Articles from The Female Patient

OBGYN.net Advertisement

August, 2001

Managing Perimenopausal Symptoms: An Integrative Medicine Approach
Tori Hudson, ND

Chest Pain in Female Adolescents: A Clinical Approach
Robin B. McFee, DO, MPH

Menopause and Mood: Are They Connected?
Monica W. Choi, PhD, CRNP

July, 2001

Postmenopausal Osteoporosis: Pharmacologic Options for Prevention

January, 2001

Transitional Management: The Use of Oral Contraceptives in Perimenopause
Ronald T. Burkman, MD, Andrew M. Kaunitz, MD, John A. Collins, MD, Maida B. Taylor, MD, MPh, Susan J. Wysocki, RNC, NP

Chronic pelvic pain, a common complaint in female adolescents, is defined as cyclic or noncyclic, intermittent or constant discomfort in the pelvic region for at least 6 months. It often frustrates the patient, her parents, and her physician, and it can lead to major functional problems such as changes in family dynamics or school absenteeism.

December, 1999

Twin-to-Twin Transfusion Syndrome
Daniel W. Skupski, MD

This syndrome, which is poorly understood from both diagnostic and treatment perspectives, results in significant perinatal morbidity and mortality. Improved outcomes depend on a better understanding of the etiology of this devastating disease and on the performance of randomized, controlled trials to evaluate treatment protocols.

November, 1999

First-Trimester Aneuploidy Screening: A Combined Approach
Boris Petrikovsky, MD, PhD; Terrence W. Hallahan, PhD; James N. Macri, PhD

Prenatal testing for Down syndrome has gained importance--and urgency--as more women delay pregnancy into their later reproductive years. A first-trimester screening technique that combines use of maternal serum markers with ultrasonographic assessment may offer reliable answers sooner than do other available tests.

August, 1999

Iatrogenic Multiple Pregnancy: Epidemiology, Risks, and Ethical Dilemmas
Louis Keith, MD; Susan Klock, PhD; Sanjay Gandhi, MD

This article discusses the nature of infertility treatment and its relation to infertile couples' desires for multiple pregnancy, the special risks of iatrogenic multiple pregnancy (IMP), the informed consent process in assisted reproductive technology, and the ethical dilemma of IMP and methods for its resolution.

Breast Cancer in Younger Women: Assessment and Risk Management
Victor G. Vogel, MD, MHS

Breast cancer is a growing concern among premenopausal women. With an emphasis on this patient population, this article discusses the known risk factors for breast cancer; models for quantitative risk assessment; and strategies for modifying breast cancer risk, including screening mammography, prophylactic mastectomy, and primary pharmacologic prevention.

May 1999

Scholarly Debate

Not Ready for Prime Time: Today's Laparoscopic Hysterectomy Has Too Many Drawbacks
Stephen M. Cohen, MD, FACOG

The Time Is Now: Benefits of Laparoscopic Hysterectomy Outweigh Risks
Harry Reich, MD, FACOG

April 1999

3-D Ultrasonography: A New Dimension in OB/GYN
Ana Monteagudo, MD; Ilan E. Timor-Tritsch, MD

At present, three-dimensional ultrasonography is largely viewed as a curiosity; its main advantage is presumed to be the realistic fetal image that it provides for prospective parents. However, as experience with this technology grows, distinct advantages are emerging for both fetal and gynecologic evaluation.

March 1999

A Basic Guide to Evaluating Amenorrhea
Alan S. Penzias, MD

The clinician and patient who are in search of a diagnosis for amenorrhea often encounter an overwhelming number of possible causes (and requisite tests) for this condition. This concise review of amenorrhea is both comprehensive and comprehensible.

February 1999

Update on Ectopic Pregnancy: Diagnosis and Treatment A Lively Roundtable Discussion on a Controversial Topic*
Thomas E. Nolan, MD, MBA, Moderator; David L. Olive, MD; David B. Seifer, MD; Thomas G. Stovall, MD, MBA

Whereas the surgical approach has long been the standard of care for ectopic pregnancy, a wider range of treatment options is now available--leading to a number of questions for the OB/GYN. Our expert panelists debate the relative merits and drawbacks of methotrexate and various invasive procedures, and also discuss their preferred diagnostic approaches, in managing the patient who presents with signs and symptoms of ectopic pregnancy.

