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Joshua Fitch is an editor for Contemporary Pediatrics. Previously, he worked at 21 WFMJ as a sports anchor and videographer, as well as a national content writer for Weigel Broadcasting Company. 

Review some of the top stories from the Contemporary OB/GYN website over the last week, and catch up on anything you may have missed.

Contemporary OB/GYN week in review: WHI cuts, urinary incontinence, and more

Despite abortion bans in several states, a new study showed no significant shift in where OBGYNs choose to practice.

OBGYN practice locations unchanged post-Dobbs

 and joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio before joining 

 You can reach her at mpetronelli@mjhlifesciences.com.

A nearly 2-fold increase in women veterans’ health literature has been reported since the previous review in 2017.

Study highlights growth of women veterans’ health literature

Leeya F. Pinder, MD, MPH, is a gynecologic oncologist and associate professor at the University of Cincinnati College of Medicine.

Leeya Pinder, MD, MPH, highlights a national conference to spotlight the role of human papillomavirus in cancer, emphasizing vaccination, screening innovations, and collaborative efforts to eliminate cervical cancer.

First US national HPV conference highlights advances in cancer prevention

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A Psychedelic to Treat Postpartum Depression?

CMV: In the Know

RSV Roundtable

STIs

Supplement: Closing the Gap in Cervical Cancer Screening

Vaginismus: Managing a Misunderstood and Underdiagnosed Condition

Why vNOTES Make Sense for My Patients

1rem

Authors

There are many ways to take estrogens and many philosophies of management. The views expressed on this page represent the opinion of the author and may or may not conform to the current "standard of care" prevalent in the United States today.

Estrogen through the ages

Saying "obstetrician-gynecologist" is a mouthful for most people, and it's probably the most abbreviated specialty in medicine, both spoken and written. However, there doesn't seem to be a consensus on how to pronounce OB-GYN. First, is it the two-syllable "O-B" or the monosyllabic "Ob"? Second, is it "gin" or "gyne" (like "Lyme")? I wonder if you have a preference. I know I do.

Almost nobody says "obstetrician-gynecologist" when speaking about these specialist physicians. But what's the "correct" way to pronounce OB/GYN?

Is It Ob-Gin or Ob-Gyne?

In a recent interview ObGyn.net conducted for 

 on comprehensive care and cancer screenings at well-woman visits, the topic of stethoscopes came up. Ilene S. Gewirtz, MD, the interviewee, mentioned that she still carries a stethoscope and listens to her patients' heart and lungs at well-woman visits. She also said that she believes she's in the minority regarding this practice. We want to know if she's right.

POLL: Many women consider their OB/GYN their primary care provider. But like your primary care counterpart, do you carry a stethoscope?

Do OB/GYNs Carry Stethoscopes?

What is your diagnosis based on these images of the ovary?

Challenge your diagnostic skills with this image quiz: Is this ovarian lesion cystic in nature or something else?

Image IQ: Ovarian Cyst or Something Else?

Breast cancer is often diagnosed at an earlier stage among women with a history of screening mammography, reducing associated mortality, according to a recent study published in 

Screening recommendations and evidence gaps

The US Preventive Services Task Force (USPSTF) recommends women aged 40 to 75 years receive biannual screening to improve the odds of early breast cancer detection.

 However, the USPSTF has also stated the evidence to recommend screening in women aged over 75 years is currently insufficient.

“Identifying this potential difference in health outcomes based on screening history may facilitate a more accurate evaluation of screening effectiveness,” wrote investigators.

The cohort study was conducted to determine the link between screening history and breast cancer outcomes among older US women. Data was obtained from the Surveillance, Epidemiology and End Results-Medicaid linkage between January 1, 2005, and December 30, 2020.

This data included screening history, demographics, biology, cancer diagnosis, and treatment for breast cancer patients. Women aged at least 70 years with estrogen receptor-positive or human epidermal growth factor receptor 2–negative breast cancer determined by screening mammogram were included in the analysis.

Additional eligibility criteria included continuous Medicaid coverage from 5 years before diagnosis through 1 year following diagnosis. Receiving 1 or more screening mammogram within 5 years before diagnosis was defined as the exposure, with patient categories including no vs any screening before diagnosis.

