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There is limited evidence about the use of medications among pregnant women with COVID‐19, as well as risk factors for hospitalization due to COVID‐19 in pregnancy. We aimed to describe the use of medications among SARS‐CoV‐2‐positive pregnant women at the time around infection and identify predictors for hospitalization due to COVID‐19 in two hospitals in Brazil. This is a hospital record‐based study among pregnant women with positive SARS‐CoV‐2 tests between March 2020 and August 2022 from two Brazilian hospitals. Characteristics of sociodemographic, obstetrical, and COVID‐19 symptoms were extracted retrospectively. The prevalence use of medications was based on self‐reported use, and this was administered at the hospital. Logistic regression was used to estimate predictors of hospitalization due to COVID‐19. There were 278 pregnant women included in the study, of which 41 (14.7%) required hospitalization due to COVID‐19. The remaining 237 (85.3%) had mild symptoms or were asymptomatic. Most of the women had the infection in the third trimester (n = 149; 53.6%). The most prevalent medications used across all trimesters were analgesics (2.4% to 20.0%), antibacterials (15.0% to 23.1%), and corticosteroids (7.2% to 10.4%). Pre‐ or gestational hypertensive disorder (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.65, 14.87) and having at least one dose of vaccine against SARS‐CoV‐2 (OR 0.13, 95% CI 0.04, 0.39) were associated with hospitalization due to COVID‐19. Analgesics, antibacterials, and corticosteroids were the most frequently used medications among pregnant women with COVID‐19. Women with hypertensive disorders have almost a five‐fold increased risk of hospitalization due to COVID‐19. Vaccination was the strongest protective factor for severe COVID‐19. The COVID‐19 vaccination among pregnant women should be promoted, and pregnant women diagnosed with COVID‐19 who have hypertensive disorders should be closely monitored. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the effects of ultra-low-dose hormone therapy (Ultra-LD HT) with 17β-estradiol 0.5 mg and norethisterone acetate 0.1 mg (E2 0.5/NETA 0.1) versus placebo on bone turnover markers (BTM) in postmenopausal women.Study Design: A multicenter, double-blind, randomized, placebo-controlled study was performed with 107 participants who received one tablet daily of E2 0.5/NETA 0.1 or placebo for 24-weeks. Bone formation markers-N-terminal propeptide of type I procollagen (PINP) and Bone-specific alkaline phosphatase (BSAP), and bone resorption markers-C-telopeptide of type I collagen (CTX-I) and N-telopeptide crosslinked of type I collagen (NTX) were assessed before and at 12 and 24-weeks of treatment.Results: Women treated with E2 0.5/NETA 0.1 had a significant reduction in the PINP marker from baseline (58.49 ± 21.12 μg/L) to week 12 (48.31 ± 20.99 μg/L) and week 24 (39.16 ± 16.50 μg/L). Placebo group, the PINP marker did not differ significantly. The analysis of the BSAP indicated a significant increase in the placebo group (13.8 ± 5.09 μg/L and 16.29 ± 4.3 μg/L, at baseline and week 24, respectively), whereas in the treatment group the values did not change. The analysis of the NTX marker showed a significant reduction only in the treatment group (43.21 ± 15.26 nM/mM and 33.89 ± 14.9 nM/mM, at baseline and week 24, respectively). CTX-I had a significant decrease in the treatment group from baseline (0.3 ± 0.16 ng/L) to week 12 (0.21 ± 0.14 ng/L) and week 24 (0.21 ± 0.12 ng/L).Conclusion: Women receiving E2 0.5/NETA 0.1 experienced reductions in bone resorption and formation markers, an expected effect during the anti-resorptive therapy, suggesting a protective bone effect with the Ultra-LD HT. [ABSTRACT FROM AUTHOR]

Summary: Human verbal expression requires coordinated interaction among cortical, neuromuscular, and peripheral events. It is affected by hormonal factors and shows different characteristics in reproductive age and postmenopausal women. The [...]

