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.

Investigation of familial tendency of endometriosis / 中华妇产科杂志

Objective: To investigate the familial heritability of endometriosis and to compare the clinical characteristics of patients with or without a family history of endometriosis. Methods: From January 2020 to June 2022, 850 patients with endometriosis confirmed by laparotomy or laparoscopy in Peking University Third Hospital were included in this study. Clinical data were collected, family history was followed up, and the differences of clinical indicators between patients with and without family history of endometriosis were compared. Results: A total of 850 patients were enrolled, with an average age of (33.8±7.0) years old, 315 (37.1%, 315/850) patients in stage Ⅲ and 496 (58.4%, 496/850) patients in stage Ⅳ. There were 100 patients with family history of endometriosis, accounting for 11.8% (100/850). Most of the 113 relatives involved were mothers, daughters and sisters (76.1%, 86/113), 81.5% (22/27) of the second and third degree relatives were maternal relatives. The median ages of patients with and without family history of endometriosis were 30 and 33 years old respectively at the time of diagnosis. The unmarried rate of patients with family history was higher [42.0% (42/100) vs 26.3% (197/750)]. The percentage of dysmenorrhea patients with family history was higher [89.0% (89/100) vs 55.5% (416/750)]. The medians of dysmenorrhea score in patients with and without family history were 6 and 2, and the median durations of dysmenorrhea were 10 and 1 years. There were significant differences in age, marital status, percentage of dysmenorrhea, dysmenorrhea score and duration (all P<0.001). The median levels of serum cancer antigen (CA) 125 in patients with family history and patients without family history at the time of diagnosis were 57.5 and 46.9 kU/L respectively, with a statistically significant difference (P<0.05). However, there were no significant differences between the two groups in nationality, bady mass index, menarche age, menstrual cycle, menstrual period, menstrual volume, serum CA19-9 level, cyst location and size, stage, history of adverse pregnancy and childbirth, infertility, adenomyosis and deep infiltrating endometriosis (all P>0.05). By comparing the specific conditions of dysmenorrhea patients with and without family history of endometriosis, there were no significant differences between the two groups in terms of the age of onset of dysmenorrhea, duration of dysmenorrhea, primary and secondary dysmenorrhea, and progressive aggravation of dysmenorrhea (all P>0.05). The difference in the degree of dysmenorrhea in dysmenorrhea patients with family history of endometriosis was significant (P<0.001). Conclusions: The incidence of endometriosis has a familial tendency, and most of the involved relatives are the first degree relatives. Compared with patients without family history of endometriosis, endometriosis patients with family history are diagnosed at an earlier age, with higher percentage of dysmenorrhea, had more severe dysmenorrhea and higher serum CA125 level.

Prevalencia de síndrome de ovario poliquístico en pacientes que acudieron a una consulta de ginecología-obstetricia y endocrinología en La Romana, República Dominicana, durante el período enero 2019-enero 2020 / Prevalence of polycystic ovary syndrome in patients who attended a gynecology-obstetrics and endocrinology private practice in La Romana, Dominican Republic during the period January 2019-January 2020

Introducción: el síndrome de ovario poliquístico (SOP) es un trastorno endocrino metabólico altamente dominante, el cual es considerado como una de las afecciones más comunes en las mujeres, tanto adolescentes como adultas durante su etapa fértil. Presenta una prevalencia de aproximadamente un 21 % a nivel global. Objetivo: determinar la prevalencia del síndrome de ovario poliquístico en pacientes que acudieron a una consulta de ginecología-obstetricia y endocrinología en la Romana, República Dominicana. Metodología: estudio observacional, retrospectivo, analítico y de corte transversal en el que se analizaron 252 récords médicos de distintas pacientes con y sin SOP para determinar la prevalencia de esta. Como herramienta de estudio se utilizó un formulario creado por el asesor y colaboradores, que se aplicó a los récords médicos empleando los criterios de Rotterdam como determinantes para el diagnóstico del SOP. Resultados: los resultados mostraron que un 67 % de las mujeres no presentaron SOP, correspondiendo a 170 pacientes, mientras que las 82 pacientes restantes presentaron SOP, representando un 33 %. Asimismo, el grupo etario con mayor frecuencia de SOP correspondió al rango de 26 a 35 años con un 52.4 %. Por otra parte, se presentaron más pacientes con SOP no obesas con un 71 %. Con relación a la presencia de ciclos menstruales regulares e irregulares, las pacientes irregulares con SOP indicaron un 47.6 % y las pacientes regulares sin SOP indicaron un 16.7 %, resultando que se acepta la hipótesis nula. Conclusiones: la prevalencia de síndrome de ovario poliquístico fue de un 33 %. El rango de edad más frecuente fue de 26 a 35 años. Predominó la presencia de pacientes con SOP no obesas. La comparación de las pacientes con ciclos menstruales irregulares fue mayor para aquellas que padecen SOP

