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Diagnosis and Treatment of Polycystic Ovary Syndrome - American Family Physician

Jul 15, 2016 - Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. Although the pathophysiology of the syndrome is complex and there is no single defect from which it is known to result, it is ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p106.html

Vaginitis: Diagnosis and Treatment - American Family Physician

Mar 1, 2018 - Vaginitis is defined as any condition with symptoms of abnormal vaginal discharge, odor, irritation, itching, or burning. The most common causes of vaginitis are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. Bacterial vaginosis is implicated in 40% to 50% of cases ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0301/p321.html

Abnormal Uterine Bleeding in Premenopausal Women - American Family Physician

Apr 1, 2019 - Abnormal uterine bleeding is a common symptom in women. The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p435.html

Uterine Fibroids: Diagnosis and Treatment - American Family Physician

Jan 15, 2017 - Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. Fibroids can cause abnormal uterine bleeding, pelvic pressure, bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p100.html

Amenorrhea: A Systematic Approach to Diagnosis and Management - American Family Physician

Jul 1, 2019 - Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p39.html

Bartholin Duct Cyst and Gland Abscess: Office Management - American Family Physician

Jun 15, 2019 - The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland does not affect lubrication. Ductal blockage of these typically pea-sized structures can result in enlargement of the ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p760.html

Common Breast Problems - American Family Physician

Apr 15, 2019 - Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p505.html

Family Planning and Contraception - American Family Physician

May 15, 2020 - This collection features AFP content on family planning and contraception, including emergency contraception, hormonal and non-hormonal contraception, infertility, in vitro fertilization, intrauterine devices, preconception care, tubal sterilization, and vasectomy. This collection ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=71

Urinary Incontinence in Women: Evaluation and Management - American Family Physician

Sep 15, 2019 - Urinary incontinence is a common problem among women worldwide, resulting in a substantial economic burden and decreased quality of life. The Women’s Preventive Services Initiative is the only major organization that recommends annual screening for urinary incontinence in all women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p339.html

Cervical Colposcopy: Indications and Risk Assessment - American Family Physician Restricted content. Login required.

Jul 1, 2020 - The practice of colposcopy, a diagnostic procedure to evaluate for vaginal, vulvar, and cervical dysplasia, has evolved to incorporate patient risk factors for high-grade cervical intraepithelial neoplasia (CIN) and cancer. Changes in cervical cancer screening and guidelines, human ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p39.html

Sexually Transmitted Infections - American Family Physician

Jul 15, 2020 - This collection features AFP content on sexually transmitted disease and related issues, including chlamydia, genital herpes, gonorrhea, human papillomavirus, and syphilis. This collection features AFP content on sexually transmitted disease and related issues, including chlamydia, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=23

Amenorrhea: An Approach to Diagnosis and Management - American Family Physician

Jun 1, 2013 - Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p781.html

Ectopic Pregnancy: Diagnosis and Management - American Family Physician Restricted content. Login required.

May 15, 2020 - Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic...

American Family Physician : Article

https://www.aafp.org/afp/2020/0515/p599.html

Menstrual Disorders - American Family Physician

Aug 1, 2020 - This collection features AFP content on menstrual conditions and related issues, including abnormal uterine bleeding, amenorrhea, dysmenorrhea, endometrial ablation, endometriosis, heavy menstrual bleeding, menorrhagia, premenstrual dysphoric disorder, premenstrual syndrome, and uterine...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=81

Cervical Cancer Screening - American Family Physician

Apr 1, 2018 - Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions (cervical intraepithelial neoplasias) and cervical carcinomas are strongly associated with sexually-transmitted high-risk human papillomavirus (HPV) infection, which causes ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p441.html

Hormone Therapy and Other Treatments for Symptoms of Menopause - American Family Physician

Dec 1, 2016 - The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1201/p884.html

Endometrial Biopsy: Tips and Pitfalls - American Family Physician Restricted content. Login required.

May 1, 2020 - Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p551.html

Premenstrual Syndrome and Premenstrual Dysphoric Disorder - American Family Physician

Aug 1, 2016 - Premenstrual disorders affect up to 12% of women. The subspecialties of psychiatry and gynecology have developed overlapping but distinct diagnoses that qualify as a premenstrual disorder; these include premenstrual syndrome and premenstrual dysphoric disorder. These conditions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p236.html

Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention - American Family ...

