General Gynecology
A pragmatic approach to the management of menopause
25 May, 2023 | 11:30h | UTCA pragmatic approach to the management of menopause – Canadian Medical Association Journal
News Release: Managing menopause: Hormone therapy is back – Canadian Medical Association Journal
RCT | Spironolactone enhances acne outcomes and offers a viable alternative to oral antibiotics
24 May, 2023 | 13:27h | UTCSummary: The SAFA (Spironolactone for Adult Female Acne) trial was a multicenter, phase 3, double-blind, randomized controlled trial in England and Wales and evaluated the efficacy of spironolactone for treating adult women with acne vulgaris. A total of 410 women, aged ≥18 years and suffering from facial acne for a minimum of six months, were randomly assigned to receive either 50 mg/day of spironolactone or a placebo, increasing to 100 mg/day until week 24.
The primary outcome was measured by the Acne-Specific Quality of Life (Acne-QoL) symptom subscale score at week 12 and 24. The trial demonstrated that spironolactone improved Acne-QoL scores more effectively than the placebo, particularly at week 24. Additionally, more participants in the spironolactone group reported acne improvement, and treatment success was significantly higher in this group at week 12. Mild side effects, notably headaches, were more common in the spironolactone group.
The findings from the SAFA trial highlight spironolactone’s effectiveness, safety, and tolerability in treating adult women with acne vulgaris, suggesting it is a viable alternative to long-term antibiotic treatments. Future research is proposed on higher initial dosages of spironolactone, and its effects on different subgroups like patients with different ages, body mass index, and ethnicity.
Editorial: What do we know about prescribing spironolactone for acne? – The BMJ
News Release: Non-antibiotic treatment for women with persistent acne shown to be effective – University of Southhampton
USPSTF Draft Statement recommends biennial screening mammography for women ages 40 to 74 years
22 May, 2023 | 13:56h | UTCBreast Cancer: Screening – U.S. Preventive Services Task Force
Critical perspectives on the statement:
Earlier screening for breast cancer: Benefits and harms – Lown Institute
Why more mammograms aren’t the solution to breast cancer – Vox
RCT | Neck–shoulder region training for chronic headache in women
15 May, 2023 | 12:59h | UTC
Commentary on Twitter
Neck-Shoulder Region Training for Chronic Headache in Women: A Randomized Controlled Trial
👀👀👇👇
"The progressive exercise program almost halved headache frequency"https://t.co/HQN2yppF27 pic.twitter.com/3ZFltwJTWl
— Physio Meets Science (@PhysioMeScience) April 26, 2023
RCT | Transvenous occlusion of incompetent pelvic veins to treat chronic pelvic pain in women
15 May, 2023 | 12:54h | UTC
Single-arm study | Halting endocrine therapy for pregnancy not linked to increased breast cancer events vs. a control cohort
10 May, 2023 | 16:01h | UTCInterrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In women with previous breast cancer who temporarily discontinued adjuvant endocrine therapy to attempt pregnancy, the frequency of breast cancer events was below the prespecified safety threshold and similar to that in controls (POSITIVE trial). https://t.co/zM3f4SbgjE
— NEJM (@NEJM) May 3, 2023
Cohort Study | Limited evidence linking COVID-19 vaccines to menstrual disturbance or postmenopausal bleeding
9 May, 2023 | 14:52h | UTCNews Release: New study finds no increased risk of menstrual changes after covid-19 vaccination – BMJ Newsroom
Commentary: Large study shows no changes to menstrual cycles after COVID vaccination – CIDRAP
Related:
Editorial: Menstruation and Covid-19 vaccination.
Commentary on Twitter
The findings of this new study do not provide substantial support for a causal association between SARS-CoV-2 vaccination and healthcare contacts related to menstrual or bleeding disordershttps://t.co/Tsw2hjIiIz
— The BMJ (@bmj_latest) May 4, 2023
Enhanced recovery after surgery (ERAS) society guidelines for gynecologic oncology: addressing implementation challenges
5 May, 2023 | 14:53h | UTC
RCT | Levonorgestrel IUS vs. hysteroscopic niche resection for postmenstrual spotting in cesarean scar
3 May, 2023 | 15:15h | UTC
Cohort Study | Long-term health consequences after ovarian removal at benign hysterectomy
3 May, 2023 | 14:58h | UTCLong-Term Health Consequences After Ovarian Removal at Benign Hysterectomy: A Nationwide Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
AUA/SUFU Guideline | Updates to surgical treatment of female stress urinary incontinence
2 May, 2023 | 13:43h | UTC
SR | Cranberries can prevent recurrent urinary tract infections in selected patients
25 Apr, 2023 | 14:41h | UTCCranberries for preventing urinary tract infections – Cochrane Library
Summary: Cranberries for preventing urinary tract infections – Cochrane Library
Commentaries:
Cranberry juice can prevent recurrent UTIs, but only for some people – The Conversation
Review confirms that cranberry products help prevent urinary tract infections – News Medical
Study suggests that routine axillary scanning in diagnostic breast ultrasound has limited impact on cancer detection
19 Apr, 2023 | 13:06h | UTCTo scan or not to scan: effect of scanning the axilla of all patients undergoing diagnostic breast ultrasound – Clinical Imaging (link to abstract – $ for full-text)
Commentary: Is scanning the axilla during diagnostic breast ultrasound necessary? – Health Imaging
M-A | Self-sampling strategies in populations at risk of Chlamydia trachomatis and Neisseria gonorrhoeae
18 Apr, 2023 | 13:09h | UTC
Commentary on Twitter