Introduction: Polycystic ovary syndrome (PCOS) is a highly dominant endocrine metabolic disorder, which is considered one of the most common conditions in women, both adolescents and adults during their fertile stage. It has a prevalence of approximately 21% globally. Objectives: To determine the prevalence of polycystic ovary syndrome in patients who attended a gynecology-obstetrics and endocrinology consultation in la Romana, Dominican Republic. Methodology: An observational, retrospective, analytical and cross-sectional study in which 252 medical records of different patients with and without PCOS were analyzed to determine its prevalence. As a study tool, a form created by the advisor and collaborators was used, which was applied to medical records, the Rotterdam criteria were employed as determinants for the diagnosis of PCOS. Results: The results showed that 67% of the women did not present PCOS corresponding to 170 patients, while the remaining 82 patients presented PCOS representing 33%. Likewise, the age group with the highest frequency of PCOS corresponded to the range of 26 to 35 years with 52.4%. On the other hand, there were more non-obese PCOS patients with 71%. Regarding the presence of regular and irregular menstrual cycles, irregular patients with PCOS indicated 47.6% and regular patients without PCOS indicated 16.7%, resulting in the acceptance of the null hypothesis. Conclusions: The prevalence of polycystic ovary syndrome was 33%. The most frequent age range was 26 to 35 years. The presence of non-obese PCOS patients predominated. The comparison of patients with irregular menstrual cycles was higher for those with PCOS

Attitude and knowledge of women between 45 and 65 years on menopause syndrome at the university college hospital, Ibadan, Nigeria

This research was designed to find out the attitude and knowledge of women between 45 and 65 years on menopause syndrome and its management. The study was conducted in University College Hospital located in Ibadan North Local Government of Oyo state. A self-designed forced-choice questionnaire was distributed to 100 women using random sampling technique. Furthermore, our study showed that most women view the onset of menopause positively and that few seek treatment. They report relatively low prevalence of menopausal symptoms, with the most significant being irregular menstrual cycles and increased blood pressure and urinary tract infections. Furthermore, our study revealed that 41% of the participants had no idea why their menstrual period stopped, while why 60% of the women had no idea what could be done to reduce menopausal symptoms. This study reveals a low level of awareness about menopausal syndrome and more should be done. (Afr J Reprod Health 2022; 26[5]: 57-62).

Mapping changes in women's visual functions during the menstrual cycle: narrative review

ABSTRACT BACKGROUND: This article systematically updates the literature on changes in visual functions during the phases of the normal menstrual cycle in women. OBJECTIVES: To update Guttridge's 1994 review of visual structures and functions associated with the menstrual cycle and broaden the search through psychophysical, neuroimaging and neurobehavioral measurements covering 1994-2020. DESIGN AND SETTING: Narrative review conducted in a neurosciences and behavior laboratory in Brazil. METHODS: The PubMed, Cochrane Clinical Answers and Google Scholar databases were searched. After screening and applying the eligibility criteria, 32 articles were examined. Through this analysis, the following information was extracted: (1) geographical distribution of the study; (2) sample size (according to age and phase of the menstrual cycle); (3) type of measurements according to psychophysical, neuroimaging and neurobehavioral instruments; (4) vision testing model; (5) visual subcategory evaluated; (6) categories of processed visual stimuli; and (7) main findings. RESULTS: The menstrual phases give rise to significant changes in visual functions, including in relation to orientation and spatial attention, visual campimetry and visual sensitivity. These relate specifically to the follicular and luteal phases. CONCLUSIONS: These findings theoretically expand the effects of menstrual cycles on visual functions found by Guttridge (1994). Despite some inconsistencies in the studies analyzed, it was found that visual processing during the follicular and luteal phases of the normal menstrual cycle of healthy women can explain physiological, cognitive, behavioral and social modulations.

Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study / Associação entre sobrepeso e anovulação consistente em mulheres inférteis com ciclo menstrual regular: Um estudo de caso-controle

Abstract Objective It has been suggested that excess body weight could represent a risk factor for infertility outcomes. The present study aimed to evaluate the association of overweight and anovulation among infertile women with regular menstrual cycles. Methods We conducted a retrospective case-control study with consistently anovulatory patients undergoing assisted reproduction treatment. The patients were stratified into normal weight (body mass index [BMI]: 18.5-24.9kg/m2) and overweight (BMI: 25.0- 29.9kg/m2).Those with polycystic ovary syndrome or obesity were excluded. The groups were matched for age, duration of infertility, prolactin, follicle stimulating hormone (FSH), thydroid stimulating hormone (TSH), luteinizing hormone (LH), and estradiol levels. Results Overweight was significantly associated with anovulation, when using the World Health Organization (WHO) criteria for anovulation: progesterone levels>5.65 ng/ml and ultrasonography evidence of follicle collapse (odds ratio [OR]: 2.69; 95% confidence interval [CI95%]: 1.04-6.98). Conclusion Body mass index above the normal range jeopardizes ovulation among non-obese infertile women with regular menstrual cycles.

