SUMMARY OBJECTIVE: The aim of this study was to assess obstetric and perinatal outcomes in women with hyperprolactinemia according to the type of treatment indicated, with cabergoline or bromocriptine. METHODS: A retrospective cohort study with 464 women diagnosed with hyperprolactinemia was undertaken at the endocrine gynecology outpatient clinic of a tertiary hospital from May 2002 to February 2022. All women diagnosed with hyperprolactinemia who were being treated with dopamine agonists (cabergoline or bromocriptine) and who became pregnant during the follow-up were included. Women whose medical records did not provide data related to pregnancy and delivery were excluded. The women were divided into two groups according to the type of treatment: bromocriptine or cabergoline. Clinical and laboratory characteristics and obstetric and perinatal outcomes, such as complications during pregnancy, type of delivery, and intrapartum complications, were evaluated in both groups. RESULTS: Of the 464 women evaluated, 72 became pregnant during the follow-up, 66 of them were using dopamine agonists, while 6 were not using medication. The mean age of the women was 28.3±6.8 years. Among the causes of hyperprolactinemia, 48.6% were idiopathic, 45.7% were tumoral, and 3.7% had other causes. Most women with idiopathic hyperprolactinemia used bromocriptine, while those with tumoral hyperprolactinemia used cabergoline (p=0.04). There was no difference in obstetric outcomes according to the type of treatment used. The majority of women did not have any complications during pregnancy (76.3%) or intrapartum (86.8%). CONCLUSION: Regardless of the type of previous drug treatment with dopamine agonists, hyperprolactinemia does not alter obstetric outcomes. OBJECTIVE indicated METHODS 46 200 2022 followup follow up included excluded RESULTS 7 followup, up, medication 28368 28 3 8 28.3±6. years 486 48 48.6 457 45 45.7 37 3.7 p=0.04. p004 p p=0.04 . 0 04 (p=0.04) 76.3% 763 76 (76.3% 86.8%. 868 86.8% 86 (86.8%) CONCLUSION 4 20 202 2836 2 28.3±6 48. 45. 3. p00 p=0.0 (p=0.04 76.3 (76.3 86.8 (86.8% 283 28.3± p0 p=0. (p=0.0 76. (76. 86. (86.8 28.3 p=0 (p=0. (76 (86. 28. p= (p=0 (7 (86 (p= ( (8 (p

ABSTRACT BACKGROUND: Abnormal uterine bleeding (AUB) is a common condition, and the Menstrual Bleeding Questionnaire (MBQ) is used for its assessment. OBJECTIVES: To translate, assess the cut-off point for diagnosis, and explore psychometric properties of the MBQ for use in Brazilian Portuguese. DESIGN AND SETTING: Prospective cohort study including 200 women (100 with and 100 without AUB) at a tertiary referral center. METHODS: MBQ translation involved a pilot-testing phase, instrument adjustment, data collection, and back-translation. Cut-off point was obtained using receiver operating curve analysis. Menstrual patterns, impact on quality of life due to AUB, internal consistency, test-retest, responsiveness, and discriminant validity were assessed. For construct validity, the Pictorial Blood Assessment Chart (PBAC) and World Health Organization Quality of Life – abbreviated version (WHOQOL-BREF) were applied. RESULTS: Women with AUB were older, had higher body mass indices, and had a worse quality of life during menstruation. Regarding the MBQ's psychometric variables, Cronbach's alpha coefficient was > 0.70 in all analyses, high intraclass correlation coefficient was found in both groups; no ceiling and floor effects were observed, and construct validity was demonstrated (correlation between MBQ score, PBAC score, and clinical menstrual cycle data). No difference between MBQ and PBAC scores were perceived after the test-retest. Significant differences were found between MBQ and PBAC scores before and after treatment. An MBQ score ≥ 24 was associated with a high probability of AUB; accuracy of 98%. CONCLUSION: The MBQ is a reliable questionnaire for Brazilian women. The cut-off ≥ 24 shows high accuracy to discriminate AUB. BACKGROUND (AUB condition (MBQ assessment OBJECTIVES translate cutoff cut off diagnosis Portuguese SETTING 20 (10 10 center METHODS pilottesting pilot testing phase adjustment collection backtranslation. backtranslation back translation. back-translation Cutoff Cut analysis patterns consistency testretest, testretest test retest, retest test-retest responsiveness assessed (PBAC WHOQOLBREF WHOQOL BREF (WHOQOL-BREF applied RESULTS older indices menstruation MBQs s variables Cronbachs Cronbach 070 0 70 0.7 analyses groups observed data. . data) testretest. retest. treatment 2 98 98% CONCLUSION (1 1 07 7 0. 9 (

