A multi-tissue metabolome atlas of primate pregnancy.

Pregnancy induces dramatic metabolic changes in females; yet, the intricacies of this metabolic reprogramming remain poorly understood, especially in primates. Using cynomolgus monkeys, we constructed a comprehensive multi-tissue metabolome atlas, analyzing 273 samples from 23 maternal tissues during pregnancy. We discovered a decline in metabolic coupling between tissues as pregnancy progressed. Core metabolic pathways that were rewired during primate pregnancy included steroidogenesis, fatty acid metabolism, and arachidonic acid metabolism. Our atlas revealed 91 pregnancy-adaptive metabolites changing consistently across 23 tissues, whose roles we verified in human cell models and patient samples. Corticosterone and palmitoyl-carnitine regulated placental maturation and maternal tissue progenitors, respectively, with implications for maternal preeclampsia, diabetes, cardiac hypertrophy, and muscle and liver regeneration. Moreover, we found that corticosterone deficiency induced preeclampsia-like inflammation, indicating the atlas's potential clinical value. Overall, our multi-tissue metabolome atlas serves as a framework for elucidating the role of metabolic regulation in female health during pregnancy.

Cervical cancer screening practice and associated factors among female health care professionals in Ethiopia 2024: a systematic review and meta-analysis.

BACKGROUND: Cervical cancer, ranking as the fourth most common gynecological cancer worldwide, claimed an estimated 570,000 lives and resulted in 311,000 new cases in 2018. This disease disproportionately affects those living in poverty and is more prevalent in countries with weak healthcare systems. Low and middle-income nations, particularly in Sub-Saharan Africa, face higher incidence and mortality rates due to limited access to vaccines, screening, and treatment. The world health organization recommends regular screening for women from age 25, setting a 90-70-90 target for low- and middle-income countries by 2030. Despite limited previous knowledge, the study aims to assess the pooled prevalence of cervical cancer screening practices and associated factors among female healthcare professionals in Ethiopia in 2024. OBJECTIVE: The study aimed to synthesize the existing literature on cervical cancer screening practice and associated factors among female health workers in Ethiopia. METHODS: Studies were searched through the search engine of Google Scholar, PubMed, and Cochrane Library. Searching was made using Keywords/ MeSH terms Cervical cancer; utilization; Preventive practice. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for the pooled prevalence and odds ratio estimations. RESULT: Seven studies were included in this systematic review and meta-analysis. The overall pooled prevalence of cervical cancer screening practice among female health workers in Ethiopia was 18%. Work place(OR = 2.858;95% CI: 0.412, 5.305),knowledge(OR = 3.457; 95% CI: 2.314, 4.601), work experience(OR = 5.421; 95% CI:4.178,6.664),being diagnosed(OR = 10.787; 95% CI: 06.197,15.377) and ever cared of cervical cancer patient (OR = 2.93; 95% CI: 2.004, 3.856) were the pooled associated factors that are significantly associated with cervical cancer screening practice among female health care worker. CONCLUSION: The implementation of preventive measures for cervical cancer screening was found to be suboptimal. Our findings underscore the importance of enhancing awareness among this demographic, which is crucial in mobilizing local communities. It is imperative to provide continuous education to female health workers regarding cervical cancer. The Ministry of Health should collaborate with various organizations to ensure the accessibility of cost-effective screening services in all healthcare facilities.

Messenger RNA Therapy for Female Reproductive Health.

Female reproductive health has traditionally been an underrepresented area of research in the drug delivery sciences. This disparity is also seen in the emerging field of mRNA therapeutics, a class of medicines that promises to treat and prevent disease by upregulating protein expression in the body. Here, we review advances in mRNA therapies through the lens of improving female reproductive health. Specifically, we begin our review by discussing the fundamental structure and biochemical modifications associated with mRNA-based drugs. Then, we discuss various packaging technologies, including lipid nanoparticles, that can be utilized to protect and transport mRNA drugs to target cells in the body. Last, we conclude our review by discussing the usage of mRNA therapy for addressing pregnancy-related health and vaccination against sexually transmitted diseases in women. Of note, we also highlight relevant clinical trials using mRNA for female reproductive health while also providing their corresponding National Clinical Trial identifiers. In undertaking this review, our aim is to provide a fundamental background understanding of mRNA therapy and its usage to specifically address female health issues with an overarching goal of providing information toward addressing gender disparity in certain aspects of health research.

Challenges to epilepsy management in Rwandan women living with epilepsy.

