Articles - Revista Brasileira de Ginecologia e Obstetrícia

  • Thesis Abstract10-14-2004

    Risk factors for fetal macrosomy in pregnancies complicated by diabetes and daily hyperglycemia

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):586-586

    Abstract

    Thesis Abstract

    Risk factors for fetal macrosomy in pregnancies complicated by diabetes and daily hyperglycemia

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):586-586

    DOI 10.1590/S0100-72032004000700017

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  • Thesis Abstract10-14-2004

    Prediction of fetal acidemia by doppler velocimetry of the ductus venosus in gestations with placental insufficiency

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):585-585

    Abstract

    Thesis Abstract

    Prediction of fetal acidemia by doppler velocimetry of the ductus venosus in gestations with placental insufficiency

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):585-585

    DOI 10.1590/S0100-72032004000700015

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  • Thesis Abstract10-14-2004

    Effect of etonogestrel implant on platelet aggregation in healthy women

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):585-585

    Abstract

    Thesis Abstract

    Effect of etonogestrel implant on platelet aggregation in healthy women

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):585-585

    DOI 10.1590/S0100-72032004000700016

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  • Thesis Abstract10-14-2004

    Gene polymorphisms in preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):584-584

    Abstract

    Thesis Abstract

    Gene polymorphisms in preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):584-584

    DOI 10.1590/S0100-72032004000700014

    Views63
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  • Thesis Abstract10-14-2004

    Comparative study of techniques to perform tubal ligation: micro-laparoscopy versus minilaparotomy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):584-584

    Abstract

    Thesis Abstract

    Comparative study of techniques to perform tubal ligation: micro-laparoscopy versus minilaparotomy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):584-584

    DOI 10.1590/S0100-72032004000700013

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  • Thesis Abstract10-14-2004

    Effect of antiretroviral agents use on glucide metabolism in HIV-1 infected pregnant women and on anthropometric and biochemical parameters of newborn infant

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):583-583

    Abstract

    Thesis Abstract

    Effect of antiretroviral agents use on glucide metabolism in HIV-1 infected pregnant women and on anthropometric and biochemical parameters of newborn infant

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):583-583

    DOI 10.1590/S0100-72032004000700012

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  • Original Article10-14-2004

    Effects of raloxifene on plasma homocysteine concentration and lipid profile in postmenopausal women

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):573-578

    Abstract

    Original Article

    Effects of raloxifene on plasma homocysteine concentration and lipid profile in postmenopausal women

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):573-578

    DOI 10.1590/S0100-72032004000700010

    Views141

    PURPOSE: to evaluate the effects of raloxifene on plasma homocysteine concentration and lipid profile in postmenopausal women. METHODS: twenty-four healthy postmenopausal women, aged 50 to 70 years, with osteopenia and/or osteoporosis, were submitted to raloxifene therapy, 60 mg/day, for six months. Plasma homocysteine concentration was determined before and after three and six months of therapy, as well as total cholesterol, HDL-cholesterol LDL-cholesterol and triglyceride levels. Plasma homocysteine was measured by a polarized immunofluorescence assay and serum lipids by the enzymatic and colorimetric method. Data were analyzed statistically by ANOVA, Newman-Keuls test and Pearson’s correlation test. RESULTS: a significant decrease in total cholesterol of 15.3% (227.6±56.3 vs 200.6±29.8 vs 192.8±32.1 mg/dl; p<0.001) and LDL-cholesterol of 21.4% (151.4±46.3 vs 122.7±29.4 vs 119.0±28.6 mg/dl; p<0.001), and a significant increase in HDL-cholesterol of 9.5% (44.7±10.8 vs 52.2±12.6 vs 49.0±10.8 mg/dl; p<0.05) were observed. There was no reduction in triglyceride levels (134.9±50.3 vs 127.5±50.0 vs 121.0±36.0 mg/dl; p>0.05). Although not significant, a decrease in homocysteine by 4.5% (11.7±3.0 vs 11.0±2.9 vs 11.2±2.1 muM/l; p>0.05) was observed between the pre-and posttreatment periods, with a significant negative correlation between basal levels and posttreatment percentual reduction (r=-0.71; p<0.0001). CONCLUSIONS: raloxifene treatment, 60 mg/day, for six months caused a significant decrease in total and LDL-cholesterol and an increase in HDL-cholesterol in postmenopausal women. Plasma homocysteine concentration tended to decrease, this effect being more favorable in patients with elevated baseline levels.