Resumo Objetivo O excesso de peso corporal tem sido associado como fator de risco para infertilidade. Este estudo teve como objetivo avaliar a associação de sobrepeso e anovulação entre mulheres inférteis com ciclos menstruais regulares. Métodos Realizamos um estudo retrospectivo de caso-controle com mulheres com anovulação consistente em tratamento por reprodução assistida. As pacientes foram estratificadas entre aquelas com peso normal (índice de massa corporal [IMC]: 18,5- 24,9 Kg/m2) e as com sobrepeso (IMC: 25,0-29,9 Kg/m2). As pacientes com síndrome do ovário policístico ou obesidade foram excluídas. Os grupos foram pareados por idade, duração da infertilidade, níveis de prolactina, hormônio folículo-estimulante (FSH), hormônio tiroestimulante (TSH), hormônio luteinizante (LH) e estradiol. Resultados O excesso de peso associou-se significativamente à anovulaçãoquando usados os critérios de anovulação da Organização Mundial de Saúde (OMS): níveis de progesterona>5,65 ng/ml e evidência ultrassonográfica de colapso folicular (razão de chances [RC]: 2,69; IC95%: 1,04-6,98). Conclusão O IMC acima da faixa normal compromete a ovulação em mulheres inférteis não obesas com ciclos menstruais regulares.

Experiências das mulheres quanto às suas trajetórias até o diagnóstico de endometriose / Experiencias de mujeres en cuanto a sus trayectorias hasta el diagnóstico de endometriosis / Experiences of women regarding their pathways to the diagnosis of endometriosis

Resumo Objetivo descrever as experiências das mulheres sobre as suas trajetórias desde o início dos sintomas até o diagnóstico da endometriose. Método pesquisa descritiva, qualitativa, realizada com dez mulheres com diagnóstico de endometriose no município do Rio de Janeiro (RJ), Brasil. Coletaram-se entrevistas semiestruturadas áudio gravadas e posteriormente submetidas à Análise de Conteúdo por meio do software Atlas.ti 8. Resultados sem o diagnóstico de endometriose, as mulheres vivenciam sintomas fortes desde a menarca. Essa situação repercute negativamente em diferentes esferas da vida, inclusive pela desvalorização de suas queixas em seus círculos de convivência. Assim, entende-se a importância da rede de apoio perante essa situação. Diante desse contexto, as mulheres peregrinam por diversos profissionais até o diagnóstico definitivo. Considerações finais e implicações para a prática as trajetórias dessas mulheres são marcadas pela desvalorização de suas queixas por profissionais de saúde e pessoas próximas, pela naturalização da dor feminina e pela dificuldade em estabelecer um diagnóstico diferencial. No entanto, a capacidade individual de reconhecer a presença de uma patologia, o conhecimento sobre a endometriose e a experiência do profissional facilitaram o diagnóstico. No contexto da assistência de enfermagem, entender essa trajetória pode promover a escuta ativa, melhor valorização das queixas, avaliação clínica e o encaminhamento para o diagnóstico precoce.

Resumen Objetivo describir las vivencias de las mujeres en sus trayectorias desde el inicio de los síntomas hasta el diagnóstico de endometriosis. Método investigación descriptiva cualitativa realizada con diez mujeres diagnosticadas con endometriosis en la ciudad de Río de Janeiro (RJ), Brasil. Se recogieron entrevistas semiestructuradas grabadas en audio y posteriormente se sometieron a Análisis de Contenido utilizando el software Atlas.ti 8. Resultados sin el diagnóstico de endometriosis, las mujeres experimentan síntomas fuertes desde la menarquia. Esta situación tiene un impacto negativo en diferentes ámbitos de la vida, incluso por la devaluación de sus quejas en sus círculos de convivencia. Así, se comprende la importancia de la red de apoyo en esta situación. Ante este contexto, las mujeres deambulan por diferentes profesionales hasta el diagnóstico definitivo. Consideraciones finales e implicaciones para la práctica las trayectorias de estas mujeres están marcadas por la devaluación de sus quejas por parte de los profesionales de la salud y personas cercanas, por la naturalización del dolor femenino y por la dificultad para establecer un diagnóstico diferencial. Sin embargo, la capacidad del individuo para reconocer la presencia de una patología, el conocimiento sobre la endometriosis y la experiencia del profesional facilitaron el diagnóstico. En el contexto del cuidado de enfermería, comprender esta trayectoria puede promover la escucha activa, mejor valoración de las quejas, evaluación clínica y la derivación para diagnóstico precoz.

Abstract Objectives to describe the experiences of women on their trajectories from the beginning of symptoms to the diagnosis of endometriosis. Method descriptive, qualitative research, conducted with ten women diagnosed with endometriosis in the city of Rio de Janeiro (RJ), Brazil. Audio recorded semi-structured interviews were collected and later submitted to Content Analysis using Atlas.ti 8 software. Results without the diagnosis of endometriosis, women experience strong symptoms from the menarche. This situation has a negative impact on different spheres of life, including the devaluation of their complaints in their circles of coexistence. Thus, the importance of the support network in this situation is understood. Faced with this context, women wander through various professionals until the definitive diagnosis. Final considerations and implications for practice the trajectories of these women are marked by the devaluation of their complaints by health professionals and people close to them, by the naturalization of female pain and by the difficulty in establishing a differential diagnosis. However, the individual's ability to recognize the presence of a pathology, the knowledge about endometriosis and the professional's experience facilitated the diagnosis. In the context of nursing care, understanding this trajectory can promote active listening, better appreciation of complaints, clinical assessment and referral to early diagnosis.

