This review examines menstrual health as a neglected dimension of women's health and occupational equity, with particular attention to high-stress and gendered occupational contexts. It asks how menstruation is addressed or silenced within workplace health frameworks, and how these dynamics are intensified in safety-critical, shift-based, and regulated occupations. A narrative review was conducted to synthesize literature from occupational health, feminist organizational scholarship, health policy, aviation studies, and workplace inclusion research. Aviation is used as a focal case, bringing together circadian disruption, fatigue exposure, public visibility, bodily discipline, and gendered occupational hierarchies. The review identifies four dynamics. First, rigid job design, workload intensity, circadian disruption, and recovery opportunities exacerbate menstrual health risks. Second, policy responses remain fragmented, uneven, and symbolic, offering recognition without accommodation or redistribution. Third, organizational cultures of silence and stigma frame menstruation as unprofessional, discouraging disclosure and reinforcing gendered norms of ideal workerhood. Fourth, inclusive and participatory leadership practices can create openings for psychological safety and employee voice, but their impact remains constrained without structural and policy reform. By reframing menstruation as an occupational health and equity issue rather than an individual concern, this review contributes to debates on embodied work, gendered organizations, and menstrual inclusion in high-pressure workplace contexts.
Women's labor force participation has increased in Japan, yet workplace support for cyclical, gender-specific health needs remains uneven. This study examined how working women in Japan managed these needs at work and how digital self-tracking might support job-aligned adjustments. Three age-stratified focus groups were conducted in the Kanto region (20-29 years, n = 7; 30-39 years, n = 6; 40-59 years, n = 8; total n = 21) in 2024. Transcripts were analyzed using conventional qualitative content analysis. Participants described formal support, including menstrual leave, as often impractical because of stigma, hierarchical norms, and concerns about fairness and workload redistribution, fostering informal coping and after-hours self-management. Menstrual-cycle apps and activity or sleep tracking were valued when outputs were accurate, interpretable, and aligned with bodily sensations; sustained use depended on low burden, peer recommendations, and clear privacy boundaries. Participants preferred concise, user-controlled summaries that could communicate the need for brief scheduling or task adjustments without divulging sensitive personal information. Privacy-preserving self-tracking was perceived as potentially useful when workplaces provided psychologically safe channels and fair procedures for translating summaries into agreed, low-disclosure micro-accommodations. These findings reflect perceived feasibility and potential usefulness rather than demonstrated effects on work functioning, absenteeism, presenteeism, organizational outcomes, or implementation effectiveness.
This study aimed to examine global research trends and key research areas in aromatherapy and women's health. Search terms and synonyms related to women's health and aromatherapy were identified from the literature and incorporated into the search strategy. A standardized search of the Web of Science database conducted on July 22, 2025, identified 277 studies, of which 159 met the inclusion criteria and were included in the analysis. The articles were analyzed using RStudio (Version 1.4.1717) and the "biblioshiny for bibliometrix" application. The PRISMA 2020 checklist was utilized to guide the reporting process in this study. The retrieved publications comprised 159 full-text English-language articles published between 1994 and 2025 across 100 journals. Publication output peaked in 2018, while citations reached their highest level in 2024, with an overall upward trend in both. Complementary Therapies in Medicine published the most articles, whereas the Journal of Alternative and Complementary Medicine received the most citations. Tabriz University of Medical Sciences was the most productive institution, and Iran was the leading country. Approximately 91.9% of authors contributed only one publication. The most cited article was "Aromatherapy in Childbirth: A Pilot Randomised Controlled Trial." The most frequent keywords were "anxiety," "essential oil," and "massage," while trending topics included "anxiety," "essential oil," and "mood." The main motor themes focused on anxiety, essential oil, massage, pain, mood, aromatherapy, inhalation, and childbirth. A growing research trend was observed, with essential oils most frequently studied, particularly for anxiety and mood during childbirth.
