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Review some of the top stories from the Contemporary OB/GYN website over the last week, and catch up on anything you may have missed.

Contemporary OB/GYN week in review: Abortion access, menopause impact, and more

A new study finds that Black women living in economically disadvantaged neighborhoods face significantly higher breast cancer mortality rates.

Neighborhood disadvantage tied to higher breast cancer mortality in black women

A recent study found that a simple RNA-based blood test can identify the risk of hypertensive disorders in pregnancy months before symptoms appear.

Mirvie’s blood test predicts preeclampsia risk early in pregnancy

A recent study highlights the effectiveness of drospirenone with estetrol in significantly reducing physical and emotional menstrual symptoms, especially among new hormonal contraceptive users.

Drospirenone found to ease menstrual symptoms

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Medico-legal Aspects of Abortion in Europe

, Shayna Mancuso, DO, FACOG, from Astellas Pharma, outlined current and emerging treatment options for managing menopause symptoms, particularly vasomotor symptoms (VMS), also known as hot flashes and night sweats.

She emphasized that managing menopause is not a one-size-fits-all approach. Instead, treatment must be individualized, taking into account each woman’s personal medical and family history, as well as her treatment preferences.

One of the most effective and widely used treatment options for menopause-related symptoms is hormone therapy. However, hormone therapy isn’t suitable for every patient. Some women may have medical contraindications or may simply choose not to pursue it. For these women, non-hormonal alternatives are available.

Mancuso highlighted fezolinetant (VEOZAH; Astellas Pharma) as a promising, first-of-its-kind, non-hormonal treatment specifically approved by the FDA for moderate to severe VMS due to menopause. Unlike traditional hormone therapy, fezolinetant works by targeting the neurokinin B (NKb) pathway. It blocks the binding of the NKb neuropeptide, which is known to trigger VMS. This mechanism allows fezolinetant to reduce the frequency and severity of moderate to severe hot flashes during both day and night.

Mancuso noted that for some women, fezolinetant can start working in as early as one week, which was seen in clinical studies at 4 and 12 weeks, however, individual results may vary. She also cautioned that fezolinetant may cause serious side effects, including liver-related issues, and therefore requires lab testing before and during use. Patients experiencing symptoms should discontinue use and consult with their physicians. Further safety details, including a Boxed warning and full 

, are available at the drug’s official website, veozah.com.

In closing, Mancuso underscored the broader mission of Astellas, the pharmaceutical company behind fezolinetant. She shared that Astellas is committed to advancing women’s health, particularly during midlife, a demographic that has historically been underserved. The company actively partners with menopause experts and advocacy groups to raise awareness, reduce stigma, and develop targeted, research-backed solutions to support women navigating menopause globally.

New research reveals impact of menopause stigma. Astellas. March 07, 2025. Accessed April 04, 2025. https://www.astellas.com/en/stories/international-womans-day-2025

Discover how fezolinetant (VEOZAH; Astellas Pharma) is helping women manage moderate to severe vasomotor symptoms of menopause with rapid and effective relief.

Clinical

Hope for menopause hot flashes discussed by Shayna Mancuso, DO

The Menopause Experience and Attitudes Study, as explained by Shayna Mancuso, DO, FACOG, from Astellas Pharma, is a comprehensive, bi-yearly global research initiative designed to better understand societal perceptions, individual experiences, and the persistent stigma surrounding menopause and perimenopause. 

Conducted by Astellas in collaboration with global menopause experts and advocates, the study collected data from approximately 13,800 participants across 6 countries. Notably, each country contributed approximately 2,300 participants, with the US segment focusing on 1,800 women aged 40 to 55 years.

The study yielded several critical findings. One of the most striking revelations was that 67% of respondents felt menopause symptoms are not taken seriously, and 55% still view menopause as a taboo subject. These statistics emphasize the ongoing cultural silence and misunderstanding surrounding the menopausal transition. In addition, 60% of women who had experienced menopause, or were close to someone who had, reported psychological effects such as anxiety, depression, shame, and embarrassment.

The study also highlighted the negative impact of menopause in professional environments. Many women reported decreased productivity and even workplace discrimination linked to menopausal symptoms. Moreover, 93% of women who had direct or indirect experience with menopause reported significant symptom impact, with 60% citing hot flashes and over 50% mentioning night sweats or vasomotor symptoms.

These findings underscore the ongoing societal challenges women face during menopause and highlight a significant need for improved education and support systems. Mancuso emphasized that menopause management should not be approached with a “one size fits all” mindset. Instead, health care providers must recognize the diversity of symptoms and experiences, tailoring care accordingly.

In addressing how clinicians can help, Mancuso stressed the importance of health care providers taking an active role in breaking the stigma and initiating open, judgment-free discussions. Physicians should ensure that women feel safe and heard when sharing their experiences. By providing comprehensive, evidence-based information on available treatments and management strategies, clinicians can empower women to become advocates for their own health during this significant phase of life.

