RESUMEN
INTRODUCTION: High levels of androgens increase muscle mass. Due to the characteristics of hyperandrogenism in polycystic ovary syndrome (PCOS), it is plausible that women with PCOS may have increased pelvic floor muscle (PFM) thickness and neuromuscular activity levels compared with controls. The aim of this study was to assess PFM thickness and neuromuscular activity among hyperandrogenic women with PCOS and controls. METHODS: This was an observational, cross-sectional, case-control study evaluating PFM by ultrasound (US) and surface electromyography (sEMG) in nonobese women with and without PCOS. Seventy-two women were divided into two groups: PCOS (n = 33) and controls (n = 39). PFM thickness during contraction was assessed by US (Vingmed CFM 800). Pelvic floor muscle activity was assessed by sEMG (MyoTrac Infinit) during contractions at different time lengths: quick, and 8 and 60 s. Descriptive analysis, analysis of variance (ANOVA), and Student's t test were used for statistical analyses. RESULTS: There were no significant differences in PFM sEMG activity between PCOS and controls in any of the contractions: quick contraction (73.23 mV/ 71.56 mV; p = 0.62), 8 s (55.77 mV/ 54.17 mV; p = 0.74), and 60 s (49.26 mV/ 47.32 mV; p = 0.68), respectively. There was no difference in PFM thickness during contractions evaluated by US between PCOS and controls (12.78 mm/ 13.43 mm; p = .48). CONCLUSIONS: This study did not find statistically significant differences in pelvic floor muscle thickness or in muscle activity between PCOS women and controls.
Asunto(s)
Hiperandrogenismo/diagnóstico por imagen , Hiperandrogenismo/fisiopatología , Diafragma Pélvico/diagnóstico por imagen , Diafragma Pélvico/fisiopatología , Síndrome del Ovario Poliquístico/diagnóstico por imagen , Síndrome del Ovario Poliquístico/fisiopatología , Adolescente , Adulto , Estudios de Casos y Controles , Estudios Transversales , Electromiografía , Femenino , Humanos , Contracción Muscular , Ultrasonografía , Adulto JovenRESUMEN
Marcada por mudanças na função ovariana, a menopausa representa redução dos níveis de estrogênio circulante. Os estrogênios aumentam o trofismo e a vascularização dos músculos do assoalho pélvico (MAP), e seu déficit na menopausa pode estar relacionado ao surgimento da incontinência urinária. O uso do estrogênio e o treinamento dos MAP são opções no tratamento da incontinência urinária. O objetivo deste artigo foi realizar uma revisão sistemática da literatura sobre os efeitos do treinamento dos MAP, da terapia hormonal e da associação de ambos na função dos MAP e da incontinência urinária. Foi feito um levantamento bibliográfico nas bases de dados da Literatura da América Latina e do Caribe (Lilacs), Pubmed e na Cochrane Library. Foram incluídos os manuscritos que investigaram os efeitos do treinamento dos MAP, da terapia hormonal ou da associação de ambos na função dos MAP e incontinência urinária. Os estudos analisados sugerem que a terapia hormonal com estrogênio pode levar à melhora da função dos MAP e da incontinência urinária, assim como o treinamento dos MAP. Quanto à associação da terapia hormonal com treinamento dos MAP, mesmo diante da escassez de estudos que tenham avaliado tal associação, os melhores níveis de evidência científica disponíveis parecem assinalar seu benefício.
Marked by changes in the ovarian function, menopause represents a reduction in the estrogen stock levels. The estrogens enhance the pelvic floor muscle (PFM) trophysm and vascularization, so its shortage at menopause may be related to the emergence of urinary incontinence. The use of estrogen and the PFM training are options in the urinary incontinence treatment. The objective of this article was to conduct a systematic literature review of the PFM training effects, the hormone therapy and their association in the function of the PFM and urinary incontinence. A bibliographic survey was conducted in the databases: Latin American and Caribbean Center on Health Sciences Information (Lilacs), Pubmed and Cochrane Library. Some articles that investigated the PFM training effects, the hormone therapy or their association in the PFM and urinary incontinence function were included. The analyzed studies suggest that hormone therapy with estrogen may lead to the improvement of the PFM function and urinary continence, as the PFM training. Regarding the association of hormone therapy with PFM training, even with few studies that have evaluated this association, the highest levels of scientific evidence available seem to note its benefit.
Asunto(s)
Humanos , Femenino , Contracción Muscular/fisiología , Estrógenos/deficiencia , Estrógenos/uso terapéutico , Incontinencia Urinaria/rehabilitación , Incontinencia Urinaria/terapia , Menopausia , Ensayos Clínicos Controlados Aleatorios como Asunto , Diafragma Pélvico/fisiología , Terapia de Reemplazo de Estrógeno , Terapia por Ejercicio/métodos , Incontinencia Urinaria de Urgencia/terapia , Incontinencia Urinaria de Esfuerzo/terapiaRESUMEN
O diabetes melito gestacional (DMG) é a condição hiperglicêmica diagnosticada pela primeira vez durante a gravidez, significando intolerância aos glúcides, de graus variados de intensidade. O tratamento tradicional, de rotina para DMG tem sido a monitoração da glicose sanguínea, prescrição de dieta e uso de insulina quando necessário...
Gestational diabetes mellitus(GDM) is a hyperglicemic condition first diagnosed during pregnancy; it implies glucide intolerance of varivable severity. GDM management has traditionally been done by diet and close monitoring of glucose levels, with insulin therapy when necessary...