Sep 15, 2019 - Pelvic inflammatory disease (PID) is an infection of the upper genital tract occurring predominantly in sexually active young women. Chlamydia trachomatis and Neisseria gonorrhoeae are common causes; however, other cervical, enteric, bacterial vaginosis–associated, and respiratory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p357.html

Postpartum Care: An Approach to the Fourth Trimester - American Family Physician

Oct 15, 2019 - The postpartum period, defined as the 12 weeks after delivery, is an important time for a new mother and her family and can be considered a fourth trimester. Outpatient postpartum care should be initiated within three weeks after delivery in person or by phone, and may require multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1015/p485.html

Pelvic Organ Prolapse - American Family Physician

Aug 1, 2017 - Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p179.html

Breastfeeding: Common Questions and Answers - American Family Physician

Sep 15, 2018 - All major health organizations recommend breastfeeding as the optimal source of infant nutrition, with exclusive breastfeeding recommended for the first six months of life. After six months, complementary foods may be introduced. Most organizations recommend breastfeeding for at least ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p368.html

Diagnosis and Initial Management of Dysmenorrhea - American Family Physician

Mar 1, 2014 - Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients’ quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p341.html

Primary Care of Breast Cancer Survivors - American Family Physician

Mar 15, 2019 - With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p370.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Cervical Cancer: Evaluation and Management - American Family Physician

Apr 1, 2018 - Human papillomavirus infection is the precursor for the development of cervical cancer and is detectable in 99.7% of squamous cell carcinoma and adenocarcinoma cases. Early detection of precancerous lesions with Papanicolaou testing remains the primary mechanism for cancer prevention. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p449.html

Breast Disorders - American Family Physician

Apr 15, 2019 - This collection features content on breast disorders and related issues, including breast cyst aspiration, breast masses, breast pain, galactorrhea, gynecomastia, and mastitis. This collection features content on breast disorders and related issues, including breast cyst aspiration, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=96

Evaluation and Treatment of Infertility - American Family Physician

Mar 1, 2015 - Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0301/p308.html

Long-Acting Reversible Contraception: Difficult Insertions and Removals - American ...

Sep 1, 2018 - The use of long-acting reversible contraception is on the rise across the United States and has contributed to a decrease in teen pregnancies. With the increased use of long-acting reversible contraception, physicians may encounter difficult insertions and removals of intrauterine ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0901/p304.html

Diagnosis and Management of Genital Ulcers - American Family Physician

Feb 1, 2012 - Herpes simplex virus infection and syphilis are the most common causes of genital ulcers in the United States. Other infectious causes include chancroid, lymphogranuloma venereum, granuloma inguinale (donovanosis), secondary bacterial infections, and fungi. Noninfectious etiologies, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0201/p254.html

Chronic Pelvic Pain in Women - American Family Physician

Mar 1, 2016 - Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p380.html

Diagnosis and Management of Endometrial Cancer - American Family Physician

Mar 15, 2016 - Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p468.html

Diagnosis and Management of Ovarian Cancer - American Family Physician

Jun 1, 2016 - Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p937.html

Evaluation and Management of Abnormal Uterine Bleeding in Premenopausal Women - ...

Jan 1, 2012 - Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0101/p35.html

Vaginitis: Diagnosis and Treatment - American Family Physician

Apr 1, 2011 - Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Bacterial vaginosis occurs when the normal lactobacilli of the vagina are replaced by mostly anaerobic bacteria. Diagnosis is commonly made using the Amsel criteria, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0401/p807.html

Common Questions About the Evaluation of Acute Pelvic Pain - American Family Physician

Jan 1, 2016 - Acute pelvic pain is defined as lower abdominal or pelvic pain of less than three months’ duration. It is a common presentation in primary care. Evaluation can be challenging because of a broad differential diagnosis and because many associated signs and symptoms are nonspecific. The ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p41.html

Dyspareunia in Women - American Family Physician

Oct 1, 2014 - Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. Dyspareunia can have a significant impact on a woman’s mental and physical health, body image, relationships with ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1001/p465.html

Provision of Contraception: Key Recommendations from the CDC - American Family Physician

May 1, 2015 - The Centers for Disease Control and Prevention has released comprehensive recommendations for provision of family planning services. Contraceptive services may be addressed in five steps, and counseling may be provided in a tiered approach, whereby the most effective options are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p625.html

Sexual Dysfunction in Women: A Practical Approach - American Family Physician

Aug 15, 2015 - Sexual dysfunction in women is a common and often distressing problem that has a negative impact on quality of life and medication compliance. The problem is often multifactorial, necessitating a multidisciplinary evaluation and treatment approach that addresses biological, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0815/p281.html

