This week at Contemporary OB/GYN®, we covered topics ranging from the efficacy of HPV vaccination toward preventing cervical cancer to the FDA approval of gepotidacin as an uncomplicated urogenital gonorrhea therapy. Click the links below to read anything you might have missed from Monday, December 8 to Friday, December 12, 2025.

Jo Morrison, BM BCh, highlights HPV vaccination to prevent cervical cancer

In an interview with Contemporary OB/GYN, Jo Morrison, BM BCh, consultant gynecological oncologist at the University of Exeter in England, discussed the robust evidence demonstrating that human papillomavirus (HPV) vaccination directly prevents cervical cancer—moving far beyond a simple association.

Morrison explained that randomized controlled trials and large-scale population studies now offer converging lines of evidence that clearly establish a causal relationship. While observational studies traditionally suggest association only, the consistent direction and magnitude of findings across study types confirm that HPV vaccination fundamentally reduces cervical cancer risk.

Brexanolone shows rapid, sustained relief in postpartum depression

Brexanolone has demonstrated strong effectiveness for the treatment of postpartum depression, with study results showing rapid, sustained improvements in both depressive and anxiety symptoms, according to Melanie Barrett, MD, psychiatrist at LifeStance Health.

In the study discussed, participants received a continuous 60-hour intravenous infusion of brexanolone over approximately 2.5 days. Women experienced significant reductions in depressive symptoms from the start of treatment through the end of the infusion, and these therapeutic benefits were sustained for up to 12 months of follow-up, highlighting both the rapid onset and durability of response.

George L. Maxwell, MD, discusses phase 3 SUNFLOWER trial to evaluate Mirena for nonatypical endometrial hyperplasia

Bayer recently announced the initiation of SUNFLOWER, a phase 3 study evaluating the efficacy and safety of the 52-mg levonorgestrel-releasing intrauterine system (Mirena) for nonatypical endometrial hyperplasia (NAEH). Approximately 121 in 100,000 women develop NAEH annually, and no FDA-approved medical treatments currently exist. The condition represents benign endometrial thickening and may result in heavy bleeding, abnormal bleeding, or postmenopausal bleeding. If untreated, NAEH may progress to uterine cancer.

George L. Maxwell, MD, president of women’s services for the Inova Health System and a gynecologic oncologist, emphasized the clinical need. “We don't have any medically or FDA-approved medical intervention for the treatment of non-atypical endometrial hyperplasia,” he said. “There's probably around 10% of these lesions that have unchecked or untreated can progress to cancer.”

FDA approves gepotidacin (Blujepa) oral therapy for uncomplicated urogenital gonorrhea

The FDA has approved the supplemental new drug application (sNDA) for gepotidacin (Blujepa; GSK) as an oral treatment option for uncomplicated urogenital gonorrhea in patients aged 12 years and older weighing at least 45 kg, and who have limited or no alternative options for the treatment of uncomplicated urogenital gonorrhoea caused by susceptible strains of Neisseria gonorrhoeae. The approval provides a noninjectable alternative to existing standard therapy for this sexually transmitted infection.

Tony Wood, chief scientific officer at GSK, said, "We're proud to have delivered the first new class of antibiotics for gonorrhoea in over three decades and a new oral option for US patients. The ability of N. gonorrhoeae to develop resistance to currently available options, including standard of care, makes it important to expand the range of effective oral treatments".

Approval of the supplemental indication was supported by findings from the phase 3 EAGLE-1 clinical trial, published in The Lancet. In the microbiological intention-to-treat population (n=406), microbiological success occurred in 92.6% (187/202; 95% CI, 88.0–95.8) of gepotidacin recipients and 91.2% (186/204; 95% CI, 86.4–94.7) of participants receiving ceftriaxone plus azithromycin, meeting the prespecified noninferiority criteria. No bacterial persistence at the urogenital site was reported in either group.

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First-trimester metformin use linked to pregnancy outcomes in PCOS patients

In a recent study published in the American Journal of Obstetrics & Gynecology, continuing preconception metformin through the first trimester was associated with greater clinical pregnancy rates and a signal toward fewer miscarriages compared with placebo or no treatment, while discontinuation at pregnancy confirmation was linked to different outcome patterns.

For miscarriage, continuation of metformin through the first trimester was associated with a lower odds ratio compared with placebo or no treatment (OR, 0.64; 95% CI, 0.32–1.25; I² = 0%; 4 studies; 544 women; low-quality evidence). In contrast, discontinuation of metformin after a positive pregnancy test was associated with a higher odds ratio for miscarriage compared with placebo or no treatment (OR, 1.46; 95% CI, 0.73–2.90; I² = 0%; 6 studies; 794 women; low-quality evidence).

Clinical pregnancy rates were greater among women who continued metformin through the first trimester compared with placebo or no treatment (OR, 1.57; 95% CI, 1.11–2.23; I² = 19%; 3 studies; 537 women; moderate-quality evidence). An increase in clinical pregnancy was also observed among women who discontinued metformin after pregnancy confirmation compared with placebo or no treatment (OR, 1.35; 95% CI, 1.01–1.80; I² = 27%; 8 studies; 1164 women; low-quality evidence).

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