Genitourinary symptoms and sexual function in women with primary ovarian insufficiency.

OBJECTIVE: There are limited studies on urogenital symptoms in women who experience menopause before the age of 40 years due to primary ovarian insufficiency (POI) or bilateral oophorectomy (surgical POI). This study aimed to compare the urogenital symptoms, including sexuality, of women with POI to those without the condition. METHODS: This cross-sectional study conducted was in seven Latin American countries, in which postmenopausal women (with POI and non-POI) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS) and the six-item Female Sexual Function Index (FSFI-6). The association of premature menopause with more urogenital symptoms and lower sexual function was evaluated with logistic regression analysis. RESULTS: Women with POI experience more urogenital symptoms (MRS urogenital score: 3.54 ± 3.16 vs. 3.15 ± 2.89, p < 0.05) and have lower sexual function (total FSFI-6 score: 13.71 ± 7.55 vs. 14.77 ± 7.57 p < 0.05) than women who experience menopause at a normal age range. There were no significant differences in symptoms when comparing women based on the type of POI (idiopathic or surgical). After adjusting for covariates, our logistic regression model determined that POI is associated with more urogenital symptoms (odds ratio [OR]: 1.38, 95% confidence interval [CI] 1.06-1.80) and lower sexual function (OR: 1.67, 95% CI 1.25-2.25). CONCLUSION: POI, whether idiopathic or secondary to bilateral oophorectomy, is associated with symptoms that affect vaginal and sexual health.

Association of bilateral oophorectomy and menopause hormone therapy with mild cognitive impairment: the REDLINC X study.

BACKGROUND: Dementia is a major public health problem. Estrogen is a regulator of the central nervous system and its deficit could be involved in cognitive decline in older women. OBJECTIVE: This study aimed to evaluate the association of bilateral oophorectomy, menopause hormone therapy (MHT) and other factors on mild cognitive impairment (MCI). METHOD: The case-control study included 941 otherwise healthy postmenopausal women aged 60 years and over from six Latin American countries. Personal and family data were recorded and MCI was assessed using the Montreal Cognitive Assessment test (MoCA). RESULTS: Average age, years of education and body mass index were 66.1 ± 5.8 years, 12.4 ± 5.0 years and 26.0 ± 4.3 kg/m2, respectively. A total of 30.2% had undergone bilateral oophorectomy and 40.3% had used MHT. A total of 232 women (24.7%) had MCI. The prevalence of MCI was higher in women with intact ovaries and non-MHT users as compared to MHT users (29.3% vs. 11.7% [odds ratio (OR) 0.32; 95% confidence interval (CI) 0.20-0.51]). Among oophorectomized women, MCI prevalence was higher among non-MHT users as compared to MHT users (45.2% vs. 12.8% [OR 0.18; 95% CI 0.10-0.32]). Logistic regression analysis determined that the variables associated with MCI were age >65 years (OR 1.69; 95% CI 1.20-2.38), parity (having >2 children; OR 1.69; 95% CI 1.21-2.37), bilateral oophorectomy (OR 1.56; 95% CI 1.09-2.24), hypertension (OR 1.41; 95% CI 1.01-1.96), being sexually active (OR 0.56; 95% CI 0.40-0.79), education >12 years (OR 0.46; 95% CI 0.32-0.65) and MHT use (OR 0.31; 95% CI 0.21-0.46). CONCLUSION: Age, parity, bilateral oophorectomy and hypertension are independent factors associated with MCI; contrary to this, higher educational level, maintaining sexual activity and using MHT are protective factors.

Morphometry of the aortic arch and its branches. A computed tomography angiography-based study.

