Latest news with #AmericanCollegeofObstetricsandGynecology
Yahoo
2 days ago
- Health
- Yahoo
New guidelines tackle long-standing pain issues with IUD insertion
Pain is a predictable part of the process for many women walking into a reproductive healthcare clinic. That problem now is receiving renewed focus in the wake of a report released May 15 by the American College of Obstetrics and Gynecology. The report compiles recommended pain management techniques for eight of the more common pain-inducing procedures routinely performed in a clinic. These include intrauterine device (IUD) insertion, endometrial and cervical biopsies and hysteroscopies. The advised techniques include local anesthetic options and providing anti-inflammatory drugs. The report details dosages and side effects for each advised treatment. The American College of Obstetrics and Gynecology, or ACOG, is urging clinicians to communicate these options to their patients in a manner that is 'individualized, culturally competent, trauma-informed, and guided by shared decision-making.' Dr. Marie Forgie, an obstetrician and gynecologist performs all of the procedures mentioned in the report through her practice at Aurora Sinai Medical Center in Milwaukee. She said understanding, predicting and managing patient pain during gynecologic procedures has been a recent 'hot topic' for the field. 'There's been limited or conflicting evidence about different pain control options, and that information has been scattered across different publications,' Forgie said. 'Having this guidance will make clear all the options that we know could potentially work.' The report emphasizes how systemic racism and gender bias in medicine has historically affected the kind and quantity of pain control options offered to patients, with Black patients receiving less attention to their pain than White patients, and women's pain garnering less concern than that of men. In August 2024, the Center for Disease Control updated its own advice on pain management for IUD insertion, recommending topical numbing creams and paracervical block injections — both lidocaine-based local anesthetics, as potentially 'useful' for reducing patient pain. The CDC's updated guidelines also urged doctors to counsel their patients on pain management before they undergo the procedure to insert the contraceptive device. Dr. Allison Linton, Planned Parenthood of Wisconsin's chief medical officer, noted that pain is difficult to study because it is subjective, and can vary patient to patient. 'Our field of reproductive health has realized for a long time that even though IUDs are a very effective form of birth control, they can be really uncomfortable to place,' Linton said. 'For quite a long time, we've all been trying to figure out how we best support patients while making sure that we are keeping them as comfortable as possible and certainly not creating more trauma in an area that historically has had a lot of trauma for a lot of patients.' Linton's routine pain management protocol has focused on giving patients 'realistic expectations' of how IUD insertions and other procedures might feel, and helping patients cope with anxiety about upcoming procedures, sometimes by offering them a pre-procedure visit to talk through pain management options. In the past one to two years, Linton said, Planned Parenthood of Wisconsin clinicians have also started offering paracervical blocks to IUD insertion patients — one of the local anesthetics recommended by the recent CDC and ACOG recommendations. Dr. Laura Jacques, an associate professor in the University of Wisconsin's obstetrics and gynecology department, recalled she has offered local anesthesia for in-office procedures since 2017 at least. 'ACOG is the standard-setting body for our field, so their new guidance will undoubtedly have broad influence on OB-GYN practice,' Jacques wrote. 'While it doesn't change my individual practice, or our practice at UW, it helps promote patient-centered care across the field.' This article originally appeared on Milwaukee Journal Sentinel: Wisconsin OB-GYNs cheer new IUD insertion pain management guidance
Yahoo
07-05-2025
- Health
- Yahoo
Why There *Still* Isn't a Routine Screening Exam for Ovarian Cancer
While not as common as other cancers, ovarian cancer is one of the leading causes of cancer deaths among women. It's particularly deadly because, in most cases, by the time it's detected, it's already reached stage III or IV. Currently, there are no reliable and accessible screening tools to catch this relatively rare form of cancer before it spreads. 'We don't have the equivalent of a pap smear or mammogram or colonoscopy,' Deborah Armstrong, MD, a professor at Johns Hopkins who specializes in treating ovarian cancer, tells us. 'It's a huge issue.' But researchers are developing new early detection tools and treatment options, Dr. Armstrong says. In honor of World Ovarian Cancer Day, we spoke to Dr. Armstrong about the latest advancements in ovarian cancer research and the breakthrough she says could be 'paradigm-shifting' when it comes to combating the disease. Ovarian cancer is notoriously difficult to detect. Why is that? Dr. Armstrong: When cancer develops in the fallopian tube [where ovarian cancer often begins], which is a very thin-walled organ, it doesn't form a mass. The cells just float off; some of them may land on the ovary, but they can also get into the peritoneal cavity — the space in the abdomen that contains the intestines, stomach, and liver. So there's no mass to cause symptoms for a patient or be easily detected via physical exam or ultrasound. And often, by the time it's diagnosed, because of the