Experience of Medicinal Insects for Gynaecological Diseases / 中医杂志

It is believed that all kinds of gynaecological diseases are mostly related to deficiency and stagnation of qi and blood. Medicinal insects are good at running and scurrying， with the effectiveness of activating blood circulation and dispelling blood stasis， moving qi and relieving pain， searching and dredging collaterals， attacking hardness and dissipating mass， and purging foetus and resolving mass， etc. Appropriate prescriptions can enhance the effectiveness of the formula in eliminating blood stasis and eliminating stagnation. In the treatment of menstrual disorders， chronic pelvic inflammatory disease， uterine cavity disease， incomplete miscarriage， ectopic pregnancy， and other gynaecological diseases， medicinal insects including Quanxie （Scorpio）， Wugong （Scolopendra）， Tubiechong （Eupolyphaga/Steleophaga）， Jiuxiangchong （Coridius chinenses）， Shuizhi （Hirudo）， Mangchong （Tabanus）， Dilong （Pheretima） and other insects for medicinal purposes could be used， and the self-prescribed empirical formulas such as Sanhuang Decoction （三黄汤）， Hongteng Decoction （红藤汤）， Penning Decoction （盆宁方）， Shapei Decoction （杀胚方）， and Gongwaiyun Decoction （宫外孕方） and so on， were all applied medicinal insects and showed effective in clinic.

Prevalence of premenstrual syndrome in female nursing students at a public university: cross-sectional study / Prevalência da síndrome pré-menstrual em acadêmicas do curso de enfermagem de uma universidade pública: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: Premenstrual Syndrome (PMS) is a set of physical, mood, cognitive and behavioral changes which happens between the two weeks before menstruation, which can hinder a woman's personal, academic, and professional performance. The objective of this study was to identify the prevalence of PMS in female nursing students. METHODS: A cross-sectional study using a virtual questionnaire on sociodemographic and gynecological characteristics and the Premenstrual Symptoms Screening Tool (PSST) questionnaire, which looks for physical and psychological symptoms of PMS, interference of symptoms in daily life and establishes a positive screening for PMS. RESULTS: A total of 114 students participated in the study. The most prevalent characteristics were being between 18 and 23 years old, single and in their 5th or 6th academic year. In addition, the majority went through the menarche between 11 and 13 years of age, with menstrual flow of 3-5 days. Of these, 40.4% used hormonal contraceptive methods and 37.7% did not use any type of contraceptive method. The prevalence of PMS was 61.4%. The most frequent symptoms were physical symptoms (93.9%), anger/irritation (91.2%), urge to cry/increased sensitivity (88.6%), anxiety/tension (86.8%) and decreased interest in social activities (85.1%). These symptoms interfere with relationships with family (81.6%), social life activities (80.7%), efficiency at work or college/productivity (79.8%), relationships with colleagues at work/college (77.2%) and responsibilities at home (75.4%). CONCLUSION: PMS is prevalent among female nursing students and its symptoms affect the daily lives of this population, interfering with their personal and social relationships as well as academic activities.

RESUMO JUSTIFICATIVA E OBJETIVOS: A síndrome pré-menstrual (SPM) é um conjunto de alterações físicas, de humor, cognitivas e comportamentais, iniciadas entre as duas semanas prévias a menstruação, que podem causar desgastes no rendimento pessoal, acadêmico e profissional da mulher. O objetivo deste estudo foi identificar a prevalência da SPM em acadêmicas do curso de enfermagem. MÉTODOS: Estudo transversal realizado por meio de um questionário virtual sobre características sociodemográficas e ginecológicas e o questionário Premenstrual Symptoms Screening Tool (PSST), que busca sintomas físicos e psicológicos da SPM, interferência dos sintomas no cotidiano, e estabelece uma triagem positiva para SPM. RESULTADOS: Foram recrutadas 114 acadêmicas da graduação em enfermagem. As características mais prevalentes foram a faixa etária entre 18 e 23 anos, solteiras e cursando o 5° ou 6° período do curso. Ademais, a maioria com menarca entre 11 e 13 anos, com fluxo menstrual de 3 a 5 dias. Destas, 40,4% usavam métodos contraceptivos hormonais e 37,7% não usavam nenhum tipo de método contraceptivo. A prevalência encontrada de SPM foi de 61,4%. Os sintomas mais frequentes foram sintomas físicos (93,9%), raiva/irritação (91,2%), vontade de chorar/aumento da sensibilidade (88,6%), ansiedade/tensão (86,8%) e interesse diminuído nas atividades sociais (85,1%). Estes sintomas interferem no relacionamento com a família (81,6%), nas atividades de vida social (80,7%), na eficiência no trabalho ou faculdade/produtividade (79,8%), nos relacionamentos com os colegas de trabalho/faculdade (77,2%) e nas responsabilidades de casa (75,4%). CONCLUSÃO: A SPM é prevalente entre as acadêmicas do curso de enfermagem e seus sintomas afetam o cotidiano desta população, interferindo nos seus relacionamentos pessoais, sociais e atividades acadêmicas.

Comparison of menstrual cycle irregularities among young women based on coronavirus disease 2019 infection status: a cross-sectional study

SUMMARY OBJECTIVE: The coronavirus disease 2019 pandemic that has emerged recently has significantly affected and continues to affect our lives. The Severe Acute Respiratory Syndrome Coronavirus 2 virus has significant effects on women's health due to gender-related physiological differences. The aim of this study was to compare the menstrual cycle status of young women according to their status of having had coronavirus disease 2019. METHODS: This descriptive cross-sectional study was conducted with 220 young women aged between 18 and 25 years who received at least one dose of coronavirus disease 2019 vaccine. The study data were collected as a survey on the online platform. RESULTS: The descriptive characteristics of young women who had had and had not had coronavirus disease 2019 were distributed homogeneously between the groups (p>0.05). Furthermore, there was no statistical difference in terms of menstrual cycle patterns (p>0.05). The mean scores from the Premenstrual Syndrome Scale and its subscales and the mean scores from the COVID Stress Scale and its subscales were similar in both groups, and no statistically significant difference was identified (p>0.05). CONCLUSION: Although menstrual cycle irregularities due to coronavirus disease 2019 have been reported, these effects are usually observed during the pandemic. A decrease in stress and anxiety with the end of the pandemic may explain the return of the menstrual cycle to normal.

