Background: Nausea and Vomiting in Pregnancy (NVP) and Hyperemesis Gravidarum (HG) are common pregnancy-related conditions that can significantly impair maternal quality of life and, in severe cases, impact pregnancy outcomes. This study aimed to assess the prevalence of NVP and HG, evaluate their association with pregnancy progression and neonatal outcomes, and investigate the role of pharmacological therapy. Methods: A prospective observational study was conducted at the University Hospital of Siena between September 2023 and September 2024. Seventy-nine pregnant women aged 28–34 years were enrolled and followed throughout pregnancy. Symptom severity was assessed using the PUQE questionnaire during scheduled outpatient visits. Patients with NVP received pharmacological treatment with doxylamine succinate/pyridoxine hydrochloride. Results: Nausea and Vomiting in Pregnancy was reported by 59% of patients, with all cases categorized as mild or moderate; no severe HG cases were observed. Symptoms resolved by the third trimester. A significant association was observed between NVP and a positive family history of the condition (OR: 3.66, 95% CI: 1.20–11.21; p = 0.025). Logistic regression analysis also revealed that NVP was associated with an increased risk of gestational hypertension (15% vs. 0%, p = 0.04), and a decreased likelihood of gestational diabetes (OR: 0.24, 95% CI: 0.07–0.86) and cesarean section (OR: 0.34, 95% CI: 0.13–0.87). No significant differences were found in neonatal outcomes, including birth weight, Apgar scores, or fetal complications. Conclusions: While NVP may influence maternal outcomes, the condition does not significantly affect neonatal health. Early pharmacological treatment improves maternal well-being and may reduce hospitalization rates. Larger multicenter studies are needed to confirm these findings.

Nutritional factors play a crucial role in many gynecological disorders, particularly those influenced by estrogen. Uterine fibroids are benign tumors that affect a large proportion of women of reproductive age, especially between 30 and 40 years. These lesions may cause significant symptoms, including pelvic pain, heavy menstrual bleeding, and infertility. In younger women, the onset of fibroids is often associated with familial and genetic predisposition, whereas in adulthood, hormonal influences linked to environmental factors and states of exogenous or endogenous hyperestrogenism are more frequently observed. In both contexts, supportive management through an appropriate diet may provide clinical benefit. Although the precise pathogenesis remains incompletely understood, hormonal, genetic, and environmental components—particularly hyperestrogenism—are considered key contributors to fibroid development. Current evidence suggests that consumption of saturated fats, particularly from red meat and full-fat dairy, may raise circulating estrogen concentrations and contribute to the development of fibroids. In contrast, diets abundant in fiber, fruits, and vegetables appear to exert a protective effect, potentially lowering fibroid risk. Obesity, through increased aromatization and consequent estrogen production, also represents an established risk factor. This narrative review aims to explore the role of nutritional determinants in the onset and progression of uterine fibroids, with a specific focus on the impact of individual nutrients, foods, and dietary patterns on clinical outcomes. Particular emphasis is placed on obesity and macronutrient composition (e.g., high-fat versus high-fiber dietary regimens) as potential modulators of circulating estrogen levels and, consequently, fibroid growth dynamics. Furthermore, the potential of nutritional strategies as complementary therapeutic approaches, capable of integrating established clinical practices, is examined.