The stage at diagnosis was reported as the primary outcome, classified as either very early or later stage diagnosis. Diagnoses were made based on American Joint Committee on Cancer TNM stages. Demographic, socioeconomic, tumor, and treatment-related covariates were obtained during diagnosis.

There were 13,028 patients included in the analysis, 3.6% of whom were Asian, 4.2% Hispanic, 6.2% non-Hispanic Black, 84.3% non-Hispanic White, and 1.7% other or unknown race and ethnicity. Of women, 38.5% were aged 70 to 74 years and 30.9% were aged 75 to 79 years.

Prior screening was reported in 77.5% of participants overall. Those with at least 1 primary care physician or annual wellness visit, aged 70 to 74 years, and non-dual eligible had increased rates, at 78.1%, 79.1%, and 79.9%, respectively.

Later-stage disease was reported in 29.3% of women at diagnosis, with a rate of 25.1% among women with prior screening. Among those without prior screening, the prevalence of later-stage diagnosis was 43.4%. This indicated a 54% reduced chance of being diagnosed at a later stage when having prior screening, with an adjusted odds ratio (aOR) of 0.46.

Being dual eligible and living in regions with higher poverty and lower education were also linked to later-stage diagnosis, with aORs of 1.17, 1.21, and 0.83, respectively. In patients with grade 3 or grade 4 tumors vs grade 1 tumors, the aOR for later diagnosis was 4.90.

The odds of breast cancer mortality were also significantly reduced among women with prior screening, at a rate of 3.3% vs 8% among women with no prior screening. This indicated an aOR of 0.63 for breast cancer-specific death among this population.

These results indicated earlier stage of diagnosis for breast cancer and reduced mortality among women aged at least 70 years with prior screening mammography. Investigators noted limitations in the data because of residual cofounding.

“Our findings support the potential for routine screening to improve breast cancer outcomes,” investigators concluded.

Huang S, Westvold SJ, Soulos PR, et al. Screening history, stage at diagnosis, and mortality in screen-detected breast cancer. 

. 2025;8(4):e255322. doi:10.1001/jamanetworkopen.2025.5322

Nicholson WK﻿, Silverstein M﻿, Wong JB﻿, et al; US Preventive Services Task Force.Screening for breast cancer: US Preventive Services Task Force recommendation statement.﻿

. 2024;331(22):1918-1930. doi:10.1001/jama.2024.5534

A new study found that routine mammography significantly reduces late-stage diagnoses and mortality in women aged 70 years and older.

Clinical

Screening mammograms linked to earlier breast cancer detection

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, April 14, 2025 - Friday, April 18, 2025), and click each link to read and watch anything you may have missed.

Mitchell Creinin, MD, reports estetrol pill eases menstrual symptoms

 Mitchell Creinin, MD, professor at University of California Davis Health, discussed a study evaluating the impact of estetrol combined with drospirenone, a novel oral contraceptive, on premenstrual and menstrual symptoms.

This was a planned secondary analysis of a phase 3 trial conducted in the United States and Canada, designed to assess not only contraceptive effectiveness but also the impact on menstrual complaints using the Menstrual Distress Questionnaire. A similar study had already been conducted and published in Europe and Russia. Due to demographic and clinical differences in the participant populations, the results were not pooled but analyzed separately.

The results showed that switchers generally reported low levels of menstrual distress at baseline, and those levels remained stable, indicating that switching to estetrol/drospirenone maintained their symptom relief. In contrast, starters showed a significant decrease in symptom intensity across key domains, particularly pain, water retention, and negative affect. Symptoms such as cramps, headaches, back pain, fatigue, swelling, tender breasts, anxiety, and irritability notably improved, with many showing at least a 40% reduction in severity.

Early menopause linked to increased risk of cognitive decline

Women with early menopause are at an increased risk of 2-year follow-up cognitive decline, according to a recent study published in 

Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

Women are disproportionately impacted by dementia compared to men, highlighting potential sex-specific risk factors. A link has also been established between early menopause and depression, which increases the risk of dementia. This led investigators to evaluate the association between early menopause and cognitive function.

“Since early menopause increases the risk of depression, which then increases the risk of dementia, we had to control for this factor to determine if early menopause in of itself was a direct risk factor,” said Miharu Nakanishi, PhD, lead author from the Tohoku University Graduate School of Medicine.

