RESUMO

Stress, infections, and psychological and social well-being can affect the reproductive system. Activation of the hypothalamic-pituitary-adrenal axis can disrupt ovarian cyclicity. Estrogens can modulate stress responsiveness and mood. Thus, understanding this interaction and how it modulates the menstrual cycle is crucial for women's reproductive health. PURPOSE: The objective of this study was to analyze the influence of a stressor, a period of the Covid-19 pandemic when there were no vaccines available yet, on the psychological state of women aged 18 to 45 years; as well as the influence of mental health on the menstrual cycle, considering the influence of age and hormonal contraceptives. METHOD: Online questionnaire using the Google Forms platform was used. RESULTS: There is a high prevalence of the onset of new psychosocial symptoms. Moreover, most women reported some type of change in their menstrual cycles. The women who were using hormonal contraceptives demonstrated a higher frequency of spotting and menstrual color alterations, while women without hormonal contraceptives demonstrated a higher frequency of cycle duration and menstrual odor alterations. Women without hormonal contraceptives were more susceptible to the development of psychosocial symptoms. Younger adult women were more affected by menstrual changes and psychosocial symptoms. Close to 90% of women who reported several psychosocial symptoms had changes in their menstrual cycles. CONCLUSION: These data suggest the impact of stressors, such as a period of the pandemic, on mental health and menstrual cycles, and younger adult women can be more susceptible. This reflects the relationship between mental and reproductive health.

RESUMO

OBJECTIVE: To analyze differences in the menstrual pattern, age at menarche, and body mass index (BMI) in adolescents with Hypothalamic-Pituitary-Ovarian (HPO) axis immaturity and Polycystic Ovary Syndrome (PCOS) through a systematic review and meta-analysis. METHODS: The PubMed, EMBASE, Web of Science, Virtual Health Library, Scopus databases were searched using combinations of descriptors. Study quality was assessed using the Newcastle-Ottawa Scale. For data analysis, the results were grouped into PCOS group and NPCOS group (HPO axis immaturity). We performed a meta-analysis of raw data and the inverse variance method, employing the standardized mean difference, of the age at menarche and BMI of adolescents. RESULTS: Participants totaled 1,718 from nine selected studies. The meta-analysis showed that the PCOS group had a higher BMI than the NPCOS group (SMD 0.334; CI95% 0.073 - 0.595; p = .012). The degree of heterogeneity of the studies was approximately 40%. No significant difference in age at menarche (SMD - 0.027; CI95% -0.227 - 0.172; p = 0.790) and menstrual patterns was found, but amenorrhea was described only in adolescents with PCOS. CONCLUSIONS: The main characteristic in menstrual pattern that differentiated PCOS patients from girls with HPO axis immaturity was amenorrhea. Also, the BMI of PCOS patients was nearly one third higher than that of adolescents with HPO axis immaturity.

Assuntos

RESUMO

Abnormal uterine bleeding (AUB) is a bleeding from the uterine corpus that is abnormal in regularity, volume, frequency or duration. It encompasses heavy menstrual bleeding, irregular menstrual bleeding and intermenstrual bleeding, which are common symptoms among women of reproductive age, impacting their overall well-being. Menstruation involves interactions between endometrial epithelial and stromal cells, immune cell influx, and changes in endometrial vasculature. These events resemble an inflammatory response with increased vessel permeability, tissue breakdown, and the arrival of innate immune cells. However, the mechanisms of menstrual cessation are poorly understood. AUB can be related to structural causes (polyp, adenomyosis, leiomyoma, malignancy/hyperplasia) and nonstructural conditions (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic). While transvaginal ultrasound is the primary method for the screening of intracavitary lesions, saline infusion sonohysterography is more accurate to detect endometrial polyps and submucous leiomyomas, while hysteroscopy with biopsy remains the reference method for a definitive diagnosis. The main goals in managing AUB are addressing and correcting the underlying primary cause, if possible, and establishing a regular bleeding pattern or amenorrhea, which can be done with antifibrinolytic agents, progestins, gonadotropin-releasing hormone agonists and antagonists, or surgical interventions, each one with specific indications and limitations. Further research is necessary to assess the effectiveness and the long-term effects of various medical and surgical treatments. Meanwhile, the availability of diagnostic methods such as transvaginal ultrasound and hysteroscopy and the universal distribution of medical treatments for AUB should be prioritized by policymakers to minimize the diagnostic and treatment delay and thus reduce the risk of AUB-related anemia and the need of hysterectomy.