November 1998

Tailoring HRT to Your Patients: An Expert Roundtable Discussion on the Issue
Andrew M. Kaunitz, MD, Moderator; Ronald T. Burkman, MD; Sandra Ann Carson, MD; Paula J. Hillard, MD; J. Kell Williams, MD

The topic of hormone replacement therapy (HRT) continues to emerge as a central theme that we, as clinicians to female patients, address every day. We recognize that the public is much more aware of and interested in HRT now than was the case a decade ago. But we also see a big discrepancy between the number of prescriptions we might write as we initiate appropriate candidates on HRT and the number of women who actually adhere to our therapeutic advice 6 months later....

October 1998

Don't Wait for a Fracture: Identifying Osteoporosis

Osteoporotic fracture occurs as a late consequence of osteoporosis and is preventable. Nevertheless, despite well-defined risk factors and the availability of precise, reliable modalities for assessing bone density, some physicians still seem reluctant to evaluate patients for this common condition. Measurement of bone density is a practical and predictive tool for determining fracture risk and can be performed routinely at menopause. Decreased bone density values indicate a need for preventive treatment.

September 1998

Women's Primary Health Grand Rounds at the University of Michigan Timothy R.B. Johnson, MD, and Hope K. Haefner, MD, Series Editors: Management of the Palpable Breast Mass
Maria T. Kopicki, MD

In the office setting, palpable breast masses are a frequent finding among female patients of all ages. The goal of diagnosis is to avoid missing malignant lesions, provide reassurance in benign conditions, and determine what treatment, if any, is indicated.

August 1998

Electrosurgery for Cervical Intraepithelial Neoplasia
Wm. Jackson Epperson, MD; John L. Pfenninger, MD

Women with cervical intraepithelial neoplasia now have a number of treatment options including cold-knife conization, laser ablation, and loop electrosurgery but, all too often, the physician s preference is the determining factor in selection of therapy. This detailed presentation of the advantages and disadvantages of electrosurgery will help the physician to decide whether this procedure truly fits the needs of a given patient.

Recurrent Miscarriage - An Updated Appraisal
G. Quadir Khan, MD, FRCOG*; Donald Heggen, MD, FACOG

One of the keys to treating recurrent miscarriage is knowing when to initiate the search for a problem. As most women who conceive will miscarry at some point and more than half of patients can have a successful pregnancy without therapy even after three miscarriages, it would seem that treatment is unnecessary in the majority of cases. However, women with certain risk factors advanced maternal age, a history of oligomenorrhea may benefit from evaluation. In this setting of parental anxiety coupled with uncertainty in diagnosis and management, emotional support, reassurance, and counseling regarding further risk are of paramount importance.

July 1998

The Feminine Nutrition Mystique
Sylvia A. Moore, PhD, RD, FADA; Janice G. Smith, BS

Physicians and patients are bombarded with reports in the popular and medical press about specific vitamins and nutrients that reduce the risk of conditions from heart disease to cancer, and the recommendations seem to change daily. This article outlines a life-long plan that brings all of the latest findings together into a coherent, comprehensible whole.

June 1998

Women's Primary Health Grand Rounds at the University of Michigan: Breast-Feeding Promotion During the Prenatal and Postpartum Periods
Elizabeth Shadigian, MD; Patricia Van Bonn, MSN, RN, IBCLC; Marilyn Cook, RNC

Despite mounting evidence suggesting that breast-feeding maximizes infant and maternal health, many physicians as well as mothers continue to feel that bottle-feeding is nearly as good. In this first article of a two-part series, the authors examine how physicians can promote breast-feeding.

May 1998

Heritable Breast and Ovarian Cancers
Gabriel M. Cohn, MD

With the media attention focused on cancer genes and registries aimed at tracing hereditary cancers, many women with a family history of cancer and some with no such history are asking their physicians for advice and testing. This article explains the nature of breast and ovarian cancer inheritance and gives recommendations for screening and intervention based on the latest findings in this fast-changing field.

April 1998

Scholarly Debate - Worth a Thousand Words: The Ultrasound Advantage
Ana Monteagudo, MD

With its accuracy, scope, and reproducibility, might transvaginal cervical imaging help us not only predict preterm labor but understand its mechanisms? The early and timely diagnosis of preterm labor (PTL) continues to elude even the most accomplished obstetrician. The diagnosis of PTL is usually based on the presence of regular uterine contractions between 20 and 37 weeks gestation in conjunction with progressive cervical change, cervical dilatation of 2 cm or more, or cervical effacement of 80% or more.

