Evidencia del mensaje de sufrimiento hereditario / Evidence for the hereditary suffering message

En este artículo pondremos un ejemplo de la vida real para demostrar con claridad todo lo escrito. Se trata del caso de una mujer de 35 años que llega a la consulta con un solo síntoma importante para ella. No le viene la menstruación desde hace años. Y si le viene, es solo esporádicamente. Refiere que la última vez que le ha venido regularmente fue cuando se separó de su novio; después se sintió libre y contenta, segura de sí misma. Años después, se ha vuelto a enamorar y han vuelto a desaparecer las menstruaciones. Cuando se configura la historia familiar nos encontramos (sin dar demasiados detalles) una historia con ciertas características que han constituido el lenguaje primordial, inconsciente y consciente, de la vida de la paciente. Resulta ser que, durante tres generaciones, mujeres dominantes y severas con los demás han tenido hijos naturales a escondidas, antes de casarse con sus maridos respectivos, que también han tenido otros hijos naturales fuera del matrimonio con anterioridad. Al final, acabaron casándose de manera oficial con sus respectivas mujeres (abuelas y madre de la paciente), ya que éstas habían quedado embarazadas. Ellos, hombres sin responsabilidad amorosa, vivieron ajenos a las obligaciones como padres; el condicionamiento social los forzó a mantener la casa y los hijos, pero sin que ello implicara la capacidad para proteger y educar a los hijos que, por tanto, siempre dependieron solo de ellas.

A percepção de mulheres sobre a menstruação: uma questão de solidariedade / Women's perception of menstruation: a question of solidarity / La percepción de mujeres sobre la menstruación: una cuestión de solidaridad

Objetivo: descrever a experiência de mulheres em relação à menstruação. Metodologia: estudo qualitativo baseado no método de análise de conteúdo temática. O cenário foi o campus de uma universidade pública no Rio de Janeiro. Participaram 23 mulheres entre 20 e 72 anos de idade. Os dados foram obtidos entre julho/2015 e julho/2016 através da entrevista semiestruturada. Resultados: foi identificada, como tema central/categoria, a questão da solidariedade entre mulheres quando o assunto é menstruação. Emergiram quatro sub-categorias: A conexão das mulheres com a menstruação; A experiência de menstruar afetando umas às outras; A influência e o suporte proveniente das mães e/ou de outras mulheres; e A transferência. Conclusão: a menstruação causa sentimentos ambíguos nas mulheres, resultando em predomínio de sentimentos negativos, como medo e sensação de vergonha. Ao mesmo tempo pode ser percebida como motivo de felicidade e tranquilidade. A solidariedade entre mulheres pode influenciar positivamente a percepção da mulher sobre a menstruação, sendo elemento de empoderamento.

Objective: to describe women's experience of menstruation. Methodology: this qualitative study was based on the thematic content analysis method. The setting was a public university campus in Rio de Janeiro. Twenty-three women from 20 to 72 years old participated. Data were obtained between July 2015 and July 2016 by semi-structured interview. Results: the central theme/category was identified as solidarity among women with regard to menstruation. Four subcategories emerged: women's connection with menstruation; one's experience of menstruating affects others; influence and support from mothers and/or other women; and transference. Conclusion: menstruation causes ambiguous feelings in women, with negative feelings, such as fear and a sense of shame, predominating. At the same time, it can be seen as a reason for happiness and tranquility. Solidarity among women is a factor of empowerment, and can influence women's perception of menstruation positively.

Objetivo: describir la experiencia de mujeres en relación con la menstruación. Metodología: estudio cualitativo basado en el método de análisis de contenido temático. El escenario fue el campus de una universidad pública en Río de Janeiro. Participaron 23 mujeres cuya edad estaba entre 20 y 72 años. Los datos se obtuvieron entre julio/2015 y julio/2016 a través de entrevista semiestructurada. Resultados: se identificó, como tema central/categoría, la solidaridad entre mujeres en relación con la menstruación. Surgieron cuatro subcategorías: la conexión de las mujeres con la menstruación; la experiencia de menstruar, afectando unas a las otras; la influencia y el apoyo de las madres y/o de otras mujeres; y la transferencia. Conclusión: la menstruación causa sentimientos ambiguos en las mujeres, resultando en predominio de sentimientos negativos, como el miedo y la sensación de vergüenza. Al mismo tiempo, podría percibirse como un motivo de felicidad y tranquilidad. La solidaridad entre mujeres puede influir positivamente en su percepción sobre la menstruación, siendo un elemento de empoderamiento

Uterine leiomyoma: understanding the impact of symptoms on womens' lives.

