Effects of SARS-COVID-19 lockdown on menstrual patterns: A transversal large sample survey.

OBJECTIVE: To elucidate the presence, importance, and characteristics of menstrual changes related to stressful circumstances during the COVID-19 lockdown in Spain. STUDY DESIGN: An online survey was administered in Spain to menstruating women aged 15-55 who had not contracted COVID-19. It collected information on activities during the lockdown, sexual activity, perceptions of emotional status, any changes in menstrual characteristics, and impact on quality of life. The analysis of menstrual changes was limited to responders who did not use hormonal contraception. RESULTS: A total of 6449 women answered the survey, and 4989 surveys were valid for the final analysis. 92.3% of women had at least one menstruation period during the lockdown, while 7.7% had amenorrhea. Quality of life (QoL) associated with menstruation worsened in 19% of women, did not change in 71.7%, and improved in 1.6%. For 50.1% of the women, global QoL worsened during the lockdown; 41.3% remained about the same and 8.7% reported improvement. Sexual activity during the lockdown decreased in 49.8% of the respondents, remained unchanged in 40.7%, and increased in 9.5%. As far the menstrual changes are concerned, there were no statistically significant differences in amenorrhea incidence, regularity of the menstrual cycle, or the amount or duration of menstrual bleeding in non-hormonal contraceptive users when evaluated by the length and characteristics of isolation, the perception of exposure to COVID-19 and the economic or employment situation. Conversely, we found statistically significant differences according to the intensity of changes in emotional status due to lockdown stressors and changes in regularity, duration, and heaviness of menstruation. CONCLUSION: Changes in emotional status, but not the length and intensity of the isolation or exposure to the disease, significantly influenced menstrual disturbances during the COVID-19 lockdown.

Sports gynecology: a new way to improve female athletes care and performance / Ginecología deportiva: una nueva forma de optimizar atención y el rendimiento de la deportist / Ginecologia do esporte: uma nova maneira de otimizar o cuidado e a performance da mulher atleta

ABSTRACT Introduction: Female participation in sports has reached a milestone in 1972 when a constitutional amendment was implemented to ensure equal opportunities for men and women. Since then, the percentage of participants in competitive sports has grown. In this context became necessary to understand menstrual cycle, contraceptive use, and its individual responses. Objective: To investigate menstrual cycle characteristics, physical and mood symptoms related to vaginal bleeding, and contraceptives used by Brazilian Olympic athletes. Also, to assess if these athletes relate that vaginal bleeding influences sportive performance, how they manage it and what can be changed to improve their health care and sportive performance. Additionally, we propose specialized female care by a gynaecologist specialized in sports medicine. Methods: Descriptive observational study was conducted from July to August 2016 and included 118 Brazilian Olympic female athletes, in menacme. The athletes completed a self-administered online questionnaire, adapted from Pre-Participation Gynaecological Examination of female athletes. Results: Participants practiced 28 different sports, mean age 27 ± 4.7 years. For 66% it was their first participation in an Olympic Game. Most used contraceptives (54%), mainly oral (61%). Most (76%) believed that vaginal bleeding influenced sports performance, and 63% preferred to compete after bleeding cessation. Fifty-eight percent would compete at preferred time of their cycle. Anxiety symptoms, bloating, increased appetite, depression, and dysmenorrhea were indicated by 52%. Among these, 49% reported that these symptoms deteriorated their sportive performance. Conclusion: Most in their first Olympic participation, Brazilian athletes used hormone contraceptives, mainly oral ones to manage and adapt their vaginal bleeding to the competition calendar because most of them referred those physical and mood symptoms deteriorated their sportive performance. The presence of a Sportive Gynaecologist as part of the Olympic Medical Staff highlighted the female athletes issues and helped them to improve sportive performance. Level of Evidence IV; Cross-sectional observational study

RESUMEN Introducción: La participación femenina en deportes alcanzó un hito en 1972, cuando se implementó una reforma constitucional para garantizar igualdad de oportunidades entre hombres y mujeres. Desde entonces, el porcentaje de participantes en deportes competitivos ha crecido. En este contexto, se hizo necesario comprender el ciclo menstrual, el uso de anticonceptivos y sus respuestas individuales. Objetivo: Investigar características del ciclo menstrual, síntomas físicos, estado de ánimo, quejas relacionadas con el sangrado vaginal y los métodos anticonceptivos utilizados por atletas olímpicas brasileñas. Evaluar si estas deportistas perciben influencia del sangrado vaginal en el rendimiento deportivo, cómo lo controlan y qué se puede cambiar para mejorar. Además, ofrecemos atención especializada por una ginecóloga especialista en medicina deportiva. Métodos: Estudio observacional, descriptivo, realizado de julio a agosto de 2016, que incluyó 118 atletas olímpicas brasileñas, en menacme. Las atletas respondieron un cuestionario en línea autoadministrado y adaptado titulado "Examen ginecológico previo a la participación". Resultados: Practicaban 28 deportes diferentes, con edad media = 27 ± 4,7 años. Para 66%, era su primera participación en un juego olímpico. Anticonceptivos usados r54%), principalmente orales (61%). La mayoría (76%) cree que el sangrado vaginal influye en el rendimiento deportivo y 63% prefirió competir después del. El 58% de los atletas competiría en su momento preferido de su ciclo. Los síntomas de ansiedad, hinchazón, aumento del apetito, depresión y dismenorrea fueron indicados por el 52%. Entre estas, 49% deterioró su rendimiento deportivo. Conclusión: En su primera participación olímpica, las atletas brasileñas utilizaron anticonceptivos hormonales, principalmente orales, para controlar y adaptar el sangrado vaginal al calendario de competición, ya que la mayoría relató que los síntomas físicos y anímicos perjudicaban su desempeño deportivo. La presencia de una Ginecóloga Deportiva como parte del Equipo Médico Olímpico destacó los problemas de las atletas y las ayudó a mejorar su rendimiento. Nivel de Evidencia IV; Estudio Observacional.

RESUMO Introdução: A participação feminina no esporte teve um marco importante em 1972, quando uma emenda constitucional foi implementada para garantir a igualdade de oportunidades para homens e mulheres. Desde então, o percentual de participantes em esportes competitivos tem crescido. Nesse contexto tornou-se necessário compreender sobre ciclo menstrual, uso de anticoncepcionais e suas respostas individuais. Objetivo: Investigar características do ciclo menstrual, sintomas físicos e de humor, queixas relacionadas ao sangramento vaginal e métodos contraceptivos usados por atletas olímpicas brasileiras. Avaliar se percebem influência do sangramento vaginal no desempenho esportivo, como elas o controlam e o que pode ser mudado para melhorar seus cuidados e desempenho esportivo. Além disso, propõe-se atendimento específico por ginecologista especializada em medicina esportiva. Métodos: Estudo observacional, descritivo, realizado de julho a agosto de 2016 que incluiu 118 atletas olímpicas brasileiras, na menacme. As atletas responderam a um questionário online autoaplicável e adaptado intitulado "Pre-Participation Gynaecological Examination". Resultados: As participantes praticavam 28 esportes diferentes, com média de idade = 27 ± 4,7 anos. Para 66%, foi a primeira participação em um evento olímpico. A maioria usava anticoncepcional (54%), principalmente oral (61%). A maioria (76%) acredita que o sangramento vaginal influencia o desempenho esportivo e 63% preferiam competir após o mesmo. 58% das atletas competiriam no momento preferido de seu ciclo. Sintomas de ansiedade, distensão abdominal, aumento do apetite, depressão e dismenorreia foram indicados por 52%. Entre esses, 49% deterioraram o desempenho esportivo. Conclusão: Em sua primeira participação olímpica, as atletas brasileiras utilizaram anticoncepcionais hormonais, principalmente orais, para controlar e adaptar o sangramento vaginal ao calendário de competição, pois a maioria referiu que os sintomas físicos e de humor prejudicaram o desempenho esportivo. A presença de uma Ginecologista Esportiva como parte da Equipe Médica Olímpica destacou os problemas das atletas femininas e as ajudou a melhorar o desempenho esportivo. Nível de Evidência IV; Estudo Observacional.

