Mobile health technologies for the monitoring of menstrual cycle: A systematic review of online stores in Brazil.

AIM: To perform a systematic review of available mHealth apps for menstrual cycle monitoring in Brazil. METHODS: A search for menstrual cycle mHealth apps from the Google Play Store and AppStore in Brazil was performed by two independent reviewers on October 2020, and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). RESULTS: Our review identified 2400 potentially relevant mHealth apps, of which 56 were eligible for inclusion. The majority of the apps offered tools to track menstruation symptoms (63%) and educational content for users (32%). The mean ( ±SD) MARS app quality score for the 28 evaluated apps in Android was 3.5 ± 0.6 on a 0-5 scale. For the 28 evaluated apps in iOS, the mean app quality score was 3.8 ± 0.4. Most of the included apps, for both systems, scored average for credibility, user interface, and engagement. CONCLUSION: The majority of available tools in Brazil are of moderate quality and limited functionality for menstrual cycle monitoring. This study highlights the top three mHealth apps available on each online store for individuals seeking menstrual cycle monitoring options.

Intrauterine device use is safe among nulligravidas and adolescent girls.

The use of intrauterine devices (IUDs), including the copper-bearing device and the levonorgestrel intrauterine system (LNG-IUS), is safe among nulligravidas and adolescent girls. However, several misconceptions limit their use in clinical practice; health-care providers are hesitant to prescribe IUDs, and several myths associated with their usage in nulligravidas and adolescents exist among both providers and women themselves. The high rates of unplanned pregnancies (which in many settings constitute a public health issue, primarily among adolescent females) can be attributed at least partially to lack of awareness and limited use of highly effective contraceptives such as IUDs. In this review, we discuss the role of non-hormonal and hormonal IUDs as effective contraceptives in nulligravidas and adolescent girls. We present a literature review of data that highlight contraceptive efficacy, side effects (including reasons for discontinuation), and continuation rates with the method. We searched the PubMed/MEDLINE, Cochrane Library, Embase, and Scopus databases for all articles published in English between January 1990 through September 2020. A large body of evidence confirmed the effectiveness of IUD/IUS, independent of age and parity. Studies showed a high expulsion rate among adolescents but not among nulligravidas. Additionally, bleeding patterns among adolescents and nulligravidas were similar to those observed among adults and parous women. The high early removal rates observed in adolescents were attributable to bleeding and/or pain, which indicate that compared with adults, adolescents are less likely to accept IUD-induced side effects. IUD placement is an excellent strategy to avoid the high rates of unplanned pregnancies in adolescents and nulligravidas. IUDs are more effective than short-acting reversible contraceptives with failure rates that are equivalent to those observed with permanent contraception. However, few long-term studies have investigated this category of women to definitively establish the role of IUD/IUS as effective means of contraception.

Quince años de estudio sobre las adherencias de labios menores / Fifteen-Year Study on the Labial Adhesions

Introducción: las adherencias de labios menores es un problema ginecológico frecuente en niñas prepuberales. De las niñas que lo padecen en algún momento de su vida (1,8 por ciento), el pico de mayor incidencia está entre los 13 y 23 meses de edad.Objetivo: mostrar los resultados de esta experiencia en el diagnóstico y manejo de esta entidad.Métodos: se realizó un estudio descriptivo, longitudinal y retrospectivo. Se revisó la totalidad de las historias clínicas de 804 niñas atendidas desde el 1º de enero de 1998 hasta el 31 de diciembre de 2012. La muestra quedó integrada por 54 casos con diagnóstico de adherencias de labios menores. Las variables estudiadas fueron: edad al diagnóstico, motivo de consulta, hallazgos clínicos, tipo de sinequia, tratamiento impuesto, entre otras.Resultados: hubo mayor incidencia de sinequias en niñas entre 3 meses y 3 años (74 por ciento), con predominio de la variedad incompleta y dentro de esta la del tercio inferior (66,6 por ciento). La distorsión anatómica de los genitales externos resultó el principal motivo de consulta (42,6 por ciento). Los mejores resultados del tratamiento se lograron con la combinación de medidas higiénicas y ejercicios de tracción lateral vulvar con el uso tópico de estrógenos. Las recidivas se presentaron en 12,9 por ciento de los casos a los seis meses de edad.Conclusiones: la adherencia de labios menores es una causa importante de consulta ginecológica en niñas. Se asocia a una gran ansiedad en padres y familiares. Se obtuvo buenos resultados con el tratamiento médico, sobre todo cuando se empleó estrógenos localmente(AU)