BACKGROUND: Most women report negative experience about the symptoms of uterine leiomyoma (UL) in their lives, such as abnormal uterine bleeding and pelvic pain. Many studies have been conducted about efficacy of UL treatment, but little research has been performed about womens health related quality of life (HRQL). METHODS: This is a semi-structured, descriptive, observational, qualitative study that was performed during eight months. Focus group (FG) interviews were performed with women attending at a tertiary hospital in Brazil, who were consecutively included in the study. Seventy women with symptomatic UL were recruited to this study. FG duration was one hour with mediators with 5-6 women at each group. Collected data from discussions was processed according to thematic analysis and stored at a qualitative software. RESULTS: Women were negatively influenced by the presence of symptomatic UL. The major themes that were noticed during analysis were: beliefs and attitudes towards UL; limitation to social and professional activities; sensation of fear/unfairness/discouragement towards the symptoms and adverse effects during treatment with GnRH analogs. CONCLUSIONS: Symptomatic UL has a negative impact on womens HRQL. Health providers should consider such impact when counseling women on their treatment options, since it may have an important influence in these patients' decision-making process. While current pharmacological treatments may improve disease specific outcomes, such as bleeding intensity and tumor volume, they fail on actually improving quality of life.

Menstrual bleeding: perspective of Brazilian women.

BACKGROUND: Menstrual patterns, induced amenorrhea and the use of some contraceptive methods which induce non-bleeding are issues under debate among health professionals and women. The objective of the study was to describe perspectives and attitudes of Brazilian women regarding menstruation and its interference in daily activities. STUDY DESIGN: A semistructured questionnaire was applied to nonpregnant, nonlactating women between 18 and 45 years old, who were menstruating, consulting at public health services for other complaints than gynecological or reproductive health care, and staff members and teachers of public universities in one city of each geographic region of Brazil and the Federal District. RESULTS: Of the 885 women interviewed, 51.5% were aged 20-29 years, almost 60% reported normal frequency of bleeding, 22% and 43% reported interference of menstruation in their school activities and in the relationship with their partner, respectively. The value attributed to each interference (<5; ≥ 5; in a scale up to 10) was >5 for more than 60% of the women in all evaluated domains. The most common reason for disliking menstruation was inconvenient and/or discomfort, and for liking menstruation were feeling healthy and confirmation of not being pregnant. The variables associated to liking menstruation were attending <8 years of school and low economic class, having more than one child and no history of premenstrual tension. CONCLUSION: A great proportion of the interviewed women disliked having menstruation even when they did not present menstrual-related problems. However, some women still preferred monthly menstruation because they felt healthy and it was a free pregnancy test.

[Menstrual cycle perception and psychological distress in a sample of Mexican women]. / Percepción del ciclo menstrual y malestar psicológico en una muestra de mujeres mexicanas.

OBJECTIVE: To evaluate the association between psychological distress and menstrual bleeding perception, in order to design a psychological intervention for women in reproductive age. MATERIAL AND METHODS: Ex post facto and retrospective study in a random sample of women living in Mexico City with ages between 15 to 35 years. The following instruments were administered after reading the informed consent form: demographic and social questionnaire, gyneco-obstetric clinical history, menstrual bleeding diagnostic scale, menstrual bleeding analogical scale and the Goldberg's General Health Questionnaire. RESULTS: 909 women were interviewed and 776 completed the study. A significant statistic association existed between the presence of menorrhagia and the symptoms of psychological distress. CONCLUSIONS: Our results suggest a temporary interaction between physiological and psychological symptoms that produce an intense sense of distress in the women.