Impact of menstrual cycle on smoking cessation: A review / El impacto del ciclo menstrual en el abandono de tabaco: Una revisión

Abstract Background Information on the way menstrual cycle phases can influence the achievement of tobacco abstinence is contradictory. Objective A scope review was conducted to determine the effect of the menstrual cycle on tobacco abstinence, considering the phases of the cycle, hormone levels, and premenstrual syndrome. Method A literature search was conducted in Scopus, PubMed, MEDLINE, and PsycINFO databases. Ten articles comparing the phases of the menstrual cycle or analyzing the association between premenstrual syndrome and a withdrawal condition (length of abstinence or withdrawal symptoms) were included. Results Two main results were identified: 1) there is no difference in withdrawal symptoms and craving between menstrual cycle phases and 2) abstinence rates in the studies were higher during the luteal phase. Discussion and conclusion The advisability of suggesting that women wishing to quit smoking should begin to do so at the start of the luteal phrase is discussed. However, smoking cessation interventions must consider all the symptoms experienced during the luteal phase.

Resumen Antecedentes La información sobre cómo las diferentes fases del ciclo menstrual pueden influir en el logro de la abstinencia de tabaco es contradictoria. Objetivo Se realizó una revisión de alcance con el fin identificar la evidencia relacionada al efecto del ciclo menstrual en la abstinencia de tabaco, considerando las variables fases del ciclo, niveles hormonales y síndrome premenstrual. Método Se llevó a cabo una búsqueda de la literatura en las bases de datos Scopus, PubMed, MEDLINE y PsycINFO. Se incluyeron diez artículos que realizaban comparaciones entre las fases del ciclo menstrual o bien análisis entre el síndrome premenstrual y una condición de abstinencia (tiempo de abstinencia o síntomas de abstinencia). Resultados Se identificaron dos resultados principales 1) no hay diferencia en los síntomas de abstinencia y el deseo por fumar entre las fases del ciclo menstrual y 2) las tasas de abstinencia de los estudios fueron mayores durante la fase lútea. Discusión y conclusión Se discute si en la fase lútea se puede sugerir el inicio de la abstinencia en mujeres que buscan dejar de fumar, sin embargo, las intervenciones para dejar de fumar deben tomar en cuenta todos los síntomas que se experimentan en la fase lútea.

Vacuna contra la COVID-19 y menstruación, desde el desconocimiento a la información: revisión sistemática / Vaccine against COVID-19 and menstruation, from ignorance to information: a systematic review

La creación de una vacuna para enfrentar la pandemia de COVID-19 conllevó un vacío de información sobre las posibles alteraciones del ciclo menstrual. El objetivo fue verificar las posibles alteraciones que se pudiesen haber generado en el ciclo menstrual de las mujeres posterior a la inoculación de la vacuna contra la COVID-19. Se realizó una revisión sistemática en las bases bibliografías Medline, Medline Complete, LILACS, CINAHL y ScIELO, utilizando los descriptores “Women”, “Woman”, “Fertile period”, “Vaccination”, “Mass vaccination”, “Immunization”, “COVID-19 vaccines”, “SARS-CoV-2 infection”, “COVID-19”, “Menstrual cycle”, “Menstruation”, “Endometrial cycle”, “Dysmenorrhea” y “Menstruation disturbances”. Mediante la utilización del protocolo PRISMA, de los 319 artículos localizados, 17 fueron incluidos en el análisis. La mayoría de los estudios incluyeron, principalmente, las vacunas Pfizer, Moderna, AstraZeneca y Johnson&Johnson/Janssen con una a tres dosis administradas. El porcentaje de ciclos menstruales alterados fue del 8,0% al 77,8%, y la alteración con mayor frecuencia referida fue la duración del ciclo menstrual, que fue desde 0,3 hasta 12 días de retraso de la menstruación. Todos los estudios refieren cambios en el ciclo menstrual con diversas prevalencias, con y sin significación estadística; sin embargo, también concluyen que estas alteraciones son reversibles y en un corto periodo de tiempo.

The creation of a vaccine to face the COVID-19 pandemic, led to an information gap on possible alterations of the menstrual cycle. The objective was to verify the possible alterations that could have been generated in the menstrual cycle of women, after the inoculation of the vaccine against COVID-19. A systematic review was carried out in the Medline, Medline Complete, LILACS, CINAHL and ScIELO bibliographic databases, using the descriptors “Women”, “Woman”, “Fertile period”, “Vaccination”, “Mass vaccination”, “Immunization”, “COVID-19 vaccines”, “SARS-CoV-2 infection”, “COVID-19”, “Menstrual cycle”, “Menstruation”, “Endometrial cycle”, “Dysmenorrhea” and “Menstruation disturbances”. Using the PRISMA protocol, of the 319 articles located, 17 were included in the analysis. Most of the studies mainly included the Pfizer, Moderna, AstraZeneca and Johnson&Johnson/Janssen vaccines with one to three doses administered. The percentage of altered menstrual cycles ranged from 8.0% to 77.8%, and the most frequently reported alteration was the length of the menstrual cycle, which occurred from 0.3 to 12 days late in menstruation. All the studies refer to changes in the menstrual cycle with different prevalences, with and without statistical significance; however, the same studies also conclude that these alterations are reversible and in a short period of time.

The influence of the menstrual cycle on the practice of physical exercise: narrative review / La influencia del ciclo menstrual en la práctica de ejercicio físico: una revisión narrativa

Introduction: The menstrual cycle (MC) is the second most important biological rhythm, regulated by the hypothalamicpituitary-ovarian axis and all the hormones involved in it. In addition to reproductive functions, it is speculated that changes in hormone production during different phases of the menstrual cycle may influence other physiological systems, which may have an impact on women’s physical performance. In this way, studying the influences of the menstrual cycle on physical exercises gains importance, since little is said about the organization of strategies and intervention for the performance of physical exercises that take into account the possible impacts and changes caused by the MC.Objective: To review the influence of MC in the practice of aerobic and resistance exercises. Material and method: The search for articles was carried out in the databases: PubMed and Google Scholar, from August to September 2021, without restriction on date and type of publication, and all articles in English and Portuguese were considered. The research was based on the phases of the menstrual cycle in eumenorrheic young women, who may or may not be athletes, but without known dysfunctions of the menstrual cycle. Conclusions: Hormonal fluctuations during MC may not significantly and directly affect the cardiorespiratory or musculoskeletal system during physical exercise, as there is the question of the biological individuality of each woman, as well as the relationship with the self-reported symptoms.(AU)

