Females of reproductive age with concussion often report greater symptom severity and duration than age-matched males; the mechanisms underlying female symptomology remain unclear. This study investigated the association between hormone profiles and time to return to learn/work (RTL/W) following concussion. A secondary aim was to explore differences in symptom severity and salivary miR-27a-5p/miR-30a-3p expression between hormone profile groups. Based on an a priori power calculation, 36 females aged 28.8 ± 7.5 (17-44 years) presenting to an emergency department within 72 h of a confirmed concussion were recruited. Participants were classified into three hormone profile groups: n = 20 natural menstrual cycle (NMC); n = 8 progestin-only hormonal contraception (PROG); and n = 8 oral contraception (Oral Contraceptive Pill; OCP). Saliva samples were collected for measurement of miR-27a-5p/miR-30a-3p, and participants completed weekly online surveys reporting symptom scores until achieving RTL/W. The mean initial symptom score was 47.0 ± 23.7 (8-100), and mean time to RTL/W was 27.3 ± 33.1 (2-179 days). Cox hazard regression revealed a statistically significant association of hormone profile with time to RTL/W. PROG (hazard ratio [HR]: 2.5, 95% confidence interval [CI]: 1.0-6.1, p = 0.048) and OCP (HR: 2.7, 95% CI: 1.1-6.4, p = 0.027) were significantly associated with increased likelihood of RTL/W compared with NMC. Initial symptom score was not significantly associated with time to RTL/W (p = 0.628). Exploratory analysis showed no statistically significant mean differences between groups for initial symptom score [F(2, 33) = 1.755, p = 0.189]. Fourteen saliva samples provided complete miR-27a-5p/miR-30a-3p data; mean miR-27a-5p/miR-30a-3p was 0.84 ± 0.06 (0.75-0.92). No statistically significant mean differences in miR-27/miR-30 expression were observed between hormone profile groups (F 2, 11 = 0.519, p = 0.609). Females using PROG or OCP were between 1.0 and 6.7 times more likely to achieve RTL/W than NMC at any given time. Hormone profile, but not initial symptom score, was predictive of time to RTL/W. Salivary miR-27a-5p/miR-30a-3p may be a useful biomarker in females with concussion and warrants further research.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by significant reproductive and metabolic complications. Insulin resistance (IR) plays a central role in the pathophysiology of PCOS and contributes to several associated metabolic abnormalities. This review highlights the key mechanisms underlying PCOS, including IR, hyperandrogenism, cardiovascular disease, gut microbiota dysbiosis, and the increased risk of type 2 diabetes mellitus (T2DM), along with current and emerging therapeutic strategies for improving disease outcomes. Accumulating evidence suggests that genetic predisposition contributes to PCOS susceptibility. Polymorphisms in genes such as the androgen receptor (AR), cytochrome P450 17A1 (CYP17), and follicle-stimulating hormone receptor (FSHR) have been associated with altered steroidogenesis and ovarian dysfunction, thereby influencing disease severity. In addition to genetic factors, environmental influences, including exposure to endocrine-disrupting chemicals (EDCs) and air pollution, may exacerbate metabolic disturbances and increase the risk of developing PCOS. Conventional therapeutic approaches focus on improving insulin sensitivity and correcting hormonal imbalances. These include pharmacological treatments such as metformin, oral contraceptives, and lifestyle modifications involving diet and physical activity. Recently, novel therapeutic strategies have emerged, including glucagon-like peptide-1 receptor agonists (GLP-1RAs), microRNA-based therapies, and interleukin-22 (IL-22)-mediated interventions, which show potential in targeting IR and metabolic dysfunction in PCOS. Furthermore, modulation of gut microbiota through probiotics, prebiotics, and fecal microbiota transplantation (FMT) represents an emerging strategy for restoring metabolic homeostasis. Overall, a comprehensive and personalized therapeutic approach integrating pharmacological, lifestyle, and microbiome-targeted interventions may significantly improve PCOS management and reduce long-term metabolic and reproductive complications.

Meningiomas are the most common central nervous system tumour and are associated with significant morbidity. Mounting evidence implicates the role of exogenous hormones in meningioma development and growth. This has led to increasing pressure on healthcare professionals to understand the risk profile of different hormonal compounds with regards to meningioma incidence and growth. This is particularly relevant when managing patients with pre-existing meningioma tumours or with one or more risk factors for meningioma formation. The aim of this review was to summarise existing evidence from clinical studies (cohort and case-control) concerning the risk of meningioma associated with different types of exogenous hormones and the associated meningioma characteristics. The literature review identified over 30 cohort and case-control studies published between 2003 and 2026. Studies demonstrated a mixed risk profile of broadly defined hormonal replacement therapy and hormonal contraceptives; however, many of these studies did not capture specific information about duration, dose or medication type. Risk associated with synthetic progestin-containing compounds such as depot medroxyprogesterone and desogestrel contraceptives was higher and related to duration of use. Highly potent synthetic progestins including cyproterone acetate (CPA) carried the strongest risk profile and showed a strong association with multiple meningiomas and anterior/middle skull base location. In conclusion, there is strong evidence for a link between meningioma incidence and highly potent synthetic progestins such as CPA, but further evidence is needed regarding menopausal hormone therapy and broadly defined oral contraceptives, as well as the doses and durations that are associated with clinically relevant risk. There is a space for translational research in this area to better understand the molecular basis underlying the relationship between hormones and meningioma growth.

