GLORIA BACHMANN

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This article describes the cervical cancer risk facing Afghan women recently evacuated to the United States, a population that largely lacked access to HPV vaccination and screening in Afghanistan. The authors argue that the recent influx of evacuees creates a public health opportunity — and obligation — to provide these preventive services to women who may have undiagnosed or advanced disease. Culturally sensitive outreach and screening programs are needed to address this gap.

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This systematic review and meta-analysis pooled data from nine studies comparing pregnancy outcomes between incarcerated and non-incarcerated women in the United States. Incarcerated pregnant individuals were about three times more likely to receive inadequate prenatal care and had 66% higher odds of delivering a low-birthweight baby. Preterm birth and stillbirth rates were similar between groups, but the findings overall highlight a critical need for standardized, federally mandated prenatal care standards inside correctional facilities.

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This study followed parents whose newborns were enrolled in a randomized trial of genome sequencing and tracked depression scores at three time points. Parents who already had elevated depression scores at the start tended to improve over the course of the study, while some parents without prior symptoms showed temporary increases after learning their child's results. Most parents attributed any emotional distress to general parenting stress rather than the genomic study itself, suggesting participation in newborn sequencing research does not meaningfully harm parental mental health.

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Medical students participated in a two-hour cooperative learning session on transgender healthcare using a modified "jigsaw" format, where students taught each other on different subtopics. Knowledge and confidence increased significantly right after the session, and though both declined at one-year follow-up, scores were still higher than before the training. Students consistently asked for more formal integration of trans health content in the medical curriculum, and the format was rated as effective.

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This narrative review found that spinal pathologies — including degenerative disease, traumatic injuries, and tumors — commonly cause sexual dysfunction in women, including pain, numbness, difficulty with orgasm, and reduced desire, yet these issues are almost never assessed or addressed in neurosurgical practice. While spinal surgery may relieve back pain, it rarely improves other dimensions of sexual function. The authors recommend routine pre- and post-operative sexual health assessment for all women undergoing spinal surgery.

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This article describes TranZap, a community-driven mobile app designed to help transgender individuals find gender-affirming healthcare providers. Existing resources for locating trans-competent care were found to be sparse and limited in scope — mostly covering surgeons and endocrinologists — so the app was developed to include all provider types and incorporate community-sourced reviews. The goal is to reduce the burden on transgender patients of finding providers who will treat them respectfully and competently.

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This commentary examines how structural racism shapes who gets incarcerated in the United States and how it compounds the health disadvantages of incarcerated women, who are disproportionately Black and Latina. Women — the fastest-growing prison population — face unique health needs including those related to menopause and reproductive health, and existing prison policies largely fail to account for gender-specific care. The authors call for reforms that address both the racist underpinnings of mass incarceration and the specific health needs of women who are imprisoned.

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This narrative review synthesized existing research on how spinal conditions and spinal surgeries affect sexual function in women, a topic rarely addressed in neurosurgical care. Spinal pathologies — from degenerative disc disease to tumors — can cause pain during sex, reduced sensation, difficulty with orgasm, and depression, but these issues are almost never part of standard surgical assessment or follow-up. The authors call for routine sexual history-taking before and after spinal surgery, and for more rigorous research on outcomes that matter to female patients.

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This narrative review covers genitourinary syndrome of menopause (GSM), a condition affecting up to half of postmenopausal women in which declining estrogen causes vaginal dryness, irritation, painful sex, and urinary symptoms. Effective treatments exist — including lubricants, local hormonal therapies, and newer oral medications — but many women go undiagnosed and untreated because providers rarely raise the topic. The review emphasizes that proactive clinical screening and a systematic treatment approach can substantially improve quality of life for affected women.

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A randomized controlled trial in 89 women with provoked vulvodynia found that extended-release gabapentin modestly improved overall sexual function — particularly desire, arousal, and satisfaction — compared to placebo, though sexual function remained well below that of pain-free women. Women with higher baseline pelvic muscle pain showed the greatest benefit. The improvement in arousal points to a central nervous system mechanism, but gabapentin alone is not enough to restore normal sexual function.

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Transgender men who retain female reproductive organs can become pregnant, yet little medical guidance exists for those who are 35 or older — a group the authors term the "new" advanced paternal age. This review covers preconception care, fertility, the effects of pausing gender-affirming hormones, and postpartum issues including chest feeding and depression screening. It highlights major gaps in evidence-based care for this population.

