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  • Original Article

    Sexual function in women with endometriosis and pelvic floor myofascial pain syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo40

    Summary

    Original Article

    Sexual function in women with endometriosis and pelvic floor myofascial pain syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo40

    DOI 10.61622/rbgo/2024rbgo40

    Views36

    Abstract

    Objective:

    To evaluate and compare the sexual function and pelvic floor muscles (PFM) function of women with endometriosis and chronic pelvic pain (CPP) with and without Myofascial Pelvic Pain Syndrome (MPPS).

    Methods:

    Cross-sectional study conducted between January 2018 and December 2020. Women with deep endometriosis underwent assessments for trigger points (TP) and PFM function using the PERFECT scale. Electromyographic activity (EMG) and sexual function through Female Sexual Function Index (FSFI) were assessed. Statistical analyses included chi-square and Mann-Whitney tests.

    Results:

    There were 46 women. 47% had increased muscle tone and 67% related TP in levator ani muscle (LAM). Weakness in PFM, with P≤2 was noted in 82% and P≥3 in only 17%. Incomplete relaxation of PFM presented in 30%. EMG results were resting 6.0, maximal voluntary isometric contraction (MVIC) 61.9 and Endurance 14.2; FSFI mean total score 24.7. We observed an association between increased muscle tone (P<.001), difficulty in relaxation (P=.019), and lower Endurance on EMG (P=.04) in women with TP in LAM. Participants with TP presented lower total FSFI score (P=.02). TP in the right OIM presented increased muscle tone (P=.01). TP in the left OIM presented lower values to function of PFM by PERFECT (P=.005), and in MVIC (P=.03) on EMG.

    Conclusion:

    Trigger points (TP) in pelvic floor muscles (PFM) and obturator internus muscle (OIM) correlates with poorer PFM and sexual function, particularly in left OIM TP cases. Endometriosis and chronic pelvic pain raise muscle tone, weaken muscles, hinder relaxation, elevate resting electrical activity, lower maximum voluntary isometric contraction, and reduce PFM endurance.

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  • Original Article

    Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):360-368

    Summary

    Original Article

    Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):360-368

    DOI 10.1055/s-0042-1743099

    Views38

    Abstract

    Objective

    To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women.

    Methods

    A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study’s participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%.

    Results

    Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81±81.84 METs), followed by work-related activities (40.77±84.71 METs). Only 19.3% women exercised during pregnancy (4.76±12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR=29.8; 95% CI 4.9-117.8). Nulliparity (OR=3.1; 95% CI 1.0-9.1), low levels of anxiety (OR=3.6; 95% CI 1.2-10.7), and unemployment (OR=4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy.

    Conclusion

    Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.

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  • Editorial

    Physical exercise during pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):531-534

    Summary

    Editorial

    Physical exercise during pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):531-534

    DOI 10.1590/SO100-720320140005176

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  • Artigo de Revisão

    Recommendations for physical exercise practice during pregnancy: a critical review

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):423-431

    Summary

    Artigo de Revisão

    Recommendations for physical exercise practice during pregnancy: a critical review

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(9):423-431

    DOI 10.1590/SO100-720320140005030

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    Physical exercise is recommended for all healthy pregnant women. Regular practice of exercises during pregnancy can provide many physical and psychological benefits, with no evidence of adverse outcomes for the fetus or the newborn when exercise is performed at mild to moderate intensity. However, few pregnant women engage in this practice and many still have fears and doubts about the safety of exercise. The objective of the present study was to inform the professionals who provide care for Brazilian pregnant women about the current recommendations regarding physical exercise during pregnancy based on the best scientific evidence available. In view of the perception that few systematic models are available about this topic and after performing several studies in this specific area, we assembled practical information of interest to both the professionals and the pregnant women. We also provide recommendations about the indications, contraindications, modalities (aerobics, resistance training, stretching and pelvic floor training), frequency, intensity and duration indicated for each gestational trimester. The review addresses physical exercise recommendation both for low risk pregnant women and for special populations, such as athletes and obese, hypertensive and diabetic subjects. The advantages of an active and healthy lifestyle should be always reinforced during and after gestation since pregnancy is an appropriate period to introduce new habits because pregnant women are usually more motivated to adhere to recommendations. Thus, routine exams, frequent returns and supervision are recommended in order to provide new guidelines that will have long-term beneficial effects for both mother and child.

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    Recommendations for physical exercise practice during pregnancy: a critical review

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