ABSTRACT Dopamine agonists are the first line of treatment for patients with symptomatic hyperprolactinemia due to prolactinomas and in those with idiopathic hyperprolactinemia. Treatment with these agents is effective in 80%-90% of the cases. Infertility treatment of patients with hyperprolactinemia is also carried out with dopamine agonists, aiming for the normalization of prolactin levels. The risk of symptomatic growth of prolactinomas during pregnancy is dependent on the tumor's size, duration of previous treatments, and prolactin levels. Notably, the corresponding risk is relatively low in cases of microprolactinomas (<5%). Remission of hyperprolactinemia occurs in about 30% of the patients after drug treatment and may also occur after pregnancy and menopause. The use of some drugs, such as antidepressants and antipsychotics, is a frequent cause of hyperprolactinemia, and managing this occurrence involves unique considerations. This position statement by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and Brazilian Society of Endocrinology and Metabolism (SBEM) addresses the recommendations for measurement of serum prolactin levels and the investigations of symptomatic and asymptomatic hyperprolactinemia and drug-induced hyperprolactinemia in women. 80%90% 8090 80% 90% 80 90 80%-90 tumors tumor s size treatments Notably <5%. 5 <5% . (<5%) 30 menopause drugs antipsychotics considerations Febrasgo (Febrasgo SBEM (SBEM druginduced induced women 80%90 809 8 9 80%-9 <5 (<5% 3 80%9 80%- < (<5 (< (

ABSTRACT Hyperprolactinemia is a frequent cause of menstrual irregularity, galactorrhea, hypogonadism, and infertility. The most common etiologies of hyperprolactinemia can be classified as physiological, pharmacological, and pathological. Among pathological conditions, it is essential to distinguish prolactinomas from other tumors and pituitary lesions presenting with hyperprolactinemia due to pituitary stalk disconnection. Proper investigation considering clinical data, laboratory tests, and, if necessary, imaging evaluation, is important to identify the correct cause of hyperprolactinemia and manage the patient properly. This position statement by the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) and Brazilian Society of Endocrinology and Metabolism (SBEM) addresses the recommendations for measurement of serum prolactin levels and the investigations of symptomatic and asymptomatic hyperprolactinemia and medication-induced hyperprolactinemia in women. irregularity galactorrhea hypogonadism infertility physiological pharmacological conditions disconnection data tests necessary evaluation properly Febrasgo (Febrasgo SBEM (SBEM medicationinduced medication induced women

