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Introduction: Clinically, a Lactobacillus rich vaginal microbiota (VMB) is considered optimal for reproductive outcomes, while a VMB populated by anaerobes is associated with dysbiosis and the clinical condition bacterial vaginosis (BV), which is linked to increased susceptibility to sexually transmitted infections and adverse reproductive outcomes. Mouse models that mimic eubiotic and dysbiotic VMB are currently lacking but could play a critical role in improving protective interventions., Methods: In this study, probiotic, eubiotic, and dysbiotic models were developed in C57BL/6 mice, using probiotic strains Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, eubiotic Lactobacillus crispatus , or dysbiotic Gardnerella vaginalis strains. Endogenous sex hormones were manipulated by either ovariectomizing (OVX) mice or administering 17β-estradiol or progesterone pellets in OVX mice. Hormone-altered mice were inoculated with probiotic Lactobacillus species, L. crispatus , or G. vaginalis , and colonization was tracked using quantitative plating assays. Glycogen and MUC-1 levels in hormone-treated mice were determined with ELISA and MUC-1 staining., Results: Following a single administration, L. rhamnosus and L. reuteri persisted in the mouse vaginal tract for up to eight days, L. crispatus persisted for up to three days, and G. vaginalis persisted for up to two days, as measured by quantitative plating assays and qPCR. Colonization of G. vaginalis was facilitated by the presence of mucin. The lack of endogenous hormones in OVX mice dramatically decreased VMB bacterial load compared to normal mice. None of the exogenous bacteria including Lactobacilli could colonize OVX mice for more than 24 hours. Treatment with 17β-estradiol but not progesterone restored the endogenous VMB and colonization with Lactobacilli and G. vaginalis . Interestingly, 17β-estradiol treated mice had significantly increased levels of glycogen compared to OVX and progesterone-treated mice., Discussion: Based on the results, we have shown that estrogen played a significant role in the ability for human VMB species to colonize in our mouse models, potentially through a glycogen mediated mechanism. These results suggest there is a dynamic interaction between sex hormones and the VMB, which can affect bacterial diversity and the ability for a VMB to colonize., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rahman, Mian, Nazli and Kaushic.)

Background Medical termination of pregnancy (MTP) pills, primarily comprising mifepristone and misoprostol, have proven highly effective and safe under medical supervision. However, unsupervised MTP pill use is on the rise, posing serious health risks. Unsafe abortions remain a global public health concern, with a high incidence in developing countries like India. Methods We conducted a cross-sectional study at a tertiary healthcare center in India from February to April 2023. We enrolled 150 women with a history of unsupervised MTP pill use. Data were collected using structured questionnaires, including demographic information, awareness, sources of information, reasons for self-medication, and knowledge of complications. Results The majority of participants (50%) were aged 25-29 years. Low-income women (<3000pc) constituted 46.66% of the sample. Husbands played a significant role in advocating MTP pill use (57.33%). Ninety percent of pills were obtained directly from pharmacies. Shockingly, 97.3% of women were unaware of MTP pill complications, and 84% did not follow the recommended regimen. Significant associations were found between income, religion, education, age, parity, and reasons for self-medication, as well as recommendations for MTP pill use. Conclusion Our study revealed a diverse demographic of women seeking unsupervised MTP pill intake. Low-income women were disproportionately affected, emphasizing the need for improved healthcare access and education. Husbands played a crucial role in advocating MTP pill use, highlighting the importance of including men in reproductive health discussions. Lack of awareness and non-adherence to recommended regimens posed substantial risks. To combat unsafe abortions, a multifaceted approach is needed. Reproductive health education, regulatory measures, improved healthcare accessibility, and tailored interventions are essential., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Pal et al.)

Stress is deeply rooted in the society and women are frequently exposed to psychological, physical and physiological stressors. Psychological stress disturbs reproductive health by inducing generation of reactive oxygen species (ROS) and thereby oxidative stress (OS). The increased OS may affect physiology of ovary, oocyte quality and cause female reproductive health disorders. To overcome stress-mediated reproductive health disorders in women, shatavari ( Asparagus racemosus ) is frequently recommended in Ayurvedic system of medicine. Although shatavari is one of the major health tonics and most popular rasayana drugs to treat reproductive ailments of women, underlying mechanism of shatavari action at the level of ovary remains poorly understood. Based on the existing studies, we propose that shatavari may improve female reproductive health complications including hormonal imbalance, polycystic ovarian syndrome (PCOS), follicular growth and development, oocyte quality and infertility possibly by reducing OS level and increasing antioxidants level in the body. Further studies are required to elucidate the mechanism of shatavari actions at the level of ovary and oocyte that directly impacts the reproductive health of women. [ABSTRACT FROM AUTHOR]