Preventing Gaps When Switching Contraceptives - American Family Physician

Mar 1, 2011 - Unintended pregnancy can occur when women stop one birth control method before starting another. To prevent gaps in contraception, physicians should ask women regularly about adverse effects, cost, difficulty remembering the next dose, and other issues that affect adherence. Women who ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0301/p567.html

Diagnosis and Management of Ectopic Pregnancy - American Family Physician

Jul 1, 2014 - Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p34.html

Natural Family Planning - American Family Physician

Nov 15, 2012 - Natural family planning methods provide a unique option for committed couples. Advantages include the lack of medical adverse effects and the opportunity for participants to learn about reproduction. Modern methods of natural family planning involve observation of biologic markers to ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1115/p924.html

Pelvic Inflammatory Disease - American Family Physician

Apr 15, 2012 - Pelvic inflammatory disease is a polymicrobial infection of the upper genital tract. It primarily affects young, sexually active women. The diagnosis is made clinically; no single test or study is sensitive or specific enough for a definitive diagnosis. Pelvic inflammatory disease ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0415/p791.html

Managing Adverse Effects of Hormonal Contraceptives - American Family Physician

Dec 15, 2010 - Adverse effects of hormonal contraceptives usually diminish with continued use of the same method. Often, physi- cians only need to reassure patients that these symptoms will likely resolve within three to five months. Long-acting injectable depot medroxyprogesterone acetate is the only...

American Family Physician : Article

https://www.aafp.org/afp/2010/1215/p1499.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Oct 15, 2009 - Adnexal masses represent a spectrum of conditions from gynecologic and nongynecologic sources. They may be benign or malignant. The initial detection and evaluation of an adnexal mass requires a high index of suspicion, a thorough history and physical examination, and careful attention ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1015/p815.html

Options for Women with Unintended Pregnancy - American Family Physician

Apr 15, 2015 - Unintended pregnancy refers to unwanted, unplanned, or mistimed pregnancies. One-half of all pregnancies in the United States are unintended, and family physicians are often asked to provide counseling, support, and resources for women with unintended pregnancies. Options include ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p544.html

Evaluation of Acute Pelvic Pain in Women - American Family Physician

Jul 15, 2010 - Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p141.html

Intrauterine Devices: An Update - American Family Physician

Mar 15, 2014 - Three intrauterine devices (IUDs) are available in the United States: the copper T 380A and two levonorgestrel-releasing IUDs, one that releases 20 mcg of levonorgestrel per 24 hours, and one that releases 14 mcg per 24 hours. All are safe and effective methods of contraception that ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0315/p445.html

Gynecologic Procedures: Colposcopy, Treatments of Cervical Intraepithelial Neoplasia, ...

Jun 15, 2013 - Women who have abnormal Papanicolaou test results may undergo colposcopy to determine the biopsy site for histologic evaluation. Traditional grading systems do not accurately assess lesion severity because colposcopic impression alone is unreliable for diagnosis. The likelihood of ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0615/p836.html

Recommendations for Preconception Counseling and Care - American Family Physician

Oct 15, 2013 - Given that nearly one-half of pregnancies are unintended, preconception care should be considered an integral part of primary care for women of reproductive age. Common issues in preconception care include family planning, achieving a healthy body weight, screening and treatment for ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1015/p499.html

Evaluation and Treatment of Endometriosis - American Family Physician

Jan 15, 2013 - Endometriosis, which affects up to 10 percent of reproductive-aged women, is the presence of endometrial tissue outside of the uterine cavity. It is more common in women with pelvic pain or infertility (25 to 40 percent and 70 to 90 percent, respectively). Some women with endometriosis ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0115/p107.html

An Update on Emergency Contraception - American Family Physician

Apr 1, 2014 - Emergency contraception decreases the risk of unintended pregnancy after unprotected sexual intercourse or after suspected failure of routine contraception (e.g., a condom breaking). Oral methods include combined contraceptive pills (i.e., Yuzpe method), single- or split-dose ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0401/p545.html

Drug Treatments for Polycystic Ovary Syndrome - American Family Physician

Apr 15, 2009 - Polycystic ovary syndrome is a condition present in approximately 5 to 10 percent of women of childbearing age. Diagnosis can be difficult because the signs and symptoms can be subtle and varied. These may include hirsutism, infertility, menstrual irregularities, and biochemical ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0415/p671.html

Contraception Choices in Women with Underlying Medical Conditions - American Family ...

Sep 15, 2010 - Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0915/p621.html

Pelvic Organ Prolapse - American Family Physician

May 1, 2010 - Pelvic organ prolapse, or genital prolapse, is the descent of one or more of the pelvic structures (bladder, uterus, vagina) from the normal anatomic location toward or through the vaginal opening. Women of all ages may be affected, although pelvic organ prolapse is more common in older...

