Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 319
Filter
1.
Article in Portuguese | LILACS | ID: biblio-1353098

ABSTRACT

Os contraceptivos intrauterinos contendo levonorgestrel, Mirena®, amplamente utilizados na ginecologia contemporânea como método eficaz de contracepção e controle de distúrbios menstruais, mostrou reduzir as taxas de câncer de endométrio. Além disso, complicações como perfuração e migração são raras, exigindo intervenção rápida. Descrição: Dois casos atípicos acerca do uso de dispositivo intrauterino hormonal, o primeiro trata de migração do dispositivo para a cavidade abdominal, após 1 ano e 8 meses da inserção, sem perfuração, com retirada videolaparoscópica. O segundo é um caso de câncer primário de endométrio em paciente com 3 anos de uso de Mirena®. Discussão: A migração do dispositivo intrauterino é uma complicação rara, pouco relatada na literatura, a abordagem videolaparoscópica é a preferencial e foi realizada no caso em questão. O dispositivo intrauterino hormonal também está relacionado à diminuição das taxas de câncer de endométrio e, inclusive, é usado como método preventivo em mulheres de alto risco. Após revisão de literatura, apenas seis casos similares foram descritos. Conclusão: O dispositivo hormonal intrauterino, apesar de seguro, pode implicar apresentações raras, como migração e perfuração, que exigem conhecimento e agilidade da equipe profissional. O segundo caso apresentado é um evento raro, que faz atentar para mulheres com padrão hemorrágico incomum em uso do Mirena®. (AU)


Intrauterine contraceptives containing levonorgestrel, Mirena®, widely used in contemporary gynecology as an effective method of contraception and control of menstrual disorders, have shown to reduce rates of endometrial cancer. In addition, complications such as perforation and migration are rare, requiring rapid intervention. Description: Two atypical cases about the use of intrauterine hormonal device, the first deals with migration of the device to the abdominal cavity, after 1 year and 8 months of insertion, without perforation, with videolaparoscopic withdrawal. The second is a case of primary endometrial cancer in a patient with 3 years of use of Mirena®. Discussion: Migration of the intrauterine device is a rare complication, little reported in the literature, the videolaparoscopic approach is the preferred one and was performed in the case in question. The hormonal intrauterine device is also related to the decreased rates of endometrial cancer and is also used as a preventive method in high-risk women. After reviewing the literature, only six similar cases were described. Conclusion: The intrauterine hormonal device, although safe, may imply rare presentations, such as migration and perforation, which require knowledge and agility of the professional team. The second case presented is a rare event, which makes it aware for women with an unusual hemorrhagic pattern to use Mirena®. (AU)


Subject(s)
Humans , Female , Adult , Levonorgestrel , Endometrial Neoplasms , Contraception , Contraceptive Agents , Intrauterine Devices , Menstruation Disturbances
2.
Prensa méd. argent ; 107(6): 318-328, 20210000. tab, graf, ilus
Article in English | LILACS | ID: biblio-1359110

ABSTRACT

Antecedentes: el síndrome de ovario poliquístico (SOP) es una afección endocrina común que se presenta en las mujeres y se asocia con problemas como irregularidades menstruales; hirsutismo; obesidad; resistencia a la insulina; acné; y vida posterior con diabetes mellitus y cáncer de útero. El objetivo del estudio fue evaluar las características fenotípicas y los factores de riesgo del síndrome de ovario poliquístico en estudiantes de enfermería. Materiales y métodos: Estudio transversal (descriptivo) que incluyó una muestra de 400 mujeres de la Facultad de Enfermería de la Universidad de Zagazig, Egipto. Se utilizaron para la recopilación de datos; hoja de cuestionario de entrevista estructurada, datos relacionados con medidas antropométricas, factores de riesgo sobre el SOP y lista de verificación observacional sobre las características fenotípicas de la PCO. Resultados: el 6% de las alumnas estudiadas tenía antecedentes familiares de PCO, casi la mitad de ellas consumía comida rápida, más de la mitad de las alumnas estudiadas tenía hirsutismo, más de una cuarta parte tenía acné, (14,5%) tenía irregularidades menstruales y una tercera parte. de ellos tenían un aumento de peso anormal continuo. Además, este estudio mostró que se encontró falta de conciencia entre la mayoría de las niñas sobre el SOP. Discusión: Por tanto, se podría concluir que los antecedentes familiares de SOP, la obesidad y los hábitos alimentarios de comida rápida se encuentran como factores predisponentes para el desarrollo de SOP. El riesgo de síndrome de ovario poliquístico aumenta con la presencia de uno o más factores predisponentes identificados. La mayoría de los factores probados como factores predisponentes en nuestro estudio están interrelacionados entre sí y son en su mayoría modificables. Aunque el SOP es un trastorno endocrino prevalente, había un conocimiento deficiente entre las estudiantes de la Facultad de Enfermería de la Universidad de Zagazig. Conclusiones: El estudio recomendó un programa de detección del ministerio de salud para la detección temprana de los factores predisponentes del SOP, incluidos los estudiantes de secundaria y los estudiantes de facultades, a través de programas educativos y mensajes a través de la consejería, folletos, para aumentar la conciencia de los estudiantes sobre los síntomas del SOP. Investigar más sobre el tamaño de la muestra más grande para identificar cómo el problema es riesgoso y cómo abordarlo. Incluyendo el problema en redes sociales y canales saludables.


