Current Women's Health Reviews - Volume 20, Issue 6, 2024

Background: Although pregnancy has been an integral part of women’s lives for millennia, not all women have found the process comfortable. About 65 percent of women in India consume Indian traditional herbs during pregnancy. Herbal medicines are used nowadays by up to half of the world's population. Phytomedicines isolated from plants contain a wide variety of bioactive components that can have both negative and positive effects. Many herbal plants, such as Sage (Salvia fruticosa), golden cotula (Matricaria aurea), anise (P. anisum), peppermint (Mentha aquatica), and cumin (Cuminum cyminum), etc., are used in pregnancy. To minimize the adverse effects, the use of Indian traditional medicine can be the best possible alternative. Objective: Regarding the usage of herbal medicines in India, there are large research gaps and a lack of a regulatory framework. This article aims to highlight the most common traditional Indian remedies used by pregnant women, along with their uses and any possible interactions between herbal remedies and prescription drugs. Method: Several databases, including the WHO guidelines, PubMed, Bentham Science, Elsevier, Springer Nature, Wiley, and Research Gate, were used to compile the data for the article following a thorough analysis of the various research findings connected to pregnancy and herbs for pregnancy care. Result: An overview of the use of herbal medicine is given in this review, along with information on its limitations and general safety. The prevalence of herbal medicine use during pregnancy in India is then discussed, along with the uses, adverse effects, side effects, and efficacy of the most popular herbal medications. Conclusion: The use of herbal medicine during pregnancy is a common phenomenon. The outcomes of this study showed Indian Traditional medicines are known to have numerous advantages that can be helpful during or after pregnancy, including raising milk production, reducing nausea, easing labor pains, reducing morning sickness, or reducing flatulence, however, some herbal remedies have the potential to be teratogenic, poisonous, and abortive, especially during the first trimester of pregnancy because the active components of some medicinal plants can cross the placental barrier and get to the foetus. To determine the safety of taking herbal medications, studies, especially clinical trial trials, must be conducted.

Background: Apart from the biological changes women experience throughout pregnancy, their exposure to a gender discrimination stemming from cultural values adopted by the society in which they live can make it difficult for them to adapt to pregnancy and thus lead to negative pregnancy experiences. Aim: This research was conducted using a cross-sectional and relation-seeking approach to evaluate the effects of social gender inequality on pregnancy experiences. Methods: Data for this cross-sectional and relation-seeking study were gathered between 25 November 2019 and 25 January 2020 using face-to face interviews the researcher conducted with childbearing women who visited the outpatient clinic and non-stress test units of a hospital for the pregnancy follow-up. Results: When using the Pregnancy Experiences Scale to assess childbearing women, higher scores indicated more positive emotions than negative emotions. Independent variables that affect the scores on the Pregnancy Experiences Scale include a willingness to be pregnant, the baby's sex, the woman’s income status, gestational week and the Perception of Gender Scale (p<0.005). A positive but weakly significant relationship was found among the total score on the Perception of Gender Scale, the total score on the Pregnancy Experiences Scale and the average scores of positive emotions intensity and frequency in all sub-dimensions (p<0.005). Conclusion: Based on the data, we conclude that women’s pregnancy experiences are generally positive, and that social gender inequality is a significant determinant affecting pregnancy experiences.

Background and Objective: Preconception care consists of biomedical, behavioral, and social services, along with health interventions, for women and couples before conception to improve their health status and reduce individual and environmental high-risk behaviors. This study aimed to assess to preconception counseling according to the theory of planned behavior with the presence of the spouse on preconception care behaviors. Materials and Methods: This study was an educational trial. The researcher randomly divided women into two intervention and control groups. The control group only received routine preconception care in the presence of the spouse. The intervention group, according to the theory of planned behavior, received 60-minute face-to-face counseling weekly sessions. The main outcomes of behavior were divided into two categories: Screening tests and vaccinations and individual lifestyle (exercise, nutrition, and smoking). The questions also focused on men’s check-up tests. The data normality was analyzed by group, variable type, and measurement stage using the Shapiro-Wilk test and the skewness and kurtosis results. Levene's and Mochli's tests were used to check the homogeneity of variances and assumption of sphericity, respectively. Data were analyzed using independent t-tests, chi-square, repeated measures test, and SPSS 26 software. Result: The previous lifestyle behaviors were respectively 15.22 + 2.836, 15.49 + 2.769, and 16.84 + 1.894 before, immediately, and 4 weeks after the intervention in control, and 12.70 + 3.69, 15.53 + 3.02, and 16.60 + 2.73 in the intervention group, indicating no significant differences (p=0.08). However, the two groups significantly increased healthy lifestyles over time (p=0.001). The results also showed that the mean of test and vaccination was respectively 4.44 ± 2.99, 2.75 ± 6.42, and 2.49 ± 8.31 before, immediately, and 4 weeks after the intervention in control, and 4.09 + 3, 6.74 + 2.87, and 8.35 + 2.37 in the intervention group, indicating no significant differences (p=0.99). Conclusion: Since the presence of the husband during the training of women's pre-pregnancy care can affect their health behaviors regardless of the type of intervention, men are suggested to attend prepregnancy training and consultations for at least one session.

