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13 articles
  • Review Article

    Management Strategies for Sexuality Complaints after Gynecologic Cancer: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(10):962-971

    Summary

    Review Article

    Management Strategies for Sexuality Complaints after Gynecologic Cancer: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(10):962-971

    DOI 10.1055/s-0042-1756312

    Views2

    Abstract

    Objective

    To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided.

    Data Source

    Searches were conducted in six electronic databases: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO, and EMBASE.

    Study Selection

    Articles published between 2010 and 2020 were selected and the following descriptors were used in the English language: female genital neoplasms and gynaecological cancer. The methodological quality of the studies used the Mixed Methods Appraisal Tool (MMAT).

    Data Collection

    The primary data extracted were: names of the authors, year of publication, country of origin, objective and type of study, data collection instrument, sample size and age range, types of cancer, and symptoms affected with the strategies adopted.

    Data Summary

    A total of 34 out of 2,536 screened articles were included. The main strategies found for patient care were patient-clinician communication, practices for sexuality care, individualized care plan, multiprofessional team support, and development of rehabilitation programs. For sexuality care, the most common practices are pelvic physiotherapy sessions and the use of vaginal gels and moisturizers.

    Conclusion

    The main complaints identified in the scientific literature were low libido and lack of interest in sexual activity, vaginal dryness, pain during sexual intercourse, and stenosis. Different care strategies may be adopted, such as follow-up with a multidisciplinary health team and sexual health rehabilitation programs, which could minimize these symptoms and ensure the quality of life of patients.

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    Management Strategies for Sexuality Complaints after Gynecologic Cancer: A Systematic Review
  • Review Article

    The Effectiveness of Herbal Medicines on Cyclic Mastalgia: A Systematic Review on Meta-analysis

    Rev Bras Ginecol Obstet. 2022;44(10):972-985

    Summary

    Review Article

    The Effectiveness of Herbal Medicines on Cyclic Mastalgia: A Systematic Review on Meta-analysis

    Rev Bras Ginecol Obstet. 2022;44(10):972-985

    DOI 10.1055/s-0042-1755456

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    Abstract

    Objective

    Different drugs are used to treat mastalgia, such as danazol and bromocriptine, and both are associated with side effects, due to which most of women and healthcare providers are interested in herbal medicines. Therefore we aim to study the effectiveness of phytoestrogens on the severity of cyclic mastalgia.

    Methods

    To carry out the present study, English electronic resources such as the Cochrane Library, ISI Web of Science, Scopus, and PubMed were used systematically and with no time limitation up to February 10, 2020.

    Results

    In total, 20 studies were included in the present meta-analysis. The results of the meta-analysis showed that herbal medicines versus the control group (standard mean difference [SMD] = - 0.585; 95% confidence interval [CI]: - 0.728–- 0.44; heterogeneity; p = 0.02; I2 = 42%), herbal medicines versus the B group (SMD = - 0.59; 95%CI: - 0.75–- 0.44; heterogeneity; p = 0.03; I2 = 42%), and its subgroups, such as phytoestrogen (SMD = - 0.691; 95%CI: - 0.82–- 0.55; heterogeneity; p = 0.669; I2 = 0%), Vitex-agnus-castus (SMD = - 0.642; 95%CI: - 0.84–- 0.44; p < 0.001; p = 203; I2 = 32%), flaxseed (SMD = - 0.63; 95%CI: - 0.901–- 0.367; p = 0.871; I2 = 0%), and evening primrose (SMD= - 0.485; 95%CI:- 0.84–- 0.12; p = 0.008; heterogeneity; p = 0.06; I2 = 56%] may have effective and helpful effects on improving cyclic breast mastalgia. Also, chamomile, isoflavone, cinnamon, and nigella sativa significantly reduced mastalgia symptoms.

    Conclusion

    Herbal medicines and their subgroups may have effective and helpful effects on improving cyclic breast mastalgia. The findings of our meta-analysis must be done cautiously because low methodological quality in some evaluated studies of this systematic review.

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    The Effectiveness of Herbal Medicines on Cyclic Mastalgia: A Systematic Review on Meta-analysis
  • Review Article

    Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(10):986-994

    Summary

    Review Article

    Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(10):986-994

    DOI 10.1055/s-0042-1756148

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    Abstract

    Objective

    To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women.

    Data Sources

    We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied.

    Selection of Studies

    We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women.

    Data Collection

    Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors.

    Data Synthesis

    A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO2 laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study).

    Conclusion

    We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).

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    Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review
  • Letter to the Editor

    Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women

    Rev Bras Ginecol Obstet. 2022;44(10):995-998

    Summary

    Letter to the Editor

    Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women

    Rev Bras Ginecol Obstet. 2022;44(10):995-998

    DOI 10.1055/s-0042-1755340

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    Dear Editor, We enthusiastically read the analysis conducted in the study Adequacy of Prenatal Care During The COVID-19 Pandemic: An Observational Study with Postpartum Women, published in volume 44 issue #4 of the Brazilian Journal of Gynecology and Obstetrics in 2022, and would like to bring some considerations about the topic. […]
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  • Febrasgo Position Statement

    Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022

    Rev Bras Ginecol Obstet. 2022;44(10):999-1009

    Summary

    Febrasgo Position Statement

    Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022

    Rev Bras Ginecol Obstet. 2022;44(10):999-1009

    DOI 10.1055/s-0042-1758490

    Views4

    Key points

    Recommendations

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    Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022

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