Sports gynecology: a new way to improve female athletes care and performance / Ginecología deportiva: una nueva forma de optimizar atención y el rendimiento de la deportist / Ginecologia do esporte: uma nova maneira de otimizar o cuidado e a performance da mulher atleta

ABSTRACT Introduction: Female participation in sports has reached a milestone in 1972 when a constitutional amendment was implemented to ensure equal opportunities for men and women. Since then, the percentage of participants in competitive sports has grown. In this context became necessary to understand menstrual cycle, contraceptive use, and its individual responses. Objective: To investigate menstrual cycle characteristics, physical and mood symptoms related to vaginal bleeding, and contraceptives used by Brazilian Olympic athletes. Also, to assess if these athletes relate that vaginal bleeding influences sportive performance, how they manage it and what can be changed to improve their health care and sportive performance. Additionally, we propose specialized female care by a gynaecologist specialized in sports medicine. Methods: Descriptive observational study was conducted from July to August 2016 and included 118 Brazilian Olympic female athletes, in menacme. The athletes completed a self-administered online questionnaire, adapted from Pre-Participation Gynaecological Examination of female athletes. Results: Participants practiced 28 different sports, mean age 27 ± 4.7 years. For 66% it was their first participation in an Olympic Game. Most used contraceptives (54%), mainly oral (61%). Most (76%) believed that vaginal bleeding influenced sports performance, and 63% preferred to compete after bleeding cessation. Fifty-eight percent would compete at preferred time of their cycle. Anxiety symptoms, bloating, increased appetite, depression, and dysmenorrhea were indicated by 52%. Among these, 49% reported that these symptoms deteriorated their sportive performance. Conclusion: Most in their first Olympic participation, Brazilian athletes used hormone contraceptives, mainly oral ones to manage and adapt their vaginal bleeding to the competition calendar because most of them referred those physical and mood symptoms deteriorated their sportive performance. The presence of a Sportive Gynaecologist as part of the Olympic Medical Staff highlighted the female athletes issues and helped them to improve sportive performance. Level of Evidence IV; Cross-sectional observational study

RESUMEN Introducción: La participación femenina en deportes alcanzó un hito en 1972, cuando se implementó una reforma constitucional para garantizar igualdad de oportunidades entre hombres y mujeres. Desde entonces, el porcentaje de participantes en deportes competitivos ha crecido. En este contexto, se hizo necesario comprender el ciclo menstrual, el uso de anticonceptivos y sus respuestas individuales. Objetivo: Investigar características del ciclo menstrual, síntomas físicos, estado de ánimo, quejas relacionadas con el sangrado vaginal y los métodos anticonceptivos utilizados por atletas olímpicas brasileñas. Evaluar si estas deportistas perciben influencia del sangrado vaginal en el rendimiento deportivo, cómo lo controlan y qué se puede cambiar para mejorar. Además, ofrecemos atención especializada por una ginecóloga especialista en medicina deportiva. Métodos: Estudio observacional, descriptivo, realizado de julio a agosto de 2016, que incluyó 118 atletas olímpicas brasileñas, en menacme. Las atletas respondieron un cuestionario en línea autoadministrado y adaptado titulado "Examen ginecológico previo a la participación". Resultados: Practicaban 28 deportes diferentes, con edad media = 27 ± 4,7 años. Para 66%, era su primera participación en un juego olímpico. Anticonceptivos usados r54%), principalmente orales (61%). La mayoría (76%) cree que el sangrado vaginal influye en el rendimiento deportivo y 63% prefirió competir después del. El 58% de los atletas competiría en su momento preferido de su ciclo. Los síntomas de ansiedad, hinchazón, aumento del apetito, depresión y dismenorrea fueron indicados por el 52%. Entre estas, 49% deterioró su rendimiento deportivo. Conclusión: En su primera participación olímpica, las atletas brasileñas utilizaron anticonceptivos hormonales, principalmente orales, para controlar y adaptar el sangrado vaginal al calendario de competición, ya que la mayoría relató que los síntomas físicos y anímicos perjudicaban su desempeño deportivo. La presencia de una Ginecóloga Deportiva como parte del Equipo Médico Olímpico destacó los problemas de las atletas y las ayudó a mejorar su rendimiento. Nivel de Evidencia IV; Estudio Observacional.