Background: Preeclampsia (PE) is gestational hypertension and one of the most serious disorders in pregnant women. Objective: This study aimed to compare second-trimester uterine artery Doppler pulsatility index (UAPI) in singleton pregnant women with and without risk of PE. Methods: A case-control study was carried out among 200 singleton pregnant women in the second trimester of pregnancy, who were referred to Imam Hospital in Ahvaz (Iran). The data were recorded on their demographic, obstetric, clinical characteristics, and Doppler indices. The average UA-PI value was considered as the mean PI between the right and left arteries. Women who were categorized into Groups 1 and 2 had a moderate-high and low risk of PE, respectively. Results: The mean UA-PI, right UA-PI, left UA-PI, systolic and diastolic blood pressures (BP), age, body mass index (BMI), and abdominal circumference (AC) of women in Group 1 were significantly higher than those in Group 2 (p<0.05). Furthermore, Group 1 had a higher frequency of abortions, comorbidities, abnormal UA Doppler results, and nulliparous women than Group 2 (p<0.05). Based on maternal age (<35, ≥35), BMI (<25, ≥25), comorbidities (yes, no), and nulliparity (yes, no) categories, those who were in Group 1 had a significantly higher mean systolic and diastolic BP, UA-PI, right UA-PI, and left UA-PI than their counterparts in Group 2 (p<0.001). Conclusion: This study declared the second-trimester UA-PI had good potential for timely prediction of PE risk in pregnant women.

Background: Vaginal examination is widely recognized as the most common method for monitoring labor progress. However, researchers are currently exploring alternative methods, which are potentially less invasive or aggressive, to assess labor progress. Objective: This study aimed to assess the correlation between the length of the xiphoid to the fundus and the cervical dilation in the active phase of labor. Methods: This cross-sectional study was conducted on 180 pregnant women in Varamin, Iran. The participants were recruited using convenience sampling. Data were collected using a researcher- made questionnaire that included specific items regarding demographic characteristics, health status, and a checklist to record the results of examinations and labor progress. The collected data were analyzed using descriptive statistics, correlation tests, and multiple linear regression with SPSS 22 software. The significance level was considered to be p <0.05. Results: A total of 174 eligible women participated in the study, with a mean age of 25.90 ± 4.56 years (mean ± SD) and a mean gestational age of 39.71 ± 1.03 weeks. There was a significant negative correlation between the length of the xiphoid to the fundus and cervical dilatation (p = 0.0001, r = -0.568). Conclusions: The study revealed a significant negative correlation between the length of the xiphoid to the fundus and the cervical dilation. Therefore, the xiphoid to fundus measurement can serve as an alternative and complementary examination in cases that need frequent vaginal examinations.

Aims: Recent studies show that body composition is one of the most important factors in the menstrual cycle. The purpose of this study is to investigate more comprehensively the effect of body composition and anthropometric indicators on the symptoms of premenstrual syndrome (PMS). Materials and Methods: This study is a secondary study that is considered a systematic review according to the implementation method. The statistical population is all the studies that have dealt with the issue of the effect of anthropometric indicators on PMS from different aspects. Results: The final synthesis was performed on 7 articles after screening the studies. The synthesis of articles related to the relationship between anthropometric indicators on PMS showed that 47.8% of women in the world have PMS, with the highest prevalence being reported in Iran at 98%. Studies have shown that the incidence of PMS, increased appetite, and weight gain in women with a BMI greater than 25 kg/m² is more common. Weight gain causes endocrine disorders that lead secretion of more sex hormones in obese or overweight women, which in turn leads to the symptoms of PMS. Studies have shown a direct and significant relationship between PMS symptoms waist circumference (WC), waist-to-height ratio (WTHR), and waist-to-hip ratio (WHR), which according to the results, more central fat mass in women causes more severe symptoms of this syndrome. Also, studies showed that the risk of depression and anxiety in women with PMS with a higher BMI and body fat mass is higher. Conclusion: Weight control and improvement of eating habits, can be effective in reducing the incidence of PMS symptoms. Furthermore, the high prevalence of PMS in studies requires further investigation and principled interventions with regard to physical and mental factors in this period.