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Purpose: To examine the relationship between Premenstrual Syndrome (PMS) and female sexual function (FSF) with the luteal (LP) and follicular phases (FP).Method: We performed a cross-sectional survey using the Female Sexual Function Index (FSFI) questionnaire in the LP and FP. We used the Brazilian's version of the Premenstrual Symptoms Screen Tool (PSST) and the Daily Record of Severity of Problems (DRSP) for diagnosis of PMS.Results: There was no difference in the FSF between groups in both cycle phases. We found an association between LP and worst scores on FSFI.Conclusion: PMS does not affect FSF. [ABSTRACT FROM AUTHOR]

Copyright of Gynecological Endocrinology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dyspareunia negatively affects women´s quality of life, and is a frequent complaint during the peri- and postmenopausal period. A randomized trial evaluated sexual function, quality of life, pain, and pelvic floor muscle function of climacteric women aged between 40 and 60 years old who were sexually active and had complaints of dyspareunia for at least six months. They were assessed before and after their randomization in one of the following interventions: the first group (n = 21) received five one-hour sessions of thermotherapy for relaxation of pelvic floor muscles, myofascial release, and pelvic training (pelvic floor muscle training-PFMT group). The second group (n = 21) received five one-hour sessions during which heat was applied to the lower back with myofascial release of abdominal diaphragm, piriformis, and iliopsoas muscles, with no involvement of pelvic training (lower back-LB group). Forty-two climacteric women with dyspareunia (mean ± SD, PFMT group: 51.9 ± 5.3 years, LB group: 50.6 ± 4.7 years, Student's t-test, p = 0.397) were studied. Pain scores (mean ± SEM) in the PFMT group decreased from 7.77 ± 0.38 to 2.25 ± 0.30; and in the LB group from 7.62 ± 0.29 to 5.58 ± 0.49 (generalized estimating equation-GEE model, p ≤ 0.001 for group, time, and interaction pairwise comparisons). Conclusion: The proposed pelvic floor muscle training protocol was effective to improve pain, quality of life, sexual function, and pelvic floor muscle function in climacteric women with dyspareunia. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of malignant and premalignant endometrial polyps and to investigate the association of malignancy with specific factors.Methods: This is a retrospective study of women submitted to hysteroscopic resection of endometrial polyps between January 2005 and July 2013 at a university hospital in southern Brazil. Data regarding clinical characteristics and pathology findings were collected from patient charts.Results: Of 359 patients, 87.2% had benign polyps and 9.9% had hyperplasia without atypia. Atypical hyperplasia was found in 2.6% of the sample. Endometrial adenocarcinoma was found in one woman (0.3%). A correlation was observed between malignant/premalignant polyps and patient age, menopausal status, and uterine bleeding. All patients with malignancies/premalignancies had abnormal uterine bleeding. Higher frequency of malignant polyps was observed in tamoxifen users, however, without statistical significance (p = 0.059%). Malignancy was not correlated with arterial hypertension, diabetes mellitus, obesity, hormone therapy, endometrial thickness, and polyp diameter.Conclusions: Malignant/premalignant findings had low prevalence and were absent in asymptomatic patients. From the data of this retrospective study, it is unclear whether routine polypectomy should be performed in asymptomatic patients. Further prospective studies including larger numbers of patients are required to guide treatment recommendations. [ABSTRACT FROM AUTHOR]

Introduction: The growth of the elderly in the population is remarkable, affecting the expansion of these individuals residing in longterm institutions for the elderly. The present study aimed to verify the relationship between nutritional status, food frequency and level of physical activity in institutionalized elderly. Material and methods: it was performed an epidemiological observatory Cohort study in Long Term Nursing Homes for the Elderly in the city of Caxias do Sul-RS. The sampling was selected through a nonprobabilistic convenience method. Therefore, the possible associations to the variables were drawn using the Chi-square test. Results and discussion: There was a significant correlation between the Calf Skinfold Measurement (CSM) and the Body Max Index (BMI) in relation to the BMI and Skeletal Muscle Mass (SMM) when faced with the level of physical activity, where 94,34% of the overweight elderly had an SMM > 6,37 kg/m² and 31,62% of the overweight women were classified as irregularly active B. The most frequently consumed foods by the elderly were rice and beans. Conclusion: It is concluded that the most of elderly presented good muscular reserve and eutrophic or overweight, low consumption of protein foods and low level of physical activity. This demonstrates the importance of the nutrition professional in the Institutions. [ABSTRACT FROM AUTHOR]

