Ilza Monteiro

• PhD
• Medical Doctor at State University of Campinas (UNICAMP)

Objective: 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. Materials and methods: A web-based survey was conducted to determine the impact of the COVID-19 pandemic on the diagnosis and management of...

Objectives: 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. Materials and methods: We conducted a pilot study at the Department of Obstetrics and Gynaecology, Universi...

To evaluate gene expression associated with unfavorable vaginal bleeding in users of the Etonogestrel (ENG) contraceptive implant. Prospective study involving 100 women who intended to use the ENG implant. Exclusion criteria included abnormal uterine bleeding, inability to attend a 1-year follow-up, and implant removal for reasons unrelated to vagi...

Objective To evaluate gene expression associated with unfavorable vaginal bleeding in users of the Etonogestrel (ENG) contraceptive implant. Materials and Methods prospective study involving 100 women who intended to use the ENG implant. Exclusion criteria included abnormal uterine bleeding, inability to attend a 1-year follow-up, and implant remo...

Objective To evaluate changes in the menstrual pattern of women of reproductive age infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) or vaccinated against coronavirus disease 2019 (COVID‐19). Methods A cross‐sectional study at the University of Campinas, Brazil using Google questionnaire applied from December 2021 through...

Objective: 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]) among nulligravidas and parous women with and without caesarean delivery. Methods: A cross-sectional study assessed pain referred by women...

Objective To synthesize the published literature to better understand the association between cesarean scar defects (CSDs) and abnormal uterine bleeding (AUB). In particular, we aimed to evaluate the risk and pattern(s) of CSD-associated AUB in addition to exploring the relationship between defect morphology with bleeding symptoms. Design Systemat...

Background: Our objectives were to determine the knowledge and interest in apps for natural contraception among women and Obstetrics and Gynaecology (OBGYN) residents. Study design: An online survey was sent to Brazilian women to gather sociodemographic data, knowledge and interest towards fertility-awareness contraceptive methods and smartphone...

Objective: To determine knowledge, attitude, and preventive (KAP) practices towards the SARS-CoV-2 (COVID-19) pandemic among women in reproductive age seeking to use copper or hormonal intrauterine devices (IUD/LNG-IUS). Methods: We conducted a cross-sectional study in which we applied a questionnaire on 400 women about KAP practices on COVID-19...

Objective To compare the expulsion rates of the levonorgestrel (LNG) 52 mg intrauterine system (IUS) among women with heavy menstrual bleeding versus women using solely for contraception. Study design We conducted an audit study of 548 (8.8%) women with heavy menstrual bleeding and 5,655 (91.2%) users for contraception (comparison group) for four...

Background and objectives Lack of information and myths or inadequate training of health care providers in the guidance and management of contraceptives could negatively affect choice and eventually continuation rates. Our objectives were to evaluate the impact of clinical and theoretical training of health care professionals on insertion and remov...

(Abstracted from Contraception 2020;102:267–269) A barrier to uptake of intrauterine devices (IUDs) is fear of pain at the time of insertion. Although nulliparity is a common factor associated with pain at IUD insertion, it is often underestimated by health care professionals.

Objective To assess the safety of the levonorgestrel 52‐mg intrauterine system (LNG‐IUS) in women with a history of thrombosis or coagulopathy and to evaluate bleeding patterns. Methods A retrospective chart review was conducted of 117 women attending a clinic between 2007 and 2019. Their sociodemographic characteristics, hematologic status, reaso...

Objective To identify sociodemographic and clinical variables associated with severe pain with levonorgestrel 52mg intrauterine system (IUS) placement among nulligravid women. Study design We performed a secondary analysis of a randomized trial that evaluated intracervical anesthesia before IUS insertion. We assessed factors associated with severe...

Objective The optimal use of contraceptive methods requires that women participate in targeted choice of methods that meet their individual needs and expectations. The Thinking About Needs in Contraception (TANCO) study is a quantitative online survey of the views of health professionals and women on aspects of contraceptive counseling and contrace...

