Therapeutics Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Review Article

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

    Revista Brasileira de Ginecologia e Obstetrícia. 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

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):986-994

    DOI 10.1055/s-0042-1756148

    Views20

    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
  • Relato de Caso

    Inflammatory bowel disease – Crohn’s disease and pregnancy: case report

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(4):196-204

    Summary

    Relato de Caso

    Inflammatory bowel disease – Crohn’s disease and pregnancy: case report

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(4):196-204

    DOI 10.1590/S0100-72032011000400008

    Views8

    The Crohn's disease, a form of inflammatory bowel disease, is frequent in women of childbearing age. Its management requires greater attention during pregnancy. We report a case of refractory Crohn's disease in a pregnant patient that evolued to ileocolectomy at puerperium. The literature regarding pregnant patients with Crohn's disease was reviewed, including counseling of patients and investigation of active disease, and the existing data was summarized on the safety of medications used to treat Crohn's disease in pregnancy and breastfeeding.

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    Inflammatory bowel disease – Crohn’s disease and pregnancy: case report

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