodynia at some point in life. The factors associated to vulvodynia were prior vaginal deliveries (p = 0.001), vulvovaginal candidiasis (p < 0.001) and urinary tract infections (p < 0.001). Other pain syndromes such as fibromyalgia (p = 0.012), painful bladder syndrome/ interstitial syndrome (p < 0.001), temporomandibular joint pain (p = 0.021), coxofemoral pain (p = 0.001) or headache (p = 0.001) have also been associated to vulvodynia.Conclusions: The prevalence of vulvodynia in Spain is similar to that found in other countries. Many factors are involved in its development and persistence, particularly the presence of other pain syndromes and recurrent infections that could trigger complex inflammatory reactions. [ABSTRACT FROM AUTHOR]

Objective: To analyse the psychometric properties of the Cervantes scale short-form (SF) in the peri- and post-menopausal periods.Methods: Outpatients women 45-65 years with menstrual problems associated with the climacteric syndrome were analysed. Original and SF versions of the Cervantes scale were administered along with the EuroQol-5D (EQ-5D) and work productivity and activity impairment questionnaire (WPAI) scales. Conceptual model, burden of administration, feasibility, reliability, criteria validity and construct validity were assessed.Results: 317 women [55.7±5.3 years (mean±standard deviation)] were recruited: 75.4% were post- and 22.3% were peri-menopausal. The Cervantes-SF was completed in 2.5±1.6min, and 86% answered all items. Cronbach's α was 0.820, and ranged from 0.510 (Aging) to 0.918 (Vasomotor Symptoms) for individual dimensions. The scale structure matched the structure of the original version, χ(2)/(degrees of freedom)=3.6, Comparative Fit Index=0.848, Tucker-Lewis Index=0.850, and root mean square error of approximation=0.099, although differences were found between sexual activity statuses. Criteria validity was good (r=0.890), concurrent validity was congruent with a priori hypothesis using either the EQ-5D or the WPAI scales. The scale discriminated significantly the severity of both vasomotor and genital climacteric associated symptoms.Conclusion: The Cervantes-SF has shown good psychometric properties for measuring Health related quality of life in peri- and post-menopausal women who regularly attended gynaecology clinics in Spain. [ABSTRACT FROM AUTHOR]

Introduction The consequences of vulvar disorders in terms of health, sexuality, and quality of life are usually undervalued, with disparities in the conceptual, diagnosis and treatment criteria. Aim The objective of this guide will be to analyse the factors associated with the diagnosis and treatment of vulvar disorders and to provide recommendations for the most appropriate diagnostic and therapeutic measures. Methodology A panel of experts from various Spanish scientific societies related to sexual health (Spanish Menopause Society [SMS] and the Asociación Española de Patología Cervical y Colposcopia [AEPCC]) met to reach a consensus on these issues and to decide the optimal timing and methods based on the best evidence available. Results We recommend a biopsy of all vulvar lesions with an uncertain diagnosis, especially with asymmetry, irregular borders, variegated and irregular colour and diameter >6 mm. For vulvodynia, we recommend the use of lubricants or topical treatments with lidocaine or bupivacaine, amitriptyline, baclofen or triamcinolone. For vulvar epithelial disorders, we recommend beginning with topical corticosteroids of moderate to high potency. For sexual dysfunction, a multidisciplinary approach is the best management strategy in these patients. [ABSTRACT FROM AUTHOR]