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Researchers used ultrasound to measure vaginal wall thickness in postmenopausal women and asked them about painful sex and other menopausal vaginal symptoms. They found no connection between how thick the vaginal walls were and whether women experienced these symptoms. This matters because doctors were hoping ultrasound measurements could become an objective, non-invasive way to diagnose and measure vaginal atrophy—a common problem after menopause—but this study shows that thickness measurements alone don't predict which women actually have symptoms.

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After menopause, about half of women develop genital, sexual, and urinary symptoms caused by falling estrogen levels. Non-hormonal vaginal lubricants and moisturizers are the first treatment option, but prescription local estrogen — in cream or ring form — is effective for persistent symptoms. Identifying and treating these symptoms can significantly improve women's daily lives.

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A multicenter, randomized, placebo-controlled crossover trial in 89 women with vulvodynia found that extended-release gabapentin did not significantly reduce pain on a standardized tampon insertion test compared to placebo. Gabapentin also failed to improve intercourse pain or daily pain. These results do not support using gabapentin alone to treat vulvodynia.

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A joint expert panel from two major North American menopause and sexual health societies developed a clinical algorithm for managing vaginal and urinary menopause symptoms in women with breast cancer or high breast cancer risk. The panel found that these women are commonly undertreated because of concerns about hormonal therapies, despite significant impact on quality of life. Their consensus recommends starting with non-hormonal options and reserving local hormone therapy for women who don't improve, after a careful risk-benefit discussion with their oncologist.

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This report describes a program where vascular surgeons partnered with gynecologists to perform uterine artery embolization — a minimally invasive procedure that shrinks fibroids — at a single academic center over 18 months. Of 26 procedures performed, 87.5% resulted in complete symptom relief with no complications. The experience demonstrates that vascular surgery teams can successfully run a fibroid embolization program when they collaborate with gynecology.

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Researchers used ultrasound to help insert intrauterine devices (IUDs—a form of birth control) in 67 women who had complications like fibroids, unusual uterine shape, or previous IUD rejection, and successfully placed the device in 84 of them. The ultrasound guidance worked when doctors could see exactly where to place the IUD, but failed in cases where patients were in too much pain, had a blocked cervix, or couldn't have an old device removed first. This approach could help women who can't get standard IUD insertions due to physical problems or sensitivity to exams.

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This study compared four recruitment strategies for a clinical trial on vulvodynia and found that mass mailing was the most effective at enrolling participants. Notably, Black women were 13 times more likely than white women to be enrolled through mass mailing rather than clinician referral, highlighting that relying on physician referrals alone would produce racially skewed trial populations. Diversifying recruitment methods is essential for inclusive research on conditions that disproportionately go undiagnosed in minority communities.

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Black and white women with provoked vestibulodynia reported similar levels of pain during tampon insertion and sex, but Black women reported significantly higher daily vulvar pain. After accounting for functional impairment, race itself was not independently associated with pain levels, suggesting that differences in disability and daily functioning — not race — drive the observed differences. Functional impairment should be a key focus in understanding pain disparities in vulvodynia.

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As the global population ages and the transgender community becomes more visible, healthcare systems are ill-equipped to serve older transgender patients who face chronic illness alongside barriers created by rigid gender classifications in medical records and care protocols. This review finds pervasive bias and discrimination that drives transgender patients away from needed care. The authors call for developing gender-neutral care templates and training to eliminate barriers for transgender and gender non-conforming patients.

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Black and white women with provoked vulvodynia describe their pain very differently: white women are far more likely to call their pain burning or stinging, while Black women more often describe it as aching. White women were 19 times more likely to report burning as their primary symptom. These differences in pain language likely contribute to lower diagnosis rates in Black women and highlight the need for race-conscious screening approaches.

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This 52-week study confirmed that ospemifene, an oral non-hormonal pill, is safe and effective for postmenopausal women with vaginal atrophy. Vaginal cell changes and pH improvements seen at 12 weeks were maintained through one year, and endometrial safety was preserved with no cases of cancer or serious hyperplasia. The results support ospemifene as a well-tolerated long-term option for women who cannot or do not want to use vaginal hormone therapy.

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Injected capsaicin is used in pain research to reliably trigger and measure pain responses, but inconsistent preparation could undermine study results. This study showed that capsaicin solution manufactured under strict pharmaceutical guidelines retains at least 95% of its potency for a full year across a range of storage temperatures. Standardized manufacturing is necessary for capsaicin to be a reliable pain model in multicenter clinical trials.

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This 52-week safety extension study followed women taking ospemifene or placebo and found no meaningful adverse changes in the uterus, cervix, or breasts with either the 30 mg or 60 mg daily dose. Hot flushes were the most common side effect but rarely led to stopping treatment, and no cases of endometrial hyperplasia or cancer occurred. A full year of ospemifene use appears safe for the uterine lining in postmenopausal women.