Here, we present the current challenges in women's reproductive health and the current state-of-the-art treatment and prevention options for STI prevention, contraception, and treatment of infections. We discuss how the versatile platform of electrospun fibers can be applied to each challenge, and postulate at how these technologies could be improved. The void of approved electrospun fiber-based products yields the potential to apply this useful technology to a number of medical applications, many of which are relevant to women's reproductive health. Given the ability to tune drug delivery characteristics and three-dimensional geometry, there are many opportunities to pursue new product designs and routes of administration for electrospun fibers. For each application, we provide an overview of the versatility of electrospun fibers as a novel dosage form and summarize their advantages in clinical applications. We also provide a perspective on why electrospun fibers are well-suited for a variety of applications within women's reproductive health and identify areas that could greatly benefit from innovations with electrospun fiber-based approaches. [ABSTRACT FROM AUTHOR]

Rationale & Objective: Female reproductive health is recognized as a predictor of morbidity, mortality, and quality of life, although data in the setting of chronic kidney disease (CKD) are limited., Study Design: A mixed-methods study was employed. Phase 1 was an anonymous, internet-based survey. Phase 2 was semistructured interviews offered to all respondents upon survey completion., Setting & Participants: The survey was disseminated internationally from October 4, 2021, to January 7, 2022, to individuals aged 18-50 years with both a uterus and CKD diagnosis., Outcomes: Menstrual health and contraceptive use by CKD stage (dialysis, nondialysis CKD, and transplant)., Analytical Approach: Survey data were analyzed using descriptive statistics. Interview data were analyzed using the framework method of analysis., Results: Of 152 respondents, 98 (mean age 33 ± 0.7 years; n = 20 dialysis, n = 59 nondialysis CKD, n = 19 transplant) satisfied the inclusion criteria, representing 3 continents. The most common causes of CKD among survey respondents were hereditary causes in dialysis (n = 6, 30%) and glomerulonephritis in nondialysis CKD (n = 22, 37%) and transplant (n = 6, 32%). The majority reported heavy menstrual bleeding (n = 12, 86% dialysis; n = 46, 94% nondialysis CKD; n = 14, 100% transplant). Less than half of participants were consistently able to afford period products. Condoms were the most common contraceptive reported. Most participants reported no contraceptive use (n = 10, 50% dialysis; n = 37, 63% nondialysis CKD; n = 7, 37% transplant), primarily because of "fear". Interviews (n = 6) revealed a perception of a relationship between kidney function and menstrual health, concerns about contraceptive use, and a desire for greater multidisciplinary care to improve kidney and reproductive health., Limitations: Self-reported outcomes, need for internet access and a device., Conclusions: Abnormal menstruation and period poverty (ie, inability to afford period products and the socioeconomic consequences of menstruation) were common, and contraceptive use was low among female individuals with CKD, highlighting an important gap in the sex-specific care of this population., Plain-Language Summary: Chronic kidney disease (CKD) in female individuals is accompanied by menstrual disorders and low contraceptive use. However, most data are limited to the dialysis and transplant populations. Therefore, this mixed-methods study aimed to describe self-assessed menstruation and contraceptive use across all stages of CKD. People aged 18-50 years with a uterus and CKD diagnosis were invited to participate in an online survey shared internationally as well as an optional telephone interview. Abnormal menstruation and period poverty (ie, inability to afford period products and the socioeconomic consequences of menstruation) were common, and contraceptive use was low among female individuals with CKD, highlighting an important gap in the sex-specific care of this population., (© 2023 Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.)

Autoantibodies are implicated in various human diseases. In this review, the effects of three different types of autoantibodies (antiphospholipid antibody, antithyroid antibody, and antisperm antibody) on female reproductive health are critically examined. Antiphospholipid antibodies are being detected more frequently in women undergoing in vitro fertilization, but their presence does not appear to influence the outcome of pregnancy, miscarriage, or live birth rates. Available evidence makes it conclusive that antiphospholipid antibodies play negligible roles in recurrent miscarriage. Treatment with aspirin together with low-molecular-weight heparin appears to be effective for recurrent miscarriage. Although antithyroid antibodies are commonly found in women of reproductive age, implantation rates and miscarriage rates are unaffected when women have normal thyroid function. Women with thyroid dysfunction should be treated with L-thyroxine before conception or at early gestational stages to avoid pregnancy complications. Antisperm antibodies are uncommon but are most often associated with ovarian hypofunction. They are believed to cause fertilization failure when found at high titers in seminal plasma, or in the mucosal immune system of women. Intrauterine artificial insemination and in vitro fertilization/embryo transfer are effective treatment modalities for antisperm antibody-related infertility, although this remains a controversial topic in the field of female infertility. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

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A quantitative and qualitative case series study of 9 couples belonging to the health area of "30 de Noviembre" Polyclinic in Santiago de Cuba was carried out from January, 2010 to December, 2012, with the aim of identifying the man's preconcepcional reproductive risk factors and their impact on the woman's reproductive health and their descendant. In the case material, the toxic habits, intrafamily violence, not using condom, as well as the extramarital relationships influenced negatively in the couple's reproductive health; while, the knowledge that men had on the Preconcepcional Reproductive Risk Program was inadequate. [ABSTRACT FROM AUTHOR]

