Gynecology & Women’s Health

"Essential Stretches" is a comprehensive guide aimed at promoting flexibility, mobility, and muscular health through 40 targeted stretches. Designed for individuals across all fitness levels—athletes, wellness enthusiasts, and beginners alike—this paper outlines clear, step-by-step instructions for stretches focused on different muscle groups. From hamstrings and glutes to shoulders and neck, each stretch is supported by practical tips and safety guidelines. The guide not only serves as a preventive tool for injury but also supports enhanced posture, muscle relaxation, and functional movement, thereby contributing to long-term physical well-being.

to determine the necessary surgical intervention. The procedures shown will include partial cystectomy and modified psoas hitch with ureteral reimplantation. Finally, this video will demonstrate how the use of a multidisciplinary approach can be beneficial.

Endometriosis is a benign disease, which affects about 10% of reproductive age women and almost 50% of infertile women. Although every year at least 300 new articles deal with this topic, endometriosis is still a enigmatic disease starting with theories of etiopathogenesis where there is still no consensus about the major cause of endometriosis. Also there is still no consensus about the management of the disease, mainly when there is an infertile patient who is preparing for in vitro fertilization procedure.

This research was aimed at studying the impact of food consumption pattern (FCP) via the Household Dietary Diversity Scores and Women
Dietary Diversity Scores and also Households incomeon the malnutrition status of women (MUAC) in the two zones, Sana’a Dry (SD) that represents
the rural part and Sana’a Temperate (ST) that represents the urban part of Sana’a Governorate, Yemen. The investigation based on data that extracted
from a comprehensive survey conducted by UNICEF during 2016 with a total sample of 1396 women in the reproductive age 15-49 years from
the two zones SD and ST. The prevalence of middle upper arm circumference (MUAC) in SD’s women is about 2.4 more than the ST’s women. The
relationship between income quintiles and MUAC in the two zones is highly significance (P-Value <0.001). Based on the income data of HHs, and the
exchange rate of 2016, it was found that 85.5% of HHs are living on less than 1US$ per capita/day. While MUAC rates are the highest among women
consuming cereals, miscellaneous, oils, sugar honey and diary in the SD zone, they are sugar honey, diary, oils and legumes in the ST zone. Only when
meat, fruits, eggs and seafood came into the FCP of women, MUAC rates have been reduced significantly in both zones. New thresholds for both HDDS
and WDDS that based on the mean number of food groups consumed (FGC) were suggested and lead to more realistic results.

O ver recent years, there has been major advancement in the use of transvaginal ultrasound (TVU) for the preoperative diagnosis and staging of deep endometriosis. The International Deep Endometriosis Analysis (IDEA) Consensus paper established guidelines for identifying, classifying and measuring endometriotic lesions and pelvic adhesions. 1 In addition, the development of an 'Ultrasound-Based Endometriosis Staging System' (UBESS) has provided us with a framework to predict the laparoscopic surgical skill level required to perform surgery for women with suspected endometriosis. 2 Although the UBESS validation study performed by our centre demonstrated a high accuracy (98%) for the ultrasound prediction of corresponding RANZCOG/AGES surgical skill level required, 3 there are some limitations with the UBESS classification. In particular, TVU is not able to predict which women will require ureterolysis (i.e. dissection of the ureter) at the time of laparoscopy, especially in the absence of any obvious ureteric disease at ultrasound. Ureterolysis is considered an advanced laparoscopic skill and is not typically performed by general gynaecologists. This surgical procedure is performed to isolate and expose the ureter, in order to free it from external pressure or adhesions or to avoid injury to it during pelvic surgery. The anatomical course of the ureters is of surgical importance, as ureters travel close to other structures (i.e. ovaries, cervix and uterine artery) in the pelvis. Ureters must be identified during pelvic surgery to ensure that they are not accidentally damaged. The course of the pelvic ureter begins with its descent into the posterior lateral pelvis, lateral to the sacrum and immediately ventral to internal iliac artery. The ureter then travels medially to the internal iliac artery and then passes underneath the uterine artery (i.e. referred to as 'water under the bridge') and into the paracervical tissue. This paracervical tissue is often

