Abstract:Polycystic ovary syndrome (PCOS) is commonly associated with obesity and metabolic disturbances. Although gut and vaginal microbiome changes have been linked to PCOS, the independent role of body mass index in these alterations remains unclear. This study aimed to compare gut and vaginal microbiomes in women with PCOS and healthy controls, emphasizing the impact of body mass index. Seventy-five women were enrolled, including 55 with PCOS and 20 healthy controls. Participants were stratified into normal-weight (<25) and overweight (≥25) groups. Vaginal and anorectal swabs were analyzed using full-length 16S rRNA nanopore sequencing. Microbial diversity and composition were assessed with alpha diversity indices, principal component analysis, analysis of composition of microbes, PERMANOVA, and vaginal community state type classification. Without body mass index stratification, women with PCOS showed differences in several vaginal taxa compared with healthy controls. Within the PCOS cohort, overweight women exhibited higher vaginal alpha diversity, reduced Lactobacillus dominance, and enrichment of anaerobic taxa compared with normal-weight women with PCOS. Differences in vaginal microbial composition were also observed between healthy and PCOS women with normal body mass index. In contrast, gut microbiome alterations were limited and less consistent across analytical approaches. Vaginal community state type analysis revealed predominance of class IV communities in both healthy women and women with PCOS. These findings suggest that higher body mass index is associated with vaginal microbiome alterations in women with PCOS, although PCOS-related factors independent of body weight may also contribute to the observed microbial differences. Lay summary:Polycystic ovary syndrome is a common condition that affects hormones, fertility, and metabolism in women. Many women with this condition are also overweight, but it is not fully understood how body weight influences the bacteria living in the body. In this study, we compared bacteria present in vaginal and anorectal samples from women with and without polycystic ovary syndrome, while also considering body weight. We found that women with higher body weight had more noticeable changes in vaginal bacterial composition, including lower amounts of protective Lactobacillus bacteria and higher diversity of anaerobic bacteria. At the same time, some bacterial differences were also observed in women with polycystic ovary syndrome who had normal body weight. Changes in gut bacteria were smaller and less consistent. These findings suggest that both body weight and polycystic ovary syndrome may influence vaginal bacterial composition and should be considered in future studies of women's reproductive health.

Treatment options for uterine myomas - the most commonly occurring benign tumors of the female reproductive organs - are varied and include pharmacological therapies, radiological management, as well as surgery. The choice of treatment option should take effectiveness and safety into account, whilst considering also the expectations of the individual patient, e.g., the desire to preserve the uterus irrespective of reproductive goals. Advances in the pathophysiology of myomas have led to the search for new therapies that fulfil these criteria. EGCG - catechin is the primary bioactive polyphenol present in green tea (Camellia sinensis). It inhibits the cell proliferation of malignant and benign tumors and induces apoptosis in tumor cells. ECGC has been shown to inhibit myoma growth in vitro and in vivo, as well as in clinical trials. A multicentre prospective FRIEND study involving 200 women with uterine myomas is currently underway. EGCG appears to be a promising, non-invasive, safe option for the treatment of uterine myomas as well as the symptoms associated with their presence: heavy menstrual bleeding, pain, and fertility disorders. Several clinical trials combining EGCG with vitamin D and B vitamins are ongoing. Recently published results have shown the safety of this therapy and a positive effect on reducing fibroid size and treating resulting ailments. Our goal is to summarize current knowledge regarding the effectiveness of EGCG in treating fibroids and the possible mechanisms of its action.