Fatores associados à síndrome pré-menstrual e ao transtorno disfórico pré-menstrual em estudantes da área de saúde / Factors associated with premenstrual syndrome and dysphoric disorder in health students

O estudo avaliou a frequência da síndrome pré-menstrual (SPM) e do transtorno disfórico pré-menstrual (TDPM) e fatores associados entre estudantes de cursos da área de saúde em uma universidade no Recife, Brasil. Realizou-se um corte transversal envolvendo 649 estudantes entre 18 e 47 anos, no período de setembro/2016 a março/2017. As estudantes que aceitaram participar do estudo e assinaram o termo de consentimento livre e esclarecido responderam a um questionário autoaplicável com dados sociodemográficos, hábitos de vida e antecedentes ginecológicos, bem como questões relacionadas aos critérios diagnósticos de SPM/TDPM. A maioria das estudantes tinha entre 18 e 24 anos (83,2%), era solteira (92,1%), morava com os pais (77,0%) e não trabalhava (84,4%). A frequência de SPM simples foi de 23,3% e da TDPM, de 26,7%. Os sinais e sintomas físicos foram os mais frequentes (84,1%) entre as estudantes com SPM. As 173 estudantes com TDPM relataram como sintomas mais frequentes a irritabilidade (89,6%) e a ansiedade (87,3%) acentuadas. O teste de qui-quadrado foi utilizado para comparar as proporções entre os fatores associados à SPM e ao TDPM, considerando p < 0,05. Os fatores de risco que tiveram associação estatística com a ocorrência de SPM/TDPM foram o índice de massa corporal (IMC) < 25 (p = 0,01) e irregularidade dos ciclos (p = 0,04).(AU)

This study evaluated the frequency of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) and associated factors among university students in health courses in Recife, Brazil. A cross-sectional study was carried out involving 649 students aged 18 to 47 years between September 2016 and March 2017. Students who agreed to participate in the study and signed a free informed consent form, was invited to answer a self-administered questionnaire with socio-demographic data, lifestyle and gynecological history, as well as issues related to the diagnostic criteria of PMS/PMDD. Most students were between 18 and 24 years old (83.2%), single (92.1%), living with parents (77.0%) and did not have a job (84.4%). The frequency of simple PMS was 23.3% and PMDD was 26.7%. Physical signs and symptoms were the most frequent (84.1%) among students with PMS. The 173 students with PMDD reported more frequent symptoms of irritability (89.6%) and anxiety (87.3%). The Pearson chi-square test was used to compare the proportions of the factors associated with PMS and PMDD, considering p < 0.05. BMI < 25 (p = 0.01) and cycle irregularity (p = 0.04) were the factors who had a statistically significant association with the occurrence of PMS/PMDD.(AU)

Acceptability and safety of the menstrual cup: A systematic review of the literature / Aceptabilidad y seguridad de la copa menstrual: revisión sistemática de la literatura

RESUMEN Objetivo: realizar una búsqueda sistemática de la literatura para evaluar la aceptabilidad y seguridad de la copa menstrual como producto de higiene genital femenina. Materiales y métodos: se realizó búsqueda en las bases de datos PubMed, Cochrane Library, Scopus, PopLine y Google Scholar, desde 1966 hasta julio de 2019. Se utilizaron los términos: "Menstrual" AND "Cup" OR "Copa" AND "Menstrual". Se incluyeron estudios cuantitativos, cualitativos y mixtos, series y reportes de caso publicados en inglés y español que hubieran evaluado la copa menstrual en mujeres en edad reproductiva. Los estudios fueron selecciona- dos y los datos fueron extraídos por dos evaluadores de manera independiente. Como resultado primario se evaluó la aceptabilidad y seguridad. La síntesis de información se presenta de manera narrativa. Resultados: se encontraron 737 títulos para revisión inicial. Finalmente, se incluyeron 38 estudios. La copa menstrual tiene una aceptabilidad que varía entre el 35 y el 90 %. Del 10 al 45 % la encontraron difícil de usar. Fue descrita como más cómoda comparada con el tampón y la toalla higiénica de fabricación industrial. La continuidad de su uso está entre el 48 y el 94 %. En cuanto a la seguridad se presentó un caso de síndrome de choque tóxico, uno de atrapamiento mecánico, uno de alergia al producto y mayor riesgo de expulsión en usuarias del dispositivo intrauterino. Conclusión: la copa menstrual es una alternativa cómoda, segura y eficiente para la higiene mens- trual. Se requieren más estudios controlados alea- torizados y cohortes prospectivas a largo plazo para determinar el riesgo de complicaciones por una exagerada colonización bacteriana o menstruación retrógrada.