Introducción: El ciclo menstrual (CM) es el segundo ritmo biológico más importante, regulado por el eje hipotalámicopituitario-ovárico y todas las hormonas involucradas en él. Además de las funciones reproductivas, se especula que los cambios en la producción de hormonas durante las diferentes fases del ciclo menstrual pueden influir en otros sistemas fisiológicos, lo que puede tener un impacto en el rendimiento físico de la mujer. De esta forma, el estudio de las influencias del ciclo menstrual sobre los ejercicios físicos cobra importancia, ya que poco se habla de la organización de estrategias e intervención para la realización de ejercicios físicos que tengan en cuenta los posibles impactos y cambios provocados por el CM. Objetivo: revisar la influencia del CM en la práctica de ejercicios aeróbicos y de resistencia.Material y método: La búsqueda de artículos se realizó en las bases de datos: PubMed, Scielo y Google Scholar, de agosto a septiembre de 2021, sin restricción de fecha y tipo de publicación, y se consideraron todos los artículos en inglés y portugués. La investigación se basó en las fases del ciclo menstrual en mujeres jóvenes eumenorreicas, que pueden ser deportistas o no, pero sin disfunciones conocidas del ciclo menstrual. Conclusiones: Las fluctuaciones hormonales durante la CM pueden no afectar significativa y directamente el sistema cardiorrespiratorio o musculoesquelético durante el ejercicio físico, ya que está la cuestión de la individualidad biológica de cada mujer, así como la relación con los síntomas autoreferidos.(AU)

Características e diferenças nos sintomas dos períodos menstrual e pré-menstrual em mulheres sedentárias / Characteristics and differences in the symptoms of themenstrual and premenstrual periods in sedentary women

Objetivo: estabelecer as diferenças de sintomas físicos e mentais nos períodos menstrual e pré-menstrual em mulheres sedentárias. Métodos: estudo transversal, por questionário, respondido por 77 mulheres saudáveis, de 18 a 35 anos, sedentárias e que não fizessem uso de anticoncepcional continuamente. O questionário incluiu questões sobre dados antropométricos, sintomas físicos e mentais nos períodos menstrual e pré-menstrual. O teste Mann-Whitney comparou os momentos menstrual e pré-menstrual. Resultados: no período menstrual, em uma escala numérica de 0 a 10 pontos, observou-se maiores queixas de dor (7/10), mau humor (7/10), desânimo (8/10), irritabilidade (8/10), ansiedade (7/10), choro (7/10), raiva (9/10) e impacto nas atividades de vida diárias (AVDs) (7/10). Já no período pré-menstrual observou-se queixas de cefaleia (5/10), edema/retenção hídrica (6/10), mau humor (6/10), tristeza (6/10), irritabilidade (7/10), choro (7/10) e raiva (6/10). Quando comparados os períodos menstrual e pré-menstrual, o período menstrual apresentou piores sintomas de dismenorreia (P<0,05), lombalgia (P<0,05), dor nos membros inferiores (P<0,05), dificuldade de concentração (P<0,05), aumento do sono (P<0,05) e desânimo (P<0,05). As voluntárias apontaram 14 sintomas piores, com intensidade igual ou maior que 7 no período menstrual, e apresentaram 9 sintomas com intensidade igual ou maior que 7 no período pré-menstrual. Conclusão: os sintomas no período menstrual são mais intensos quando comparados ao período pré-menstrual e podem afetar AVDs. O presente estudo destaca a importância de análises e cuidados em relação ao período menstrual, já que tem grande impacto nos fatores físicos, mentais e emocionais das mulheres sedentárias.

Objective: to establish the differences in physical and mental symptoms in menstrual and premenstrual periods in sedentary women. Methods: cross-sectional study, through questionnaire, answered by 77 healthy women, aged 18 to 35 years, sedentary and who did not use contraceptives continuously. The questionnaire included questions about anthropometric data, physical and mental symptoms in menstrual and premenstrual periods. The Mann-Whitney test compared menstrual and premenstrual times. Results: in the menstrual period, on a numerical scale from 0 to 10 points, there were more complaints of pain (7/10), bad mood (7/10), discouragement (8/10), irritability (8/10), anxiety (7/10), crying (7/10), anger (9/10) and impact on ADLs (7/10). In the premenstrual period, there were complaints of headache (5/10), edema/water retention (6/10), bad mood (6/10), sadness (6/10), irritability (7/10), crying (7/10) and anger (6/10). When comparing the menstrual and premenstrual periods, the menstrual period had worse symptoms of dysmenorrhea (P<0.05), low back pain (P<0.05), pain in the lower limbs (P<0.05), difficulty concentrating (P<0.05), increased sleep (P<0.05) and discouragement (P<0.05). The volunteers reported 14 worse symptoms, with intensity equal to or greater than 7 in the menstrual period, and 9 symptoms with intensity equal to or greater than 7 in the premenstrual period. Conclusion: the symptoms in the menstrual period are more intense when compared to the pre-menstrual period and can affect the ADLs. This study highlights the importance of analysis and greater care in relation to the menstrual period, as it has a great impact on physical, mental and emotional factors in sedentary women.

Experimental pain thresholds and psychosocial features across menstrual cycle in myofascial orofacial pain compared to healthy individuals: cross-sectional study / Limiares de dor experimental e características psicossociais ao longo do ciclo menstrual na dor miofascial orofacial em comparação com indivíduos saudáveis: estudo transversal

ABSTRACT BACKGROUND AND OBJECTIVES: The hormonal impact on pain perception during the menstrual cycle is a major focus of study, and further elucidation in temporomandibular disorders (TMD) field is necessary. Thus, this cross-sectional study evaluated experimental pain thresholds, psychosocial features, and clinical pain report on TMD women across menstrual cycle versus healthy controls. METHODS: A total of 220 women's clinical files were screened, with 80 selected and divided into control group (healthy individuals, n=40) and TMD group (myofascial pain, n=40). Regarding the menstrual cycle phases, the files were divided into Pre-Luteal and Luteal. The Perceived Stress Scale (PSS), Pain Catastrophizing Scale (PCS), Mechanical Pain Threshold (MPT), Wind-up (WUR), Pressure Pain Threshold (PPT), Conditioned Pain Modulation (CPM) and Visual Analogue Scale (VAS) were analyzed at a 5% significance level, by Two-Way ANOVA test and post hoc Tukey test. RESULTS: PSS and PCS were significantly different between TMD and control group (p<0.001), regardless of menstrual cycle. Healthy individuals in the Luteal phase presented higher MPT values compared to the other phases (p<0.001). PPT showed significant difference across menstrual phases (p=0.022), but no differences in multiple comparisons. VAS values showed no difference between menstrual cycle phases (p=0.376). CONCLUSION: Finally, healthy individuals in the Luteal phase have higher MPT and PPT values on the orofacial region. Pain report in patients with TMD showed no difference throughout the menstrual cycle, showing that small alterations on experimental pain thresholds may not be clinically relevant. The presence of chronic pain seems to be more related to psychosocial features than hormonal fluctuations.

RESUMO JUSTIFICATIVA E OBJETIVOS: O impacto do ciclo menstrual na percepção da dor é um foco importante de estudo, sendo necessária uma maior elucidação na disfunção temporomandibular (DTM). Assim, este estudo transversal avaliou limiares de dor experimental, características psicossociais e relatos de dor em mulheres com DTM ao longo do ciclo menstrual, comparadas com controles saudáveis. MÉTODOS: 220 prontuários de mulheres foram analisados, sendo 80 selecionados para os grupos de controle (saudáveis, n=40) e DTM (dor miofascial, n=40). Nas fases do ciclo menstrual, as pacientes foram divididas nas categorias Pré-Luteal e Luteal. Os instrumentos Escala de Estresse Percebido (PSS), Escala de Pensamentos Catastróficos (PCS), Limiar de Dor Mecânica (MPT), Wind-up Ratio (WUR), Limiar de Dor à Pressão (PPT), Modulação Condicionada da Dor (CPM) e Escala analógica visual (EAV) foram analisados com nível de significância de 5%, pelos testes ANOVA de dois fatores e Tukey post hoc. RESULTADOS: As escalas PSS e PCS foram significativamente diferentes entre os grupos DTM e controle (p<0,001), independentemente do ciclo menstrual. Indivíduos saudáveis na fase luteal apresentaram MPT maior em comparação com outras fases (p,0,001). O PPT mostrou diferença significativa entre as fases menstruais (p=0,022), sem diferença nas comparações múltiplas. Os valores da EAV não apresentaram diferença entre as fases menstruais (p=376). CONCLUSÃO: Indivíduos saudáveis na fase luteal têm MPT e PPTl maior na região orofacial. Os relatos de dor em pacientes com DTM não mostraram diferença ao longo do ciclo menstrual, indicando que pequenas alterações nos limiares experimentais podem ser clinicamente relevantes. A presença de dor crônica parece estar mais relacionada com características psicossociais do que com flutuações hormonais.