Contraception for patients with mental health conditions

Mental health conditions affect about 1 in 7 people globally. Anxiety and depressive disorder account for most cases. 

Reproductive-age females are more likely to be affected by depression and anxiety disorders than men, with an age-standardized prevalence of 24% among women vs 13.3% among men in the US. Those who are pregnant or who are recently in the postpartum period are increasingly at risk; depressive disorders diagnosed during US delivery hospitalizations increased 7-fold from 4.1 diagnoses per 1000 hospitalizations in 2000 to 28.7 diagnoses per 1000 hospitalizations in 2015.

Perinatal mental health conditions are associated with adverse outcomes for the pregnant or postpartum person as well as fetus, infant, partner, or family. Additionally, perinatal depression may signal a trajectory for chronic depression and its lasting implications.

Outpatient cervical ripening with a Foley catheter

Labor induction is a common obstetric practice in the United States, occurring in 31.9% of deliveries in 2022. Elective induction rates have continued to rise since the publication of the results of the ARRIVE trial (NCT01990612) in 2018, which demonstrated a reduction in cesarean delivery and hypertensive disorders of pregnancy for low-risk nulliparous patients undergoing induction at 39 weeks.

The American College of Obstetricians and Gynecologists states that mechanical methods of outpatient labor induction may be an appropriate option in selected patient populations. Although a formal recommendation was not made, recent findings suggest this is a safe and effective alternative to inpatient practices. 

Cervical ripening balloons apply direct pressure to the internal cervical os, causing endogenous prostaglandin release. A bladder catheter (Foley) or a commercial intracervical balloon (eg, Cook Cervical Ripening Balloon) can be used with similar efficacy, although the Foley catheter is often more readily available and considered more cost-effective.

First baby born via fully automated ICSI system

The first baby was born using a fully automated, digitally controlled intracytoplasmic sperm injection (ICSI) system on April 10, 2025, as reported in 

Jacques Cohen, PhD, embryologist at Conceivable Life Sciences, led a multidisciplinary team of specialists alongside others to develop the automated system. It was developed to automate all 23 steps of ICSI, with either artificial intelligence (AI) or a remote operator independently performing the steps.

“With AI, the system autonomously selects sperm and precisely immobilizes its midsection with a laser ready for injection - executing this rapid, precise process with a level of accuracy beyond human capability,” said Mendizabal-Ruiz, PhD, lead engineer professor and an additional study head.

Contemporary OB/GYN week in review: Menstrual symptoms, cognitive decline, and more

Those of us in management have come to recognize meetings as an inevitable part of our workday. The greater your administrative to clinical time, the greater the amount of time you will spend in meetings both as a meeting participant and as a leader. the increased number of remote meetings has had a negative impact as the threshold for creating a meeting decreased and the ease of inviting participants to meetings increased. The cost of meetings is rarely considered, but the next time you are at meeting, think about this: It is not unreasonable to estimate that an hourlong meeting of clinicians may cost close to $1000 in missed clinical revenue. It is imperative that meetings are managed as effectively as any common clinical scenario.

Whillans et al describe 6 pitfalls that lead to excessive meetings

1. Meeting FOMO (fear of missing out): What will our colleagues, or worse, our bosses think of us declining an invitation for a meeting of marginal necessity? this is rooted in the belief that just being present is being productive.

2. Selfish urgency: As leaders, not everything that we think is important justifies disrupting others’ days or adding an extra hour to the workday.

3. Meeting as a commitment device: using a meeting solely to establish a deadline is not a great use of time.

4. The mere urgency effect: This is where we feel better for completing a task, no matter what the value is. An example is low-value regular meetings. If we complete a series of meetings, we feel we have accomplished something, even if we have not.

5. Meeting amnesia: this is the meeting to review what was accomplished (or not) at the previous meeting. A much better tactic would be real-time debriefs or distribution of meeting summaries.

6. Pluralistic ignorance: Chances are we are not the only one who recognizes that a standing meeting is a waste of time. Open dialogue can remove a standing meeting from our calendars. Action plans and end goals are neededthere is a lot of science around effective meetings. 

