GynoFiles

When a sentence begins with 'I read on the internet', the gyno takes a deep breath, and if the next clause contains a mention of one of the excellent sources of data we exhale and and smile. If the source is a chat room, or a site selling untested therapies, you can hear a few more deep breaths before we launch into a discussion of data. Of course, it's very important to get information about the consequences of any prescription therapy, and being prescribed contraceptive therapy is no exception. However, there are consequences of no therapy (in the case of contraception it's unplanned pregnancy) as well, and thus sprouts the prescriptive principal of 'risk vs benefit.' Your job is to help your provider sort out your personal risks and your personal perception of benefit. But it's important to not be weighing in factors that are truly myths.The June 2016 of AJOG has pointed out that contraceptive effectiveness is as much about chasing the ghosts of contr...

In pregnancy we have come to realize the shorter a cervix is, for the given stage of pregnancy, the more at risk the mom is for preterm birth. Oddly we know very little about why some pregnancies are destined to go overdue. first babies, previous late pregnancies, obesity, and genetics are the most commonly associated factors with prolonged pregnancies over 42 weeks. But, it's really not known why a particular pregnancy doesn't deliver by the due date. In a study from Northwestern University School of Medicine, published in Obstetrics and Gynecology September 2015 they studied over 9000 women, having their first baby, and found that the longer the cervix at 18-24 weeks, the more likely the pregnancy was going to be over due. Rates over 4.91 cm at that stage of pregnancy were associated with the latest pregnancies.Routine measurement of the cervix in the second trimester is almost always done now. The screening has been intended to predict who may be at risk for premature deli...

Women all want to know if and when they are going to go through menopause. We know it's related to just how old you are, we know the age of menopause is related to your mom's age at menopause, and we know it has something to do with the reserve of eggs in the ovary. Only 1% of women will reach menopause by age 40. Over 95% of women reach menopause by age 55, so around age 50, regardless of what else is going on, many women are wondering if they have gone through menopause. A study from the Family Planning Association of Hong Kong published in a recent Contraception begins to answer a question that has confounded gynecologists for over 50 years. If a woman in on birth control pills, how can she tell if she has gone through menopause? Simplistic answers are to stop the birth control pills, wait until their effects wear off and see if a woman then goes without a period for the requisite year by which menopause would be defined. Waiting a year for an answer is a clearly ludicr...

When it comes to women in menopause, and what symptoms to expect and how long to anticipate they will last it's important to understand what phase you are in. The physicians of an important workshop in 2001 developed a formal list of the menopause transition phases. The physicians call these special phases the Stage of menopause you are in. Which 'Stage' is important to help you and your physician understand how symptomatic you are, how much bleeding there is, and how long this is going to continue. Specifically they rely on definite menstrual period descriptions and actual recommendations regarding the FSH levels.  There are Five Stages before the final period (FMP, Final Menstrual Period), and two after the Formal “Menopause.” The fie stages are labeled from -5 to -1 and after menopause the stages are +1 and +2. In 2011 a group met to fine tune the stages and their conference was called "ReSTAGE". ReSTAGE took information from the TREMIN study, the Melbou...