nature of how these cells tend to drift off, the disease is already disseminated. Are there new early screening methods that are being developed? Some research has looked at how to repurpose pap smears. For those tests, mostly cervical cells are collected, but sometimes cells are taken from the endometrium, ovaries, and fallopian tubes. Researchers are trying to determine if those cells can be examined and checked for abnormalities. It's like trying to find a needle in a haystack within a pap smear. There's another thing called the falloposcope, which is a scope that travels up the fallopian tubes. Currently, there are a lot of issues with using an instrument like this because it can incite an inflammatory response and potentially affect fertility, so it's nowhere near ready for primetime. Can you discuss some of the important developments in ovarian cancer research? The biggest thing is the discovery that most ovarian cancers actually begin in the fallopian tube. That's important because we used to recommend that women who are at elevated risk have their ovaries removed, which causes abrupt menopause and comes with a lot of medical consequences. However, removing the fallopian tubes doesn't trigger those hormonal changes. So the American College of Obstetrics and Gynecology now recommends what's called the opportunistic salpingectomy, or the removal of the fallopian tubes during another pelvic surgery. So if a woman's having a gallbladder surgery or hernia operation, it's recommended that if they're done with childbearing, they have their tubes removed at the same time to reduce their risk. Can you discuss some of the risk factors for ovarian cancer? One is the number of ovulations a woman has over her lifetime. We know that when an egg is ejected from the ovary, an injury to the surface of the ovary and potentially the fallopian tube occurs. That's why both pregnancy and birth control use, which suppresses ovulation, are associated with decreased risk. There's also the issue of talc, or baby powder. When it's regularly applied to the genital area, fibers from that substance have been shown to ascend through the genital tract. The effect is kind of similar to what we see in steel workers, who are exposed to asbestos and are regularly breathing it in and, because of that, can develop mesothelioma. It's a similar carcinogenic effect. What are some of the new treatments on the horizon? There's a whole family of drugs called antibody-drug conjugates (ADC) used for ovarian and other cancers. These are designed to specifically target and kill tumor cells, unlike chemotherapy, which can also indiscriminately kill off normal cells. One that's FDA approved is Rituximab, which targets the folate receptor alpha, which is overly expressed in ovarian cancers. Another ADC targets HER2, which is well-known in the breast cancer space because about 20 percent of those tumors over-express this protein. HER2 therapies have been used to treat breast cancer for a while, but recent studies have found that endometrial, cervical, and ovarian cancers were also responsive to these drugs. This interview has been edited and condensed for clarity. The post Why There *Still* Isn't a Routine Screening Exam for Ovarian Cancer appeared first on Katie Couric Media.
Yahoo
05-02-2025
- Health
- Yahoo
Baby Olivia Act passes committee and heads to full house, aiming to show fetal development in public schools
LITTLE ROCK, Ark. – A bill aiming to show a fetal development video in public schools passed in the House Education Committee on Tuesday, aiming to create the Baby Olivia Act. Representative Mary Bentley, the bill's sponsor says the bill wants to include human growth and development discussion in health classrooms for students in public schools and open enrollment public charter schools. 'This story is the growth of Olivia, as she progresses from one developmental stage to the next in preparation for her continued life outside of the womb,' Bentley said. 'Under learns in the fifth grade we started teaching a health class, in health class, they'll have a 3-minute video every year.' Bill filed to show Baby Olivia gestation video in Arkansas health classrooms The Baby Olivia video is made by live-action a pro-life organization, a point of contention in the meeting. Kristin Stuart spoke against the bill. 'Education should be based on medically accurate, peer-reviewed information not politically charged materials designed to manipulate student's emotions,' Stuart said. Jimmie Cavin spoke for the bill. 'This bill requires discussion and instruction into the biological process of human development inside the womb, it's not indoctrination, it's biology,' Cavin said. Pro-Life supporters march to the Capitol for the 47th annual March for Life Representative Bentley says the students won't see the name 'live-action.' The next debate was about the medical accuracy of the video. Bentley says this was created by Doctors. 'Each in every word and every image have the backing of experts in embryonic and fetal development,' Bentley said. Yet, Representative Denise Garner says that the American College of Obstetrics and Gynecology, says the video is inaccurate. 'Folks that set the standard for medical care for women's health have said this bill is medically inaccurate,' Garner said. Pro-life, pro-choice leaders in Arkansas react to Supreme Court ruling on abortion pills Also, Representative Bentley was asked if parents could pull their children out and not have them view the video. She said there is nothing in the bill that prevents a parent from doing that. The bill will now head to the full house. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
