Current Women's Health Reviews - Volume 21, Issue 4, 2025

Sexually Transmitted Infections (STIs) can cause serious health complications, including pelvic inflammatory disease, infertility, ectopic pregnancy, adverse pregnancy outcomes, and cervical cancer. Adolescents and young adults are particularly vulnerable to STIs due to risk-taking behaviors, multiple sexual partners, and inconsistent condom use. Our study aimed to examine the knowledge about contraceptive methods and sexually transmitted infections, and attitudes toward sexual health education among adolescents in Croatia.

The participants were high school students aged 16 to 18 years. The study was conducted at Antun Gustav Matoš Gymnasium, Zabok. We obtained study data via an anonymous survey.

The study included 204 adolescents in their final years of high school. The total number of adolescents who had sexual intercourse was 47 (23%). The percentage of sexually active female and male adolescents was 21% and 27%, respectively. In the surveyed group of adolescents, 86% had never heard of subcutaneous progestin implants and 72% had never heard of contraceptive sponges. All adolescents had heard of oral contraceptives and condoms. In the surveyed group of adolescents, 58% had never heard of trichomoniasis and 10% had never heard of HSV. All adolescents had heard of HIV and syphilis. A total of 147 (72%) of the surveyed adolescents believed it as necessary to provide health education in schools.

The initiation of sexual activity among adolescents in Croatia remains unchanged when compared to previous studies. Their current knowledge of sexually transmitted diseases and contraceptive methods should be improved through continuous, well-designed, and comprehensive sexual health education.

This study aimed to evaluate the suggested strategies to prevent anaemia in pregnancy through a 5-year scoping review (November, 2017 to November, 2022).

A comprehensive list of keyword combinations linked to anemia prevention in pregnancy and pertinent approaches to inform the search strategy were evaluated. Significant events, including pregnancy and anemia, were cross-referenced with the frequency and variability of terms across time. Literature from Pubmed (MEDLINE), Google Scholar, PLOS One, and Cochrane database were reviewed.

Evidence-based preventative therapy options for iron deficiency anaemia in pregnancy include prophylactic iron supplementation, food fortification with iron and folate, and health education. There is a wealth of research on the effects of these therapies on the occurrence of anaemia during pregnancy. However, these prospects are endangered by several variables, such as inadequate health facilities, low maternal health literacy, low utilisation of maternal health care in developing countries, a dearth of resources for health education, and lack of a government policy that prevents anaemia during pregnancy.

If the highlighted challenges are appropriately addressed through the provision of health education material, the effectiveness of anaemia prevention in pregnancy could be sustained.

Endometriosis is a chronic disease that affects about 5-15% of women of reproductive age. Considering the extensive impact of this disease on women's sexual function, the present study was conducted to determine the prevalence of sexual dysfunction in Iranian women with endometriosis and the factors associated with it.

This cross-sectional study was performed on 300 women (150 women with endometriosis and 150 healthy women) at Imam Khomeini Hospital in Tehran city, Iran, from April to December 2022. Data collection was done using a paper form. Data collection tools included a demographic information questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and the Depression, Anxiety, and Stress Scale (DASS-21) questionnaire. The data were analyzed using SPSS software version 24, employing descriptive and analytical statistics.

The prevalence of sexual dysfunction was 65.34% in women with endometriosis and 46% in healthy individuals. There was a significant relationship between age, menstrual status, stress, anxiety, and depression with sexual dysfunction in women with endometriosis (p < 0.05). Additionally, individuals with endometriosis were more susceptible to stress, anxiety, and depression compared to healthy individuals (p < 0.05).

Considering the high prevalence of sexual dysfunction in Iranian women with endometriosis, addressing sexual issues in individuals with endometriosis should be a consideration for healthcare providers, and systematic programs should be implemented to improve their sexual health.

Cervical cancer is reported as one of the most prevalent malignancies worldwide in women. There is a substantial connection between cervical diseases and infection with Human Papillomavirus (HPV), especially Types 16 and 18 of HPV.

This study aimed to assess the HPV genotype distribution to determine its most common type at a referral hospital in Iran.

This cross-sectional study was conducted on 400 women with positive HPV result tests who visited the gynecologic oncology clinic of Baqiyatallah Hospital from 2017-2021.

The average age of subjects was 37.46±9.75 years (range=19-74). About 167 (41.8%) of the patients were between 25 to 35 years. The analysis showed that 137 (34.2%) patients had only low-risk (LR) typing, 129 (32.2%) patients had only high-risk (HR) typing, and 134 (33.5%) patients had both HR and LR typing. The most frequent LR HPV types were HPV 6 (18.5%) and 11 (17%), and the most frequent HR HPV types were HPV-16 (14.7%), 52 (8.2%), 18, and 31 (6.5%).

