The authors analysed the gonadal function and age of menarche of 23 female adolescents and young women with SLE, and correlated these with clinical, SLEDAI and therapeutic parameters. The presence of one or more clinical and laboratory parameters defined normal gonadal function: normal menstrual cycles with or without dysmenorrhea; elevated cervical mucus length; normal levels of plasma FSH, LH, estradiol, progesterone, prolactin and testosterone; normal urinary hormonal cytology; serial pelvic ultrasound compatible with ovulatory pattern; and present or previous pregnancy. The mean age of menarche (13.5 +/- 1.4 years) was greater than that found among 2578 healthy Brazilian adolescents (12.5 +/- 1.3 years; P = 0.0002). The delay in menarche correlated with an increase in the duration of the disease (P = 0.0085) and the cumulative dose of prednisone (P = 0.0013) used until the appearance of the menarche. The mean phase length in SLE was 31.5 +/- 10.3. Sixteen female (70%) patients showed normal and seven (30%) abnormal gonadal function. Gonadal function was not correlated with parameters of SLE. These results suggest that the patients of this study reach adulthood with a high chance of fertility.
Sexual activity during adolescence may represent a risk for young women's quality of life as well as their health. This practice can result in early pregnancy, abortion, AIDS and other sexually transmitted diseases. The need for sexual education in order to identify and prevent the risk factors of an unwanted pregnancy during adolescence becomes increasingly clearer. In order to accomplish this purpose all segments of society shall be convened. If the goal is educating, informing or, even better, forming, then the school stands out from among the other reference groups because this is its essential role. A few basic principles should be established for the success of the educators' actions. Perhaps the most important one being not only to base sexual education on the use of preservatives and contraceptive methods, but rather on rescuing the individual as a result of his/her own actions. This favors the development of a sense of citizenship, respect, commitment, self-care and care for others.
RESUMOObjetivo: Relatar os resultados do Fórum "Adolescência e Contracepção de Emergência", que teve como proposta trazer maiores esclarecimentos sobre a contracepção de emergência (CE), além de apoio ético e técnico para sua prescrição, a partir da análise de três vertentes principais de discussão: o perfil da clientela adolescente; as questões éticas que envolvem a CE; a eficácia e o risco do método. Síntese dos dados: A adolescência caracteriza-se por mudanças, transformações e experimentações que vinculam essa fase da vida à vulnerabilidade e risco. Alguns desses riscos estão relacionados ao exercício inadvertido ou impensado da sexualidade, cujas conseqüências são bem conhecidas: gravidez precoce, aborto e doenças sexualmente transmissíveis, entre as quais HPV e AIDS. É fundamental, portanto, que a assistência a essa faixa etária inclua o enfoque de prevenção, na qual a educação sexual seja vista como um processo do qual é parte relevante a orientação anticoncepcional, incluindo-se nesta a contracepção em situações de emergência.Conclusões: O artigo apresenta as conclusões resultantes das discussões realizadas durante esse evento. Seu principal desdobramento foi a Resolução do Conselho Federal de Medicina: a CE não é abortiva e pode ser usada em qualquer etapa da vida reprodutiva.Palavras-chaves: adolescente; bioética; gravidez na adolescência; anticoncepção pós-coito. ABSTRACTObjective: To report the results of the Forum "Adolescence and Emergency Contraception". The objectives of this Forum were to enlighten and to bring ethical and technical support to the prescription of emergency contraception through the analysis of three main points: the profile of the adolescent clientele; the ethical issues involved in the emergency contraception; the risks and efficiency of this method.Data sources: Discussion based on current literature on the theme in the Forum held in 2005, which included pediatricians, obstetricians, gynecologists, members of bioethics committees, members of the Federal Council of Medicine, delegates from the Ministry of Health, lawyers and judges.Data synthesis: Adolescence includes change, transformation and experimenting, all of which lead to vulnerability and risk. Some of these are related to unoriented or unthought sexuality, whose consequences are well known: early pregnancy, abortion and sexually transmitted diseases, among which are HPV and HIV infections. Therefore, the medical assistance to adolescents must be focused on prevention, in which sexual education includes contraception orientation, particularly in emergency situations.Conclusions: This review presents the conclusions that were achieved during the meeting. Its main consequence was a resolution by the Federal Council of Medicine stating that emergency contraception is not abortive and may be used at any stage of the reproductive life.
The purpose of this paper was to assess post-menarcheal growth in a cohort of Brazilian girls and correlate it with the age, stature and BMI at menarche. Records of the age, weight, and stature at menarche, and 5 years later, of 111 girls who attended the Adolescent Unit of the Child Institute-HC-Medical School of the University of São Paulo, were recovered. The median age at menarche was 12.67 years and the mean increase in height was 7.54 +/- 3.35 cm. The largest span of growth was observed in girls who reached menarche before 12.67 years (r= -0.46; p= 0.0001) and in the ones who had less stature at this moment (r= -0.44; p= 0.0001). The best correlation was observed in girls with stature between p25 and p75 of NCHS reference data (r= -0.72; p= 0.0001). Adolescents with greater BMI had earlier menarche (11.9 years). No correlation was found between BMI and post-menarcheal growth (r= 0). In this cohort, post-menarcheal growth was similar to other studies and correlations offer information to assess the potential of growth after menarche.
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