Abnormal bone mineral density (BMD), including osteopenia/low bone mass and osteoporosis, imposes a substantial clinical and socioeconomic burden on Chinese women. However, prevalence estimates vary markedly because primary studies differ in age composition, study setting, and the BMD outcome category reported. To systematically review and meta-analyze the prevalence of distinct BMD outcomes and the influencing factors associated with abnormal BMD among Chinese women aged 40 years and older. We searched nine international and Chinese databases from inception to July 10, 2025, for cross-sectional or case-control studies involving Chinese women aged 40 years or older. Prevalence was synthesized separately for abnormal BMD, osteopenia/low bone mass, and osteoporosis. Twenty-eight studies comprising 36,984 participants were included. Outcome-specific meta-analyses showed a pooled prevalence of 61 percent for abnormal BMD (95 percent CI: 50 percent-72 percent; n = 17,294), 41 percent for osteopenia/low bone mass (95 percent CI: 37 percent-46 percent; n = 19,032), and 29 percent for osteoporosis (95 percent CI: 23 percent-35 percent; n = 35,082). Heterogeneity remained substantial (I2 = 99.5 percent, 97.1 percent, and 99.1 percent). Postmenopausal status, menopause duration > 5 years, older age, BMI < 18 kg/m2, lack of exercise, low vitamin D intake, and fracture history were associated with higher odds of abnormal BMD, whereas regular exercise, dairy products, bean products, and calcium supplementation were protective. Abnormal BMD represents a substantial bone-health burden among Chinese women aged 40 years and older. Outcome-specific meta-analyses showed pooled prevalence estimates of 61 percent for abnormal BMD, 41 percent for osteopenia/low bone mass, and 29 percent for osteoporosis. Both non-modifiable susceptibility factors and potentially modifiable lifestyle and nutritional factors were associated with abnormal BMD. These findings support risk-based BMD assessment and targeted strategies addressing modifiable factors, including physical activity and adequate calcium and vitamin D intake, to promote bone health in middle-aged and older Chinese women.
Although lumbopelvic disorders are common during pregnancy, evidence regarding their impact on health-related quality of life (HRQoL) remains limited. This study therefore aimed to assess the associations between urinary incontinence, fecal incontinence, constipation, sexual dysfunction, low back pain, and HRQoL during pregnancy. Analysis of covariance (ANCOVA) models and multivariate linear regression analyses were used to examine the associations between these conditions and HRQoL among 375 pregnant women in Nicaragua. Pregnant women with these disorders had significantly poorer HRQoL than those without them. The physical component score was associated with urinary incontinence (β = -0.22, 95 percent CI: -0.42 to -0.01), constipation (β = -0.43, 95 percent CI: -0.64 to -0.21), sexual dysfunction (β = -0.13, 95 percent CI: -0.24 to -0.02) and low back pain (β = -0.75, 95 percent CI: -1.07 to -0.44). The mental component score was associated with constipation (β = -0.41, 95 percent CI: -0.61 to -0.21 and sexual dysfunction (β = -0.13, 95 percent CI: -0.23 to -0.02). In conclusion, this study suggests that urinary incontinence, constipation, sexual dysfunction, and low back pain may be associated with poor physical well-being during pregnancy. Constipation and sexual dysfunction may also be associated with poor mental HRQoL.
Intimate partner violence (IPV) is a widespread public health concern with serious mental health consequences. However, limited research has examined the relationship between IPV and mental health among Chinese immigrant women in the U.S. particularly in relation to broader sociocultural and immigration-related contexts. This study examined how various forms of IPV and immigration- and acculturation-related factors were associated with depression risk among 974 Chinese immigrant women in the U.S. using secondary data analysis. Measures included sociodemographic characteristics, physical, sexual, and emotional IPV, and immigration- and acculturation-related factors (immigration status, nativity, and language and social interaction preferences). Multivariable logistic regression and classification tree analyses were conducted. Emotional abuse was significantly associated with increased risk of depression, while bicultural or predominantly heritage-based social interactions were associated with reduced risk. The classification tree identified women aged ≥28 years with single-cultural social interactions and a history of emotional abuse, especially at risk for depression. Findings underscore the importance of addressing emotional abuse and promoting bicultural social engagement in efforts to reduce depression among Chinese immigrant women. Culturally responsive IPV screening tools and mental health services that support bicultural engagement may improve detection and intervention efforts in this population.