Introduction: The most commonly encountered foreign body in the vagina is a tampon, which is routinely removed during gynaecological examinations. While these cases are common and well-known in medical practice, there are also situations involving much more unusual foreign bodies. This article focuses on these rare and often surprising cases, which can pose diagnostic and therapeutic challenges. Highlighting this topic aims to draw attention to the variety of situations gynaecologists may encounter in their daily professional practice. Case Study: A 62-year-old woman was admitted to the Gynaecological Obstetric Clinical Hospital of the Poznan University of Sciences to have a foreign body removed from her vagina. An MRI examination revealed a calcified well-defined structure (94 mm × 68 mm × 96 mm). The material removed during surgery were calcified fragments surrounding a plastic deodorant cap. After decalcification of the lesion, a histopathological examination ruled out cancerous cells. The patient received gynaecological and urological treatments due to a vesicovaginal fistula. Conclusions: The gynaecologists’ expertise and skills in diagnosing and removing foreign bodies are essential in order to provide postmenopausal women with comprehensive and responsible medical care.

Background/Objectives: Sexual health is shaped by lifestyle factors alongside biomedical determinants. This review synthesises evidence on physiotherapy, balneology/peloidotherapy, and diet therapy as preventive and therapeutic adjuncts for female sexual dysfunctions and related gynaecological conditions. Methods: A structured narrative review of PubMed and Google Scholar (June-July 2025) was conducted by three independent reviewers using predefined keywords in English and Polish. Case reports, preprints, and studies before 2015 were excluded. From 7322 records, 47 studies met the inclusion criteria for qualitative synthesis. Results: Physiotherapy-particularly pelvic floor muscle training, multimodal manual therapy, neuromuscular electrical stimulation (including PTNS), magnetostimulation, short-wave diathermy, and capacitive-resistive monopolar radiofrequency-was consistently associated with reductions in dyspareunia, chronic pelvic pain, and urinary symptoms, with parallel improvements in sexual function and quality of life. Balneological procedures (brine baths/irrigations, crenotherapy, selected radon/sulphide/iodine-bromine applications) and peloidotherapy demonstrated analgesic, anti-inflammatory, and perfusion-enhancing effects, with signals of benefit in vulvodynia, endometriosis, and infertility support. Dietary measures-higher fruit intake (notably citrus), adequate vitamin D, targeted omega-3 use in PCOS, a Mediterranean dietary pattern, and prudent red-meat limitation-were associated with favourable endocrine-metabolic profiles and, in selected contexts, reduced disease risk. Conclusions: Integrating lifestyle-medicine modalities with standard care may meaningfully prevent and manage female sexual dysfunctions by addressing pain, perfusion, neuromuscular control, and endocrine-metabolic drivers. Implementation frameworks and high-quality trials are warranted to refine indications, dosing, and long-term effectiveness.

Ovarian cancer (OC) is a severe gynecological malignancy with a high mortality rate among women worldwide. It is often diagnosed at advanced stages due to the lack of effective screening methods. This study investigated the expression patterns of microRNAs (miRNAs) hsa-miR-21-5p and hsa-miR-145-5p as potential OC prognostic and diagnostic biomarkers and their correlation with estrogen-dependent (ESR1 & 2, PELP1 and c-SRC) and hypoxia-neovascularization-induced (HIF1A, EPAS1, and VEGFA) pathway genes. Tissue samples obtained from twenty patients with confirmed ovarian cancer and twenty controls were analyzed using quantitative polymerase chain reaction (qPCR) to examine miRNA and mRNA levels. The qPCR analysis revealed significantly higher hsa-miR-21-5p and lower hsa-miR-145-5p expression in OC tissues than controls. Moreover, a significant trend was observed in hsa-miR-21-5p and hsa-miR-145-5p expression levels across normal, non-cancerous changes and malignant ovarian tissues. The hsa-miR-21-5p showed better diagnostic potential than hsa-miR-145-5p. We also observed inconsistent correlations in hsa-miR-21-5p and hsa-mir-145-5p and estrogen-related and hypoxia-neovascularization-dependent genes in ovarian cancer across all groups. This suggests that the relationship between these miRNAs and the selected genes is context-specific. Our findings suggest that hsa-miR-21-5p and hsa-miR-145-5p expression levels may be prognostic or diagnostic markers for ovarian cancer patients.