BACKGROUND AND PURPOSE: In Rwanda, epilepsy prevalence ranges between 29‰ and 49‰. Many women living with epilepsy (WwE) are of childbearing age. Epilepsy characteristics and management, contraception, pregnancy, puerperium and stigma in WwE presenting at the neurology clinic of Ndera, Rwanda, were investigated. METHODS: This prospective cross-sectional study investigated demographics, epilepsy characteristics, treatment, contraception, folic acid use, pregnancy, puerperium and stigma in WwE aged ≥18 years. Subgroups were analysed by status of any pregnancy and time of epilepsy diagnosis relative to pregnancy, with significant differences expected. RESULTS: During December 2020 and January 2021, a hundred WwE were enrolled (range 18-67 years). Fifty-two women had never been pregnant, 39 women had epilepsy onset before pregnancy and nine were diagnosed after pregnancy. No significant differences in age, marital status or occupation were observed. Contraception was used by 27%, of whom 50% were taking enzyme-inducing anti-epileptic medication. Valproate was used by 46% of WwE of reproductive age. Thirty-nine women with epilepsy onset before pregnancy reported 91 pregnancies, with 14% spontaneous abortions. None used folic acid before conception, and 59% only during pregnancy. Five of 78 newborns were preterm. No offspring had major congenital malformations. Nearly 25% of WwE were not compliant with their anti-epileptic medication schedule during pregnancy or breastfeeding. Internalized stigma was observed in more than 60%. Up to 25% had been discriminated against at school or work. CONCLUSION: A comprehensive strategy considering the reproductive health and societal challenges of WwE is needed to drive optimal epilepsy management, reproductive health outcomes and societal inclusion.

Obstetric Perineal Tears, Birth Characteristics and the Association with Urinary Incontinence Among Primiparous Women 12 Months Postpartum: A Prospective Cohort Study.

INTRODUCTION AND HYPOTHESIS: Postpartum urinary incontinence (UI) is common and a concern for many women, as UI leads to a lower quality of life and self-esteem. Perineal tears may be a risk factor for UI, yet few studies have investigated the association between the degree of perineal tear and risk of developing UI postpartum. The objective was to examine how the degree of perineal tear and selected obstetric risk factors were associated with any UI and stress ultrasound (SUI) 12 months postpartum among primiparous women. METHODS: A prospective cohort study was conducted at four Danish hospitals. Baseline data were obtained at a clinical examination 2 weeks postpartum. Symptoms of UI were evaluated 12 months postpartum by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form questionnaire (web-based). Multivariate regression analyses were performed to investigate the risk factors for UI. RESULTS: A total of 603 primiparous women (203 with none/labia/first-degree tears, 200 with second-degree tears and 200 with third-/fourth-degree tears) were included between July 2015 and January 2018. Women with tears involving the perineal muscles reported any UI more often than women with no/labia or first-degree tears (spontaneous second-degree tear: RR 2.04, 95% CI 0.92-4.50; episiotomy: RR 2.22, 95% CI 0.99-4.96; third- or fourth-degree tear: RR 2.73, 95% CI 1.18-6.28). The same was found for SUI, but with wider confidence intervals. CONCLUSIONS: A higher prevalence of any UI and SUI was found among women with perineal tears involving any perineal muscles, compared with women with no, labia, or first-degree tears.

Energy availability modulates regional blood flow via estrogen-independent pathways in regularly menstruating young women.

PURPOSE: This study aimed to investigate the impact of short-term low energy availability (LEA) on vascular function in young, regularly menstruating women. METHODS: Participants were 19 women, aged 22.9 ± 4.2 years, with body mass index 18-30 kg·m2. They were divided into two groups and completed two conditions in a crossover design: a 3-day control condition (CON) with an energy availability of 45 kcals·kgFFM-1·day-1 and a 3-day LEA condition of 15 kcals·kgFFM-1 day-1. Assessments were conducted during the early follicular phase of the menstrual cycle. Outcome measures included forearm blood flow (FBF), heart rate, blood pressure, arterial stiffness, resting energy expenditure (REE), metabolic blood markers and body composition. RESULTS: Significant time-by-condition interactions were found for resting FBF (p = .004), REE (p = .042), triiodothyronine (p = .006), ß-hydroxybutyrate (p = .002) and body mass (p < .001). Resting FBF was 1.43 ± 1.01 and 1.31 ± 0.61 (arbitrary units) at pre and post, respectively, in LEA and 1.52 ± 0.7 and 1.76 ± 0.57 at pre and post in CON. The LEA condition led to a decrease in triiodothyronine (pre: 1.54 ± 0.28, post: 1.29 ± 0.27 ng ml-1), REE (pre: 1588 ± 165, post: 1487 ± 160 kcals day-1) and body mass (pre: 61.4 ± 7.5, post: 59.6 ± 7.3 kg). Changes in resting FBF were significantly correlated with changes in REE in the LEA condition (r = 0.53; p = 0.02). CONCLUSION: Short-term LEA modifies regional blood flow and this might contribute to the observed decreased in REE. Findings emphasize the need for careful management of energy availability in populations at risk of LEA.