ABSTRACT Objective: Evaluate the risk factors for the development of post-molar gestational trophoblastic neoplasia. Methods: Retrospective cohort study with 320 women with gestational trophoblastic disease (GTD) followed in a tertiary hospital from January 2005 to January 2020. Data referring to the women's sociodemographic profile, clinical, laboratory and treatment aspects and types of GTD were analyzed. Results: The mean age of women with the benign form was 26.4±8.6 years and with the malignant forms 26.9±8.5 years (p=0.536). Most women with malignant forms came from regions further away from reference center (p=0.012), had vesicle elimination at the time of diagnosis (p=0.028) and needed more than one uterine evacuation (p<0.001) when compared to the benign forms. There was no difference between laboratory tests in both forms. Being between 30 and 39 years old increased the chance of developing invasive mole by 2.5 (p=0.004; 95%CI:1.3–4.9) and coming from regions far from reference center by 4.01 (p=0.020; CI95%: 1.2-12.9). The women with the highest risk of malignant forms were those with the longest time of become normal on human gonadotrophic hormone (hCG) testing (each week the risk increases 1.3 times; p<0.001, 95%CI: 1.2-1.3). Conclusion: The prolonged hCG fall curve is the main indicator of an increased chance of GTN. Women from regions further away from reference center have a greater chance of developing malignant forms, probably due to the difficulty in accessing the reference center and, therefore, adequate follow-up that would allow early identification of more serious cases. Objective postmolar post molar neoplasia Methods 32 (GTD 200 2020 womens s profile clinical analyzed Results 26486 26 4 8 6 26.4±8. 26985 9 5 26.9±8. p=0.536. p0536 p p=0.536 . 0 536 (p=0.536) p=0.012, p0012 p=0.012 , 012 (p=0.012) p=0.028 p0028 028 (p=0.028 p<0.001 p0001 001 (p<0.001 3 25 2 2. p=0.004 p0004 004 (p=0.004 95%CI1.3–4.9 95CI1349 CI 95%CI 1.3–4.9 95 1 95%CI:1.3–4.9 401 01 4.0 p=0.020 p0020 020 (p=0.020 CI95% CI95 1.212.9. 12129 1.2 12.9 12 1.2-12.9) (hCG each 13 1. times 95CI 1.21.3. 1213 1.2-1.3) Conclusion GTN therefore followup follow up cases 20 202 2648 26.4±8 2698 26.9±8 p053 p=0.53 53 (p=0.536 p001 p=0.01 (p=0.012 p=0.02 p002 02 (p=0.02 p<0.00 p000 00 (p<0.00 p=0.00 (p=0.00 CI1 95%CI1.3–4. 95CI134 1349 1.3–4. 95%CI:1.3–4. 40 4. CI9 212 1.212.9 1212 129 12. 1.2-12.9 21 1.21.3 121 1.2-1.3 264 26.4± 269 26.9± p05 p=0.5 (p=0.53 p00 p=0.0 (p=0.01 (p=0.0 p<0.0 (p<0.0 95%CI1.3–4 95CI13 134 1.3–4 95%CI:1.3–4 1.212. 1.2-12. 1.21. 1.2-1. 26.4 26.9 p0 p=0. (p=0.5 (p=0. p<0. (p<0. 95%CI1.3– 95CI1 1.3– 95%CI:1.3– 1.212 1.2-12 1.21 1.2-1 26. p=0 (p=0 p<0 (p<0 95%CI1.3 95%CI:1.3 1.2- p= (p= p< (p< 95%CI1. 95%CI:1. (p 95%CI1 95%CI:1

Abstract Objective To correlate the morphological aspects with pelvic pain in women with deep infiltrating endometriosis. Methods A retrospective study with 67 women with deep endometriosis who underwent surgical treatment in a tertiary hospital from 2007 to 2017. The following variables were considered: age, parity, body mass index, site of involvement, hormonal treatment before surgery, pelvic pain, and morphometric analysis. The histological slides of the surgical specimens were revised and, using the ImageJ software for morphometric study, the percentages of stromal/glandular tissues were calculated in the histological sections. Results The mean age of the women was 38.9 ± 6.5 years. The mean pain score was 8.8 ± 1.9 and the mean time of symptomatology was 4.7 ± 3.5 years, with 87% of the patients undergoing hormone treatment prior to surgery. The average expression of CD10, CK7, and S100 markers was 19.5 ± 11.8%, 9.4 ± 5.9%, and 7.9 ± 5.8% respectively. It was found that the greater the expression of CD10, the greater the level of pain (p = 0.02). No correlation was observed between the expression of CD10, CK7, and S100 markers and age and duration of symptoms. Conclusion Women with deep infiltrating endometriosis have a positive association between the level of pain and the fibrosis component in the endometrial tissue's histological composition. 6 200 2017 considered parity index involvement surgery analysis stromalglandular stromal glandular sections 389 38 9 38. 65 5 6. years 88 8 8. 19 1 1. 47 4 7 4. 35 3 3. 87 CD10 CD CK7 CK S S10 195 19. 118 11 11.8% 94 9. 59 5.9% 79 7. 58 5.8 respectively p 0.02. 002 0.02 . 0 02 0.02) symptoms tissue s composition 20 201 CD1 S1 11.8 5.9 5. 00 0.0 2 11. 0.