Gender disparities in academic medicine persist despite increasing women's representation in higher education. Prior research highlights the underrepresentation of women in senior ranks and leadership roles, yet few studies have assessed these disparities using time-adjusted productivity metrics. This study aims to evaluate gender-based differences in academic rank, scholarly productivity, and leadership representation among MD/PhD faculty in North America, accounting for career length and institutional variability. A secondary analysis was conducted on a dataset of 6,149 MD/PhD faculty from 122 accredited North American medical schools. Time-adjusted measures of productivity, H-index per year and citations per year, were calculated. Gender differences in rank, productivity, and leadership were assessed using Mann-Whitney U tests and descriptive statistics. Institutional-level representation of women in leadership roles was also analyzed. Women held significantly lower academic ranks than males and were underrepresented in departmental leadership roles. Despite achieving assistant and full professorships earlier, women were overall less likely to reach these positions. Males exhibited higher time-adjusted H-index and citation rates (p < .0001), with a compounded 3.5-year publication gap. Institutional analysis revealed stark variability: 38 institutions had no women in MD/PhD leadership roles, while fewer than 20 percent achieved gender parity. Gender disparities in academic medicine cannot be explained by productivity alone. Structural barriers, opaque promotion criteria, and institutional cultures continue to impede women's advancement and leadership. Addressing these inequities requires transparent policies, targeted mentorship, equity audits, and inclusive leadership pathways to support a more equitable academic workforce.
Female medical trainees face significant barriers in balancing career and family. We examined the prevalence of advertised paid parental leave on program websites and whether the sex distribution of departmental and program leadership influences parental leave policymaking in US adult neurology residency programs. The sex of department chairs and program directors and advertised parental leave policies in 174 US adult neurology residency programs were acquired from their respective websites in July 2022. The prevalence of programs with advertised paid parental leave and/or female leadership was calculated. Pearson's chi-squared analyses compared paid parental leave advertisement with the sex of department chairs and program directors. Subgroup analyses were conducted for four geographical regions. Of 174 programs, 18 percent and 41 percent of department chairs and program directors were female, respectively, and 43 percent advertised paid parental leave. There was no association between the sex of department chairs or program directors with advertised paid parental leave. Regional comparisons showed no difference in advertised paid parental leave. We report significant female underrepresentation in academic leadership and the lack of advertised paid parental leave in most US adult neurology residency programs. Future recommendations include advocacy for equitable sex representation in leadership and addressing residency challenges.
Women's sexual function and satisfaction can be impacted by various natural life events, such as childbirth and breastfeeding. The impact of BETTER model-based sexual counseling on sexual function and satisfaction among primiparous breastfeeding women with sexual dysfunction was assessed in a randomized controlled trial conducted in Hamadan, Iran, in 2024. Eighty eligible women were randomly allocated to intervention and control groups, and data were collected using a demographic and midwifery questionnaire, the Female Sexual Function Index, and the Larson Sexual Satisfaction Questionnaire at baseline and four weeks post-intervention. The intervention group received four weekly group counseling sessions based on the BETTER model, while the control group did not. Statistical analysis was performed using SPSS version 19 with a 95 percent confidence level. Post-intervention, the intervention group exhibited significantly higher mean scores for sexual function (28.67 ± 2.70 vs. 21.67 ± 3.45; p = .001) and sexual satisfaction (100.24 ± 4.85 vs. 93.81 ± 11.53; p = .003) compared to the control group. Within the intervention group, significant improvements were observed post-intervention in all sexual function domains and sexual satisfaction compared to baseline (p < .05). Findings indicate that BETTER model-based sexual counseling is beneficial and applicable for improving sexual function and sexual satisfaction in primiparous mothers.
Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a globally prevalent endocrine disorder affecting reproductive-aged women and associated with numerous long-term health risks. While growing international research on PMOS examines both medical and non-medical aspects of this condition, few studies exist within the Caribbean region, mostly focused on the clinical aspects. Thus, the current study explores the possible psychosocial impacts of women diagnosed with PMOS in Trinidad and Tobago. A qualitative study was conducted with 24 women aged 18-45 years with a physician-confirmed PMOS diagnosis. Participants were recruited through purposive and snowball sampling in April-June 2025. Data were collected through semi-structured interviews conducted both face-to-face and online via Zoom and were thematically analyzed using Dedoose (v.9.0.17). Three key themes emerged from the data: fertility and wellbeing; weight gain and weight stigma; and bodily changes and surveillance. Concerns around fertility were present despite no confirmed infertility diagnosis and were shaped by societal expectations of childbearing and motherhood. Weight gain triggered feelings of guilt, self-blame, and personal failure, compounded by weight stigma from family, healthcare providers, and professional colleagues. Also, bodily changes including hirsutism, acne and hyperpigmentation led to negative social reactions and increased body surveillance. Across all themes, psychosocial impacts were shaped by social interactions grounded in gendered cultural norms surrounding femininity and womanhood. Therefore, there is the need for a more holistic approach to PMOS care and management that moves beyond addressing clinical features and includes measures that address the psychologically and socially produced experiences associated with the condition.