In recent years, the relationship between microbiota and various aspects of health has become a focal point for scientific investigation. The complex interplay between microbial communities and the development, progression, and treatment of gynaecological malignancies is a burgeoning field not yet fully understood. Recent research indicates that gut, vaginal, and uterine microbiota play a critical role in the response to treatments of ovarian cancer, and particularly in chemotherapy, anti-angiogenic therapy, and PARP inhibitors. Microbiota and microbial metabolites can modulate immune responses, drug metabolism, and angiogenesis, affecting the outcomes of therapy. This review explores the relationship between microbiota and anticancer therapies, and discusses the connection between dysbiosis and treatment resistance, highlighting the potential of microbiota as biomarkers and therapeutic targets in ovarian cancer treatment.

Objective: Unusual clinical course Background: Human Papilloma Virus (HPV)-associated Vulvar Squamous Cell Carcinomas (VSCC) present more frequently in young women than HPV- independent tumors. Due to its association with HPV infection, the incidence of vulvar cancer is increasing in young women; however, during pregnancy, it is still extremely rare. Case Report: We present the case of a 36-year-old pregnant woman at 23 weeks of pregnancy, diagnosed with HPV 16-associated VSCC, Federation of Gynecology and Obstetrics (FIGO) stage IB. Information on the coexistence of VSCC with pregnancy is unique, so it seems extremely important to disseminate it to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. The size of the tumor was 0.5 cm with a depth of invasion 0.3 cm. The patient underwent therapy and gave birth by cesarean section at 38 weeks of pregnancy because of orthopedic indications. Surgical removal of the vulvar tumor was performed, including a margin of 1.5 cm of healthy tissue. Due to the patient's lack of consent, the sentinel node biopsy was not performed. No recurrence has been observed for 9 years. Conclusions: The poorer prognosis of HPV-associated VSCC is independent of age and stage, with worse outcomes even in early-stage disease. For this reason, it is essential to sensitize clinicians to the possibility of such a diagnosis and to pay attention to the possibility of taking effective treatment during pregnancy, but safe for the fetus.

Background and Objectives: The study investigated whether the method of achieving hemostasis affects the ovarian reserve in patients undergoing laparoscopic surgery due to ovarian tumors or cysts. Materials and Methods: Patients with unilateral tumors or ovarian cysts, who qualified for laparoscopic tumor enucleation, were randomly selected to receive modified polysaccharides or bipolar coagulation. Ovarian reserve was analyzed by anti-Mullerian hormone (AMH) level. Results: The study included 38 patients: 19 patients in the modified polysaccharide group and 19 in the bipolar coagulation group. Patients after bipolar coagulation treatment had statistically significantly lower AMH 6 months after surgery compared to the group treated with modified starch. The levels of AMH in the study and control groups were 3.96 +/− 2.12 vs. 2.51 +/− 1.39 ng/mL, respectively; p = 0.018. A statistically significant decrease in AMH was also demonstrated in the bipolar coagulation group as compared to the preoperative assessment (p = 0.049). There was no statistically significant decrease in AMH in the group of patients treated with the modified starch. Conclusions: Using a modified polysaccharide during laparoscopic cystectomy is effective and has a positive effect on the ovarian reserve compared to the use of bipolar coagulation. Both the AMH level 6 months after surgery and the percentage decrease in AMH were more favorable in the group of patients treated with modified starch.

The aim of this review was to describe the uterine microbiome composition that has been analyzed so far and describe potential pathways in the carcinogenesis of the endometrium. The microbiome in the uterine environment is involved in apoptosis and proliferation during the menstruation cycle, pregnancy maintenance, and immune system support. However, bacteria in the uterus could stimulate inflammation, which when chronic results in malignancy. An altered gut microbiota initiates an inflammatory response through microorganism-associated molecular patterns, which leads to intensified steroidogenesis in the ovaries and cancers. Moreover, intestinal bacteria secreting the enzyme β-glucuronidase may increase the level of circulating estrogen and, as a result, be influential in gynecological cancers. Both the uterine and the gut microbiota play a pivotal role in immune modulation, which is why there is a demand for further investigation from both the diagnostic and the therapeutic perspectives.