American Family Physician : Article

https://www.aafp.org/afp/2010/0501/p1111.html

Breast Cancer Screening: ACP Releases Guidance Statements - Practice Guidelines - ... Restricted content. Login required.

Feb 1, 2020 - The American College of Physicians reviewed guidelines from other organizations and developed four statements to provide advice to clinicians about breast cancer screening for women who are at average risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0201/p184.html

Premenstrual Syndrome and Premenstrual Dysphoric Disorder - American Family Physician

Oct 15, 2011 - Premenstrual syndrome is defined as recurrent moderate psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20 to 32 percent of premenopausal women. Women with premenstrual dysphoric disorder experience affective or ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p918.html

Update on ASCCP Consensus Guidelines for Abnormal Cervical Screening Tests and Cervical...

Jul 15, 2009 - New data have emerged since publication of the American Society for Colposcopy and Cervical Pathology's 2001 consensus guidelines for management of abnormal cervical cytology and histology. The 2006 guidelines include recommendations for special populations (i.e., adolescents and ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0715/p147.html

Treatment of Menorrhagia - American Family Physician

Jun 15, 2007 - Menorrhagia is defined as excessive uterine bleeding occurring at regular intervals or prolonged uterine bleeding lasting more than seven days. The classic definition of menorrhagia (i.e., greater than 80 mL of blood loss per cycle) is rarely used clinically. Women describe the loss or ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0615/p1813.html

Human Papillomavirus: Clinical Manifestations and Prevention - American Family Physician

Nov 15, 2010 - Human papillomaviruses cause the most common sexually trans- mitted infection in the world and are responsible for nearly all cases of cervical cancer. Genital human papillomavirus infection can be divided into low-risk infections (causing genital warts) and high-risk infections ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1115/p1209.html

Amenorrhea: Evaluation and Treatment - American Family Physician

Apr 15, 2006 - A thorough history and physical examination as well as laboratory testing can help narrow the differential diagnosis of amenorrhea. In patients with primary amenorrhea, the presence or absence of sexual development should direct the evaluation. Constitutional delay of growth and puberty...

American Family Physician : Article

https://www.aafp.org/afp/2006/0415/p1374.html

Insertion and Removal of Intrauterine Devices - American Family Physician

Jan 1, 2005 - The intrauterine device (IUD) is an effective contraceptive for many women. The copper-releasing IUD can be used for 10 years before replacement and is a good choice for women who cannot, or choose not to, use hormone-releasing contraceptives. However, some women experience an increase ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0101/p95.html

Misoprostol Dosing for First-Trimester Abortion - FPIN's Clinical Inquiries - American ... Restricted content. Login required.

Sep 1, 2020 - Vaginal, oral, and sublingual misoprostol in single doses of 600 to 800 mcg are equally effective for promoting completed abortion in patients with an incomplete first-trimester spontaneous abortion.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0901/od1.html

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: ...

Feb 15, 2020 - The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2020/0215/p233.html

Heavy Menstrual Bleeding in Premenopausal Patients and the Role of NSAIDs - Cochrane ... Restricted content. Login required.

Aug 1, 2020 - NSAIDs are effective for reducing heavy menstrual bleeding in premenopausal patients with menorrhagia when compared with placebo.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0801/p147.html

Management of Bartholin's Duct Cyst and Gland Abscess - American Family Physician

Jul 1, 2003 - Bartholin's duct cysts and gland abscesses are common problems in women of reproductive age. Bartholin's glands are located bilaterally at the posterior introitus and drain through ducts that empty into the vestibule at approximately the 4 o'clock and 8 o'clock positions. These normally...

American Family Physician : Article

https://www.aafp.org/afp/2003/0701/p135.html

Ovarian Cancer: An Overview - American Family Physician

Sep 15, 2009 - Although ovarian cancer may occur at any age, it is more common in patients older than 50 years. Patients often present with nonspecific pelvic or abdominal symptoms. Initial diagnostic tests include transvaginal ultrasonography and serum cancer antigen 125 measurement; however, these ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0915/p609.html

Heavy Menstrual Bleeding in Adolescents: ACOG Management Recommendations - Practice ... Restricted content. Login required.

May 15, 2020 - The American College of Obstetricians and Gynecologists (ACOG) has new recommendations and conclusions about menstrual bleeding disorders in adolescents.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0515/p633.html

Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion -...