This study showed that the most frequent age category in both low- and HR HPV-positive women is the age 25 to 35 years. The second most common HR-HPV subtypes included HPV-52, not HPV-18, which indicates variations in HR-HPV subtypes in different populations and races and warrants further research.

Premenstrual Syndrome (PMS) is one of the most common psychosomatic disorders in women of reproductive age, affecting their daily activities. This syndrome also has a negative impact on marital satisfaction and marital adjustment. Therefore, a study was conducted in 2022 with the aim of investigating the effect of an educational intervention in women with premenstrual syndrome and their spouses on marital satisfaction and marital adjustment in comprehensive health centers in Qom City.

This interventional study was conducted on two groups in 2022, including 41 participants in the intervention group and 39 participants in the control group who were referred to healthcare centers of Qom University of Medical Sciences. Sampling was conducted through multi-stage sampling. Data collection tools included a Premenstrual Symptoms Screening Tool, the Index of Marital Satisfaction (IMS), and the Spanier Dyadic Adjustment Scale. The individuals in the intervention group received educational sessions on PMS over four sessions, each lasting two hours. The collected data were analyzed using SPSS version 16, utilizing t-tests and Chi-squared tests. A significant level of 0.05 was considered.

A statistically significant difference was observed in the mean score of the Marital Satisfaction Questionnaire between the intervention and control groups after the intervention (p = 0.01). Additionally, there were significant differences in the mean scores of the Spanier Dyadic Adjustment Scale's total score (p = 0.019), correlation dimension (p = 0.001), and affection expression dimension (p = 0.044) between the two groups after the intervention.

Educating couples about Premenstrual sSyndrome (PMS) can lead to increased marital satisfaction and marital adjustment. It is recommended that structured educational programs on PMS and support for affected women's spouses be implemented in healthcare centers.

Cervical erosion (Qurūḥ al-Raḥim) is one of the most frequent gynecological conditions seen in clinical practice. Therefore, the objective of the current study was to assess the impact of the topical application of Marham-i-Bāsalīqūn in Qurūḥ al-Raḥim.

A randomized comparative clinical study was carried out at the Institute Hospital in Bengaluru. Diagnosed cases (n=40) of cervical erosion were randomly assigned to test (n=20) and control (n=20) groups. A total of 6 g ointment of Marham-i-Bāsalīqūn (test drug) and tested Unani formulation (control drug) was applied with an applicator per vaginum over the eroded area of the cervix daily once at bedtime for 14 days. A single dose of the antibiotic regimen (azithromycin-1g and cefixime-400 mg) was administered orally in both groups. Subjective parameters like vaginal discharge, pruritus vulvae, low back ache, lower abdominal pain, and postcoital bleeding were assessed during the trial. The main outcome measure was an improvement in the cervical erosion grading score. The inference was executed with appropriate statistical analysis.

Improvement in the cervical erosion grading score was achieved in 50% and 40% of patients in the control and test groups, respectively, after 2 weeks of treatment with P<0.0001, which was considered highly significant. A highly significant improvement in subjective parameters was observed during the trial with P<0.0001.

Considering the high prevalence of cervical erosion among women of reproductive age group, effective treatment and safe strategies are highly recommended. Marham-i-Bāsalīqūn is cost-effective and has several therapeutic actions that can help to promote the healing of erosion and relieve the associated symptoms.

The clinical trial was registered at the Clinical Trial Registry of India (CTRI) with registration number CTRI/2022/02/040419.

Brucellosis is a multi-organ infectious disease that can affect people of all ages. Systemic symptoms of brucellosis include back pain, headache, fatigue, weakness, general body pain, fever and chills, anorexia, muscle pain, sweating, weight loss, joint pain, cough, neurological symptoms, abdominal pain, diarrhea, and constipation. In this report, the case of a pregnant woman suffering from Malta fever with severe signs that she could not walk is reported.

In this paper, the case of a 28-year-old G3P2 female patient (third pregnancy, two normal deliveries) with 37 weeks of pregnancy and a history of brucellosis in the last two months, being under painkiller treatment, and who has been unable to walk (sacroiliitis) for two weeks, has been reported. Previously, treatment with gentamicin 2 times a day for 6 days was started, and in May 2022, the patient was admitted to Imam Reza Hospital in Mashhad by ambulance. After consultation with an infectious disease specialist, the patient received gentamicin IV QID at a dose of 5 mg/kg, ceftriaxone BID at a dose of 1 mg and IV, and rifampin QID at a dose of 600 mg and PO. She was subjected to CBC differential test twice a week, and BUN and CR assessments were performed every other day. She has received acetaminophen 500 mg PO and Q 6 hrs in the hospital during hospitalization. Radiography of the pelvis was done to check the bilateral sacroiliac joint; it has been found to be normal and no evidence of joint effusion has been seen. After a week of hospitalization and observation in the hospital, vaginal delivery was performed without any problems and she gave birth to a baby boy with an Apgar score of 9-10.