Linoleic acid (ω-6 LA) and α-linolenic acid (ω-3 ALA) are essential fatty acids (EFA) for human beings. They must be consumed through diet and then extensively metabolized, a process that plays a fundamental role in health and eventually in disease prevention. Given the numerous changes depending on age and sex, EFA metabolic adaptations require further investigations along the women’s life cycle, from onset to decline of the reproductive age. Thus, this review explains women’s life cycle stages and their involvement in diet intake, digestion and absorption, the role of microbiota, metabolism, bioavailability, and EFA fate and major metabolites. This knowledge is crucial to promoting lipid homeostasis according to female physiology through well- directed health strategies. Concerning this, the promotion of breastfeeding, nutrition, and physical activity is cardinal to counteract ALA deficiency, LA/ALA imbalance, and the release of unhealthy derivatives. These perturbations arise after menopause that compromise both lipogenic and lipolytic pathways. The close interplay of diet, age, female organism, and microbiota also plays a central role in regulating lipid metabolism. Consequently, future studies are encouraged to propose efficient interventions for each stage of women's cycle. In this sense, plant-derived foods and products are promising to be included in women’s nutrition to improve EFA metabolism.

Background: The experiences that women gain during childbirth remain with them throughout life. This study aimed to provide strategies to promote positive childbirth experiences. Method: This Delphi study was conducted in three rounds from September to November 2019. A purposively selected 17 national experts, including obstetricians, reproductive health professionals, and midwives, participated in this study. Results: Most of the 52 initial strategies in the first round (50 strategies) were approved with a few corrections in the first and second rounds, and 23 strategies were presented in the third-round questionnaire; most panelists agreed upon them. Finally, they approved 73 strategies with five categories: promoting professional support, enhancing control skills, encouraging empowerment, promoting spouse and other important support, and improving childbirth preparation. Conclusion: The Delphi approach allows for developing a consensus that will serve as a template for education, practice, and future research in maternity care units. Hence, multidimensional approaches are required to promote positive childbirth experiences that can potentially improve mothers’ well-being outcomes.

A premenstrual syndrome is a group of regular physiological, mental, emotional, and behavioral symptoms that appear periodically in the luteal phase of the menstrual cycle, and they vanish quickly with the beginning of menstruation or a few days afterward. Thus, severe premenstrual syndrome (PMS) affects 5–8% of women; the majority of these individuals also match the factors for premenstrual dysphoric disorder (PMDD). Premenstrual syndrome typically includes physical problems like headache, tiredness, indigestion, insomnia, nausea, and breast tenderness as well as symptoms associated with emotions (mood swings, anxiousness, and aggressiveness). Although the true mechanism of PMS is unknown, a number of theories point to increased sensitivity to typical hormonal changes and imbalances in neurotransmitters. A multidisciplinary team using an integrative holistic approach in the direction of an individualized strategy gradually manages PMS. The first phase entails educating women about PMS, self-screening, herbs like St John’s Wort, chaste berry, saffron; Ginkgo biloba; chamomile, evening primrose, turmeric and so on, various nutrition supplements as Vitamin B6; calcium; magnesium and lifestyle adjustments like dietary modifications; exercise; yoga; sleep hygiene. The second step involves implementing various relaxation therapies, cognitive behavioral therapy (CBT), stress reduction techniques, and acupuncture. The available treatment as various drugs like SSRIs; serotonergic antidepressants; anxiolytics and hormonal therapy that are used currently to treat PMS, exhibits unwanted side effects. Therefore, this issue and other similar gynecological conditions have been discussed and managed with herbal medicines and other natural solutions in this comprehensive piece of work.