RGS2 and female common diseases: a guard of women's health.

Currently, women around the world are still suffering from various female common diseases with the high incidence, such as ovarian cancer, uterine fibroids and preeclampsia (PE), and some diseases are even with the high mortality rate. As a negative feedback regulator in G Protein-Coupled Receptor signaling (GPCR), the Regulator of G-protein Signaling (RGS) protein family participates in regulating kinds of cell biological functions by destabilizing the enzyme-substrate complex through the transformation of hydrolysis of G Guanosine Triphosphate (GTP). Recent work has indicated that, the Regulator of G-protein Signaling 2 (RGS2), a member belonging to the RGS protein family, is closely associated with the occurrence and development of certain female diseases, providing with the evidence that RGS2 functions in sustaining women's health. In this review paper, we summarize the current knowledge of RGS2 in female common diseases, and also tap and discuss its therapeutic potential by targeting multiple mechanisms.

Lactobacillus isalae sp. nov., isolated from the female reproductive tract.

A novel strain of the genus Lactobacillus, named AMBV1719T, was isolated from the vagina of a healthy participant in our large-scale citizen science project on the female microbiome, named Isala. Phylogenetic analysis showed that the 16S rRNA gene of AMBV1719T is most similar to that of Lactobacillus taiwanensis with a sequence similarity of 99.873 %. However, a genome-wide comparison using average nucleotide identity (ANI) revealed that isolate AMBV1719T showed the highest ANI with Lactobacillus paragasseri JCM 5343T, with a value of only 88.17 %. This low ANI value with the most closely related strains known to date indicated that AMBV1719T represents a distinct species. This strain has a limited ability to degrade carbon sources compared to Lactobacillus gasseri, indicating its adaptation to the host. Its genome has a length of 2.12 Mb with a G+C content of 34.8 mol%. We thus propose the name Lactobacillus isalae sp. nov. for this novel species, with AMBV1719T (=LMG 32886T=CECT 30756T) as the type strain.

An overview of the female reproductive system.

This is the first of two articles providing an overview of the female reproductive system. This article looks at the internal organs associated with the female reproductive system, as well as the vulva. The author describes the relevant pathophysiology and provides an outline of disorders associated with these reproductive organs. The role of health professionals in managing and treating these disorders is discussed, and the importance of providing women-centred care highlighted. A case study and care plan is used to illustrate the importance of individualised care, including history taking, assessment of the presenting symptoms, treatment strategies, health education and advice on follow-up actions. A second article will provide an overview of breasts.

Sex Differences Across the Life Course: A Focus On Unique Nutritional and Health Considerations among Women.

In the United States, women, while having a longer life expectancy than men, experience a differential risk for chronic diseases and have unique nutritional needs based on physiological and hormonal changes across the life span. However, much of what is known about health is based on research conducted in men. Additional complexity in assessing nutritional needs within gender include the variations in genetics, body compositions, hormonal milieus, underlying chronic diseases, and medication usage, with this list expanding as we consider these variables across the life course. It is clear women experience nutrient shortfalls during key periods of their lives, which may differentially impact their health. Consequently, as we move into the era of precision nutrition, understanding these sex- and gender-based differences may help optimize recommendations and interventions chosen to support health and weight management. Recently, a scientific conference was convened with content experts to explore these topics from a life-course perspective at biological, physiological, and behavioral levels. This publication summarizes the presentations and discussions from the workshop and provides an overview of important nutrition and related lifestyle considerations across the life course. The landscape of addressing female-specific nutritional needs continues to grow; now more than ever, it is essential to increase our understanding of the physiological differences between men and women, and determine how these physiological considerations may aid in optimizing nutritional strategies to support certain personal goals related to health, quality of life, sleep, and exercise performance among women.

Willingness to pay for HPV vaccine among female health care workers in a Chinese nationwide survey.