In the original publication [...].

We investigated the association between methylenetetrahydrofolate reductase (gene MTHFR 677C>T, rs1801133), 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR 2756A>G, rs1805087), and methylenetetrahydrofolate dehydrogenase, cyclohydrolase and formyltetrahydrofolate synthetase 1 (gene MTHFD1 1958G>A, rs2236225)—well-studied functional variants involved in one-carbon metabolism—and gynecologic cancer risk, and the interaction between these polymorphisms and depression. A total of 200 gynecologic cancer cases and 240 healthy controls were recruited to participate in this study. Three single-nucleotide variants (SNVs) (rs1801133, rs1805087, rs2236225) were genotyped using the PCR-restriction fragment length polymorphism method. Depression was assessed in all patients using the Hamilton Depression Scale. Depression was statistically significantly more frequent in women with gynecologic cancers (69.5% vs. 34.2% in controls, p < 0.001). MTHFD1 rs2236225 was associated with an increased risk of gynecologic cancers (in dominant OR = 1.53, p = 0.033, and in log-additive models OR = 1.37, p = 0.024). Moreover, an association was found between depression risk and MTHFR rs1801133 genotypes in the controls but not in women with gynecologic cancers (in codominant model CC vs. TT: OR = 3.39, 95%: 1.49–7.74, p = 0.011). Cancers of the female reproductive system are associated with the occurrence of depression, and ovarian cancer may be associated with the rs2236225 variant of the MTHFD1 gene. In addition, in healthy aging women in the Polish population, the rs1801133 variant of the MTHFR gene is associated with depression.

Objectives: Testing pregnant women as early as in the first trimester has multiple advantages. Firstly, the first trimester screening combining ultrasound and serum marker testing (PAPP-A and free β-hCG) offers the highest currently possible — except for expensive tests using cell-free DNA biomarkers from the mother’s blood (ccf DNA) — detectability of aneuploid fetuses. Secondly, nuchal translucency (NT) measurement helps determine the risk of numerous abnormalities other than aneuoploidies. Lastly, nearly complete ultrasound assessment of fetal anatomy can be performed as early as in the first trimester of pregnancy. Material and methods: This study is based on prospective analysis. Study subjects were 236 pregnant women. One hundred thirty-one patients with a single pregnancy were qualified into the study group and had a combined ultrasound and biochemical screening for Down’s syndrome performed between 11 + 0 and 13 + 6 weeks of gestation, with the measured PAPP-A value at ≤ 0.50 MoM (multiples of the median). The control group comprised 105 pregnant women with PAPP-A value at a similar stage of pregnancy at > 0.5 MoM. Results: The average observed value of the PAPP-A in the study group was 0.35 MoM while in the control group 1.29 MoM. Moreover, combined observation of infant birth weights in both groups compared to the PAPP-A MoM values has shown a significant relationship between those characteristics (r = 0.15, p = 0.0184). Conclusions: The results showed that pregnant women with low PAPP-A MoM value measured during the first trimester have a higher risk of giving birth to a low-birth-weight infant (which is the value below 2500 g), than the pregnant women whose PAPP-A MoM value in the first trimester did not meet this criterion.

Ovarian cancer is a common cause of death among women worldwide. The current diagnostic and prognostic procedures available for the treatment of ovarian cancer are either not specific or are very expensive. Gene expression profiling has proved to be a very effective tool in the exploration of new molecular markers in patients with ovarian cancer, although the link between such markers and patient survival and clinical outcomes is still elusive. We are looking for genes that may function in the development and progression of ovarian cancer. The aim of our study was to evaluate the expression of selected suppressor genes (ATM, BRCA1, BRCA2), proto-oncogenes (KRAS, c-JUN, c-FOS), pro-apoptotic genes (NOXA, PUMA), genes related to chromatin remodeling (MEN1), and genes related to carcinogenesis (NOD2, CHEK2, EGFR). Tissue samples from 30 normal ovaries and 60 ovarian carcinoma tumors were provided for analysis of the gene and protein expression. Gene expression analysis was performed using the real-time PCR method. The protein concentrations from tissue homogenates were determined using the ELISA technique according to the manufacturers' protocols. An increase in the expression level of mRNA and protein in women with ovarian cancer was observed for KRAS, c-FOS, PUMA, and EGFR. No significant changes in the transcriptional levels we observed for BRCA1, BRCA2, NOD2, or CHEK2. In conclusion, we suggest that KRAS, NOXA, PUMA, c-FOS, and c-JUN may be associated with poor prognosis in ovarian cancer.

