Introduction: A large majority of women may spend a significant part of their lives in the postmenopausal stage. Transition to menopause usually represents a milestone affecting their quality of life. Vasomotor symptoms are characterized by hot flashes and/or night sweats.
Objective: This study used a survey intended to determine the prevalence of moderate to severe vasomotor symptoms and to collect data to evaluate the associated economic burden through the collection of healthcare resource utilization, as well as the number of women seeking medical advice (primary care and different types of specialty healthcare professionals), number of women receiving drug therapy and calculating out-of-pocket expenses.
Methods: Cross-sectional study in peri- and postmenopausal women aged 40 to 65 years with moderate to severe menopause-associated vasomotor symptoms in Mexico, as a sub-study of the NCT05083884 clinical trial. An active panel was used to identify participants, who filled an online survey regarding the symptoms they experienced in the previous week, how it impacts their quality of life, sleep pattern, and their interactions with healthcare professionals.
Results: A total of 7,728 women were contacted, of whom 1,697 were selected; 412 filled out the survey, of which 17% presented vasomotor symptoms. Most of them experienced more than 3 symptoms, affecting their work and non-work-related activities by 5.9% and 35.7%, respectively. Furthermore, 78.4% of respondents sought medical care. Over 50% of women reported being on some type of treatment.
Conclusions: In accordance with other studies, an elevated proportion of women was found to experience moderate to severe vasomotor symptoms, and these symptoms had an impact on their quality of life.

ABSTRACT
Objective: To assess the cost-effectiveness of two ovarian stimulation procedures comparing the use of FSH antagonists with the use of FSH progestin primed controlled ovarian stimulation in an oocyte donor program.
Design: To calculate cost-effectiveness ratios (costs per outcome achieved) from clinical practices using a retrospective cohort single university center study carried out from 2012 to 2021.
Main outcome measure(s): Cost-effectiveness ratios as cost per mature oocyte and cost per treatment.
Results: According to the economic analysis, ovarian stimulation with FSH antagonist protocol increased statistically significantly the overall cost of the treatment as well as the cost per retrieved and effective oocyte. The cost of gonadotrophins per mature oocyte retrieved was 49.27 ± 17.94 € and the cost of medication per mature retrieved oocyte was 59.26 ± 28.01 €. In the FSH primed progesterone group, the cost of gonadotrophins per mature retrieved oocyte was 44.67 ± 16.65 € and the cost of medication per mature retrieved oocyte retrieved 44.91 ± 20.86 €.
Conclusion: Cost-effectiveness is a compelling reason for an egg donation program. Progestins can present an effective and less expensive option for egg donation programs in terms of cost.

Background: Non-ablative erbium laser has become one of the newly proposed treatments for various female pelvic floor disorders.
Objective: To determine the effect of non-ablative erbium YAG (Er:YAG) laser treatment for colorectal anal disorders in women with mild and moderate pelvic organ prolapse (POP).
Method: This was a retrospective study that analyzed data from the charts of 91 patients with colorectal anal disorders and mild or moderate of POP: 67 of them (Group 1) were treated by vaginal, vulvar, and perianal non-ablative Er:YAG laser irradiation, and 24 (Group 2) were treated with additional rectal irradiation.
Results: The average POP-Q stages after laser treatment improved from 1.60 ± 0.49 to 0.67 ± 0.75 (p<0.001). The severity of colorectal anal symptoms decreased significantly after the laser treatment. The overall score of the modified CRADI-14 scale decreased from 18.8 ± 4.8 to 6.9 ± 2.4 in Group 1 and from 18.3 ± 5.2 to 4.5 ± 1.0 in Group 2 (p<0.001). The improvement of symptoms in Group 2 was more significant compared to Group 1 (-13.8 ± 4.7 and -11.9 ± 4.6, respectively, p=0.008), despite fewer laser sessions in Group 2 on average (1.5 and 2.4, respectively). Conclusions: Non-ablative Er:YAG laser can be a new safe option for the treatment of colorectal anal disorders in patients with mild and moderate POP.

Phyllodes tumors of the vulva have an uncertain histogenetic origin. However, these tumors share morphological similarities with breast neoplasms. In view of its rarity, both the classification and the current treatment are not well established, with surgical resection being performed in most cases. We report the case of a 23-year-old Brazilian woman with a history of a vulvar mass in her left labia majora, whose transvaginal ultrasound revealed a nonspecific nodule with no vascularization on Doppler. The patient underwent exeresis of the lesion. The histological analysis was compatible with a benign phyllodes tumor of the vulva. When compared to the international literature, no cases have been reported among Brazilian women and this case is among the youngest affected by this condition. Although rare, phyllodes tumor should be remembered as a differential diagnosis for other vulvar tumors.

