Women's Health and Education Center (WHEC)


List of Articles

  • Hysteroscopic Sterilization
    Transvaginal approaches to sterilization involve gaining access to the fallopian tubes through the cervix. A device or occlusive material is then placed hysteroscopically or blindly block each tube. The purpose of this document is to review hysteroscopic sterilization. Past, current, and upcoming techniques are reviewed to determine how they measure up to tubal ligation. Although sterilization is intended to be permanent, expressions of regret and requests for reversal are not uncommon and are much likely to occur among women sterilized at young ages. The availability and use of contraception have contributed greatly to women's health. The emphasis will be on the safety and effectiveness of hysteroscopic sterilization as compared with the alternatives.

  • Medical Disorders and Contraception
    Decisions regarding contraception for women with coexisting medical problems may be complicated. In some cases, medications taken for certain chronic conditions may alter the effectiveness of hormonal contraception, and pregnancy in these cases may pose substantial risks to the mother as well as her fetus. In addition, differences in content and delivery methods of hormonal contraceptives may affect patients with certain conditions differently. When selecting one of the many effective contraceptive methods available, healthcare providers and women need to consider each method's risk/benefit profile relative to the specific underlying illness. The purpose of this document is to provide information to help healthcare providers and women with coexisting medical conditions make sound decisions regarding the selection and appropriateness of various hormonal contraceptives and facilitate use of contraceptive choices that do not exacerbate medical problems. Addressed in this document are; to recognize that increased risks are associated with pregnancy in women with various medical conditions and evaluate evidence-based risks and benefits of use of intrauterine devices (IUDs) in women with various medical conditions.

  • Robotic Gynecologic Surgery
    Minimally invasive surgical techniques for performing hysterectomies and other gynecologic surgeries have been shown to reduce patient morbidity and shorten hospital stay. The purpose of this document is to review the recent adoption, experience, and applications of robot-assisted laparoscopy in gynecologic surgery. It will likely continue to develop as more gynecologic surgeons are trained and more patients seek minimally invasive surgical options. Well-designed, prospective studies with well-defined clinical, long-term outcomes, including complications, cost, pain, return to normal activity, and quality of life, are needed to fully assess the value of this new technology. Surgical innovation is necessary. There are ethical and societal issues that remain incompletely understood about the use of robotic surgery.

  • Contraception: Depot Medroxyprogesterone Acetate
    An unintended pregnancy represents a lost opportunity for preconceptional care for the fetus and a higher risk of pregnancy-related morbidity in the mother. Unintended pregnancies have been also associated with higher rates of unhealthy behaviors, such as smoking or alcohol use, and the lower rates of prenatal vitamin use, which increase the risk of low-birth weight infants and other adverse pregnancy outcomes. A woman's use of her contraceptive method is affected by features of the method itself (dosing frequency, ease of use, cost and availability) as well as by her perceptions about the method. The purpose of this document is to describe advantages and disadvantages of depot medroxyprogesterone acetate (DMPA) use by individual adolescent and adult women. It also evaluates evidence regarding short- and long-term effects of DMPA on skeletal health. Counseling of all reproductive-age women, about the importance of maintaining a healthy lifestyle to minimize risks of osteoporotic fractures later in life, is essential. The review utilizes an evidence-based approach to the recently approved black box changes in DMPA product labeling.

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