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At-home abortions safe and effective up to 12 weeks, study finds
At-home abortions should be permitted for up to 12 weeks across the UK, researchers say, after finding they are as safe as procedures carried out in hospital.
The study reviewed outcomes of abortions between 10 and 12 weeks of pregnancy in NHS Lothian, Scotland, from 2020 to 2025.
Medical abortion involves taking two drugs – mifepristone and misoprostol – to end a pregnancy.
The World Health Organization recommends that early medical abortions can be managed safely at home during the first 12 weeks.
Legislation in England and Wales currently limits at-home care to 10 weeks, while Northern Ireland bans it altogether.
Scotland allows it up to 12 weeks.
Heidi Stewart, chief executive of the British Pregnancy Advisory Service, said: “This important study from Scotland adds to the already extensive body of evidence that at-home medical abortion between 10 and 12 weeks’ gestation is safe and effective.
“Thousands of women each year in the UK are being compelled to attend hospital appointments and undergo surgical procedures when, as this research makes clear, they could be treated at home.”
Researchers analysed 14,458 referrals to abortion services. Of these, 485 women (3.5 per cent) were assessed as 10 to 12 weeks pregnant, either by last menstrual period or ultrasound.
The study found that 97 per cent of abortions were successful, whether at home or in hospital.
Complications such as heavy bleeding or infection were rare.
One case of haemorrhage occurred a month later, but researchers said hospital admission at the time of abortion would not have prevented it.
They concluded that medical abortions at home between 10 and 12 weeks are “highly effective and safe.”
The authors said: “In line with WHO guidance, action is needed to extend [early medical abortion] at home up to 12 weeks to women across the rest of the UK and beyond.”
Stewart added: “When the abortion law was first passed in 1967, it was designed to protect and improve women’s health.
“Nearly 60 years later, this legislation is restricting our ability to innovate and develop services in line with clinical practice.
“It is time for parliament to modernise our out-of-date legal framework, and finally allow healthcare professionals to give all women in the UK the best possible care, including the choice of at-home medical abortion throughout the first trimester.”
A new study is the first to systematically examine how severe menstrual symptoms affect working life, exposing a major research gap and the need for more inclusive policies.
Researchers analysed global studies to identify common themes and to map the challenges women face at work.
The work, led by the University of Portsmouth, highlights how little research exists on workplace menstrual health despite evidence that 25 per cent of women experience severe symptoms.
These include cramps, breast tenderness, mood changes, headaches, fatigue and back pain, alongside heavy bleeding, painful periods, anaemia (low red blood cells), irregular cycles, fibroids (non-cancerous growths) and endometriosis (tissue similar to the womb lining growing outside the uterus).
Lead author Amtullah Oluwakanyinsola Adegoke said: “We need to recognise that women and girls menstruate – it’s a natural part of life.
“As members of society, their needs should be acknowledged as part of the life cycle.
“While menopause awareness has grown, menstrual health and endometriosis are still not widely understood.”
While analysing previous data, the researchers found a survey of more than 42,000 women aged 15 to 45 which revealed that one in three experienced symptoms severe enough to interfere with daily activities, including work.
Researchers identified three themes: impact on women’s workplace wellbeing and quality of life; presenteeism and absenteeism linked to symptoms; and organisational practices, policies and menstrual health inclusion programmes.
The study found that supported employees are more productive, take fewer sick days, stay in their roles longer and engage more.
Poor menstrual health support can lead to depression, poor concentration, reduced performance and an overall negative effect on wellbeing.
Only 18 per cent of organisations include some form of menstrual health support within their wellbeing initiatives, and just 12 per cent provide dedicated support.
Professor Karen Johnston from the University of Portsmouth said: “Menstrual health remains a largely neglected area of research.
“The majority of existing studies in medical journals focus on clinical aspects, highlighting the need to use menopause research to support the argument for menstruation. Although other topics have received increased attention in the UK, menstrual health continues to be underexplored.
“It shouldn’t be a taboo topic – it should be part of an organisation’s health and wellbeing agenda.
“Alongside training, organisations should explore flexible working and ways to support employees experiencing severe menstrual problems.”
The study emphasised the importance of creating more inclusive workplaces through supportive measures such as menstrual leave, flexible working, access to hygiene products and encouraging open conversations.
