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.

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.

Objectives: To evaluate the impact of hormonal therapy on the evolution of painful symptoms in premenopausal women with adenomyosis, with or without concomitant endometriosis, over an 18-month follow-up period. This study aimed to compare the symptomatic progression between treated and untreated patients, highlighting the potential role of medical therapy in symptom control and disease stabilization. Secondary, an objective was to explore sonographic changes within our study population, in parallel with clinical outcomes. Methods: This retrospective observational study, conducted at the Endometriosis Referral Center of the University Hospital of Siena, included 40 women with ultrasound evidence of adenomyosis with and without endometriosis. The population was divided into two groups: 20 patients receiving hormone treatment and 20 not receiving hormone treatment. All patients underwent clinical and ultrasound examinations throughout an 18-month follow-up period, during which types, locations, degrees of disease, and associated symptoms were evaluated. Results: Forty patients enrolled in the study presenting with symptoms such as dysmenorrhea, dyspareunia, and heavy menstrual bleeding were included. A total of 22 patients showed isolated adenomyosis, while 18 adenomyosis and endometriosis both. The mean age was 38.5 years (±4.2 SD), with 57.5% being nulliparous. The types of adenomyosis detected were focal in 25%, diffuse in 50%, and mixed (both focal and diffuse) in 25%. Disease severity was classified as mild in 15%, moderate in 45%, and severe in 40%. After 18 months of continuous hormonal therapy, a reduction in focal adenomyosis was observed in 10%, and an improvement of dysmenorrhea and Heavy Menstrual Bleeding (HMB) was noted, while a slight ameliorating of dyspareunia was detected. In contrast, untreated patients showed either unchanged or worsened symptoms. Conclusions: The findings underscore the value of medical therapy in the management of adenomyosis, supporting current recommendations. Given the heterogeneity of clinical presentations and frequent overlap with endometriosis, a personalized treatment approach remains essential. Further larger-scale, long-term studies are needed to confirm these preliminary results and explore the potential impact on fertility preservation.

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.

Background: Nutritional status and lifestyle factors are increasingly recognized as relevant modulators of women’s reproductive health. However, data remain limited on the relationship between body composition, dietary habits, and menstrual cycle characteristics in apparently healthy young women. This study aimed to assess nutritional status, body composition, and lifestyle behaviors in young women and to explore their associations with menstrual cycle regularity. Methods: This cross-sectional study included 49 apparently healthy women aged 19–30 years. Anthropometric measurements and body composition were assessed using bioelectrical impedance analysis. Dietary habits were evaluated through a simplified food frequency questionnaire, and adherence to the Mediterranean diet was assessed using the PREDIMED score. Physical activity was estimated using MET values based on the Compendium of Physical Activities. Menstrual cycle characteristics were collected via questionnaire. Group comparisons were performed between women with regular and irregular menstrual cycles. Results: The sample was predominantly normal-weight (mean BMI 22.36 ± 4.26 kg/m²). Anthropometric and bioelectrical impedance parameters did not differ significantly between women with regular and irregular cycles. Women with irregular cycles showed higher resistance and extracellular water and lower phase angle and body cell mass, although differences were not statistically significant. A significant association was found for meat consumption, which was lower in women with irregular cycles (p = 0.007). No associations were observed for other dietary variables, physical activity, or meal frequency. Conclusions: Menstrual regularity in young women was not associated with major anthropometric differences but may be linked to subtle aspects of nutritional status and dietary habits. Lower meat consumption emerged as a potential dietary factor associated with menstrual irregularity. Although associations were modest, these findings support the relevance of nutritional and lifestyle factors in menstrual health. Larger longitudinal studies are needed to clarify these relationships.