Background: Polycystic ovarian syndrome (PCOS) is a common endocrine condition that occurs in women and is associated with problems such as menstrual irregularities; hirsutism; obesity; insulin resistance; acne; and later life with diabetes mellitus and uterine cancer. The study aim was to assess phenotype characteristics and risk factors of polycystic ovarian syndrome among nursing students. Materials and Methods: Cross sectional study (descriptive) included a sample of 400 females from Faculty of Nursing, Zagazig University, Egypt. Were used for data collection; structured-interviewing questionnaire sheet, data related to anthropometric measures, risk factors about PCOS and observational check list about phenotype characteristics of PCO. Results: 6% of the studied student females had family history of PCO, nearly half of them had fast food, more than half of studied student females had hirsutism, more than one quarter had acne, (14.5%) had menstrual irregularity and one third of them had continuous abnormal weight gain. Also, this study showed that lack of awareness was found among majority of girls about PCOS. Discussion: Therefore, it could be concluded that, family history of PCOS, obesity and fast-food diet habits are found to be the predisposing factors for development of PCOS. The risk of PCOS increases with presence of one or more identified predisposing factors. Most of the factors tested as predisposing factors in our study are interlinked to each other and are mostly modifiable Although that PCOS is prevalent endocrine disorder, there was poor knowledge among student females in Faculty of Nursing Zagazig University. Conclusion: The study recommended screening program from ministry of health for early detection of predisposing factors of PCOS including the secondary school students and faculties students through educational programs and messages through the counseling, brochures, to increase students' awareness about PCOS symptoms. Further research on larger sample size to identify how the problem is risky and how to deal it. Including the problem in social media and healthy channels


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Phenotype , Preventive Health Services , Students, Nursing/statistics & numerical data , Health Knowledge, Attitudes, Practice , Interviews as Topic/statistics & numerical data , Risk Factors , Health Surveys/statistics & numerical data , Early Diagnosis , Educational and Promotional Materials , Feeding Behavior , Medical History Taking , Menstruation Disturbances
3.
Rev. bras. ginecol. obstet ; 43(5): 395-402, May 2021. graf
Article in English | LILACS | ID: biblio-1288555

ABSTRACT

Abstract In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, andmenstrual cycle.Onthe other hand, an imbalance causedby low energy availability dueto a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of themost recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote theacquisition ofmore consolidated knowledgeon an undervaluedtheme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.


Resumo Emumaatleta saudável, oaporte calórico é suficientepara anecessidade energética esportiva e para as funções fisiológicas corporais, permitindo um equilíbrio entre disponibilidade energética (DE), metabolismo ósseo e função menstrual. Por outro lado, um desequilíbrio devido à baixa disponibilidade energética (BDE) por dieta restritiva, perturbações alimentares ou grandes períodos de gasto energético conduz a uma desregulação multissistêmica priorizando as funções essenciais do corpo. Este fenômeno, descrito inicialmente como tríade da mulher atleta e, atualmente, comodéfice energético relativo no esporte (RED-S, nasigla eminglês) tem como pilares a BDE, disfunção menstrual e alterações na densidade mineral óssea (DMO), estando presente em uma percentagem considerável de atletas de alta competição, com consequências nefastas para o seu futuro a curto, médio e longo prazo. A presente revisão foi realizada a partir da análise crítica das publicações mais recentes disponíveis e pretende proporcionar uma percepção global do tema RED-S. O objetivo é promover a aquisição de um conhecimento mais consolidado sobre uma temática subvalorizada, possibilitando a aquisição de estratégias preventivas, diagnóstico precoce e/ou tratamento adequado.


Subject(s)
Humans , Female , Energy Intake/physiology , Female Athlete Triad Syndrome/diagnosis , Female Athlete Triad Syndrome/prevention & control , Athletic Performance , Relative Energy Deficiency in Sport , Feeding and Eating Disorders/complications , Energy Metabolism/physiology , Athletes , Amenorrhea , Menstruation Disturbances/complications
4.
Rev. bras. ginecol. obstet ; 43(4): 291-296, Apr. 2021. tab
Article in English | LILACS | ID: biblio-1280045

ABSTRACT

Abstract Objective To evaluate whether continuation rates with the 52-mg levonorgestrelreleasing intrauterine system (LNG-IUS) up to 5 years after placement differed between women using the method exclusively for contraception and those using the device for medical reasons alone. Methods A retrospective cohort study was conducted in a family planning clinic with 5,034 LNG-IUS users: 4,287 using the method exclusively for contraception and 747 for medical reasons alone. The continuation rate at 1 to 5 years of use was calculated by life table analysis. Results Initially, the continuation rate was significantly higher in the contraception group: 85.8 versus 83.4 and 77.4 versus 76.0 per 100 women-years in the 1st and 2nd years of use, respectively. There were more discontinuations due to bleeding/spotting in the medical reasons group in the first two years. The discontinuation rate according to reason for use was not significantly different from the third to the fifth year of use. No women discontinued due to amenorrhea in either group. Conclusion The continuation rate was significantly higher in the contraception group in the first two years of use. Amenorrhea was not a reason for discontinuation in either group, suggesting that counselling in this respect was adequate. Nevertheless, counselling could perhaps have been better with regards to the expected long period of bleeding and spotting in the first two years after placement.


Resumo Objetivo Avaliar a taxa de continuação até 5 anos de uso do sistema intrauterino liberador de 52-mg levonorgestrel por dia (SIU LNG) -IUS) é diferente entre mulheres que o usam exclusivamente como anticoncepcional que entre as que usam exclusivamente por razões médicas. Métodos Estudo retrospectivo realizado em uma clínica de Planejamento Familiar 5.034 usuárias de SIU LNG, 4.287 que optaram pelo método apenas como anticoncepcional e 747 que o usavamsomente por razoesmédicas. A taxa de continuação de um até cinco ano foi calculada por meio de análise de tabela de vida Resultados No início a taxa de continuação foi significativamente maior no grupo da anticoncepção: 85,8 versus 83,4 e 77,4 versus 76,0 por 100 anos-mulher no 1° e 2° ano de uso, respectivamente. Houve mais descontinuações por sangrado-manchado no grupo de razões médicas nos dos primeiros anos. A taxa de continuação não foi significativamente diferente desde o terceiro até o quinto ano de uso. Nenhuma mulher de ambos os grupos descontinuou por amenorreia. Conclusão A taxa de continuação foi significativamente maior no grupo de anticoncepção durante os dos primeiros anos de uso. Amenorreia não foi motivo de descontinuação em ambos os grupos, sugerindo que a orientação a esse respeito foi adequada. Entretanto, a orientação referente ao longo período de sangramentos irregulares nos dois primeiros anos após a inserção, precisaria ser melhorado.


