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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):83-88
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):83-88
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Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):988-993
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Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):988-993
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Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):183-190
, Considering that myths and misconceptions regarding natural procreation spread rapidly in the era of easy access to information and to social networks, adequate counseling about natural fertility and spontaneous conception should be encouraged in any kind of health assistance. Despite the fact that there is no strong-powered evidence about any of the aspects related to natural fertility, literature on how to increase the chances of a spontaneous pregnancy is available. In the present article, the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO, in the Portuguese acronym) Committee on Endocrine Gynecology provides suggestions to optimize counseling for non-infertile people attempting spontaneous conception.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):183-190
, Considering that myths and misconceptions regarding natural procreation spread rapidly in the era of easy access to information and to social networks, adequate counseling about natural fertility and spontaneous conception should be encouraged in any kind of health assistance. Despite the fact that there is no strong-powered evidence about any of the aspects related to natural fertility, literature on how to increase the chances of a spontaneous pregnancy is available. In the present article, the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO, in the Portuguese acronym) Committee on Endocrine Gynecology provides suggestions to optimize counseling for non-infertile people attempting spontaneous conception.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(3):126-132
DOI 10.1590/S0100-72032010000300005
PURPOSE: to compare serum homocysteine levels in polycystic ovary syndrome (PCOS) and non-PCOS women and correlate them with clinical, hormonal and metabolic parameters. METHODS: transverse study with carried out on 110 women, including 56 with PCOS and 54 normal controls. Patients were submitted to anamnesis, physical examination and pelvic sonograms and to the determination of homocysteine, C-reactive protein (CRP), glucose insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), free thyroxin (Free T4), prolactin, and testosterone. For the statistical analysis, we used the Student's t test, Pearson's product-moment correlation coefficient and the χ2 test. The "enter" method was used to determine independent association between variables. RESULTS: there was a significant increase in the average serum homocysteine levels in the group of patients with PCOS compared to controls (5.97±2.95 versus 5,17±1.33 µmol/L; p=0,015). As expected, since they are affected by PCOS, values of body mass index (BMI), waist circumference, total cholesterol, HDL cholesterol, triglycerides, insulin and HOMA were significantly different between groups. Serum homocysteine levels, BMI and PCOS were correlated. Multivariate analysis showed that PCOS, by itself, does not correlate with high serum homocysteine levels. CONCLUSIONS: PCOS women have significantly higher serum levels of homocysteine that may increase their risk for cardiovascular disease. However, other intrinsic PCOS-related factors, not identified in this study, may be responsible for this alteration.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(3):126-132
DOI 10.1590/S0100-72032010000300005
PURPOSE: to compare serum homocysteine levels in polycystic ovary syndrome (PCOS) and non-PCOS women and correlate them with clinical, hormonal and metabolic parameters. METHODS: transverse study with carried out on 110 women, including 56 with PCOS and 54 normal controls. Patients were submitted to anamnesis, physical examination and pelvic sonograms and to the determination of homocysteine, C-reactive protein (CRP), glucose insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), free thyroxin (Free T4), prolactin, and testosterone. For the statistical analysis, we used the Student's t test, Pearson's product-moment correlation coefficient and the χ2 test. The "enter" method was used to determine independent association between variables. RESULTS: there was a significant increase in the average serum homocysteine levels in the group of patients with PCOS compared to controls (5.97±2.95 versus 5,17±1.33 µmol/L; p=0,015). As expected, since they are affected by PCOS, values of body mass index (BMI), waist circumference, total cholesterol, HDL cholesterol, triglycerides, insulin and HOMA were significantly different between groups. Serum homocysteine levels, BMI and PCOS were correlated. Multivariate analysis showed that PCOS, by itself, does not correlate with high serum homocysteine levels. CONCLUSIONS: PCOS women have significantly higher serum levels of homocysteine that may increase their risk for cardiovascular disease. However, other intrinsic PCOS-related factors, not identified in this study, may be responsible for this alteration.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):524-530
DOI 10.1590/S0100-72032008001000008