Endometriosis that afflicts one in 10 women of reproductive age is characterized by growth of endometrial tissue in the extra-uterine sites and encompasses metabolic-, immunologic-, and endocrine-disruption. Importantly, several comorbidities are associated with endometriosis, especially autoimmune disorders such as inflammatory bowel disease. Primarily thought of as a condition arising from retrograde menstruation, emerging evidence uncovered a functional link between the gut microbiota and endometriosis. Specifically, recent findings revealed altered gut microbiota profiles in endometriosis and in turn this altered microbiota appears to be causal in the disease progression, implying a bidirectional crosstalk. In this review, we discuss the complex etiology and pathogenesis of endometriosis, emphasizing on this recently recognized role of gut microbiome. We review the gut microbiome structure and functions and its complex network of interactions with the host for maintenance of homeostasis that is crucial for disease prevention. We highlight the underlying mechanisms on how some bacteria promote disease progression and others protect against endometriosis. Furthermore, we highlight the areas that require future emphases in the gut microbiome-endometriosis nexus and the potential microbiome-based therapies for amelioration of endometriosis., (© The Author(s) 2022. Published by Oxford University Press on behalf of Society for the Study of Reproduction. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This article examines why and how the Chinese Communist Party (CCP) presented the Soviet Union's psycho-prophylactic method of delivery (known as Lamaze method to the Western world) as 'truly socialist and scientific,' and how pregnant women and medical practitioners in China experienced it in the delivery rooms in the 1950s. The CCP's adoption of the Soviet Union's methods of delivery reflected its struggles with 'scientific,' yet 'bourgeois,' Western medicine and its efforts to create an alternative model of modernity, in which 'science served the masses,' during the Cold War. [ABSTRACT FROM AUTHOR]

Female infertility is a major public health concern and a global challenge. It is a disorder of the reproductive system, defined as the inability to achieve a clinical pregnancy. Nutrition and other environmental factors are found to impact reproductive health in women as well as the outcome of assisted reproductive technologies (ART). Dietary factors, such as polyunsaturated fatty acids (PUFA), fiber as well as the intake of Mediterranean diet appear to exert beneficial effects on female reproductive outcomes. The exact mechanisms associating diet to female fertility are yet to be identified, although genomic, epigenomic, and microbial pathways may be implicated. This review aims to summarize the current knowledge on the impact of dietary components on female reproduction and ART outcomes, and to discuss the relevant interplay of diet with genome, epigenome and microbial composition., (Copyright © 2022 Kohil, Chouliaras, Alabduljabbar, Lakshmanan, Ahmed, Awwad and Terranegra.)

Background In the wake of the recent Roe vs. Wade judgment, we performed a Google Trends analysis to identify the impact of this decision on the interests regarding contraceptive choices in the United States. Methods A Google Trends search between April 6 and July 5, 2022, with the United States as the area of interest, was performed using the five most popular contraception choices. In addition, a second trend search was performed using oral and injectable hormonal birth control measures. Results Trends showed a spike in interest regarding various contraceptive methods immediately following the verdict. The highest increase in interest was noted for "vasectomy," followed by "tubal ligation." With respect to oral and injectable birth control measures, "morning after pill" showed a marked spike in interest. Conclusion This verdict has triggered increased interest in contraceptive practices, which can be translated into better reproductive health with proper public health initiatives., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Datta et al.)

STUDY QUESTION Does in utero exposure to constituents of cigarette smoke have a programming effect on daughters' age of menarche and markers of long-term reproductive health? SUMMARY ANSWER In utero exposure to constituents of cigarette smoke was associated with earlier age of menarche and—to a lesser extent—changes in the testosterone profile of the young women. WHAT IS KNOWN ALREADY Studies observe potential effects of in utero exposure to constituents of cigarette smoke on the intrauterine formation of female gonads, but the consequences on long-term reproductive health in daughters remain unclear. STUDY DESIGN, SIZE AND DURATION A prospective cohort study was designed using data from 965 pregnant women enrolled prior to a routine 30th-week antenatal examination at a midwifery practice in Denmark from 1988 to 1989 and a follow-up of their 19–21-year-old daughters in 2008. Participants/materials, setting and methods The pregnant women provided information on lifestyle factors during pregnancy, including the exact number of cigarettes smoked per day during the first and the second trimesters. A total of 438 eligible daughters were asked to complete a web-based questionnaire on reproductive health and subsequently invited to participate in a clinical examination during 2008. Of the 367 daughters (84%) who answered the questionnaire, 267 (61%) agreed to further examination. Information on menstrual pattern was provided at examination, blood samples were drawn to be analyzed for serum levels of reproductive hormones [FSH, LH, estradiol (E2), sex hormone-binding globulin, anti-Müllerian hormone, dehydroepiandrosterone-sulphate (DHEAS), free testosterone and free E2] and number of follicles (2–9 mm) were examined by transvaginal ultrasound. MAIN RESULTS AND THE ROLE OF CHANCE We observed an inverse association between in utero exposure to constituents of cigarette smoke and age of menarche (P = 0.001). Daughters exposed to >0–9 cigarettes/day debuted with –2.7 [95% confidence interval (CI) –5.2 to –0.1] percentage earlier age of menarche, whereas daughters exposed to ≥10 cigarettes/day had –4.1 (95% CI: –6.6 to –1.5) percentage earlier age of menarche corresponding to 6.5 (95% CI: –10.7 to –2.2) months. There was a non-significant tendency towards lower levels of testosterone and DHEAS with increasing in utero exposure to constituents of cigarette smoke but no associations with follicle number, cycle length or serum levels of the other reproductive hormones were observed. LIMITATIONS AND REASONS FOR CAUTION We collected information on age of menarche retrospectively but the recall time was relatively short (2–10 years) and the reported values were within the normal range of Caucasians. Analyses of reproductive hormones are presented only for the group of daughters who were non-users of hormonal contraceptives because users were excluded, leaving only a low number of daughters available for the analyses (n = 75), as reflected in the wide CIs. The analyses of hormones werefurther adjusted for menstrual phase at time of clinical examination (follicular, ovulation and luteal phase) because blood samples were not collected on a specific day of the menstrual cycle. WIDER IMPLICATIONS OF THE FINDINGS This study supports the limited evidence of an inverse association between maternal smoking during pregnancy and age of menarche and further addresses to what extent reproductive capacity and hormones may be programmed by maternal smoking during pregnancy. A trend toward earlier maturation of females is suggested to have implications on long-term reproductive function. STUDY FUNDING/COMPETING INTEREST(S) Supported by a scholarship from The Lundbeck Foundation (R93-A8476). No conflict of interest declared. [ABSTRACT FROM AUTHOR]