Subject(s)
Humans , Female , Adult , Young Adult , Levonorgestrel/administration & dosage , Contraceptive Agents, Hormonal/administration & dosage , Intrauterine Devices, Medicated/adverse effects , Parity , Brazil , Patient Education as Topic , Regression Analysis , Retrospective Studies , Follow-Up Studies , Levonorgestrel/adverse effects , Marital Status , Counseling , Educational Status , Contraceptive Agents, Hormonal/adverse effects , Menstruation Disturbances
5.
Femina ; 49(1): 39-43, 20210131. ilus
Article in Portuguese | LILACS | ID: biblio-1146939

ABSTRACT

"Tríade da mulher atleta" e "deficiência relativa de energia no esporte" são afecções comuns encontradas em esportistas. Tendo como fisiopatologia a disponibilidade energética negativa, essas síndromes têm impacto negativo na saúde das atletas. Apesar de serem frequentemente discutidas entre especialistas vinculados ao mundo desportivo, ainda são pouco conhecidas entre outras especialidades. Essa revisão da literatura foi proposta com o intuito de expor o problema ao ginecologista e obstetra, considerando esses profissionais importantes aliados na prevenção e diagnóstico precoce. Da mesma maneira, a intervenção terapêutica correta minimiza os diversos prejuízos à saúde e melhora o desempenho esportivo.(AU)


"Female athlete triad" and "relative energy deficiency in sport" are conditions relatively common among women participating in sports. Its pathophysiology based on negative energy availability, these syndromes have a negative impact on the athlete's health. Although they are frequently discussed among specialists linked to the sports all over the world, a little has been known among other physicians. This literature review was proposed in order to expose the problem to the gynecologist and obstetrician, considering these professionals as important allies in prevention and early diagnosis. In the same way, the correct therapeutic intervention allows to minimizes the numerous damages to athlete's health and to improve their sports performance.(AU)


Subject(s)
Humans , Female , Female Athlete Triad Syndrome/complications , Female Athlete Triad Syndrome/physiopathology , Female Athlete Triad Syndrome/prevention & control , Osteoporosis , Bone Diseases, Metabolic , Risk Factors , Sports Nutritional Sciences , Menstruation Disturbances
6.
Rev. cuba. endocrinol ; 31(1): e187, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126455

ABSTRACT

RESUMEN Introducción: En la hiperplasia adrenal congénita el aumento de los niveles de andrógenos suprarrenales en las pacientes no tratadas o mal controladas, puede alterar el inicio y/o la progresión puberal (progresión puberal/progresiones puberales?). Objetivos: Describir las características puberales de pacientes con hiperplasia adrenal congénita asignadas como femeninas e identificar si existe asociación entre elementos relacionados con la enfermedad y el inicio y progresión puberales. Métodos: Se incluyeron todas las pacientes con diagnóstico de hiperplasia adrenal congénita asignadas como femeninas, que fueron atendidas en el INEN de enero 2000 a mayo 2019. Resultados: Fueron estudiadas 47 pacientes, con una media de edad de 14,76 ± 7,04 años. Se comprobó un predominio de las formas clínicas clásicas en 25 pacientes (53,19 por ciento), de ellas 11 (23,40 por ciento) fueron formas virilizantes simples, 14 (29,78 por ciento) perdedoras de sal y 22 (46,80 por ciento) formas no clásicas. El inicio del vello pubiano fue a una edad promedio de 7,78 ± 3,2 años. El comienzo de la telarquia resultó en una media de 10,09 ± 2,4 años y la menarquia a los 12,2 ± 2,3 años como promedio. De las 29 pacientes que ya habían menstruado 16 (55,2 por ciento) presentaban irregularidades menstruales. El tiempo entre el inicio puberal y la menarquia fue de 3,4 años en las formas no clásicas, 5,6 años en las perdedoras de sal y 7,0 años en las virilizantes simples. La edad al diagnóstico, la edad de inicio del tratamiento y la dosis de esteroides empleada se relacionaron con algunos aspectos puberales. Conclusiones: El diagnóstico oportuno y el ajuste cuidadoso del esquema esteroideo, constituyen pilares importantes en el inicio y progresión puberales, y en la consecución de ciclos ovulatorios regulares que aseguren desde la adolescencia, un inicio y desarrollo puberales normales y en edades reproductivas, la optimización de la fertilidad(AU)


ABSTRACT Introduction: In the congenital adrenal hyperplasia, the increased levels of adrenal androgens in patients untreated or poorly controlled can alter the start and/or pubertal progression (pubertal progression/pubertal progressions). Objectives: To describe the pubertal characteristics of patients with congenital adrenal hyperplasia assigned as females and to identify whether there is an association between elements related to the disease and the pubertal onset and progression. Methods: There were included all patients diagnosed with congenital adrenal hyperplasia assigned as females that were attended at the National Institute of Endocrinology from January 2000 to May 2019. Results: 47 patients were studied, with an average age of 14.76 ± 7.04 years. It was found a predominance of classic clinical forms in 25 patients (53.19 percent, of which 11 (23.40 percent) had simple virilization forms, 14 (29.78 percent) were salt-losers and 22 (46.80 percent) had non-classical forms. The onset of the pubic hair was at an average age of 7.78 ± 3.2 years. The beginning of the thelarche resulted in an average of 10.09 ± 2.4 years and menarche at the 12.2 ± 2.3 years on average. Of the 29 patients who had menstruated, 16 (55.2 percent) presented menstrual irregularities. The time between the puberty onset and menarche was 3.4 years in the non-classical forms, 5.6 years in the salt-losers, and 7.0 years in the simple virilizations. The age at initial diagnosis treatment and the dose of steroids used were related to some pubertal aspects. Conclusions: Early diagnosis and careful adjustment of the steroid scheme are important pillars in the pubertal onset and progression, the achievement of regular ovulatory cycles, and with it, in the optimization of fertility(AU)


Subject(s)
Humans , Female , Child , Adolescent , Menarche/physiology , Puberty , Adrenal Hyperplasia, Congenital/diagnosis , Menstruation Disturbances/therapy , Epidemiology, Descriptive , Cross-Sectional Studies
8.
Homeopatia Méx ; 89(723): 36-38, 2020.
Article in Spanish | MTYCI, LILACS, HomeoIndex, MTYCI | ID: biblio-1373602