Background: There are limited data available to indicate whether oncological outcomes might be influenced by the uterine manipulator, which is used at the time of hysterectomy for minimally invasive surgery in patients with endometrial cancer. The current evidence derives from retrospective studies with limited sample sizes. Without substantial evidence to support its use, surgeons are required to make decisions about its use based only on their personal choice and surgical experience.Objective: To evaluate the use of the uterine manipulator on oncological outcomes after minimally invasive surgery, for apparent early-stage endometrial cancer.Study Design: We performed a retrospective multicentric study to assess the oncological safety of uterine manipulator use in patients with apparent early-stage endometrial cancer, treated with minimally invasive surgery. The type of manipulator, surgical staging, histology, lymphovascular space invasion, International Federation of Gynecology and Obstetrics stage, adjuvant treatment, recurrence, and pattern of recurrence were evaluated. The primary objective was to determine the relapse rate. The secondary objective was to determine recurrence-free survival, overall survival, and the pattern of recurrence.Results: A total of 2661 women from 15 centers were included; 1756 patients underwent hysterectomy with a uterine manipulator and 905 without it. Both groups were balanced with respect to histology, tumor grade, myometrial invasion, International Federation of Gynecology and Obstetrics stage, and adjuvant therapy. The rate of recurrence was 11.69% in the uterine manipulator group and 7.4% in the no-manipulator group (P<.001). The use of the uterine manipulator was associated with a higher risk of recurrence (hazard ratio, 2.31; 95% confidence interval, 1.27-4.20; P=.006). The use of uterine manipulator in uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics [FIGO] I-II) was associated with lower disease-free survival (hazard ratio, 1.74; 95% confidence interval, 0.57-0.97; P=.027) and higher risk of death (hazard ratio, 1.74; 95% confidence interval, 1.07-2.83; P=.026). No differences were found regarding the pattern of recurrence between both groups (chi-square statistic, 1.74; P=.63).Conclusion: In this study, the use of a uterine manipulator was associated with a worse oncological outcome in patients with uterus-confined endometrial cancer (International Federation of Gynecology and Obstetrics I-II) who underwent minimally invasive surgery. Prospective trials are essential to confirm these results. [ABSTRACT FROM AUTHOR]

Simple Summary: In 239 women with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spanish and Portuguese centers between 2009 and 2018, the overall survival rate was 94.1% after a median follow-up of 51 months. Recurrence was diagnosed in 26 patients. In the multivariate analysis, independent risk factors for recurrence were tumor size > 20 mm, adenocarcinoma as histological type, presence of positive pelvic lymph nodes, tumor grades 2 and 3, and not performing sentinel lymph node biopsy. The present oncological and surgical results surpassed the target of quality indicators in cervical cancer proposed by the European Society of Gynecology Oncology. When selecting a robot-assisted surgical approach to perform radical hysterectomy in the surgical treatment of primary early-stage cervical cancer, it is recommended to take into account the tumor grade and histological type, results of the sentinel lymph node biopsy, and the size of the tumor. This retrospective analysis aimed to assess the risk factors for recurrence in patients diagnosed with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spain and Portugal between 2009 and 2018. A second primary objective was to audit the oncological outcomes according to quality indicators (QI) proposed by the European Society of Gynecology Oncology (ESGO). The study population included 239 women. After a median follow-up of 51 months, recurrence occurred in 26 patients (10.9%). Independent factors for recurrence were clinical tumor size > 20 mm (hazard ratio (HR) 2.37), adenocarcinoma as histological type (HR 2.51), positive pelvic lymph nodes (HR 4.83), tumor grade 2 (HR 4.99), tumor grade 3 (HR 8.06), and having not performed sentinel lymph node biopsy (SLNB) (HR 4.08). All 5 QI selected were surpassed by our results. In patients with early-stage cervical cancer undergoing robotic radical hysterectomy, clinicians should be aware that tumor grade 2 and 3, tumor size > 20 mm, adenocarcinoma, positive pelvic nodes, and lack of performance of SLNB are risk factors for recurrence. Fulfillment of QI targets of the ESGO might be considered as an objective oncological outcome indicator supporting the minimally invasive approach for early-stage cervical cancer treatment. [ABSTRACT FROM AUTHOR]

Introduction While we recognise that the term premature menopause is more accepted by most non-specialist health care providers and by the general population, ‘primary ovarian insufficiency’ (POI) is currently considered the most apposite term to explain the loss of ovarian function, because it better explains the variability of the clinical picture, does not specify definitive failure, and highlights the specific ovarian source. Its pathogenesis involves a congenital reduction in the number of primordial follicles, poor follicle recruitment, or accelerated follicular apoptosis. However, its cause is unknown in most cases. Aim This guide analyses the factors associated with the diagnosis and treatment of POI and provides recommendations on the most appropriate diagnostic and therapeutic measures for women under 40 years of age who experience POI. Methodology A panel of experts from various Spanish scientific societies related to POI (Spanish Menopause Society, Spanish Fertility Society, and Spanish Contraception Society) met to reach a consensus on these issues. Results Hormonal therapy (HT) is considered the treatment of choice to alleviate the symptoms of hypoestrogenism and to prevent long-term consequences. We suggest that HT should be continued until at least age 51, the average age at natural menopause. The best treatment to achieve pregnancy is oocyte/embryo donation. If a patient is to undergo treatment that will reduce her fertility, she should be informed of this issue and the available techniques to preserve ovarian function, mainly vitrification of oocytes. [ABSTRACT FROM AUTHOR]