Influencia del ciclo menstrual en el rendimiento físico y cognitivo en mujeres eumenorreicas / Influence of the menstrual cycle on physical and cognitive performance in eumenorrheic women

Introducción: Las hormonas sexuales femeninas propias del ciclo menstrual no solo tienen funciones reproductivas, tambiéninfluyen en otros sistemas fisiológicos pudiendo afectar al rendimiento deportivo y cognitivo. El propósito del presente estudioha sido evaluar distintos aspectos como la composición corporal, la resistencia, la fuerza muscular y algunas capacidadescognitivas en diferentes etapas del ciclo menstrual. Material y método: En el estudio participaron ocho mujeres jóvenes eumenorreicas (edad = 23,1 ± 4,4 años) con ciclosmenstruales regulares. Se realizó una prueba de densitometría y una bioimpedancia para estudiar la composición corporal, unaprueba de memoria visual a corto plazo y un test de tiempo de reacción para evaluar habilidades cognitivas y se analizaroncaracterísticas del músculo (grosor y rigidez del recto anterior y fuerza muscular) junto a una prueba de esfuerzo para evaluarel rendimiento durante las fases folicular media (FF) y lútea media (FL) del ciclo menstrual de las participantes. Resultados: Durante la fase folicular las participantes registraron un mayor tiempo total (FF = 488,5 ± 93,18 s vs. FL = 468,6± 81,29 s; p = 0,015) y una frecuencia cardiaca inicial menor (FF = 83,3 ± 10,23 PPM vs. FL = 92,9 ± 7,67 PPM; p = 0,034) en laprueba de esfuerzo. Además, Respecto a las habilidades cognitivas, en la fase folicular se obtuvieron mejores resultados enel tiempo de reacción tanto con la mano derecha (FF = 0,426 ± 0,082 s vs. FL = 0,453 ± 0,087 s; p = 0,036) como con la manoizquierda (FF = 0,435 ± 0,096 s vs. FL = 0,466 ± 0,077 s; p = 0,034). Por otro lado, se encontró un mayor porcentaje de grasa(FF = 27,3 ± 5,1% vs. FL = 27,9 ± 5,0%; p = 0,041) en la fase lútea. Conclusión: El rendimiento en resistencia y en aspectos cognitivos como es el tiempo de reacción fue mejor en la FaseFolicular mientras que se observó un mayor porcentaje de grasa en la Fase Lútea. Sin embargo, la memoria, la fuerza y lascaracterísticas...(AU)

Introduction: The female sexual hormones typical of the menstrual cycle not only have reproductive functions, they alsoinfluence other physiological systems and can affect sports and cognitive performance. The purpose of this study has beento evaluate different aspects such as body composition, endurance, muscle strength and some cognitive abilities at differentstages of the menstrual cycle. Material and method: Eight young eumenorrheic women (age = 23.1 ± 4.4 years) with regular menstrual cycles participatedin the study. A densitometry and bioimpedance test were performed to study body composition, a short-term visual memorytest and a reaction time test to assess cognitive abilities, and muscle characteristics (thickness and stiffness of the anteriorrectus and muscle strength) along with a progressive test to exhaustion were analyzed to assess performance during themid-follicular (FF) and mid-luteal (FL) phases of the participants’ menstrual cycle. Results: During the follicular phase, the participants registered a greater total time (FF = 488.5 ± 93.18 s vs. FL = 468.6 ± 81.29 s;P = 0.015) and a lower initial heart rate (FF = 83.3 ± 10.23 PPM vs. FL = 92.9 ± 7.67 PPM; P = 0.034) in the progressive test toexhaustion. Regarding cognitive abilities, in the follicular phase, better results were obtained in reaction time both with theright hand (FF = 0.426 ± 0.082 s vs. FL = 0.453 ± 0.087 s; P = 0.036) and with the left hand (FF = 0.435 ± 0.096 s vs. FL = 0.466 ±0.077 s; P = 0.034). On the other hand, a higher percentage of fat (FF = 27.3 ± 5.1% vs. FL = 27.9 ± 5.0%; P = 0.041) was foundin the luteal phase. Conclusion: Performance in endurance and in cognitive test, such as reaction time was better in the Follicular Phase, whilea higher percentage of fat was observed in the Luteal Phase. However, memory, strength and muscular characteristics werenot affected by the hormonal fluctuations of the menstrual cycle.(AU)

Uso de anticonceptivos y conocimiento del periodo fértil del ciclo menstrual en adolescentes

Introducción: La comprensión de los cambios fisiológicos que se presentan en las mujeres adolescentes son fundamentales para el cuidado de su salud sexual. Esto favorece un comportamiento anticonceptivo orientado a la elección de métodos seguros y eficaces. Objetivo: Establecer la asociación entre el uso de métodos anticonceptivos y el conocimiento del periodo fértil del ciclo menstrual en adolescentes peruanas. Métodos: Estudio transversal basado en el análisis secundario de la Encuesta Demográfica y de Salud Familiar del año 2021. La muestra fue de 717 de mujeres adolescentes con registro completo en las bases de datos. Se calcularon recuentos ponderados, no ponderados y se aplicó la prueba ji cuadrado con un 95 % de nivel de confianza. Resultados: El 19 % de las adolescentes reconocen el periodo fértil del ciclo menstrual y 6,3 % refirió que este periodo sucede durante la menstruación. El 80,8 % de las mujeres que cursan la adolescencia temprana, no conocen el momento del periodo. Respecto al uso de anticonceptivos, el 21,5 % era usuaria de preservativos y 16,3 % de inyectables; no obstante, 47 % señaló que no utilizaban ningún anticonceptivo. El 53,5 % de las adolescentes en etapa tardía indicaron que sí utilizan anticonceptivos. Entre las que son usuarias de estos métodos, 86,3 % no reconocen el periodo fértil. Conclusiones: En las adolescentes, el uso de métodos anticonceptivos no se asocia de manera significativa con el conocimiento que tienen acerca del periodo fértil del ciclo menstrual.

Introduction: The understanding of the physiological changes that occur in adolescent women are essential for the care of their sexual health. Thus, this favors a contraceptive behavior oriented to the choice of safe and effective methods. Objective: To establish the association between the use of contraceptive methods and the knowledge of the fertile period of the menstrual cycle in Peruvian adolescents. Methods: Cross-sectional study based on the secondary analysis of the 2021 Demographic and Family Health Survey. The sample consisted of 717 adolescent women with complete registration in the databases. Weighted and unweighted counts were calculated; and the Chi square test was applied at a 95% confidence level. Results: 19% of adolescents recognize the fertile period of the menstrual cycle and 6.3% reported that this period occurs during menstruation. In addition, 80.8% of women in early adolescence do not know the time of their period. Regarding the use of contraceptives, 21.5% were users of condoms and 16.3% of injectables; however, 47% indicated that they did not use any contraceptive. 53.5% of late-stage adolescents indicated that they do use contraceptives. Among those who are users of these methods, 86.3% do not recognize the fertile period. Conclusions: In adolescents, the use of contraceptive methods is not significantly associated with the knowledge they have about the fertile period of the menstrual cycle.