RESUMO

BACKGROUND: Primary dysmenorrhea (PD) is an etiological cyclic pelvic pain related to the menstrual period; it can negatively impact women's quality of life and productivity. The aim of the present study was to estimate the prevalence of PD and analyze associated symptoms in Brazilian women. METHODS: An online cross-sectional study was carried out in Brazil, with a structured questionnaire regarding dysmenorrhea and associated symptoms. PD intensity was measured with the Numerical Rating Scale for Pain and classified as mild (1-3), moderate (4-7) and severe (> 8). The association between qualitative variables was performed using Pearson's Chi-Square Test. The quantification of this association was measured using multinomial logistic regression models, with calculation of Odds Ratio and confidence interval. A significance level of 5% was considered. RESULTS: A total of 10,070 women were included. Most participants classified PD intensity as moderate (40.4%, 41.9% and 49.7%) and severe (21.2%, 24.8% and 28.4%) in the previous month, 3 months and 5 years, respectively. The most common symptoms associated with PD were irritability, abdominal distension sensation, anxiety and feeling more emotional. The increased of the risk (OR > 1.0) for moderate and severe PD-related pain intensity is related to age, nulliparity and presence PD since adolescence. CONCLUSION: There is a high prevalence of PD among Brazilian women, and the most common symptoms reported were irritability, abdominal distension sensation, anxiety and feeling more emotional.

Assuntos

RESUMO

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

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

RESUMO

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

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

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

Assuntos

RESUMO

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

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

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

Assuntos

RESUMO

Background: Hemolacria or the presence of blood in tears is a rare condition, and there are only a few cases reported in the literature. Hemolacria is associated with multiple underlying diseases, including vicarious menstruation due to extragenital endometriosis. Case report: We present a 26-year-old woman with hemolacria and abdominal pain related to her menstrual cycle. The patient was diagnosed with bilateral ovarian endometriomas. After ruling out other possible causes of hemolacria, a progestin-only treatment was applied, with improvement of the abdominal pain and complete remission of hemolacria. Conclusions: When faced with hemolacria, a thorough anamnesis and physical examination must be performed, sometimes involving more than one specialist to reach a diagnosis. Considering hemolacria is a sign of a subjacent pathology, its treatment should be specific one for the disease in each case.

Antecedentes: La hemolacria o presencia de sangre en las lágrimas es una afección poco frecuente y sólo hay unos pocos casos descritos en la literatura. La hemolacria se asocia a múltiples enfermedades subyacentes, incluida la menstruación vicaria debida a endometriosis extragenital. Caso clínico: Presentamos a una mujer de 26 años con hemolacria y dolor abdominal relacionado con su ciclo menstrual. La paciente fue diagnosticada de endometriomas ováricos bilaterales. Tras descartar otras posibles causas de hemolacria, se aplicó un tratamiento sólo con progestágenos, con mejoría del dolor abdominal y remisión completa de la hemolacria. Conclusiones: Ante una hemolacria se debe realizar una anamnesis y exploración física minuciosa, en la que a veces interviene más de un especialista para llegar al diagnóstico. Teniendo en cuenta que la hemolacria es signo de una patología subyacente, su tratamiento debe ser el específico para la enfermedad en cada caso.

Assuntos

RESUMO

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.

Assuntos

RESUMO

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

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

Assuntos