Resumo Objetivo Correlacionar os aspectos morfológicos com a dor pélvica em mulheres com endometriose profunda. Métodos Estudo retrospectivo com 67 mulheres com endometriose profunda submetidas a tratamento cirúrgico em hospital terciário de 2007 a 2017. As seguintes variáveis foram consideradas: idade, paridade, índice de massa corporal, local do acometimento, tratamento hormonal antes da cirurgia, dor pélvica e análise morfométrica. As lâminas histológicas das peças cirúrgicas foram revisadas e, por meio do software ImageJ para estudo morfométrico, foram calculadas as porcentagens de tecidos estromais/glandulares nos cortes histológicos. Resultados A média etária das mulheres foi de 38,9 ± 6,5 anos. O escore de dor médio foi de 8,8 ± 1,9 e o tempo médio de sintomatologia foi de 4,7 ± 3,5 anos, sendo que 87% das pacientes realizavam tratamento hormonal antes da cirurgia. A expressão média dos marcadores CD10, CK7 e S100 foi de 19,5 ± 11,8%, 9,4 ± 5,9% e 7,9 ± 5,8%, respectivamente. Verificou-se que quanto maior a expressão de CD10, maior o nível de dor (p = 0,02). Não foi observada correlação entre a expressão dos marcadores CD10, CK7 e S100 com a idade e duração dos sintomas. Conclusão Mulheres com endometriose profunda apresentam associação positiva entre o nível de dor e o componente de fibrose na composição histológica do tecido endometrial. 6 200 2017 consideradas paridade corporal acometimento cirurgia morfométrica morfométrico estromaisglandulares estromais glandulares histológicos 389 38 9 38, 65 5 6, anos 88 8 8, 19 1 1, 47 4 7 4, 35 3 3, 87 CD10 CD CK S S10 195 19, 118 11 11,8% 94 9, 59 5,9 79 7, 58 5,8% respectivamente Verificouse Verificou se p 0,02. 002 0,02 . 0 02 0,02) sintomas endometrial 20 201 CD1 S1 11,8 5, 5,8 00 0,0 2 11, 0,

RESUMO Contexto: Mulheres com endometriose intestinal podem apresentar maior incidência de constipação o que influencia na qualidade de vida. Objetivo: Correlacionar a função intestinal com a função sexual e qualidade de vida de mulheres com endometriose profunda de acordo com o tipo de tratamento. Métodos: Estudo transversal realizado com 141 mulheres com endometriose intestinal no período de maio de 2020 a abril de 2021. As mulheres foram divididas em dois grupos de acordo com o tipo de tratamento: 51 mulheres com tratamento cirúrgico e 90 mulheres com tratamento médico. O Questionário de Qualidade de Vida em Endometriose foi utilizado para avaliar a qualidade de vida e o Índice de Função Sexual Feminina foi utilizado para avaliar a função sexual. Para avaliar a função intestinal foram utilizados os seguintes questionários: Índice de Qualidade de Vida Gastrointestinal e Inventário de Estresse do Assoalho Pélvico. Resultados: A média de idade das mulheres do grupo cirúrgico (37,98±5,91 anos) foi maior que a do grupo médico (35,68±5,45 anos) (P=0,006). Não houve diferença estatisticamente significativa entre sintomas de dor (P=0,905), ingestão de água (P=0,573) ou fibra (P=0,173) e atividade física (P=0,792) em ambos os grupos. Não houve diferença entre qualidade de vida e função sexual em ambos os grupos. Houve uma correlação direta da função intestinal com qualidade de vida e função sexual em ambos os grupos. Conclusão: A função intestinal está diretamente correlacionada com a função sexual e qualidade de vida, independentemente do tipo de tratamento. Contexto Objetivo Métodos 14 202 2021 5 9 questionários Pélvico Resultados 37,98±5,91 3798591 37 98 91 (37,98±5,9 anos 35,68±5,45 3568545 35 68 45 (35,68±5,4 P=0,006. P0006 P P=0,006 . 0 006 (P=0,006) P=0,905, P0905 P=0,905 , 905 (P=0,905) P=0,573 P0573 573 (P=0,573 P=0,173 P0173 173 (P=0,173 P=0,792 P0792 792 (P=0,792 Conclusão 1 20 37,98±5,9 379859 3 (37,98±5, 35,68±5,4 356854 6 4 (35,68±5, P000 P=0,00 00 (P=0,006 P090 P=0,90 (P=0,905 P=0,57 P057 57 (P=0,57 P=0,17 P017 17 (P=0,17 P=0,79 P079 79 (P=0,79 2 37,98±5, 37985 (37,98±5 35,68±5, 35685 (35,68±5 P00 P=0,0 (P=0,00 P09 P=0,9 (P=0,90 P=0,5 P05 (P=0,5 P=0,1 P01 (P=0,1 P=0,7 P07 7 (P=0,7 37,98±5 3798 (37,98± 35,68±5 3568 (35,68± P0 P=0, (P=0,0 (P=0,9 (P=0, 37,98± 379 (37,98 35,68± 356 (35,68 P=0 (P=0 37,98 (37,9 35,68 (35,6 P= (P= 37,9 (37, 35,6 (35, (P 37, (37 35, (35 (3 (

