RESUMO
Objective: identifying the instruments used to measure quality of life during menopausal transition and post-menopause in women with obesity or overweight. Methods: a systematic search using the Embase, Pubmed and Cochrane databases, and the following key-words: menopause/climacteric, quality of life, overweight/obesity. Nineteen papers that fulfilled the including criteria were found. Results: eighteen studies using generic health questionnaires (global quality of life) were identified, six of them were specific for menopause and one specific for obesity. Eleven studies used generic questionnaires, while only eight questionnaires were specific for menopause. Conclusion: there was no consensus in the literature about the use of quality of life questionnaires in women with overweight and obesity in climacterium, which makes de comparison and reproducibility of the results difficult. This is an alert about the need for standardization to better evaluate this specific population. .
Objetivo: identificar os instrumentos utilizados para aferir a qualidade de vida de mulheres com sobrepeso e obesidade no climatério (transição para menopausa e pós-menopausa). Métodos: busca sistemática nas bases de dados Embase, Pubmed e Cochrane com os descritores: menopause/climacteric, quality of life, overweight/obesity. Foram incluídos 19 artigos que preencheram os critérios de inclusão. Resultados: foram identificados 18 questionários genéricos (qualidade de vida global), 6 específicos para menopausa e 1 específico para obesidade. Onze estudos utilizaram instrumentos genéricos, enquanto 8 utilizaram específicos para menopausa. Conclusão: não houve consenso na literatura quanto ao uso de instrumentos de qualidade de vida em mulheres com sobrepeso e obesidade no climatério, o que dificulta a comparação e a reprodutibilidade dos resultados. Este é um alerta quanto à necessidade de padronização para melhor avaliar essa população específica. .
RESUMO
Although the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women's quality of life is jeopardized. Depending on the size of the microperforation, MH's clinical features me be very similar to those found in imperforated hymen cases. However, MH may present infectious complications since the accumulated secretion retained in the vaginal canal has contact with the external environment and therefore represents a source of entry for infectious agents. The authors report a case of a 28-year-old woman who sought the gynecologist complaining of inability to have vaginal intercourse. She referred normal menses, but in fact, although regular, bleeding was filiform and was exteriorized only through the right side of the vagina. Physical examination and imaging disclosed a microperforation of the hymenal membrane at 10 o'clock position. Hymenotomy under general anesthesia was undertaken. Outcome was favorable and the patient could thenceforth have a normal life. We conclude that this anomaly may be overlooked, interfering on its incidence determination. The delayed onset of symptoms and psychological embarrassing aspects, which postpone gynecological consultation, may contribute for misdiagnoses. We call attention to a mandatory detailed anamnesis and thorough physical examination to diagnose this anomaly before the puberty, when complications are less frequent and treatment is advisable.