RESUMO Introdução: A participação feminina no esporte teve um marco importante em 1972, quando uma emenda constitucional foi implementada para garantir a igualdade de oportunidades para homens e mulheres. Desde então, o percentual de participantes em esportes competitivos tem crescido. Nesse contexto tornou-se necessário compreender sobre ciclo menstrual, uso de anticoncepcionais e suas respostas individuais. Objetivo: Investigar características do ciclo menstrual, sintomas físicos e de humor, queixas relacionadas ao sangramento vaginal e métodos contraceptivos usados por atletas olímpicas brasileiras. Avaliar se percebem influência do sangramento vaginal no desempenho esportivo, como elas o controlam e o que pode ser mudado para melhorar seus cuidados e desempenho esportivo. Além disso, propõe-se atendimento específico por ginecologista especializada em medicina esportiva. Métodos: Estudo observacional, descritivo, realizado de julho a agosto de 2016 que incluiu 118 atletas olímpicas brasileiras, na menacme. As atletas responderam a um questionário online autoaplicável e adaptado intitulado "Pre-Participation Gynaecological Examination". Resultados: As participantes praticavam 28 esportes diferentes, com média de idade = 27 ± 4,7 anos. Para 66%, foi a primeira participação em um evento olímpico. A maioria usava anticoncepcional (54%), principalmente oral (61%). A maioria (76%) acredita que o sangramento vaginal influencia o desempenho esportivo e 63% preferiam competir após o mesmo. 58% das atletas competiriam no momento preferido de seu ciclo. Sintomas de ansiedade, distensão abdominal, aumento do apetite, depressão e dismenorreia foram indicados por 52%. Entre esses, 49% deterioraram o desempenho esportivo. Conclusão: Em sua primeira participação olímpica, as atletas brasileiras utilizaram anticoncepcionais hormonais, principalmente orais, para controlar e adaptar o sangramento vaginal ao calendário de competição, pois a maioria referiu que os sintomas físicos e de humor prejudicaram o desempenho esportivo. A presença de uma Ginecologista Esportiva como parte da Equipe Médica Olímpica destacou os problemas das atletas femininas e as ajudou a melhorar o desempenho esportivo. Nível de Evidência IV; Estudo Observacional.

Assessing a cut-off point for the diagnosis of abnormal uterine bleeding using the Menstrual Bleeding Questionnaire (MBQ): a validation and cultural translation study with Brazilian women

ABSTRACT BACKGROUND: Abnormal uterine bleeding (AUB) is a common condition, and the Menstrual Bleeding Questionnaire (MBQ) is used for its assessment. OBJECTIVES: To translate, assess the cut-off point for diagnosis, and explore psychometric properties of the MBQ for use in Brazilian Portuguese. DESIGN AND SETTING: Prospective cohort study including 200 women (100 with and 100 without AUB) at a tertiary referral center. METHODS: MBQ translation involved a pilot-testing phase, instrument adjustment, data collection, and back-translation. Cut-off point was obtained using receiver operating curve analysis. Menstrual patterns, impact on quality of life due to AUB, internal consistency, test-retest, responsiveness, and discriminant validity were assessed. For construct validity, the Pictorial Blood Assessment Chart (PBAC) and World Health Organization Quality of Life - abbreviated version (WHOQOL-BREF) were applied. RESULTS: Women with AUB were older, had higher body mass indices, and had a worse quality of life during menstruation. Regarding the MBQ's psychometric variables, Cronbach's alpha coefficient was > 0.70 in all analyses, high intraclass correlation coefficient was found in both groups; no ceiling and floor effects were observed, and construct validity was demonstrated (correlation between MBQ score, PBAC score, and clinical menstrual cycle data). No difference between MBQ and PBAC scores were perceived after the test-retest. Significant differences were found between MBQ and PBAC scores before and after treatment. An MBQ score ≥ 24 was associated with a high probability of AUB; accuracy of 98%. CONCLUSION: The MBQ is a reliable questionnaire for Brazilian women. The cut-off ≥ 24 shows high accuracy to discriminate AUB.

Desafios da gestão menstrual: uma revisão integrativa / Challenges of menstrual management: an integrative review / Desafíos de la gestión menstrual: una revisión integrativa

Objetivo: analisar as evidências disponíveis na literatura sobre os desafios da gestão menstrual. Método: revisão integrativa da literatura realizada nas bases de dados PubMed, BVS, SciELO e Mendeley, utilizando os descritores "Menstruação", "Produtos de Higiene Menstrual" e "Saúde", para responder à questão norteadora "Quais são as dificuldades e os impactos encontrados pelas pessoas na gestão de suas menstruações?". Resultados: foram incluídos dezessete estudos os quais permitiram a construção de infográfico, que destacou como principais desafios da gestão menstrual.: barreiras culturais e sociais, acesso a produtos de higiene menstrual, infraestrutura e ambientes adequados, educação e conscientização, e impacto na saúde e bem-estar. Considerações finais: barreiras culturais, falta de educação menstrual e acesso limitado a produtos e infraestrutura prejudicam a saúde e o bem-estar das mulheres, impactando suas atividades diárias, no âmbito escolar e/ou profissional. Reconhecer essas questões é crucial para a proposição de intervenções e políticas públicas.

Objective: To analyze the available evidence in the literature regarding the challenges of menstrual management. Method: Integrative literature review conducted in the PubMed, BVS, SciELO, and Mendeley databases, using the keywords "Menstruation," "Menstrual Hygiene Products," and "Health," to answer the guiding question "What are the difficulties and impacts encountered by individuals in managing their menstruation?" Results: Seventeen studies were included, allowing the construction of an infographic that highlighted the main challenges of menstrual management: cultural and social barriers, access to menstrual hygiene products, adequate infrastructure and environments, education and awareness, and health and well-being impact. Final considerations:cultural barriers, lack of menstrual education, and limited access to products and infrastructure negatively impact women's health and well-being, affecting their daily activities, both in educational and/or professional settings. Recognizing these issues is crucial for proposing interventions and public policies.

Objetivos:analizar las evidencias disponibles en la literatura sobre los desafíos de la gestión menstrual. Método: revisión integrativa de la literatura realizada en las bases de datos PubMed, BVS, SciELO y Mendeley, utilizando los descriptores "Menstruación", "Productos de Higiene Menstrual" y "Salud", para responder a la pregunta guía "¿Cuáles son las dificultades y los impactos encontrados por las personas en la gestión de sus menstruaciones?". Resultados: se incluyeron diecisiete estudios que permitieron la construcción de un infográfico, que destacó como principales desafíos de la gestión menstrual: barreras culturales y sociales, acceso a productos de higiene menstrual, infraestructura y entornos adecuados, educación y concienciación, e impacto en la salud y el bienestar. Consideraciones finales: barreras culturales, falta de educación y acceso limitado afectan la salud y bienestar femenino, impactando actividades diarias y profesionales. Reconocer estas cuestiones es crucial para proponer intervenciones y políticas públicas.