BACKGROUND: Payment methods for human papillomavirus (HPV) vaccine could substantially influence vaccination behavior. In China, HPV vaccination uptake remains currently low. This study aims to determine willingness to pay (WTP) for HPV vaccines among Chinese female health care workers under different payment scenarios. METHODS: This is a nationwide online survey recruiting female health care workers aged 18-45 years from 31 provinces throughout China. We collected the respondents' vaccination status of HPV vaccines and their sociodemographics. Two WTPs were defined and estimated in the study. A general WTP for HPV vaccination was determined using the contingent valuation method with double dichotomous choice bidding. A WTP out-of-pocket was estimated for each HPV vaccine under two scenarios, including partial coverage by governmental subsidy or partial incorporation in basic medical insurance. Accordingly, a multivariable linear regression model was employed to determine the association between sociodemographis and general WTP. Then the maximum WTP out-of-pocket was compared among the respondents' attitude shift towards HPV vaccination, payment scenarios, and levels of vaccine attributes, using non-parametric Kruskal-Wallis test. RESULTS: A total of 15,969 respondents were included in the study. The median general WTP was 2000 CNY (interquartile range, 1000-3200 CNY), positively associated with younger age, unmarried status, higher monthly income, fewer children, more positive vaccination behavior, working in tertiary hospital, higher local GDP and HDI (each P < 0.05). Moreover, the median WTP out-of-pocket was 1250 CNY (540-2000 CNY). It was significantly higher for vaccines partly covered by governmental subsidy (median, 1250 CNY; interquartile range, 560-2000 CNY), imported vaccines (1260 CNY; 630-1960 CNY), and 9-valent vaccines (1400 CNY; 750-2240 CNY) (each P < 0.001). Additionally, majority of respondents did not change their attitude towards HPV vaccination between two payment scenarios; those remaining with more expensive HPV vaccines (51.1%) had higher WTP out-of-pocket (1400 CNY; 560-2250 CNY) than those with cheaper vaccines (39.0%) (1120 CNY; 490-1960 CNY) (P < 0.001). CONCLUSION: Chinese female health care workers have high WTP for HPV vaccines. A direct public funding for HPV vaccination is more preferable. Our findings may facilitate the adjustment of HPV vaccination strategy and payment mechanism in China.

Predictors of cervical cancer screening service utilization among female health care workers in a tertiary hospital in Osogbo, Osun State.

Cervical cancer is the second commonest cancer in Nigerian women that can be reduced through effective screening. This study aimed to determine the utilization of cervical cancer screening services among female health care workers in a tertiary hospital. It is a descriptive cross-sectional study that utilized a pretested questionnaire to collect data from 170 respondents. Data were analyzed using descriptive statistics and logistic regression. 61.2% had good knowledge about cervical cancer, and 75.3% reported utilization of cervical cancer screening services. Factors that affect utilization of cervical cancer screening services are fear of negative results (82.4%), lack of time (78.2%), cost of screening (63.5%), and support from husband (61.2%). Logistic regression analysis showed that age (ß = 4.009, p = < 0.001), year of experience (ß = -4.350, p <0.001), fear of negative results (ß = -2.479, p = 0.014) and lack of support from husband (ß = 4.380, p < 0.001) significantly predict utilization of screening services. Conclusively, female health workers know about the prevention of cervical cancer and are willing to utilize screening. It is recommended that cervical cancer screening should be made mandatory for female health care workers, to reduce the incidence of cervical cancer cases.

[The female health: status, causes of deterioration, measures of improvement].

The deterioration of health status of female population is recognized as one of the important medical social problems. On its resolution depends reproduction of population and improvement of social demographic indices in the Russian Federation. The female health can be considered as one of the indices of physical, spiritual and social well-being of family. One of significant aspects of considering importance of female health status is her attitude to issues of her own health. The situation is aggravated by increase of asocial behavior in young women, accompanied by decreasing of quality of life and significant loss of moral values. Besides, organization of treatment and prevention measures for early detection and reduction of gynecological morbidity does not meet modern requirements. The economic conditions and ecological situation negatively contribute to deterioration of female health. Such social factors as lack of work or threat of losing it, low per capita income, inadequate housing and poor-quality nutrition, harmful habits deteriorate health status of female population. The status of one's own health and disease prevention are in last place in female population. In modern conditions, due to employment overload, women pay no due attention to their own health, do not undergo medical examinations, rarely visit physicians as study results confirm. The female health protection is facilitated not only by medical and diagnostic measures, but also by wide range of preventive activities, formation of healthy lifestyle, favorable conditions for education, work and life, legal and social support of women during child-bearing and child-rearing. The female health protection goes far beyond scope of medical problem and requires corresponding management decision-making and inter-departmental measures on legal and financial support of motherhood and childhood. Therefore, protection and promotion of female health, including reproductive health, are necessary conditions of achieving national security and improving demographic indices of the Russian Federation.