Aims To compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (BF) in increasing muscle strength, improving myoelectric activity, and improving pre-contraction and quality of life in postmenopausal women with stress urinary incontinence. Methods Randomized controlled trial of 49 postmenopausal women with stress urinary incontinence. Participants were allocated across three groups: control, PFME alone, and PFME + BF. Forty-five women completed the study (14 control, 15 PFME, 16 PFME + BF; mean age 58.26 years). Outcome assessment was carried out using digital palpation (modified Oxford grading scale), electromyography, and the International Consultation Incontinence Questionnaire-Short Form (ICIQ-SF) quality of life instrument. The treatment protocol consisted of eight twice-weekly, 20-min one-on-one sessions. Controls were assessed only at baseline and after 1 month. Results The PFME and PFME + BF groups exhibited significant increases in muscle strength (Oxford scale) ( P < 0.0001), precontraction while coughing ( P < 0.0001), maximum voluntary contraction, duration of endurance contraction, and ICIQ-SF scores ( P < 0.0001). PFME + BF was associated with significantly superior improvement of muscle strength, precontraction while coughing, maximum voluntary contraction, and duration of endurance contraction as compared to PFME alone ( P < 0.05). Conclusions This preliminary study suggests that pelvic floor muscle training, with and without biofeedback, is associated with increased muscle strength, myoelectric activity, precontraction of pelvic floor muscles, and improved quality of life in postmenopausal women with stress urinary incontinence. [ABSTRACT FROM AUTHOR]

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Pelvic floor alterations during menopausal years, resulting from aging and hormonal decline, may lead to several forms of sexual dysfunction. Dyspareunia—pain during sexual intercourse—is among the most frequent. Nevertheless, few studies so far have evaluated pelvic floor muscle function in postmenopausal women with dyspareunia. The authors thus carried out a cross-sectional study to assess myoelectric activity in pelvic floor muscles in peri- and postmenopausal women with and without dyspareunia receiving routine care at an outpatient clinic. In addition, sexual function (using the Female Sexual Function Index) and quality of life (using the Cervantes Scale) were assessed. Fifty-one peri- and postmenopausal women between 45 to 60 years of age (M = 52.1, SD = 4.9) were evaluated, 27 with and 24 without dyspareunia. There were no statistically significant differences in resting muscle activity, maximal voluntary contraction, and sustained contraction between women with and without dyspareunia. There were statistically significant between-group differences on the Cervantes Scale (p =.009) and in all Female Sexual Function Index domains except desire and satisfaction (arousal, p =.019; lubrication, p =.030; orgasm, p =.032; pain, p <.001; desire, p =.061; satisfaction, p =.081), indicating that women with dyspareunia experience worse quality of life and less satisfactory sexual function as compared with women without dyspareunia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Emergency contraception (EC) has many important indications. The aim of the study was to investigate the prevalence of use and knowledge about the correct use of EC among women referred for treatment at a university hospital in Brazil. AIM: The aim of the study was to investigate the prevalence of use and knowledge about the correct use of EC among women referred for treatment at a university hospital in Brazil. METHODS: Study Design: Cross-sectional study. Settings: The study was conducted with patients admitted to the Hospital de Clínicas de Porto Alegre (HCPA) from 2009 to 2010. Patients: Sexually active women aged 18 to 50 years. Interventions: Patients answered a questionnaire on the use of and knowledge about EC. Main Outcome Measures: Primary outcome: prevalence of knowledge about correct EC use. Secondary outcome: prevalence of EC use. RESULTS: 134 patients participated in this study. 61.2% of women reported regular use of birth control pills, 18.7% of condoms, 9.0% of other methods, 3.0% of intrauterine device, and 8.1% used no contraceptive method. As for EC, 86.5% of interviewees reported having knowledge about the method, and 43.1% of these reported knowing how to use EC. However, only 12.0% of interviewees correctly reported how EC should be used. The prevalence of EC use in our sample was 19.4%. CONCLUSIONS: Although most interviewees reported having some knowledge about EC, only a small number were able to accurately describe its proper use. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Mother & Child Health (BJMCH) / Revista Brasileira de Saude Materno Infantil (RBSMI) is the property of Instituto de Medicina Integral and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Polymorphisms in the oestrogen receptor 1 ( ESR1) and oestrogen receptor 2 ( ESR2) genes are associated with intermediate or endpoint markers of cardiovascular disease and with the efficacy of postmenopausal hormone therapy (HT). Contradictory findings have been described in the past and the role of these genetics variants remains unclear. Methods: A cross-sectional study was carried out with 266 postmenopausal women, of whom 115 received oral HT (HT+) and 151 did not receive any HT (HT−). We analysed three single-nucleotide polymorphisms (SNPs) in ESR1 (rs1801132, rs7757956 and rs2813544) and two in ESR2 (rs3020450 and rs7154455) and derived haplotypes with three additional polymorphisms that had been previously investigated by our group ( ESR1 rs2234693 and ESR2 rs1256049 and rs4986938). Results: The ESR1 rs2813544 polymorphism was associated with low-density lipoprotein cholesterol (LDL-C) in HT+ postmenopausal women ( p = 0.044; pC = 0.388), while one ESR2 gene haplotype was associated with total cholesterol (T-chol) ( p = 0.015; pC = 0.090) and LDL-C in HT+ postmenopausal women ( p = 0.021; pC = 0.126). Conclusion: Our findings suggest that, in HT+ postmenopausal women, the rs2813544 polymorphism may influence LDL-C levels and, as previously described, ESR2 rs1256049 is associated with T-chol and LDL-C. No previous study has investigated the association of this SNP set with lipoprotein levels in women while taking into account the hormonal status of the patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: We investigated the influence of an etonogestrel-releasing (ETG) implant and copper intrauterine device (IUD) on carbohydrate metabolism. Study Design: In this nonrandomized, open-label, prospective controlled trial, 40 healthy women received an implant or IUD (20 per group). Outcome measures were fasting glucose, fasting insulin, oral glucose tolerance test (OGTT) and glycosylated hemoglobin A1C (HbA1C) levels at baseline and after 6 and 12 months. Results: The groups were similar in age, body mass index and laboratory parameters at baseline. Carbohydrate metabolism was not modified by the ETG implant at baseline and at 6 and 12 months (mean±SD) (fasting glucose: 85.9±5.13, 87.05±5.36, 88.19±5.05; insulin: 7.77±2.42, 10.64±9.4, 8.82±3.73; OGTT: 94.8±25.28, 96.5±19.67, 99.47±24.6; HbA1C: 5.27±.34, 5.55±.39, 5.7±0.37). The same was true for the IUD (fasting glucose: 88.87±7.2, 89.65±5.86, 88.75±4.79; insulin: 7.94±3.6, 8.3±4.1, 7.34±3.02; OGTT: 96.85±15.16, 97.48±13.42, 91.3±22.16; HbA1C: 5.41±.49, 5.75±.41, 5.9±0.73). Conclusions: The ETG-releasing implant did not affect carbohydrate metabolism in normal women after 12 months. [Copyright &y& Elsevier]