Objective: Human papillomavirus (HPV) infection and menopause entail a considerable impairment in health-related quality of life (HRQoL). The objective of the present study was to analyze the impact of the menopause status on HRQoL in women with HPV infection., Methods: A cross-sectional, nationwide, multicenter sample of women with HPV infection was conducted throughout clinics of gynecology representative of the Spanish population with regard to age, geographic density, and autonomous regions. Demographic and clinical characteristics and the specific HPV-QoL questionnaire score with its domains were compared according to reproductive status: premenopausal and peri-/postmenopausal. Correlation with other validated patient-reported outcomes measurements was also tested, including General Health Questionnaire-12 (GHQ-12), Female Sexual Function Index (FSFI), and Hospital Anxiety and Depression Scale (HADS)., Results: A sample of 1,016 noninstitutionalized women, aged 18-80 y, was recorded, 191 (18.8%) peri-/postmenopausal and 825 (81.2%) premenopausal. Total HPV-QoL scoring was significantly lower in peri-/postmenopausal (38.8, 95% CI [35.2-42.4]) compared to premenopausal (46.4, 95% CI [45.0-47.8]) women, and also in every domain of the scale (P < 0.05), except in social well-being and health domains, with a small effect size of 0.39. In women with sexual dysfunction according to FSFI, adjusted total scoring and domains sexuality, general well-being, and psychological well-being scored significantly higher in premenopause women (P < 0.01), although the magnitude of differences were of small to moderate size., Conclusions: HRQoL was impaired during menopause in women with HPV infection according to HPV-QoL questionnaire. The sexuality domain was the most differentiating dimension between these populations., Competing Interests: Financial disclosures/conflicts of interest: This work was sponsored by the Asociación Española De Patología Cervical y Colposcopia (AEPCC). No financial or editorial support was provided except for a review of the English, conducted by Javier Calvo-Torres. Javier Rejas is an independent member of the EACCOS Research Group, Universidad Autónoma de Madrid, Madrid, Spain, and declares no conflicts of interest as a consequence of participating in this study. Isabel Gippini gave a lecture at GINEP en La Coruña about quality of life in menopause, paid for by Theramex, and had accommodations paid for by Dynamesh where she gave a lecture about robotic colposacropexy. The other authors have nothing to disclose., (Copyright © 2024 by The Menopause Society.)

Many women seek treatment to improve menopausal vasomotor symptoms (VMS). The selection of women most likely to benefit from menopause hormone therapy (MHT) is crucial in clinical practice. There is general agreement that women younger than 60 years or who initiate MHT within the first 10 years of menopause, with no contraindications, have greater benefits considering symptomatic relief and additional advantages. This group may have the advantage of protection from osteoporosis and from other chronic diseases that affect postmenopausal women, namely cardiovascular disease (CVD). Cumulating evidence supports MHT for symptomatic women. However, inadequate use according to the needs of symptomatic women led to a burden of suffering worldwide. In recent years, the emergent use of non-regulated body-identical hormones (non-rBHT) can expose patients to potential harms. These hormone preparations are not regulated through the same tests of safety, efficacy or dosing consistency as regulated-BHT (r-BHT). The POESIT (Portugal + Spain + Italy) recommendations highlight the use of 17β-estradiol (E2) and micronized progesterone (P4) as the real r-BHT. In addition, the group emphasizes as an example the data from the REPLENISH study with 1 mg E2/100 mg P4. The combination of the two hormones in one convenient pill showed a clear reduction or elimination of hot flashes and an improvement in sleep quality and, consequently, quality of life. At the same time, this combination has shown high rates of amenorrhea and no significant impact on lipid, glucose or coagulation parameters. Both the REPLENISH study and a real-life retrospective study pointed to the possibility of a lower risk of venous thromboembolism (VTE) with this formulation than with other combinations.