Objective Changes in bleeding patterns could influence the decisions of healthcare professionals to change the levonorgestrel-releasing intrauterine system (LNG-IUS) before 7 years of use, the recommended period of extended use. We evaluated changes in the bleeding patterns of users of the 52 mg LNG-IUS at the end of use of the first (IUS-1) and du...

Unplanned pregnancy (UP) is a public health problem, which affects millions of women worldwide. Providing long-acting reversible contraceptive (LARC) methods is an excellent strategy to avoid or at least reduce UP, because the effectiveness of these methods is higher than other methods, and is indeed comparable to that of permanent contraception. A...

O sangramento uterino anormal (SUA), ou menorragia, é definido como qualquer perda anormal de sangue de origem uterina, descartando afecções orgânicas demonstráveis do trato genital e gravidez. Como distúrbio frequente em qualquer época do período reprodutivo feminino, é importante analisar a influência do SUA na sexualidade das mulheres com esta q...

Background: Fear of pain during the insertion of intrauterine contraceptives is a barrier to using these methods, especially for nulligravidas. An intracervical block may be easier and more reproducible than a paracervical block; however, this intervention has not been evaluated in nulligravid women to reduce pain with intrauterine contraceptive i...

A 2013 review found no evidence to support the routine use of pain relief for intrauterine contraceptive (IUC) placement, however, fear of pain with placement continues to be a barrier to use for some women. This narrative review set out to identify (1) new evidence that may support routine use of pain management strategies for IUC placement; (2) p...

Objective: To evaluate endocervical and vaginal environment changes in women using a levonorgestrel-releasing intrauterine system (LNG-IUS). Methods: A quasi-experimental study included sixty women who had an LNG-IUS inserted in the Family Planning Clinic of UNICAMP between April and November of 2016. Women in reproductive age, non-pregnant, wit...

Objectives: In some settings women are advised to return to the clinic after intrauterine contraceptive (IUC) placement, for a follow-up visit to check the strings and identify any expulsions. Our objective was to evaluate whether the number of follow-up visits to check the strings at the external cervical os after IUC placement predicts or prevent...

Introduction: Contraceptive vaginal rings (CVRs) are good contraceptive options because they do not require skilled providers, are self-administered, and show a higher stability of drug diffusion. Area covered: This article provides a review of the developments made with CVRs over the past number of years, while giving focus to the latest CVRs that...

Objective: To assess the clinical performance (pregnancy and occurrence of pelvic infection) of the levonorgestrel 52-mg intrauterine system (LNG IUS) in solid organ transplant recipients. Study design: We performed a retrospective chart review of all patients seen in the Family Planning Clinic at the University of Campinas Department of Obstetr...

STUDY QUESTION Can the high rate and associated burden of unintended pregnancy (UP) and adolescent pregnancy in Latin America and the Caribbean (LAC) be reduced through wider access to and use of long-acting reversible contraceptive (LARC) methods? SUMMARY ANSWER Studies show that impoved access to and use of LARC methods is an effective tool for...

Objectives: Our aim was to assess national hormonal and non-hormonal contraceptive sales in Brazil after the Zika virus outbreak. Methods: Pharmaceutical companies based in Brazil provided data on monthly sales from September 2016 to June 2017. Data from both the public and private sectors were obtained about sales of registered, available modern c...

Objective: To assess the contraceptive performance of the 52-mg 20 μg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena, Bayer Oy, Turku, Finland) among women who maintain the same device without changes after 60months. Study design: This is a chart review study in which we assessed the charts of 766 women who continue the same L...

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 ke...

Background The objective was to analyse the contribution of the provision at no cost to users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS) towards disability-adjusted life years (DALY) averted over a 9-year period. Methods We analysed data from 15 030 new users of the LNG-IUS who had the device inserted at 26 Brazilian t...

Study question: Has there been any influence of the Zika virus (ZIKV) outbreak on the sales of contraceptive methods in Brazil? Summary answer: Contraceptive sales in the 24 months of evaluation showed little variation and no significant change has been observed since the ZIKV outbreak. What is known already: Transmission of ZIKV is primarily...