March 1998

Alzheimer's Disease in Women: Can Estrogen Play a Preventive Role?

Because of the widespread use of estrogen replacement by postmenopausal women, physicians are asking whether estrogen use could have any impact on senile dementia--particularly Alzheimer's disease. This article explores the epidemiologic and clinical findings to date, especially with regard to prevention.

February 1998

Gasless Gynecologic Laparoscopy
Jeffrey M. Goldberg, MD; Tommaso Falcone, MD

The CO² pneumoperitoneum required for gynecologic laparoscopy poses well-known cardiopulmonary risks, especially in elderly patients. This article describes a technique for suspending the abdominal wall that could eliminate some of these drawbacks in the near future.

January 1998

The Good News About Hormonal Contraception and Gynecologic Cancer
Andrew M. Kaunitz, MD, and Guy I. Benrubi, MD

In the ever-mounting push to wipe out gynecologic cancer through early detection and controlling lifestyle contributors, both physicians and patients continue to overlook the substantial protection offered by hormonal contraception. This article discusses ways in which oral contraceptives and other hormonal modalities can help reduce the risk of breast, endometrial, and ovarian cancers.

Putting Herpes in Perspective
Deborah Breeding, RN

For many people who have genital herpes, the physical pain caused by the infection is less of an issue than the emotional anguish it causes. You can cope with herpes by learning what you re up against, treating it appropriately, and maintaining a positive attitude.

December 1997

Genital Wart Management: A Partnership Between Physician and Patient
Jonathan B. Parmer, MD, Eugene J. Basiliere, MD, Elaine K. Orenberg, PhD

With its implications of sexual transmission and potential cervical cancer, a diagnosis of genital warts can be emotionally distressing to patients. Because no single treatment serves every patient, the best approach to selecting a therapeutic option considers the extent of the disease, wart location, and the patient's individual needs.

November 1997

Update on Retropubic Incontinence Surgery: A Comparison of Two Procedures
Joseph A. Riggs, MD, John C. Riggs, MD

A 27-year study of 1300 women undergoing retropubic cystourethropexy using either the modified Marshall-Marchetti-Krantz procedure or the modified Pereyra procedure compares long-term results when the type of surgery is selected on the basis of patient criteria.

October 1997

Fetal Testing in the First Trimester of Pregnancy

The advantages of ever-earlier prenatal testing seem obvious: the sooner a problem is detected, the sooner therapy or termination can be undertaken. However, as this article points out, such benefits must be balanced against the disadvantages of more ambiguous findings and the increased risk of procedure-related miscarriage.

Medical History Inaccuracies in Patients Undergoing Breast Biopsy
Murray H. Seltzer, MD, Diane M. Koster, RN

Noting an alarming number of inconsistencies in patient-reported medical histories, these authors found that more than 75% of 100 patients undergoing breast biopsy made omissions in providing medical data. As some of these omissions can adversely affect patient care, they propose electronic centralization of medical histories--with confidentiality safeguards--as a means of decreasing medical data errors.

September 1997

Hormone Suppression in the Differential Diagnosis of Chronic Pelvic Pain
Gary A. Fields, MD

The management of chronic pelvic pain can be frustrating, because the possible cause can be gynecologic or nongynecologic. Symptoms vary, and often do not correlate with laparoscopic findings. This article describes the use of the hormone suppression test to distinguish between gynecologic and nongynecologic sources of pelvic pain and thus direct further testing and treatment.

August 1997

Postpartum Depression
Kathryn A. Leopold, MD, Lauren B. Zoschnick, MD

Despite the recent growth in publicity, postpartum depression is still all too often unrecognized or cavalierly dismissed. However, this common disorder is readily diagnosed and treated by the primary care physician who is willing to take the most basic measures.

July 1997

Understanding Herpes Simplex Virus
Amy Solomon, MD, Samuel Smith, MD

Genital herpes simplex virus is epidemic among sexually active women. Patients must be educated about their infection and the potential for transmission to a partner or newborn--including the role of asymptomatic shedding. This review provides current information on the diagnosis, recurrence, transmission, treatment, and pregnancy risks of genital herpes.

femalepatient, women's health, obstetrics, gynecology, infertility, pregnancy, hysterectomy, fibroids, and more

OBGYN.net: The Universe of Women's Health