BACKGROUND: The current study aims to determine the prevalence of variations of the aortic arch using computed tomography angiography (CTA), as well as morphometries and gender correlations. MATERIALS AND METHODS: A retrospective, transverse, observational and descriptive study of 220 CTA was performed. The branching pattern, most cranial vertebral level of the aortic arch, area of the proximal, middle and distal segments of the arch, area of each branch, and the path of atypical arteries were recorded. Results were analysed and stratified by gender. RESULTS: The typical aortic arch branching pattern was present in 77.7% without statistical significance between genders. The most common variant was a two-branch pattern with a common trunk and a left subclavian (13.6%), followed by a typical branching pattern with an added left vertebral artery (7.3%). T3 was the most frequent cranial level (32.3%), followed by T2-T3 (26.8%), and T3-T4 (23.2%). The mean areas of the aortic arch were 685.5 ± 183.9, 476.1 ± 124.1, and 445.0 ± 145.1 mm2 for the proximal, middle and distal segments, with statistical difference between men and women in the middle and distal segments. Three paths of atypical arteries were identified: bifurcated vertebral artery (0.5%), aberrant right subclavian artery (0.5%), and left subclavian ostium obstruction (0.5%). CONCLUSIONS: Mexican population has one of the highest prevalence of variations in the aortic arch branching pattern. The high probability of finding these should be taken into consideration when assessing patients. A standardised classification method would contemplate future un-reported findings, without causing confusion by the different numbers assigned by each author.

[Utero-vaginal duplication with hematocolpus. Diagnosis by magnetic resonance imaging (MRI)]. / Duplicación útero-vaginal total con hematocolpos. Diagnóstico por imagenes por resonancia magnética (IRM).

A 21-year-old woman with complete uterus-vaginal duplication, hemivaginal obstruction and ipsilateral renal agenesis is presented. Ultrasonography shows uterus duplication with a parauterine cystic mass. MRI demonstrated uterus duplication and also a para/infra uterine mass with T1 and T2 weighted high-signal-intensity disclosing its serohematic nature. Surgical procedure confirmed the MRI findings.

[Value of plasma progesterone (rapid assay) during ovarian stimulation for in vitro fertilization using LHRH agonists and hMG]. / Intérêt de l'étude de la progestérone plasmatique (dosage rapide) au cours de la stimulation ovarienne pour fécondation in vitro utilisant les agonistes de LHRH et les hMG.

We have studied all the cycles (= 276) induced for in vitro fertilization using a LHRH agonist and the hMG (113 short protocols, 163 long protocols) from 01.90 to 07.90 to know the plasmatic profiles of the estradiol (E2), of the LH and specially of the progesterone (P) between J-7 and the day of the hCG (= J0). We observe in the short protocol an elevation (effect flare up) and afterwards a fall concomitant of the P and of the LH up to J-5, J-6 (effect of pituitary down regulation), in the short and long protocols a progressive elevation of J-3 up to J0 of the P parallel to E2, so that the LH remain stable or decrease. The LH of J0 is higher in short protocol than in long protocol (10.14 +/- 2.9 versus 4.72 +/- 1.3 Ul/l, p < 0.00001). We found the same progressive elevation of the P of J-3 up to J0 in pregnant and not pregnant patients. The surveillance of the P coupled to the E2 and to the follicular ultrasonography could help in the choice of the day of the hCG and avoid a post-maturity of oocyte. The consequences of the elevation of P In the morning of J0 have been study for P levels < 1 ng/ml (73 cases) and P > or = 1 ng/ml (203 cases) and afterwards for progressive elevation of P levels (1.5-2-2.5-3 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Duplicación útero-vaginal total con hematocolpos. Diagnóstico por imagenes por resonancia magnética (IRM). / [Utero-vaginal duplication with hematocolpus. Diagnosis by magnetic resonance imaging (MRI)]

A 21-year-old woman with complete uterus-vaginal duplication, hemivaginal obstruction and ipsilateral renal agenesis is presented. Ultrasonography shows uterus duplication with a parauterine cystic mass. MRI demonstrated uterus duplication and also a para/infra uterine mass with T1 and T2 weighted high-signal-intensity disclosing its serohematic nature. Surgical procedure confirmed the MRI findings.