Premature ovarian insufficiency: knowledge, attitudes, and quality of care offered by gynecologists.

OBJECTIVE: Premature ovarian insufficiency (POI) affects up to 3% of the global female population, influencing metabolic, cardiovascular, and reproductive health. Medical expertise in diagnosis, effects, and treatment strategies, particularly for gynecologists, is crucial for ensuring improved healthcare for women. The objective of this study is to assess the state of medical knowledge regarding the diagnosis, treatment, and follow-up of POI among Brazilian gynecologists. METHODS: A cross-sectional study was conducted using online questionnaires administered to 16,000 members of the Brazilian Federation of Gynecology and Obstetrics. RESULTS: In total, 460 questionnaires were received from gynecologists who had an average age of 44.49 ± 12.57 years and 19.37 ± 12.95 years of professional experience. Fifty-three percent of gynecologists diagnosed POI correctly, and 49% requested karyotype analysis, while fewer than 10% identified all POI etiologies. Over 90% of gynecologists understood the long-term consequences of POI for bone and cardiovascular health. Despite being a consequence of hypoestrogenism, hormone therapy was recommended only by 20% of doctors, with no more than 50% of them prescribing appropriate doses for young women. Regarding self-perception, 60% of gynecologists declared deficient knowledge regarding how to offer care and guidance to women, with hormone therapy being reported as the most important reason (47%). CONCLUSIONS: Current concepts and guidelines for POI are not adequately understood or applied in Brazilian clinical practice, leading to suboptimal care.

Assessment of quality of life and psychological repercussions in women with endometriosis according to pain intensity.

The objective is to evaluate quality of life, anxiety, and depression in women with endometriosis, and to correlate these parameters with pain intensity. This multicenter cross-sectional study was conducted on 102 women with endometriosis from 2017 to 2020. The women were divided into two groups according to the pain intensity: group 1 (severe pain, 62 women) and group 2 (mild/moderate pain, 40 women). The Endometriosis Health Profile Questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory were used to assess quality of life and levels of anxiety and depression, respectively. In both groups, mean age and mean body mass index were similar (p˃ 0.5). Most women had deep endometriosis and were on treatment, but group 2 had a longer treatment time (p = 0.044). Group 1 exhibited more depression and anxiety than group 2 (17.1 ± 9.98 vs. 11.15 ± 9.25, p = 0.003 and 23.71 ± 12.92 vs 12.58 ± 10.53, p = 0.001, respectively). Women with high pain had a significantly worse quality of life than those with low pain (48.88 ± 16.02 vs. 23.32 ± 15.93, p < 0.001). Women with endometriosis and high pain intensity have a worse quality of life, and more severe levels of anxiety and depression.

When Solving Dyspareunia Is Not Enough to Restore Sexual Function in Women With Deep Infiltrating Endometriosis Treated With Dienogest.

The aim of the study was to evaluate dyspareunia and sexual function (SF) in women with deep infiltrating endometriosis (DIE) who were treated with dienogest (DNG) for 12 months. The prospective cohort study took place at the University of Campinas, Brazil, and included 30 women with sonographic diagnosis of DIE and sexual dysfunction treated with 2 mg/daily DNG for 12 months. SF parameters were assessed by the Female Sexual Function Index (FSFI) before and after treatment, and dyspareunia was quantified through the visual analog scale (VAS) during the follow-ups performed every three months. Statistical analysis was performed by ANOVA test and through the use of software SAS, Version 9.4. Women were on average 36.13 ± 6.24 years old, and all of them showed sexual dysfunction (FSFI =17.6 ± 5.7) before DNG; 88.3% had dyspareunia as the main symptom related to DIE (VAS before: 5.3 ± 3.1). At the end of the treatment, dyspareunia showed a decrease of intensity (VAS after: 3.7 ± 3.3; p = .0093) and an improvement on FSFI index was accomplished (p = .0023); however, it did not restore SF completely, considering the FSFI cutoff < 26.55. Long-term treatment for DIE with DNG has provided a decrease in dyspareunia and also an enhancement of SF, although SF has not been restored to normal levels.

Sociodemographic characteristics of women in a public hospital in Campinas who underwent legal abortion due to sexual violence: cross-sectional study.