Background: The present study investigated the relationship between spousal support during postpartum period and the sexual function and sexual quality of life among lactating women. Methods: A cross-sectional study was carried out from October to March 2021 comprising 301 breastfeeding women referred to comprehensive health centers in Qazvin, Iran. The sampling method was performed in two stages. First, via cluster sampling, ten comprehensive health centers were randomly selected. Then based on the list of lactating mothers, 31 mothers in each center were randomly selected and invited to complete the survey. The survey included three psychometric instruments (i.e., Postpartum Partner Support Scale (PPSS), Female Sexual Function Index (FSFI) and Sexual Quality of Life-Female version (SQoL-F)) as well as a reproductive and demographic information questionnaire. The findings were analyzed using univariable and multivariable regression models at a significance level of p<0.05. Results: The participants had a mean age of 30.33 years and a mean length of marriage of 7.99 years. A total of 219 women were exclusively breastfeeding (72.8%), and 82 used a combination of breastfeeding and formula milk to feed their infants (27.2%). The mean (standard deviation) scores in the postpartum period were 61.34 out of 80 (SD=11.41) on the PPSS, 86.52 out of 108 (SD=19.68) on the SQoL-F, and 22.78 out of 36 (SD=6.20) on the FSFI. Based on adjusted multivariable regression models, spousal support in the postpartum period was a significant predictor of sexual quality of life (β=0.39, p<0.001) but not a significant predictor of sexual function. Sexual quality of life was a significant predictor of sexual function (β=0.44, p<0.001). Conclusion: Given the importance of spousal support during the postpartum period in relation to sexual quality of life and sexual function, designing and implementing counseling programs based on the role of spousal support during postpartum sexual life would be helpful.

Introduction: Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a disease of pregnancy that occurs very rarely before 20 weeks of gestation. We report a case of HELLP syndrome developing at 14 weeks and 2 days of gestation. Case Presentation: A 33-year-old Asian primipara at 14 weeks and 2 days of gestation visited the emergency room with a fever and headache. Initial blood pressure was 140/70 mm Hg, temperature 38.5°C, heart rate 130 beats/min with tachycardia. Her prenatal examination has been unremarkable, and fetal ultrasonography was within normal range. The laboratory results showed low platelet count with elevated liver enzymes, D-dimer, and fibrinogen but no sign of jaundice. Her WBC differential suggested a bacterial infection. Thus, we diagnosed early HELLP syndrome and immediately started conservative treatments. One day after admission, symptoms and laboratory results showed aggravation of the disease. We performed termination, followed by dilation and curettage for retained placenta. Her general condition improved rapidly after the operation. Placental biopsy showed both acute and chronic inflammation. She also had anticardiolipin antibody IgM, and after discharge, she was referred to a rheumatology specialist to address the antiphospholipid syndrome issue. Discussion: Although the triggers of HELLP syndrome are unclear, a recent inflammatory hypothesis suggests that placenta-derived inflammatory cytokines are involved. In our case, the anti-cardiolipin antibody may have triggered microangiopathy of the placenta. Our analysis of published HELLP cases revealed that, apart from the three diagnostic criteria, the most common abnormal laboratory finding was antiphospholipid antibodies. Therefore, despite its rarity, if a sign of inflammation is present in a patient, it is important to consider HELLP syndrome regardless of gestational age.

Background: About 70% of gynecological consultations for women in perimenopause are due to metrorrhagia. In most cases, they are only the witness of hormonal disturbances resulting from a luteal deficiency. Transvaginal ultrasound is the first innocuous and available additional examination that is requested as part of an etiological assessment. Objective: Our study aims to evaluate the contribution of ultrasonography in perimenopausal metrorrhagia and investigate possible clinical-ultrasound correlation. Methods: This analytical descriptive study was carried out on 50 treated for perimenopausal metrorrhagia in the emergency department of the Tunis Maternity and Neonatology Center for four months (November 1, 2017, to February 28, 2018). We included in our study patients who were not yet postmenopausal who were ≥ 45 years of age, and who sought care for breakthrough bleeding. All patients in our study initially underwent endovaginal ultrasonography, sometimes coupled with suprapubic ultrasonography. Results: The mean age of our patients was 46.3 years. Pelvic ultrasonography revealed an enlarged uterus in 16 patients (32%), with 14 of them having fibromatous uteri measuring between 3 to 10 centimeters. The findings indicate no significant correlation between ultrasound results and bleeding abundance (P = 0.321), pelvic pain (P = 0.108), and general condition (P = 0.437). Conclusion: Endovaginal pelvic ultrasonography is a quick, painless test and is the first test to be done first in an emergency department with perimenopausal vaginal bleeding. The correlation between clinical and ultrasound findings is highly random, making it impossible to assume a well-- coded diagnostic and therapeutic presumption.