ABSTRACT Background: Women with intestinal endometriosis may have a higher incidence of constipation, which may influence their quality of life. Objective: To correlate bowel function with sexual function and quality of life in women with deep endometriosis according to the type of treatment. Methods: Cross-sectional study carried out with 141 women with bowel endometriosis from May 2020 to April 2021. Women were divided into two groups according to kind of treatment: 51 women with surgery treatment and 90 women with medical treatment. The Endometriosis Health Profile Questionnaire were used to assess quality of life e Female Sexual Function Index were used to assess sexual function. To access bowel function we used the following questionnaires: Gastrointestinal Quality of Life Index and Pelvic Floor Distress Inventory. Results: The mean age of women in the surgical group (37.98±5.91years) was higher than that of the medical group (35.68±5.45years) (P=0.006). There was no statistically significant difference between pain symptoms (P=0.905), water intake (P=0.573) or fiber (P=0.173) and physical activity (P=0.792) in both groups. There was no difference between quality of life and sexual function in both groups. There was a direct correlation of bowel function with quality of life and sexual function in both groups. Conclusion: Bowel function is directly correlated with sexual function and quality of life, regardless of the type of treatment. Background constipation Objective Methods Crosssectional Cross sectional 14 202 2021 5 9 questionnaires Inventory Results 37.98±5.91years 3798591years years 37 98 91years (37.98±5.91years 35.68±5.45years 3568545years 35 68 45years (35.68±5.45years P=0.006. P0006 P P=0.006 . 0 006 (P=0.006) P=0.905, P0905 P=0.905 , 905 (P=0.905) P=0.573 P0573 573 (P=0.573 P=0.173 P0173 173 (P=0.173 P=0.792 P0792 792 (P=0.792 Conclusion 1 20 3 6 P000 P=0.00 00 (P=0.006 P090 P=0.90 (P=0.905 P=0.57 P057 57 (P=0.57 P=0.17 P017 17 (P=0.17 P=0.79 P079 79 (P=0.79 2 P00 P=0.0 (P=0.00 P09 P=0.9 (P=0.90 P=0.5 P05 (P=0.5 P=0.1 P01 (P=0.1 P=0.7 P07 7 (P=0.7 P0 P=0. (P=0.0 (P=0.9 (P=0. P=0 (P=0 P= (P= (P

Resumo Objetivo A insuficiência ovariana prematura (IOP) é caracterizada pelo hipoestrogenismo precoce. Risco aumentado de doença cardiovascular (CV) é uma consequência a longo prazo da IOP e um desafio da terapia hormonal (TH) é reduzir o risco CV. Métodos Estudo transversal com análise do perfil lipídico (colesterol total, LDL-C, HDL-C, VLDL-C e triglicerídeos), glicemia e pressão arterial de mulheres com IOP em uso de TH, em comparação a mulheres com função ovariana normal (controles) pareadas por idade e IMC. Resultados A média de idade e IMC de 102 pacientes com IOP em uso de TH e 102 controles foi de 37,2 ± 6,0 e 37,3 ± 5,9 anos, respectivamente; 27,0 ± 5,2 e 27,1 ± 5,4 kg/m2. Não houve diferença entre os grupos na pressão arterial sistólica e diastólica, glicemia, colesterol total, LDL-C, VLDL-C e triglicerídeos. Os níveis de HDL-C foram significativamente maiores no grupo IOP (56,3 ± 14,6 e 52 ± 13,9mg/dL; p = 0,03). A hipertensão arterial foi a doença crônica mais prevalente (12% no grupo POI, 19% no grupo controle, p = ns), seguida da dislipidemia (6 e 5%, no grupo POI e controle). Conclusão Mulheres com IOP em uso de TH apresentam níveis pressóricos, perfil lipídico e glicêmico e prevalência de hipertensão e dislipidemia semelhantes às mulheres da mesma idade e IMC com função gonadal preservada, além de melhores níveis de HDL. (IOP precoce CV (CV (TH total LDLC, LDLC LDL C, C LDL-C HDLC, HDLC HDL VLDLC VLDL triglicerídeos, triglicerídeos , triglicerídeos) (controles 10 372 37 2 37, 60 6 0 6, 373 3 59 5 9 5, anos respectivamente 270 27 27, 271 1 54 4 kgm2 kgm kg m2 m kg/m2 diastólica 56,3 563 56 (56, 146 14 14, 13,9mg/dL 139mgdL mgdL 13 9mg dL mg 0,03. 003 0,03 . 03 0,03) 12% 12 (12 19 controle ns, ns ns) ( 5% controle. controle) pressóricos preservada kg/m 56, (56 00 0,0 (1 (5 0,

