Highlights from literature

Poor mental health in the transgender population, especially that linked to suicidal ideation, has been linked to poorer outcomes than in the non-transgender population. This systematic review examined the effect of gender-affirming surgeries on suicide-related outcomes. Eleven studies involving more than 30 000 individuals were included. The researchers concluded that suicidal ideation generally decreased following gender-affirming surgeries; however, the results surrounding suicide attempts and death by suicide were inconsistent. The known increased mental health implications in those requesting gender-affirming surgeries require the involvement of multidisciplinary care and increased attention to the individuals’ psychological needs, especially when suicidal ideation has been expressed. J Psychosexual Health https://doi.org/10.1177/26318318231189836

In the United States, 47% of abortions are procedural. Pain and anxiety are significant negative experiences of those undergoing abortions and traditional non-opioid analgesics are ineffective at managing this totally. This randomised controlled trial looked at the alternative therapy of inhaling lavender aromatherapy versus placebo, and included 112 participants undergoing a procedural abortion under 10 weeks’ gestation. Although the study found no benefit as regards pain reduction, it did find high levels of patient satisfaction with this affordable and acceptable non-opioid adjunct to current standard of care during procedural abortion. Contraception https://doi.org/10.1016/j.contraception.2023.110311

Spinal cord injury is a life-changing injury, and little is known about its impact on sexual satisfaction and sexual distress and the associated predictive factors. This cross-sectional research used validated patient-reported outcome measures to anwer this question. The 91 participants were assessed regarding sexual satisfaction, sexual distress, psychological factors (mood, sexual and body esteem) and perceptual factors (mindfulness). Orgasm experience and psychological factors showed a moderate association with sexual satisfaction and sexual distress. Sexual and body esteem were predictive of sexual distress only. In those individuals who were sexually active, above all the other variables, sexual mindfulness predicted both sexual satisfaction and sexual distress. These results highlight the importance in addressing the topic of sexual health during the recovery and rehabilitation of individuals post spinal cord injury. J Sex Res https://doi.org/10.1080/00224499.2023.2260816

Barriers to abortion provision can be varied and differ in different parts of the world, and with a declining number of abortion providers in Germany, these barriers need to be minimised to enable access to this service. This qualitative study employed in-depth, semi-structured, one-on-one interviews with 14 medical students and four gynaecologists in Berlin, Germany to assess what might be leading to the 46% reduction in abortion-providing facilities. The study found that there was a perceived taboo and stigmatisation surrounding abortion provision and that this could lead to reluctance in providing this care. Education around abortion care during medical school was rarely addressed, despite this being requested by medical students. Providing structured education around abortion is acceptable to medical students and will hopefully lead to a reduction in stigmatisation, which in turn may result in practitioners more capable of providing the required abortion care. Contraception https://doi.org/10.1016/j.contraception.2023.110325

Intracytoplasmic sperm injection (ICSI) has been used since 1990; however, its use in non-male factor infertility is increasing but existing systematic reviews provide conflicting evidence on its effectiveness in improving fertility rates. In this systematic review and meta-analysis, 18 RCTs looking at 3249 cycles demonstrated no increase in live birth rate. In subgroup analysis, no difference was found regardless of female age or controlled ovarian stimulation protocol. The findings of this study suggest that ICSI leads to no difference in reproductive outcomes compared to in vitro fertilisation in patients with non-male factor infertility. Acta Obstet Gynecol Scand https://doi.org/10.1111/aogs.14698

Endometriosis is estimated to affect 10% of women during their reproductive lives and displays a large heterogenicity in symptoms with multiple different treatment options. The use of patient-centred oucomes improves the engagement of the patient in their own care and understanding of the disease pathology and has been shown to improve clinical outcomes. The researchers employed an international group of healthcare professionals, researchers and patient representatives to identify patient- and clinician-centred outcomes for use in routine endometriosis care. This Delphi study comprised two rounds followed by an consensus discussion, which led to the acceptance of 23 outcome measures: 10 clinician-related outcomes (eg, clinical, imaging and surgical indicators), six patient-related outcomes (eg, pain-related symptoms, symptomatic impact, work productivity, disease-related quality of life) and seven patient-related complementary outcomes that were considered unsuitable for routine care in endometriosis but which covered important dimensions (eg, sexual activity and psychological impact). The resulting list covering physical, psychological and sexual implications of endometriosis can be used by all those managing patients with this condition. Acta Obstet Gynecol Scand https://doi.org/10.1111/aogs.14694

Antibiotic resistance in Neisseria gonorrhoreae (NG) is a growing concern around the world and monitoring it in low- and low-middle-income (LMIC) countries adds an additional challenge. Antibiotic resistance in NG is chromosomally mediated and whole-genome sequencing can be utilised to identify antimicrobial resistance and also antimicrobial susceptibility. This retrospective study examined a subset of NG isolates obtained from patients attending a medical laboratory in Madagascar from 2014 to 2020 with 364 isolates obtained. There were high rates (>90%) of penicillin and tetracycline resistance, and genetic mutations were identified associated with antibiotic resistance. This study has generated a detailed dataset of information on NG antimicrobial resistance obtained through phenotypical and genotypical methods, which will serve as a baseline for future surveillance of NG in Madagascar. Sex Trans Infect http://dx.doi.org/10.1136/sextrans-2023-055878