Objectives: The aim of this study was to compare the clinical performance of depot medroxyprogesterone acetate (DMPA) in women who received injections every 3 months at the Family Planning Clinic, and those who received every other injection at a health care facility near their place of residence, only returning to the clinic every 6 months. Mate...

Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera®, Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and te...

Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, a...

BMD and implanon. To evaluate BC and BMD in ENG-releasing implant users as compared to copper intrauterine device (Cu-IUD)-users.

boné mineral density and implanon

There is scarce information about bone mineral density (BMD) and body composition (BC) among users of the etonogestrel (ENG)-releasing implant. To evaluate BC and BMD in ENG-releasing implant users as compared to copper intrauterine device (Cu-IUD)-users. A prospective study was conducted on 75 users of both contraceptive methods. BMD was evaluated...

STUDY QUESTION What is the contribution of the provision, at no cost for users, of long acting reversible contraceptive methods (LARC; copper intrauterine device [IUD], the levonorgestrel-releasing intrauterine system [LNG-IUS], contraceptive implants and depot-medroxyprogesterone [DMPA] injection) towards the disability-adjusted life years (DALY)...

Objectives: The aim of the study was to assess the expression of estrogen receptor (ER), progesterone receptor (PR), Ki-67, and Bcl-2 and their correlation in the endometrium of postmenopausal women in a hypoestrogenic state in order to identify which women, including those with an atrophic endometrium, would be at risk for proliferative changes. S...

We compared the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) with cyclic oral medroxyprogesterone acetate (MPA) on hemoglobin and serum ferritin levels in women with heavy menstrual bleeding (HMB). This was a multicenter, randomized study assessing the efficacy of the LNG-IUS and oral MPA (10 mg/day for 10 days) in women wi...

Heavy menstrual bleeding (HMB) is the most common complaint of women seeking gynecological care. Treatments included surgical or medical options including hysterectomy and the levonorgestrel-releasing intrauterine system (LNG-IUS) due to the profound suppression of endometrial growth that intrauterine LNG exerts which results in amenorrhea or in a...

Intrauterine diseases are common morbid disorders. Endometrial and endocervical polyps, myomas, synechiae, uterine malformations, endometrial hyperplasia and endometrial cancer are cited among intrauterine pathology. The investigations using transvaginal sonography and outpatient hysteroscopy had been a gold standard. Transvaginal sonography shows...

Despite the high contraceptive efficacy and the additional noncontraceptive benefits of the levonorgestrel-releasing intrauterine system (LNG-IUS), concerns persist with respect to its use in nulligravidas. The objective of this study was to evaluate the ease of insertion and clinical performance of the LNG-IUS in nulligravida women up to 1 year af...

Introduction: Fifty years after the first contraceptive, the market remains restricted regarding composition, cost and routes of administration, and satisfying the needs of millions of women with different requirements according to their stage in life. Areas covered: Women need contraception for almost 30 years of their life. Currently available...

To evaluate the correlation between endometrial cavity length and expulsion rate in acceptors of the TCu380A intrauterine device (IUD) or the levonorgestrel-releasing intrauterine system (LNG-IUS). The study included 235 nulligravida and parous women who received a TCu380A IUD or LNG-IUS and who were observed for up to 1 year. The length of the ute...

Introdução: As doenças intra-uterinas são freqüentes entre as mulheres. Dentre estas pode-mos citar os pólipos endometriais, miomas, sinéquias intra-uterinas, malformações uterinas, hiperplasias endometriais e câncer de endométrio. Para seu diagnóstico dispõe-se de métodos como o ultra-som e a histeroscopia, considerada padrão-ouro. O ultra-som ava...

The first combined oral contraceptive (OC) was launched in the US 50 years ago and was followed by another formulation introduced in Germany one year later. The most common estrogen component in current formulations is ethinylestradiol; however, many concerns have been raised with respect to this estrogen. Although the natural estrogen produced by...