ABSTRACT Objective: To conduct a systematic review of the literature and assess the acceptability and safety of the menstrual cup as a feminine hygiene product. Materials and methods: A search was conducted in the PubMed, Cochrane Library, Scopus, PopLine and Google Scholar databases for publications be- tween 1966 and July 2019. The terms ("Menstrual" AND "Cup") OR ("Copa" AND "Menstrual") were used. Quantitative, qualitative and mixed studies were included, as well as case series and case reports published in English and Spanish assessing the menstrual cup in women in childbearing age. The studies were selected and the data extracted by two reviewers working independently. Acceptability and safety were assessed as the primary result. The summary of the information is presented in narrative form. Results: Overall, 737 titles were found for initial review and, in the end, 38 studies were included in this work. The acceptability of the menstrual cup ranges between 35 % and 90 %. Between 10 to 45 % of women found it difficult to use. It was described as more comfortable when compared to tampons and pads. Continued use of the cup ranges between 48 and 94 %. In terms of safety, there was one case of toxic shock syndrome, one case of mechanical entrapment, and another case of allergy; and a higher risk of expulsion was found among intrauterine device users. Conclusion: The menstrual cup appears to be a comfortable, safe and efficient option for menstrual hygiene. Further randomized controlled studies and long-term prospective cohort studies are needed in order to determine the risk of complications due to excess bacterial colonization or retrograde menstruation.

A dismenorreia e suas consequências em estudantes universitárias no Rio de Janeiro / Dysmenorrhea and its consequences in university students in Rio de Janeiro

Objetivo: Avaliar a prevalência da dismenorreia e suas consequências em uma população universitária. Métodos: Trata-se de um estudo descritivo, transversal, com 207 mulheres entre 18 e 46 anos de idade, universitárias. Os sujeitos da pesquisa responderam a um questionário desenvolvido para esse estudo. Resultados: A prevalência global de dismenorreia, entre as universitárias, foi de 84,1%; dessas, 58,6% classificaram a dor em intensidade leve a moderada e 41,4%, em intensa. O absenteísmo escolar e a dificuldade para se concentrar nos estudos durante o período menstrual foram significativamente influenciados pela dismenorreia intensa. Entre as estudantes, 60,9% deixaram de fazer atividades físicas ou de lazer e 41% tinham dificuldade para se concentrar e estudar devido à dismenorreia. Conclusão: A dismenorreia tem uma elevada prevalência na população universitária, contribuindo para um aumento do absenteísmo escolar e para um prejuízo social. A maioria utiliza a automedicação e poucas procuram atendimento médico eletivo com a finalidade de resolver esse problema.(AU)

Objective: Evaluate the prevalence of dysmenorrhea and its consequences in a university population. Methods: A cross-sectional descriptive study with 207 female university students between 18 and 46 years. Data collection was performed through a specific questionnaire developed for this study. Results: The overall prevalence of dysmenorrhea among university was 84.1%, of which 58.6% classified the pain intensity as mild to moderate and 41.4% as severe. School absenteeism and a difficulty to concentrate on studies during the menstrual period were significantly influenced by the presence of severe dysmenorrhea, with 60.9% of students interrupting some physical or leisure activity, and 41% reporting that they had difficulty concentrating and studying due to the dysmenorrhea. Conclusion: Dysmenorrhea has a high prevalence in the university population, contributing to a significant increase in school absenteeism and impairing social life. Most students use self-medication and few seek elective medical care to resolve this problem.(AU)

Menstrual Cycle Characteristics and Premenstrual Syndrome Prevalence Based on the Daily Record of Severity of Problems in Korean Young Adult Women / 간호학회지

PURPOSE: This descriptive study aimed to identify the menstrual cycle characteristics and premenstrual syndrome (PMS) prevalence in Korean young adult women using the retrospective and prospective Daily Record of Severity of Problems (DRSP).METHODS: In the first stage, participants included 151 nursing students studying in a university located in Seoul. Data were collected from April 20 to June 2, 2017, using the questionnaire on menstrual characteristics, pictorial blood assessment chart, and retrospective DRSP. In the second stage, participants included 17 students with PMS, based on the screening conducted in the first stage. Data were collected using the prospective DRSP from May 29 to 2 September 2, 2017.RESULTS: Of the study sample, 104 participants (68.9%) had regular periods. Those with regular periods had 11.97 periods annually with a menstrual cycle of 29.38 days and a period duration of 5.72 days. Fifty-five participants (37.4%) showed menorrhagia. Sixty-four participants (42.4%) were found to have PMS based on their retrospective DRSP. When the ratio of women (52.9%) with PMS shown in the prospective DRSP was used as a positive predictive value, the estimated PMS prevalence was 22.4%.CONCLUSION: This study provides clinically significant PMS prevalence among Korean young adult women, positive predictive value of the retrospective DRSP, and valid data to basically understand the menstrual cycle characteristics experienced by these women.

