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1.
Artigo em Inglês | MEDLINE | ID: mdl-33671663

RESUMO

Abdominal muscles may be both morphologically and functionally affected by pregnancy. Dysfunction of the muscles can lead to persistent postpartum low back pain. The recovery process of the abdominal muscles following childbirth is not well understood. This study aimed to demonstrate the changes in the thickness and contractile function of abdominal muscles during the first six months postpartum. Nine perinatal and 15 nulliparous females participated. The thicknesses and contraction/relaxation thickness ratios of the rectus abdominis (RA), external abdominal oblique (EO), internal abdominal oblique (IO), and transverse abdominis (TrA) were measured using ultrasound images from 36-39 weeks' gestation until six months postpartum. The RA, IO, and TrA muscles were thinner in perinatal females than controls at 36-39 weeks of gestation (4.8 vs. 9.47 mm (RA), 5.45 vs. 7.73 mm (IO), 2.56 vs. 3.38 mm (TrA), respectively). The thinner IO muscle persisted for six months after delivery. The decreased TrA thickness ratio persisted until four months post-delivery. Abdominal muscle thickness and contractile function decreased in the postpartum period. Therefore, abdominal muscle exercises might help prevent postpartum symptoms; however, because deterioration of muscle function is significant in the first four months, careful attention should be paid to exercise intensity. The study limitation was a relatively small sample size, thus future studies should involve more participants.


Assuntos
Músculos Abdominais , Dor Lombar , Músculos Abdominais/diagnóstico por imagem , Exercício Físico , Feminino , Humanos , Contração Muscular , Gravidez , Ultrassonografia
2.
J Obstet Gynaecol Res ; 47(1): 5-25, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33145837

RESUMO

Nine years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the 4th Revised Edition was published in 2020. The 2020 Guidelines includes 4 additional clinical questions (CQ), which brings the total to 99 CQ (12 on infectious disease, 29 on oncology and benign tumors, 29 on endocrinology and infertility and 29 on healthcare for women). Currently, a consensus has been reached on the Guidelines, and therefore, the objective of this report is to present the general policies regarding diagnostic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding Recommendation Level (A, B, C) is indicated.


Assuntos
Ginecologia , Obstetrícia , Médicos , Feminino , Humanos , Japão , Gravidez , Sociedades Médicas
3.
J Obstet Gynaecol Res ; 47(2): 792-799, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33336549

RESUMO

AIM: To examine the effects of administration of monophasic oral contraceptive (OC) on the body composition and aerobic and anaerobic capacities of female athletes. METHODS: Ten female athletes (23.0 ± 4.1 years old) participated in this study. All the subjects were examined during the menstrual cycle (early follicular [EF], middle luteal [ML]) and OC cycle (inactive OC, and active OC phases). After the menstrual cycle measurements, all the subjects began taking OC. The athletes tested using a body composition, circumferences, the lactate curve test, the maximal oxygen consumption test, and the Wingate test during all phases. RESULTS: Waist circumference was lower during the OC cycle than menstrual cycle (P < 0.05), and the other circumferences of parts were not different during the menstrual or OC cycles. However, there were no differences in body composition before and after taking OC. The phase of the menstrual or OC cycle did not affect maximal oxygen consumption, heart rate max or power output at a blood lactate concentration of 2 and 4 mmol/L between the menstrual and OC cycle phases. Although, the peak blood lactate level after the Wingate test was higher during the OC cycle (inactive OC phase, 13.0 ± 2.4 mmol/L; active OC phase, 12.4 ± 3.0 mmol/L) than during the menstrual cycle (EF phase, 11.9 ± 2.1 mmol/L; ML phase, 11.4 ± 2.1 mmol/L; P < 0.05), the peak and average power in the Wingate test did not change during the menstrual and OC cycle phases. CONCLUSION: Administration of monophasic OC did not affect the body composition or aerobic and anaerobic capacities of female athletes.