Evaluate in outpatients, the endometrial morphology and histology of non-bleeding postmenopausal women. We conducted a descriptive study where 52 menopausal women were selected, between 50 and 60 years of age, who had not used hormone replacement therapy in the last six months and did not present any kind of vaginal bleeding after menopause. These...

To compare the efficacy and safety of the levonorgestrel-releasing intrauterine system and oral medroxyprogesterone acetate in the treatment of idiopathic heavy menstrual bleeding. In this multicenter, randomized, controlled study, women aged 18 years or older with heavy menstrual bleeding (menstrual blood loss 80 mL or more per cycle) were randoml...

The levonorgestrel-releasing intrauterine system (LNG-IUS) induces amenorrhoea, and its effect on bone mineral density (BMD) may constitute a concern. This study evaluated BMD in long-term users of the LNG-IUS or intrauterine device (IUD). BMD was evaluated at the midshaft of the ulna and ultra-distal radius using dual-energy X-ray absorptiometry i...

The levonorgestrel-releasing intrauterine system (LNG-IUS) is a contraceptive method approved for five years of use. However, there is some evidence that its life span may be longer. The aim of the study was to evaluate serum levonorgestrel (LNG) and estradiol (E(2)) levels and endometrial thickness every 6 months from 7 to 8 1/2 years after insert...

This is a prospective study that focused on the dynamics of operating rooms using operational indexes that measure optimization, resistance, overload and utilization of the surgical unit, and also identified the factors most associated with these indexes. A total of 1,908 surgeries were analyzed over a period of two months in 2007. The average rate...

To compare the efficiency of transvaginal sonography and outpatient hysteroscopy in the diagnosis of intrauterine pathology in postmenopausal women. Two-hundred and forty-three postmenopausal women were selected. All women had undergone outpatient hysteroscopy in the year 2006. These women were referred from the Basic Healthcare Units in Campinas,...

This article provides a perspective on the use of the levonorgestrel-releasing intrauterine system as a contraceptive method and as therapy in different situations, as well as presenting the corresponding controversies and unresolved issues. All studies have reported high contraceptive efficacy, an improvement in menstrual blood loss in women with...

Background The aim of this study was to evaluate bone mineral density (BMD) at baseline and at 18 and 36 months of use of etonogestrel (ENG)-and levonorgestrel (LNG)-releasing contraceptive implants. This is a continuation of a previous study in which BMD was evaluated at baseline and at 18 months of use. Methods A total of 111 women, 19–43 years...

Intrauterine adhesion (IUA) is a possible complication of uterine curettage following abortion. Because IUA is an important cause of infertility, some investigators have been advocating its inclusion in the routine investigational workup after every abortion curettage procedure. The aim of this study was to evaluate the uterine cavity of patients s...

This report is a review of the medical literature on the use of the levonorgestrel-releasing intrauterine system (LNG-IUS) in women with endometriosis, adenomyosis, cyclic pelvic pain and dysmenorrhea. A review was carried out using the MEDLINE and EMBASE databases to evaluate the use of LNG-IUS in women with endometriosis and adenomyosis. Nine stu...

OBJETIVE: To evaluate the endometrium of menopausal women before and after six months use of total isoflavone. METHODS: A non-controlled clinical, type "before and after" trial was carried out with 32 post-menopause women, between 40 and 60 years of age. They received 80mg/day of total isoflavones obtained from Trifolium pratense (Climadilâ) during...

To evaluate the endometrium of menopausal women before and after six months use of total isoflavone. A non-controlled clinical, type "before and after" trial was carried out with 32 post-menopause women, between 40 and 60 years of age. They received 80 mg/day of total isoflavones obtained from Trifolium pratense (Climadilâ) during six months. They...

To evaluate the prevalence of ovarian cysts in users of two contraceptive implants compared to users of intrauterine contraceptive (IUC). A total of 344 women were enrolled at 3 months of use of the etonogestrel-releasing implant (Implanon), the levonorgestrel-releasing implant (Jadelle) or the TCu380A IUC. Bimanual pelvic examination and vaginal u...