Clinical manifestations of brucellosis in pregnant women are weakness, arthralgia, fever, fatigue, excessive night sweats, anorexia, muscle pain, chills, depression, weight loss, headache, and back pain. The most common symptoms are fever, hepatomegaly, spleen involvement, joint complications, and obstetric symptoms, including vaginal bleeding, postpartum endometritis, pelvic or groin pain, premature rupture of membranes, and chorioamnionitis. Rifampicin and trimethoprim-sulfamethoxazole for 6 to 8 weeks constitute the most common and recommended treatment.

Methotrexate (MTX) was traditionally administered using the multi-dose regimen or single-dose protocols to treat ectopic pregnancies. The two-dose regimen was described as a cross between these two previous protocols aiming to lower side effects than multi-dose with a higher success rate of single-dose protocols. Hence, this study compared double-dose versus single-dose methotrexate therapy in the treatment of ectopic pregnancy.

This prospective cohort study was performed on the women referred to the academic hospitals of Mashhad University of Medical Sciences from March 2018 to July 2021 who were diagnosed as having stable tubal ectopic pregnancy and selected for medical treatment with methotrexate. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software (version 26). P≤0.05 was considered a significant level.

A total number of 347 patients were included in this study. About 300 cases were evaluated: 240 cases in single-dose and 60 cases in the double-dose group. The Beta Human chorionic gonadotropin (Beta-hCG) declined more than 15% between days 4 and 7 and was significantly higher in the double-dose group (P<0.001). Regarding the time from MTX administration until Beta-hCG level <5 mIU/mg, this time was significantly shorter in the double-dose group (P=0.045). Considering the side effects, there was no complication in any of the groups. However, tubal rupture was seen in 17 cases of double-dose and 10 cases in the single-dose group, respectively.

The results of the current study showed a higher treatment success rate in double-dose MTX protocol with comparable side effects compared to single-dose MTX protocol for the treatment of stable tubal ectopic pregnancy.

Scientific midwifery associations can play a leading role in improving maternal health policies and practices. This study aimed to evaluate the Iran Scientific Association of Midwifery (ISAM) using a translated valid version of the Member Association Capacity Assessment tool (MACAT) and also to explain the needs and propose the related strategies and actions to improve ISAM capacities.

This was a mixed sequential (Quantitative-Qualitative) explanatory research in 2022. The study was performed in three phases based on the study's objectives. In the first phase, the MACAT of the International Confederation of Midwives (ICM) was translated into Persian. Then, the validity of MACAT was assessed by 10 experts. After the validity approval of the Persian version of the MACAT, in the second phase, which was a descriptive study, the capacity of ISAM was assessed by two trained evaluators using MACAT. In the third phase of the study, with a qualitative research and using a focused group discussion and six in-depth individual interviews with 14 key informants, the demonstrated challenges in the first phase of the study and the related suggestions for the problem solutions were discussed. The data from the qualitative phase of the study were analyzed using directed Qualitative content analysis. Lincoln and Guba’s criteria were used to confirm the trustworthiness of the data. Then the needs were explained, and the strategies and actions were suggested to improve ISAM capacities in the seven dimensions of MACAT, including governance, management, financial resources, functions, communication, collaboration, and visibility.

In the first phase of the study, the MACAT was translated into Persian, and its validity assessment showed S-CVI= 0.91 and I-CVI= 0.89. CVR scores of all items were also above 0.62 and so acceptable. In the second phase of the study, the document review and the observations showed 88 out of 96 items scored 1 (91 percent) while 8 items scored zero. In the third phase of the study, 83 codes in the 6 dimensions were categorized from directed content analysis. Then, 53 actions were proposed for seven main strategies for improving the governance, enhancing the management practices and leadership methods, increasing functions, increasing collaboration, partnership, and networks, and expanding visibility and increasing sustainability to improve ISAM capabilities.

The Scientific Midwifery Association obtained 91 percent of the scores. The most important challenges of the ISAM were (1) low advocacy, (2) a shortage of human and financial resources and sponsors, and (3) low contribution in policy and decision-making in midwifery affairs. The most necessary actions for the ISAM capacity improvement were suggested to be (1) considering more independence in a culturally and politically-based context governance, (2) paying attention to infrastructure improvement, and (3) defining the mechanisms in communication with the other midwifery-related sectors, other NGOs, and potential sponsors; (4) the ISAM involvement in making macro policies and midwifery affairs, and (5) using the ISAM capacity for participating in mega health projects for fundraising.