Acceso y prácticas de higiene menstrual en América Latina: revisión de alcance / Menstrual hygiene access and practices in Latin America: scoping review / Acesso e práticas de higiene menstrual na América Latina: revisão de escopo

Objetivo: sintetizar la evidencia disponible relacionada con el acceso y las prácticas de higiene menstrual en América Latina y el Caribe. Método: revisión de alcance de la literatura con protocolo de investigación registrado en el Open Science Framework, realizada en las bases de datos bibliográficas: PubMed, Scopus, Web of Science y Portal Regional da Biblioteca Virtual em Saúde. Los datos fueron analizados mediante estadística descriptiva simple y análisis temático. Resultados: se incluyeron 15 publicaciones, la mayoría de las cuales trataban sobre adolescentes en Brasil: 12 artículos, dos informes técnicos y una monografía de trabajo de conclusión de curso. Como temas recurrentes en las publicaciones se destacan: acceso a condiciones dignas para el manejo de la higiene menstrual; necesidad de acceso a información sobre el manejo de la higiene menstrual; y prácticas para el manejo de la higiene menstrual. Conclusión: adolescentes informan dificultades para acceder a baños, agua y materiales absorbentes, y falta de información sobre la salud menstrual, incluso en las escuelas, lo que lleva al ausentismo escolar. De esta manera, las lagunas en la literatura científica latinoamericana revelan desigualdades y diversidad en las experiencias menstruales interseccionadas por categorías como género, clase social y etnia.

Objective: to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean. Method: literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis. Results: 15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene. Conclusion: adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity

Objetivo: sintetizar evidências disponíveis relacionadas ao acesso e práticas de higiene menstrual na América Latina e Caribe. Método: revisão de escopo da literatura com protocolo de pesquisa registrado no Open Science Framework, realizada nas bases de dados bibliográficas: PubMed, Scopus, Web of Science e Portal Regional da Biblioteca Virtual em Saúde. Os dados foram analisados por estatística descritiva simples e análise temática. Resultados: foram incluídas 15 publicações, cuja maioria abordava adolescentes no Brasil: 12 artigos, dois relatórios técnicos e uma monografia de trabalho de conclusão de curso. Como temas recorrentes nas publicações, destacam-se: acesso a condições dignas para o manejo da higiene menstrual; necessidade de acesso à informação sobre manejo da higiene menstrual; e práticas para manejo da higiene menstrual. Conclusão: adolescentes relatam dificuldades de acesso a sanitários, água e materiais absorventes, e falta de informação sobre saúde menstrual, inclusive nas escolas, levando ao absenteísmo escolar. Assim, lacunas na literatura científica latino-americana revelam desigualdades e diversidade nas experiências menstruais interseccionadas por categorias como gênero, classe social e etnia.

Impact of menstrual cycle on smoking cessation: A review / El impacto del ciclo menstrual en el abandono de tabaco: Una revisión

Abstract Background Information on the way menstrual cycle phases can influence the achievement of tobacco abstinence is contradictory. Objective A scope review was conducted to determine the effect of the menstrual cycle on tobacco abstinence, considering the phases of the cycle, hormone levels, and premenstrual syndrome. Method A literature search was conducted in Scopus, PubMed, MEDLINE, and PsycINFO databases. Ten articles comparing the phases of the menstrual cycle or analyzing the association between premenstrual syndrome and a withdrawal condition (length of abstinence or withdrawal symptoms) were included. Results Two main results were identified: 1) there is no difference in withdrawal symptoms and craving between menstrual cycle phases and 2) abstinence rates in the studies were higher during the luteal phase. Discussion and conclusion The advisability of suggesting that women wishing to quit smoking should begin to do so at the start of the luteal phrase is discussed. However, smoking cessation interventions must consider all the symptoms experienced during the luteal phase.

Resumen Antecedentes La información sobre cómo las diferentes fases del ciclo menstrual pueden influir en el logro de la abstinencia de tabaco es contradictoria. Objetivo Se realizó una revisión de alcance con el fin identificar la evidencia relacionada al efecto del ciclo menstrual en la abstinencia de tabaco, considerando las variables fases del ciclo, niveles hormonales y síndrome premenstrual. Método Se llevó a cabo una búsqueda de la literatura en las bases de datos Scopus, PubMed, MEDLINE y PsycINFO. Se incluyeron diez artículos que realizaban comparaciones entre las fases del ciclo menstrual o bien análisis entre el síndrome premenstrual y una condición de abstinencia (tiempo de abstinencia o síntomas de abstinencia). Resultados Se identificaron dos resultados principales 1) no hay diferencia en los síntomas de abstinencia y el deseo por fumar entre las fases del ciclo menstrual y 2) las tasas de abstinencia de los estudios fueron mayores durante la fase lútea. Discusión y conclusión Se discute si en la fase lútea se puede sugerir el inicio de la abstinencia en mujeres que buscan dejar de fumar, sin embargo, las intervenciones para dejar de fumar deben tomar en cuenta todos los síntomas que se experimentan en la fase lútea.