Abstract Objective Premature ovarian insufficiency (POI) is characterized by early hypoestrogenism. An increased risk of cardiovascular (CV) disease is a long-term consequence of POI. A challenge of hormone therapy (HT) is to reduce the CV risk. Methods Cross-sectional study with lipid profile analysis (total cholesterol, LDL-C, HDL-C, VLDL-C and triglycerides), blood glucose levels and arterial blood pressure of women with POI using HT, compared with age and BMI-matched women with normal ovarian function (controls). Results The mean age and BMI of 102 POI patients using HT and 102 controls were 37.2 ± 6.0 and 37.3 ± 5.9 years, respectively; 27.0 ± 5.2 and 27.1 ± 5.4 kg/m2. There wasn't difference between groups in arterial systolic and diastolic blood pressure, blood glucose levels, total cholesterol, LDL-C, VLDL-C and triglycerides. HDL-C levels were significantly higher in the POI group (56.3 ± 14.6 and 52 ± 13.9mg/dL; p = 0.03). Arterial hypertension was the most prevalent chronic disease (12% in the POI group, 19% in the control group, p = ns), followed by dyslipidemia (6 and 5%, in POI and control women). Conclusion Women with POI using HT have blood pressure levels, lipid and glycemic profile and prevalence of hypertension and dyslipidemia similar to women of the same age and BMI with preserved gonadal function, in addition to better HDL levels. (POI hypoestrogenism (CV longterm long term (HT Crosssectional Cross sectional cholesterol LDLC, LDLC LDL C, C LDL-C HDLC, HDLC VLDLC VLDL triglycerides, triglycerides , triglycerides) BMImatched matched controls. . (controls) 10 372 37 2 37. 60 6 0 6. 373 3 59 5 9 5. years respectively 270 27 27. 271 1 54 4 kgm2 kgm kg m2 m kg/m2 wasnt wasn t 56.3 563 56 (56. 146 14 14. 13.9mg/dL 139mgdL mgdL 13 9mg dL mg 0.03. 003 0.03 03 0.03) 12% 12 (12 19 ns, ns ns) ( 5% women. women) (controls kg/m 56. (56 00 0.0 (1 (5 0.

SUMMARY OBJECTIVE: This study aimed to comparatively evaluate the presence of abnormal uterine bleeding and associated factors among women from the five official Brazilian geographic regions. METHODS: This is a cross-sectional, population-based, multicenter study of reproductive-age women from the five regions of Brazil. All participants answered questionnaires containing personal and socioeconomic data and information on uterine bleeding (self-perception and objective data). RESULTS: A total of 1,761 Brazilian women were included, 724 from the Southeast, 408 from the Northeast, 221 from the South, 213 from the North, and 195 from the Central-West. Considering women's self-perception, the prevalence of abnormal uterine bleeding was 37.56% in the North region, 39.46% in the Northeast, 21.54% in the Central-West, 29.56% in the Southeast, and 25.34% in the South (p<0.001). Abnormal uterine bleeding was more prevalent in the North and Northeast, where women had lower purchasing power, became pregnant more often, and were the only ones financially responsible for supporting the family more often (p<0.001). The menstrual cycle lasted <24 days in less than 20% of the women in all regions (p=NS). Among these, approximately 8 out of 10 women had never undergone treatment in four out of the five regions evaluated. More than half of the evaluated women reported a worsening of their quality of life during bleeding. CONCLUSION: The prevalence of abnormal uterine bleeding in Brazilian women was higher in the North and Northeast, followed by the Southeast, South, and Central-West regions. There was a worsening of quality of life during menstruation regardless of the woman's self-perception of abnormal uterine bleeding. Such results can direct the actions of health managers toward a better approach to abnormal bleeding. OBJECTIVE METHODS crosssectional, crosssectional cross sectional, sectional cross-sectional populationbased, populationbased population based, based population-based reproductiveage reproductive age Brazil selfperception self perception data. . data) RESULTS 1761 1 761 1,76 included 72 Southeast 40 Northeast 22 21 19 CentralWest. CentralWest Central West. West womens s selfperception, perception, 3756 37 56 37.56 region 3946 39 46 39.46 2154 54 21.54 CentralWest, West, 2956 29 29.56 2534 25 34 25.34 p<0.001. p0001 p p<0.001 0 001 (p<0.001) power 24 <2 20 p=NS. pNS p=NS NS (p=NS) these CONCLUSION womans woman 176 76 1,7 7 4 2 375 3 5 37.5 394 39.4 215 21.5 295 29.5 253 25.3 p000 p<0.00 00 (p<0.001 < (p=NS 17 1, 37. 39. 21. 29. 25. p00 p<0.0 (p<0.00 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