The uterine fibroid/myoma tumour: analysis of the global research architecture using density-equalizing mapping.

Uterine fibroids can severely impact a woman's quality of life, result in significant morbidity and are a leading indication for hysterectomy. Many aspects of the disease remain largely obscure. Despite these knowledge gaps, no detailed maps of the global fibroid research architecture have yet been generated. This study used the NewQIS approach to assess worldwide research productivity, encompassing numerous aspects of the scientific output, quality and socioeconomic features. Regression analysis indicated an increase in fibroid research activity in the investigated time periods. Global research output was dominated by leading Western countries, with the USA at the forefront, but also by East Asian countries. Socioeconomic benchmarking revealed that Taiwan had the highest fibroid research activity per GDP, with a calculated average of 279.46 fibroid-related publications per 1000 billion USD GDP. Finland was the most active country with respect to research activity per population size. Subject area analyses revealed major differences in research focuses, for example 'Radiology, Nuclear Medicine and Medical Imaging' was assigned to 29.92% of South Korean and to only 10.38% of US-American publications. In conclusion, this analysis of global fibroid research activity illustrates a multitude of important features ranging from quantitative and semi-qualitative fibroid research aspects to socioeconomic benchmarking.

Associations between snus use, body mass index and general health in a cross-sectional population-based sample of women.

BACKGROUND: In Norway, snus use among women has increased substantially over the last decade, particularly in younger age groups. Snus use is associated with increased morbidity among men, but few studies have addressed health consequences of snus use among women. AIM: To investigate the associations between body mass index (BMI) and female snus use, and between self-rated general health and female snus use. METHODS: A nationally representative net sample of 13,756 women in Norway, aged 18-45 years, participated in a survey on lifestyle and health. Ordinal logistic regression was applied to address associations between snus use and BMI/general health, adjusting for age and lifestyle factors. RESULTS: Compared to never users of snus, daily snus users had a lower likelihood of high BMI (OR: 0.83, 95% CI: 0.68-1.00), a higher likelihood of low BMI (OR: 1.63, 95% CI: 1.14-2.33), and a higher likelihood of poor/fair health (OR: 1.43, 95% CI: 1.08-1.90). Former and occasional snus users did not differ from never users in terms of BMI or general health in multiply adjusted models. Daily smokers had the highest likelihood of reporting poor/fair health (OR: 2.18, 95% CI: 1.8-2.63) relative to never smokers. CONCLUSIONS: Daily female snus use was associated with a lower likelihood of being overweight, and a higher likelihood of being underweight. Moreover, daily snus use was associated with a higher likelihood of worse general health. Former and occasional female snus use was not associated with BMI or general health.

Task sharing in health workforce: An overview of community health worker programmes in Afghanistan, Egypt and Pakistan.

BACKGROUND: Community health workers (CHWs) help reduce healthcare disparities and improve access to and quality of care in many countries. AIM: To provide an overview to compare and contrast characteristics of CHW programmes in Egypt, Pakistan and Afghanistan and describe the strengths, weaknesses and challenges of the programmes. METHODS: Scientific databases and grey literature were searched including PubMed, Medline, Cochrane Review Library, WHO databases, and grey literature websites including those of national health ministries. We shortlisted 23 articles to be included in this study. RESULTS: The three programmes reviewed vary in their organization, structure, enrolment and payment structure for CHWs. Key challenges identified in the review include: commodity security that compromises quality of services; inadequate and irregular training; unpredictable or inadequate remuneration structure; and lack of standardization among organizations and government ministries. Strengths identified are that the programmes are accepted and integrated into many communities; and have the support of health ministries, which enhances sustainability and regulates standardized training and supervision. These also increase participation and empowerment of women, evident in the fact that CHWs have organized among themselves to demand better treatment and more respect for the work that they do. CONCLUSION: Our findings should alert policy-makers to the need to review CHWs' scope of practice, update education curricula, and prioritize in-service training modules and improved working conditions. The effectiveness and impact of CHW programmes has been shown countless times, demonstrating that task sharing in healthcare is a successful strategy with which to approach global health goals.

Polycystic ovary syndrome: analysis of the global research architecture using density equalizing mapping.