Ovarian cancer (OC) has the highest mortality rate of all gynecological malignancies. Moreover, at the time of the first clinical manifestation, most patients have an advanced stage of the disease. Our study examined differences in mRNA levels of hypoxia-inducible factor 1-alpha (HIF1A); endothelial PAS domain protein 1, also known as hypoxia-inducible factor 2-alpha (HIF2A/EPAS1); and vascular endothelial growth factor A (VEGFA) between cancerous tissue, benign hyperplastic changes in the ovary, and normal tissue. Our cohorts consisted of 52 patients diagnosed with OC (n = 55), benign non-cancerous changes (n = 21), and normal tissue samples (n = 38). The mRNA expression level was evaluated using RT-qPCR. We found that gene expression changes were visible not only in the case-control study, but also along with changes in severity. Additionally, the gene expression was differentiated in age, BMI, menopausal status, and the number of comorbidy-related groups. Furthermore, our findings demonstrate that analyzing the correlation between genes is essential. In a case-to-case and case-to-control study, we observed disturbances in the expression levels of interdependent genes. Our findings suggest that mutual association in the expression of both HIF1A and HIF2A/EPAS1 with VEGFA has prognostic importance for patients with OC. Our observations may help identify patients for clinical trials aimed at inhibiting the hypoxia-induced neovascularization-dependent pathways.

In order to identify the molecular pathways governing melanoma and track its progression, the next-generation sequencing (NGS) approach and targeted sequencing of cancer genes were employed. The primary tumor, as well as metastatic tissue, of an 84-year-old patient diagnosed with vulvar melanoma (VM), were investigated. The primary tumor specimen showed multiple somatic mutations in TP53 gene, suggesting its major contribution to melanoma origin. The metastatic sample showed additional alterations, including other melanoma-related genes. Clinical relevancy is postulated to juxtamembrane region instability of KIT gene (c-KIT). We did not identify BRAF or NRAS alterations, which are typical for the most common melanoma pathway–MAPK cascade. However, it should be noted that this is the first report evidencing PDGFRA in melanoma, although its role in triggering VM needs to be further elucidated.

Glassy Cell carcinoma (GCC) of the cervix is classified as a unique, aggressive neoplasm, with different sensitivity to chemotherapy and radiotherapy. It is such an extremely rare tumor that it is practically not observed during pregnancy. Information on the coexistence of cervical GCC with pregnancy is also unique, so it seems extremely important to disseminate it in order to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. We present the case of a 26-year-old pregnant woman, 18 weeks gestation, diagnosed with GCC of the cervix, IB3 grade in the International Federation of Gynecology and Obstetrics (FIGO) scale. Despite the unfavorable prognosis, the use of chemotherapy in a pregnant patient brought on a favorable therapeutic effect, without any negative effects on the fetus. The article also presents a literature review on the epidemiology, pathology, immunohistochemistry, treatment and prognosis of this rare disease.