Experimental studies have demonstrated that disinfection byproducts (DBPs) can cause ovarian toxicity including inhibition of antral follicle growth and disruption of steroidogenesis, but there is a paucity of human evidence. We aimed to investigate whether urinary biomarkers of exposure to drinking water DBPs were associated with ovarian reserve. The present study included 956 women attending an infertility clinic in Wuhan, China from December 2018 to January 2020. Antral follicle count (AFC), ovarian volume (OV), anti-Mullerian hormone (AMH), and follicle-stimulating hormone (FSH) were measured as indicators of ovarian reserve. Urinary dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) were assessed as potential biomarkers of drinking water DBP exposures. Multivariate linear and Poisson regression models were applied to estimate the associations of urinary DCAA and TCAA concentrations with indicators of ovarian reserve. Elevated urinary DCAA and TCAA levels were monotonically associated with reduced total AFC (− 5.98%; 95% CI: − 10.30%, − 1.44% in DCAA and − 12.98%; 95% CI: − 17.00%, − 8.76% in TCAA comparing the extreme tertiles; both P for trends ≤ 0.01), and the former was only observed in right AFC but not in left AFC, whereas the latter was estimated for both right and left AFC. Moreover, elevated urinary TCAA levels were monotonically associated with decreased AMH (− 14.09%; 95% CI: − 24.79%, − 1.86% comparing the extreme tertiles; P for trend = 0.03). These negative associations were still observed for the exposure biomarkers modeled as continuous variables. Our findings suggest that exposure to drinking water DBPs may be associated with decreased ovarian reserve. [Display omitted] ● The effects of DBP exposures on ovarian reserve were firstly evaluated in humans. ● Urinary DCAA and TCAA were measured as biomarkers of DBP exposures. ● Urinary TCAA was associated with reduced AFC and AMH. ● Urinary DCAA was associated with decreased right AFC. [ABSTRACT FROM AUTHOR]

There are few studies in literature about exposure to urban pollutants and effects on female reproductive health. The aim of the study was to evaluate if the occupational exposure to chemical urban stressor could cause luteinizing hormone (LH) plasma levels alterations in female traffic police compared to a control group. One hundred and eighty subjects were included in the study, subdivided into three different groups according to the day of the menstrual cycle (7th, 14th, 21st) in which a blood sample was taken. In follicular and lutheal phase of ovarian cycle, the LH mean levels were significantly higher in traffic police vs. controls. The distribution of LH values in traffic police and controls was significant in follicular, and lutheal phase. In ovulatory phase, LH mean levels were lower but not significant in traffic police compared to controls. An increase was found concerning mental health disorders referred to the questionnaire items in traffic police vs. controls, although the difference was not significant. Our results suggest that occupational exposure to urban stressor in female traffic police, may alter LH plasma concentrations. LH may be used in occupational set as an early biomarker of exposure to urban stressor. [ABSTRACT FROM AUTHOR]

There is growing evidence of the impact of estrogenic contaminants in the environment. Studies have shown that male fish in detergent-contaminated water express female characteristics, turtles are sex-reversed by polychlorinated biphenyls (PCBs), male frogs exposed to a common herbicide form multiple ovaries, pseudohermaphroditic offspring are produced by polar bears, and seals in contaminated water have an excess of uterine fibroids. Endocrine-disrupting chemicals (those found in the external environment that can mimic or inhibit endogenous hormones) mostly exhibit estrogenic effects, but a few are anti-estrogenic or anti-androgenic. Many of these compounds are industrial contaminants, such as pesticides and plasticizers, and others are natural phytoestrogens found in plants such as soy and in herbal supplements. Recent work shows that human development can also be feminized by exposure to estrogenic chemicals. Estrogen is the key hormone in the initiation (puberty) and the end (menopause) of reproductive life in women and thus of considerable importance in women''s health. The same chemicals that affect wildlife may affect breast growth and lactation, and could have a role in uterine diseases such as fibroids and endometriosis. New studies provide a mechanism of action for estrogenic chemicals and other endocrine disrupters at the molecular level (called epigenetics) that may help explain the long-term effects of endocrine disruption. [Copyright &y& Elsevier]

