Menstrual pain affects over half of menstruating adolescents, and there is a desire for accessible, adjunct treatments, such as behavioural health interventions in mobile health (mHealth) formats. To date, no mHealth apps for adolescents with menstrual pain have been designed with youth. Although user-centred design is best practice, many challenges can arise, particularly when working with industry partners in the design process. We report on the development and usability testing phase of an industry-developed app for adolescents with menstrual pain, along with exploration of challenges and emerging recommendations throughout the process. The user-centred design process was composed of three phases. In Phase 1 we identified an industry partner and established a patient advisory committee. In Phase 2, adolescents (N = 22) reviewed iteratively developed versions of app design and content using a think-aloud procedure, followed by a semi-structured interview. The app was well-received by adolescents, although in each phase, feedback related to (1) visual design, (2) interface design, (3) content, and (4) app features was observed. In Phase 3, research team members and a patient advisor reflected on the process of working with industry. Identified reflections were thematically analysed and an overarching theme of Integration of Research, Industry, Institutional, and Funding Needs was generated, with four subthemes: timeline considerations; genuine patient involvement; financial constraints; and establishing mutual understanding. We provide a checklist of recommendations for working with youth and industry in app design and practical considerations when working with industry partners and adolescent stakeholders are discussed.

Dysmenorrhea is often linked to uterine inflammation, but the additional factors and pathways that contribute to its pathophysiology remain poorly understood. Given growing evidence linking endoplasmic reticulum (ER) stress to inflammation and pain sensitization, we examined circulating ER stress-associated heat shock proteins (HSPs) GRP78 and gp96 in individuals with dysmenorrhea (n = 82), a dysmenorrhea subtype with bladder pain sensitivity (DYSB, n = 26) previously shown to increase risk for chronic pain, and controls (n = 19). After correcting for Menstrual phase, naproxen exposure, and oral contraceptive use, GRP78 was higher in DYSB than in DYS (ratio 1.33; p = .028), while gp96 was lower in both DYS (ratio 0.62; p = .019) and DYSB (ratio 0.59; p = .031) compared to controls. gp96 was also lower during the menstrual phase with naproxen compared to the non-menstrual phase (ratio 0.73; p = .014), whereas GRP78 was not significantly affected by menstrual phase, naproxen, or oral contraceptive use, and neither protein was associated with anxiety, depression, or sleep disturbance scores. These cross-sectional findings suggest that dysmenorrhea, particularly the bladder-sensitive subtype (DYSB), is associated with divergent circulating levels of two ER stress-related proteins. The inverse pattern of higher GRP78 and lower gp96 levels points to selective, rather than global, ER chaperone dysregulation as a candidate mechanism. However, future mechanistic and longitudinal investigations will be required to establish whether GRP78 and gp96 carry predictive or pathophysiological relevance.

Nursing requires significant physical and emotional effort, leading to high workplace stress. Most nurses are young, female, and of childbearing age, facing job-related stress and personal health challenges. This review explores three common health issues among female nurses: menstrual disorders, early pregnancy loss, and mental illness, which contribute to absenteeism and reduced job performance. Nurses experience higher rates of menstrual irregularity, dysmenorrhea, and pregnancy loss than nonmedical workers, along with increased anxiety and depression but lower healthcare-seeking due to stigma. Risk factors include night shifts, long hours, and insomnia. Nurses also prefer minimally invasive treatments for benign uterine conditions due to greater medical knowledge. To enhance nurses' well-being, we suggest strategies promoting diversity, equity, and inclusion to improve their work environment and overall health.

Introduction: Obstructed HemiVagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome, also known as Herlyn-Werner-Wunderlich syndrome, is a rare congenital Müllerian duct anomaly, characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Symptoms typically appear shortly after menarche and include dysmenorrhea and pelvic pain. The psychological burden associated with fertility and reproductive outcomes in women with OHVIRA syndrome remains poorly investigated. Materials and methods: A 30-year-old primigravida with left renal agenesis and a history of vaginal abscess, dysmenorrhea, and chronic pelvic pain received a delayed OHVIRA syndrome diagnosis. The patient had previously been informed that spontaneous conception and an uncomplicated pregnancy were highly unlikely because of her congenital gynecological condition, resulting in significant fertility-related anxiety and psychological distress. Under careful supervision and counseling, she conceived successfully, and the pregnancy progressed without complications; an elective cesarean section was performed at term. A literature search using the PubMed and Embase databases was conducted between November 2025 to April 2026 to identify studies reporting reproductive outcomes and psychological aspects in patients diagnosed with OHVIRA syndrome and other Müllerian anomalies. Results: Evidence-based counseling contributed to improvement of quality of life and reduction of pregnancy-related anxiety of the reported patient with OHVIRA syndrome. A limited number of studies discuss the mental burden and fertility-related anxiety of patients with OHVIRA syndrome and other Müllerian anomalies. Conclusions: Spontaneous conception and uncomplicated pregnancy are possible for women with OHVIRA syndrome. The psychological burden associated with congenital gynecological conditions remains under-recognized and requires further investigation. Comprehensive counseling and interdisciplinary care are essential to improve reproductive education, mental health support, and pregnancy outcomes in patients with congenital gynecological anomalies.