Assuntos
Atletas , Anticoncepcionais Orais , Adolescente , Adulto , Anaerobiose , Composição Corporal , Anticoncepcionais Orais/farmacologia , Feminino , Humanos , Ciclo Menstrual , Adulto Jovem
4.
J Obstet Gynaecol Res ; 47(2): 476-485, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33084213

RESUMO

Sport plays a major role in maintaining and improving physical function and health of women from adolescence to sexual maturity, through to menopause and old age, and it also plays a key role in social productivity and medicine from the perspective of preventive medicine. However, in routine clinical practice, there are many gynecological problems that affect the condition and performance of female athletes due to a lack of appropriate medical intervention, such as neglect of amenorrhea and menstruation-related symptoms. In addition, the number of athletes aiming to return to competition post-partum has been increasing in recent years, but there is little medical data on the well-being of female athletes during pregnancy and the post-partum period. I previously conducted clinical research on three separate topics, with the aim of clarifying the current issues unique to female athletes, mainly in terms of conditioning and injury prevention. The goal was that clinical research was to examine the situation of athletes with and without disabilities and provide feedback from the survey results to athletes and coaches. This paper divides the clinical studies conducted to date into three topics that will be explored herein: (i) research on the female athlete triad (Triad); (ii) research on oral contraceptives/low-dose estrogen-progestin; and (iii) research on pregnancy and post-partum period.


Assuntos
Síndrome da Tríade da Mulher Atleta , Medicina Esportiva , Esportes , Adolescente , Amenorreia , Atletas , Feminino , Humanos
5.
J Obstet Gynaecol Res ; 46(8): 1436-1442, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32537947

RESUMO

BACKGROUND: Approximately 10% of female athletes have a history of stress fractures, which most commonly occur between the ages of 16 and 17 years old. PURPOSE: We investigated whether tartrate-resistant acid phosphatase 5b (TRACP-5b), which is a bone resorption marker, can serve as a valid predictor of stress fractures in female athletes in their teens and 20s. METHODS: Three hundred and sixteen elite female athletes were recruited between 2013 and 2015. Serum TRACP-5b and various hormones were examined in blood samples. The serum TRACP-5b level was compared between athletes with and without stress fractures within 3 months after the initial collection of their blood samples. RESULTS: The 316 athletes were divided into two age groups: 13-19 years old and 20-29 years old. Thirty-six athletes (11.4%) experienced new stress fractures within 3 months after the initial collection of their blood samples. The median serum TRACP-5b level was significantly higher in teenage athletes with new stress fractures than in teenage athletes without new stress fractures. In univariate logistic regression analysis, the Z-score of serum TRACP-5b was a significant predictive factor of stress fractures in teenage athletes only (odds ratio: 1.87; 95% CI: 1.31-2.66; P < 0.0012). CONCLUSION: For teenage female athletes, TRACP-5b is a predictor of the risk of stress fractures, and measuring TRACP-5b levels may be useful to prevent stress fractures.


Assuntos
Fraturas de Estresse , Fosfatase Ácida , Adolescente , Atletas , Biomarcadores , Feminino , Fraturas de Estresse/epidemiologia , Humanos , Isoenzimas , Fosfatase Ácida Resistente a Tartarato
6.
Scand J Med Sci Sports ; 30(8): 1379-1386, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32285553