The aim of this paper is to examine the reproductive health status for the wives of chlamydia-infected, but largely asymptomatic men. In a cross-sectional study in rural Tanzania 447 men and 393 women, aged 15-44 years, were screened for chlamydial infection. The prevalence was 9.6% and 6.9%, respectively. Among 43 chlamydia-positive men, 17 were married. Data from both spouses, independently examined, could be matched for 12 couples. None of the 12 husbands had discharge, one had dysuria and 3 had pyuria. Three wives tested positive for chlamydial infection, two others had pelvic inflammatory disease, four others had pyuria. Men reported more sexual partners than women and were considered being the index case for the chlamydial infection. While three of 11 wives (27%) tested chlamydia-positive from a cervical sample, transmission might have occurred in 5-8 cases (transmission rate (42-67%), indicating that these 12 largely asymptomatic chlamydia-positive men were highly infectious to their sexual partners. [ABSTRACT FROM AUTHOR]

Background: Off-label medication usage (OLMU) is prevalent in the treatment of various diseases, including female reproductive health issues (FRHIs). However, there is a paucity of literature on the perspective of health professionals on this subject. The purpose of the current study was to assess gynecologists/obstetricians' knowledge, attitude and practice toward OLMU in the treatment of FRHIs., Methods: The current cross-sectional study was conducted in September and October 2021, at five tertiary care hospitals (two public and three private sector), different clinics and maternity homes in a metropolitan city of Karachi, Pakistan. The target population was gynecologists, obstetricians and physicians/residents working in the ob/gyn department in various hospitals and clinical settings of Karachi., Results: The overall response rate was 77.1%. The mean age of the study respondents was 36.1 ± 7.7 years; n = 85 (55.9%) respondents were working in primary patient care. The majorly reported OLMU by the respondents were clomiphene citrate in unexplained infertility ( n = 66; 43.4%), metformin to improve cycle regularity in females with polycystic ovary syndrome (PCOS) ( n = 59; 38.8%) and letrozole to induce ovulation ( n = 31; 20.4%). The majorly stated categories of OLMU were at a different dose ( n = 95; 62.5%) and at different indications than approved to treat ( n = 89; 58.5%). It was reported by the majority of the respondents ( n = 95; 62.5%) that they do not follow any guidelines or regulations for OLMU in their work setting; however, the response was statistically varied with the working organization (CI 2.14-2.93; p = 0.037) and practice area (CI 2.85-4.32; p = 0.0001) of respondents., Conclusions: The present study revealed that the respondents were well-familiar with the practice of OLMU in the treatment of FRHIs. They expressed their concerns about decreasing such practices by being involved in collective decision-making procedures, and they were inclined to accept initiatives aimed at ensuring drug safety in patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer SI declared a past co-authorship with the author HR to the handling editor., (Copyright © 2022 Shakeel, Iffat, Qamar, Nesar, Butt, Siddiqui, Rehman and Rehman.)

Zika virus (ZIKV) belongs to mosquito-borne flaviviruses. Unlike other members in the family, ZIKV can be sexually transmitted, and the female genital tracts are susceptible to ZIKV. However, the impact of ZIKV infection on nonpregnant female reproductive health is not understood. In this study, we investigated the effects of ZIKV infection on the ovary by using nonpregnant female interferon α/β receptor-deficient ( Ifnar1 -/- ) mice. The results showed that the ovary supported ZIKV replication, and the granulosa and theca cells of antral follicles were susceptible. ZIKV replication in situ significantly reduced the numbers of antral follicles, aggravated follicular atresia, and disrupted folliculogenesis. Notably, ZIKV replication in the ovary caused disordered ovarian steroidogenesis manifested by decreased expression of key enzymes linked to sex hormone synthesis, including the cytochrome P450 17A1 (CYP17A1) and aromatase (CYP19A1). Further, we observed that ZIKV infection disrupted the estrous cycle and thus prolonged the time to conceive. More importantly, although ZIKV RNA could not be detected at 3 months postinfection, damaged ovarian structure and dysfunction were also observed. Taken together, our study demonstrates that ZIKV infection in nonpregnant female mice cause ovarian damage and dysfunction, even long after ZIKV clearance. These data provide important information to understand the effects of ZIKV infection in female reproductive tissues and basic evidence for further studies. IMPORTANCE Zika virus (ZIKV), a flavivirus, is primarily transmitted by mosquito bites. But it can also be transmitted vertically and sexually. Although ZIKV-associated Guillain-Barré syndrome and microcephaly have drawn great attention, there have been few studies on the potential effects of ZIKV on the genital tract of nonpregnant females. This study investigated the effects of ZIKV on the ovaries in mice. We found that ZIKV replicated in the ovary and the granulosa and theca cells of antral follicles were susceptible. ZIKV replication in situ significantly damaged ovarian structure and function and disrupted folliculogenesis. Notably, ZIKV infection further disrupted the estrous cycle and prolonged the time to conceive in mice by causing disordered ovarian steroidogenesis. These effects were observed in both the acute phase and the recovery phase after viral elimination. Overall, the new findings provide important additions to make out the potential adverse impacts of ZIKV on reproductive health in females.