Asociación de la infección por SARS-CoV-2 y la administración de las vacunas contra la COVID-19 con alteraciones en el ciclo menstrual. Revisión de la literatura / Association of SARS-CoV-2 infection and administration of COVID-19 vaccines with alterations in the menstrual cycle. Literature review

Son diversos los factores que pueden afectar al ciclo menstrual de la mujer, entre ellos enfermedades o fármacos, como la enfermedad COVID-19 y las vacunas. El objetivo de esta revisión es explorar los estudios publicados hasta la fecha que han estudiado la presencia de alteraciones que puedan relacionarse con la COVID-19 o la vacunación contra el virus SARS-CoV-2.Se ha realizado una revisión en la base de datos PubMed, seleccionando 10 artículos en los que se ha estudiado el ciclo menstrual de mujeres adultas en edad fértil, tres de ellos en los que las participantes han sido diagnosticadas de COVID-19 y siete en los que las participantes han sido vacunadas contra el virus SARS-CoV-2.Respecto a las alteraciones relacionadas con la COVID-19, entre un 16 y un 47,2% de las participantes presentaron una prolongación de su ciclo, siendo más frecuente en aquellas que informaron de más síntomas de COVID-19, observando una normalización tras uno a dos ciclos.Respecto a las alteraciones descritas tras la vacunación contra el SARS-CoV-2, el 45-78% de las participantes refirieron alteraciones del ciclo menstrual, con resultados dispares respecto a los diferentes parámetros analizados, excepto en que las alteraciones se resolvían en unos dos meses.Tanto la enfermedad COVID-19 como la vacunación parecen estar relacionadas con la presentación de alteraciones en la menstruación, siendo estas limitadas en el tiempo y no graves. Sin embargo, los estudios son escasos hasta la fecha, por lo que es importante seguir desarrollando estudios que aporten evidencia científica.(AU)

A number of factors can affect a woman's menstrual cycle, including diseases or drugs, such as COVID-19 disease and vaccinations. The aim of this review is to explore the studies published to date that have studied the presence of alterations that may be related to COVID-19 or vaccination against the SARS-CoV-2 virus.We conducted a review in the PubMed database, selecting 10 articles in which the menstrual cycle of adult women of childbearing age was studied, 3 of them in which the participants had been diagnosed with COVID-19 and 7 in which the participants had been vaccinated against the SARS-CoV-2 virus.Regarding COVID-19-related disturbances, 16%-47.2% of the participants presented a prolongation of their cycle, which was more frequent in those who reported more COVID-19 symptoms, and which normalised after 1-2 cycles.Regarding the alterations described after SARS-CoV-2 vaccination, 45%-78% of participants reported menstrual cycle alterations, with disparate results for the different parameters analysed, except that the alterations resolved in about 2 months.Both COVID-19 disease and vaccination appear to be associated with the occurrence of menstrual disturbances, which are limited in time and not severe. However, studies are scarce to date, and it is important to continue to develop studies that provide scientific evidence.(AU)

Influencia de la fase de menstruación y de ovulación en el rango articular de extensión del tobillo y primera articulación metatarsofalángica / Influence of the menstruation and ovulation phase in the extension range of motion of the ankle and first metatarsophalangeal joint

Objetivos: Se trata de un estudio de investigación observacional prospectivo, cuyo objetivo fue valorar si existen diferencias en el rango articular de las articulaciones: tobillo, primera articulación metatarsofalángica del primer dedo durante la fase de ovulación y de menstruación. Pacientes y métodos: Se tomó como muestra a 14 mujeres de 20 a 25 años, que cumplían con los criterios de inclusión. Fueron exploradas en el Área Clínica de Podología de la Universidad de Sevilla por la investigadora del trabajo, reuniendo todos los requisitos de instalaciones y protección de datos para la paciente. Se tomaron dos medidas: durante la ovulación y durante la menstruación. Las propias pacientes informaron de su ciclo menstrual, tras firmar el previo consentimiento informado. Resultados: Tras el análisis estadístico se observó que la flexión dorsal del tobillo, con rodilla extendida y flexionada, y la extensión de la primera metatarsofalángica del primer dedo aumentaron significativamente (p < 0.001 en ambos pies) su rango articular durante la fase de ovulación. Conclusiones: Se han apreciado diferencias en el rango de extensión del tobillo y de la primera articulación metatarsofalángica del primer dedo, siendo mayor el rango en la fase ovulatoria.(AU)

Objective: This is a prospective, observational research study whose objective was to assess whether there are differences in the joint range of the joints: ankle, first metatarsophalangeal of the first toe during the ovulation and menstruation phase. Patients and methods: A sample of 14 women between the ages of 20 and 25, who met the inclusion criteria, were taken as a sample. They were explored in the Podiatry Clinical Area of the University of Seville by the researcher of the work, meeting all the facilities and data protection requirements for the patient. Two measurements were taken, during ovulation and another during menstruation. The patient themselves reported their menstrual cycle after signing the prior informed consent. Results: After the statistical analysis, it was observed that the dorsiflexion of the ankle, with the knee extended and flexed, and the extension of the first metatarsophalangeal of the first toe significantly increased (p < 0,001 in both feet) their joint range during the ovulation phase.Conclusions: Differences have been observed in the range of extensión of the ankle and of the first metatarsophalangeal joint of the first finger, the range being greater in the ovulatory phase.(AU)

Treatment approach to a patient with catamenial epilepsy. case report

ABSTRACT Introduction: Catamenial epilepsy refers to the worsening or exacerbation of seizures due to hormonal changes during the menstrual cycle. It is thought to be secondary to the neuroactive properties of endogenous steroid hormones and the natural cyclic variation in their serum levels throughout the menstrual cycle. Case presentation: A 31-year-old female patient from Bogotá (Colombia) was admitted to the emergency department due to an episode of tonic-clonic seizure associated with the menstrual period. Since the onset of the seizures was related to menstruation (every 28 days), it was established that the patient had structural focal epilepsy with catamenial features. Advantages of medical vs. surgical treatment were discussed during a multidisciplinary medical board and it was decided to start pharmacological treatment with progestogens, which resulted in complete remission of the seizures as established during a follow-up visit. Conclusions: Catamenial epilepsy should be considered as a cause of epilepsy refractory to antiepileptic medications. Furthermore, it should be approached from a multidisciplinary perspective and its management should be focused on improving the patients' quality of life.

RESUMEN Introducción. La epilepsia catamenial se define como un empeoramiento o la exacerbación de las crisis epilépticas en relación con el cambio hormonal durante el ciclo menstrual femenino. Se cree que esta se produce por las propiedades neuroactivas de las hormonas esteroides endógenas y la variación cíclica natural en sus niveles séricos a lo largo de dicho ciclo. Presentación del caso. Mujer de 31 años de Bogotá (Colombia), quien fue llevada al servicio de urgencias por un episodio de crisis epiléptica con convulsiones tonicoclónicas asociado al período menstrual. Debido a que la aparición de las crisis epilépticas se asociaba con la menstruación (cada 28 días), se estableció que la paciente presentaba epilepsia focal estructural de características catameniales. En junta médica multidisciplinar se discutieron las ventajas del manejo médico y el manejo quirúrgico, y se decidió instaurar tratamiento farmacológico con progestágenos, el cual, tras seguimiento, evidenció supresión total de las crisis. Conclusiones. La epilepsia catamenial debe considerarse como una causa de epilepsia refractaria al tratamiento antiepiléptico. Además, su abordaje debe ser multidisciplinario y su tratamiento debe ir enfocado a mejorar la calidad de vida de los pacientes.