This case report delves into the intricate clinical scenario of a 24-year-old primipara from Mozambique who underwent surgical intervention for suspected inflammatory pelvic disease. Despite presenting with a one-month history of abdominal pain, fever, and gastrointestinal symptoms, diagnostic challenges arose, ultimately leading to a laparotomy revealing extensive adhesions, left colonic fistula, and necrotic ovarian changes. Various surgical procedures were performed, including total left salpingectomy, proximal right salpingectomy, cystectomy of the right ovarian cyst, and partial excision of the necrotic right ovary, along with colostomy creation for colonic involvement. Histopathological examination suggested a chronic granulomatous inflammatory process, aligning with clinical suspicion of pelvic tuberculosis. Microbiological results indicated Candida lusitaniae co-infection. Postoperative Interferon-Gamma Release Assay was positive, supporting mycobacterial infection suspicion. The complexity of abdominal tuberculosis, with its diverse manifestations, requires a multidisciplinary diagnostic and therapeutic approach. This case underscores the importance of heightened awareness and comprehensive management in female genital tuberculosis cases.

The caesarean section consists of the delivery of one or several babies through a surgical incision made in the maternal abdominal wall and uterus. It is one of the oldest surgical procedures and, over the centuries, the technique and conditions of the caesarean section have evolved significantly. What used to be an extremely risky procedure has now become a safe and common operation. Today, the caesarean section is performed both for medical reasons and as a personal choice, and remains a subject of debate in the field of obstetrics and bioethics.

Background: Vitamins and mineral supplementation is key in the various stages of a woman's reproductive life.
Objective: To analyze the perceptions and behaviors of women of childbearing age in a developed country regarding the use of vitamin supplements from preconception to postpartum.
Methods: This was an observational cross-sectional study of women of childbearing age conducted in Portugal between April and May 2023. Sample size and recruitment were planned to ensure national geographic representativeness of this population. Participants completed a questionnaire designed specifically for study purposes to characterize their perceptions and attitudes toward preconception and pregnancy-related vitamin supplementation. Data were analyzed in Microsoft Excel and SPSS Statistics 20.0.
Results: A total of 1,033 women aged 2049 completed the study survey. The gynecologist (72.3%), followed by the general practitioner (63.3%), were the main sources of information on preconception, pregnancy, and postpartum care for women with children. Only about half of these women (51.4%) had attended a preconception appointment for a median of 6 months before becoming pregnant. More than 80% of women (84%) had taken vitamin supplements as recommended by their doctor during their previous pregnancy, and two-thirds (65%) did it for more than three months. Among those who took folic acid, this figure was 76.9%. Folic acid was the most commonly used supplement (87%), followed by iron (66%), iodine (25%), vitamin D (13%), and others (16%). Most women (96.1%) had no history of fetal or infant congenital anomalies. Postnatally, although most women had attended appointments with the general practitioner or gynecologist (91.7%), only 35.6% used postpartum supplementation, mainly iron (34.5%), but also folic acid (17.3%) and others (iodine, vitamin D, among others; 37.7%).
Conclusions: This real-world study provides valuable insights into women's perceptions and behaviors regarding the use of dietary supplements from preconception to postpartum.

Massive subchorionic thrombohematoma (Breus’ mole) is a rare condition characterized by a significant clot of maternal blood separating the chorionic plate from the villous chorion. The exact etiology and pathogenesis remain unclear. This condition can lead to complications such as restricted fetal growth, oligohydramnios, preeclampsia, preterm birth, and intrauterine fetal death. We report two cases of Breus’ mole in order to emphasize the importance of diagnostic suspicion for effective management. The analysis was retrospective, and both patients gave consent for the reporting of their cases. Case one had a gestational age of 24+4, an uncontrolled maternal chronic hypertension. Ultrasound revealed placentomegaly, severe early fetal growth restriction, oligo- anhydramnios sequence, and severe anemia due to placental insufficiency. During hospitalization, pressure adjustment and corticosteroid therapy were necessary, as a new ultrasound indicated pathological ductus venosus. A cesarean section was performed, but the infant did not survive. Case two had a gestational age of 26+5, with acquired thrombophilia. Ultrasound showed oligohydramnios, placentomegaly, and pathological ductus venosus, which lead to cesarean indication. In conclusion, due to its rarity and unknown pathogenesis, little can be done in terms of prophylaxis. However, we must suspect the condition to improve management of potential cases with complications. More in-depth studies are needed in order to improve outcomes.