A global study uncovers the widespread stigma, emotional toll, and workplace challenges women face during menopause, highlighting the urgent need for awareness, support, and personalized care.

Shayna Mancuso, DO, highlights the real impact of menopause

Maternal diet

Elinor L. Sullivan, PhD, and Elizabeth K. Wood, PhD, professor and assistant professor, respectively, at Oregon Health & Science University, discussed how infant neurodevelopment is influenced by maternal diet during the third trimester of pregnancy.

The most influencing factor was the glycemic nature of a maternal diet, impacted by the consumption of products with simple sugars such as white bread, chips, and soft drinks. According to Wood and Sullivan, switching to more complex carbohydrates may help alleviate these concerns, providing a targeted therapy.

Please provide a brief overview of your study evaluating the link between maternal diet and infant behavioral health.

And so, we kind of set out this study to try to examine the influence of early environmental factors. We’re really focused on things such as maternal nutrition, metabolic health, mental health, and stress, to see how those factors influence child brain development and behavioral development. And our overall goal is to try to determine which factors are harmful and which factors are protective and try to see which of them have the greatest impact on the developing brain and behavior, so that we can support expecting mothers and help give them the best their babies the best start. And I'll turn to you, Elizabeth for the more granular details of the study.

Yeah, so in an effort to try to understand which maternal health factors during pregnancy are important to predicting risk for infant mental health concerns, we followed a cohort of 310 expecting mothers during the second and third trimesters of their pregnancy. So, we collected detailed information about those pregnancies, including dietary information, information about their body composition, and we also collected blood samples from them so we could look at their insulin sensitivity. Then when the infants were born, we assessed those infants for something called negative affect, which is essentially this temperament trait that reflects risk for future mental health concerns like ADHD, anxiety, and depression.

What were the results of the study, and what is the significance of these findings?

Yeah, so, we found that the quality of the maternal diet— and when I say quality, I mean the glycemic nature of the maternal diet, so how sugary the maternal diet is— we found that that dietary piece is associated with risk for future infant mental health concerns. So, we show that the type of carbohydrate in the maternal diet matters, so small dietary modifications like switching simple sugars, like white bread, chips, or soft drinks, for foods that have more complex carbohydrates like whole grains, beans or fiber rich vegetables, may help optimize pregnancy for supporting future infant mental health. And so, we also found that the third trimester was a particularly important window for this. So, while consuming a healthy diet over the course of pregnancy is of course, important for the health of the mother and the health of the baby, we found that the dietary content, or the diet consumed during the third trimester was particularly important and impactful on infant mental health risk.

We found that this is very compelling, because we've now targeted a specific part of the diet. We recognize it's really difficult to change one's entire diet, but perhaps by targeting a specific area, such as the glycemic index, or carbohydrate source that you're consuming, individuals may be able to make that small dietary change and thus optimize the development of their child. And again, also, as Elizabeth said, targeting the third trimester as well.

This video is part 1 of a 3-part series. Click 

Study confirms link between maternal diet, risk to infant behavioral health. Oregon Health & Science University. March 26, 2025. Accessed March 28, 2025. 

https://www.eurekalert.org/news-releases/1078391

Wood EK, Nomura O, Ablow JC, et al. Higher prenatal dietary glycemic index in the third trimester of pregnancy is associated with infant negative affect at 6 months. 

. 2025;15. doi:10.1038/s41598-025-91886-0

A new study from Elinor L. Sullivan, PhD, and Elizabeth K. Wood, PhD, highlights how the glycemic quality of a mother’s diet, particularly in the third trimester, may influence an infant’s risk for future mental health concerns.

Experts discuss how maternal diet during pregnancy impacts infant development

Impact on infant health in late pregnancy

Elinor L. Sullivan, PhD, and Elizabeth K. Wood, PhD, professor and assistant professor, respectively, at Oregon Health & Science University, discussed how the link between maternal diet and infant development is strongest during the third trimester of pregnancy.

The study evaluated diet impacts in the second trimester vs the third trimester, with the latter leading to more significant outcomes. Notably, this effect was only found for diet rather than body composition or metabolic health.

How does the association between maternal diet and infant development differ between trimesters of pregnancy?

Yes, so because we collected this detailed information during the second and third trimesters, we were able to test associations looking at only second trimester variables or looking at only third trimester variables. So that's diet and body composition and insulin sensitivity in the second trimester as it relates to infant mental health or diet in the third trimester, their body composition in the third trimester, and the insulin sensitivity in the third trimester as it relates to infant mental health. And we found effects for the diet, the dietary glycemic index, or that kind of simple sugar components of the maternal diet being related to infant mental health risk later in life. So that is, and that's at 6 months in infant life, and we did not see those same effects with the variables that we collected in the second trimester.

