Menstrual health: Inequities in a cohort of menstruating people in the Brazilian southeastern region.

OBJECTIVE: To assess menstrual hygiene management (MHM) and period poverty in a group of low- and medium-income menstruating people. METHODS: A cross-sectional study was conducted at the University of Campinas, Brazil, from January to June 2022 with 535 participants aged 18-49. For data collection, we used the abbreviated version of the WHO Quality-of-Life questionnaire (WHOQOL-BREF) and a pre-tested questionnaire with items regarding MHM and period poverty. RESULTS: We found an inverse relationship between the risk of no access to supplies to perform menstrual hygiene, which increased by 2.5% and each point less in the environmental domain of quality of life (QoL), and this risk increased by up to 3.1 times among participants who reported difficulty making ends meet. The risk of not having adequate conditions to perform menstrual hygiene at home increased by up to 2.6% for every one-point drop in the environmental domain of QoL. The risk of not having adequate conditions to perform menstrual hygiene outside the home increased by up to 1.3% for less points in the psychological domain of QoL, and 44.4% of those who indicated inadequate conditions for menstrual hygiene reported two or more childbirths. CONCLUSIONS: Menstruating people who have an increased risk of lacking menstrual supplies and have an increased risk of inadequate conditions for MHM at home and outside the home, as well as those who have two or more deliveries and those having difficulties making ends meet, scored low on the QoL, especially in the environmental and psychological dimensions.

Narratives of experiences of violence of Venezuelan migrant women sheltered at the northwestern Brazilian border.

OBJECTIVES: To know the experiences of Venezuelan migrant women living in shelters in Roraima state at the northwestern border between Venezuela and Brazil regarding situations of violence as part of the dynamics of everyday life. MATERIALS AND METHODS: Data were collected in January 2020 through 12 focus group discussions (FGDs) with 5 to 14 Venezuelan migrant women aged 18-49 years old living transitorily in five shelters established by the United Nations High Commissioner for Refugees (UNHCR) and the Brazilian government. We obtained individual and shared views on the experiences regarding violence that migrant women may experience in their everyday life. To organize the FGDs, variations in age and the time women were living at the shelters were considered. All FGDs were held in a place at the shelter that guaranteed privacy and secrecy so that women could express themselves freely. The initial question was broad and open ended and was followed by more specific questions about situations of domestic violence and other types of violence. RESULTS: The main themes identified were the following: i) women's perceptions on domestic violence, ii) women's perceptions on how humanitarian organizations were managing the episodes of domestic violence, and iii) situations considered violence in everyday life at the shelters. The FGDs showed that the reported violence inside the shelters was high, and several forms of violence emerged. Violence was identified as physical aggression and psychological threats, and violence in everyday life at the shelter included xenophobia when the migrants went outside the shelters that was perceived and described as violence. CONCLUSIONS: According to the perspective of Venezuelan migrant women violence was part of everyday life among those living in the UNHCR shelters at the northwestern border of Brazil-Venezuela. These women are not comfortable with this situation, and it is difficult for them to understand and handle the episodes of violence.

"Babies born early?" - silences about prematurity and their consequences.

BACKGROUND: The principal aim of this study was to understand how communication between parents and health professionals concerning prematurity occurs, from delivery to admission to the neonatal Intensive Care Unit. METHODS: This is an exploratory, descriptive study with a qualitative methodology. Data were collected using tape-recorded and Focal Groups technique interview with mothers of premature newborns and health professionals involved in caring for preterm infants, at southeast Brazil. RESULTS: The word "premature" was not said or heard during prenatal care. From the narratives, it was observed that there was a lack of information available to pregnant women about preterm birth, failure in medical care regarding signs and symptoms reported by pregnant women, and lack of communication between the medical teams, mothers and family during delivery and Neonatal Intensive Care Unit (NICU) admission. CONCLUSION: There is a fine line between born too soon and die too soon, that increases stress, fear and distance impacting negatively over communication between mothers and health professionals during antenatal care, childbirth and NICU admission.

Factors associated with knowledge about menopause and hormone therapy in middle-aged Brazilian women: a population-based household survey.

OBJECTIVES: The aim of the study was to evaluate knowledge about menopause and hormone therapy (HT) among middle-aged Brazilian women and identify the factors associated with the level of knowledge. METHODS: A cross-sectional study was conducted with 749 women aged 45 to 60 years, residing in the Metropolitan Region of Campinas, Brazil. The dependent variable was knowledge about menopause and HT evaluated using a numerical score based on the answers given to three questions that had several response options. The independent variables were sociodemographic characteristics, personal habits, and health conditions. Statistical analysis was carried out by Mann-Whitney, Kruskal-Wallis, and a generalized linear model. RESULTS: The mean age was 52.5 (±4.4) years. Most of the women were postmenopausal (68%) and 19.5% had a history of current or previous use of HT. The final score for knowledge about menopause ranged from +1 to +11, with a mean of 4.59 (±1.86) and a median of 4. Women with higher levels of schooling (coefficient = 0.64, P < 0.001); with higher socioeconomic status (coefficient = 0.47, P < 0.002); with vaginal dryness (coefficient = 0.47, P = 0.003); who consumed alcohol (coefficient = 0.61, P = 0.006); who use or had ever used any type of treatment to counteract menopausal symptoms (coefficient = 0.41, P = 0.008); with anxiety (coefficient = 0.35, P = 0.037); and with depression (coefficient = 0.31, P = 0.043) possessed greater knowledge about menopause and HT. Women with a higher number (≥3) of vaginal deliveries (coefficient = -0.61, P < 0.001) and a higher body mass index (coefficient = -0.02, P = 0.046) possessed less knowledge about menopause and HT. CONCLUSIONS: The knowledge about menopause and HT demonstrated by the interviewees was low and possibly related to the time of exposure to qualified information.