RESUMO

BACKGROUND: The effects of transdermal estradiol treatment (HT) in amenorrheic athletes (AA) with low body weight (BW) and low bone mineral density (BMD) are unknown. PURPOSE: To investigate whether HT increases BMD in AA with low BW and to compare the results with levels in AA who have recovered spontaneous menstruation (SM). METHODS: Female athletes (n = 151) were recruited at the Japan Institute of Sports Sciences and the University of Tokyo. All participants were divided into four groups: an AA group (untreated group) (n = 36), a HT group (n = 55), a SM group (n = 21), and an eumenorrheic athletes (EA) group (n = 39). Height, body weight, blood tests, and dual-energy X-ray absorptiometry were measured at baseline and after 12 months. The HT group was treated daily for 12 months with transdermal estrogen therapy. In addition, participants received oral progestin for 7 days once every 3 months. RESULTS: After 12 months, BMD in the AA group was significantly lower than at baseline; however, BMD in the other three groups was significantly higher than at baseline. The ratio of the change in BMD values before and after 12 months was -1.6 ± 3.2% for the AA group, 5.3 ± 8.7% for the HT group, 11.1 ± 8.9% for the SM group, and 2.3 ± 5.7% for the EA group. The rate of change in BMD values in the SM group was greater than that in the HT group. CONCLUSION: HT increased BMD in AA with low BW, and the increase in those with SM was greater than that in those treated with HT.


Assuntos
Amenorreia , Atletas , Peso Corporal , Densidade Óssea/efeitos dos fármacos , Estradiol/uso terapêutico , Administração Cutânea , Biomarcadores/sangue , Estrogênios/uso terapêutico , Feminino , Humanos
7.
Clin J Sport Med ; 30(3): 245-250, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32341292

RESUMO

OBJECTIVE: To determine whether secondary amenorrhea during teenage years influences bone mineral density (BMD) in female athletes in their 20s. DESIGN: Original research. SETTING: Japan Institute of Sports Sciences. PARTICIPANTS: Two hundred ten elite female athletes older than 20 years were included in the study. MAIN OUTCOME MEASURES: Information on the participants' past (ie, during their teenage years) and current menstrual cycle, training time, history of stress fractures, and blood tests for hormones received was obtained. Bone mineral density of the lumbar spine was evaluated by dual-energy x-ray absorptiometry; low BMD was defined as a Z-score ≤-1. We investigated the correlation factors for low BMD in athletes in their 20s by univariable and multivariable logistic regression analysis. RESULTS: A total of 39 (18.6%) female athletes had low BMD. Secondary amenorrhea in their teens [odds ratio (OR), 7.11, 95% confidence interval (CI), 2.38-21.24; P < 0.001] and present body mass index (BMI) (OR, 0.56, 95% CI, 0.42-0.73; P < 0.001) were independent correlation factors for low BMD in the multivariable logistic regression analysis. The average Z-score for those with secondary amenorrhea in their teens and 20s, secondary amenorrhea in their 20s only, and regular menstruation was -1.56 ± 1.00, -0.45 ± 1.21, and 0.82 ± 1.11 g/cm, respectively. CONCLUSIONS: Secondary amenorrhea for at least 1 year during teenage years in female athletes and BMI at present was strongly associated with low BMD in their 20s.


Assuntos
Amenorreia/fisiopatologia , Densidade Óssea/fisiologia , Doenças Ósseas Metabólicas/fisiopatologia , Esportes/fisiologia , Absorciometria de Fóton , Adolescente , Amenorreia/prevenção & controle , Índice de Massa Corporal , Doenças Ósseas Metabólicas/prevenção & controle , Estradiol/sangue , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiologia , Hormônio Luteinizante/sangue , Ciclo Menstrual/fisiologia , Adulto Jovem
8.
Scand J Med Sci Sports ; 29(10): 1501-1510, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31100189