OBJETIVO: Determinar a variação de peso corpóreo em mulheres usuárias de sistema intra-uterino liberador de 20 mg/dia de levonorgestrel (SIU-LNG, Mirena®) e compará-la com a variação de peso de usuárias de dispositivo intra-uterino T cobre 380A (DIU Tcu) e usuárias de acetato de medroxiprogesterona de depósito (AMP-D) ao longo de cinco anos. MÉTODO...

To evaluate and compare the relationship of body mass index (BMI) and the immunoexpression of estrogen (ER) and progesterone receptors (PR) in endometrial polyps (EP) and endometrium, in gland and stromal cells of postmenopausal women. Thirty-five postmenopausal women with benign endometrial polyps, who had not been taking medication with hormonal...

Assess weight variations in Brazilian users of the 20 microg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) for comparison with a cohort of users of the TCu 380A intrauterine device (IUD) and a cohort of users of the injectable contraceptive, depot-medroxyprogesterone acetate (DMPA) over a period of five years. A total of 163 us...

This study aimed to assess the prevalence of bacterial vaginosis (BV) and other cervicovaginal infections, as well as the incidence of complications among new users of IUD, 1 and 6 months after its insertion, in the City of Campinas, Brazil. A total of 223 women who had a TCu-380A IUD inserted from May through November 2001, were included in the st...

The objective of this study was to evaluate the efficacy and performance, for up to 1 year, of an intrauterine system releasing 20 microg/day of levonorgestrel (LNG-IUS, Mirena) in the treatment of women with menorrhagia. It was a descriptive, prospective, non-comparative study. A 20 microg/day LNG-releasing-IUS was inserted on any day during bleed...

The objectives of this study were to evaluate the acceptability of the LNG-IUS Mirena(R), when offered as an additional option in a free choice context, and to evaluate the possibility of using this method in women with increased bleeding wanting an IUD and in copper IUD users requesting removal of the device for bleeding problems. A total of 256 w...

A modification of the TCu380A IUD to create the model TCu380S was introduced many years ago. The TCu380S utilizes copper sleeves that are flush in the plastic and are set at both ends of the horizontal arm. The objective of this study is to compare the clinical performance of the TCu380A and the TCu380S IUDs, especially regarding contraceptive perf...

In order to evaluate the puberal development of girls treated by Acute Lymphocytic Leukaemia (ALL) a retrospective study was done at Campinas-SP, Brazil. Forty two girls were treated by ALL with either 18 or 24 Grays of cranial irradiation. All patients were treated with chemotherapy including intrathecal methotrexate in similar dose regimens in ei...

OBJETIVO: Com o objetivo de avaliar o desenvolvimento puberal após o tratamento de leucemia linfóide aguda (LLA) na infância, foi realizado um estudo retrospectivo, em meninas tratadas de janeiro de 1980 a janeiro de 1991, no Centro de Investigações Hematológicas "Dr. Domingos A. Boldrini", em Campinas-SP. CASUÍSTICA E MÉTODO: Foram selecionadas 42...

OBJETIVO: Determinar alterações no crescimento após o tratamento de leucemia linfóide aguda em meninas. PACIENTES E MÉTODO: Realizou-se estudo retrospectivo com 59 meninas que apresentavam medidas de estatura antes e com no mínimo um ano do tratamento, subdivididas de acordo com a dose de radioterapia cranial utilizada [18 ou 24 Grays (Gy)] e com a...

The treatment of the acute lymphocytic leukaemia can determine impaired growth. All the patients had length measurements at the time of the beginning of the treatment and, at least, one year after the end of it. There was impaired growth after the treatment according to the dose regimens (18 or 24 Grays). No relation was observed related to the age...

The objective of this study was to evaluate the return of fertility in women who used Cyclofem as a contraceptive method during the introductory studies conducted in Brazil, Chile, Colombia, and Peru. From these four cohorts, 101 women were eligible for the study. Thirty-one were not included in the study either because they refused to be interview...