Vacuna contra la COVID-19 y menstruación, desde el desconocimiento a la información: revisión sistemática / Vaccine against COVID-19 and menstruation, from ignorance to information: a systematic review

La creación de una vacuna para enfrentar la pandemia de COVID-19 conllevó un vacío de información sobre las posibles alteraciones del ciclo menstrual. El objetivo fue verificar las posibles alteraciones que se pudiesen haber generado en el ciclo menstrual de las mujeres posterior a la inoculación de la vacuna contra la COVID-19. Se realizó una revisión sistemática en las bases bibliografías Medline, Medline Complete, LILACS, CINAHL y ScIELO, utilizando los descriptores “Women”, “Woman”, “Fertile period”, “Vaccination”, “Mass vaccination”, “Immunization”, “COVID-19 vaccines”, “SARS-CoV-2 infection”, “COVID-19”, “Menstrual cycle”, “Menstruation”, “Endometrial cycle”, “Dysmenorrhea” y “Menstruation disturbances”. Mediante la utilización del protocolo PRISMA, de los 319 artículos localizados, 17 fueron incluidos en el análisis. La mayoría de los estudios incluyeron, principalmente, las vacunas Pfizer, Moderna, AstraZeneca y Johnson&Johnson/Janssen con una a tres dosis administradas. El porcentaje de ciclos menstruales alterados fue del 8,0% al 77,8%, y la alteración con mayor frecuencia referida fue la duración del ciclo menstrual, que fue desde 0,3 hasta 12 días de retraso de la menstruación. Todos los estudios refieren cambios en el ciclo menstrual con diversas prevalencias, con y sin significación estadística; sin embargo, también concluyen que estas alteraciones son reversibles y en un corto periodo de tiempo.

The creation of a vaccine to face the COVID-19 pandemic, led to an information gap on possible alterations of the menstrual cycle. The objective was to verify the possible alterations that could have been generated in the menstrual cycle of women, after the inoculation of the vaccine against COVID-19. A systematic review was carried out in the Medline, Medline Complete, LILACS, CINAHL and ScIELO bibliographic databases, using the descriptors “Women”, “Woman”, “Fertile period”, “Vaccination”, “Mass vaccination”, “Immunization”, “COVID-19 vaccines”, “SARS-CoV-2 infection”, “COVID-19”, “Menstrual cycle”, “Menstruation”, “Endometrial cycle”, “Dysmenorrhea” and “Menstruation disturbances”. Using the PRISMA protocol, of the 319 articles located, 17 were included in the analysis. Most of the studies mainly included the Pfizer, Moderna, AstraZeneca and Johnson&Johnson/Janssen vaccines with one to three doses administered. The percentage of altered menstrual cycles ranged from 8.0% to 77.8%, and the most frequently reported alteration was the length of the menstrual cycle, which occurred from 0.3 to 12 days late in menstruation. All the studies refer to changes in the menstrual cycle with different prevalences, with and without statistical significance; however, the same studies also conclude that these alterations are reversible and in a short period of time.

Características e diferenças nos sintomas dos períodos menstrual e pré-menstrual em mulheres sedentárias / Characteristics and differences in the symptoms of themenstrual and premenstrual periods in sedentary women

Objetivo: estabelecer as diferenças de sintomas físicos e mentais nos períodos menstrual e pré-menstrual em mulheres sedentárias. Métodos: estudo transversal, por questionário, respondido por 77 mulheres saudáveis, de 18 a 35 anos, sedentárias e que não fizessem uso de anticoncepcional continuamente. O questionário incluiu questões sobre dados antropométricos, sintomas físicos e mentais nos períodos menstrual e pré-menstrual. O teste Mann-Whitney comparou os momentos menstrual e pré-menstrual. Resultados: no período menstrual, em uma escala numérica de 0 a 10 pontos, observou-se maiores queixas de dor (7/10), mau humor (7/10), desânimo (8/10), irritabilidade (8/10), ansiedade (7/10), choro (7/10), raiva (9/10) e impacto nas atividades de vida diárias (AVDs) (7/10). Já no período pré-menstrual observou-se queixas de cefaleia (5/10), edema/retenção hídrica (6/10), mau humor (6/10), tristeza (6/10), irritabilidade (7/10), choro (7/10) e raiva (6/10). Quando comparados os períodos menstrual e pré-menstrual, o período menstrual apresentou piores sintomas de dismenorreia (P<0,05), lombalgia (P<0,05), dor nos membros inferiores (P<0,05), dificuldade de concentração (P<0,05), aumento do sono (P<0,05) e desânimo (P<0,05). As voluntárias apontaram 14 sintomas piores, com intensidade igual ou maior que 7 no período menstrual, e apresentaram 9 sintomas com intensidade igual ou maior que 7 no período pré-menstrual. Conclusão: os sintomas no período menstrual são mais intensos quando comparados ao período pré-menstrual e podem afetar AVDs. O presente estudo destaca a importância de análises e cuidados em relação ao período menstrual, já que tem grande impacto nos fatores físicos, mentais e emocionais das mulheres sedentárias.

Objective: to establish the differences in physical and mental symptoms in menstrual and premenstrual periods in sedentary women. Methods: cross-sectional study, through questionnaire, answered by 77 healthy women, aged 18 to 35 years, sedentary and who did not use contraceptives continuously. The questionnaire included questions about anthropometric data, physical and mental symptoms in menstrual and premenstrual periods. The Mann-Whitney test compared menstrual and premenstrual times. Results: in the menstrual period, on a numerical scale from 0 to 10 points, there were more complaints of pain (7/10), bad mood (7/10), discouragement (8/10), irritability (8/10), anxiety (7/10), crying (7/10), anger (9/10) and impact on ADLs (7/10). In the premenstrual period, there were complaints of headache (5/10), edema/water retention (6/10), bad mood (6/10), sadness (6/10), irritability (7/10), crying (7/10) and anger (6/10). When comparing the menstrual and premenstrual periods, the menstrual period had worse symptoms of dysmenorrhea (P<0.05), low back pain (P<0.05), pain in the lower limbs (P<0.05), difficulty concentrating (P<0.05), increased sleep (P<0.05) and discouragement (P<0.05). The volunteers reported 14 worse symptoms, with intensity equal to or greater than 7 in the menstrual period, and 9 symptoms with intensity equal to or greater than 7 in the premenstrual period. Conclusion: the symptoms in the menstrual period are more intense when compared to the pre-menstrual period and can affect the ADLs. This study highlights the importance of analysis and greater care in relation to the menstrual period, as it has a great impact on physical, mental and emotional factors in sedentary women.