Nonpersistent endocrine disrupting chemicals and reproductive health of women

Ultrasound monitoring of the uterus and ovaries of dominant and subordinate females of yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) in captive colonies during the ovarian cycle and anestrus periods / Acompanhamento ultrassonográfico do útero e ovários de fêmeas dominantes e subordinadas de macacos-prego-do-peito-amarelo (Sapajus xanthosternos) e macacos-prego-de-crista (Sapajus robustus) em colônias cativas, durante o ciclo ovariano e períodos de anestro

The yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) are endangered species due to destruction of their natural habitat and predatory chase. However, it is still necessary to elucidate some details of their reproductive physiology in order to obtain better indices in the assisted reproduction of these species. This study aimed to evaluate the ovarian cycle of 13 dominant and subordinate females of S. xanthosternos (n=8) and S. robustus (n=5) using sagittal and transversally scanned ultrasound of their uterus and ovaries. Sonograms were performed every seven days for two months. The ovarian cycle phase and anestrous condition were confirmed by colpocytology. Our results showed different uterine parameters (craniocaudal diameter, dorso-ventral diameter, and transverse diameter) (P<0.05) between anestrous subordinate females and other ovarian cycle phases and social classes. The mean of uterine volume was higher in dominant females than subordinate females in all cycle phases (P<0.05), except in follicular phase. During anestrus, endometrial width was smaller in subordinate females than in dominant females (P<0.05). Subordinate females showed differences in endometrial measures (P<0.05) between anestrous period and follicular and luteal periods. Ovarian measures in dominant females were higher than in subordinate females only during anestrus (P<0.05). In the subordinate females, ovarian parameters were different (P<0.05) between anestrus and follicular and luteal phases. Dominant females showed higher volume of right ovary compared to volume of the left ovary during anestrus and follicular phase (P<0.05). Follicles and corpus luteum were distinguished by ultrasonography in most exams (86.11%). During anestrus, measurable ovarian structures were not observed in both ovaries in dominant and subordinate females. In conclusion, the methodology used in this study allowed to evaluate the ovarian cycle in S. xanthosternos e S. robustus females and that cycle phase/anestrus and social class of the female influenced the size of the uterus and ovaries.(AU)

O macaco-prego-do-peito-amarelo (Sapajus xanthosternos) e o macaco-prego-de-crista (Sapajus robustus) encontram-se em risco de extinção devido a destruição do seu habitat e a caça predatória. Porém, ainda necessita-se elucidar alguns detalhes de sua fisiologia reprodutiva, para obterem-se melhores índices por meio de reprodução assistida. Sendo assim, o objetivo deste trabalho foi acompanhar o ciclo ovariano de 13 fêmeas dominantes e subordinadas de S. xanthosternos (n=8) e S. robustus (n=5) por meio de cortes ultrassonográficos sagitais e transversais do útero e dos ovários. Estas fêmeas foram examinadas uma vez por semana durante dois meses. A fase do ciclo ovariano/anestro foi confirmada pela colpocitologia. Os resultados da pesquisa demonstrou diferença significativa (P<0,05) relacionada ao diâmetro crânio-caudal, diâmetro dorso-ventral e diâmetro transversal entre as fêmeas subordinadas em anestro com todas as outras fases do ciclo ovariano e classes sociais. A média do volume uterino foi maior nas fêmeas dominantes que nas subordinadas em todas as fases do ciclo (P<0,05) a exceção da fase folicular. A largura endometrial, durante o período de anestro, foi menor nas fêmeas subordinadas quando comparada às dominantes (P<0,05). Nas fêmeas subordinadas, houve diferenças (P<0,05) nas mensurações endometriais entre o período de anestro e das fases folicular e lútea. Quanto aos ovários, as médias das medidas observadas nas fêmeas dominantes foram superiores as das subordinadas durante o anestro (P<0,05). As médias das medidas das variáveis ovarianas das fêmeas subordinadas apresentaram diferenças entre o anestro e as fases folicular e lútea (P<0,05). Nas fêmeas dominantes o volume do ovário direito foi maior que o do ovário esquerdo durante o anestro e na fase folicular (P<0,05). Folículos e corpos lúteos foram diferenciados pela ultrassonografia na maioria das coletas (86,11%). Durante o anestro não foram observadas estruturas ovarianas mensuráveis nos ovários em ambas as classes sociais. Concluiu-se que a metodologia empregada neste estudo permitiu o acompanhamento do ciclo ovariano das fêmeas S. xanthosternos e S. robustus e que as fases do ciclo/anestro e a classe social das fêmeas influenciaram as medidas do útero e ovários.(AU)

Intervention for the comprehension of menstrual cycle, body function and pregnancy in adolescents from rural context / Intervención para comprender el ciclo menstrual, funcionamiento del cuerpo y embarazo en adolescentes de contexto rural

Abstract: Objective: To measure the impact of an intervention on adolescents' knowledge of the phase of the menstrual cycle with more likelihood of pregnancy and identify its associated factors. Materials and methods: A quasi-experimental study in two rural communities. Difference-in-differences analyses was performed. Results: There was a 22.1% average reduction in wrong answers on the phase of the menstrual cycle with more likelihood of pregnancy in the intervention group versus the control group (p<0.001). We founded six factors associated with this knowledge: marry and have children, right to receive education and information on sexual and reproductive health; gender equity; use of the condom; condom self-efficacy; emergency and contraceptive pills. Conclusion: There is a prevailing need to improve -among sexuality topics- basic knowledge of reproductive biology, while at the same time insisting on the benefits of using birth control methods provided for practicing responsible sexuality.