Abstract Objectives To assess the status of the pelvic floor muscle (PFM) of premature ovarian insufficiency women (POI women) and the incidence of fecal incontinence (FI) and pelvic organ prolapse (POP). Methods A secondary analysis of a cross-sectional study with 150 women with POI was performed. Pelvic floor muscle assessment was performed with the PERFECT scale. The subscales POPDI-6 and CRADI-8 of the questionnaire Pelvic Floor Distress Inventory-20 (PFDI-20) were used for pelvic floor symptoms focused on FI and POP. Moreover, FI and POP were also assessed as dichotomous variables (yes/no). Results Women with FI and POP did not present differences in the PFM assessment across P (p = 0.61), E (p = 0.78), R (p = 0.22), and F (p = 0.79) variables when compared with women with POI; no differences were also seen between women with and without POP according the pelvic muscles: P (p = 0.91), E (p = 0.99), R (p = 0.62), and F (p = 0.10). Women with FI and POP presented higher scores in all PFDI-20 subscales and total score when compared with the control group (p < 0.05). Conclusions Pelvic floor muscle assessment within POI women with or without FI or POP did not differ. However, PF symptoms are more severe in the FI or POP groups. (PFM (FI . (POP) crosssectional cross sectional 15 scale POPDI6 POPDI 6 POPDI- CRADI8 CRADI 8 CRADI- Inventory20 Inventory 20 Inventory-2 PFDI20 PFDI (PFDI-20 Moreover yes/no. yesno yes/no yes (yes/no) p 0.61, 061 0.61 , 0 61 0.61) 0.78, 078 0.78 78 0.78) 0.22, 022 0.22 22 0.22) 0.79 079 79 muscles 0.91, 091 0.91 91 0.91) 0.99, 099 0.99 99 0.99) 0.62, 062 0.62 62 0.62) 0.10. 010 0.10 10 0.10) PFDI-2 0.05. 005 0.05 05 0.05) differ However groups (POP 1 Inventory2 2 Inventory- PFDI2 (PFDI-2 (yes/no 06 0.6 07 0.7 7 02 0.2 09 0.9 9 01 0.1 PFDI- 00 0.0 (PFDI- 0. (PFDI

SUMMARY OBJECTIVE: The aim of this study was to associate the degree of infiltration of rectovaginal septum endometriosis with dyspareunia and sexual function. METHODS: A cross-sectional study was carried out with 127 women followed up at a tertiary hospital from March 2021 to March 2022. The women’s sociodemographic and clinical conditions and dyspareunia were evaluated. The sexual function was evaluated by the Female Sexual Function Index. RESULTS: A total of 53 women with type I, 37 with type II, and 37 with type III rectovaginal septum endometriosis were evaluated. The women had a mean age of 38.76±6.63 years and a mean body mass index of 27.62±5.11 kg/m2. The mean time of diagnosis of endometriosis was 6.94±4.98 years. On average, the study participants engaged in sexual activity/intercourse 1.88±1.25 times per week. There was no difference between the dyspareunia score (p=0.822) and sexual function (p=0.174) according to the types of rectovaginal septum endometriosis. Overall, 93.7% of the women with endometriosis had sexual dysfunction. There was no correlation between the degree of rectovaginal septum endometriosis infiltration with dyspareunia (r=0.05; p=0.55) or sexual function (r=0.07; p=0.39). CONCLUSION: Women with endometriosis have impaired sexual function, regardless of the degree of endometriosis infiltration. OBJECTIVE METHODS crosssectional cross sectional 12 202 2022 womens s Index RESULTS 5 I 3 II 3876663 38 76 6 63 38.76±6.6 2762511 27 62 11 27.62±5.1 kgm2 kgm kg m2 m kg/m2 694498 94 4 98 6.94±4.9 average activityintercourse activity intercourse 188125 1 88 25 1.88±1.2 week p=0.822 p0822 p 0 822 (p=0.822 p=0.174 p0174 174 (p=0.174 Overall 937 93 7 93.7 dysfunction r=0.05 r005 r 05 (r=0.05 p=0.55 p055 55 r=0.07 r007 07 (r=0.07 p=0.39. p039 p=0.39 . 39 p=0.39) CONCLUSION 20 387666 38.76±6. 276251 2 27.62±5. kg/m 69449 9 6.94±4. 18812 8 1.88±1. p=0.82 p082 82 (p=0.82 p=0.17 p017 17 (p=0.17 93. r=0.0 r00 (r=0.0 p=0.5 p05 p03 p=0.3 38766 38.76±6 27625 27.62±5 6944 6.94±4 1881 1.88±1 p=0.8 p08 (p=0.8 p=0.1 p01 (p=0.1 r=0. r0 (r=0. p=0. p0 3876 38.76± 2762 27.62± 694 6.94± 188 1.88± (p=0. r=0 (r=0 p=0 387 38.76 276 27.62 69 6.94 18 1.88 (p=0 r= (r= p= 38.7 27.6 6.9 1.8 (p= (r 38. 27. 6. 1. (p