Experimental pain thresholds and psychosocial features across menstrual cycle in myofascial orofacial pain compared to healthy individuals: cross-sectional study / Limiares de dor experimental e características psicossociais ao longo do ciclo menstrual na dor miofascial orofacial em comparação com indivíduos saudáveis: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: The hormonal impact on pain perception during the menstrual cycle is a major focus of study, and further elucidation in temporomandibular disorders (TMD) field is necessary. Thus, this cross-sectional study evaluated experimental pain thresholds, psychosocial features, and clinical pain report on TMD women across menstrual cycle versus healthy controls. METHODS: A total of 220 women's clinical files were screened, with 80 selected and divided into control group (healthy individuals, n=40) and TMD group (myofascial pain, n=40). Regarding the menstrual cycle phases, the files were divided into Pre-Luteal and Luteal. The Perceived Stress Scale (PSS), Pain Catastrophizing Scale (PCS), Mechanical Pain Threshold (MPT), Wind-up (WUR), Pressure Pain Threshold (PPT), Conditioned Pain Modulation (CPM) and Visual Analogue Scale (VAS) were analyzed at a 5% significance level, by Two-Way ANOVA test and post hoc Tukey test. RESULTS: PSS and PCS were significantly different between TMD and control group (p<0.001), regardless of menstrual cycle. Healthy individuals in the Luteal phase presented higher MPT values compared to the other phases (p<0.001). PPT showed significant difference across menstrual phases (p=0.022), but no differences in multiple comparisons. VAS values showed no difference between menstrual cycle phases (p=0.376). CONCLUSION: Finally, healthy individuals in the Luteal phase have higher MPT and PPT values on the orofacial region. Pain report in patients with TMD showed no difference throughout the menstrual cycle, showing that small alterations on experimental pain thresholds may not be clinically relevant. The presence of chronic pain seems to be more related to psychosocial features than hormonal fluctuations.

RESUMO JUSTIFICATIVA E OBJETIVOS: O impacto do ciclo menstrual na percepção da dor é um foco importante de estudo, sendo necessária uma maior elucidação na disfunção temporomandibular (DTM). Assim, este estudo transversal avaliou limiares de dor experimental, características psicossociais e relatos de dor em mulheres com DTM ao longo do ciclo menstrual, comparadas com controles saudáveis. MÉTODOS: 220 prontuários de mulheres foram analisados, sendo 80 selecionados para os grupos de controle (saudáveis, n=40) e DTM (dor miofascial, n=40). Nas fases do ciclo menstrual, as pacientes foram divididas nas categorias Pré-Luteal e Luteal. Os instrumentos Escala de Estresse Percebido (PSS), Escala de Pensamentos Catastróficos (PCS), Limiar de Dor Mecânica (MPT), Wind-up Ratio (WUR), Limiar de Dor à Pressão (PPT), Modulação Condicionada da Dor (CPM) e Escala analógica visual (EAV) foram analisados com nível de significância de 5%, pelos testes ANOVA de dois fatores e Tukey post hoc. RESULTADOS: As escalas PSS e PCS foram significativamente diferentes entre os grupos DTM e controle (p<0,001), independentemente do ciclo menstrual. Indivíduos saudáveis na fase luteal apresentaram MPT maior em comparação com outras fases (p,0,001). O PPT mostrou diferença significativa entre as fases menstruais (p=0,022), sem diferença nas comparações múltiplas. Os valores da EAV não apresentaram diferença entre as fases menstruais (p=376). CONCLUSÃO: Indivíduos saudáveis na fase luteal têm MPT e PPTl maior na região orofacial. Os relatos de dor em pacientes com DTM não mostraram diferença ao longo do ciclo menstrual, indicando que pequenas alterações nos limiares experimentais podem ser clinicamente relevantes. A presença de dor crônica parece estar mais relacionada com características psicossociais do que com flutuações hormonais.

Effect of COVID-19 on Menstruation: An Observational Study

Introduction: COVID-19 patients have been reported to have systemic complications. Analyzing its effect on the endocrine system is essential to ensure women’s reproductive health. Aim: This study aimed to determine the effect of COVID-19 disease on menstruation. Methods: It was a hospital-based cross-sectional study conducted from October 2021 to April 2022, using a validated questionnaire to collect the data. The study included females (15 to 49 years) who had confirmed COVID infection. Results: A total of 132 females participated in the study. For 29 (22%) patients presenting with menstrual cycle changes, most common change was prolonged cycle (14%). An increase in menstrual volume was reported by 12%, where as 35% of patients experienced more pain during menstruation. Menstrual irregularities were significantly higher in severe infection (p-value 0.04). Conclusion: There were transient changes in menstruation in COVID-19-infected patients, with a higher probability of menstruation abnormalities among severely infected patients.

A study on menstrual abnormalities among undergraduate students of medical college, Kolkata

Background: Menstruation is a taboo subject among adolescents girl; lack of knowledge regarding the menstruation, menstrual hygiene, and menstrual abnormalities has significant negative influence on young women. Most of the time menstrual abnormalities were not reported timely resulting in their late diagnosis as well as intervention, burdening adolescents and young adult women physically and mentally. Aims and Objectives: This study aimed to identify the menstrual patterns, abnormalities, effects of these abnormalities on the student population in form of social withdrawal, sickness absenteeism, and degrading academic performances. Materials and Methods: A cross-sectional study on menstrual abnormalities among 187 undergraduate students of Medical College Kolkata was conducted to illuminate menstrual problems and its effects on their regular activities. By systematic random sampling technique participants were selected. Questions were related to menstruation, variations in menstrual patterns, dysmenorrhea and its severity, premenstrual symptom, family and medical history in relation to menstrual abnormalities, social withdrawal, monthly sickness absenteeism and degrading of academic performances. Results: The mean age of subjects at menarche was 13.19 ± 0.931 years. Of all the abnormalities, dysmenorrhea was the highest with 84% of prevalence, followed by pre-menstrual symptom with prevalence of 68.4%. Social withdrawal (17.8%), college absenteeism (5.7%), and degrading of academic performance (8.2%) were reported among the students. Conclusion: Menstrual abnormalities must be promptly diagnosed and treated, and students must get counseling addressing these issues if they are to improve their health and quality of life and reduce their chances of developing further illnesses.

