Ilza Monteiro

This study aimed to systematically evaluate the quality of widely accessible, English language, patient‐facing resources on heavy menstrual bleeding (HMB), identifying strengths, gaps, and opportunities for improvement. Resources were obtained from (1) a systematic Google Trends‐informed Google search and (2) submissions from subject matter experts. Eligible resources were independently reviewed and scored using validated tools for credibility (QUEST), aesthetics (modified Abbott's scale), and readability. To evaluate clinical utility, resources were graded using a tool designed by international experts for comprehensiveness and accuracy across six domains. Inter‐rater reliability was assessed with the intraclass correlation coefficient (ICC) and Cohen's kappa. Of 353 resources identified, 63 met the inclusion criteria. Mean QUEST score (maximum = 28) was 18.7 ± 5.1, with 4/63 (6%) resources meeting all credibility criteria. Mean aesthetics score (maximum = 7) was 5.3 ± 1.1, with only 15/63 (24%) resources with graphics. Most resources (40/63, 64%) were written at a grade 10–12 reading level. Mean comprehensiveness score (maximum = 6) was 4.6 ± 0.8, with gaps most often observed in advice on when to seek emergency care and information about iron deficiency. Mean accuracy score (maximum = 12) was 8.0 ± 2.3, with only 3/63 (13%) resources containing completely accurate content. There was moderate‐to‐substantial agreement across reviewers (ICC = 0.60–65 for aesthetics credibility; κ = 0.38–49 for accuracy comprehensiveness). In conclusion, most online resources accessed by patients are moderately credible, difficult to read, and underutilize figures. Content gaps exist mainly related to education on safety and iron deficiency. Very few resources are entirely accurate. We recommend targeted revisions to patient education resources to better inform and empower patients experiencing HMB.

Synopsis: Brazilian experts evaluated the consensus on opportunistic salpingectomy as a preventive approach against ovarian cancer, highlighting adoption potential and key implementation barriers in clinical practice.

The use of compounded hormonal pellets has recently gained popularity in Brazil, driven by claims of benefits beyond their intended clinical indications, such as enhanced muscle mass, improved physical and sexual performance, and overall well-being. However, this growing trend raises significant concerns within the medical community due to the lack of robust scientific evidence supporting their safety and efficacy in the treatment of gynecological conditions, as well as insufficient regulatory oversight.

To determine practice patterns in the diagnosis and management of nongestational abnormal uterine bleeding (AUB) in women in reproductive years during the SARS-CoV-2 (COVID-19) pandemic in Brazil. A web-based survey was conducted to determine the impact of the COVID-19 pandemic on the diagnosis and management of women with AUB. Survey elements included treatment location, the use of ultrasonography, laboratory evaluation for iron deficiency and some hormone determinations, and endometrial evaluation by histopathology, as well as the practice of hysteroscopy, hysterectomy and medical therapy including the placement of the 52 mg levonorgestrel-intrauterine system (LNG-IUS₅₂). The survey was completed electronically at scientific meetings or sent by e-mail to Brazil-based OBGYNs between April and September 2021 during the COVID-19 quarantine. Fully completed questionnaires were received from 541 physicians aged (mean ± SD) 46.6 ± 12.5 years. Whereas the overall number of AUB-related visits decreased (p < 0.001) compared to the pre-pandemic period, the reduction was in office-based encounters; AUB-related visits at emergency facilities did not change. Telehealth-based AUB consultations increased from 1.3% at pre-pandemic to 34.3% (p < 0.001) during the pandemic. There were significant reductions in the use of diagnostic hysteroscopy (p < 0.001), endometrial biopsy (p < 0.001), therapies with the LNG-IUS₅₂, combined oral contraceptives and hysterectomies (p = 0.002, p = 0.006 and p < 0.001, respectively). In Brazil, during the COVID-19 pandemic, there was a decrease in AUB-related consultations, a slight increase in telehealth visits and a reduction in the use of procedures and treatments.

To evaluate improvements in laboratory markers of anaemia (haemoglobin, haematocrit, serum iron, and ferritin) in women with subjective heavy menstrual bleeding (HMB) treated with the levonorgestrel 19.5-mg intrauterine device. We conducted a pilot study at the Department of Obstetrics and Gynaecology, University of Campinas, Faculty of Medical Sciences, Campinas, SP, Brazil. We compared anaemia markers in 73 women aged 18-48 years suffering from HMB, one year after placement of the IUD. The mean age of participants was 30.0 years (range 24-38); more than half were white, and the mean body mass index (kg/m²) was 27.0. Twenty (27.4%) participants exited the study due to loss to follow-up (n = 12; 16.4%), expulsion (n = 7; 9.6%) and uterine perforation (n = 1; 1.4%). One-year post-IUD placement, amenorrhoea was reported by 10 (13.7%) women. According to intention-to-treat and per protocol analyses, the proportion of women with normal haemoglobin levels significantly improved (p = 0.014 in both analyses), as did haematocrit (p < 0.001 in both analyses) and serum iron (p = 0.003 in both analyses) compared to baseline evaluations. The proportion of women with normal ferritin levels also improved (p < 0.001) in both analyses using a cut-off of 15 ng/ml, though no significant difference was observed using a 30 ng/ml cut-off (p = 0.083 in both analyses). The levonorgestrel 19.5-mg IUD effectively improved laboratory markers of anaemia one year after placement in women with HMB.

We compared pain and the ease of insertion of two different types of intrauterine devices (IUDs; the levonorgestrel intrauterine systems 52 mg (LNG-IUS 52 mg) and the copper-bearing IUD [TCu380A]) ...

Our objectives were to determine the knowledge and interest in apps for natural contraception among women and Obstetrics and Gynaecology (OBGYN) residents.An online survey was sent to Brazilian wom...