Objective: To evaluate the effects of oral estradiol and transdermal 17&bgr;-estradiol on serum concentrations of IGF1 and its binding proteins in women with hypopituitarism. Design: Prospective, comparative study. Methods: Eleven patients with hypopituitarism were randomly allocated to receive 2 mg oral estradiol (n=6) or 50 &mgr;g/day of transdermal 17&bgr;-estradiol (n=5) for 3 months. Results: The oral estrogen group showed a significant reduction in IGF1 levels (mean: 42.7%±41.4, P=0.046); no difference was observed in the transdermal estrogen group. There was a significant increase in IGFBP1 levels (mean: 170.2%±230.9, P=0.028) in the oral group, but not in the transdermal group. There was no significant difference within either group in terms of median IGFBP3 levels. In relation to lipid profiles, there was a significant increase in mean high-density lipoprotein cholesterol levels in the oral group after 3 months of treatment, (27.8±9.3, P=0.003). We found no differences in the anthropometric measurements, blood pressure, heart rate, glucose, insulin, C-peptide, or the homeostasis model assessment index after treatment. Conclusions: Our preliminary data indicate that different estrogen administration routes can influence IGF1 and IGFBP1 levels. These findings in patients with hypopituitarism have an impact on their response to treatment with GH, since patients receiving oral estrogen require increased GH dosage. These results suggest that oral estrogens may reduce the beneficial effects of GH replacement on fat and protein metabolism, body composition, and quality of life. [ABSTRACT FROM AUTHOR]

Insomnia is a frequent climacteric symptom. This pilot, double-blind, randomized placebo-controlled trial compared estradiol associated with trimegestone or placebo in 12 women with perimenopausal insomnia. The Pittsburgh Sleep Quality Index (PSQI) was administered, and polysomnography was performed at baseline and after 28 days. Sleep efficiency and median score of the PSQI improved significantly in the hormone therapy group (HT) ( p = 0.041 and p = 0.027, respectively) and not in placebo group. Perimenopausal insomnia improved after short-term HT. [ABSTRACT FROM AUTHOR]