Background: Cervical cancer is the most common gynaecologic cancer in Ghana where it is also the second most common cause of all female cancers. A number of vaccines are available to provide both individual and population-level protection against persistent infection with high-risk human papillomaviruses (HR-HPV) and reduce the burden of cervical cancer. Data on the epidemiology of vaccine-preventable papillomaviruses in Ghana is scant., Methods: A cross-sectional observational study was implemented from May 2011 to November 2014 to understand the epidemiology of genital human papillomavirus (HPV) genotypes and cervical dysplasia in the Greater Kumasi area of Ghana. A nested multiplex polymerase chain reaction (NMPCR) assay incorporating degenerate E6/E7 consensus primers and type-specific primers was used for the detection and typing of eighteen (18) HPV genotypes among women who had never attended cervical screening prior to this study., Results: The general prevalence of HPV infection in Kumasi was 37.2%. The age-standardized prevalence was 40.9% overall. The frequency of HR-HPV genotypes present in decreasing order were HPV-52, -56, -35, -18, -58, -68, -51, -39, -45, -16, -59, -33 and -31. Low-risk HPVs were also detected in the following order: HPV-42, -43, -66, -6/11 and -44., Conclusions: The study shows that currently available prophylactic vaccines have the potential to be useful in the primary prevention of HPV infections in the country. This study strengthens the belief that prophylactic HPV vaccination could be a long-term strategy to reduce the burden of HPV infections and potentially reduce the burden of HPV-associated cancers and epithelial cell abnormalities among health-seeking women in Kumasi. Efforts to make vaccines available to young girls should be prioritized.

Fragile X syndrome (FXS) and its associated disorders are caused by the expansion of the CGG repeat in the 5′ untranslated region of the fragile X mental retardation 1 gene (FMR1). The full mutation, defined as >200 cytosine-guanine-guanine (CGG) triplet repeats, causes FXS. Individuals with 55–199 CGG repeats, classified as premutation carriers, are affected by two distinct disorders depending on their premutation status. Disorders associated with premutation carriers include: Fragile X-associated Tremor Ataxia Syndrome (FXTAS) and Fragile X-associated Primary Ovarian Insufficiency (FXPOI). The molecular similarities of FXTAS and FXPOI (e.g. overabundance of FMR1 transcript and intranuclear inclusions) suggest that similar molecular mechanisms underlie both FXTAS and FXPOI. The current hypothesis describes the underlying mechanism for FXTAS as an mRNA gain-of-function mutation, however the underlying mechanism for FXPOI remains unresolved. New data suggests that repeat associated non-AUG (RAN) translation could underlie FXPOI. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) increasingly affects younger people, including adolescents and young adults. CKD among females is accompanied by unique reproductive and gynecologic health concerns; though to date, this area has not been well studied. Hormonal disruptions attributed to CKD may underlie the high prevalence of abnormal uterine bleeding and influence the age of menarche in adolescents. Period poverty as a socioeconomic barrier further exacerbates the female-specific burdens of CKD. Reduced fertility in CKD is likely multifactorial and may be related to a reduction in ovarian reserve, reproductive hormone disturbances, and gonadotoxic medication use in addition to low sexual function and activity. Fertility, sexual function and activity, and risk of sexually transmitted infections increase with transplantation. Pregnancy is possible at any stage of CKD, although often accompanied by high risks of maternal and fetal complications. Contraception is thus an important consideration in CKD, but use is low and the risks and benefits of different forms in the setting of CKD are not well characterized. Though patients with CKD report reproductive health as an important element of care, many nephrologists report lack of confidence and training in this area, highlighting the need for targeted research and education. The unique reproductive health care needs of the growing transgender youth population warrant attention in nephrology training with multidisciplinary input. This review will discuss female reproductive health and gynecologic considerations in adolescents and young adults with CKD while proposing clinical and research strategies to improve this understudied yet important aspect of kidney care., (© 2021 International Society of Nephrology. Published by Elsevier Inc.)