This study aimed to evaluate the validity and reliability of the Turkish version of the Menstrual Quality of Life (PERIOD-QOL) scale. This methodological study was conducted with 332 nurses and midwives. Validity and reliability were analyzed using item analysis, content and construct validity, exploratory and confirmatory factor analysis, Cronbach's alpha coefficient, the Spearman-Brown formula, and the test-retest method. Cronbach's alpha, Spearman-Brown reliability, and test-retest reliability coefficients were 0.86, 0.81, and 0.63, respectively. According to the emerging unidimensional structure, factor loadings of the scale items were between 0.50 and 0.80, and this structure alone explained 45.75 percent of the total variance. The results of the known groups validity method showed that the mean PERIOD-QOL total score of nurses and midwives with very little to little menstrual bleeding (38.00 ± 6.89) was higher than those with heavy menstrual bleeding (28.73 ± 8.09) and very heavy to extremely heavy menstrual bleeding (23.50 ± 10.34) (p < .05). The confirmatory factor analysis revealed perfect and good-fit indices (χ2/df = 2.95, RMSEA = 0.077, SRMR = 0.044, CFI = 0.98, IFI = 0.98, GFI = 0.95, and NFI = 0.97). The mean items of the scale ranged between 2.71 ± 1.38 and 4.27 ± 1.19. The Turkish version of the PERIOD-QOL scale is a valid and reliable tool to assess the level and perception of menstrual QOL of women.
Anthropometric and body composition indices offer a non-invasive and cost-efficient approach to assessing body fat distribution. This study designed to assess the effectiveness of both conventional and novel anthropometric indices in diagnosing abdominal obesity among women, with a particular focus on waist circumference (WC) as a central metric. A cross-sectional analysis was done on 916 healthy women aged 18-50 years. Measurements included weight, height, waist circumference, and hip circumference, with novel indices derived from these data. Percent Body Fat (PBF) and Visceral Fat Area (VFA) were estimated using bioelectrical impedance analysis, and the diagnostic accuracy of the indices was assessed through receiver operating characteristic (ROC) curve analysis. The Abdominal Volume Index (AVI) and Fat Mass (FM) demonstrated the highest diagnostic accuracy, with Youden Indices of 1.00 (AUC = 1.00) and 0.99 (AUC = 0.99), respectively. In contrast, the A Body Shape Index (ABSI) (Youden index = 0.003, AUC = 0.37) and Hip Index (HI) (Youden index = -0.67, AUC = 0.11) showed poor diagnostic performance. Notably, the Body Mass Index adjusted for Fat Mass (BMI FAT) (Youden index = 0.88, AUC = 0.98) outperformed traditional BMI (Youden index = 0.83, AUC = 0.98), underscoring its potential for more accurate obesity classification. This study highlights the importance of selecting appropriate anthropometric indices for the accurate assessment and management of abdominal obesity in women, providing valuable insights for clinical practice and public health strategies.
Ectopic pregnancy is a serious gynecological emergency that imposes a significant global burden. This research aims to provide an effective reference for future strategic planning in various countries. Ectopic pregnancy data from 1990 to 2021 were analyzed, the autoregressive integrated moving average (ARIMA) and exponential smoothing (ES) models were used to predict future disease burden. Compared with 1990, the number of deaths and disability-adjusted life years (DALYs) increased, while the incidence number decreased notably. The age‑standardized incidence rate (ASIR) decreased by 46.12 per 100,000 (estimated annual percentage change (EAPC): -0.91, 95 percent CI: -1.02 to -0.8). The age‑standardized mortality rate (ASMR) remained stable (EAPC: 0.01, 95 percent CI: -0.07-0.08), and the age‑standardized DALY rate (ASDR) decreased slightly (EAPC: 0.05, 95 percent CI: -0.03-0.13). Prevalence also declined (ASPR EAPC: -0.91, 95 percent CI: -1.02 to -0.8), though incidence remains the primary focus for this acute condition. Across all indicators, the burden of ectopic pregnancy was concentrated within the age group of 10-54 years and predominantly in the 20-29 age group. Disease burden in low sociodemographic index (SDI) regions was higher than in other SDI regions. The regions and countries with the highest disease burden were located mainly in Africa. Although some global indicators have decreased over the past 30 years, the burden in low SDI regions has remained high. Enhancing cross-national collaboration may help reduce the disease burden in high-burden nations and areas.