Detection of endometrial cancer in asymptomatic women has not proved to be a cost-effective procedure. Studies on this matter have shown that ultrasonography as a detecting method presents a high ratio of false-positive results and a negligible effect on the mortality rate. This way, the assistance strategy should be based on earlier diagnosis and appropriate treatment in women who present postmenopause bleeding. Being a non-invasive method, largely available and with high sensitivity, the transvaginal ultrasonography should be the initial investigative method. Though there is no consensus about the echographical endometrial thickness, above which the investigation is to proceed, diagnostic hysteroscopy should be the next step. The risk of neoplasia in endometriums with thickness under or equal to 3 mm is low enough to limit hysteroscopy to exceptional cases. Biopsy must be a necessary part of the hysteroscopy, because the diagnosis, made on visual basis, alone may lead to false results. Outpatient hysteroscopy can be done in more than 95% of the cases, even in menopausal women, rarely with severe complications. The adoption of "non-contact" examination techniques and the progressive reduction of the hysteroscope diameter have decreased the discomfort associated to small outpatient procedures.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):524-530
DOI 10.1590/S0100-72032008001000008
Detection of endometrial cancer in asymptomatic women has not proved to be a cost-effective procedure. Studies on this matter have shown that ultrasonography as a detecting method presents a high ratio of false-positive results and a negligible effect on the mortality rate. This way, the assistance strategy should be based on earlier diagnosis and appropriate treatment in women who present postmenopause bleeding. Being a non-invasive method, largely available and with high sensitivity, the transvaginal ultrasonography should be the initial investigative method. Though there is no consensus about the echographical endometrial thickness, above which the investigation is to proceed, diagnostic hysteroscopy should be the next step. The risk of neoplasia in endometriums with thickness under or equal to 3 mm is low enough to limit hysteroscopy to exceptional cases. Biopsy must be a necessary part of the hysteroscopy, because the diagnosis, made on visual basis, alone may lead to false results. Outpatient hysteroscopy can be done in more than 95% of the cases, even in menopausal women, rarely with severe complications. The adoption of "non-contact" examination techniques and the progressive reduction of the hysteroscope diameter have decreased the discomfort associated to small outpatient procedures.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):532-537
DOI 10.1590/S0100-72032007001000007
PURPOSE: to determine the effects of soy-derived isoflavone on hot flashes, menopausal symptoms, and endometrial thickness in postmenopausal women. METHODS: this double-blind, placebo-controlled, randomized study involved 90 postmenopausal patients aged 45-60 years old attended at the Outpatient Menopause Clinic. All patients had been experiencing hot flashes accompanied or not by other hypo-estrogenic symptoms. Patients were randomized to receive either two soy capsules containing 50 mg of soy-derived isoflavone or two identical placebo capsules, twice a day for 12 weeks in a double-blind fashion. Each patient was observed for 12 weeks, with two evaluations being made, one at baseline and the other at the end of the study. At each time point, the patients were given a diary to record the severity of the climacteric symptoms experienced, assessed with a modified Kupperman index, using a 100 mm Visual Analogue Scale (VAS). The intensity of hot flashes was also assessed separately. The patients were also submitted to a transvaginal echography for the measurement of endometrial thickness. Yates chi2, ANOVA or t de Student and Mann-Whitney were used for statistical analysis. RESULTS: no significant difference was detected in the Kupperman index (64 versus 82, p>0,05) or in the hot flashes (20 versus 20, p>0,05) between the isoflavone and placebo groups. No significant difference was either detected concerning the Kupperman index and hot flashes before and after treatment, when the two groups were analyzed separately. No difference was detected in the endometrial thickness either in the isoflavone or the placebo group (0.28 versus 0.26 mm, respectively, p>0.05). CONCLUSIONS: our results indicate that 100 mg of isoflavone are not more effective than placebo in reducing hot flashes and hypo-estrogenic symptoms in postmenopausal women and present no effect on the endometrium thickness.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):532-537
DOI 10.1590/S0100-72032007001000007
PURPOSE: to determine the effects of soy-derived isoflavone on hot flashes, menopausal symptoms, and endometrial thickness in postmenopausal women. METHODS: this double-blind, placebo-controlled, randomized study involved 90 postmenopausal patients aged 45-60 years old attended at the Outpatient Menopause Clinic. All patients had been experiencing hot flashes accompanied or not by other hypo-estrogenic symptoms. Patients were randomized to receive either two soy capsules containing 50 mg of soy-derived isoflavone or two identical placebo capsules, twice a day for 12 weeks in a double-blind fashion. Each patient was observed for 12 weeks, with two evaluations being made, one at baseline and the other at the end of the study. At each time point, the patients were given a diary to record the severity of the climacteric symptoms experienced, assessed with a modified Kupperman index, using a 100 mm Visual Analogue Scale (VAS). The intensity of hot flashes was also assessed separately. The patients were also submitted to a transvaginal echography for the measurement of endometrial thickness. Yates chi2, ANOVA or t de Student and Mann-Whitney were used for statistical analysis. RESULTS: no significant difference was detected in the Kupperman index (64 versus 82, p>0,05) or in the hot flashes (20 versus 20, p>0,05) between the isoflavone and placebo groups. No significant difference was either detected concerning the Kupperman index and hot flashes before and after treatment, when the two groups were analyzed separately. No difference was detected in the endometrial thickness either in the isoflavone or the placebo group (0.28 versus 0.26 mm, respectively, p>0.05). CONCLUSIONS: our results indicate that 100 mg of isoflavone are not more effective than placebo in reducing hot flashes and hypo-estrogenic symptoms in postmenopausal women and present no effect on the endometrium thickness.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