The HELLP syndrome (hemolysis, liver damage and thrombocytopenia) is a rare (0.5–0.9%) but serious complication of pregnancy or puerperium associated with a higher risk of maternal and fetal mortality and morbidity. Liver and spleen hematomas rarely entangle (<2%) HELLP cases, but rupture of the hematomas presents an immediate threat to life. We present the history of a 35-year old pregnant woman (at the 31st week) admitted to our hospital due to the risk of premature delivery. On the first day, the patient did not report any complains, and the only abnormality was thrombocytopenia 106 G/L. However, within several hours, tests showed platelet levels of 40.0 G/L, LDH 2862.0 U/L and AST 2051.6 U/L, and the woman was diagnosed with severe HELLP syndrome, complicated by hematomas of the liver and spleen, seizures (eclampsia), severe arterial hypertension and coagulation disorders. The purpose of this article is to highlight the need for early investigation of the causes of thrombocytopenia and the differentiation of HELLP from other thrombotic microangiopathies (TMAs).

Żylna choroba zakrzepowo-zatorow (ŻChZZ), jest jednym z najgroźniejszych powikłań choroby nowotworowej. Terapia przeciwnowotworowa, zabiegi operacyjne czy znacznego stopnia zaawansowanie choroby nowotworowej to tylko niektóre czynniki ryzyka ŻChZZ, stanowiącej nadal jedną z najczęstszych przyczyn zgonu w populacji pacjentów onkologicznych. Duże ryzyko wystąpienia zakrzepicy żył głębokich (ZŻG) oraz ryzyko różnych powikłań, w tym powikłań krwotocznych, pomiędzy poszczególnymi grupami chorych onkologicznych sugeruje przeprowadzenie indywidualnej oceny ryzyka i postępowanie profilaktyczne zależne od sytuacji klinicznej konkretnego pacjenta. Uzasadnia to także stałą aktualizację wytycznych postępowania profilaktycznego proponowanego chorym onkologicznym, czego dowodem jest niniejszy dokument, będący aktualizacją opublikowanych w 2016 wytycznych. W dokumencie zawarto dane opublikowane po 2016 roku i zawiera on najnowsze wskazania dotyczące postępowania profilaktycznego w populacji chorych onkologicznych, ze szczególnym uwzględnieniem profilaktyki przeciwzakrzepowej w dyscyplinach zabiegowych. Został ponadto poszerzony o wskazania dotyczące pacjentów poniżej 18. roku życia.

Ovarian cancer remains the leading cause of death due to gynecologic malignancy. Estrogen-related pathways genes, such as estrogen receptors (ESR1 and ESR2) and their coregulators, proline-, glutamic acid-, and leucine-rich protein 1 (PELP1), and proto-oncogene tyrosine-protein kinase c-Src (SRC) are involved in ovarian cancer induction and development, still they require in-depth study. In our study, tissue samples were obtained from 52 females of Caucasian descent (control group without cancerous evidence (n = 27), including noncancerous benign changes (n = 15), and the ovarian carcinoma (n = 25)). Using quantitative analyses, we investigated ESRs, PELP1, and SRC mRNA expression association with ovarian tumorigenesis. Proteins’ presence and their location were determined by Western blot and immunohistochemistry. Results showed that PELP1 and SRC expression levels were found to differ in tissues of different sample types. The expression patterns were complex and differed in the case of ovarian cancer patients compared to controls. The most robust protein immunoreactivity was observed for PELP1 and the weakest for ESR1. The expression patterns of analyzed genes represent a potentially interesting target in ovarian cancer biology, especially PELP1. This study suggests that specific estrogen-mediated functions in the ovary and ovary-derived cancer might result from different local interactions of estrogen with their receptors and coregulators.

Background: MPMs are generally divided into 2-categories. The most common is endometrial andovarian cancer but the coexistence is still unclear. Case: A 49-year old patient was admitted because of ovarian tumor extending from the right ovary an ascites. Immunohistochemistry reactions showed synchronous cancer: cervical (IIA1/T2a1), endometrial (IIIA/T3a) and ovarian (III B/T3b). Conclusion: Synchronous malignancies of female genital tract are very rare clinical situation. They account for about of 0.8-1.7% of malignancies. In relation to prognosis multiple synchronous cancers have a better outcome than metastatic disease of the same organs and the prognosis is limited to the tumor with the worst prognosis.