NEED FOR IMPROVING THE KNOWLEDGE AND PRACTICES OF ADOLESCENT GIRLS REGARDING MENSTRUAL HYGIENE AND REPRODUCTIVE HEALTH: A STUDY FROM URBANIZED VILLAGES OF NORTH INDIA

Context: In India nearly 71% of adolescent girls have no knowledge about menstruation until menarche. Menstrual practices still face several social, cultural, and religious restrictions and discouragement of open discussion on the topic acts like a major deterrent in the path of menstrual hygiene management. Moreover, lack of knowledge and incorrect practices during menstruation can sometimes have serious health outcomes. Hence, it becomes imperative to ascertain the knowledge of adolescent girls about menstruation and reproductive health and the practices adopted by them during menstruation so that health education programs can to tailored to address the gaps. The study Aims: aims to assess the knowledge of adolescent girls and their current practices with regard to menstrual hygiene and reproductive health and study the association of these with socio-demographic variables. This cross-sectional community based Methods: descriptive study was conducted among 181 adolescent girls selected from two urbanized villages of Meerut district of India using a semi-structured questionnaire. For assessment of level of knowledge a scoring system was developed. Both descriptive and inferential statistics were used for analysis. Based on the scoring, 77.3% of our study participants had overall poor Results: knowledge about menstruation and reproductive health, nearly 20% had satisfactory knowledge and only 2.2% had good knowledge. Most participants reported using sanitary napkins during menses (80.7%) and the remaining were using clean cloth (19.3%). 100% of the participants whose mothers were illiterate had poor knowledge about menstrual hygiene and reproductive health. Participants whose mothers were engaged in semi-skilled or skilled work were more likely to have satisfactory (39.4%) or good (4.3%) knowledge scores. Overall knowledge of our study participants regarding Conclusion: menstrual hygiene and reproductive health was poor; however the practices adopted by them during menstruation were good. The two main impediments in the path of menstrual hygiene management were lack of knowledge and non availability of services at affordable cost

Uso de anticonceptivos y conocimiento del periodo fértil del ciclo menstrual en adolescentes

Introducción: La comprensión de los cambios fisiológicos que se presentan en las mujeres adolescentes son fundamentales para el cuidado de su salud sexual. Esto favorece un comportamiento anticonceptivo orientado a la elección de métodos seguros y eficaces. Objetivo: Establecer la asociación entre el uso de métodos anticonceptivos y el conocimiento del periodo fértil del ciclo menstrual en adolescentes peruanas. Métodos: Estudio transversal basado en el análisis secundario de la Encuesta Demográfica y de Salud Familiar del año 2021. La muestra fue de 717 de mujeres adolescentes con registro completo en las bases de datos. Se calcularon recuentos ponderados, no ponderados y se aplicó la prueba ji cuadrado con un 95 % de nivel de confianza. Resultados: El 19 % de las adolescentes reconocen el periodo fértil del ciclo menstrual y 6,3 % refirió que este periodo sucede durante la menstruación. El 80,8 % de las mujeres que cursan la adolescencia temprana, no conocen el momento del periodo. Respecto al uso de anticonceptivos, el 21,5 % era usuaria de preservativos y 16,3 % de inyectables; no obstante, 47 % señaló que no utilizaban ningún anticonceptivo. El 53,5 % de las adolescentes en etapa tardía indicaron que sí utilizan anticonceptivos. Entre las que son usuarias de estos métodos, 86,3 % no reconocen el periodo fértil. Conclusiones: En las adolescentes, el uso de métodos anticonceptivos no se asocia de manera significativa con el conocimiento que tienen acerca del periodo fértil del ciclo menstrual.

Introduction: The understanding of the physiological changes that occur in adolescent women are essential for the care of their sexual health. Thus, this favors a contraceptive behavior oriented to the choice of safe and effective methods. Objective: To establish the association between the use of contraceptive methods and the knowledge of the fertile period of the menstrual cycle in Peruvian adolescents. Methods: Cross-sectional study based on the secondary analysis of the 2021 Demographic and Family Health Survey. The sample consisted of 717 adolescent women with complete registration in the databases. Weighted and unweighted counts were calculated; and the Chi square test was applied at a 95% confidence level. Results: 19% of adolescents recognize the fertile period of the menstrual cycle and 6.3% reported that this period occurs during menstruation. In addition, 80.8% of women in early adolescence do not know the time of their period. Regarding the use of contraceptives, 21.5% were users of condoms and 16.3% of injectables; however, 47% indicated that they did not use any contraceptive. 53.5% of late-stage adolescents indicated that they do use contraceptives. Among those who are users of these methods, 86.3% do not recognize the fertile period. Conclusions: In adolescents, the use of contraceptive methods is not significantly associated with the knowledge they have about the fertile period of the menstrual cycle.

Reproductive rights of women with intellectual disability in India.

