Roe Andrea H, Merjaneh Lina, Oxman Rachael, Hughan Kara S
Division of Family Planning, Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, United States.
Division of Endocrinology, Department of Pediatrics, University of Washington, Seattle, WA 98115, United States.
J Clin Transl Endocrinol. 2021 Nov 17;26:100277. doi: 10.1016/j.jcte.2021.100277. eCollection 2021 Dec.
As females with cystic fibrosis (CF) increasingly reach their reproductive years, gynecologic issues have become an important area of clinical care and research. First, females with CF may have disease-specific gynecologic problems, including cyclic pulmonary symptoms, vaginal yeast infections, and urinary incontinence. Next, contraceptive methods are thought to be overall safe and effective, however further research is needed to confirm this and to understand the lower rates of uptake among females with CF compared to the general population. Further, females with CF have reduced fertility, although the etiology of this is unknown and under investigation. While assisted reproductive technologies may help achieve pregnancy, decision-making around parenthood remains complex. Finally, while patients and providers agree on the importance of sexual and reproductive health care, females with CF underutilize basic preventive services such as cervical cancer screening, and better approaches are needed to bridge the gap with gynecology. In this review, we discuss the current state of gynecologic care for females with CF, as well as clinical and research opportunities for improvement.
随着患有囊性纤维化（CF）的女性越来越多地步入生育年龄，妇科问题已成为临床护理和研究的一个重要领域。首先，患有CF的女性可能会出现特定于疾病的妇科问题，包括周期性肺部症状、阴道酵母菌感染和尿失禁。其次，避孕方法被认为总体上是安全有效的，然而，需要进一步研究来证实这一点，并了解与普通人群相比，CF女性的避孕方法使用率较低的原因。此外，患有CF的女性生育能力下降，尽管其病因尚不清楚且正在研究中。虽然辅助生殖技术可能有助于实现妊娠，但围绕生育的决策仍然很复杂。最后，虽然患者和医疗服务提供者都认同性健康和生殖健康护理的重要性，但CF女性对宫颈癌筛查等基本预防服务的利用不足，需要更好的方法来缩小与妇科护理之间的差距。在这篇综述中,我们讨论了CF女性妇科护理的现状，以及改进的临床和研究机会。
