Journal of women's health
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Journal of women's health · Oct 2020
Prevalence of Inadequate Cervical Cancer Screening in Low-Income Older Women.
Objective: At age 65 years, cervical cancer screening is not recommended in women with an adequate history of negative screening tests in the previous 10 years if they do not have other high-risk factors for cervical cancer. The purpose of this study was to assess the proportion of older low-income women at a safety net urban hospital system without other risk factors for cervical cancer who should have cervical cancer screening because of an inadequate screening history, and to evaluate if they were triaged appropriately. Materials and Methods: Medical records from 200 women 65 years and older at the Gynecology clinic of John H. Stroger Hospital of Cook County were evaluated for adequate cervical cancer screening or hysterectomy to see if they could stop screening. ⋯ Of these women, 46 (38.7%) did not have appropriate testing carried out. Of 73 correctly screened women, 16 (21.9%) required biopsies, of which 11 demonstrated high-grade lesions or cancers. Conclusions: Many older women, especially low-income women, need to continue screening for cervical cancer because of inadequate screening histories. This is a group at increased risk for cervical cancer, and it is imperative that clinicians evaluate previous test results before exiting a woman from screening at age 65 years.
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Journal of women's health · Sep 2020
Does Nomegestrol Acetate Plus 17β-Estradiol Oral Contraceptive Improve Endometriosis-Associated Chronic Pelvic Pain in Women?
Background: To evaluate the effects of a 24/4 regimen combined oral contraceptive (COC) containing 1.5 mg 17β-estradiol (E2) and 2.5 mg nomegestrol acetate (NOMAC) compared to on-demand nonsteroidal anti-inflammatory drugs (NSAIDs) on women affected by endometriosis-associated chronic pelvic pain (the primary end point) and their quality of life (QoL) and sexual function (the secondary end points). Materials and Methods: Ninety-nine women on E2/NOMAC constituted the study group; and 63 women on NSAIDs constituted the control group. The visual analogic scale was used to measure the levels of pelvic pain, dysmenorrhea, and dyspareunia. To assess their QoL, sexual function, and sexual distress, the Short Form-36 (SF-36), the Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale (FSDS) were used, respectively. ⋯ Women on NSAIDs did not report any reduction in pain symptoms or improvement in QoL (p ≤ 0.4). However, they had a limited improvement of their FSFI and FSDS (p < 0.001). The improvement of the pain symptoms, QoL, FSFI, and FSDS, was more evident in women on E2/NOMAC than in those on NSAIDs, when the study group and control group values were compared at the 3- and 6-month follow-ups (p < 0.001). Conclusions: Women on E2/NOMAC COC showed a better reduction of endometriosis-associated chronic pelvic pain and an improvement of their QoL and sexual activity than those of the women on NSAIDs.
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Journal of women's health · Sep 2020
Feasibility and Utility of a Cardiovascular Risk Screening Tool in Women Undergoing Routine Gynecology Evaluation.
The goals of this multicenter survey were to examine the prevalence and patient awareness of cardiovascular risk factors, and the association between history of adverse pregnancy outcomes (APO—including gestational hypertension, gestational diabetes, and preeclampsia) and prevalence of cardiovascular risks among women presenting to outpatient obstetrics/gynecology (OB/GYN) clinics. ⋯ Awareness of cardiovascular risk factors and symptoms among all women surveyed in this study was poor, although awareness for some risk factors was relatively higher among patients with APO. This study demonstrates the feasibility of cardiovascular assessment in OB/GYN clinics using a simple questionnaire and its potential role for early recognition and timely intervention.