Navegando por Palavras-chave "contraception"

Agora exibindo 1 - 4 de 4
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Contraception and family planning at the extreme of reproductive life - climacteric
    (Assoc Medica Brasileira, 2016) Katalin de Jarmy Di Bella, Zsuzsanna Ilona [UNIFESP]; Homem de Mello Bianchi, Ana Maria [UNIFESP]; de Araujo, Fabio Fernando [UNIFESP]; Ferreira Sartori, Marair Gracio [UNIFESP]; Batista Castello Girao, Manoel Joao [UNIFESP]
    Menopause is an endocrine phenomenon characterized by gradual estrogen decline. This is a stage in a woman's life in which contraception is extremely important as the risks associated with pregnancy and childbirth increase, both maternal issues associated with higher incidence of comorbidities and issues related to fetal abnormalities, mitochondrial abnormalities, or genetic syndromes. On the other hand, there is a growing number of women who have postponed motherhood and need effective contraception, but without prolonging the return to fertility. Long-acting reversible contraceptives (LARCs), low-dose oral hormonal contraceptives and non-oral contraceptives are preferred. The levonorgestrel-releasing intrauterine system is a very good alternative that can maintain endometrial protection after menopause. Definitive methods such as tubal ligation and vasectomy are options for couples that already have their offspring. In this review, we present evidence for contraceptive indication and the effects of hormonal methods on climacteric including options for contraception, control of bleeding during perimenopause and of climacteric symptoms, as well as the transition from such methods to hormone therapy if indicated.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Contraceptive counseling and use among 197 female kidney transplant recipients
    (Lippincott Williams & Wilkins, 2008-09-15) Guazzelli, Cristina A. F.; Torloni, Maria R.; Sanches, Tatila F.; Barbieri, Marcia; Pestana, Jose O. M. A.; Universidade Federal de São Paulo (UNIFESP)
    Background. There is growing interest about the quality of life of female transplant recipients, including their sexual and reproductive health. Although menstrual irregularity and infertility are common in women with advanced chronic diseases, most regain their reproductive function shortly after transplantation. Because an unplanned pregnancy soon after transplantation can expose both mother and fetus to considerable risk, it is recommended that these women should receive contraceptive counseling. However, the actual implementation and effectiveness of this recommendation has not been extensively studied.Methods. A total of 197 reproductive age, female, stable kidney graft recipients attending a large Brazilian transplantation clinic were interviewed. They were asked about menstrual pattern, sexual activity, counseling, and their use of contraceptive methods both before and after the transplant.Results. Before transplantation 70.6% reported menstrual irregularity, 91.9% of them were sexually active, 74.1% were counseled to use contraception and 86.3% used some contraceptive method. After the graft, 50.2% had menstrual irregularity, 79.7% were sexually active, 48.7% were advised to use contraceptives and 72.1% were actually using a method. After transplantation, there were 14 pregnancies in 11 women and 92.9% (13/14) of these were unplanned.Conclusions. Although most female kidney transplant recipients were sexually active both before and after transplantation, many were not counseled about the need for contraception and did not use any form of birth control. Health professionals involved in the management of these patients need to include contraceptive counseling as part of their routine care.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Long-Acting Reversible Contraception
    (Federacao Brasileira Soc Ginecologia & Obstetricia-Febrasgo, 2017) Machado, Rogerio Bonassi; Urbano Monteiro, Ilza Maria; Magalhaes, Jarbas; Falbo Guazzelli, Cristina Aparecida [UNIFESP]; Brito, Milena Bastos; Finotti, Marta Franco; Lubianca, Jaqueline Neves; Sakamoto, Luis Carlos; Franceschini, Silvio Antonio
    Unwanted pregnancy is a major public health problem both in developed and developing countries. Although the reduction in the rates of these pregnancies requires multifactorial approaches, increasing access to long-acting contraceptive methods can contribute significantly to change this scenario. In Brazil, gynecologists and obstetricians play a key role in contraceptive counseling, being decisive in the choice of long-acting reversible methods, characterized by intrauterine devices (IUDs) and the contraceptive implant. The vast scope due to the reduced number of situations to indicate long-acting methods should be emphasized in routine contraceptive counseling. On the other hand, gynecologists and obstetricians should adapt the techniques of insertion of long-actingmethods, and engage in facilitating conditions to access these contraceptives through public and private health systems in Brazil. This study is part of a project called Diretrizes e Recomendacoes FEBRASGO (Guidelines and Recommendations of the FEBRASGO - Brazilian Federation of Gynecology and Obstetrics Associations from the Portuguese acronym). It aims to review the main characteristics of long-acting contraceptives and critically consider the current situation and future prospects to improve access to these methods, proposing practical recommendations of interest in the routine of gynecologists and obstetricians.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Uterine volume and menstrual patterns in users of the levonorgestrel-releasing intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas
    (Elsevier B.V., 2007-03-01) Magalhaes, Jarbas; Aldrighi, Jose Mendes; Lima, Geraldo Rodrigues de; Personna Ctr Gynecol & Womans Hlth; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Background: A prospective cohort study was carried out to evaluate uterine volume and the volume of uterine leiomyomas in women using the levonorgestrel intrauterine system (LNG-IUS) to treat idiopathic menorrhagia (n=32) and menorrhagia, due to leiomyomas (n=27). A control group used the device as a contraceptive method (n = 2 8).Methods: Clinical and ultrasonographic evaluations were carried out at insertion and at 3, 6, 12, 24 and 36 months later. Total uterine volume and the volume of the leiomyomas were calculated using the ellipsoid formula (anteroposterior diameter) x (transverse diameter)x(longitudinal diameter) x (4/3) x (pi). in the case of multiple leiomyomas, the volume of each myoma was added to calculate the total volume of leiomyomas in each patient. Menstrual bleeding episodes were recorded.Results: Uterine volume decreased significantly in both groups of menorrhagic patients but not in the control group. in the group of women with idiopathic menorrhagia, a mean reduction of 36.4 +/- 15.3 (S.D.) cm(3) (from 127.1 cm(3) to 90.7 cm(3)) was observed (p=.041), and a greater and more significant mean reduction of 63.6 +/- 19.0 (S.D.) cm(3) (from 156.6 cm(3) to 93 CM) occurred in the group of women with leiomyomas (p=.014). in the contraception group, the reduction was of only 2.9 +/- 5.4 (S.D.) cm(3) in mean uterine volume (from 70.3 cm 3 to 67.4 cm 3), which was not statistically significant (p=.085). the mean volume of leiomyomas decreased by 5.2 +/- 3.1 (S.D.) cm 3 (from 12.8 cm(3) to 7.6 cm(3)) after 3 years of use, but this difference was not significant (p =.4099). After 3 6 months of use, amenorrhea and oligomenorrhea were the most frequent bleeding patterns, occurring in 45-57% and 33-39% of users in the three groups, respectively. Amenorrhea was higher in the contraception group (57.1%) and in women with idiopathic menorrhagia (53.4%) than women in the group with menorrhagia due to leiomyomas (44.5%) (p=.027). Moreover, the prevalence of spotting was almost three times higher (11%) in women with menorrhagia caused by leiomyomas and nearly double (7.7%) in the idiopathic menorrhagia group when compared with 4% in the control contraception group (p=.024).Conclusion: the LNG-IUS significantly reduces uterine volume in women with menorrhagia with and without leiomyoma; however, it does not significantly reduce the volume of leiomyomas. (c) 2007 Elsevier Inc. All rights reserved.