Epilepsia con patrón catamenial / Epilepsy with catamenial pattern

La epilepsia con patrón catamenial se define como el aumento en la frecuencia de crisis epilépticas durante una etapa específica del ciclo menstrual respecto al basal. Se ha descrito que alrededor de un tercio de las mujeres con epilepsia presenta patrón catamenial. Los cambios en el patrón de crisis epilépticas se explicarían por la influencia de las fluctuaciones catameniales de las hormonas gonadales femeninas sobre la excitabilidad neuronal. La progesterona, a través de su metabolito alopregnanolona, desempeña un papel protector incrementando la transmisión gabérgica; sin embargo, su efecto en los receptores de progesterona cerebral puede incrementar la excitabilidad neuronal. Los efectos de los estrógenos son complejos y tienden a incrementar la excitabilidad neuronal, aunque dependen de su concentración y tiempo de exposición. Se han propuesto tres patrones catameniales de exacerbación de crisis epilépticas: el patrón perimenstrual, el patrón periovulatorio y el patrón lúteo. El abordaje diagnóstico se realiza mediante un proceso sistemático de cuatro pasos: a) historia clínica del patrón del ciclo menstrual y de las crisis epilépticas; b) métodos diagnósticos para caracterizar el ciclo menstrual y el patrón de las crisis epilépticas; c) comprobar los criterios diagnósticos, y d) categorizar el patrón catamenial. Las opciones de tratamiento estudiadas requieren mayor nivel de evidencia, y no existe ningún tratamiento específico aprobado por la Food and Drug Administration. Se recomienda la optimización del tratamiento anti crisis epilépticas convencional como primera opción terapéutica. Otras opciones terapéuticas, como tratamientos no hormonales y hormonales, podrían ser de utilidad en caso de que la primera opción terapéutica resulte ineficaz.(AU)

Catamenial pattern epilepsy is defined as an increase in the frequency of seizures during a specific stage of the menstrual cycle compared to baseline. It has been described that around a third of women with epilepsy have a catamenial pattern. The changes in the seizure pattern would be explained by the influence of catamenial fluctuations, of female gonadal hormones on neuronal excitability. Progesterone through its metabolite allopregnanolone plays a protective role by increasing GABAergic transmission; however, its effect on brain progesterone receptors can increase neuronal excitability. The effects of estrogens are complex, they tend to increase neuronal excitability, although their effects depend on their concentration and exposure time. Three catamenial patterns of seizure exacerbation have been proposed: the perimenstrual pattern, the periovulatory pattern, and the luteal pattern. The diagnostic approach is carried out through a systematic process of 4 steps: a) clinical history of the pattern of the menstrual cycle and epileptic seizures; b) diagnostic methods to characterize the menstrual cycle and the pattern of seizures; c) check diagnostic criteria; and d) categorize the catamenial pattern. The treatment options studied require a higher level of evidence, and there is no specific treatment. Optimization of conventional antiseizure treatment is recommended as the first therapeutic option. Other therapeutic options, such as non-hormonal and hormonal treatments, could be useful in case the first therapeutic option proves to be ineffective.(AU)

Variables emocionales y food craving: influencia del ciclo menstrual / Emotional variables and food craving: influence of the menstrual cycle

Antecedentes: El ciclo reproductor femenino - que implica interacciones entre el cerebro, el útero y los ovarios - está constituido por la fase folicular o proliferativa (también denominada pre-ovulatoria), posteriormente, tiene lugar la ovulación, tras ella comienza la fase lútea o secretora y, por último, tiene lugar la fase menstrual. Durante el ciclo menstrual la mujer experimenta cambios hormonales que pueden provocarle síntomas físicos, psicológicos y comportamentales como cambios en el apetito, pudiendo afectarle así a su ingesta alimentaria. Un fenómeno observado durante la menstruación es el food craving, definido como una necesidad irresistible de consumir comida (“ansia”), siendo predominante desear consumir alimentos procesados durante la fase premenstrual, conducta que, también se asocia a un estado de ánimo negativo. No obstante, numerosos y diversos patrones alimentarios, así como también fluctuaciones en el estado emocional, se han observado en la mujer durante las diversas fases del ciclo menstrual. Por ello, es necesario una mayor investigación en esta área. Objetivos y método: El presente trabajo, tiene como objetivos observar la variación del food craving en función de las diferentes fases del ciclo menstrual y observar la influencia de variables emocionales (ansiedad-estado de ánimo negativo) en el “ansia por comer” (food craving). Para ello, se ha realizado una búsqueda bibliográfica en las bases de datos PubMed, Scopus y otras fuentes como Wiley Online Library y ResearchGate, para obtener y contrastar las ideas de los autores de estudios previos con respecto al tema.(AU)

Background: The female reproductive cycle which involves interactions between the brain, the uterus and the ovaries, is made up of the follicular or proliferative phase (also called pre-ovulatory), later, ovulation takes place, after which the luteal or secretory phase begins and, finally, the menstrual phase takes place. During the menstrual cycle, the woman experiences hormonal changes that can cause physical, psychological and behavioral symptoms such as changes in appetite, thus affecting her food intake. A phenomenon observed during menstruation is food craving, defined as an irresistible need to consume food ("craving"), predominantly wanting to consume processed foods during the premenstrual phase, a behavior that, is also associated with a negative mood. However, numerous and diverse eating patterns, as well as fluctuations in emotional state, have been observed in women during the various phases of the menstrual cycle. Therefore, further research is needed in this area. Objectives and method: The present work aims to observe the variation of food craving in function of the different phases of the menstrual cycle and to observe the influence of emotional variables (anxiety-negative mood) in the “craving to eat” (food craving). For this, a bibliographic search was carried out in the databases PubMed, Scopus and other sources such as Wiley Online Library and ResearchGate, to obtain and contrast the ideas of the authors of previous studies regarding the topic. Discussion: It has been observed that there is a tendency to a higher energy-food pattern during the luteal phase together with an experience “food craving” also increased during this stage, in comparison with other phases of the menstrual cycle.(AU)

Percepción de cambios en el ciclo menstrual posteriores a la vacunación contra SARS-CoV-2 / Perception of menstrual cycle changes following SARS-CoV-2 vaccination

Resumen OBJETIVO: Identificar si la vacunación contra la COVID-19 se asocia con cambios en el patrón menstrual. MATERIALES Y MÉTODOS: Estudio observacional y transversal anónimo efectuado entre el 4 y 29 de octubre del 2021 en un grupo de mujeres que completaron un cuestionario elaborado para saber si hubo cambios en el ciclo menstrual posteriores a la vacunación. La encuesta se aplicó durante un periodo de cuatro semanas. Para el análisis estadístico se utilizó el programa SPSS. Los cambios antes y después de la aplicación de la primera y segunda dosis de la vacuna contra COVID-19 se evaluaron con una prueba t de muestras pareadas y χ2. RESULTADOS: Se reunieron 4501 pacientes de las que se excluyeron 1815 por no cumplir con los criterios de inclusión; al final quedaron para el análisis 2686. De éstas el 37.9% (n = 1018) tuvieron cambios en el ciclo menstrual posteriores a la vacunación contra COVID-19; en 61.8% (n = 630) fueron en la cantidad del sangrado. De las mujeres que reportaron cambios en el ciclo menstrual, el 64.34% (n = 655) fueron posteriores a la aplicación de vacunas tipo ARN mensajero (35.06%; p = 0.19, IC95%: -0.35-0.19). En relación con la cantidad de dosis aplicadas 72.10% (n = 734) reportaron modificaciones en el ciclo menstrual después de la segunda vacuna (p = 0.01, IC95%: 0.58-0.98). CONCLUSIONES: La vacunación contra COVID-19 se asocia con pequeños cambios en el ciclo menstrual, sin significación estadística. Las mujeres que reciben dos dosis de la vacuna tuvieron cambios en la cantidad del sangrado.