Objective: The primary objective was to evaluate the response rate of conservative treatment for endometrial cancer, and the secondary objective was to assess oncological, fertility and obstetric outcomes in patients who underwent fertility preservation treatment., Material and Methods: This multicentre, observational, retrospective study evaluated endometrial cancer patients who underwent fertility-sparing treatment in Spanish centres between January 2010 and January 2020. Seventy-three patients with stage IA endometrioid adenocarcinoma of the uterus were included in the study., Results: The levonorgestrel intrauterine device (LNG-IUD) was the most common fertility-sparing treatment (53.4%), followed by megestrol acetate (20.5%) and medroxyprogesterone acetate (16.4%). During the 24-month follow-up period, the rate of complete response to fertility-sparing management was 74% (n = 54), and 8.2% (n = 6) of patients presented a partial response. Additionally, 13 (17.8%) patients presented with persistent disease and six (8.2%) relapsed after response. The LNG-IUD was associated with a higher complete response rate than the other methods (87.2 vs. 58.8%; p = 0.01). Surgical treatment (at least hysterectomy) was performed in 44 (60.3%) patients as the end of fertility-sparing treatment. Four (5.5%) patients presented relapse after surgery, associated with final FIGO stage III (p = 0.036), myometrial invasion > 50% (p = 0.018) and final tumour grade 2-3 (p = 0.018). The mean follow-up period was 57.8 (range 6-159) months. The 5-year relapse-free survival and overall survival rates were 92.6% [95% CI (81.3, 97.2)] and 93.5% [95% CI (80.7, 97.9)], respectively. During follow-up, three patients (4.1%) died of the disease after completion of surgical treatment. Up to 50.7% of patients included in the study attempted to get pregnant. Of these, the rate of pregnancy was 81.1% (n = 30/37), and reproductive techniques were used for this purpose in 78.4% of cases., Conclusions: Fertility-sparing management presented a high response rate in patients with endometrial cancer. LNG-IUD was associated with a better response rate compared to the other treatment options. Moreover, in patients using this management method, pregnancy could be achieved using reproductive techniques., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The aim of the study was to evaluate the level of knowledge that women have about menopause and to analyse whether sociodemographic aspects can influence it. For this, a multi-centre observational study was conducted in Spain using a survey including 2500 women between 35 and 75 years. Participants were administered a 10-question questionnaire with a maximum score of 45 points. The responses of 2355 women were analysed. The median age was 52 years (IQR 45-59) and the median of knowledge score was 22 points (IQR 16-27). Age ( p  < .001), menopausal status ( p  = .030), early menopause ( p  = .001), educational level ( p  < .001), type of healthcare ( p  < .001) and sources of information on menopause ( p  < .001) were factors related to the score on the questionnaire. We conclude that Spanish women have limited knowledge about menopause and it is urgent to implement training programs that can improve it.IMPACT STATEMENT What is already known on this subject? The knowledge and attitudes about menopause among women can vary across countries and also according to sociocultural context. It also seems that negative attitudes towards menopause and poor knowledge of the physiology and the most frequent symptoms have an increasing effect on the severity of the specific symptoms of menopause that cause further discomfort. What do the results of this study add? There are very few available reports or research on the issue of postmenopausal health in Spain. We believe that it is appropriate to explore the level of knowledge of women in our country. We have verified that the level of knowledge of Spanish women is low and that some sociodemographic aspects can influence it What are the implications of these findings for clinical practice and/or further research? Taking into account our results, it is a priority to implement health training programs to improve knowledge about menopause in Spanish women and overcome false myths and wrong beliefs.