We also found it compelling that it was the diet, instead of body composition or metabolic health, that seemed to be more important for the child's behavioral development, and we think that's really compelling, because it's much easier to again, make a small change in the diet than to be able to overly shift your whole metabolic health or body composition, especially during a time of pregnancy, where making big changes in weight or metabolic health is not necessarily recommended. So, we think again, dietary changes will be easier and a more rapid possible change for individuals.

This video is part 2 of a 3-part series. Click 

New research from Elinor L. Sullivan, PhD, and Elizabeth K. Wood, PhD, suggests that a mother's diet in the third trimester, particularly its glycemic index, plays a key role in infant mental health at 6 months, highlighting the importance of prenatal nutrition.

How the impact of maternal diet on infant health is strengthened in late pregnancy

endometriosis patient April Christina shared her journey with endometriosis, a condition that significantly impacted her quality of life from a young age. 

She recalled experiencing severe menstrual pain, nausea, and vomiting as early as 9 years old, which made it difficult for her to understand and manage her symptoms. It took many years before she received an official diagnosis of endometriosis. In her late 20s, she underwent her first excision surgery after previously having an exploratory laparoscopy in her early 20s, which confirmed the condition. 

Christina noted that while clinical guidelines suggest diagnosis can take between 8 and 10 years, her own journey was even longer. However, finally receiving a diagnosis brought a sense of relief, as it validated the symptoms she had been struggling with for so long. In discussing how she manages her condition, Christina emphasized the importance of a strong, multidisciplinary care team. She highlighted the role of various health care professionals, including nurses, physicians, and administrative staff, in helping her coordinate and receive effective treatment. She also mentions that, because of the complexity of her symptoms, she was evaluated by multiple specialists, including a pulmonologist, to rule out complications such as blood clots. 

According to Christina, one of the most valuable aspects of her care experience was that all of her physicians were within the same facility, allowing for better communication and collaboration in managing her treatment plan. Christina also discussed the emotional and mental challenges that come with endometriosis, particularly in relation to infertility. She expressed appreciation for the support of a 

, who helped her navigate the emotional toll of her diagnosis and treatment. This, combined with her medical care team, provided her with both emotional and clinical support, making it easier to cope with the challenges of endometriosis. 

Overall, Christina’s story highlights the long and often difficult journey to an endometriosis diagnosis, the necessity of a well-coordinated care team, and the importance of emotional support in managing both the physical and mental aspects of the condition. Her experience underscores the need for greater awareness and education about endometriosis to ensure earlier diagnosis and better patient care.

Diagnosed with endometriosis after years of debilitating symptoms, April Christina shares her experience with treatment, multidisciplinary care, and the emotional toll of infertility.

April Christina’s endometriosis journey: Diagnosis delays, treatment, and support

Connie Stark, RNC, PNC, director of fertility coaching at Robyn, and an endometriosis patient April Christina discussed how fertility coaching helps women dealing with endometriosis and infertility, highlighting the support provided by 

Connie Stark, a registered nurse and fertility coach, explained the role of fertility coaches, emphasizing that their approach is personalized and designed to complement medical care. The coaching service is provided at no cost through a text-based platform and aims to help women navigate the complexities of fertility treatment.

Stark described how fertility coaches break down overwhelming medical information, provide credible resources, and help clients develop a structured plan for their fertility journey. She shared that in Christina’s case, the coaching process involved offering strategies to manage stress, emotional well-being, and lifestyle adjustments such as nutrition and self-care. 

According to Stark, one of the key aspects of fertility coaching is empowering women with knowledge and tools to make informed decisions about their treatment options, such as egg freezing or in vitro fertilization. Additionally, coaching helps women prepare for appointments with fertility specialists by identifying the right questions to ask and advocating for personalized care.

Stark also offered immediate steps for women diagnosed with endometriosis and infertility. She stressed the importance of finding a knowledgeable fertility specialist, advocating for a treatment plan, and considering fertility preservation even if pregnancy is not an immediate goal. Effective communication with partners, family, and health care providers is essential, and having a fertility coach as a resource can help women feel more prepared and in control.

April Christina added that gathering as much medical data as possible is crucial in understanding one's fertility potential. She advised women to take baseline blood tests early on, even if they do not plan to conceive right away. Having this information allows individuals to make proactive decisions and create an action plan when the time comes to expand their family.

Stark concluded by reinforcing the idea that seeking support through fertility coaching is a sign of strength. She encouraged women to take advantage of resources such as Fertility Out Loud, where they can access guidance, credible information, and a supportive community to help them through their journey with endometriosis and infertility.

Discover how fertility coaching provides personalized support, expert resources, and emotional guidance to help women with endometriosis make informed decisions about their reproductive health.

Bojana Pinter, MD

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