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  • Original Article10-14-2004

    Mammographic parenchymal pattern in climacteric women receiving hormone replacement therapy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):563-571

    Abstract

    Original Article

    Mammographic parenchymal pattern in climacteric women receiving hormone replacement therapy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):563-571

    DOI 10.1590/S0100-72032004000700009

    Views83

    PURPOSE: to measure changes and predictors of changes in mammographic density of climacteric women, before and one year after hormone replacement therapy. METHODS: seventy climacteric women of 45 years or more participated in the study. They were followed-up at a Climacteric Outpatient Service. All of them used regularly either estrogenic or estroprogestative HRT for one year. They were submitted to one basal mammography and another at the end of the first year. HRT schedules could be different from each other, although with the same bioequivalence. Mammographic density was evaluated blindly at the beginning and at the end of the treatment. Age, ovarian function, time since menopause, body mass index, waist/hip ratio, age at menarche, age at first pregnancy, and smoking were evaluated as well. Mammographic density was classified according to the American College of Radiology BI-RADS system into one of the following four parenchymal patterns: A) entirely liposubstituted breasts, B) liposubstituted breasts with disperse glandular parenchyma, C) heterogeneously dense breasts, and D) extremely dense breasts. We proposed a subdivision of each category in to A e A1, B e B1, C and C1, D and D1 in order to identify smaller variations in mammographic density. Therefore, we attributed initial and final scores of 1-8 to each of the patients according to the mammographic density before and after HRT, corresponding to categories A to D1. The proportions of women that presented increase, decrease and no variation in mammographic density after 1 year of HRT were calculated. In addition, we estimated initial to final score variation using the paired t-test of the Statistical Package for Social Sciences (SPSS). RESULTS: mammographic density increased in 22.9%, decreased in 7.1% and did not change in 70% of the studied cases. A significant difference was observed between the score means before (2.2±1.82) and after HRT (2.5±1.9) (p=0.019). The androgenic distribution of body fat was associated with a denser mammographic pattern. CONCLUSIONS: an increase in mammographic density was shown in women undergoing HRT, and was most pronounced in women with androgenic fat distribution. Additional studies must be carried out in order to evaluate if this increment in mammographic density could impair the mammographic screening of breast cancer.

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  • Original Article03-27-2020

    Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):12-18

    Abstract

    Original Article

    Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):12-18

    DOI 10.1055/s-0039-1700797

    Views368

    Abstract

    Objective

    To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul.

    Materials and Methods

    A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group.

    Results

    The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56-6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR]=2.19; 95%CI: 1.42-3.37; p<0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR=3.01; 95%CI: 1.97-4.61; p<0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR =1.84; 95%CI: 1.25-2.71; p=0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables.

    Conclusion

    In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.

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  • Systematic Review05-01-2017