Objective: The aim of the study was to evaluate the efficacy of Papilocare, a Coriolus versicolor-based vaginal gel, in repairing human papillomavirus (HPV)-related low-grade cervical lesions., Methods: The study is a multicenter, open-label, randomized, parallel-group, watchful waiting approach-controlled trial involving 91 HPV-positive women with low-grade Pap smear alterations and consistent colposcopy., Results: The percentage of patients with normal Pap smear and concordant colposcopy 3 and 6 months after receiving treatment (78.0% and 84.9%) was significantly higher than without treatment (54.8% and 64.5%), especially in high-risk HPV patients (79.5% and 87.8% vs 52.0% and 56.0%). At 6-month visit, overall HPV clearance was achieved by a greater number of patients receiving treatment (59.6%) compared with those without treatment (41.9%), especially high-risk HPV ones (62.5% vs 40.0%). The cervical re-epithelization score was significantly higher with treatment (mean = 4.5) than without (mean = 4.1). Compared with baseline, perceived stress decreased in the treatment group (from 21.1 to 19.0) and increased in the control group (from 17.7 to 20.7). A total of 7 possible or probable treatment-related adverse events were reported, most of them (n = 6) being mild or moderate in severity., Conclusions: Treatment with Papilocare has demonstrated a better clinical benefit than the conventional watchful waiting approach in clinical practice for total and high-risk HPV patients in terms of its efficacy to treat HPV-related cervical lesions and to clear all HPV strains after a single 6-month period. It has demonstrated an adequate safety and tolerability and confers additional benefits such as higher re-epithelization, stress reduction, and high treatment adherence., Competing Interests: J.C. declares that he has received travel and/or research grants and/or honoraria for conferences and/or consultancy fees from Genómica, GSK, Merck, Procare Health, Qiagen, Roche, and SPMSD. S.P. declares that he has a financial relationship (as a scientific advisor, member of the advisory board, or consultant) with Pfizer, Amgen, MSD, Sandoz, Procare Health, Bayer, MSD, Serelys, and Shionogi. Furthermore, as a speaker or member of the advisory board, he has received research grants or honoraria from Servier, Pfizer, Abbott, Shionogi, Amgen, Novo Nordisk, Theramex, Bayer Healthcare, Serelys, and Gedeon Richter. D.D. declares that he has received speaking and consultancy fees from Sanofi Pasteur, MSD, and Procare Health. L.S. declares that he has received speaking and consultancy fees from Shionogi, Iprad, and Procare Health. A.C.L. declares that he has received consultancy fees from Procare Health. S.P.G. declares that she has received travel and/or research grants and/or honoraria for conferences and/or scientific advisory and consultancy fees from Isdín, Pfizer, Servier, Amgen, MSD, Kern-Gynea, Casen Recordati, Sandoz, Procare Health, Bayer, Lacer, Shionogi, GSK, Bioiberica, Theramex, Gedeon Richter, Iprad, Seid, Ordesa, and Zambon. C.V. declares that she has received speaking fees from Procare Health. C.C.-M. declares that she has received speaking fees from Bayer and a grant for congress attendance from GSK. P.C. declares that he has received travel grants, conference registration grants and/or honoraria for conferences, and/or consultancy fees from Genómica, GSK, MSD, Abex, Shionogi, Amgen, Lacer, and Pfizer. J.d.l.F. declares that he has received travel and/or research grants and/or honoraria for conferences and/or consultancy fees from GSK, Merck, Procare Health, Roche, SPMSD, Italfármaco, Adamed, Pfizer, and Effik. J.A.L. declares that he has received honoraria for lectures from Procare Health, Gedeon Richter, and Sanofi. The other authors have declared they have no conflicts of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.)

Objective: The Cervantes Scale is a specific health-related quality of life questionnaire that was originally developed in Spanish to be used in Spain for women through and beyond menopause. It contains 31 items and is time-consuming. The aim of this study was to produce an abridged version with the same dimensional structure and with similar psychometric properties., Methods: A representative sample of 516 postmenopausal women (mean [SD] age, 57 [4.31] y) seen in outpatient gynecology clinics and extracted from an observational cross-sectional study was used. Item analysis, internal consistency reliability, item-total and item-dimension correlations, and item correlation with the 12-item Medical Outcomes Study Short Form Health Survey Version 2.0 were studied. Dimensional and full-model confirmatory factor analyses were used to check structure stability. A threefold cross-validation method was used to obtain stable estimates by means of multigroup analysis., Results: The scale was reduced to a 16-item version, the Cervantes Short-Form Scale, containing four main dimensions (Menopause and Health, Psychological, Sexuality, and Couple Relations), with the first dimension composed of three subdimensions (Vasomotor Symptoms, Health, and Aging). Goodness-of-fit statistics were better than those of the extended version (χ(2)/df = 2.493; adjusted goodness-of-fit index, 0.802; parsimony comparative fit index, 0.749; root mean standard error of approximation, 0.054). Internal consistency was good (Cronbach's α = 0.880). Correlations between the extended and the reduced dimensions were high and significant in all cases (P < 0.001; r values ranged from 0.90 for Sexuality to 0.969 for Vasomotor Symptoms)., Conclusions: The Cervantes Scale can be reduced to a 16-item abridged version (Cervantes Short-Form Scale) that maintains the original dimensional structure and psychometric properties. At 51% of the original length, this version can be administered faster, making it especially suitable for routine medical practice.

Postmenopausal osteoporosis is a major female health problem that increases morbidity, mortality and healthcare system costs. Considering that gynecologists are the primary health practitioners involved in the treatment of women with osteoporosis in our country, a panel of experts from the Spanish Menopause Society met to establish a set of criteria and procedures for the diagnosis and treatment of this disease based on the best available evidence and according to the model proposed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system to elaborate clinical practice guidelines and to classify the quality of the evidence and the strength of the recommendations. These recommendations should be a reference to gynecologist and other health professionals involved in the treatment of postmenopausal women., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)