Journal of Women's Health

Use of chemical hair straighteners (“relaxers”) is associated with higher risks of hormonally mediated conditions. We hypothesized users of relaxers would have a higher prevalence of abnormal uterine bleeding (AUB) and dysmenorrhea.

We analyzed baseline data from Pregnancy Study Online, an internet-based preconception cohort study of North American pregnancy planners. We included 14,366 participants aged 21–39 years who enrolled during 2014–2024 and reported on their typical menstrual cycle characteristics when not using hormones. We collected data on history of use, age at first use, frequency per year, duration of use, and number of burns. We defined AUB as cycle length <24 or >38 days, flow ≥ 7 days, irregular cycles, and/or heavy flow (>30 pads/tampons per menses). We defined dysmenorrhea as severe cramps requiring medication and bed rest. We used modified Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the associations of relaxer use with AUB and dysmenorrhea, adjusted for potential confounders.

Overall, 2% of participants were current users and 10% were former users of relaxers. The frequencies of AUB and dysmenorrhea were 31% and 8%, respectively. PRs for current (versus never) relaxer use were 1.16 (95% CI: 1.00–1.33) for AUB and 1.30 (95% CI: 0.94–1.80) for dysmenorrhea. Participants who reported ever experiencing burns (versus never use) had a higher prevalence of dysmenorrhea (1–4 burns: PR = 1.42, 95% CI: 1.04–1.93; ≥5 burns: PR = 1.46, 95% CI: 1.00–2.13).

Relaxer use was associated with a higher prevalence of menstrual disturbances.

Prenatal cannabis use is becoming increasingly prevalent throughout the United States. Yet little is known about how motivations for cannabis use vary across maternal sociodemographic characteristics or how motivations are related to frequency of use. We aimed to address these evidence gaps via a comprehensive descriptive analysis of existing surveillance system data.

Using data from the 2017–2021 Pregnancy Risk Assessment Monitoring System Marijuana Supplement, we estimated weighted prevalence estimates of self-reported motivations for cannabis use during pregnancy. We examined variations in motivations across sociodemographic characteristics and frequency of use. We also examined write-in responses for motivations for cannabis use.

In our sample representing approximately 802,954 live births from 10 U.S. states, the most common motivations for prenatal cannabis use were for mental health reasons (82.81%; 95% confidence interval [CI]: 77.52, 87.06), to relieve gastrointestinal symptoms (77.10%; 95% CI: 70.51, 82.59), to relieve pain during pregnancy (48.67%; 95% CI: 41.84, 55.56), for fun or relaxation (40.18%; 95% CI: 33.69, 47.04), and to relieve symptoms of a chronic condition (26.31%; 95% CI: 20.55, 33.01). Most women (84.32%) reported two or more reasons for use, which was associated with daily or near-daily use. Qualitative analysis of write-in responses identified alleviation of pregnancy-related symptoms (e.g., nausea/vomiting, appetite, sleeplessness) as the most common motivation for use (54.90%).

Given a growing body of evidence about adverse health outcomes associated with prenatal cannabis use, findings underscore the importance of patient–provider communication and messaging about safe alternatives to cannabis use during pregnancy.

Functional hypothalamic amenorrhea (FHA) is a common form of secondary amenorrhea caused partly by undernutrition relative to demand.

To compare the dietary nutritional intake between women with FHA and eumenorrheic controls and evaluate micronutrient profiles.

This cross-sectional study included 30 women with FHA and 29 eumenorrheic controls not on hormones. FHA was defined as ≥3 consecutive months of amenorrhea, estradiol of <50 pg/mL, and FSH and LH of <10 mIU/L, excluding other etiologies. A 3-day food diary was collected for dietary analysis, excluding dietary supplements using ESHA Research Food Processor.