RESUMO

BACKGROUND: The female athlete triad (Triad), defined by the American College of Sports Medicine as low energy availability (LEA) with or without disordered eating, menstrual dysfunction, and low bone mineral density (BMD), is associated with stress fractures and athletes aged 16-17 years are most susceptible. PURPOSE: To examine whether the Triad increases the risk of stress fractures, athletes were assigned to a "teenage" group and a "20s" group. METHODS: This prospective study enrolled 390 elite female athletes and was conducted from 2012 to 2016 at Japan Institute of Sports Sciences. Blood concentrations of various hormones were examined, and BMD was measured at the lumbar spine and throughout the whole body using dual-energy X-ray absorptiometry. LEA was defined as body weight ≤85% of the ideal body weight for teenage athletes, or BMI ≤17.5 for athletes in their 20s. Low BMD was defined as a BMD Z-score of <-1.0 in the lumbar spine and the whole body. RESULTS: Among 390 athletes enrolled, 36 developed new stress fractures within 3 months of registration. The risk for stress fractures due to the Triad in teenage athletes was higher than for athletes in their 20s. In teenage female athletes, secondary amenorrhea, low BMD for the whole body, and a low ratio of actual body weight to ideal body weight increased the risk for stress fractures by 12.9 times, 4.5 times, and 1.1 times, respectively. CONCLUSION: To prevent stress fractures in female athletes with the Triad, age of athletes should be taken into consideration.


Assuntos
Síndrome da Tríade da Mulher Atleta/complicações , Fraturas de Estresse/etiologia , Absorciometria de Fóton , Adolescente , Amenorreia/fisiopatologia , Atletas , Peso Corporal , Densidade Óssea , Feminino , Humanos , Japão , Vértebras Lombares/patologia , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
9.
J Obstet Gynaecol Res ; 45(4): 766-786, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30675969

RESUMO

Six years after the first edition of The Guideline for Gynecological Practice, which was jointly edited by The Japan Society of Obstetrics and Gynecology and The Japan Association of Obstetricians and Gynecologists, the third revised edition was published in 2017. The 2017 Guidelines includes 10 additional clinical questions (CQ), which brings the total to 95 CQ (12 on infectious disease, 28 on oncology and benign tumors, 27 on endocrinology and infertility and 28 on healthcare for women). Currently a consensus has been reached on the Guidelines and therefore the objective of this report is to present the general policies regarding diagnostic and treatment methods used in standard gynecological outpatient care that are considered appropriate. At the end of each answer, the corresponding recommendation level (A, B, C) is indicated.


Assuntos
Assistência Ambulatorial/normas , Doenças dos Genitais Femininos/diagnóstico , Doenças dos Genitais Femininos/terapia , Ginecologia/normas , Guias de Prática Clínica como Assunto/normas , Feminino , Humanos , Japão , Obstetrícia/normas , Sociedades Médicas/normas
10.
J Obstet Gynaecol Res ; 44(6): 1007-1014, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29607594

RESUMO

The female athlete triad (FAT) is defined by the American College of Sports Medicine (ACSM) as low energy availability (low EA), functional hypothalamic amenorrhoea and osteoporosis. In low EA, lutein dysfunction first develops, followed by anovulation and, subsequently, oligomenorrhea, leading to amenorrhea. Moreover, low estradiol concentrations due to amenorrhea decrease bone mineral density (BMD). In athletes with one of the factors of FAT, the risk of a stress fracture is 2.4-4.9 times higher and may increase the risk of fracture throughout the lifespan. Low EA is the starting point of FAT, and the FAT concept emphasizes the importance of energy intake that is commensurate with exercise energy expenditure in athletes. In amenorrheic athletes who undergo gynecological examination, it is important to appropriately evaluate whether the cause is low EA and to review exercise energy expenditure and energy intake. It remains difficult even for experts to calculate available energy using the ACSM definition formula when evaluating energy deficiency. Moreover, performing early FAT screening during teenage years and cooperation between the department of obstetrics and gynecology and sports dietitians are also issues. The aim of this paper is to review the management of FAT from the viewpoint of gynecologists.