Resumen: Objetivo: Medir el efecto de una intervención en el conocimiento de los adolescentes sobre la fase del ciclo menstrual de mayor posibilidad de embarazo e identificar sus factores asociados. Material y métodos: Estudio cuasiexperimental en comunidades rurales. Se realizó un análisis de diferencias en diferencias. Resultados: Hubo una reducción promedio de 22.1% de respuestas incorrectas sobre la fase del ciclo menstrual de mayor posibilidad de embarazo en el grupo intervención vs. control (p<0.001). Se encontraron seis factores asociados con este conocimiento: casarse y tener hijos; derecho a recibir educación e información sobre salud sexual y reproductiva; equidad de género; uso correcto del condón; autoeficacia del uso del condón y pastillas anticonceptivas y de emergencia. Conclusión: Entre las diferentes temáticas de sexualidad, prevalece la necesidad de mejorar los conocimientos básicos sobre biología de la reproducción, insistiendo a la vez sobre los beneficios que conlleva el uso de métodos anticonceptivos para ejercer una sexualidad responsable.

Prevalence of Celiac in Infertile Women Due to Unexlained Infertility

Introduction: Celiac disease is an immune response to a gluten-based diet that affects the small intestines of people with a genetic predisposition to disease. Celiac has intra intestinal and extra instestinal manifestations., In recent years, celiac and infertility have been considered. The present study examines the effect of celiac disease and its treatment on the menstrual cycle, pregnancy and menopause. In this study, we compared the prevalence of celiac disease in fertile women with infertile women in Zahedan. Materials and Methods: In this case control study, 150 patients with unexplained infertility from Febraury 2016 to 2017 referred to Infrtility Clinic of Alis ibn-Abitaleb Hospital in Zahedan (Iran), were included in the study. Total IgA and IgA TTG were evaluated. IƒTTG is positive, for confirmation of diagnosis, biopsy is performed from the distal part of the duodenum. In control group, 150 fertile women with two or more children with the same characteristics were studied. Results: Theree patients with unexlained infertility (2%) were positive for TTG. Two of them (1/3%) were positive to celiac disease in small intestinal biopsy. None of the women in the control group had TTG positive (p=0.49) Discussion and Conclusion: It seems that some infertile patients with unexplained infertility suffer from celiac disease, but with a (p=0.49), it seems that celiac screening as a cause of infertility with unexplained cause needs more studies with larger sample size in Iran (AU)

Reality of premature ovarian failure in Argentina

SUMMARY Premature Ovarian Insufficiency is defined as a decline in ovarian function that is accompanied by two biochemical determinations of Follicle Stimulating Hormone in hypergonadotropic values, in addition to low levels of circulating estrogens in women under 40 years old. Although some of its possible etiologies are recognized and diagnosed, most of the time, its cause remains unknown. It is a pathology with medical, psychological, and reproductive implications. Patients may experience climacteric symptoms, infertility, and emotional distress. In the medium and long term, cardiovascular and bone health can be affected, and some degree of cognitive deterioration can be evidenced. The therapeutic approach needs to be comprehensive for the patient and multidisciplinary. SAEGRE created in Argentina an interhospital network dedicated to gathering relevant statistical information regarding this and other pathologies in order to provide better assistance for these patients.

RESUMO Insuficiência ovariana primária é definida como um declínio da função ovariana acompanhado por dois determinantes bioquímicos do Hormônio Folículo Estimulante em valores hipergonadotróficos, além de baixos níveis de estrogênios circulantes em mulheres com menos de 40 anos de idade. Embora algumas das suas possíveis etiologias serem reconhecidas e diagnosticadas, na maioria das vezes sua causa permanece desconhecida. Trata-se de patologia com a implicações médicas, psicológicas e reprodutivas. Os pacientes podem vivenciar sintomas climatéricos, infertilidade e problemas emocionais. A médio e longo prazo, a saúde cardiovascular e óssea pode ser afetada, e algum grau de deterioração cognitiva pode ser observado. A abordagem terapêutica precisa ser abrangente para o paciente e multidisciplinar. A SAEGRE criou na Argentina uma rede interospitalar dedicada a reunir informações estatísticas relevantes sobre esta e outras patologias, a fim de proporcionar uma melhor assistência para esses pacientes.

Hormones and Auditory Perception: Study of Dichotic Listening in Women during the Menstrual Cycle

Abstract Introduction Dichotic listening refers to the ability to hear different sounds presented to each ear simultaneously. Objective The aim of the present study was to assess dichotic listening in women throughout the menstrual cycle. Methods The volunteers who met the eligibility criteria participated in a dichotic listening assessment composed of three tests: 1) staggered spondaic word test; 2) dichotic digits test; and 3) consonant-vowel test. The female participants were tested during two different phases of the menstrual cycle: the follicular (days 11 to 13) and luteal (days 23 to 26) phases. The phases were confirmed by measuring serum levels of the hormone estradiol. Results A total of 20 volunteers aged 18 to 49 years participated in the study (9 females and 11 males). In test 1, only the right ear of females showed better performance during the follicular phase (high estrogen levels), compared with the luteal phase (low estrogen levels); in test 2, there were no significant differences for any of the groups; and in test 3, both males and females showed significantly better performance in their right ear compared with their left ear. Conclusion The better performance of females during the follicular phase of the cycle may indicate that estrogen levels might have an influence on dichotic listening in women. (AU)