    Zika Virus Infection in Pregnant Women and Microcephaly

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248

    Abstract

    Systematic Review

    Zika Virus Infection in Pregnant Women and Microcephaly

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248

    DOI 10.1055/s-0037-1603450

    Views409

    Abstract

    From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damagetothe central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection’s devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment. All of these changes of varying severity directly or indirectly compromise the future life of these children, and are already considered a congenital syndrome linked to the ZIKV. Diagnosis is one of the main difficulties in the approach of this infection. Considering the clinical part, it has manifestations common to infections by the dengue virus and the chikungunya fever, varying only in subjective intensities. The most frequent clinical variables are rash, febrile state, non-purulent conjunctivitis and arthralgia, among others. In terms of laboratory resources, there are also limitations to the subsidiary diagnosis. Molecular biology tests are based on polymerase chain reaction (PCR)with reverse transcriptase (RT) action, since the ZIKV is a ribonucleic acid (RNA) virus. The RT-PCR shows serum or plasma positivity for a short period of time, no more than five days after the onset of the signs and symptoms. The ZIKVurine test is positive for a longer period, up to 14 days. There are still no reliable techniques for the serological diagnosis of this infection. If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment. However, evidence is needed to rule out other infections that also cause rashes, such as dengue, chikungunya, syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes. There is no specific antiviral therapy against ZIKV, and the therapeutic approach to infected pregnant women is limited to the use of antipyretics and analgesics. Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded. There is no need to modify the schedule of prenatal visits for pregnant women infected by ZIKV, but it is necessary to guarantee three ultrasound examinations during pregnancy for low-risk pregnancies, and monthly for pregnant women with confirmed ZIKV infection. Vaginal delivery and natural breastfeeding are advised.

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    Zika Virus Infection in Pregnant Women and Microcephaly
  • Review Article06-27-2022

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433

    Abstract

    Review Article

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433

    DOI 10.1055/s-0042-1742292

    Views434

    Abstract

    Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarianmorphology ought not to be used as a diagnostic criterion. Treatment should targetmanifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

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  • Review Article05-01-2018

    Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):287-293

    Abstract

    Review Article

    Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):287-293

    DOI 10.1055/s-0038-1660777

    Views419

    Abstract

    Objective

    To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials.

    Methods

    A search of the literature was conducted usingMedline, PubMed, MeSH and ScienceDirect. Combinations of the search terms “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” and “uterine artery” were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included.

    Results

    Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ~ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants.

    Conclusion

    The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR.

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  • Review Article09-16-2019

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519

    Abstract

    Review Article

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519

    DOI 10.1055/s-0039-1695002

    Views387

    Abstract

    Objective

    We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence – UI, fecal incontinence – FI, and pelvic organ prolapse – POP).

    Data

    sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.

    Data collection

    Two authors performed data extraction into a standardized spreadsheet.

    Data synthesis

    Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).

    Conclusion

    Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.

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  • Original Article04-09-2024

    Screening and prevention of preterm birth: how is it done in clinical practice?

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32

    Abstract

    Original Article

    Screening and prevention of preterm birth: how is it done in clinical practice?

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32

    DOI 10.61622/rbgo/2024rbgo32

    Views552

    Abstract

    Objective:

    To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.

    Methods:

    Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.

    Results:

    The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.

    Conclusion:

    In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.

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  • Review Article01-23-2022

    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

    Abstract

    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

    Views390

    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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  • Original Article04-08-2022

    Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141

    Abstract

    Original Article

    Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141

    DOI 10.1055/s-0041-1741456

    Views385

    Abstract

    Objective

    To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in university students, the factors associated with PMS, the most prevalent symptoms, and the interference of symptoms in academic, family, social, and work activities.

    Methods

    This cross-sectional study included 1,115 university students aged ≥ 18 years from the University of Rio Verde, Goiás. Premenstrual syndrome and PMDD were identified using the Premenstrual Symptoms Screening Tool. Associations with sociodemographic, behavioral, reproductive, nutritional, and health factors were investigated using the Poisson regression.

    Results

    The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). The most prevalent symptoms were physical, such as breast tenderness, bloating, e weight gain (73%); followed by psychological ones such as overeating/food cravings, tearful/more sensitive to rejection (> 60%). More than 30% of the patients reported that the symptoms interfered in a moderate-tosevere way in their social and academic activities. After adjusted analysis, PMS was more prevalent in those who were attending the 1st/2nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71).

    Conclusion

    Almost half of the university students had PMS and ~ 11%, PMDD. Physical symptoms were themost common and interfered in amoderate-to-severe way in various aspects of life. Attending the first semesters, consuming alcohol, and having depression were risk factors for PMS. The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome.

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