Despite global prevalence of Menopause, evidence on lived experiences across diverse populations remains limited, particularly in Brazil. Addressing these gaps is essential for designing equitable health policies. MARIE-Brazil conducted a qualitative study to explore menopausal experiences. Twenty women were selected from a cohort of 262 women in the MARIE-Brazil quantitative study who consented to the qualitative phase. Semi-structured interviews were conducted using a topic guide with participants self-identifying as experiencing perimenopause, menopause, or post-menopause. Sampling captured heterogeneity across age, menopausal stage, socio-economic position, ethnicity, and healthcare access. The findings indicate intersecting biological, psychological, socio-cultural, and health system determinants shaping experiences. Participants reported vasomotor symptoms, sleep, cognitive, and urogenital changes that influenced quality of life and occupational participation. Barriers to care included limited clinical knowledge, "front-desk gatekeeping," and financial inaccessibility of treatments. Cultural stigma and gender norms exacerbated inequities, while peer networks and supportive clinicians improved coping. Menopause is not solely a biological milestone but a multifaceted transition shaped by structural and cultural determinants. Findings highlight urgent needs to adapt robust clinical protocols (e.g. Brazilian Federation of Gynecology and Obstetrics Associations-FEBRASGO, Brazilian Society of Climacteric-SOBRAC) for the public sector (SUS) and provide training for non-clinical staff, and accessible treatment pathways. Incorporating lived experiences into service design and policy frameworks is critical to promoting equity in menopause care across diverse Brazilian population.
Identify barriers and reasons for initiating the use of long-acting reversible contraceptive (LARC) methods in a cohort of Brazilian women. A cross-sectional study surveyed women aged 18-49 attending a tertiary Family Planning clinic for long-acting reversible contraception (LARC). A tailored questionnaire gathered information on demographics, contraceptive preferences, motivations for choosing LARC and challenges in obtaining their preferred method. we revised it to: The participants had a mean age of 29.5 years (SD = 8.0). Nearly half (47.9%) were between 20 and 29 years old. The sample was predominantly composed of non-white women (600, 50.5%), the majority of whom were single (56.0%), had completed 10 to 12 years of schooling (56.9%), and 56.9% came from a region outside Campinas. Among the 1,193 women 965 (81.2%) choose the levonorgestrel 52 mg IUD, whereas 43 (3,6%) chose the etonogestrel implant, and 164 (13,79%) the copper-IUD. The primary motivations for seeking LARC at a tertiary clinic included lack of availability at Primary Basic Units, free of cost, and presence of trained healthcare providers. The main reasons for choosing the SIU-levonorgestrel 52 mg were high efficacy, bleeding control, and preference for achieving amenorrhea. Social disparities, limited availability, lack of trained health care hinder awareness and access to LARCs. In conclusion, the key barriers identified were the lack of availability of preferred LARC methods in public healthcare facilities and the considerable delay between a woman's decision to use contraception and its actual initiation.
A prospective longitudinal study was conducted among 70 users of the etonogestrel contraceptive implant. World Health Organization Quality of Life (WHOQOL-BREF), Female Sexual Function Index (FSFI), and Birth Control Satisfaction Assessment Tool (ORTHO-BC) were administered to participants, who were followed for six months. The mean age was 28.3 years. Most participants were single (62.9 percent) and had ≥12 years of education (92.9 percent). Regarding sexual function, no statistically significant changes were observed in FSFI scores over the six-month period, either in the total score or across domains (p > .05). In contrast, quality of life assessment using the WHOQOL-BREF showed a significant reduction in the psychological (p = .003), social relationships (p = .042), and environmental (p = .037) domains, indicating a decline in these aspects over time. The psychological domain of the WHOQOL showed significant correlations with all FSFI domains (p < .05). In multivariate regression analysis, the FSFI satisfaction domain was an independent predictor of improvement in the psychological domain of the WHOQOL. These findings highlight the need for comprehensive counseling regarding potential adjustments in well-being after implant insertion. The etonogestrel contraceptive implant did not alter women's sexual function, and its adverse effects did not impact their overall quality of life. The method was well accepted by the participants.