The mean age of women with FHA and controls was 26.4 years ± 6.2 versus 30.3 years ± 3.7 (p = 0.002), with no differences in BMI (p = 0.16) or the waist-to-hip ratio (p = 0.71). Women with FHA and controls consumed comparable median calorie intake (1784 kcal [1465, 2011] vs. 1732 kcal [1578, 1982], p = 0.62), with no differences in self-reported exercise patterns. Women with FHA consumed more dietary protein (84.2g [74, 112] vs. 74 g [59, 92], p = 0.001) and dietary fiber (30.1 g [22, 43] vs. 17.3 g [15, 23], p = 0.02) versus controls, respectively. When expressed as a percentage of estimated average requirements (% estimated average requirement), women with FHA had higher intakes of vitamin A (105% [45, 219] vs. 43% [21, 86], p = 0.005), vitamin C (201% [139, 351] vs. 107% [75, 190], p = 0.004), and iron (169% [146, 220] vs. 120% [99, 192], p = 0.027) compared with controls.

Women with FHA had similar caloric intake to eumenorrheic controls but consumed more dietary protein, fiber, vitamin A, vitamin C, and iron. Future studies should examine the nutritional profiles of women with FHA in relation to long-term health consequences such as bone and vascular health.

The primary objective of this study was to estimate the specificity of cytology and high-risk human papillomavirus (hrHPV) testing to predict the presence of cervical intraepithelial neoplasia 2 (CIN2+) among transmasculine patients. The exploratory objective compared the specificity of cytology and hrHPV tests among three populations: transmasculine patients using testosterone, premenopausal cisgender, and postmenopausal cisgender patients.

This multicenter retrospective cohort study included individuals aged 18–65 undergoing cervical cancer screening from 2015 to 2024. Transmasculine patients were included if using ≥30 mg daily transdermal or ≥30 mg weekly subcutaneous testosterone for at least 6 months with no estrogen supplementation. Patients with co-tests followed by colposcopy or hysterectomy were included in the sensitivity and specificity analysis. McNemar’s test was used to examine differences in specificity between cytology and hrHPV tests within each cohort.

Of 2,437 records screened, 149 (70 transmasculine, 30 postmenopausal, and 49 premenopausal) met the inclusion criteria with co-tests followed by histologic confirmation via colposcopy or hysterectomy. In the transmasculine cohort, the specificity of screening to predict CIN2+ was comparable between cytology (68.9% [95% CI: 55.7 − 80.1%]) and hrHPV tests (63.9% [95% CI: 50.6 − 75.8%]) with a p-value of 0.26. Sensitivity was equivalent in the transmasculine cohort. In the postmenopausal cohort, specificity was significantly lower for hrHPV screening compared to cytology (24.1% vs. 69.0%).

The ability of cytology and hrHPV screening to predict the presence of CIN2 + was not different in the transmasculine population. With high insufficient cytology rates, transitioning to primary hrHPV screening can limit unwanted pelvic exams and unnecessary diagnostic testing in transmasculine patients.

Reducing suicide risk among Veterans is a national priority. Although firearms are the leading method of suicide among women Veterans, involved in nearly half of such deaths, firearm suicide prevention interventions tailored to women Veterans remain understudied.

To assess women Veterans’ perceptions of and satisfaction with an online decision aid to reduce firearm suicide risk in women Veterans: Supporting Suicide prevention through Awareness, Firearm Safety, Education and Resources (eSAFER).

This quality improvement project used mixed methods, including online surveys (n = 90) and telephone interviews (n = 35) with women Veterans between September 18 and 30, 2024.

Women Veterans reported high satisfaction with eSAFER, finding important its focus on: statistics specific to women Veterans, prevention, nonlethal safety considerations, empowerment with personalized options, engagement of trusted individuals, and inclusion of resources. Most (94%, n = 81) reported that it encouraged them to engage others with their safety plan. All interviewed participants reported equal or greater comfort using the online version relative to receiving a paper version in clinic or by postal mail, preferring its ease of completion, accessibility, confidentiality, and the ability to keep/share their plan.

An online decision aid tailored to women Veterans may reduce firearm suicide risk by increasing risk recognition, guiding personalized safety choices, and facilitating completion and support from others. eSAFER is a scalable tool to reach high-risk populations tailored to their needs.

