Search

This narrative review delves into the area of endogenous hormones and their impact on cognitive function, with a focus on women transitioning through perimenopause. While artificial intelligence technologies have revolutionized cognitive research, the inclusion of hormonal biomarkers remains sparse. The review synthesizes findings from diverse studies exploring the relationships between estrogen, progesterone, testosterone, other sex hormones, and cognitive performance. The research question explores the potential for monitoring endogenous hormonal levels during perimenopause to predict cognitive decline and inform preventive strategies. An analysis of relevant studies reveals a complex relationship, with varying impacts on cognitive domains. Thus, high E2 levels correlate positively with verbal memory and retrieval efficiency, contrasting with lower levels associated with enhanced visual memory, and testosterone shows positive links to verbal fluency. The limitations of existing research, including heterogeneous methodologies and a dearth of premenopausal representation, emphasize the necessity for future studies. To achieve this objective, it is important to leverage data from studies implementing standardized methodologies for tracking endogenous hormonal levels while accounting for cycle phases and menopausal transition stages. Additionally, employing standardized assessments for cognitive decline and analyzing extensive datasets derived from real-world sources, such as hospital or outpatient clinic chains, and digital apps, is crucial.

FSH, estrogen and progesterone testing are widely utilized in clinical practice. Lateral flow assays (LFAs) are cost-effective tools used for diagnosing infectious diseases, pregnancy, and substance testing. The focus of this narrative review is the potential for the wider utilization of listed hormone LFAs. A search was conducted with PubMed, Google Scholar and Wiley online libraries using keywords without any limitation on the publication date; animal studies were excluded. Clinical guidelines for the related conditions were included. According to published data, E3G and PdG are used to determine ovulatory cycles and can be utilized for research purposes to establish the normal range of menstrual cycles, as there is currently disagreement among guidelines. FSH measurement in blood samples is utilized to predict oocyte yield in assisted cycles and to differentiate women with premature ovarian insufficiency from hypothalamic amenorrhea, and can be replaced with more convenient urine testing. PdG was tested to assess the risk of pregnancy complications, specifically miscarriage and ectopic pregnancy, and might become a screening tool for miscarriage in the future. PMS, PMDD and ovarian carcinogenesis could be extensively studied using LFAs to gain a better understanding of the biology behind these conditions. Before implementing these LFAs into clinical practice, the reproducibility of progesterone assays should be evaluated. The results are critical for treatment decisions, and universally recognized standards for estradiol measurement should be developed.

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

Objective: Most countries teach limited information about sex and reproductive health education, often concentrating on how not to get pregnant. In this study, we examine what 16- to 18-year-olds in England have learnt and their views about reproductive health education. Design: This is a mixed-methods study. An anonymous, online survey was conducted on Qualtrics software using multiple-choice and open-ended questions. Schools were recruited via the Biotutors forum, and they distributed the survey to students aged 16-18years. Setting: Data collection took place across England. Methods: A total of 931 students completed the survey, of whom 636 were girls, 250 were boys, 31 as other genders, and 14 did not disclose their gender. Quantitative data were analysed descriptively, and associations were explored using Chi-square tests. Qualitative data were analysed thematically. Results: Over half (65%) of the students rated the sex education they had received as adequate or below. Over half (74%) reported that they do not, or only sometimes, talk to their parents/guardians about these topics. Half (49%) did not know when a woman is most fertile. Students showed a better knowledge of female fertility than male fertility. There was no relationship between how much teaching respondents said they had received and their knowledge of reproductive health topics. From the free text question 'How do you think we can improve sex and fertility education in schools?', five themes were identified: inclusivity for all students; comprehensive with relevant topic variety; logistical improvements needed to teaching; the need for honest, transparent and non-judgemental teaching; and sex positivity. Conclusion: Schools should teach a wider range of issues relevant to sexual and reproductive health. Data from this study have assisted the creation of a teachers' education resource which is being developed in partnership with the International Reproductive Health Education Collaboration (IRHEC).

Sex and fertility education is essential to enable people to make informed choices. School is an important source of education, so we examined the current curriculum relating to sex and fertility education in England and compared it with students' accounts of their experiences. We analysed the Awarding Body GCSE science and biology specifications (for 14-16 year-olds) and the A-level biology specifications (for 16-18 year-olds), as these related to relationships, sexuality and fertility. An online survey was conducted with 221 16-17 year-old school students to evaluate their views about their sex and fertility education. We found significant variation between the specifications of the Awarding Bodies at both GCSE and A level. Most of the specifications specify sexually transmitted infections (STIs), hormonal aspects of reproduction and contraception. In the school survey, students indicated that topics such as puberty, contraception and STIs were more likely to be learnt in school. However, topics such as endometriosis, menopause and miscarriage were more likely to be learnt outside school. From both our curriculum analysis and student survey we conclude that there are significant gaps in the curriculum with many important topics being neglected.