Introduction: Vitamin D Deficiency (VDD) is a global problem among pregnant women in many populations. There is an association between VDD and some pregnancy outcomes, as well as gestational diabetes mellitus (GDM) and pre-eclampsia. We aimed to evaluate the effect of vitamin D supplementation on metabolic status (Fasting Blood Sugar (FBS), insulin, Homeostasis model of assessment- insulin resistance (HOMA-IR) and lipid profile) and blood pressure (BP) among pregnant women with VDD. Methods: A clinical trial was carried out on 30 pregnant women with VDD referring to the Gynecology & Obstetrics Clinic of Baqiyatallah Hospital, Tehran, Iran. The present study had two phases of vitamin D3 supplementation (50000 IU / week for 12 weeks and then 50000 IU / month for three months). Serum total cholesterol, triglyceride, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), 25-hydroxyvitamin D (25(OH) D) level, insulin, Fasting Blood Sugar (FBS) and both systolic and diastolic blood pressure were measured. Homeostasis model of assessment-insulin resistance (HOMA-IR) was also determined. Results: The results showed that mean levels of Insulin (p=0.010), HOMA-IR (p=0.020), 25(OH) D level (p=0.001), cholesterol (p=0.001), triglyceride (p=0.001) and LDL (p=0.001) significantly increases during study period. However, Diastolic and systolic blood pressure, FBS, and HDL levels did not change significantly over time. Conclusion: The results of this investigation showed that weekly and monthly vitamin D3 supplementation in pregnant women with VDD had beneficial effects on glycemic status, lipid profile and blood pressure.

Background: Childbirth is an important event and special experience in women's lives. Labor pain is the most severe pain that women undergo in their lives. Pain management during labor is crucial for the well-being of the mother and fetus. Objective: This study aimed to compare the effect of combined LI4 and SP6 acupressure with SP6 acupressure on reducing labor pain. Methods: A total of 108 primiparous women who participated in the study were randomized into three groups, combining LI4 and SP6 acupressure, SP6 acupressure, and a control group. Pain intensity was evaluated before, immediately, 1 and 2 hours after the intervention and the second stage of labor by visual analogue scale (VAS). Results: Although the pain intensity immediately after the intervention was lower in the combined SP6 and LI4 acupressure group than in the other groups, the differences were not significant between the three groups (p = 0.147). The pain intensity 1 hour after the intervention and in the second stage of labor had a statistically significant difference between the three groups (p =0.006, p =0.001). The pain intensity 2 hours after the intervention was lower in the combined SP6 and LI4 acupressure group than the other groups, but it was not statistically significantly different (p= 0.05). The pain intensity 1 hour after the intervention was not statistically different between the SP6 group and the control group (p= 0.095). The pain intensity 2 hours after the intervention was lower in the combined SP6 and LI4 acupressure group compared to the control group, but it was not significant (p=0.06). The pain intensity in the second stage of labor was lower in the combined SP6 and LI4 acupressure group and SP6 acupressure group compared to the control group (p =0.001, p = 0.017), but there was no significant difference between the SP6 acupressure group and combined SP6 and LI4 acupressure group (p=1.000). Conclusion: The obtained results revealed that combination intervention is a safe, effective, noninvasive and economical method in alleviating labor pain intensity. Healthcare providers are expected to master the acupressure technique as an alternative, complementary therapy, which can be used as an alternative or additional therapy.

Background: Fertility, the most important factor in population growth, is affected by various factors, including pandemics. COVID-19 (CV) was a global challenge that spread rapidly around the world. Objective: This study aimed to investigate predictors of fertility desire during the covid virus pandemic. Methods: In this cross-sectional study, 315 women who visited health centers in northern Iran for vaccination against covid virus were recruited using convenient sampling. The participants completed the sociodemographic information, Fertility Desire Scale, and Fear of covid virus scale. Logistic regression analysis was employed to assess the predictive factors of fertility desire. Results: The participants' mean age and marriage duration were 34.4 ± 6.7, and 7.3±11.5 years, respectively. It showed fertility desire among household women was about twofold more compared to employed ones [Odds Ratio (OR) = 1.96, p = 0.009)]. The fertility desire was decreased among more educated women (OR = 0.43, p= 0.035), women with one child (OR = 0.44, p= 0.030), and women with no infant gender preferences (OR = 0.53, p= 0.032). Fear of covid virus and any history of covid virus infection in the participants or their close relatives did not change fertility desire (P > 0.05). Conclusion: In conclusion, health policymakers should pay more attention to the potential effects of women's employment, their educational status, and their attitude toward infant gender preferences on fertility desire during the development of programs. Further research is needed to examine this empirical association on a global scale and its effect on trying to conceive.

