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Gynecology

• Editor's Note
• List of Articles

List of Articles

• Menopause: Managing Mood, Memory and Female Sexual Dysfunctions
  The review describes the diagnostic criteria, helpful screening tools, and initial treatment guidelines in order to better equip the obstetricians and gynecologists to manage these patients with depressive episodes, memory loss, Alzheimer’s disease and female sexual dysfunctions. Sexual concerns should be addressed routinely as part of all comprehensive women’s health visits. Gynecologists are often the first health care provider a woman turns to when seeking help for sexual problems. It is important to provide a safe and non-judgmental environment that facilitates discussion of these issues. Patients and their clinicians can be reassured that for the majority of women, cognitive function is not likely to worsen in postmenopause in any pattern other than that expected with normal aging. Although it not likely that in postmenopause, a woman’s cognitive function will return to what it was premenopause, she may adapt to and compensate for the symptoms with time. Stimulant medication may have a role in the treatment of subjective cognitive impairment, particularly for women with comorbid fatigue or impaired concentration who are not showing evidence of objective impairment. There is some evidence that modifying lifestyle factors can decrease the risk of dementia and even cognitive decline associated with normal aging. It is hoped that the continued research into the causes of Alzheimer’s disease will provide some of the necessary information about the prevention and treatment of this relentless and socially damaging disease.
  
  
• Bone Health: Osteoporosis Prevention Strategies
  Osteoporosis is an important health problem affecting mature women. Americans with osteoporosis or with low bone mass, approximately 80% are women. Osteoporosis-related fractures will occur in more than 40% of women over the age of 50. Hip fractures will occur in more than 40% of women over the age of 50. An estimated 1.3 to 1.5 million fractures occurring annually are attributed to osteoporosis, accounts for about 15% of the total. Within 1 year after a hip fracture, up to 20% of the victims will die, 25% of the survivors will be confined to long-term care facilities, and 50% will experience long-term loss of mobility. Spinal fractures can be associated with pain, loss of height, and deformities. Osteoporosis also is associated with tooth loss and the resorption of alveolar ridge. Obstetricians and gynecologists play a major role in the prevention, diagnosis, and treatment of osteoporosis as outlined in this document. It is intended as an educational tool that presents current information.
  
  
• Clinical Management of Endometriosis
  Endometriosis is a chronic and recurrent reproductive disorder with variable clinical presentations. Management varies depending on the patient’s age, symptoms, extent of the disease, reproductive goals, treatment risks, side effects, and cost considerations. The purpose of this document is to review the agents used in the medical management of endometriosis and discuss the use of assisted reproduction technique (ART) for patients with endometriosis who desire pregnancy. The etiology, the relationship between the extent of disease and the degree of symptoms, the effect on fertility, and the most appropriate treatment of endometriosis remain incomplete. This review also presents the evidence, including risks and benefits, for the effectiveness of medical and surgical therapy for adult women who are symptomatic with pelvic pain or infertility or both. The latest approaches using the variety of available medical and surgical treatments are discussed as they specifically relate to the adolescent population. Endometriosis is a relatively common chronic gynecologic disorder that usually presents with chronic pelvic pain or infertility. The societal effect of this disorder is enormous both in monetary costs and in quality of life.
  
  
• Vaccines & Immunizations (PDF)
  The Advisory Committee on Immunization Practices (ACIP) recently issued the 2011 Recommended Adult Immunization Schedule. The schedule includes a recommendation in effect as of December 21, 2010. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Considerations should include provider assessment, patient preference, and the potential for adverse events. Each schedule must be read with foot-notes regarding dosage and other important information, which can be found at the CDC website (link has been provided). The language in several foot-notes is changed to clarify previous wording.
  
  

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