ABSTRACT

En este artículo pondremos un ejemplo de la vida real para demostrar con claridad todo lo escrito. Se trata del caso de una mujer de 35 años que llega a la consulta con un solo síntoma importante para ella. No le viene la menstruación desde hace años. Y si le viene, es solo esporádicamente. Refiere que la última vez que le ha venido regularmente fue cuando se separó de su novio; después se sintió libre y contenta, segura de sí misma. Años después, se ha vuelto a enamorar y han vuelto a desaparecer las menstruaciones. Cuando se configura la historia familiar nos encontramos (sin dar demasiados detalles) una historia con ciertas características que han constituido el lenguaje primordial, inconsciente y consciente, de la vida de la paciente. Resulta ser que, durante tres generaciones, mujeres dominantes y severas con los demás han tenido hijos naturales a escondidas, antes de casarse con sus maridos respectivos, que también han tenido otros hijos naturales fuera del matrimonio con anterioridad. Al final, acabaron casándose de manera oficial con sus respectivas mujeres (abuelas y madre de la paciente), ya que éstas habían quedado embarazadas. Ellos, hombres sin responsabilidad amorosa, vivieron ajenos a las obligaciones como padres; el condicionamiento social los forzó a mantener la casa y los hijos, pero sin que ello implicara la capacidad para proteger y educar a los hijos que, por tanto, siempre dependieron solo de ellas.


Subject(s)
Humans , Female , Adult , Clinical Evolution , Menstruation Disturbances/psychology
9.
Rev. enferm. UERJ ; 27: e40120, jan.-dez. 2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1024388

ABSTRACT

Objetivo: descrever a experiência de mulheres em relação à menstruação. Metodologia: estudo qualitativo baseado no método de análise de conteúdo temática. O cenário foi o campus de uma universidade pública no Rio de Janeiro. Participaram 23 mulheres entre 20 e 72 anos de idade. Os dados foram obtidos entre julho/2015 e julho/2016 através da entrevista semiestruturada. Resultados: foi identificada, como tema central/categoria, a questão da solidariedade entre mulheres quando o assunto é menstruação. Emergiram quatro sub-categorias: A conexão das mulheres com a menstruação; A experiência de menstruar afetando umas às outras; A influência e o suporte proveniente das mães e/ou de outras mulheres; e A transferência. Conclusão: a menstruação causa sentimentos ambíguos nas mulheres, resultando em predomínio de sentimentos negativos, como medo e sensação de vergonha. Ao mesmo tempo pode ser percebida como motivo de felicidade e tranquilidade. A solidariedade entre mulheres pode influenciar positivamente a percepção da mulher sobre a menstruação, sendo elemento de empoderamento.


Objective: to describe women's experience of menstruation. Methodology: this qualitative study was based on the thematic content analysis method. The setting was a public university campus in Rio de Janeiro. Twenty-three women from 20 to 72 years old participated. Data were obtained between July 2015 and July 2016 by semi-structured interview. Results: the central theme/category was identified as solidarity among women with regard to menstruation. Four subcategories emerged: women's connection with menstruation; one's experience of menstruating affects others; influence and support from mothers and/or other women; and transference. Conclusion: menstruation causes ambiguous feelings in women, with negative feelings, such as fear and a sense of shame, predominating. At the same time, it can be seen as a reason for happiness and tranquility. Solidarity among women is a factor of empowerment, and can influence women's perception of menstruation positively.


Objetivo: describir la experiencia de mujeres en relación con la menstruación. Metodología: estudio cualitativo basado en el método de análisis de contenido temático. El escenario fue el campus de una universidad pública en Río de Janeiro. Participaron 23 mujeres cuya edad estaba entre 20 y 72 años. Los datos se obtuvieron entre julio/2015 y julio/2016 a través de entrevista semiestructurada. Resultados: se identificó, como tema central/categoría, la solidaridad entre mujeres en relación con la menstruación. Surgieron cuatro subcategorías: la conexión de las mujeres con la menstruación; la experiencia de menstruar, afectando unas a las otras; la influencia y el apoyo de las madres y/o de otras mujeres; y la transferencia. Conclusión: la menstruación causa sentimientos ambiguos en las mujeres, resultando en predominio de sentimientos negativos, como el miedo y la sensación de vergüenza. Al mismo tiempo, podría percibirse como un motivo de felicidad y tranquilidad. La solidaridad entre mujeres puede influir positivamente en su percepción sobre la menstruación, siendo un elemento de empoderamiento


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Social Support , Women's Health , Menstruation/psychology , Obstetric Nursing , Menstruation , Menstruation Disturbances/psychology
10.
Rev. bras. ginecol. obstet ; 41(9): 564-574, Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1042333

ABSTRACT

Abstract Objective To assess the efficacy of non-surgical treatment for adenomyosis. Data Sources A search was performed by two authors in the Pubmed, Scopus, and Scielo databases and in the grey literature from inception to March 2018, with no language restriction. Selection of Studies We have included prospective randomized studies for treating symptomaticwomen with adenomyosis (abnormal uterine bleeding and/or pelvic pain) diagnosed by ultrasound or magnetic resonance imaging. Data Collection Studies were primarily selected by title and abstract. The articles that were eligible for inclusion were evaluated in their entirety, and their data was extracted for further processing and analysis. Data Synthesis From567retrieved records only 5 remained for analysis. The intervention groups were: levonorgestrel intrauterine system (LNG-IUS)(n= 2), dienogest (n= 2), and letrozole (n= 1). Levonorgestrel intrauterine system was effective to control bleeding when compared to hysterectomy or combined oral contraceptives (COCs). One study assessed chronic pelvic pain and reported that LNG-IUS was superior to COC to reduce symptoms. Regarding dienogest, it was efficient to reduce pelvic pain when compared to placebo or goserelin, but less effective to control bleeding than gonadotropin-releasing hormone (GnRH) analog. Letrozolewas as efficient asGnRHanalog to relieve dysmenorrhea and dyspareunia, but not for chronic pelvic pain. Reduction of uterine volumewas seen with aromatase inhibitors, GnRH analog, and LGN-IUD. Conclusion Levonorgestrel intrauterine system and dienogest have significantly improved the control of bleeding and pelvic pain, respectively, in women with adenomyosis. However, there is insufficient data from the retrieved studies to endorse eachmedication for this disease. Further randomized control tests (RCTs) are needed to address pharmacological treatment of adenomyosis.