The reproductive rights of women with intellectual disability (WID) are a matter of concern for all stakeholders, including the woman herself, caregivers, guardians and her treating physicians. The judicial system often calls upon psychiatrists to opine regarding the “capacity to consent” of a WID to procedures such as medical termination of pregnancy and permanent sterilisation. Apart from physical and obstetric examinations, assessment of mental status and intelligence quotient (IQ) are also carried out to facilitate an understanding of the above issue. The Rights of Persons with Disabilities Act, 2016, (RPwD) and the Mental Healthcare Act, 2017, elucidate what constitutes free and informed consent as well as how to assess capacity. The assessment process of “capacity to consent” to reproductive system procedures among WID is important and can guide clinicians. Before assessing capacity, the treating physicians should educate a WID with appropriate information on the proposed procedure, its risks and benefits through various means of communication and then evaluate the “capacity to consent” to the procedure. This article summarises the provisions of the existing legislations on the reproductive rights of WID and puts forward guidance for clinicians on how to approach the issue.

Hyperprolactinemia among the patients of menstrual disorders in a tertiary care hospital

Background: Menstrual disorders are a common clinical problem due to multiple causes. Hyperprolactinemia, is disorders of hypothalamic-pituitary axis in young women, is usually associated with amenorrhea, oligomenorrhea, anovulation, and ovulatory cycles with short or inadequate luteal phase, and galactorrhoea. Menstrual disorder affects physical and mental health of every woman. Aims and Objectives: The aim of the study was to know hyperprolactinemia among the patients of menstrual disorders in a tertiary care hospital. Materials and Methods: Women with menstrual irregularities attending Gynae outpatient department and admitted initially checked clinically and their serum prolactin level were measured. Women in reproductive age group (15–45 years) with complain of abnormal uterine bleeding were included in the study. Menopausal women, women with organic diseases in uterus and cervix, and pregnant women were excluded from the study. Results: Prolactin level is statistically significant with age (P = 0.011). The patients from age group of 20 to 35 years had high proportion (14.4%) of hyperprolactinemia followed by age group <20 years. (12.9%) and >35 years (12.9%). The women presenting with menstrual disorders enlisted in the study were evaluated on the basis of their sociodemographic parameters. About (15.5%) were below 20 years. About (27%) were above 35 years and majority of the women (57.5%) enrolled in the study were from age group of 2035 years of age. Serum prolactin level was observed in 15.4% in patients with frequent menses, 9.1% in patients with metrorrhagia and 7.7% in patients with heavy menstrual bleeding. That result was statistically significant with P = 0.039. Conclusion: Serum prolactin level should be evaluated in every patient of menstrual disorders.

Prader-Willi syndrome diagnosed in adulthood: A case report / 中华内分泌代谢杂志

This article reports a case of Prader-Willi syndrome(PWS) diagnosed in adulthood. PWS is a rare genetic disease with most of the reported cases being diagnosed in infancy and childhood, and adulthood case is rarely reported. The patient had insidious symptoms in infancy and was diagnosed as PWS using genetic test in adulthood due to diabetes and menstrual disorders. This article focuses on the patient′s clinical manifestations in adulthood, and reviews relevant literature to improve the understanding of the disease.

Three Cases Demonstrating the Effectiveness of Boiogito Treatment Against Rapid Weight Gain and Edema: Women Suffering from Irregular Menstruation Without Obesity / 日本東洋医学雑誌

We encountered three patients with edema and menstrual disorder that was improved by boiogito. Case 1 was a 17-year-old woman with fatiguability and irritability, treated with kamishoyosan. After adding boiogito to kamishoyosan because of facial and foot edema, palmar sweating and weight gain, her menstrual period became regular. Case 2 was a 15-year-old woman with headache as well as facial and foot edema, who was receiving goreisan. She complained of knee discomfort and worried about weight gain even though she was thin. So we prescribed her boiogito, and her menstrual disorder improved. Case 3 was a 42-year-old woman with fluid retention, who suffered from general fatigue, coldness, and menstrual disorder. She was prescribed boiogito because of weight gain as well as foot edema and coldness, and her menstrual cycle gradually became regular. Boiogito appears to be effective in patients with menstrual disorder who show “exterior deficiency edema” that is maldistribution of fluid on the body surface, such as water retention, sweating, or edema. Boiogito resulted in a feeling of lightness. Even if water retention is not clearly observed, the symptoms of rapid weight gain, edema or edematous feeling, and subjective coldness may be indications for boiogito.

Sugar craving and stress levels during different phases of menstrual cycle among university students

@#Introduction: The menstrual cycle in women is often associated with appetite control, mood, and behavioural changes due to hormonal imbalance. However, levels of sugar craving and stress during pre- and post-menstrual periods have not been thoroughly studied. This cross-sectional study aimed to compare levels of stress and sugar cravings during different phases of menstrual cycle among university students. Methods: Participants aged 19–25 years were assessed for sugar craving and stress during pre- and post-menstrual periods. They were requested to fill out the Sugar Craving Assessment Tool (SCAT) and Perceived Stress Scale (PSS-10) questionnaires on the first day of menses (the pre-menses phase) by recalling how they felt throughout the past seven days. The participants completed the same set of questionnaires again two days after their menses ended (post-menses phase) by recalling how they felt within the previous two days. Results: Ninety-three students participated in the study. Pre-menstrual SCAT score (40.0±19.6) was higher than post-menstrual SCAT score (32.1±19.4), t(91)=4.82, p<0.001. Mean PSS-10 score was also higher before menstruation (22.8±6.2) than after menstruation (17.5±6.1), t(91)=6.26, p<0.001. There was no significant difference in mean sugar craving scores of different stress categories, either during pre-menses [F(2,90)=1.39, p=0.256] or post-menses [F(2,90)=0.89, p=0.415]. Conclusion: The findings indicate that levels of sugar craving and stress were higher during pre-menstrual phase compared to post-menstrual phase in young adults. However, whether sugar cravings are linked to stress during the menstrual cycle is inconclusive and requires further investigation.