Women with epilepsy (WWE) have varying concerns at different ages and require relevant counseling and management. We conducted a retrospective chart review of WWE seen at the specialized women’s epilepsy clinic at Westchester Medical Center (WMC) from May 2024 to June 2025.

We included patients 18 or older assigned female at birth referred for epilepsy evaluation and management. There were 117 patients who were subdivided into the age groups of 18–30, 31–44, and above 45 years old. 65.9% of patients received care related to the management of seizures or epilepsy, whereas 23% were found to have seizure mimics such as syncope, tremors, migraines, or transient ischemic attacks, and 11% were identified as functional seizures or functional neurological disorder. Our results show that 22% of patients with epilepsy on antiseizure medications (ASMs) had never received contraception counseling, 48% were unaware of fetal malformation risks from ASMs and the benefit of folic acid supplementation, and 71% had not been counseled on bone health.

Women seen in a specialized women’s epilepsy clinic at WMC demonstrated distinct age-related concerns. Younger patients focused on reproductive health, whereas older patients prioritized comorbidities and seizure mimics. Unlike prior data, patients aged 31–44 and 45 and above had greater counseling needs than the 18–30 age group transitioning from pediatric care. These findings support the need for age-specific epilepsy counseling and targeted counseling to improve patient compliance. This study underscores the need for a specialized epilepsy clinic in addressing both medical and psychosocial aspects of care for WWE.

Perinatal health disparities are an important public health concern. Women from racial/ethnic minority groups have elevated rates of maternal and infant morbidities and mortality. In the general population, the social determinants of health (SDoH) are known to worsen overall health outcomes. We did not find a review of studies on SDoH during the perinatal period in different racial/ethnic groups. This narrative review focused on studies comparing Black and/or Hispanic women with non-Hispanic (NH) White women.

Articles were identified using PubMed, PsycINFO, and EMBASE databases based on specified criteria. Six systematic reviews, one scoping review, and one integrative review met the inclusion criteria.

The rates of maternal comorbidities, including hypertension, diabetes, and obesity, as well as preterm birth, low birth weight, still births, and maternal and infant mortality, were higher in Black and Hispanic women than in NH White women. Adverse SDoHs that were more common in minority populations included socioeconomically disadvantaged neighborhoods, food insecurity, low education, poverty, segregation, and air pollution. While adverse SDoHs were associated with worse maternal and infant health, some studies unexpectedly reported more severe effects of these SDoHs in White women than in minority women. Several studies have had methodological limitations.

This underexplored area of research highlights the urgent need for well-designed research on SDoHs related to maternal–infant health in different racial/ethnic groups, such as the development and testing of pragmatic interventions. Public health professionals, researchers, and policymakers should address health care disparities to improve perinatal outcomes.

Maternal cardiovascular health during and after pregnancy is shaped by biological, behavioral, and social factors. Inadequate personal and family support remains underexplored as a driver of postpartum cardiovascular risk. Understanding this relationship is vital for developing targeted interventions.

Using the TriNetX U.S. Collaborative Network, we examined postpartum cardiovascular outcomes among women aged 15–60 years with documented problems in personal or family support (poor support cohort, Cohort 1) compared with matched controls (Cohort 2) with no support-related Z63 codes. Personal/family support concerns were defined using ICD-10 Z63.x codes recorded 9 months before to 1 year after delivery or postpartum encounters. Propensity score matching was applied. Outcomes were assessed within 1 year.

After matching (n = 10,669 per cohort), inadequate support was associated with higher odds of major adverse cardiac and cerebrovascular events (odd ratio [OR] 5.012, 95% CI: 3.461–7.257) and acute kidney injury (OR: 1.438, 95% CI: 1.015–2.039). No significant differences were observed for myocardial infarction, stroke, heart failure, or peripartum cardiomyopathy.

Poor personal and family support is associated with adverse maternal cardiovascular outcomes. Caution is warranted in interpreting mortality due to potential misclassification. Integrating psychosocial support into postpartum care may reduce risk and improve maternal outcomes.