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Women's Health and Education Center (WHEC)

Gynecology

List of Articles

  • Premenstrual Disorders
    Premenstrual physical and mood symptoms are common among reproductive-age women, but diagnostic criteria and treatment strategies to recognize premenstrual disorders are not always clearly understood. The purpose of this document to examine the evidence for commonly used approaches in the treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Until recently, the difficulty in managing PMS / PMDD was largely attributed to imprecise diagnostic criteria, poorly designed clinical trials, and promotion of treatment options for which there was no scientific support. In the mid-1980s, however, rigorous criteria for the diagnosis of PMS / PMDD were defined. Since then, most studies of pathophysiology and treatment have met recognized standards of scientific design. Selective serotonin reuptake inhibitors (SSRIs) are found to be effective in treating PMS / PMDD symptoms and many other treatment options are discussed.

  • Vulvodynia
    Vulvovaginal disorders are increasingly recognized as a source of significant pain and discomfort and lead to a substantial decrease in quality of life for many women. The purpose of this document is to discuss signs, symptoms and management of vulvodynia. Provoked vestibulodynia, formerly referred to as vulvar vestibulitis syndrome, is suspected to be the most frequent type of vulvodynia in premenopausal women. In addition to disrupting sexual functioning, there is preliminary evidence to suggest that this pain problem can adversely affect general psychological well-being and overall quality of life. Despite its high prevalence and associated negative sequelae, there is a dearth of controlled treatment outcome studies focusing on vulvodynia. Although there are now several published studies evaluating different treatment approaches for vestibulodynia, there are only a handful of randomized trials, resulting in a hodgepodge of interventions for which there is little empirical support. Thus, current guidelines and recommendations are largely based on clinical observations and uncontrolled data rather than being anchored in findings from rigorous studies.

  • Obesity In The United States
    Obesity has in fact become so prevalent that the World Health Organization (WHO) has classified it as a global epidemic. The past two decades in particular have seen an explosion of the rates of obesity, especially in the United States. The economic, social and psychological burden of obesity on the individual and on society will continue to grow until the factors contributing to the increasing rates of obesity over the past two decades are identified and addressed. Though this article has focused on how an individual can approach obesity, society needs to develop a plan of action. Encouraging physical activity programs in schools and communities for children, developing cheap, healthful alternatives to fast food, providing better social and psychological support to those struggling with chaotic lifestyles, and redefining work load and the workplace so they are more compatible with maintaining healthy, balanced personal lives may be some strategies to consider.

  • Polycystic Ovary Syndrome
    Polycystic ovary syndrome (PCOS) is a condition of unexplained chronic anovulation state. The purpose of this document is to enhance understanding of the best available evidence on the diagnosis and clinical management of polycystic ovary syndrome (PCOS). A question which has puzzled gynecologists and endocrinologists for many years is what causes polycystic ovaries. The characteristic polycystic ovary emerges when a state of anovulation persists for any length of time. Whether diagnosis is by ultrasound or by the traditional clinical and biochemical criteria, a cross-section of anovulatory women at any one point of time will reveal that approximately 75% will have polycystic ovaries. Variety of treatments of PCOS is also discussed in this chapter and the healthcare providers must appreciate the clinical impact of anovulation and should undertake appropriate managements.

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