Background. Estrogens influence many physiological processes including cardiovascular health. Polymorphisms in phase I and II estrogen metabolism enzymes are associated with lipid levels in women. Methods. A cross-sectional study was carried out with 269 postmenopausal women, 116 who received oral hormonal therapy (HT) (39-75 years) with estrogens or estrogens plus progestagen, 153 that did not receive any HT (38-85 years), and 155 premenopausal women (18-52 years). Polymorphisms in UGT1A1 (rs5839491) and SULT1A1 (rs1042028) were analysed by PCR-based methods. Adjusted lipid levels means were compared among genotypes by one-way analysis of variance, with corrections for multiple testing. Results. The UGT1A1*28 polymorphism was associated with total cholesterol (T-chol) ( p = 0.030; corrected p = 0.060) and low-density lipoprotein cholesterol (LDL-C) levels ( p = 0.011, corrected p = 0.022) in premenopausal women. The premenopausal and postmenopausal women, both carriers of SULT1A1*2/*2, had lower levels of T-chol and LDL-C means than carriers of the SULT1A1*1/*1 ( p = 0.004, corrected p = 0.008 and 0.009, corrected p = 0.018, respectively). Conclusion. The data showed the presence of an association between the UGT1A1*28/*28 and SULT1A1*2/*2 and T-chol and LDL-C levels in women with different hormonal status. No previous studies investigated the association of the polymorphisms examined in this study with lipoprotein levels in women separately by hormonal status. [ABSTRACT FROM AUTHOR]

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FERNANDES, E.O.,et al.: Hormone Replacement Therapy Does Not Affect the 24-hour Heart Rate Variability in Postmenopausal Women: Results of a Randomized, Placebo-controlled Trial with Two Regimens. Postmenopausal women are at greater risk of coronary heart disease. The results of previous studies of the effects of hormone replacement therapy (HRT) on cardiac autonomic modulation in postmenopausal women have been contradictory. This study examined whether continuous treatment for 3 months with estradiol alone (ERT) or with estradiol plus norethisterone (HRT), increases 24-hour heart rate variability (HRV) in postmenopausal women. In this double-blind, placebo-controlled trial, 40 healthy postmenopausal women, 46–63 years of age, were randomly assigned to (1) continuous 2 mg of estradiol plus 1 mg of norethisterone acetate daily (HRT, n= 13), or (2) 2 mg of estradiol daily (ERT, n= 14), or (3) placebo (n= 13). Before and after 3 months of therapy, blood estradiol concentrations were measured and 24-hour electrocardiograms recorded for evaluation of 24-hour time-domain indices of HRV, and indices derived from the three-dimensional return map. Both hormone replacement regimens significantly increased blood estradiol concentrations, while no change occurred in the placebo group. In the three treatment groups, multiple 24-hour time-domain indices of HRV and indices derived from the three-dimensional return map remained unchanged. In healthy postmenopausal women, HRT with estradiol or estradiol and norethisterone for 3 months did not modify cardiac autonomic activity evaluated by 24-hour indices of HRV. These findings are consistent with a lack of protective cardiovascular effect of HRT described in recent large randomized trials.(PACE 2005; 28:S172–S177) [ABSTRACT FROM AUTHOR]

Objective: Vasomotor symptoms affect 60-80% of women during the menopausal transition. Anxiety, depression, and anxiety sensitivity can have an important role in the distressful experience of vasomotor symptoms. Our aim was to evaluate the prevalence and association of vasomotor and negative affect symptoms. Methods: A cross-sectional study was conducted with 89 perimenopausal women aged 45-55 years. Broad psychiatric and clinical evaluations were carried out. The primary outcome was the vasomotor symptom problem rating and the main study factor was anxiety sensitivity. Linear regression analyses were conducted to examine the associations between the study factors and the primary outcome, and a multiple regression model was created to assess which variables were independently associated with vasomotor symptom problem rating. Results: The prevalence of anxiety, depression, and vasomotor symptoms were 58, 62, and 73%, respectively. Negative affect symptoms were positively associated with vasomotor symptom problem rating. The association of anxiety sensitivity and vasomotor symptom problem rating remained significant after controlling for perimenopausal stage, thyrotropin, follicle-stimulating hormone levels, and psychotropic medication use (β = 0.314, p = 0.002). Conclusion: A better understanding of the experience of vasomotor symptoms is needed, especially the role of negative affect symptoms and anxiety sensitivity. New strategies focusing on related thoughts and behaviors could improve the quality of life of perimenopausal women. [ABSTRACT FROM AUTHOR]

The article looks at study which evaluate sexual function and satisfaction in pregnant women under pre-natal care provided by the public health system. It mentions a study with pregnant women receiving ambulatory care at the public health system in the Southern region of Brazil and rate of global sexual dysfunction with application of the Female Sexual Function Index (FSFI) questionnaire. It also concludes prevalence of sexual dysfunction among pregnant women in the public system was high.