DOI 10.1590/S0100-72032007000500004
PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3% women with PCOS had us-CRP levels defined as low, 34.8% as moderate and 37% as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4%) than in the women from the control group (6.8%). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):241-247
DOI 10.1590/S0100-72032007000500004
PURPOSE: to evaluate the ultra-sensitive C-Reactive Protein level (us-CRP) in patients with Polycystic Ovary Syndrome (PCOS), and the correlation of clinical and laboratory parameters with the us-CRP level. Methods: in this cross-sectional study, 46 women with Polycystic Ovary Syndrome, according to the Rotterdam criteria, and 44 control women have been included. Serum was analyzed for C reactive protein (CRP) levels. Body mass index (BMI), age, circumference waist, HOMA-IR, total, low and high density lipoprotein cholesterol, triglycerides, glucose, testosterone and insulin levels were correlated to CRP level through a linear regression model. RESULTS: PCOS patients not only were older and had higher BMI, but their waist circumference, fasting insulin, HOMA-IR, total and LDL cholesterol were also higher, as compared to the women from the control group. A significant difference was observed in the us-CRP level between the PCOS (2.7 mg/dL±2.17) the control (1.6 mg/dL±1.49) groups. When us-CRP levels were categorized as of low (<1.0 mg/L), moderate (1-3.0 mg/L) and high (3.0 mg/L) risk for cardiovascular episodes, only 28.3% women with PCOS had us-CRP levels defined as low, 34.8% as moderate and 37% as high risk. The prevalence of Metabolic Syndrome was higher in the women with PCOS (30.4%) than in the women from the control group (6.8%). Through a stepwise linear regression model, only waist circumference, presence of metabolic syndrome and age had a confounding effect in the relation between us-CRP and PCOS. After adjustment for confounding factors, PCOS showed an independent effect on us-CRP level. CONCLUSIONS: the us-CRP levels were higher in the PCOS women than in the healthy controls. By a regression model, PCOS showed an independent effect on us-CRP level.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):10-17
DOI 10.1590/S0100-72032007000100003
PURPOSE: to evaluate the prevalence of metabolic syndrome in women with polycystic ovary syndrome (PCOS). METHODS: forty six women with PCOS, in accord with Rotterdam criteria (2003), and 44 women with regular menses, without any clinical or laboratorial hyperandrogenism features, and no ultrasonographic ovarian microcysts (control group) were evaluated. For metabolic syndrome, the National Cholesterol Education Program (NCEP, 2002) and the International Diabetes Federation (IDF, 2005) guidelines were considered. RESULTS: the prevalence of metabolic syndrome were 30.4% (NCEP) and 32.6% (IDF) for the women with PCOS, nearly 4-fold higher than that reported for the control group (p<0.004), which were 6.8% (NCEP) and 9.1% (IDF). Women with PCOS had persistently higher prevalence rates of the metabolic syndrome, regardless of matched age and body mass index. The most prevalent factor of the metabolic syndrome among the PCOS subjects was low serum HDL cholesterol which was below 50 mg/dl (52.2%). Waist circumference above 88 cm (47.8%), blood pressure above 130/85 mmHg and fasting glycemia above 110 mg/dl (4.3%) were significantly more frequent among women with PCOS than among control women. CONCLUSIONS: the metabolic syndrome is significantly more frequent in women with PCOS, placing them at higher risk for cardiovascular disease.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):10-17
DOI 10.1590/S0100-72032007000100003
PURPOSE: to evaluate the prevalence of metabolic syndrome in women with polycystic ovary syndrome (PCOS). METHODS: forty six women with PCOS, in accord with Rotterdam criteria (2003), and 44 women with regular menses, without any clinical or laboratorial hyperandrogenism features, and no ultrasonographic ovarian microcysts (control group) were evaluated. For metabolic syndrome, the National Cholesterol Education Program (NCEP, 2002) and the International Diabetes Federation (IDF, 2005) guidelines were considered. RESULTS: the prevalence of metabolic syndrome were 30.4% (NCEP) and 32.6% (IDF) for the women with PCOS, nearly 4-fold higher than that reported for the control group (p<0.004), which were 6.8% (NCEP) and 9.1% (IDF). Women with PCOS had persistently higher prevalence rates of the metabolic syndrome, regardless of matched age and body mass index. The most prevalent factor of the metabolic syndrome among the PCOS subjects was low serum HDL cholesterol which was below 50 mg/dl (52.2%). Waist circumference above 88 cm (47.8%), blood pressure above 130/85 mmHg and fasting glycemia above 110 mg/dl (4.3%) were significantly more frequent among women with PCOS than among control women. CONCLUSIONS: the metabolic syndrome is significantly more frequent in women with PCOS, placing them at higher risk for cardiovascular disease.