Lidando com um fenômeno natural e que ficará para sempre: a menstruação e suas influências na vida da mulher / Dealing with a natural phenomenon that will remain forever: menstruation and its influences in the life of women

A menstruação, biologicamente e de acordo com a visão médica, é definida como a eliminação de sangue e tecido superficial do endométrio após a prévia involução, em consequência à queda das concentrações séricas de estrogênios e progesterona ao final do ciclo ovariano. Porém, a Organização Mundial da Saúde (OMS) tem procurado desestimular este conceito mecanicista, buscando afirmar que o ato de menstruar também envolve variáveis psicológicas, sociais e culturais. Foram definidos os seguintes objetivos: Descrever as relações de influência da menstruação na vida de mulheres, segundo sua própria percepção e Analisar a relação de mulheres com a menstruação à luz do interacionismo simbólico. O estudo proposto é descritivo, qualitativo e visa a explorar diferentes aspectos das experiências de vida das participantes. Optou-se por abordagem qualitativa, baseada nos pressupostos da Grounded Theory, por oferecer elementos para a discussão e análise dos dados de modo comparativo constante dos resultados, e do interacionismo simbólico, que possibilita que a pesquisa qualitativa atinja o objetivo de pesquisar o sentido que os indivíduos propõem aos objetos, pessoas e símbolos com os quais interagem no meio social. Dos resultados evidenciados, foram geradas quatro categorias: "A chegada de algo inesperado e desconhecido que ficará para sempre...", "A influência dos outros na vivência/experiência da menstruação", "O conhecimento do corpo e a relação consigo mesma e com o mundo à sua volta" e "Reconhecendo e lidando com as influências na vida". Observou-se que as mulheres, ao lidarem com o fenômeno da menstruação, mesmo esta sendo algo natural, vivenciam-na diferentemente, sendo o seu meio social e sua cultura grandes influenciadores do processo, além de o próprio evento ser um marco em sua vida, pois, muitas vezes, ocorre de modo inesperado, podendo gerar ações positivas ou negativas. O suporte social é outra estratégia bastante importante como apoio tanto para as adolescentes que vivenciam esse momento de transição para a fase adulta como para as mulheres adultas que consideram importante receber apoio de seus familiares, amigos, entre outros. A participação do enfermeiro pode tornar-se uma importante mediação junto a essa mulher, para auxiliá-la na busca de significados mais contundentes por meio de um cuidado mais integral, qualificado, fazendo com que a mulher tenha uma visão reflexiva sobre o ato de estar menstruada e sobre as influências da menstruação em sua vida, bem como um olhar para além de assumir naturalmente este evento, conformar-se ou não aceitar a menstruação. Ao ajudá-la a ressignificar esse fenômeno, trazendo para ela uma visão diferenciada, mostrando a menstruação como algo natural, possibilitando que a mulher assuma a menstruação como símbolo do feminino e instrumento de empoderamento, a enfermagem desenvolve ação importante do cuidado, atribuindo a esse cuidado cunho libertador. Os resultados do presente estudo evidenciaram situações que merecem aprofundamento em estudos posteriores.

Menstruation, biologically and according to the medical view, is defined as the elimination of blood and superficial tissue of the endometrium after previous involution, as a result of the drop in serum concentrations of estrogens and progesterone at the end of the ovarian cycle. However, the World Health Organization (WHO) has tried to discourage this mechanistic concept and sought to affirm that the act of menstruating also involves psychological, social and cultural variables. The following objectives were defined: Describe the relations of the influence of menstruation in the lives of women, according to their own perception and Analyze the relation of women with menstruation in the light of symbolic interactionism. The proposed study is descriptive, qualitative and aimed at exploring different aspects of the participants' life experiences. We chose a qualitative approach, based on the assumptions of the Grounded Theory, for it offers elements for the discussion and analysis of the data results in a constant comparative way, and of the Symbolic Interactionism, which enables the qualitative research to achieve the objective of researching the meaning that individuals propose to the objects, people and symbols with which they interact in the social environment. From the results, four categories were generated: "The arrival of something unexpected and unknown that will remain forever...", "The influence of others in living/experiencing menstruation", "The knowledge of the body and the relationship with herself and the world around her" and "Recognizing and dealing with the influences in life". It was observed that women, when dealing with the phenomenon of menstruation, although it is something natural, experience it differently, their social environment and culture being great influencers of this process, besides the event itself being a milestone in her life because it often occurs unexpectedly, and can generate positive or negative actions. Social support is another particularly important strategy as a support for both adolescents who experience this moment of transition to adulthood and for adult women who consider it important to receive support from their relatives, friends, among others. The participation of the nurse can become an important mediation with this woman to help her in the search for more significant meanings by means of a more integral, qualified care, causing the woman to have a reflexive vision about the act of being menstruated and about the influences of menstruation in her life, as well as having a look beyond just assuming this event naturally, conforming herself or not accepting the menstruation. By helping her to re-signify this phenomenon, bringing her a differentiated view, showing menstruation as something natural, enabling women to assume menstruation as a symbol of the feminine and an instrument of empowerment, nursing will be developing an important action of care with a liberating imprint. The results of the present study evidenced situations which deserve to be deepened in further studies.