Very-low-dose estradiol increases BMD
January 1st 2005An estradiol dose of 14 ?g reduces bone turnover and preserves bone mineral density (BMD) in postmenopausal women, say results of a randomized trial presented at the 15th Annual Meeting of the North American Menopause Society. The once-a-week regimen also does not stimulate the endometrium or increase vaginal bleeding.
Raloxifene shown safe for 8 years
January 1st 2005A study extending experience with raloxifene to 8 years shows no adverse impact on gynecologic health with longer-term use. Results of the Continuing Outcomes Relevant to EVISTA (CORE) trial build on and support previous findings from the 4-year Multiple Outcomes of Raloxifene Evaluation (MORE) trial.
Comparing VTE risks of various hormone formulations
January 1st 2005Women who use oral contraceptives (OC) or hormone replacement therapy (HRT) have a two- to sixfold increased risk of a venous thromboembolic event (VTE) compared with nonusers, according to a recent review of available data. Users of OCs containing desogestrel or gestodene, as opposed to levonorgestrel, are at slightly higher risk. And users of OCs or HRT who carry an inherited hypercoaguable state are at exponentially higher risk.
Might MRI save lives in women at high risk for breast Ca?
January 1st 2005In women who carry BRCA1 or BRCA2 mutations, MRI is more sensitive for detecting breast cancers than mammography, ultrasound, or clinical breast exam (CBE) alone, but whether this translates into reduced mortality is still unknown. This is according to the results of a surveillance study involving 236 Canadian women between the ages of 25 and 65.
A new SERM relieves vaginal atrophy
January 1st 2005Lasofoxifene is the first selective estrogen receptor modulator (SERM) to help vaginal atrophy, says a multicenter trial presented at the 15th Annual Meeting of the North American Menopause Society (NAMS). Investigators found the drug reduced dryness with few side effects.
Celiac disease: not as rare as previously thought
January 1st 2005Celiac disease-once believed to be rare-actually affects up to 1% of the US population. So underdiagnosed is the problem that the National Institutes of Health convened a consensus panel, which recently announced recommendations for appropriate diagnosis and management of the disease.
Why mammography sometimes misses the mark
January 1st 2005The sensitivity and specificity of screening mammography is lower in women taking hormone replacement therapy (HRT), those who have had breast surgery, and those who are thin, according to results from a sample of women from the Million Women Study.
Cesarean delivery (Part 3): Is it time to embrace elective procedures?
December 1st 2004In June 2000, I arrived a few minutes late to the American College of Obstetricians and Gynecologists' headquarters for a meeting of the Committee on Obstetric Practice. As Chair, I was used to dealing with political hot potatoes, but that day, I was handed a real sizzler. Earlier that morning, then ACOG president, Benjamin Harer, MD, speaking for himself and not the College, had seemingly endorsed "elective" cesarean deliveries (CD) in an interview with Diane Sawyer on "Good Morning America." After watching an excerpt of the interview in which Dr. Harer debated a non-physician advocate of home VBACs attended by midwives, I was struck by the logic of his arguments and his grace under fire. Yet it fell to my committee to restate ACOG's official position against such surgeries, which we did in a press release
Editorial: Cesarean delivery (Part 2): Managing the logjam
November 1st 2004Last month, I reviewed the factors that have driven the dramatic increase in cesarean delivery (CD) rates over the past several years. This month, I'll review the potential impact of this trend on a "typical" obstetric service. While both staff and physical capacity will be taxed by increased CD rates, I believe that patient safety may also be threatened as a result of the incremental demand on limited obstetrical operating room (OR) availability. I offer several strategies to manage the coming chaos.
Roundtable: The ob/gyn and legal liability: condition critical, Part 1
November 1st 2004It's hard to imagine a more serious crisis than the current legal liability debacle facing American ob/gyns. Dr. Charles Lockwood has gathered the profession's thought leaders to help analyze its complexities and discuss possible solutions.
Grand Rounds: What's the best approach to spontaneous premature ovarian failure?
November 1st 2004Learning that she has what used to be called premature menopause can devastate a woman in her 20s or 30s. Diagnose this mysterious condition without delay, deliver the bad news in person, and provide sensitiveanswers to four basic questions.
How reproductive genetics puts ob/gyns at legal risk
November 1st 2004Using reproductive and genetic technologies to provide prospective parents with information about a future child or to avoid having a child with a genetic abnormality is an emerging field of medicine-one that has its share of legal risks, according to a report entitled "Reproductive Genetics and the Law."