Pregnancy complications may predict cardiovascular risk By Adrienne D. Zertuche, MD, MPH, FACOG After surviving the nearly year-long prenatal plight with morning sickness, back pain, heartburn and swelling – and then successfully navigating the early postpartum weeks of vaginal bleeding, raw nipples, urinary incontinence and sleeplessness – most women cannot wait to mark ... Continue Reading
Contraception for the Medically Complex Patient
It is estimated that 84.6% of women between the ages of 18 and 49 years old are at risk for unintended pregnancy in the state of Georgia12. As the obesity epidemic continues to drive an increase in chronic disease, the percentage of women at risk for pregnancy-related adverse events is on the rise9. Now more than ever, there is a call to action to promote and optimize health ... Continue Reading
Addressing Menopause Symptoms
It is time to take another look at hormone replacement therapy. It is time to reconsider hormone therapy use. With the publication of the Women’s Health Initiative (WHI) in 2001, many women were taken off hormone replacement therapy abruptly. These women then came in with complaints of hot flashes, mood changes and vaginal dryness. These symptoms interfered with their ... Continue Reading
Depression: Throughout the Female Lifespan
Detection, prevention and treatment of depression. Depression in women is more prevalent than in men, and there are specific times in a patient’s life that make them more vulnerable: during adolescence, pregnancy, postpartum and menopausal transition. Screening for depression during these sensitive times in our patients’ lives is the key to the prevention of morbidity and ... Continue Reading
Colorectal Cancer in Women: Challenges and Opportunities
Colorectal cancer (CRC) remains a major health challenge in the United States and throughout the developed world. Eminently preventable and treatable in most situations, the successful management of CRC as a public health problem requires a comprehensive strategy of risk assessment, prevention, early detection, effective treatment, awareness and, most importantly, access to ... Continue Reading
Nutrition and Infertility: Trends and Interventions
By Lauren Manaker, MS, RDN, LD, CLEC
In the United States, an average of 10 percent of people of reproductive age have experienced infertility challenges, regardless of gender.1 Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse†according to the World Health Organization.2 In 2018, the ... Continue Reading
The Impact of Nutrition on Endometriosis and Reproductive Health
By Pavan K. Ananth, M.D., MPH, and Ceana H. Nezhat, M.D.
Endometriosis affects one in eight women and can have devastating effects. It impacts all age groups with varying consequences and is not restricted to the reproductive tract. Severe endometriosis can cause bowel obstruction or perforation, ureteral stricture, renal failure and hemothorax, not to mention debilitating pain. Despite these serious, and sometimes ... Continue Reading
Fertility Treatment for the PCOS Patient
By Kathryn Calhoun, M.D.
Chronic anovulation is a hallmark of Polycystic Ovary Syndrome (PCOS), so the vast majority of women with PCOS will require fertility treatment to conceive. In a young PCOS patient with no obvious barriers to conception (other than anovulation), it is reasonable to start ovulation induction medicines before evaluating her uterus/tubes or her partner's semen analysis. If the ... Continue Reading
History of Surgery in Pregnancy
By Sarah McClellan, MPH, and Ceana Nezhat, M.D. Historically, pregnancy has been a time of joy and apprehension. During the Renaissance, women would write out their wills as soon as they became pregnant.2 History, in fact, is full of maternal death. Thomas Jefferson lost his wife following childbirth in 1782. Princess Charlotte of Wales, granddaughter of King George III and ... Continue Reading
Managing Diabetes Mellitus During Non-Obstetric Surgery in Pregnancy
By Iris Krishna, M.D., MPH One of the more commonly encountered medical complications in pregnancy is diabetes mellitus. Diabetes mellitus in pregnancy is characterized as pregestational or gestational diabetes. Pregestational diabetes is diagnosed prior to pregnancy and affects approximately 1 percent of pregnancies, while gestational diabetes is diagnosed during pregnancy ... Continue Reading
Anesthesia for Surgery in Pregnant Patients
By Laura E Gilbertson, M.D., Milad Sharifpour, M.D., and Grant C Lynde, M.D. More than 75,000 pregnant patients undergo non-obstetric surgery in the United States each year. Fortunately, good preparation and planning can lead to good outcomes for both mother and child. Finding physicians and hospitals with experience in caring for parturients with comorbid conditions is ... Continue Reading
Polycystic Ovary Syndrome – A Simplified Approach to Diagnosis
By Jennifer F. Kawwass, MD and Heather S. Hipp, MD
Polycystic Ovary Syndrome, or PCOS, the enigmatic syndrome ascribed to infertile, overweight females with irregular menstrual cycles, may be simpler to understand than it seems. The syndrome can be confusing: no clear linear causal pathway has been elucidated, and many endocrine axes interact to accentuate the classical physical manifestations. In addition, it is a broad ... Continue Reading
Sexually Transmitted Infections and Fertility
By Kalinda D. Woods, M.D. Those of us who study science may remember sitting in an introductory general biology lecture hall at some point in our academic past. An esteemed lecturer after formal introduction and orientation to the course may have opened the semester of study by insisting students internalize a single concept to begin to study biology: life persists. The ... Continue Reading
Gynecology Spotlight
By Helen K. Kelley Atlanta Medicine recently spoke with some Atlanta-area gynecologists to learn about new effective surgical techniques, comparisons of surgeries in terms of costs and advantages, and how conversations about family planning and contraception choices are reducing the number of unintended pregnancies among their patients. New tissue removal techniques for ... Continue Reading
Current Management of Twin Gestation
By Tossy Fogle, M.D. The twin birth rate hit a new high in 2014 at 33.9 twins per 1,000 births.1 This has been attributed to an older maternal age at conception, which naturally increases the rate of twinning, and an increased use of assisted reproductive technology. The triplet and higher-order multiple birth rate peaked in 1998 at 193.5 births per 100,000 births. Since ... Continue Reading