Introduction: Labial adhesions is a common gynecological problem in prepubertal adolescents. The highest peak incidence is between 13 and 23 months old of those girls sufferingfrom this problem at some point in their life (1.8 percent).Objective: Show the results of this experience in the diagnosis and management of this condition.Methods: A descriptive, longitudinal and retrospective study was conducted at revising all the medical records of 804 girls assisted from 1st January 1998 to 31st December, 2012. The sample was composed of 54 cases diagnosed with labial adhesions. The variables studied were age at diagnosis, presenting complaint, clinical findings, type of synechia, treatment, among others.Results: There was higher incidence of synechiae in children between 3 months and 3 years (74 percent), predominantly incomplete, andin the lower third (66.6 percent). The anatomical distortion of the external genitalia was the main reason for consultation (42.6 percent). Best treatment results were achieved with the combination of hygienic measures and vulvar lateral traction exercises with topical estrogen use. Recurrences occurred in 12.9 percent of cases at six months of age.Conclusions: Labialadhesion is a major cause of gynecological consultation in girls. It is associated with great anxiety in parents and relatives. Good results were obtainedwith medical treatment, especially when the topical use of estrogen(AU)

Quince años de estudio sobre las adherencias de labios menores / Fifteen-Year Study on the Labial Adhesions

Introducción: las adherencias de labios menores es un problema ginecológico frecuente en niñas prepuberales. De las niñas que lo padecen en algún momento de su vida (1,8 por ciento), el pico de mayor incidencia está entre los 13 y 23 meses de edad. Objetivo: mostrar los resultados de esta experiencia en el diagnóstico y manejo de esta entidad. Métodos: se realizó un estudio descriptivo, longitudinal y retrospectivo. Se revisó la totalidad de las historias clínicas de 804 niñas atendidas desde el 1º de enero de 1998 hasta el 31 de diciembre de 2012. La muestra quedó integrada por 54 casos con diagnóstico de adherencias de labios menores. Las variables estudiadas fueron: edad al diagnóstico, motivo de consulta, hallazgos clínicos, tipo de sinequia, tratamiento impuesto, entre otras. Resultados: hubo mayor incidencia de sinequias en niñas entre 3 meses y 3 años (74 por ciento), con predominio de la variedad incompleta y dentro de esta la del tercio inferior (66,6 por ciento). La distorsión anatómica de los genitales externos resultó el principal motivo de consulta (42,6 por ciento). Los mejores resultados del tratamiento se lograron con la combinación de medidas higiénicas y ejercicios de tracción lateral vulvar con el uso tópico de estrógenos. Las recidivas se presentaron en 12,9 por ciento de los casos a los seis meses de edad. Conclusiones: la adherencia de labios menores es una causa importante de consulta ginecológica en niñas. Se asocia a una gran ansiedad en padres y familiares. Se obtuvo buenos resultados con el tratamiento médico, sobre todo cuando se empleó estrógenos localmente(AU)

Introduction: Labial adhesions is a common gynecological problem in prepubertal adolescents. The highest peak incidence is between 13 and 23 months old of those girls sufferingfrom this problem at some point in their life (1.8 percent). Objective: Show the results of this experience in the diagnosis and management of this condition. Methods: A descriptive, longitudinal and retrospective study was conducted at revising all the medical records of 804 girls assisted from 1st January 1998 to 31st December, 2012. The sample was composed of 54 cases diagnosed with labial adhesions. The variables studied were age at diagnosis, presenting complaint, clinical findings, type of synechia, treatment, among others. Results: There was higher incidence of synechiae in children between 3 months and 3 years (74 percent), predominantly incomplete, andin the lower third (66.6 percent). The anatomical distortion of the external genitalia was the main reason for consultation (42.6 percent). Best treatment results were achieved with the combination of hygienic measures and vulvar lateral traction exercises with topical estrogen use. Recurrences occurred in 12.9 percent of cases at six months of age. Conclusions: Labialadhesion is a major cause of gynecological consultation in girls. It is associated with great anxiety in parents and relatives. Good results were obtainedwith medical treatment, especially when the topical use of estrogen(AU)