In the UK, there is no legal requirement for paid menstrual leave, so employees typically use standard sick leave.
An overlooked fat-derived hormone may drive higher breast cancer death risk in postmenopausal women with obesity, an analysis suggests.
The review identifies oestrone, a form of oestrogen produced in fat tissue, as a major driver of oestrogen receptor positive (ER+) breast cancer, the most common and deadly form of the disease in postmenopausal women.
ER+ means the cancer grows in response to oestrogen. It also raises the possibility that treatment could be improved with the addition of weight-loss drugs known as GLP-1 receptor agonists.
The analysis was led by Joyce Slingerland, who co-leads the Cancer Host Interaction Program at Georgetown University’s Lombardi Comprehensive Cancer Center in the US.
She said postmenopausal women with obesity are more likely to be diagnosed with ER+ breast cancer and are two to three times more likely to die from it.
Slingerland said: “That’s particularly concerning because it’s estimated that obesity will affect nearly half of women in the United States by the end of the decade.”
Before menopause, the most abundant oestrogen in women is 17β-oestradiol, produced primarily by the ovaries.
After menopause, its levels fall dramatically and oestrone becomes the most abundant form circulating in the blood.
Despite their similar chemical structure, the research suggests these two forms of oestrogen behave very differently.
While 17β-oestradiol turns on genes that reduce inflammation, oestrone does the opposite, activating genes that trigger intense inflammatory activity.
In the context of obesity, levels of oestrone are two to four times higher in fat, breast and other tissues.
The analysis suggests these elevated levels set off a cascade that causes precancerous changes and activates cancer-fuelling genes.
Previous research by the team showed that oestrone-fuelled inflammation activates genes involved in a process that promotes cancer spread.
When researchers treated obese mice with ER+ breast cancer with oestrone, their tumours grew faster and rapidly spread throughout the body compared with mice treated with 17β-oestradiol.
Slingerland said: “Our work has provided some of the causal links between oestrone and the worse outcomes seen in postmenopausal women with ER-positive breast cancer who are obese.
“Simply put, these two oestrogens are not equal to each other.”
The author argues that clinical studies of GLP-1 drugs in women with ER+ breast cancer who have obesity are a logical next step.
Slingerland said: “The GLP-1 drugs have revolutionised weight loss.
“Because of oestrone’s powerful inflammatory effects in fat, there’s real potential that, by inducing weight loss, GLP-1 drugs can pump the brakes on oestrone’s cancer-fuelling behaviour.”
Older women with both insomnia and sleep apnoea show worse verbal memory than those with sleep apnoea alone, a new study has found.
The research revealed that older adults with comorbid insomnia and sleep apnoea, often referred to as COMISA, demonstrated worse memory performance than those with sleep apnoea alone. Sleep apnoea is a condition where breathing repeatedly stops and starts during sleep.
However, when analysed by sex, the association was only significant in women, not men.
The study, conducted by researchers at UC San Diego School of Medicine, involved 110 older adults aged 65 to 83 diagnosed with obstructive sleep apnoea.
Participants completed an overnight sleep study and cognitive testing. COMISA was present in 37 per cent of participants.
Lead author Breanna Holloway, a postdoctoral researcher at UC San Diego School of Medicine, said: “We expected that having both insomnia and sleep apnoea would worsen memory for everyone, but only older women showed this vulnerability.
“That was striking, especially because women typically outperform men on verbal memory tasks.
“The fact that COMISA seemed to offset that advantage hints at a hidden sleep-related pathway to cognitive decline in women.
“Prior studies have shown increased incidence of Alzheimer’s disease in women with untreated sleep apnoea.”
The researchers suggest sex differences in sleep architecture may explain the vulnerability observed in women.
Post hoc analyses revealed that women with COMISA had reduced rapid eye movement (REM) sleep, the stage associated with dreaming and memory consolidation, and more slow wave (deep) sleep compared with men.
Holloway said: “These results point to an overlooked risk in women with both insomnia and sleep apnoea.”
“Because women are more likely to have insomnia and often go undiagnosed for sleep apnoea, recognising and treating COMISA early could help protect memory and reduce dementia risk.”
The researchers noted that the findings support sex-specific screening and treatment strategies.
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