Resumo Objetivo: Avaliar a eficácia de tratamento não cirúrgico para adenomiose. Fontes de dados: Uma pesquisa foi realizada por dois autores nas bases de dados Pubmed, Scopus, Scielo e na literatura cinzenta desde o início de cada base de dados até março de 2018, sem restrição de idioma. Seleção de estudos: Incluímos estudos prospectivos randomizados para tratamento de mulheres sintomáticas com adenomiose (sangramento uterino anormal e/ou dor pélvica) diagnosticadas por ultrassonografia ou ressonância magnética. Coleta de dados: Os estudos foram selecionados principalmente por título e resumo. Os artigos que preencheram os critérios de inclusão foram avaliados na íntegra, e seus dados foram extraídos para posterior processamento e análise. Síntese dos dados: De 567 registros recuperados, somente 5 permaneceram para análise. Os grupos de intervenção foram: sistema intrauterino de levonorgestrel (SIU-LNG) (n= 2), dienogest (n= 2), e letrozol (n= 1). O SIU-LNG foi efetivo no controle do sangramento quando comparado à histerectomia ou aos contraceptivos orais combinados (COCs).Umestudo avaliou a dor pélvica crônica e relatou que o SIU-LNGfoi superior ao COC para reduzir os sintomas.Emrelação ao dienogest, este foi eficienteemreduzir a dor pélvica quando comparado ao placebo ou à goserelina, mas foi menos eficaz no controle do sangramento do que o análogo do hormônio liberador de gonadotropina (GnRH). O letrozol foi tão eficiente quanto o análogo do GnRH para aliviar a dismenorreia e a dispareunia, mas não para a dor pélvica crônica. Redução do volume uterino foi observada com inibidores de aromatase, análogo de GnRH, e SIU-LNG. Conclusão: O SIU-LNG e dienogest apresentaram bons resultados para o controle de sangramento e dor pélvica, respectivamente, em mulheres com adenomiose. No entanto, não há dados suficientes para endossar cada medicação para tratar essa doença. Futuros estudos randomizados são necessários para avaliar o tratamento farmacológico da adenomiose.


Subject(s)
Humans , Female , Adenomyosis/drug therapy , Uterus/drug effects , Contraceptive Agents/therapeutic use , Aromatase Inhibitors/therapeutic use , Hormone Antagonists/therapeutic use , Intrauterine Devices, Medicated , Menstruation Disturbances/drug therapy
11.
Rev. medica electron ; 41(4): 940-958, jul.-ago. 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1094100

ABSTRACT

RESUMEN El síndrome de ovario poliquístico se ha convertido en un problema de salud pública, siendo el más común de los desórdenes endocrinos en mujeres en edad reproductiva con estudios que reportan una prevalencia de hasta un 21%. El diagnóstico de esta entidad es importante debido a que representa riesgos metabólicos, cardiovasculares y afecta la capacidad reproductiva de estas pacientes. Se realizó una revisión bibliográfica de los principales artículos relacionados sobre el tema, resumiendo los aspectos fundamentales de este problema de salud.


ABSTRACT Polycystic ovary syndrome has become a public health problem, being the most common of the endocrine disorders in reproductive-age women, with studies reporting prevalence by 21 %. The diagnosis of this entity is important because it represents metabolic and cardiovascular risk, and affects the reproductive capacity of these patients. The authors carried out bibliographic review of the main articles related with the theme, summarizing the basic aspects of this health problem.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/complications , Polycystic Ovary Syndrome/etiology , Polycystic Ovary Syndrome/physiopathology , Polycystic Ovary Syndrome/diagnostic imaging , Preventive Health Services , Cardiovascular Diseases/diagnosis , Disease Management , Metabolic Syndrome/diagnosis , Endocrine System Diseases/diagnosis , Disease Prevention , Reproductive Health , Healthy Lifestyle , Genitalia/physiopathology , Insulin Resistance , Ultrasonography , Hirsutism/diagnosis , Hypertension/diagnosis , Menstruation Disturbances/diagnosis , Obesity/diagnosis
12.
Rev. bras. ginecol. obstet ; 41(3): 203-205, Mar. 2019. graf
Article in English | LILACS | ID: biblio-1003537

ABSTRACT

Abstract Introduction Autoimmune progesterone dermatitis (APD) is a rare autoimmune dermatosis characterized by recurrent cutaneous and mucosal lesions during the luteal phase of the menstrual cycle that disappear some days after the menses. Case Report A 34-year-old primipara woman with no significant past medical history and no prior exogenous hormone use, who presented with cyclic skin eruptions starting 1 year after the delivery. The lesions occurred 6 days before the menses and disappeared in between 1 and 2 days after the menstruation ceased. The patient was diagnosed after a positive response to an intradermal test with progesterone and was successfully treated with combined oral contraceptives. The skin eruptions have not returned since the initiation of this therapy. Conclusion Dermatologists, gynecologists, and obstetricians should be aware of this rare entity. Furthermore, if this condition is suspected, a thorough history taking on the menstrual cycle and results of the intradermal progesterone test are mandatory.


Subject(s)
Humans , Female , Adult , Progesterone/adverse effects , Autoimmune Diseases/drug therapy , Contraceptives, Oral, Combined/administration & dosage , Dermatitis/drug therapy , Menstruation Disturbances/drug therapy , Recurrence , Autoimmune Diseases/diagnosis , Skin Tests , Treatment Outcome , Dermatitis/diagnosis , Ethinyl Estradiol/administration & dosage , Androstenes/administration & dosage , Menstruation Disturbances/diagnosis
13.
Article in English | WPRIM | ID: wpr-760662

ABSTRACT

OBJECTIVE: This study was aimed at identifying a correlation between polycystic ovarian morphology (PCOM) and the severity of primary dysmenorrhea in young Korean women. METHODS: A total of 592 patients who visited a tertiary hospital from March 2008 to March 2015 for dysmenorrhea were examined. After excluding those with secondary causes of menstrual pain (for example, myoma, adenomyosis, endometriosis, and pelvic inflammatory disease), 361 women were recruited and retrospectively analyzed. Severe dysmenorrhea was defined as a visual analog scale (VAS) score ≥6. RESULTS: The mean patient age was 23.0±4.0 years, the average menstrual cycle length was 34.4±23.7 days, and the average pain intensity was VAS 6.7±0.1 at baseline. PCOM was assessed by ultrasound in 54 women (15%). Patients with severe menstrual pain were more likely to have irregular menstrual cycles (P=0.03) and heavy menstrual flow (P=0.01) than those with mild menstrual pain. After adjusting for weight, height, menstrual cycle interval, and menstrual flow in the logistic regression analysis, PCOM (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.05–4.97; P=0.04) and heavy menstrual flow (OR, 1.85; 95% CI, 1.05–3.28; P=0.04) were found to be significant independent factors influencing pain. CONCLUSION: Our study shows that PCOM may have a correlation with the severity of primary dysmenorrhea. Since PCOM may play a role in the development of menstrual pain, patients with PCOM should be under active surveillance with resources for prompt pain management readily available. It may also be necessary to further investigate the molecular mechanisms of pain development in primary dysmenorrhea.