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A large phase 3 trial with 605 postmenopausal women found that once-daily oral ospemifene significantly reduced painful intercourse and improved vaginal tissue health compared to placebo after 12 weeks. Hot flushes were the most common side effect but caused few dropouts, and no serious drug-related adverse events occurred. Ospemifene offers an effective oral treatment option for postmenopausal women with vaginal atrophy and painful sex.

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This paper describes the design of a multicenter NIH-funded clinical trial testing extended-release gabapentin for provoked vestibulodynia, a chronic vulvar pain condition affecting roughly 14 million U.S. women. In addition to measuring pain relief, the trial collected biological data — muscle sensitivity, nerve responses, cardiac measures — to identify subtypes of the condition that might respond differently to treatment. The trial was designed to be the first rigorous multicenter test of a drug already used in practice for this condition.

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In a review of 357 women seeking fibroid embolization, women with fibroids located inside the uterine cavity (submucosal) were no more likely to report heavy bleeding or be anemic than women with fibroids in other locations — contradicting common clinical assumptions. However, among women reporting pain or bleeding, those with submucosal fibroids had larger overall uterine weights. Uterine size rather than fibroid location appears to be the better predictor of symptom severity.

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A phase 3 trial in 826 postmenopausal women found that ospemifene at 60 mg daily significantly improved all four key measures of vaginal atrophy — vaginal cell composition, acidity, vaginal dryness, and painful intercourse — compared to placebo over 12 weeks. The 30 mg dose was effective for most measures but fell short for painful intercourse. Ospemifene was well tolerated and showed a favorable safety profile.

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Women who experienced stomach upset with weekly bisphosphonate pills for osteoporosis reported major improvements after switching to a once-monthly formulation of ibandronate, with over 60% seeing relief from heartburn and over 70% from other stomach problems. More than 80% of those who had stomach upset within 48 hours of their weekly pill reported greater overall satisfaction after the switch. Monthly dosing significantly reduces the gastrointestinal side effects that cause many women to stop taking osteoporosis medications.

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A subset analysis of a randomized trial found that a very low-dose transdermal estrogen patch (0.014 mg/day) significantly improved vaginal pH and tissue health in postmenopausal women with moderate to severe vulvovaginal symptoms. Both the microdose estrogen and a slightly higher dose with added progestogen outperformed placebo. The results support using the lowest effective estrogen dose to treat vaginal symptoms while minimizing systemic hormone exposure.

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Researchers developed and validated a 17-item scale to measure sexual well-being specifically in women without sexual health problems, filling a gap left by existing tools that focus on dysfunction. The scale captures five dimensions — interpersonal, cognitive-emotional, physical arousal, orgasm-satisfaction, and external lubrication — with strong reliability and validity. This instrument gives researchers a precise way to measure what normal, healthy sexual well-being looks like across different ages.

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Survey data consistently show that women with more active and satisfying sex lives report higher emotional well-being, greater relationship satisfaction, and better overall quality of life. The direction of causation is unclear, but the association is robust. This commentary proposes a new conceptual model to study these connections systematically in controlled research.

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This 2008 position statement from the North American Menopause Society reviewed updated evidence on hormone therapy after menopause and concluded that starting hormones around the time of menopause offers a favorable balance of benefits and risks — including relief of symptoms and protection against bone loss — but this balance shifts unfavorably with increasing age and longer time since menopause. The statement provides clinicians with a nuanced framework for individualizing treatment decisions. It also identified priorities for future research.

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A follow-up survey of women from a previous national study found that nearly 5% of previously symptom-free women developed new vulvodynia-like pain within one year, while roughly half of those who had reported symptoms before still had them. Women with vulvodynia were more than twice as likely to have had pain with their first tampon use. The findings suggest that chronic genital pain is more persistent and more common than previously recognized.

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A survey of 97 medically underserved Latinas at a community health clinic found that nearly a third were using no birth control, and those who were tended to choose less effective non-hormonal methods. The vast majority — 84% — said 25 or younger was the ideal age for a first pregnancy, and nearly all considered having children an extremely important goal. Counseling for this population should start by addressing pregnancy planning and preparation rather than focusing solely on contraception.

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A multicenter randomized trial tested whether a very low-dose estrogen patch (0.014 mg/day) could reduce hot flashes in postmenopausal women while minimizing side effects. By week 12, the microdose patch reduced moderate to severe hot flash frequency significantly more than placebo, with 41% of women achieving a 75% or greater reduction. No increase in adverse events was seen compared to placebo, supporting the lowest-effective-dose approach to menopause hormone therapy.