Resumo Objetivos Avaliar o impacto do tratamento cirúrgico para endometriose infiltrante profunda (EIP) nas disfunções do assoalho pélvico (incontinência urinária [IU], prolapso de órgãos pélvicos [POP], incontinência fecal [IF] ou constipação e função sexual [dispareunia]). Fonte de Dados A presente revisão sistemática foi realizada na base de dados PubMed. Para a seleção dos estudos, os artigos deveriam ser publicados até 5 de janeiro de 2021, sem restrição de idioma. Seleção dos Estudos Foram incluídos seis estudos randomizados e controlados que avaliaram o tratamento cirúrgico para EIP e a comparação de diferentes técnicas cirúrgicas. Coleta de Dados Os estudos foram selecionados de forma independente por título e resumo por dois autores. As discordâncias foram avaliadas por umterceiro autor. Todos os estudos incluídos foram avaliados de acordo coma ferramenta Cochrane de risco de viés e a qualidade de evidência foi analisada usando os critérios GRADE. A análise de subgrupo por diferentes tratamentos e períodos de acompanhamento também foi realizada. Resultados Seis estudos foram incluídos na análise quantitativa. O risco de viés mostrou um risco incerto de viés para a maioria dos estudos, sendo a ocultação da alocação a categoria menos relatada. A qualidade de evidência foi considerada baixa. Alta heterogeneidade foi encontrada entre os estudos. Nenhum estudo avaliou a IU ou o POP comparativamente antes e após a cirurgia. Conclusão A dispareunia e a IF melhoraram após o procedimento cirúrgico, mas não foi possível demonstrar qual técnica cirúrgica esteve relacionada a estes desfechos, pois houve heterogeneidade cirúrgica. Esta diversidade foi encontrada nos dados, com a recomendação de estudos prospectivos futuros abordando distúrbios do assoalho pélvico com EIP.

Abstract Objectives To evaluate the impact of surgical treatment of deep infiltrative endometriosis (DIE) on pelvic floor dysfunction (urinary incontinence [UI], pelvic organ prolapse [POP], fecal incontinence [FI)] or constipation, and sexual function [dyspareunia]). Data Source The present systematic review was performed in the PubMed database. For the selection of studies, articles should be published by January 5, 2021, without language restriction. Study Selection Six randomized controlled studies that evaluated surgical treatment for DIE and the comparison of different surgical techniques were included. Data Collection The studies were selected independently by title and abstract by two authors. Disagreements were resolved by a third author. All included studies were also evaluated according to the Cochrane risk of bias tool and the quality of the evidence was analyzed using the GRADE criteria. Subgroup analysis by different treatments and follow-up periods was also performed. Results Six studies were included in the quantitative analysis. The risk of bias between studies showed an uncertain risk of bias for most studies, with concealment of allocation being the least reported category. The quality of the evidence was considered low. High heterogeneity was found between the studies. No study has evaluated UI or POP comparatively before and after surgery. Conclusion Dyspareunia and FI have improved after the surgical procedure, but it was not possible to demonstratewhich surgical technique was related to these outcomes as there was surgical heterogeneity. This diversity was found across data, with the recommendation of future prospective studies addressing pelvic floor disorders withDIE.