Subject(s)
Adenomyosis , Dysmenorrhea , Endometriosis , Female , Humans , Logistic Models , Menstrual Cycle , Menstruation Disturbances , Myoma , Pain Management , Polycystic Ovary Syndrome , Retrospective Studies , Tertiary Care Centers , Ultrasonography , Visual Analog Scale
14.
Rev. fac. cienc. méd. (Impr.) ; 15(2): 17-23, jul.-dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-988611

ABSTRACT

El síndrome de ovario poliquísticoes unaendocrinopatía frecuente en la mujer en edad fértil, causado por exceso de andrógenos y es causa de infertilidad anovulatoria. Actualmente uno de los criterios utilizados para el diagnóstico, son los de Rotterdam y para esto se necesita de la clínica (hiperandrogenismo y disfunción ovulatoria), exámenes de laboratorio (hiperandrogenismo) y/o ultrasonido característico de dicho síndrome. Objetivo:determinar el síndrome de ovario poliquístico confirmado por métodos laboratoriales e imágenes y tratamiento indicado en consulta externa del Hospital Escuela Universitario. Material y métodos: estudio retrospectivo, transversal, no aleatorio. Se revisaron 56 expedientes de pacientes con el diagnóstico de síndrome de ovario poliquístico valorados mediante criterios de Rotterdam, 31(55.4%) tenian diagnóstico ultrasonográfico. Se utilizó un instrumento de recolección de datos tipo cuestionario registrandose lo siguiente: edad, sintomatología, exámenes laboratoriales, diagnóstico con descripción ultrasonográficas y tratamiento farmacológico. Resultados: con el diagnóstico de síndrome ovario poliquístico, 31(55.4%) teníandiagnósticos1 Médico especialista en ginecología y obstetricia, Hospital Escuela Universitario2Estudiante de sexto año, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras.Autor de correspondencia: Silder Moncada Correo electrónico: silderjavier78@gmail.comRecibido: 19/09/2017Aceptado: 07/02/2019ultrasonográficos, en 26(83.9%) pacientes no se encontró consignado en el expediente síntomas de hiperandrogenismo, se consignó acantosis nigricans en 2(6.5%), alopecia y acné 3(9.7%), respectivamente como signo hiperandrogénico. Los fármacos utilizados para tratar síndrome de ovario poliquístico fueron metformina y anticonceptivos orales. Conclusión: el diagnóstico y tratamiento de síndrome de ovario poliquístico no sigue protocolos estandarizados, ya que de los 31 expedientes con resultado por ultrasonido, solo 5(16.1%) reunían los criterios para el diagnóstico de dicha patología...(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/diagnostic imaging , Hyperandrogenism/complications , Contraceptives, Oral/pharmacology , Menstruation Disturbances/complications
15.
Revista Digital de Postgrado ; 7(2): 26-34, 2018. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1095355

ABSTRACT

Determinar la prevalencia de dismenorrea en adolescentes estudiantes universitarias inscritas en la Escuela de Medicina de la Facultad de Medicina de la Universidad del Zulia, en Maracaibo, Venezuela. Métodos: Investigación descriptiva con diseño no experimental y transeccional, donde se evaluaron 232 adolescentes, mediante la aplicación de un cuestionario mixto con 34 preguntas cerradas referentes a la dismenorrea. Resultados: La prevalencia de dismenorrea se ubicó en 75 % (n=174/232). Sólo 24 % manifestaban haber consultado con un profesional médico y la mayoría consumían alguna medicación analgésica (89 %). En cuanto a los factores de riesgo identificados, sólo mostraron una asociación significativa con la presencia de dismenorrea el consumo de cafeína (OR=3,935; IC95 %= 1,818­8,515; p <0,001), el antecedente familiar de dismenorrea (OR=1,985; IC95 %= 0,966­4,081; p <0,05), la hipermenorrea (OR=1,965; IC95 %= 1,077­3,584; p <0,05); la depresión (OR=8,250; IC 95 %= 1,086­62,630; p= 0,01) y las dificultades familiares (OR=3,681; IC 95 %= 1,820­7,446; p <0,05). Por otra parte, se encontró una asociación significativa entre la dismenorrea con el ausentismo académico (p< 0,05) y la productividad académica (p< 0,05); ésta última demostró una doble probabilidad de verse afectada debido a la presencia de dismenorrea (OR=1,906; IC 95 %= 1,034­3,511; p< 0,05). Conclusión: La dismenorrea es un problema de salud importante en las adolescentes universitarias evaluadas, lo cual se asociaba con diversos factores de riesgo modificables o no, la cual repercute en su productividad(AU)