Introduction. In India, the fragmented and heavily under-sourced diversion of resources towards the COVID-19 Pandemic has heavily limited the workings of non-COVID-related health services. Several factors, including the suspension of transport facilities, the shutdown of private facilities, conversion of public-health facilities into COVID-19 treatment centers, and the diversion of medical professionals towards COVID-19 emergency-response have lengthened these restrictions. This has gendered implications for low-income women and girls. A lack of structured social security and healthcare-provision systems obligates these persons to assume the primary caretaker role in their households. Aims. This paper aims to outline the evidence for the lived experiences of low-income Indian women as they strive to balance their paid-work and unpaid-caretaker-obligations during the COVID-19 Pandemic. On a macro level, our work aims to assess the extent to which women's health, economic, and social empowerment can be achieved through existing programs and policies. Methods. Our findings were drawn from qualitative research conducted in urban and peri-urban regions of Jaipur and Lucknow. A mixed-methods approach was used, combining online surveys with semi-structured interviews and participatory exercises to generate high-quality data. All girls and young women selected for participation were between the ages of 15-24. Results. Interviewees described their caretaking experience as physically and emotionally depleting. As substitute providers of care, they felt unprepared and unfit to administer health procedures. Although many felt that they "needed" to earn some sort of income, their paid work options were few and poorly paid. As a result, most participants could only fulfill their domestic caretaking responsibilities in the most basic capacity. Analysis of participants' survey reports revealed that women had little knowledge of the COVID-19 pandemic and its consequences on their lives. Conclusions. The strengthening of social security measures is of the utmost importance. In the future, policy should take into consideration the costs of womens' caregiving responsibilities on themselves, their children, and their families. A gendered approach to the political economy must be adopted.

Cardiovascular diseases are a major cause of maternal
mortality and morbidity worldwide, including developed countries
[1]. The first-line drug to treat hypertension in pregnant women
is methyldopa, which is an α2-adrenergic agent that has shown
maternal and fetal safety and efficacy. However, methyldopa is not
effective in all cases, and sometimes it is important to consider
other pharmacological agents [1,2].

Cardiovascular diseases are a major cause of maternal
mortality and morbidity worldwide, including developed countries
[1]. The first-line drug to treat hypertension in pregnant women
is methyldopa, which is an α2-adrenergic agent that has shown
maternal and fetal safety and efficacy. However, methyldopa is not
effective in all cases, and sometimes it is important to consider
other pharmacological agents

Endometriosis presents a diagnostic challenge as clinical
symptoms do not correlate well with the extent of disease [1].
Cramer, et al. [2] found that menstrual cycle length shorter than 27
days, menses longer than 7 days and severe cramping dysmenorrhea
were predictive of endometriosis with relative risks of 2.1 (95%CI
1.5-2.9), 2.4 (95%CI 1.4-4.0) and 6.7(95%CI 4.4-10.2) respectively.
The study compared 268 women with infertility and laparoscopically
confirmed endometriosis with 3794 women admitted for delivery
(controls) using a retrospective questionnaire. The study was
limited by recall bias and the criteria for laparoscopic diagnosis
were not clearly defined. No significant correlation was found with
chronic pelvic pain. The issue has been studied prospectively [3,4]
in 134 women scheduled for laparoscopy for chronic pelvic pain
(CPP). Dyschezia, dyspareunia, and non-menstrual pain were all
identified as predictors of deep infiltrating endometriosis (DIE)
with odds ratios of 3.9 (95%CI 1.7-8.9), 4.6 (95%CI 1.5-14.2) and
2.5 (95%CI 1.1-5.6) respectively. Mrs. SF presented with all of these
symptoms to a greater or lesser extent. One criticism of Chapron’s
study is that the diagnosis was made on laparoscopic appearance
without histological confirmation. Visualization alone has been
shown to have a positive predictive value (PPV) for endometriosis
of 45% and up to 36% of lesions were down staged on histology