Background: Perimenopause is characterized by pronounced fluctuations in ovarian steroids, which are associated with an increase vulnerability to anxiety symptoms. Growing evidence indicates that declining estrogen levels influence gut microbiota composition and microbial metabolic activity, thereby modulating neuroimmune and neuroendocrine pathways involved in emotional regulation. This review explores gut microbiota alterations occurring during the menopausal transition and critically evaluates dietary strategies targeting microbiota–gut–brain mechanisms potentially relevant to perimenopausal anxiety. Methods: A structured literature search was conducted in PubMed, Scopus, and Web of Science to identify clinical, translational, and preclinical studies addressing: (i) gut microbiota changes across perimenopause and menopause; (ii) microbiota–gut–brain pathways implicated in anxiety; and (iii) dietary patterns, nutrients, probiotics, and prebiotics with documented microbiota-modulating effects. The available evidence was synthesized narratively, with particular attention to biological plausibility and clinical relevance. Results: The perimenopause transition is associated with reduced microbial diversity, depletion of Lactobacillus, Bifidobacterium, and short-chain fatty acid (SCFA)-producing taxa, and enrichment of pro-inflammatory microbial signatures. These alterations are linked to increased intestinal permeability, altered tryptophan-kynurenine metabolism, immune activation, and dysregulated hypothalamic–pituitary–adrenal axis activity. Dietary interventions, including Mediterranean-style diets, fiber- and polyphenol-rich foods, fermented products, and selected probiotic and prebiotic formulations, have been shown to modulate gut microbial composition, enhance SCFA production, and attenuate inflammatory and neuroendocrine stress pathways. Preliminary evidence suggests potential anxiolytic benefits; however, randomized controlled trials specifically targeting perimenopausal populations remain limited. Conclusions: Gut microbiota dysbiosis may contribute to anxiety vulnerability in perimenopausal women through interconnected immune, metabolic, and neuroendocrine mechanisms. Dietary modulation of the intestinal microbiota represents a biologically plausible and low-risk complementary approach to support emotional well-being during this transitional period. Well-designed, perimenopause-specific clinical trials are needed to confirm efficacy and inform microbiome-based nutritional strategies.

Premenstrual syndrome is a common hormone-related condition marked by recurrent physical and affective symptoms that can substantially impair daily functioning. While cyclical ovarian hormone fluctuations are physiological, clinically relevant symptoms occur only in a subset of women, indicating the contribution of individual vulnerability and modifiable environmental factors. In this context, growing attention has been directed toward the role of nutrition. This narrative review synthesizes and critically discusses current evidence on the relationship between dietary factors and premenstrual syndrome, with emphasis on both primary prevention and symptom modulation. Available observational and interventional data suggest that dietary patterns characterized by high intake of ultra-processed foods, refined carbohydrates, and saturated fats are more frequently associated with increased symptom severity, whereas healthier dietary patterns may be linked to a lower symptom burden. Certain micronutrients—including calcium, vitamin D, zinc, iron, and omega-3 fatty acids—have demonstrated potential benefits, although findings remain heterogeneous and methodologically limited. Overall, nutrition emerges as a plausible complementary strategy in premenstrual syndrome management; however, well-designed prospective studies are needed to support robust, evidence-based dietary recommendations.

Adenomyosis is a chronic estrogen-dependent disorder that may adversely affect reproductive health. Increasing evidence suggests that its reproductive and obstetric consequences may vary according to disease phenotype, including focal versus diffuse forms and inner versus outer myometrial localization. This narrative review summarizes current evidence on adenomyosis, infertility, recurrent pregnancy loss, and maternal–fetal outcomes, with particular attention to phenotype-specific clinical implications. MEDLINE and Scopus were searched for English-language studies from database inception through March 2026, and the selected evidence was qualitatively synthesized according to the main clinical topics. Available evidence indicates that adenomyosis is associated with impaired fertility through defective endometrial receptivity, progesterone resistance, abnormal uterine peristalsis, chronic inflammation, and immune dysregulation. Adenomyosis has also been associated with miscarriage and adverse obstetric outcomes, including preterm birth, hypertensive disorders, placental dysfunction, fetal growth restriction, and postpartum hemorrhage. Emerging data suggest distinct profiles, with internal adenomyosis more closely related to implantation failure, recurrent pregnancy loss, and placental complications, whereas external adenomyosis is more frequently associated with endometriosis and primary infertility. However, phenotype-specific associations require further validation. Accurate phenotypic characterization may improve reproductive counseling and individualized management. Prospective studies using standardized diagnostic criteria are needed to confirm phenotype-specific risks and develop targeted therapeutic and obstetric strategies.