Background: Large Language Models (LLMs) demonstrate promise in medical applications, but their performance in hormonal contraception consultation remains underexplored. Objective: To evaluate the accuracy and comprehensiveness of LLM-generated hormonal contraception counseling compared to evidence-based guidelines. Methods: Ten fictitious clinical case scenarios representing common contraceptive counseling situations were presented to Chat-GPT, Google Gemini, and OpenEvidence. Cases assessed medical eligibility screening, contraindication recognition, drug interactions, side effect management, and emergency contraception guidance. Two board-certified obstetrician-gynecologists independently evaluated the responses based on international clinical guidelines. Results: Across the ten predefined clinical scenarios, all three LLMs achieved high accuracy in identifying contraindications according to Medical Eligibility Criteria (MEC) and provided appropriate alternative contraceptive recommendations. Models demonstrated high proficiency in managing drug interactions, particularly the lamotrigine-estrogen interaction, and provided evidence-based side effect management strategies. However, the communication styles differed. Chat-GPT emphasized structured consultation and shared decision-making, Gemini provided practical action-oriented guidance, and OpenEvidence delivered concise evidence-focused summaries. Conclusions: In this limited set of standardized fictitious cases, the evaluated LLMs generally provided responses that were broadly aligned with selected guideline recommendations. Current LLMs require cautious deployment, given limitations in individualized assessment and health literacy optimization, and are best positioned as complementary educational tools rather than replacements for professional contraceptive counseling.

Endometriosis is a chronic estrogen-dependent condition affecting women of reproductive age and commonly presents with dysmenorrhea, chronic pelvic pain, dyspareunia, and infertility. In a substantial proportion of patients, pain persists despite first-line hormonal treatment, making alternative pharmacologic strategies necessary. GnRH agonists and antagonists act primarily by suppressing ovarian estrogen production and thereby reduce an important hormonal driver of disease activity. Although both classes are effective for pain relief, they differ in onset of action, reversibility, tolerability, and suitability for prolonged use. This narrative review summarizes the current evidence on GnRH-based therapies for endometriosis-associated pain, with particular attention to biological rationale, clinical efficacy, safety, and the role of add-back therapy. Overall, both agonists and antagonists appear to provide clinically significant symptom improvement, especially in women who do not respond adequately to oral contraceptives or progestins. Their clinical use, however, is limited by hypoestrogenic adverse effects such as vasomotor symptoms and bone mineral density loss, which often require monitoring and adjunctive add-back therapy. Oral GnRH antagonists may offer practical advantages in selected patients through rapid action, the absence of a flare effect, and dose-adjustable hormonal suppression, although treatment choice must also consider long-term safety, cost, access, and individual patient characteristics. In summary, GnRH analogues remain useful second-line options, but treatment should be individualized according to symptom severity, previous treatment response, reproductive goals, tolerability, bone health, cost, and availability.

Rodent species belonging to the Arvicanthis genus cause substantial field and postharvest losses in many African countries, where management still relies mainly on lethal control methods. Hormonal fertility control may provide a complementary strategy for reducing rodent population growth. We investigated the antifertility effects of bait containing quinestrol, a synthetic estrogen, levonorgestrel, a synthetic progestogen, and their combination at 10, 50, and 100 ppm in the Nile grass rat (Arvicanthis niloticus). These compounds suppress fertility by disrupting normal reproductive endocrine function. Adult male and female animals were exposed to treated bait under laboratory conditions, and reproductive responses were evaluated through measurements of bait intake, body weight change, reproductive organ weights, sperm count, sperm motility, pregnancy rate, and litter size. Quinestrol and combined treatments significantly reduced male reproductive organ weights and impaired sperm quality. Female reproductive organ weights were generally unaffected, although uterine edema occurred at higher concentrations. Quinestrol at 50 ppm completely inhibited pregnancy in treated females, regardless of the male mating partner. In addition, untreated females paired with treated males exhibited lower pregnancy rates and reduced litter sizes. Our findings demonstrate the potential of hormonal fertility control as a complementary strategy for sustainable rodent pest management in Africa. Future studies should focus on improving bait intake, field evaluation, and determining the duration and reversibility of contraceptive effects.

This study aims to determine the effect of an education intervention on female athletes' menstrual health knowledge, communication, and perceived importance of menstrual cycle tracking, and whether factors such as age, education level, or hormonal contraceptive use influence these outcomes. Three athlete cohorts engaged in two workshops and received targeted handouts. Participants (n = 51) completed surveys before, after, and 3 months following the intervention, which included a menstrual health knowledge assessment and a series of ratings to ascertain perceived knowledge; likelihood that they would discuss menstrual health with teammates, coaches, medical staff, and performance staff; and perceived importance of menstrual cycle tracking. Bayesian generalised linear mixed models and Bayesian linear mixed models were used to understand the effect of time and interactions between time and age, educational level, or hormonal contraceptive use. Actual and perceived knowledge and likelihood to communicate with teammates and performance staff appeared to be higher post-intervention and were retained for at least three months. The importance of menstrual cycle tracking increased from post-intervention to follow-up, while no change in communication with coaches or medical staff was observed. There appeared to be some effect of age, education level, and hormonal contraceptive use on knowledge and communication with medical staff. A menstrual health education intervention could be a practical and effective strategy to promote menstrual health literacy and communication in sport settings.