Abstract OBJECTIVE: Identify whether vaccination against COVID-19 is associated with changes in menstrual pattern. MATERIALS AND METHODS: An anonymous observational, cross-sectional to be held from October 4 to 29, 2021 was conducted in a group of women who completed a questionnaire designed to inquire about changes in the menstrual cycle following vaccination. The survey was administered over a four-week period. SPSS software was used for statistical analysis. Changes before and after the application of the first and second doses of COVID-19 vaccine were evaluated with a paired samples t-test and 2. RESULTS: 4501 patients were collected of whom 1815 were excluded because they did not meet the inclusion criteria; in the end 2686 remained for analysis. Of these, 37.9% (n = 1018) had changes in the menstrual cycle following COVID-19 vaccination; in 61.8% (n = 630) it was in the amount of bleeding. Of the women who reported menstrual cycle changes, 64.34% (n = 655) were after application of messenger RNA vaccines (35.06%; p = 0.19, 95%CI: -0.35-0.19). In relation to the number of doses applied 72.10% (n = 734) reported modifications in the menstrual cycle after l second vaccine (p = 0.01, CI95%: 0.58-0.98). CONCLUSIONS: Vaccination against COVID-19 is associated with small changes in the menstrual cycle, without statistical significance. Women receiving two doses of vaccine had changes in the amount of bleeding.

Menstrual cycle among adolescents: girls' awareness and influence of age at menarche and overweight / Ciclo menstrual em adolescentes: percepção das adolescentes e influência da idade de menarca e excesso de peso

Abstract Objective: To characterize the menstrual cycle (regularity and menstrual flow length), the prevalence of dysmenorrhea and self-monitoring of the cycle in students from Lisbon region, and explore the effect of chronological age, age at menarche and body mass index (BMI) on menstrual disorders. Methods: This is a cross-sectional study with 848 girls aged 12-18 years. A questionnaire about the sociodemographic context and characteristics of the menstrual cycle, and weight and height measures were assessed. BMI was classified according to International Obesity Taskforce criteria. A descriptive analysis of the variables was made, and Odds Ratios (ORs) and 95% confidence intervals (95%CIs) were determined. Results: Mean age at menarche was 12.4 years and mean BMI was 22.0kg/m2. Among adolescents, 59% have regular menstrual cycle, 83% have menstrual flow length of ≤6 days. 88% suffered from dysmenorrhea, among which 8,7% declare absenteeism from school and 49% took pain medication, and 65% self-monitor their menstrual cycle. Higher maternal education was associated with a higher self-monitoring of menstrual cycle among the sample (OR 1.60; 95%CI 1.15-2.17). Girls with menarche <12 years-of-age are more likely to have menstrual flow length of >6 days (OR 1.73; 95%CI 1.19-2.51) and dysmenorrhea (OR 1.87; 95%CI 1.11-3.16) than those with menarche ≥12 years-of-age. No significant association between BMI and menstrual cycle variables was observed. Conclusions: The results suggest that menstrual disorders are frequent and may be associated with early menarche, but not with BMI. It is important to encourage self-monitoring of the menstrual cycle to detect menstrual disorders timely and promote health and well-being.

Resumo Objetivo: Caracterizar o ciclo menstrual (regularidade e duração da menstruação), prevalência de dismenorreia e automonitoramento do ciclo em estudantes da região de Lisboa, e explorar o efeito da idade cronológica, idade de menarca e índice de massa corpórea (IMC) nos distúrbios menstruais. Métodos: Este é um estudo transversal com 848 meninas entre 12 e 18 anos. Foi aplicado um questionário sobre contexto sociodemográfico e características menstruais e feita a medição do peso e altura. O IMC foi classificado pelos critérios da International Obesity Taskforce. Fez-se uma análise descritiva das variáveis e determinaram-se Odds Ratio (p<0,005; IC95%). Resultados: A média da idade de menarca foi 12.4 anos e do IMC foi de 22.0kg/m2. Entre as jovens, 59% afirmaram ter ciclo menstrual regular, 83% menstruação com duração ≤6 dias, 88% sofrem de dismenorreia, entre as quais 8,7% faltaram à escola e 49% consumiram analgésicos, e 65% automonitoram o ciclo menstrual. Uma educação materna elevada está associada a maior monitorização do ciclo menstrual entre as jovens (OR 1,60; IC95% 1,15-2,17). Meninas com idade de menarca <12 anos têm maior chance de ter menstruação com duração >6 dias (OR 1,73; IC95% 1,19-2,51) e dismenorreia (OR 1,87; IC95% 1,11-3,16) do que aquelas com menarca ≥12 anos. Não se observou associação entre o IMC e as características menstruais. Conclusões: Os resultados sugerem que os distúrbios menstruais são frequentes nas adolescentes e podem estar associados com a menarca precoce, mas não com o IMC. É importante incentivar a automonitoramento do ciclo menstrual para detectar adequadamente as perturbações menstruais e promover a saúde e bem-estar.

Editorial note. Introduction to the Special Issue "Brain and Behavior: A Neuroscientific / Psychophysiological Approach", in honor and memory of Prof. Jesús Gómez Amor / Nota editorial. Introducción al tema monográfico “Cerebro y conducta: un enfoque neurocientífico/psicofisiológico”, en honor y recuerdo del Prof. Jesús Gómez Amor

Editorial note in which the special theme is presented and a brief comment is made on the articles that compose it.(AU)

Nota editorial en la que se presenta el monográfico y se hace un breve comentario de los artículos que lo componen.(AU)

Neumotórax catamenial

RESUMEN Introducción: El neumotórax catamenial es aquel neumotórax espontáneo y recurrente que se presenta relacionado con el ciclo menstrual. Más frecuente en mujeres con edad fértil por encima de los 30 años de edad y a predominio del hemitórax derecho. El diagnóstico primario es difícil y el tratamiento que mejores resultados registra es la cirugía por técnicas de mínimo acceso, asociada a tratamiento hormonal. Objetivo: Presentar un caso de neumotórax catamenial, sus características clínicas y el procedimiento videotoracoscópico empleado. Caso clínico: Paciente de 48 años de edad, con antecedentes de dolor torácico y tos al inicio de la menstruación. Además, dos neumotórax espontáneos derechos anteriores. Ingresó de urgencia con el diagnóstico de neumotórax espontáneo derecho. Se realizó biopsia, frenorrafia y pleurodesis por videotoracoscopía. Conclusiones: Los elementos clínicos y radiológicos inducen a pensar en el diagnóstico de neumotórax catamenial, apoyado por la presencia de fenestraciones diafragmáticas y la no reaparición del cuadro de neumotórax después del cierre de los defectos diafragmáticos y el tratamiento satisfactorio con pleurodesis con talco, por cirugía de mínimo acceso.