Objective: To determine the dose-dependent effect of contemporary marijuana exposure on female menstrual cyclicity and reproductive endocrine physiology in a nonhuman primate model., Design: Research animal study., Setting: Research institute environment., Animals: Adult female rhesus macaques (6-12 years of age; n = 8)., Interventions: Daily delta-9-tetrahydrocannabinol (THC) edible at medically and recreationally relevant contemporary doses., Main Outcome Measures: Menstrual cycle length (MCL), anti-Müllerian hormone, prolactin, basal follicle-stimulating hormone (FSH), estradiol (E2) and progesterone, luteinizing hormone (LH), and thyroid-stimulating hormone., Results: The average before THC weight was 6.9 kg (standard deviation, 0.8), and at the highest THC dosing, the average weight was 7.2 kg (standard deviation, 0.8). With increasing THC dosing, MCL and FSH concentrations increased, while basal E2 concentration was stable. The average MCL concentration increased 4.0 days for each mg/7 kg/day of THC (95% CI, 1.4-6.6 days). Follicle-stimulating hormone concentration increased significantly with increasing THC dose, 0.34 ng/mL for each mg/7 kg/day of THC (95% CI, 0.14-0.57 ng/mL). No significant trends were observed between THC dosing and average basal progesterone, anti-Müllerian hormone, prolactin, LH, or thyroid-stimulating hormone concentrations., Conclusions: In rhesus macaques, a dose response toward increased MCL and basal FSH concentrations but plateau of basal E2 and LH concentrations was observed with increasing THC dosing, suggesting ovulatory dysfunction. Further studies are needed to determine the effects of a longer duration of exposure and whether the significant increase in MCL and FSH concentrations results in reduced fecundity.

Metabolic dysfunction and genomic instability are known to affect female fertility. Aroclor 1254 (A1254) is an endocrine disruptor that affects mitochondrial function following ingestion, inhalation, or dermal exposure. Numerous studies to date have addressed associations between A1254 toxicity and chronic neurological disorders, while A1254 exposure is little known to have a toxic effect on the female reproductive system. Furthermore, interactive mechanisms between metabolic dysfunction and the repair of DNA damage deserve further investigation. In this paper, an in vitro porcine primary granulosa cell (GC) culture model was used to investigate the mechanisms of exposure and effects of the exogenous chemical carcinogen A1254 on reproductive toxicology. High-throughput RNA sequencing obtained 2329 differentially expressed genes (DEGs) to be analyzed using COG classification, GO, and KEGG. When combined with immunofluorescence, Western blot analysis, and real-time RT-PCR analysis, this data showed that the mitochondrial-ROS-driven feed-forward loop increased phospho-PDGFRα/β, which stimulates apoptosis by suppressing the PI3K-Akt pathway. We also noticed that inhibition of the Akt-PDP1-PDK1 axis attenuated mitochondrial function. In contrast, following iPath analysis, partial metabolic pathways were enhanced. Importantly, we found that A1254 activated a DNA damage response, the major regulators of which belong to the PI3K-related protein kinases (PIKKs) and oncogenes, which led to the "Warburg effect". It is not easy to restore the damage that A1254 causes to metabolism through dysregulation and the Warburg effect, owing to the fact that oncogenes can regulate cytoplasmic metabolism. Therefore, we suspect that the PDGFR-PI3K-Akt pathway may be a latent interaction between mitochondrial dysfunction and the response of DNA damage. Image 1 • Mitochondrial-ROS-driven feed-forward loop activates PDGFRα/β phosphorylation. • Reducing the Akt-PDP1-PDK axis prompts autophagy and apoptosis. • Metabolic remodeling with low oxidative phosphorylation adjusts mitochondria. • Altered metabolic patterns reimburse mitochondrial dysfunction by oncogenes. [ABSTRACT FROM AUTHOR]

Waddlia chondrophila is an emerging intracellular pathogen belonging to the order of Chlamydiales, and was previously associated with adverse pregnancy outcomes, as well as tubal factor infertility (TFI). In this study, we investigate the link between both W. chondrophila and Chlamydia trachomatis IgG seropositivity and TFI. Antibodies against both bacteria were measured in 890 serum samples of women visiting a fertility clinic. After a hysterosalpingography and/or laparoscopy, they were classified as either TFI-negative (TFI−) or TFI-positive (TFI+). The total seroprevalence was 13.4% for C. trachomatis and 38.8% for W. chondrophila. C. trachomatis antibodies were present significantly more often in the TFI+ group than in the TFI− group, while for W. chondrophila no difference could be observed. In conclusion, our study confirms the association between C. trachomatis seropositivity and TFI, but no association was found between W. chondrophila seropositivity and TFI. The high percentage of W. chondrophila seropositivity in all women attending a fertility clinic does, however, demonstrate the need for further research on this Chlamydia-like bacterium and its possible role in infertility. [ABSTRACT FROM AUTHOR]

Currently available test methods are not well-suited for the identification of chemicals that disturb hormonal processes involved in female reproductive development and function. This renders women's reproductive health at increasing risk globally, which, coupled with increasing incidence rates of reproductive disorders, is of great concern. A woman's reproductive health is largely established during embryonic and fetal development and subsequently matures during puberty. The endocrine system influences development, maturation, and function of the female reproductive system, thereby making appropriate hormone levels imperative for correct functioning of reproductive processes. It is concerning that the effects of human-made chemicals on the endocrine system and female reproductive health are poorly addressed in regulatory chemical safety assessment, partly because adequate test methods are lacking. Our EU-funded project FREIA aims to address this need by increasing understanding of how endocrine disrupting chemicals (EDCs) can impact female reproductive health. We will use this information to provide better test methods that enable fit-for-purpose chemical regulation and then share our knowledge, promote a sustainable society, and improve the reproductive health of women globally. [ABSTRACT FROM AUTHOR]

