Journal of women's health
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Journal of women's health · Apr 2021
Practice Guideline Meta AnalysisInternational Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women.
Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. ⋯ Strengths & Limitations: This evidence-based guideline builds on a recently published comprehensive meta-analysis and the Global Position Statement endorsed by numerous societies. The limitation is that testosterone therapy is not approved for women by most regulatory agencies, thereby making prescribing and proper dosing challenging. Conclusion: Despite substantial evidence regarding safety, efficacy, and clinical use, access to testosterone therapy for the treatment of HSDD in women remains a significant unmet need.
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Journal of women's health · Mar 2021
Meta AnalysisBrexanolone in Postpartum Depression: Post Hoc Analyses to Help Inform Clinical Decision-Making.
Background: Brexanolone (BRX) injection was approved by the United States Food and Drug Administration in 2019 for the treatment of adults with postpartum depression (PPD) based on two Phase 3 clinical trials. Materials and Methods: Data from the three trials were combined. PPD-specific 17-item Hamilton Rating Scale for Depression (HAMD-17) group-level minimal important difference (MID) and patient-level meaningful change (meaningful change threshold [MCT]) were estimated and applied to differences in BRX versus placebo (PBO) at hour 60 (primary endpoint) and day 30 (end of trial follow-up). ⋯ Conclusions: BRX provided meaningful changes relative to PBO, rapid (hour 60), and sustained improvements (day 30) in PPD symptoms, low NNT, and large NNH. These results may help inform treatment decision-making. Clinicaltrials.gov registration numbers: NCT02614547, NCT02942004, and NCT02942017.
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Journal of women's health · May 2020
Meta AnalysisMaternal Race/Ethnicity and Postpartum Diabetes Screening: A Systematic Review and Meta-Analysis.
Introduction: Fifty percent of women with gestational diabetes mellitus (GDM) may progress to type 2 diabetes with highest risk among black women. This study aims to characterize postpartum diabetes screening rates among U. S. women with GDM by racial and ethnic group to characterize potential disparities. ⋯ Discussion: Postpartum screening for diabetes after GDM remains low, and black women have among the lowest postpartum screening rates despite highest risk for type 2 diabetes progression. Reporting of race/ethnicity, screening methods, and screening time frames varied across studies. Conclusion: Future studies must standardize racial/ethnic data reporting and examine interventions that address postpartum diabetes screening and prevention.
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Journal of women's health · Apr 2020
Meta AnalysisPregravid Oral Contraceptive Use and the Risk of Preterm Birth, Low Birth Weight, and Spontaneous Abortion: A Systematic Review and Meta-Analysis.
Background: Although oral contraceptives (OCs) have been widely used by women of childbearing age, their influence on pregnancy and birth outcomes, such as preterm birth (PB), low birth weight (LBW), and spontaneous abortion (SAB), is unclear. The aim of this systemic review was to assess these complications in women who had used OCs before pregnancy compared with those in a control group. Materials and Methods: The databases of PubMed, EMBASE, and Web of Science were searched up to December 2018. ⋯ Results showed that the risk of PB was slightly higher in the exposed group (OR = 1.17, 95% confidence interval [CI] = 1.07-1.27, p = 0.0005); however, there was a lower risk for SAB compared with the control group (OR = 0.63, 95% CI = 0.41-0.96, p = 0.03). No significant difference was found in the incidence of LBW (OR = 1.36, 95% CI = 0.92-2.02, p = 0.12). Conclusions: This systematic review and meta-analysis demonstrated a higher risk for PB and a lower risk for SAB in women with previous ORs use, whereas no association was found between ORs use and LBW risk.
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Journal of women's health · Feb 2020
Meta AnalysisVitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis.
Background: Cyclic mastalgia (CM) is premenstrual bilateral and diffuse breast pain that presents cyclically and affects women in their reproductive years. It may associate with latent hyperprolactinemia due to the insufficient inhibitory effect of dopamine on the pituitary gland. Vitex agnus-castus (VAC) is known for its dopaminergic activity and its possible actions on CM and latent hyperprolactinemia. ⋯ However, the risk of bias in most studies was unclear due to insufficient information. Conclusions: VAC is a safe and effective treatment option for CM. More high-quality clinical trials are needed to strengthen the evidence base.