Women are at increased risk of fecal incontinence (FI) due to pelvic floor dysfunction. Running, may further contribute to FI symptoms. The main aim of this study was to gain insight into the experiences of Dutch female recreational runners with FI during running. We conducted a qualitative study using semi-structured interviews. Participants, recruited through Facebook and running groups, were eligible if they had experienced FI symptoms during running for at least 3 months without FI in daily life. Interviews focused on personal experiences with FI related to running. Data were analyzed using thematic content analysis. Twenty-one participants, aged 31-72 years participated. Two themes emerged: Firstly, feelings and beliefs about FI described emotional responses, while some women expressed acceptance, others reported sadness. Barriers to seeking medical care included a lack of knowledge about treatment options, feelings of shame, and fear of not being taken seriously. Secondly, coping and adaptation strategies describe practical measures such as toilet mapping, carrying toilet paper or clean clothing, and wearing dark clothing. This study highlights the complex experiences of female runners dealing with FI and emphasizes the need for greater awareness, education, and support within the running community to effectively address this issue.
Postpartum diastasis recti abdominis (DRA), characterized by increased inter-rectus distance (IRD), is common and linked to functional impairments, but its association with pelvic floor dysfunction (PFD) remains uncertain. This study investigated whether IRD correlates with pelvic floor muscle (PFM) function and examined the association between DRA and PFD in primiparous women during the remote postpartum period. This cross-sectional study included primiparous women 45 days to 12 months postpartum. The IRD and PFM function were assessed using standardized ultrasound protocols, with additional clinical, anthropometric, and questionnaire data collected in face-to-face interviews. PFD and sexual function were evaluated using the QMAP-Br and FSFI-6 instruments, respectively. Among 51 primiparous women, DRA was most prevalent at the umbilical level (31.4 percent), weak PFM function was observed in 60.8 percent, and sexual dysfunction in 62.8 percent. No significant correlations were found between IRD and PFM function. Weak correlations were identified between IRD (supraumbilical and umbilical levels) and PFD, and between IRD and sexual function. Greater IRD at the umbilical and infraumbilical levels was associated with a lower likelihood of absent/weak PFM function, and DRA at the infraumbilical level was strongly associated with sexual dysfunction. Current findings suggest that IRD is not associated with PFM function and shows only weak correlations with PDF. These results support the multifactorial nature of postpartum PFM function, indicating that IRD alone does not explain these outcomes.
This study aimed to investigate the knowledge and practices of a group of refugee adolescent girls in Türkiye regarding menstrual hygiene management, the extent of period poverty, and genital hygiene behaviors. A cross-sectional design was employed. The study was conducted with 330 students in a multi-program high school. Data were collected using a Demographic Characteristics Form, a Menstrual Cycle Characteristics Form, a Period Poverty Characteristics Form, and the Genital Hygiene Behavior Scale. It was found that 23 percent of refugee adolescents experienced financial difficulties in purchasing menstrual hygiene products, 41.2 percent had to use alternative hygiene products due to economic reasons, and 44.2 percent were worried that their menstrual hygiene products would run out. Among the adolescents, 43.0 percent reported insufficient knowledge about the menstrual process, 61.8 percent stated that they had not received adequate education on menstruation and hygiene at school, and 73.9 percent reported inadequate opportunities for menstrual hygiene management in their schools. Adolescents who reported not having received information about the menstrual process had lower total scores on the Genital Hygiene Behavior Scale. According to the findings, a significant portion of adolescents faced difficulties accessing basic sanitation services, menstrual hygiene education, and safe and hygienic menstrual products during menstruation. Menstrual health should be addressed as a fundamental issue within the context of global and reproductive health. In the short term, awareness-raising initiatives should be implemented to prevent period poverty, and women and girls should be educated. In the long term, comprehensive social policies should be developed.