Polycystic ovary syndrome (PCOS) is the most common cause of female infertility worldwide. Although the related research output is constantly growing, no detailed global map of the scientific architecture has so far been created encompassing quantitative, qualitative, socioeconomic and gender aspects. We used the NewQIS platform to assess all PCOS-related publications indexed between 1900 and 2014 in the Web of Science, and applied density equalizing mapping projections, scientometric techniques and economic benchmarking procedures. A total of 6261 PCOS-specific publications and 703 international research collaborations were found. The USA was identified as the most active country in total and collaborative research activity. In the socioeconomic analysis, the USA was also ranked first (25.49 PCOS-related publications per gross domestic product [GDP]/capita), followed by the UK, Italy and Greece. When research activity was related to population size, Scandinavian countries and Greece were leading the field. For many highly productive countries, gender analysis revealed a high ratio of female scientists working on PCOS with the exception of Japan. In this study, we have created the first picture of global PCOS research, which largely differs from other gynaecologic conditions and indicates that most related research and collaborations originate from high-income countries.

Decision-making in job attendance within health care--a qualitative study.

BACKGROUND: Musculoskeletal complaints are considered a major cause of sickness absence, particularly in areas such as the health sector. However, little is known about the personal decision-making process for self-certified sickness absence. AIMS: To explore female health care workers' thoughts and experiences about work attendance when experiencing musculoskeletal symptoms. METHODS: A qualitative study using individual, semi-structured, in-depth interviews with eight female health care workers was performed. Questions were related to factors influencing the decision to attend work and decision-making when facing the dilemma of attending work when experiencing musculoskeletal symptoms. The data were analysed according to the systematic text condensation. RESULTS: Subjects reported a high threshold before calling in sick. Self-certified sickness absence was not a strategy for coping with musculoskeletal symptoms as participants chose to be physically active and work part-time rather than taking sickness absence. Making decisions about attending work fostered conflicting norms, as women faced a dilemma between feeling guilt towards colleagues and patients and taking care of their own health. CONCLUSIONS: The findings highlight the complexity of managing work when experiencing musculoskeletal symptoms, and the dilemmas faced by those affected. The importance of work environment factors and the fact that some women feel compelled to work part-time in order to prioritize their own health require further consideration.

Unwanted pregnancy and traditional self-induced abortion methods known among women aged 15 to 49.

OBJECTIVE: To determine the traditional methods known and used to terminate an unwanted pregnancy and the fertility characteristics of married women. METHODS: The descriptive cross-sectional study was conducted in Turkey at Afyonkarahisar Zübeyde Hanim Child and Maternity Hospital's outpatient clinic between December 27, 2010 and January 7, 2011, and comprised married women aged 17 to 49 who presented for an examination. Questions related to socio-demographic and fertility characteristics as well as known and used traditional abortion methods were included in the questionnaire which was administered through face-to-face interviews. SPSS 18.0 was used for statistical analysis. RESULTS: The median age of the 600 women in the study was 29.5 (range: 17-49) years. Overall, 134 (22.3%) women had experienced an unwanted pregnancy. In 53 (39.6%) cases, the unwanted pregnancy had occurred between the ages of 30 and 39, and 116(86.6%) women had married when they were between 15 and 24 (p< 0.008) years old. Pregnancy had been concluded normally in 78(58.2%)women with an unwanted pregnancy and 34(35.8%)preferred the withdrawal method for contraception. Traditional abortion methods were known to 413(68.8%)women, but only 8(1.3%) had used any of them. The harms of using a traditional abortion method were known to 464(77.3%)women. CONCLUSIONS: Very few women used traditional abortion methods to terminate pregnancy. Knowing the characteristics of women and their need for family planning should be the first priority for the prevention of unwanted pregnancies.

Lithium Induced Amenorrhea: A First Case Report.

A 19-year-old female, known case of bipolar disorder had history of amenorrhea (absence of menstruation) for three years. While other causes of amenorrhea such as CNS, pregnancy, other medications, and thyroid issues were ruled out, she was found to have hyper-prolactinemia. Although antipsychotic medications are known to cause amenorrhea due to dopamine receptor blockade, which may result in hyperprolactinemia, the patient's symptoms began before she started these medications. Only drug that she was on for long period is lithium. Current literature shows mixed evidence about lithium's impact on prolactin levels, which can affect menstruation. This case may represent the first report of lithium causing amenorrhea through elevated prolactin levels. Clinicians should be aware of this potential side effect and monitor patients accordingly. Further studies are needed to confirm and understand this potential link.