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Gynecology

• Editor's Note
• List of Articles

List of Articles

• Contraception and New Millennium
  The new millennium has brought optimism to the field of family planning. Recent research and modification to existing contraceptive products have generated confidence, among both healthcare professionals and the public, in the safety, efficacy, and importance of contraceptives. According to World Health Organization’s (WHO's) statistics there are an estimated 200 million pregnancies around the world each year, and one third of these, or 75 million, are unwanted. These pregnancies contribute to women's health problems in two ways. First, unwanted pregnancy can threaten women's health or well being because she may have existing health problems or lack of support and resources, which she needs to have a healthy pregnancy and raise a healthy child.
  
  
• Dysfunctional Uterine Bleeding
  Dysfunctional uterine bleeding (DUB) is abnormal bleeding from the uterine endometrium that is unrelated to an anatomic lesion of the uterus. The purpose of this document is to provide management guidelines for the treatment of patients with menstrual irregularities associated with anovulation based on the best available evidence. Dysfunctional uterine bleeding anovulatory type is the most common form of non-cyclic uterine bleeding and it is a condition for which women frequently seek gynecologic care and accounts for considerable patient anxiety and inconvenience. The choice of treatment for anovulatory bleeding depends on several factors, including the woman's age, the severity of her bleeding, and her desire for fertility. Over the last decade, significant advances have been made in the evaluation and management of women with anovulatory bleeding.
  
  
• 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.
  
  

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