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder affecting women worldwide. It refers to a condition that often has ‘poly’ liquid containing sacks around ovaries. It affects reproductive-aged females, giving rise to menstrual and related reproductive issues. PCOS is marked by hormonal imbalance, often resulting in hyperandrogenism. Women with PCOS might experience abnormal insulin activity and complications such as acne, mood swings, hirsutism, obesity, and infertility. The disease is linked with severe clinical ailments such as type 2 diabetes (T2DM), cardiovascular diseases (CVDs), and cancer. A faulty lifestyle, neuroendocrine factors, genetic causes, and androgen exposures often cause PCOS. The approach of society towards physiological problems such as PCOS in women is that it must be under the veil that is the ultimate barrier to the early diagnosis of PCOS. Thus, this review summarizes the causes, symptoms, pathophysiology, diagnosis, and possible treatment (medical, herbal, and lifestyle improvement, acupuncture, and bariatric surgery) related to PCOS.

Introduction: Intimate domestic violence causes psychological consequences in pregnancy and maternal competency. We aimed to assess the effect of domestic violence on mental health and maternal competency with the moderating role of mother-infant attachment behavior. Methods: This prospective longitudinal study was conducted on 254 primiparous mothers in the third trimester of pregnancy referring to selected health centers in Qazvin province, Iran. Data collection tools were questionnaires. Data were analyzed by SPSS and Smart Partial Lease Square3 software. Results: The results of the structural equations model showed that domestic violence has a positive and significant effect on mental health disorders (β = 0.87). Mental health disorder has a negative and significant effect on parental acceptance (β = -0.55). Domestic violence has a negative and significant effect on mother-infant attachment behavior (β = -0.83), also mother-infant attachment behavior is a moderator of the relationship between pregnancy violence and maternal competency (T-value = 3.17). Conclusion: The results revealed that domestic violence during pregnancy affects the mental health of pregnant mothers and maternal competency and mother-infant attachment behavior moderates this relationship. Therefore, it is recommended that mothers facing domestic violence be identified and receive psychological support and counseling, and also improve maternal competence and mother-infant attachment behavior in mothers exposed to violence.

Introduction: During the COVID-19 pandemic, various groups, including women with cancer, were affected as a high-risk group in terms of disease diagnosis and treatment. Despite the importance of therapeutic changes in cancers, such as breast and gynecological cancer, there is no comprehensive study in this regard that also refers to the coronavirus. The need for a deep understanding of the impact of coronavirus on the treatment plan of this group of patients caused the researcher to design and implement this study that aims to investigate the treatment challenge among cancer patients during the COVID-19 pandemic. Materials and Methods: To answer the study question, a comprehensive search was carried out in databases, such as PubMed, Web of Science Core Collection, and Scopus, using keywords, including cancer, gynecologic cancer, breast cancer, treatment, delay, and modification. Full-texted, English language and original articles were included in this study. Results: In total, 27 articles were selected for the study. The findings of this study revealed that COVID-19 greatly affects the treatment of gynecology and breast cancer. These patients experience delay or modification of cancer treatment. Increased time between diagnosis and treatment, delay, change or cancellation of surgery and change in treatment plan are the most important changes in cancer treatment during the COVID-19 pandemic. Conclusion: The COVID-19 pandemic has had a significant impact on various aspects of gynecology and breast cancer care worldwide. In the current pandemic, there has been a significant delay in the diagnosis and treatment of gynecological and breast cancer, which, due to its higher morbidity and mortality, has made the condition more difficult for cancer patients and treatment teams.

The complex heterogeneous disorder known as polycystic ovarian syndrome (PCOS) includes endocrine, reproductive, metabolic, psychological, and other pathological aspects. Yet, nothing is understood regarding the cause of PCOS. Insulin resistance and hyperandrogenism are major contributors to the pathophysiology of PCOS, according to various studies. Because of this, a lot of PCOS treatment regimens include changing a person's lifestyle through practices, like exercise, nutrition, and vitamin supplementation. Recent studies have indicated a number of nutrients, including vitamins, minerals, and vitamin-like substances, for the therapy of PCOS since they all have at least one functional characteristic in the pathways that are affected by PCOS. As a result, it is claimed that PCOS may be caused by a vitamin or mineral deficiency. It is the goal of this review to conduct a critical literature analysis on nutritional supplementation for the management of PCOS.