To determine the prevalence of dysmenorrhea in adolescent university students enrolled in the Medicine School at the Faculty of Medicine of the University of Zulia in Maracaibo, Venezuela. Methods: A descriptive research with non-experimental, and transeccional design was conducted; where assessed 232 adolescents by applying a mixed questionnaire with 34 closed questions concerning dysmenorrhea. Results: The prevalence of dysmenorrhea was at 75 % (n= 174/232). Only 24 % reported having consulted with a medical professional and most consumed any pain medication (89 %). As for the risk factors identified, only they showed a significant association with the presence of dysmenorrhea caffeine consumption (OR = 3.935; 95 % CI = 1.818 to 8.515; p <0.001), family history of dysmenorrhea (OR = 1,985; 95 % CI = 0.966 to 4.081; p <0.05), hypermenorrea (OR = 1.965; 95 % CI = 1.077 to 3.584; p <0.05); depression (OR = 8.250; 95 % CI = 1.086 to 62.630; p = 0.01) and family difficulties (OR = 3,681; 95 % CI = 1.820 to 7.446; p <0.05). Moreover, a significant association between dysmenorrhea with academic absenteeism (p <0.05) and academic productivity (p <0.05) was found; the latter showed twice as likely to be affected due to the presence of dysmenorrhea (OR = 1.906; 95 % CI = 1.034 to 3.511; p <0.05). Conclusion: Dysmenorrhea is a major health problem in this university adolescents evaluated, which was associated with several modifiable factors or risk, which affects their academic productivity and contributes to increasing student absenteeism(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Students, Medical , Dysmenorrhea , Menstruation Disturbances , Gynecology , Internal Medicine
16.
Fisioter. Mov. (Online) ; 31: e003118, 2018. tab, graf
Article in English | LILACS | ID: biblio-953579

ABSTRACT

Abstract Introduction: Among the menstrual disorders of the female reproductive period, Premenstrual Syndrome (PMS) and Dysmenorrhea are the most prevalent. The intensity of the signs and symptoms in each of these conditions may compromise the physical, psychological and social well-being of the woman at the stage of the menstrual cycle. Objective: To compare the signs and symptoms of menstrual disorders in women who practice regular exercise or not. Methods: A cross-sectional study carried out on women who practice exercises regularly and sedentary women. The IPAQ questionnaires and the evaluation of signs and symptoms of dysmenorrhea and PMS were applied to non-sedentary and sedentary students from the Federal University of Sergipe, Campus Lagarto. Results: Both groups had similar data for mean age and the mean Body Mass Index (BMI), therefore, passive of comparison. The prevalence of dysmenorrhea was significantly higher among sedentary women, 82% in the sedentary group and 46% in the non-sedentary group (p < 0.001), as well as some negative impacts on the psychological, social and physical state of both PMS and dysmenorrhea. Conclusion: The prevalence of signs and symptoms of dysmenorrhea was significantly higher in the Sedentary Group. Analyzing the behavior of PMS in relation to the practice of physical exercises, it was observed that the signs and symptoms of depressed mood, fatigue, difficulty to concentrate, lack of interest in social and home activities were more significant in the Sedentary Group.


Resumo Introdução: Entre os distúrbios menstruais do período reprodutivo feminino, a Síndrome Pré-Menstrual (SPM) e a Dismenorréia, são as mais prevalentes. A intensidade dos sinais e sintomas de cada uma destas afecções, podem comprometer o bem estar físico, psicológico e social da mulher na fase do ciclo menstrual. Objetivo: Comparar os sinais e sintomas de distúrbios menstruais em mulheres praticantes ou não de exercício físico regular. Métodos: Estudo transversal, realizado em mulheres praticantes de exercício físico regular e sedentárias. Os questionários IPAQ e de avaliação dos sinais e sintomas de Dismenorréia e SPM, foram aplicados em alunas de academia e da Universidade Federal de Sergipe, Campus Lagarto. Resultados: As integrantes dos grupos praticantes e sedentários foram semelhantes em relação à média de idade e a média de Índice de Massa Corpórea (IMC), sendo portanto, passivas de comparação. A prevalência de dismenorreia foi significativamente maior entre as sedentárias, sendo 82% no grupo sedentárias e 46% no grupo praticantes (p < 0,001) bem como alguns impactos negativos sobre o estado psicológico, social e físico, tanto das entrevistadas com SPM quanto com dismenorreia. Conclusão: A prevalência de sinais e sintomas de dismenorreia foi significativamente maior no Grupo de Sedentárias. Quando analisado o comportamento da SPM em relação à prática de exercícios físicos, foi constatado que os sinais e sintomas de: o humor depressivo, fadiga, dificuldade de concentração, falta de interesse em atividades sociais e de casa, foram significativamente mais expressivos no Grupo Sedentário.


Subject(s)
Premenstrual Syndrome , Dysmenorrhea , Menstruation Disturbances , Exercise , Sedentary Behavior
17.
Article in Chinese | WPRIM | ID: wpr-317609