Opinion Endometriosis (EMS) is a common estrogen-dependent gynecological disorder, which affects quality of life and fertility of productive-aged women [1]. Current treatment of EMS is mainly based on surgery and post-operative maintenance treatment of ovarian suppressive agents. A major challenge for women with EMS is the post-operative recurrence [2-3]. Some medical treatments have been suggested for EMS, such as oral contraceptive pills, and gonadotropin-releasing hormone agonists (GnRH-a). GnRH-a is an important treatment modality for EMS, significantly reducing EMS-related symptoms [4-6]. However, the employment of GnRH-a could reduce the estrogen level, leading to severe peri-menopausal symptoms such as hot flash, colpoxerosis, sexual hypoactivity, and bone loss, which hinders its long-term and extensive application [7]. The peri-menopausal symptoms could be solved by the hormone based "add-back therapy" [8-10]. As for add-back therapy, three regimens were recommended by Obstetrics and Gynecology Branch of Chinese Medical Association [11]. Estrogen and progesterone regimen: continuous combination of estrogen and progesterone. Estradiol valerate 0.5-1.5mg/d, or conjugated estrogen0.3~0.45mg/d or estradiol patch releasing 25~50μg daily, or estradiol gel 1.25g/d via percutaneous daub; for progesterone, 5mg/d dydrogesterone or 2~4mg/d medroxyprogesterone is often used. Compound preparation estradiol spironolone tablets can also be used, 1 tablet per day. Single progesterone: 1.25~2.5mg norethindrone acetate daily. Continuous use of tibolone, 1.25~2.5mg/d is recommended. According to the conventional understanding, the purpose of add-back to GnRH-a is to supplement estrogen to alleviate the series of problems caused by low estrogen. So why should we discuss this single progesterone regimen (In fact, this regimen has not been used too much clinically)? Many clinical teachers have asked this question in the gynecologic endocrine conference, this was a brief state of my personal understanding. Before answering this question, let me briefly review the mechanism of add-back therapy to GnRH-a administration. The use of GnRH-a, which will inhibit the gonadal axis, is bound to result in patients' low estrogen status. In order to alleviate the series of problems caused by this low estrogen status, meanwhile to prolong patients' GnRH-a application time and compliance, based on the theory of "estrogen dosage window" (Different tissues have different sensitivity to estrogen), some scholars put forward a therapeutic regimen (Add-back) to keep estrogen at a normal level in the body so that it will not stimulate ectopic endometrial growth without causing perimenopausal symptoms and bone loss [E2:146~183 pmol/L (40~50 pg/ml)]. Such estrogen level does not affect curative effect and can reduce side effects [12]. Since it is to solve the problem of low estrogen, it is easy to understand the other two estrogen regimens: estrogen plus progesterone combination regimen (why to add progesterone dydrogesterone 5mg or MPA 2-4mg? EMS is an estrogen-dependent disease, the combination regimen is more conducive to endometrial atrophy, but there are also reports on single estrogen regimen); Use tibolone continuously with a recommended dose of 1.25~2.5 mg/d (tibolone component: 7-methylenethinolone, its metabolites have three kinds of activities: estrogen, progesterone and androgen effects respectively, as a result, the compound effect is equivalent to the combination regimen.). Some Gynecologists often feel confused regarding the single progesterone regimen (norethindrone acetate 1.25-2.5mg, qd) together with its mechanism. This work is licensed under Creative Commons Attribution 4.0 License WJGWH.MS.ID.000521.

Many people suffering needlessly from diverticulitis, prostate enlargement, bladder stones and infections, kidney stones, menopausal discomforts, and various signs of toxicity, all resulting from personal hygiene problems caused by our modern western culture.

Many natural biological functions, such as urinating, defecating, sweating, and menstruating, are uncomfortable to discuss in our culture.  As a result, the cultural causes of these diseases are never considered or mentioned.

This article presents new theories on the cultural causes of common diseases, rooted in the way we are trained to ignore the call of Nature.