Irregularidades menstruais: inter-relações com o psiquismo / Menstrual irregularities: relationship with pshychic

Dados provenientes de estudos em animais e humanos indicam que o estresse psicológico pode determinar alteração relevante sobre a função menstrual. Vários estudos procuraram analisar eventos estressores comuns - novo emprego, dificuldades financeiras, discussões diárias - e sua relação com características menstruais, como o intervalo e quantidade do fluxo, bem como com quadros de amenorréia. Sugere-se que as alterações menstruais funcionais resultam primariamente da ação direta dos hormônios do eixo hipotálamo-hipófise-adrenal, provavelmente modulados por CRH, induzindo maior atividade de ACTH e beta-endorfina. Clinicamente, os quadros mais freqüentemente associados aos distúrbios psíquicos referem-se às anovulações de origem central e às amenorréias hipotalâmicas. A caracterização do envolvimento psíquico nessas condições representa elemento fundamental para a adequada abordagem terapêutica.

Data from both animal and human research indicate that psychological stress is associated with altered menstrual function. A number of studies have examined the relationship between more common stressors (job strain, financial worries, daily hassles) and menstrual cycle characteristics, such as cycle length and quality of bleeding, as well as amenorrhea. Numerous investigators have suggested that functional reproductive deficits result primarily from direct actions of the hypothalamic-pituitary-adrenocortical, probably modulated by a CRH-stimulated increase in the opioid beta-endorphin. The characterization of the psychic envolvement in these conditions represents basic element for the adequate therapeutical approach.

The polycystic ovary syndrome--a medical condition but also an important psychosocial problem.

PCOS, the leading cause of anovulatory infertility that affects up to one fifth of the female population, is a complex chronic disease of genetic as well as environmental determination, but still unclear etiology. Besides of infertility, PCOS leads to menstrual dysfunctions, hirsutism and obesity--symptoms that are known to cause profound psychosocial distress. The present paper review the problematic of etiology and symptom expression of PCOS, which is not only a disease needing medical treatment but also a psychosocial problem for the affected women. PCOS may not only coinduced by psychosocial factors, the main symptoms of PCOS such as infertility, menstrual dysfunctions, hirsutism and obesity cause by themselves increased psychosocial stress.

Aspectos psicobiológicos de la conducta delictiva / Psychobiological aspects of criminal behavior

Desde los estudios clásicos de Lombroso sobre la biotipología del delincuente, se han realizado estudios relacionados con los aspectos biológicos de la conducta delictiva, que recaen fundamentalmente sobre aspectos neurofisiológicos, hormonales, genéticos, y más recientemente, etológicos. Entre los primeros se destaca la relación entre la conducta delictiva y la actividad anormal de las estructuras nerviosas que constituyen en Sistema Límbico, su relación con la conducta agresiva y la incidencia de la Epilepsia Temporal en reos. La relación entre las alteraciones premenstruales y la conducta anormal, incluyendo la conducta delictiva en mujeres, es la mas destacada en estudios sobre la función hormonal y la conducta delictiva. La existencia de anormalidades cromosómicas, tales como un cromosoma Y exstra, ha sido el principal enfoque en el aspecto genético de los delincuentes, asociado con anormalidades en el metabolismo de la testosterona en éstos. Los aspectos de territorialidad y dominancia, han sido algunos de los aspectos etológicos estudiados en los índices de criminalidad en grandes masas de población y en las macrópolis. No existen conclusiones definitivas sobre el papel de estas variables en la conducta social anormal, aunque constituyen algunos aspectos relevantes dentro del estudio de la conducta compleja, tal como ocurre en la conducta delictiva. Las teorías contemporáneas contemplan la interrelación de estas variables psicobiológicas, con factores económicos y geopolíticos, habilidades sociales, etc.

Sindrome pre-menstrual: um diagnostico psiquiatrico? / Premenstrual syndrome: a psychiatric diagnosis?

O autor aborda a complexidade conceitual e diagnostica que cerca as diversas alteracoes psiquiatricas relacionadas ao periodo pre-menstrual, e como estas alteracoes tem sido objeto de estudos, atraves de extensa revisao da literatura nesta area. Discute-se os atuais criterios para o diagnostico das mudancas pre-menstruais, como diagnostico das mudancas pre-menstruais, como diagnostico primario ( disforia do periodo luteo tardio), alem das suas relacoes com periodos de exacerbacao de outros quadros (transtornos afeticos, alimentares, transtorno do panico). Propostas terapeuticas sao aventadas, para uma posterior e ampla abordagem.