A review of 100 articles on the subject came up with some tips

: Do you really need a meeting? Can a quick call or email suffice? Invite the smallest number of people required. This not only makes the meeting easier to manage and more effective but will greatly facilitate its scheduling in a timely manner. Build an agenda and stick to it. This seems so simple yet is probably the most common reason a meeting succeeds or fails. Everyone should know the end goal of the meeting. An agenda describes the process, but an end point will drive efficiency. It is a great tool for refocusing those who may be derailing the meeting. End with an action plan and a follow-up deadline for items on the agenda. this will effectively reduce the frequency of a second, less valuable meeting. Allow participants to leave a meeting if they feel that they are not contributing or that the meeting is not of value. After evaluating whether a meeting is necessary, deciding who needs to attend, and establishing an agenda and goals, the next decision point is the duration of the meeting. Meeting content seems to follow the laws of natural gas: It will expand to fill the available allotted time. scheduling your meetings for shorter periods of time will force discipline around roles and agendas and will free your teams up to be more productive in other spaces. 

Lucy Handley takes the 30-minute meeting 1 step further and promotes a 15-minute meeting.

 The purpose of the 15-minute meeting is 2-fold. The 15-minute meeting is not just about going more quickly. It is about prework. The foundation of this prework is asynchronous communication. A shorter meeting requires individuals to read materials sent prior to the meeting so they need not be reviewed. 

One highly creative approach is a brief video sent premeeting by the organizer. this shows that the organizer values the participants’ time and will lead to greater focus. Although the 15-minute meeting is not for every subject, it can be a great strategic tool. Make the most of online meetingsAlthough the foundation of meetings remained unchanged when they moved online via Zoom, Microsoft teams, etc, there still are special considerations. 

 discussed the potential for remote meetings to be draining rather than energizing to those working remotely, along with reasons and tactics for mitigating the risk of disengagement. Although the discomfort of constantly being on display and having to look at a screen of others throughout a meeting is something we can get used to, other issues such as multitasking during meetings will always hinder the productivity of a session. Although some have advocated mandatory “cameras on,” constantly being present on screen can increase the fatigue of a remote workday.

 Suggestions for improving appearance on remote video calls include both technical and physical strategies. Computers’ imbedded microphones and cameras rarely compare in quality to many inexpensive combined apparatuses, which are easy to install. Individuals should be aware of posture and facial expressions, watch out for lighting mishaps, and make sure they are well lit from the front. Unlike an add-on camera/microphone, which is essential, professional lighting is not something everyone needs. But it is important to ensure there is not an intense light source behind you, which can cause you to appear as a silhouette.

In a recent Harvard Business Reviewarticle,

 Rae Ringel wrote that “I’m going to give you 10 minutes of your life back” is a phrase to stop using. Ringel points out that if a meeting is run properly, one might be able to say, “Because everyone was so productive, we’re done 10 minutes early. Thank you so much for your presence and participation.” That’s the kind of meeting you should be aiming for.  

1. Whillans A, Feldman D, Wisniewski D. The psychology behind meeting overload. Harvard Business Review. November 12, 2021. Accessed June 29, 2022. https://hbr.org/2021/11/the-psychology-behind-meeting-overload

2. LePage E. Tips for effective meetings we learned from reading 100 articles. Unito. January 13, 2020. Accessed June 29, 2022. https://unito.io/blog/running-effective-meetings-tips/

3.Handley L. The rise of the 15-minute meeting —and how to run one. CNBC. January 25, 2022. Accessed June 29, 2022. https://www.cnbc.com/2022/01/25/the-rise-of-the-15-minute-meeting-and-how-to-run-one.html 

4.Discovery RSM. How to have effective zoom meetings—and make them less boring. Forbes. March 4, 2021. Accessed June 29, 2022. https://www.forbes.com/sites/rsmdiscovery/2021/03/04/how-to-have-effective-zoom-meetings-and-make-them-less-boring/

5.Gabriel AS, Robertson D, Shockley K. Research: cameras on or off? Harvard Business Review. October 26, 2021. Accessed June 29, 2022. https://hbr.org/2021/10/research-cameras-on-or-off

6.Ringel R. Please stop using these phrases in meetings. Harvard Business Review. January 11, 2022. Accessed June 29, 2022. https://hbr.org/2022/01/please-stop-using-these-phrases-in-meetings4 / 466%

Tips to avoid wasting time and optimize meetings you do need.


Anthony Karpas, MD

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