#OnlineFirst https://t.co/hOPwxJ2SLD
Vialard et al ➡️ diagnostic accuracy of self-sampling followed by CT/GC NAAT was similar to clinician-collected for extragenital sites in high-income countries. Vaginal self-sampling for women in low-income countries had lower accuracy. pic.twitter.com/lIzbQPufJl
— STI_BMJ (@STI_BMJ) April 11, 2023
RCT | Safety of Fezolinetant for vasomotor symptoms associated with menopause
17 Apr, 2023 | 12:54h | UTCRelated:
RCT | Fezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause
RCT | Efficacy of Fezolinetant in moderate-to-severe vasomotor symptoms associated with menopause
M-A | The risk of long-term cardiometabolic disease in women with premature or early menopause
11 Apr, 2023 | 13:59h | UTC
Review | Urinary incontinence and pelvic organ prolapse in women
10 Apr, 2023 | 13:27h | UTC
Review | Comprehensive care of women with genetic predisposition to breast and ovarian cancer
5 Apr, 2023 | 13:32h | UTC
M-A | Vaginal swab outperforms urine for detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis
5 Apr, 2023 | 13:23h | UTC
Consensus Paper | Definition and criteria for diagnosing cesarean scar disorder
5 Apr, 2023 | 12:51h | UTCDefinition and Criteria for Diagnosing Cesarean Scar Disorder – JAMA Network Open
SR | Adding ultrasound to mammography increases breast cancer detection, but increases false-positives and biopsies
3 Apr, 2023 | 13:55h | UTCSummary: The systematic review examined the effectiveness and safety of combining mammography with breast ultrasonography versus mammography alone for breast cancer screening in women at average risk. The research included one randomized controlled trial, two prospective cohort studies, and five retrospective cohort studies, involving a total of 209,207 women.
High certainty evidence from one trial indicated that combining mammography with ultrasonography led to the detection of more breast cancer cases than mammography alone (5 vs. 3 per 1000 women). However, this combination also led to a higher number of false-positive results and biopsies. For every 1000 women screened with the combined approach, 37 more received a false-positive result, and 27 more women underwent a biopsy.
Secondary analysis of the trial data revealed that in women with dense breasts, the combined screening detected more cancer cases than mammography alone, while cohort studies for women with non-dense breasts showed no statistically significant difference between the two screening methods.
The included studies did not analyze whether the higher number of detected cancers with the combined screening method resulted in lower mortality rates compared to mammography alone. Further research, including randomized controlled trials or prospective cohort studies with longer observation periods, is needed to assess the impact of the two screening interventions on morbidity and mortality.
RCT | Early postpartum IUD placement noninferior vs. placement at 6-8 weeks for complete expulsion, but not for partial expulsion
31 Mar, 2023 | 13:48h | UTCEarly vs Interval Postpartum Intrauterine Device Placement: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
News Release: Study: Risk of IUD Expulsion in Early Postpartum Placement – UC San Diego Health
Commentary: IUD Placement at Two to Four Weeks Postpartum Noninferior – HealthDay
Related:
Commentary on Twitter
Early IUD placement at 2 to 4 weeks postpartum compared with 6 to 8 weeks postpartum was noninferior for complete expulsion, but not partial expulsion. https://t.co/VMfWce3JJd pic.twitter.com/vdLrhCXa5Q
— JAMA (@JAMA_current) March 23, 2023
Study shows a slight breast cancer risk increase with progestogen-only birth control, comparable to combined oral methods
29 Mar, 2023 | 13:35h | UTCSummary: A UK study and meta-analysis examined breast cancer risk linked to hormonal contraceptives, emphasizing progestagen-only contraceptives in premenopausal women. Utilizing a nested case-control design with the Clinical Practice Research Datalink (CPRD), a primary care database, the study included 9,498 women under 50 diagnosed with invasive breast cancer between 1996 and 2017, and 18,171 closely matched controls. The meta-analysis merged CPRD findings with 12 observational studies on progestagen-only preparations.
The results revealed that current or recent use of combined oral contraceptives, oral progestagen-only contraceptives, injectable progestagen, and progestagen intrauterine devices all led to a similar increase in breast cancer risk. The 15-year absolute excess risk associated with five years of oral combined or progestagen-only contraceptive use ranged from 8 per 100,000 users aged 16-20 to 265 per 100,000 users aged 35-39. The study concluded that both contraceptive types were linked to a slight breast cancer risk increase, and these risks must be weighed against the benefits of contraceptive use during childbearing years.
News Release: Study finds similar association of progestogen-only and combined hormonal contraceptives with breast cancer risk – PLOS
Consensus Statement | Management of vaginal intraepithelial neoplasia
28 Mar, 2023 | 14:37h | UTC
RCT | Fezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause
23 Mar, 2023 | 13:01h | UTCFezolinetant for treatment of moderate-to-severe vasomotor symptoms associated with menopause (SKYLIGHT 1): a phase 3 randomised controlled study – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter (thread – click for more)
70% of women experience hot flushes or night sweats during #menopause.
A new study investigates the role Fezolinetant, a non-hormonal treatment, could play in reducing these symptoms. https://t.co/zv4b9WU03h
— The Lancet (@TheLancet) March 15, 2023