CONTEXT AND OBJECTIVE:: Sexual violence is increasingly frequent worldwide. The aim here was to evaluate the sociodemographic and psychological characteristics of women who requested legal abortion, at a public healthcare service, after sufering sexual violence. DESIGN AND SETTING:: Retrospective descriptive study on 131 women who underwent legal abortion at the University of Campinas between 1994 and 2014, consequent to sexual violence. METHODS:: The sociodemographic and psychological characteristics of women who were victims of sexual violence were evaluated from their medical records. The tests used to evaluate possible associations were the chi-square and/or Fisher's exact test. RESULTS:: The women's mean age was 23 ± 9.2 years; 77.9% were white and 71.8% were single; 32.8% were students and 58.6% had employment outside of their homes. The majority reported that they did not know the aggressor (62.3%), but among the adolescents, 58% of the aggressors were known. The majority asked for abortion up to the 12th weeks of gestation (63.4%). Only 2.3% presented curettage complications. The psychological situation most frequently encountered was determined, in 34.4% of the cases before the abortion; and good in 32.8% after the abortion. CONCLUSIONS:: There was greater occurrence of sexual violence among students and women who worked outside. Among the students, most of these were adolescents and had no previous sexual life. The teenagers were raped by a known aggressor.

Sociodemographic characteristics of women in a public hospital in Campinas who underwent legal abortion due to sexual violence: cross-sectional study / Características sociodemográficas de mulheres que realizaram aborto legal decorrente de violência sexual em um Hospital Público em Campinas: estudo transversal

ABSTRACT CONTEXT AND OBJECTIVE: Sexual violence is increasingly frequent worldwide. The aim here was to evaluate the sociodemographic and psychological characteristics of women who requested legal abortion, at a public healthcare service, after sufering sexual violence. DESIGN AND SETTING: Retrospective descriptive study on 131 women who underwent legal abortion at the University of Campinas between 1994 and 2014, consequent to sexual violence. METHODS: The sociodemographic and psychological characteristics of women who were victims of sexual violence were evaluated from their medical records. The tests used to evaluate possible associations were the chi-square and/or Fisher's exact test. RESULTS: The women's mean age was 23 ± 9.2 years; 77.9% were white and 71.8% were single; 32.8% were students and 58.6% had employment outside of their homes. The majority reported that they did not know the aggressor (62.3%), but among the adolescents, 58% of the aggressors were known. The majority asked for abortion up to the 12th weeks of gestation (63.4%). Only 2.3% presented curettage complications. The psychological situation most frequently encountered was determined, in 34.4% of the cases before the abortion; and good in 32.8% after the abortion. CONCLUSIONS: There was greater occurrence of sexual violence among students and women who worked outside. Among the students, most of these were adolescents and had no previous sexual life. The teenagers were raped by a known aggressor.

RESUMO CONTEXTO E OBJETIVO: A violência sexual está cada vez mais frequente no mundo. O objetivo foi avaliar as características sociodemográfcas e psicológicas das mulheres que solicitaram o aborto legal em um serviço público após violência sexual. DESENHO DO ESTUDO E LOCAL: Estudo descritivo retrospectivo com 131 mulheres que realizaram aborto legal após violência sexual na Universidade Estadual de Campinas no período de 1994 a 2014. MÉTODOS: Foram avaliadas as características sociodemográfcas e psicológicas das mulheres vítimas de violência sexual por meio de seus prontuários. Os testes utilizados para avaliar possíveis associações foram o qui-quadrado e/ou o teste exato de Fisher. RESULTADOS: A idade média foi de 23 ± 9,2; 77,9% eram brancas e 71,8% solteiras; 32,8% eram estudantes e 58,6% trabalham fora. A maioria relatou desconhecer o agressor (62,3%), porém entre as adolescentes, 58% dos agressores eram conhecidos. A maioria das mulheres solicitou o aborto com até 12 semanas de gestação (63,4%). Apenas 2,3% apresentaram complicações decorrentes da curetagem e a situação psicológica mais encontrada foi decidida em 34,4% no pré-aborto e bem em 32,8% dos casos no pós-aborto. CONCLUSÕES: Houve maior ocorrência de violência sexual entre estudantes e mulheres que trabalham fora. As estudantes, na maioria, eram adolescentes sem vida sexual prévia. As adolescentes foram violentadas por agressor conhecido. CONCLUSÕES: Houve maior ocorrência de violência sexual entre estudantes e mulheres que trabalham fora. As estudantes, na maioria, eram adolescentes sem vida sexual prévia. As adolescentes foram violentadas por agressor conhecido.