Assuntos
Síndrome da Tríade da Mulher Atleta/diagnóstico , Síndrome da Tríade da Mulher Atleta/tratamento farmacológico , Síndrome da Tríade da Mulher Atleta/metabolismo , Feminino , Humanos
11.
Biomed Pharmacother ; 100: 116-123, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29427922

RESUMO

A single administration of mice with memantine (1-amino-3,5-dimethyladamantane), a glutamatergic N-methyl-d-aspartate (NMDA) receptor antagonist, induced stereotyped behaviors in dose- and time-dependent manners. The predominant behavioral component of the stereotypy was a continuous, exaggerated sniffing which was accompanied by persistent locomotion. In contrast, a psychostimulant methamphetamine (METH) predominantly induced a stereotyped biting and other forms of intense stationary stereotypical behaviors. Memantine-induced stereotyped sniffing was attenuated by pretreatment with haloperidol, a dopamine D2 receptor antagonist, in a dose-dependent manner. The memantine-induced stereotyped sniffing was also attenuated by pretreatment with betahistine (2-[2-(methylamino)ethyl]pyridine), an agent which increases histamine turnover and releases histamine in the brain. These observations suggest that memantine might induce stereotypies through neuronal mechanisms that are somewhat different from those of METH, but still overlap to a certain extent, since memantine-induced stereotypies can be attenuated by the mechanisms that also suppress METH-induced stereotypy. Importantly, these data suggests that the effects of memantine may be more limited to the ventral striatum including nucleus accumbens than those of METH, which is associated with dorsal striatal stimulation at high doses. In this respect memantine may also have pharmacological properties such as compartmentation (i.e. brain distribution) and neuronal mechanisms different from those of other NMDA receptor antagonists, such as ketamine, which may have important implications for therapeutic uses of these drugs.


Assuntos
Dopaminérgicos/farmacologia , Memantina/farmacologia , Receptores de N-Metil-D-Aspartato/antagonistas & inibidores , Comportamento Estereotipado/efeitos dos fármacos , Estriado Ventral/efeitos dos fármacos , Animais , Dopaminérgicos/farmacocinética , Relação Dose-Resposta a Droga , Masculino , Memantina/farmacocinética , Camundongos Endogâmicos ICR , Atividade Motora/efeitos dos fármacos , Núcleo Accumbens/efeitos dos fármacos , Núcleo Accumbens/metabolismo , Receptores de Dopamina D2/agonistas , Fatores de Tempo , Estriado Ventral/metabolismo
12.
J Obstet Gynaecol Res ; 43(3): 530-535, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28026087

RESUMO

AIM: Recent investigations have demonstrated that athletes with high relaxin-2 levels have a high risk of anterior cruciate ligament injuries, while athletes taking oral contraceptives (OC) have low relaxin-2 levels. It has not yet been clarified whether taking OC reduces relaxin-2 levels. The purpose of this study was to investigate changes in relaxin-2 levels in athletes taking OC. METHODS: Levels of relaxin-2, estradiol, progesterone, luteinizing hormone and follicle-stimulating hormone were measured in serum samples (n = 183) from 106 elite female athletes. Five athletes with serum relaxin-2 concentrations > 6 pg/mL during the luteal phase were recruited to assess the effect of OC therapy. RESULTS: Serum relaxin-2 concentrations were significantly higher during the luteal phase (n = 57) than in the follicular phase (n = 72), or in athletes on OC therapy (n = 10) (P < 0.001, P < 0.001 and P < 0.05, respectively). In the luteal phase, 36.8% (21/57) of the athletes had relaxin levels > 6 pg/mL. In 23 athletes, serum relaxin-2 concentrations were measured during both the follicular and luteal phases, revealing that relaxin-2 levels were significantly higher in the luteal phase compared with the follicular phase. In 5 out of 23 athletes, serum relaxin-2 concentrations were > 6 pg/mL in the luteal phase and during the second cycle of OC therapy, relaxin-2 concentrations decreased dramatically to below the detection limit (0.26 pg/mL). CONCLUSIONS: High serum relaxin-2 concentrations were only detected during the luteal phase. In athletes with high relaxin-2 concentrations during the luteal phase, OC therapy decreased serum relaxin-2 levels.


Assuntos
Atletas , Anticoncepcionais Orais/sangue , Relaxina/sangue , Adulto , Amenorreia/sangue , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Ciclo Menstrual/sangue , Progesterona/sangue , Adulto Jovem
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