ABSTRACT

<p><b>OBJECTIVE</b>To explore the value of nutrition management in obese patients with type 2 diabetes mellitus(T2DM) after laparoscopic sleeve gastrectomy(LSG).</p><p><b>METHODS</b>Clinical data of 22 obese T2DM patients undergoing LSG from March 2013 to July 2015 in Fudan University Pudong Medical Center were collected. All the patients strictly followed the specialized instruction by nutritionists: diabetic and low calorie diet 3347.2 to 5020.8 kJ (800 to 1200 kcal) per day before the operation; low calorie liquid diet 2510.4 kJ(600 kcal) per day before operation for promoting gastric emptying; fasting diet before postoperative ventilation; clear liquid diet 1673.6 to 2510.4 kJ (400 to 600 kcal) per day after postoperative ventilation (liquid intake >2000 ml); low fat liquid diet 2928.8 to 3765.6 kJ (700 to 900 kcal) per day (protein 60 g per day at least, 2000 ml liquid) 2 weeks after the operation; semi-liquid diet 1 month after operation and gradually normal diet. All the 22 patients were followed up at 1 week, 1, 3, 6 months after operation on time. Changes of body weight, waist circumference, hip circumference, body mass index(BMI), blood glucose indexes induding fasting blood glucose(FBG), 2-hour postparandial blood glucose(PBG), fasting C-peptide, 2-hour postprandial C-peptide, fasting serum inculin(FINS), 2-hour postprandial inculin(INS), HbAlc, blood pressure and blood lipid indexes were observed and analyzed before and 1 week, 1, 3, 6 months after operation.</p><p><b>RESULTS</b>The average age of 22 patients (10 men and 12 women) was 38.6 years (18 to 66 years). The duration of diabetes varied from 1 month to 15 years. Comorbidity included 12 patients of high blood pressure, 14 of fatty liver, 1 of coronary heart disease, 1 of gout, 1 of chronic thyroiditis and 1 of menstrual disorder. LSG was performed successfully in all the patients and no severe complications and transference to laparotomy occurred. As compared to pre-operation, at 6 months after operation, the average body weight decreased from (103.9±20.2) kg to (80.9±12.6) kg (t=6.294, P=0.000), waist circumference from (118.6±13.8) cm to (96.4±8.0) cm (t=6.331, P=0.000), hip circumference from (116.9±12.6) cm to (104.0±7.7) cm (t=3.854, P=0.000), BMI from (36.2±5.9) kg/mto (27.9±3.5) kg/m(t=5.630, P=0.000), showing a decreasing trend over time. There was no underweight patient after 6 months follow-up. As compared to pre-operation, at 6 months after operation, the average FBG reduced from (7.4±1.4) mmol/L to (6.0±0.9) mmol/L (t=3.172, P=0.003), 2 h PBG from (14.1±4.9) mmol/L to (7.5±2.2) mmol/L (t=7.026, P=0.000), FINS from (160.0±71.9) mIU/L to (43.8±20.8) mIU/L (t=7.259, P=0.000), 2-hour postprandial INS from (437.6±261.4) mIU/L to (140.5±104.6) mIU/L (t=5.858, P=0.000), fasting C-peptide from (1.1±0.6) μg/L to (0.7±0.3) μg/L (t=3.560, P=0.000), 2-hour postprandial C-peptide from (2.5±0.9) μg/L to (1.5±0.7) μg/L (t=3.865, P=0.000), HbAlc from (8.0±1.6)% to (5.9±0.6)% (t=5.953, P=0.000), showing a decreasing trend over time except FBG, 2h postprandial C-peptide and HbAlc(all P<0.05). FBG and 2-hour PBG of 16 patients returned to normal 3 months after the operation. Blood pressure and trigly ceride decreased obviously 6 months after operation compared to pre-operation with significant difference(P<0.05). At 6 months after operation, blood pressure of 8 comorbidity patients with high blood pressure became normal (8/12, 66.7%) and of 4 patients improved(4/12, 33.3%); B ultrasound examination revealed normal in 11 comorbidity patients with fatty liver(11/14,78.6%) and improvement in 3 patients (3/14,15.4%). Blood uric acid of the gout patient and the menstruation of the menstrual disorder patient returned to normal 3 months and 1 month after the operation respectively.</p><p><b>CONCLUSION</b>As for obese patients with T2DM undergoing LSG, reasonable nutrition management is helpful to decrease body weight, and to obtain an ideal improvement of blood glucose and blood lipid levels.</p>


Subject(s)
Adolescent , Adult , Aged , Bariatric Surgery , Blood Glucose , Physiology , Body Weights and Measures , C-Peptide , Blood , Physiology , Caloric Restriction , Combined Modality Therapy , Comorbidity , Coronary Disease , Diabetes Mellitus, Type 2 , Therapeutics , Diet Therapy , Methods , Diet, Diabetic , Endoscopy , Fatty Liver , General Surgery , Female , Food, Formulated , Gastrectomy , Glycated Hemoglobin A , Physiology , Gout , General Surgery , Hashimoto Disease , Humans , Hypertension , General Surgery , Insulin , Blood , Physiology , Lipids , Blood , Physiology , Male , Menstruation Disturbances , General Surgery , Middle Aged , Obesity , Therapeutics , Perioperative Care , Methods , Thyroiditis , Treatment Outcome , Triglycerides , Blood , Physiology
18.
Psychiatry Investigation ; : 727-733, 2017.
Article in English | WPRIM | ID: wpr-44352

ABSTRACT

OBJECTIVE: North Korean women defectors have suffered from anxiety, depression, and somatization after defection. Also they have had many menstrual problems like amenorrhea. This study was done to identify the correlations of anxiety, depression, and somatization to menstrual problems among North Korean woman defectors in South Korea. METHODS: The participants in this study were 126 women from 5 government resettlement centers throughout South Korea. Questionnaires which included State-Trait Anxiety Inventory (STAI), Center for Epidemiological studies-Depression Scale (CED-S), and Symptom Checklist-90-Revised (SCL-90-R) were used to identify anxiety and somatization. Data were collected between June and September, 2012. RESULTS: The women reported the following problems; amenorrhea (9.5%), hypomenorrhea (13.6%), menorrhagia (19.8%), polymenorrhea (13.5%), oligomenorrhea (4.8%), changes in amount of menstrual discharge (4.0%), and changes in amount of blood clot (9.5%). Anxiety (r=0.20, p=0.002), depression (r=0.25, p=0.005), and Somatization (r=0.35, p<0.001) were correlated with number of menstrual problems. CONCLUSION: The results of this study indicate that mental health services need to be taken into account in interventions for North Korean woman defectors to improve their reproductive health including addressing menstrual problems.


Subject(s)
Amenorrhea , Anxiety , Depression , Female , Humans , Korea , Menorrhagia , Menstruation , Menstruation Disturbances , Mental Health Services , Oligomenorrhea , Reproductive Health
20.
Article in Chinese | WPRIM | ID: wpr-815082

ABSTRACT

Van Wyk-Grumbach syndrome (VWGS) is a rare complication of prolonged untreated juvenile hypothyroidism characterized by precocious puberty and enlarged multicystic ovaries. A 13-year-old girl visited our outpatient clinic due to menstrual irregularities. She had precocious puberty, pituitary hyperplasia and multiple cystic ovaries in addition to clinical signs of severe congenital hypothyroidism. After the initiation of L-thyroxine therapy, the symptoms were alleviated in a short time. This rare syndrome is easy to be misdiagnosed as pituitary and ovarian tumor. High degree of suspicion and timely diagnosis can prevent unnecessary surgical procedures because the symptoms can be reversed with thyroid hormone supplementation.


Subject(s)
Adolescent , Congenital Hypothyroidism , Diagnosis , Diagnosis, Differential , Diagnostic Errors , Female , Humans , Hyperpituitarism , Hyperplasia , Menstruation Disturbances , Ovarian Cysts , Diagnosis , Ovary , Pathology , Pituitary Gland , Pathology , Puberty, Precocious , Diagnosis , Syndrome , Thyroxine , Therapeutic Uses
SELECTION OF CITATIONS
SEARCH DETAIL