Understanding and attitudes of Brazilian men with regard to premenstrual syndrome.

OBJECTIVE: To assess the understanding and attitudes of Brazilian men regarding premenstrual syndrome (PMS). METHODS: In a survey-based study between September 2007 and April 2008, information was collected from men aged 18-40 years who were attending public healthcare services or were university and faculty staff at 5 cities in different geographic regions of Brazil and the Federal District. RESULTS: In total, 527 men were interviewed. Of these, 86.3% had heard of PMS, and 34.3% reported that it is a natural part of the menstrual cycle. The most commonly reported characteristics of PMS were emotional symptoms (55.2%), including nervousness or anxiety; irritability, anger, or aggressiveness; and a greater tendency to start arguments and fights. A significant relationship was found between men who had heard of PMS and being aged 20-35 years, having a university degree, being white, and belonging to a higher socioeconomic stratum (P<0.001). Furthermore, men with a university degree were more likely to know that PMS symptoms occur before menses (P<0.004). CONCLUSION: Many of the men interviewed were knowledgeable about PMS symptoms; however, this awareness was more common among men of higher socioeconomic strata with more years of schooling.

An emerging "maternal near-miss syndrome": narratives of women who almost died during pregnancy and childbirth.

BACKGROUND: An improvement in maternal health conditions can only be achieved when a reduction in the number of deaths is accompanied by a reduction in the frequency of severe complications of pregnancy. The objective of this study was to investigate women's experiences related to the burden of severe maternal morbidity. METHODS: This qualitative study is based on narratives of women who survived severe complications of pregnancy and who were admitted to the intensive care unit of a public university hospital in the city of Campinas, Brazil. A sample of 30 women was recruited between April 2007 and January 2008. Before hospital discharge, eligible women who agreed to participate responded to a semidirected interview. The interviews were recorded and the transcripts received a thematic analysis. RESULTS: Two major themes were identified, one more closely related to the experience of a critical illness and the other to the experience of care. A complex set of reactions was found in the women who survived, indicating the occurrence of acute stress-related disorders. CONCLUSIONS: On the basis of narratives of women who almost died during pregnancy and childbirth, we reported on an acute stress disorder that may be associated with the occurrence of severe maternal complications, which we named, the "maternal near-miss syndrome." The implementation of integrated care that encompasses the physical, psychological, social, and spiritual aspects of women's health may help to alleviate the burden that maternal complications impose on millions of women around the world.

Support to woman by a companion of her choice during childbirth: a randomized controlled trial.

BACKGROUND: To evaluate the effectiveness and safety of the support given to women by a companion of their choice during labor and delivery. METHODS: A total of 212 primiparous women were enrolled in a randomized controlled clinical trial carried out between February 2004 and March 2005. One hundred and five women were allocated to the group in which support was permitted and 107 to the group in which there was no support. Variables regarding patient satisfaction and events related to obstetrical care, neonatal results and breastfeeding were evaluated. Student's t-test or Wilcoxon's test, chi-square or Fisher's exact test, risk ratios, and their respective 95% confidence intervals were used in the statistical analysis. RESULTS: Overall, the women in the support group were more satisfied with labor (median 88.0 versus 76.0, p < 0.0001) and delivery (median 91.4 versus 77.1, p < 0.0001). During labor, patient satisfaction was associated with the presence of a companion (RR 8.06; 95%CI: 4.84 - 13.43), with care received (RR 1.11; 95%CI: 1.01 - 1.22) and with medical guidance (RR 1.14 95%CI: 1.01 - 1.28). During delivery, satisfaction was associated with having a companion (RR 5.57, 95%CI: 3.70 - 8.38), with care received (RR 1.11 95%CI: 1.01 - 1.22) and with vaginal delivery (RR 1.33 95%CI:1.02 - 1.74). The only factor that was significantly lower in the support group was the occurrence of meconium-stained amniotic fluid (RR 0.51; 95%CI: 0.28 - 0.94). There was no statistically significant difference between the two groups with respect to any of the other variables. CONCLUSION: The presence of a companion of the woman's choice had a positive influence on her satisfaction with the birth process and did not interfere with other events and interventions, with neonatal outcome or breastfeeding.

Variáveis reprodutivas e risco para doenças benignas de mama. Estudo caso-controle / Reproductive variables and risk of benign breast diseases. A case-control study

Foram estudadas 257 mulheres com diagnòstico de doença benígna da mama (DBM), atestado por anamotopatològico ou citologia, e um controle para cada uma delas. Foram apresentados resultados das possíveis relaçöes entre variáveis reprodutivas e o risco para DBM. Os casos e controles foram comparados levando em conta a idade na menarca e na menopausa, o número de gravidezes, de meses em que amamentaram e de ciclos menstruais ovulatòrios, e os antecedentes familiares do câncer de mama. Mostraram influência significativa, em relaçäo às DBM, a nuliparidade, aumentando o risco enquanto a idade de 30 ou mais anos no primeiro parto o reduziu; o número de ciclos ovulatòrios, que foi significativamente maior para os casos, e a média de meses de uso da pílula, menor entre as mulheres com DBM. O uso de contraceptivos orais apresentou um efeito protetor apenas quando a duraçäo total do uso foi maior que dois anos. Os resultados näo se revelaram novos ou diferentes se comparados com outros estudos, mas confirmam a relativa concordância entre os fatores de risco para a DBM e para o câncer de mama, ainda que as relaçöes entre esses fatores e as DBM näo sejam täo claras como o säo para o câncer, e existam também algumas discrepâncias