Introduction The constellation of the physical and psychological symptoms that appear several days before menstrual period is regarded as the premenstrual syndrome (PMS). The current study evaluated the symptoms associated with PMS and their impact on the day-to-day activities of women. Methodology An observational cross-sectional study was conducted at a squatter settlement in Karachi, Pakistan, from January 2019 to February 2020. Amenorrheic, pregnant women, and women who were on birth control at the time of data collection were excluded from the study. The demographics, symptoms of PMS experienced by the participants, and the impact of PMS symptoms on the daily lives of women were recorded. Statistical Package for the Social Sciences v.25 (IBM Corp., Armonk, NY) was used for data analysis.  Results The mean age ± standard deviation of 23.93 years ± 9.41 years was recorded. As many as 213 (63%) women reported dysmenorrhea, followed by fatigue in 108 (32%), bloating in 64 (18.9%), and back pain in 45 (13.3%) women. Irritability and anxiety were experienced by 134 (39.6%) and 117 (34.6%) women, respectively. When asked about their attitude and perception towards menstruation, more than four-fifth respondents confessed that they feel impure when they are experiencing their monthly period. About 38 women (11.2%) believed that menstruation is God's way of punishing the womankind. For the question, "Do you feel that your normal routine is significantly disturbed during your period?", 40% responded in affirmation. Conclusion The findings of the current study reflected a generally negative attitude towards menstruation, which significantly affected the routine lives of women in our setting. The study further concluded that dysmenorrhea, fatigue, irritability, and anxiety were the most common symptoms of PMS experienced by women., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Abbas et al.)

Currently available test methods are not well-suited for the identification of chemicals that disturb hormonal processes involved in female reproductive development and function. This renders women's reproductive health at increasing risk globally, which, coupled with increasing incidence rates of reproductive disorders, is of great concern. A woman's reproductive health is largely established during embryonic and fetal development and subsequently matures during puberty. The endocrine system influences development, maturation, and function of the female reproductive system, thereby making appropriate hormone levels imperative for correct functioning of reproductive processes. It is concerning that the effects of human-made chemicals on the endocrine system and female reproductive health are poorly addressed in regulatory chemical safety assessment, partly because adequate test methods are lacking. Our EU-funded project FREIA aims to address this need by increasing understanding of how endocrine disrupting chemicals (EDCs) can impact female reproductive health. We will use this information to provide better test methods that enable fit-for-purpose chemical regulation and then share our knowledge, promote a sustainable society, and improve the reproductive health of women globally.

Objective: To analyze the changes of relevant indicators in reproductive health status among Bangladeshi women from 1999 to 2018 and to assess whether the 2030 Sustainable Development Goals (SDGs) can be achieved. Methods: Data were obtained from both the Bangladesh Demographic and Health as well as from the Maternal Mortality and Health Care Surveys. The trends of SDGs indicators related to reproductive health from 1999 to 2018 were analyzed and compared, and the average annual rate of change was calculated. Development index was used to assess the difficulty of achieving the SDGs. Results: The maternal mortality rate increased first and then leveled off from 2001 to 2016. From 1999 to 2018, the coverage of reproductive health care services and the proportion of women who had the right to make the decision on their own health care service, were generally increasing. Proportion of the following areas as: "contraceptive needs, women who consider that partner violence is justified, the rate of early marriage, and the rate of early childbearing etc. ", were declining at various degrees. Development index of the antenatal care coverage, rate of delivery in medical facilities, percentage of live births attended by medically trained providers and the rate of postnatal care etc. , were less than 1. The development indices of the maternal mortality rates were close to 1, while all the other indicators were greater than 1. Conclusions: The reproductive health-related SDGs indicators in Bangladesh appeared somehow degrees of progress from 1999 to 2018. However, for most indicators, the average annual rate of change was still lower than the expected to achieve the 2030 target which called for acceleration in the next few years.

Many women are exposed to carbon disulfide (C2) hazards at work every day. Working with C2 may cause some women to experience abnormalities in their reproductive health. Until now obtained data is generally concentrated on the health effects of C2 observed in the viscose industry. To date, C2 has not been studied precisely for its potential to have damaging effects on female reproductive system, especially the frequency of menstrual disturbances and the course of menopause. The aim of the study was to sum up female reproductive health hazards amongst women chronically exposed to C2 in their workplace in the viscose industry. In order to study the effect of C2 in the contemporary viscose industry, exposure measurements should be collected in prospective or cross-sectional studies. In conclusion, reproductive health hazards for women chronically exposed to C2 in the workplace in the viscose industry are the following: 1) menstrual disorders essentially are more frequent than in the case of the healthy women, 2) for women chronically exposed to C2 the average menopausal age is statistically earlier, as compared to healthy women, 3) complex disturbances in neurohormonal system for women exposed to C2, resulting from toxic influences of C2, which cause the secretion of estrogens and progesterone in ovaries and dehydroepiandrosterone sulfate in the adrenal gland to diminish. Med Pr 2018;69(3):329-335., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)