ABSTRACT Introduction: The catamenial pneumothorax is that spontaneous and recurrent pneumothorax related with the menstrual cycle. More frequent in women with fertile age above the 30 years of age and predominance of the right hemithorax. The primary diagnosis is difficult and the treatment that best results recorded is the surgery by minimal access techniques associated with hormone treatment. Objective: Present a case of catamenial neumothorax, to describe their clinical characteristics and the videothoracoscopic proceeding used. Clinical case: 48 years old female patient, with history of chest pain and coughing at the beginning of menstruation and having suffered two spontaneous rights pneumothorax. We performed biopsy, phrenorraphy and pleurodesis by videothoracoscopy, after 18 months the symptomatology did not reappear. Conclusions: The clinical and radiological elements induce to think of the diagnosis of catamenial pneumothorax, supported by the presence of diaphragmatic fenestrations and the not reappearance of the pneumothorax frame after the closure of the diaphragmatic defects and satisfactory treatment with talc pleurodesis by minimal access surgery.

Influencia de factores dietéticos en el dolor menstrual / Influence of dietary factors in menstrual pain

Objetivo: conocer la influencia de los hábitos alimentarios en la presencia de dismenorrea y su intensidad, averiguar las preferencias de alimentos durante la menstruación y las creencias sobre la relación de la nutrición con el dolor menstrual.Método: se realizó un estudio descriptivo transversal con mujeres entre 18 y 45 años estudiantes de Enfermería de una universidad de Barcelona (España) (n= 74). Se administró una encuesta online sobre la frecuencia de consumo de varios grupos alimentarios, padecimiento de dismenorrea, preferencias dietéticas durante la menstruación y percepciones de alimentos perjudiciales o beneficiosos para su dolor. Se utilizaron pruebas estadísticas no paramétricas con una significación p≤ 0,05.Resultados: participaron 67 mujeres (90,5%), de las cuales un 61,2% padecía dismenorrea. No consumir comida precocinada, pasteles, refrescos y algunas especias favoreció no padecer dismenorrea (p< 0,05). En cambio, consumir cúrcuma y pasteles favoreció su aparición (p< 0,05). Hubo también una mayor proporción de mujeres con dolor moderado entre las que consumían aguacate y más mujeres con dolor leve que grave al tomarsnacks. Las especias que provocaban dolores más leves o no dolor fueron la cúrcuma y comino, y la que más el orégano. Un 76,1% prefería el chocolate o dulces durante la menstruación seguido de 38,8% fruta y verdura y un 29,9% comida rápida, aunque creían más beneficiosas las frutas y las verduras.Conclusiones: dietas bajas en azúcares, ricas en grasas no saturadas y en determinadas especias resulta en un tratamiento no farmacológico efectivo de la dismenorrea. Se precisan estudios con muestras mayores para concluir resultados más sólidos.(AU)

Objective: to understand the influence of dietary habits in the presence and intensity of dysmenorrhoea, to find out the types of food preferred during menstruation, and the beliefs regarding the relationship between nutrition and menstrual pain.Method: a descriptive cross-sectional study was conducted on 18-to-45-year-old female Nursing students from a university in Barcelona (Spain) (N= 74). An online survey was administered on the frequency of use of different food groups, suffering dysmenorrhea, dietary preferences during menstruation, and perceptions of types of food as damaging or beneficial for pain. Non-parametric statistical tests were conducted, with a p≤ 0,05 significance.Results: the study included 67 women (90.5%); 61.2% of them suffered dysmenorrhea. Not eating ready-made meals, cakes, soft drinks, and some spices, contributed to not suffering dysmenorrhoea (p< 0.05). On the other hand, eating curcuma and cakes encouraged its development (p< 0.05). There was also a higher proportion of women with moderate pain among those who ate avocado, and more women with mild vs. severe pain when eating snacks. The spices causing milder or no pain were curcuma and caraway, while oregano was the spice causing higher pain. 76.1% preferred chocolate or sweets during menstruation, followed by 38.8% with fruit and vegetables, and 29.9% with fast food, even though they believed fruit and vegetables were more beneficial.Conclusions: diets with low sugar content, and rich in non-saturated fats and certain spices, result in an effective non-pharmacological treatment for dysmenorrhea. Studies are required with larger samples in order to draw conclusions with stronger outcomes.(AU)

Acceptability and safety of the menstrual cup: A systematic review of the literature / Aceptabilidad y seguridad de la copa menstrual: revisión sistemática de la literatura

Objectives: To conduct a systematic review of the literature and assess the acceptability and safety of the menstrual cup as a feminine hygiene product. Materials and methods: A search was conducted in the PubMed, Cochrane Library, Scopus, PopLine and Google Scholar databases for publications be- tween 1966 and July 2019. The terms ("Menstrual" AND "Cup") OR ("Copa" AND "Menstrual") were used. Quantitative, qualitative and mixed studies were included, as well as case series and case reports published in English and Spanish assessing the menstrual cup in women in childbearing age. The studies were selected and the data extracted by two reviewers working independently. Acceptability and safety were assessed as the primary result. The summary of the information is presented in narrative form. Results: Overall, 737 titles were found for initial review and, in the end, 38 studies were included in this work. The acceptability of the menstrual cup ranges between 35 % and 90 %. Between 10 to 45 % of women found it difficult to use. It was described as more comfortable when compared to tampons and pads. Continued use of the cup ranges between 48 and 94 %. In terms of safety, there was one case of toxic shock syndrome, one case of mechanical entrapment, and another case of allergy; and a higher risk of expulsion was found among intrauterine device users. Conclusion: The menstrual cup appears to be a comfortable, safe and efficient option for menstrual hygiene. Further randomized controlled studies and long-term prospective cohort studies are needed in order to determine the risk of complications due to excess bacterial colonization or retrograde menstruation.

TITULO: ACEPTABILIDAD Y SEGURIDAD DE LA COPA MENSTRUAL: REVISIÓN SISTEMÁTICA DE LA LITERATURA. OBJETIVO: Realizar una búsqueda sistemática de la literatura para evaluar la aceptabilidad y seguridad de la copa menstrual como producto de higiene genital femenina. METODOS: Se realizó búsqueda en las bases de datos PubMed, Cochrane Library, Scopus, PopLine y Google Scholar, desde 1966 hasta julio de 2019. Se utilizaron los términos: "Menstrual" AND "Cup" OR "Copa" AND "Menstrual". Se incluyeron estudios cuantitativos, cualitativos y mixtos, series y reportes de caso publicados en inglés y español que hubieran evaluado la copa menstrual en mujeres en edad reproductiva. Los estudios fueron selecciona- dos y los datos fueron extraídos por dos evaluadores de manera independiente. Como resultado primario se evaluó la aceptabilidad y seguridad. La síntesis de información se presenta de manera narrativa. RESULTADOS: Se encontraron 737 títulos para revisión inicial. Finalmente, se incluyeron 38 estudios. La copa menstrual tiene una aceptabilidad que varía entre el 35 y el 90 %. Del 10 al 45 % la encontraron difícil de usar. Fue descrita como más cómoda comparada con el tampón y la toalla higiénica de fabricación industrial. La continuidad de su uso está entre el 48 y el 94 %. En cuanto a la seguridad se presentó un caso de síndrome de choque tóxico, uno de atrapamiento mecánico, uno de alergia al producto y mayor riesgo de expulsión en usuarias del dispositivo intrauterino. CONCLUSIONES: La copa menstrual es una alternativa cómoda, segura y eficiente para la higiene mens- trual. Se requieren más estudios controlados alea- torizados y cohortes prospectivas a largo plazo para determinar el riesgo de complicaciones por una exagerada colonización bacteriana o menstruación retrógrada.