Community pharmacists play an increasingly important role in the care of transgender individuals receiving gender-affirming hormone therapy (GAHT). However, the content of structured pharmaceutical consultations tailored to this population has not yet been clearly defined. This systematic review aimed to identify therapeutic issues relevant to community pharmacy practice in order to inform the development of structured pharmaceutical consultations. A systematic literature review was conducted in accordance with the PRISMA 2020 Statement. The review question was structured using the PICo framework, with transgender individuals as the population, treatment-related issues associated with GAHT as the phenomenon of interest, and community pharmacy practice as the context. Electronic searches of Medline, Google Scholar, and APA PsycINFO were performed on 17 July 2024. Studies involving transgender adolescents or adults receiving GAHT and reporting therapeutic effects, adverse events, monitoring requirements, or medication-related issues were eligible. Two reviewers independently screened the studies and extracted data using a standardized form. Owing to the heterogeneity of study designs, the findings were synthesized narratively according to therapeutic domains relevant to community pharmacy practice. Among 755 screened records, 116 articles met the inclusion criteria. Seven therapeutic domains relevant to pharmacist-led consultations were identified: cardiovascular and cardiometabolic effects, dermatologic effects, gynecologic effects, musculoskeletal effects, biological and pharmacological effects, psychiatric effects, and other adverse effects or specific clinical situations. The evidence highlighted treatment-specific monitoring needs, medication-related risks, fertility and contraceptive considerations, laboratory monitoring requirements, drug-drug interactions, and mental health outcomes. Community pharmacists may contribute to the monitoring and optimization of GAHT, adverse effect management, patient education, fertility and contraceptive counseling, pharmacovigilance, and interdisciplinary collaboration within the scope of their professional practice. These findings provide an evidence-informed basis for the future development of structured pharmaceutical consultations tailored to transgender individuals.

Although ovarian cancer screening is not recommended for non-high-risk women, they seek screening to alleviate their fear of the disease. Therefore, we investigated whether receiving consecutive negative results is associated with lower risk of ovarian cancer mortality compared to no screening. This study was conducted using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial, conducted in the United States (n = 52,633). Five-year cumulative ovarian cancer mortality was compared between females with three consecutive negative screening results using transvaginal ultrasound and CA-125 tests (negative group) and those not undergoing screening (control group) via Gray's test. Sensitivity analyses were also conducted considering known factors affecting ovarian cancer risk, such as oral contraceptive use, hormone therapy, parity, and family history of ovarian or breast cancer. The 5-year cumulative ovarian cancer mortality in the negative group was 8.6 deaths/10,000 persons (95% confidence interval [CI], 4.6-12.6 deaths/10,000 persons), which was not different from that in the control group (8.8 deaths/10,000 persons; 95% CI, 5.6-12.1 deaths/10,000 persons; p = 0.79). Furthermore, no evidence of a difference in ovarian cancer mortality was observed between the negative and control groups even among women at low risk, such as those with oral contraceptive use, no menopausal hormone therapy, being parous, and without a family history of breast cancer and ovarian cancer (all p-value ≥ 0.35). It is essential for both physicians and patients to understand that even three consecutive annual negative screenings for ovarian cancer should not be interpreted as evidence of lower ovarian cancer mortality compared with no screening.

This is a protocol for a Cochrane review (intervention). The objectives are as follows: To evaluate the benefits and harms of combined hormonal, progestin-only, and nonhormonal contraceptive methods for postpartum contraception in lactating individuals.

Rats can either use place memory, response memory or rely on a single cue to navigate their environment. Which navigation strategy a female rat is biased towards is influenced by circulating levels of ovarian hormones. Hormonal contraceptive use is typically associated with changes in circulating levels of endogenous ovarian hormones. The aim of the current study was to examine the effects of synthetic hormones used in hormonal contraceptives on navigation strategies. A total of 61 gonadally intact female rats were tested in two Morris water maze tasks. Rats were administered ethinyl estradiol (EE; 10 μg/kg; n = 10), levonorgestrel (LNG; 20 μg/kg, n = 10), a combination of both EE and LNG (10 μg/kg and 20 μg/kg, n = 10), or vehicle control (n = 31). Controls were tested during either proestrus (n = 10), estrus (n = 11) or diestrus (n = 10). In the place vs. response task, proestrus females exhibited an initial place memory bias while estrus females exhibited an initial response memory bias (OR = 18). However, all groups, apart from the EE + LNG group, eventually spent more time in the place quadrant (η[2] = 0.53), suggesting a corrective shift towards place memory when unable to locate the platform. In the cue task, all groups, apart from the EE + LNG, showed an initial bias to the other quadrant (η[2] = 0.41). This initial bias was abolished in all groups, apart from proestrus females, by the end of the probe. The EE + LNG group failed to exhibit a bias for any of the navigation strategies throughout, suggesting that this formulation of combined EE + LNG may impede memory bias formation.

Female reproductive health is an important yet frequently neglected component of care in women with CKD. As the global burden of CKD rises, increasing numbers of women of reproductive age are affected, with consequences across the reproductive lifespan, including fertility, menstruation, sexual function, contraception, pregnancy and menopause. CKD disrupts normal reproductive physiology through complex and multifactorial mechanisms. The hypothalamic-pituitary-ovarian axis is often affected in CKD. Loss of pulsatile gonadotrophin-releasing hormone (GnRH) secretion and hyperprolactinemia can lead to hormonal dysregulation and menstrual irregularities. Additional mechanisms contributing to reduced fertility include diminished ovarian reserve, altered endometrial receptivity and reproductive decision-making influenced by chronic illness. Chronic inflammation, a hallmark of CKD, may also negatively affect reproductive health. Together, these factors contribute to reduced fertility, menstrual abnormalities, premature menopause and sexual dysfunction; all of which can adversely affect quality of life and long-term health outcomes. Many nephrologists report feeling ill-equipped to counsel patients on reproductive decision-making, contraception and fertility preservation, highlighting an important gap in clinical care. The use of gonadotoxic therapies, such as cyclophosphamide, further complicates reproductive planning. Early counselling and consideration of fertility preservation strategies, including GnRH agonists and oocyte cryopreservation, are therefore important.

Objective: To describe pregnancy prevention methods (PPMs) used among US college women before and after the Dobbs Supreme Court decision. Participants: Students assigned female at birth, aged 18-25, attending four-year US institutions who reported vaginal intercourse in the past year. Methods: Repeated cross-sectional analyses used ACHA-NCHA-III Spring 2021/2022 and IIIb Spring 2024/2025 data to compare PPM use at last vaginal intercourse (LVI), emergency contraception (EC) use, and unintended pregnancy (UIP). Logistic regression assessed post-Dobbs hormonal method use. Results: Hormonal method use declined from 54.1% to 45.8%, primarily due to reduced birth control pill use (49.5% to 40.9%). Condoms, fertility awareness, method nonuse, and EC use increased; LARC use declined slightly; UIP remained stable. Conclusions: College women shifted away from birth control pills and toward condoms, EC, fertility awareness, and no method use. These descriptive findings support monitoring method nonuse, ensuring timely access to EC, and providing confidential, evidence-based contraceptive counseling.