Jul 15, 2019 - Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p119.html

Endometrial Cancer - American Family Physician

Nov 15, 2009 - Endometrial cancer is the leading cause of gynecologic cancer in the United States. Etiologically, endometrial carcinoma usually results from unopposed estrogen stimulation of the endometrium, although non-estrogen-related forms occur as well. The most common presentation of endometrial...

American Family Physician : Article

https://www.aafp.org/afp/2009/1115/p1075.html

Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer ... Restricted content. Login required.

Jun 1, 2020 - Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695a.html

Tranexamic Acid for Postpartum Hemorrhage - Medicine by the Numbers - American Family ... Restricted content. Login required.

May 1, 2020 - Postpartum hemorrhage is the most common cause of maternal death worldwide. Tranexamic acid is an antifibrinolytic agent that has shown to decrease bleeding in surgical patients and all-cause death in trauma patients. Does early administration of tranexamic acid reduce the rate of death...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0501/od2.html

Segesterone Acetate and Ethinyl Estradiol Vaginal Ring (Annovera) for Contraception - ... Restricted content. Login required.

May 15, 2020 - Annovera is an effective combined progestin/estrogen contraceptive device that can be used for one year.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0515/p618.html

Integrating Breast Cancer Risk Management into Primary Care - Editorials - American ...

Mar 15, 2020 - It is important that primary care physicians have the ability and resources to identify women eligible for genetic counseling and testing for breast cancer.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0315/p330.html

Non-Neoplastic Epithelial Disorders of the Vulva - American Family Physician

Feb 1, 2008 - Lichen sclerosus, lichen planus, and lichen simplex chronicus are three of the most common non-neoplastic epithelial disorders of the vulva. Lichen sclerosus is characterized by intense vulvar itching and can affect men and women of all ages, but it manifests most commonly in ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0201/p321.html

Medication Use to Reduce Risk of Breast Cancer - Putting Prevention into Practice - ... Restricted content. Login required.

Mar 15, 2020 - E.F., a 40-year-old woman, comes to your office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0315/p373.html

Pain Medications Before IUD Placement - FPIN's Help Desk Answers - American Family ... Restricted content. Login required.

Jan 15, 2020 - Topical lidocaine preparations including gels, creams, and sprays may modestly decrease pain with tenaculum placement but not during IUD insertion.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2020/0115/p119.html

Probiotics to Augment Antifungal Treatment of Vulvovaginal Candidiasis - FPIN's ... Restricted content. Login required.

Apr 1, 2020 - Adding probiotics (typically Lactobacillus species) to antifungal therapy for vulvovaginal candidiasis improves short-term cure rates by 14% and reduces one-month relapse rates by 66%.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0401/p432.html

Medication Use to Reduce Risk of Breast Cancer: Recommendation Statement - U.S. ...

Mar 15, 2020 - The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2020/0315/od1.html

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer - ... Restricted content. Login required.

Feb 15, 2020 - A 31-year-old woman presents to your office for a well-woman examination. She is sexually active in a monogamous relationship and has never been pregnant. She tells you that her mother was diagnosed with tubal cancer at age 40 and that her sister, who is 42 years of age, was recently ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0215/p239.html

Evaluation of Palpable Breast Masses - American Family Physician

May 1, 2005 - Palpable breast masses are common and usually benign, but efficient evaluation and prompt diagnosis are necessary to rule out malignancy. A thorough clinical breast examination, imaging, and tissue sampling are needed for a definitive diagnosis. Fine-needle aspiration is fast, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1731.html

Drug Treatment of Common STDs: Part II. Vaginal Infections, Pelvic Inflammatory Disease...

Oct 15, 1999 - The Centers for Disease Control and Prevention (CDC) released new guidelines for the treatment of sexually transmitted diseases (STDs) in 1998. Several treatment advances have been made since the previous guidelines were published. Part II of this two-part series on STDs describes ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1015/p1716.html

Diagnosis and Management of Ectopic Pregnancy - American Family Physician

Nov 1, 2005 - Ectopic pregnancy is a high-risk condition that occurs in 1.9 percent of reported pregnancies. The condition is the leading cause of pregnancy-related death in the first trimester. If a woman of reproductive age presents with abdominal pain, vaginal bleeding, syncope, or hypotension, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1707.html

Combined Hormonal Contraceptives for Heavy Menstrual Bleeding - Cochrane for Clinicians... Restricted content. Login required.

Dec 1, 2019 - Combined oral contraceptives decrease the number of women reporting menorrhagia over six months compared with placebo (absolute risk reduction = 36.7%; number needed to treat = 2.7).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1201/p677.html

Breast Implant—Associated Anaplastic Large Cell Lymphoma - Editorials - American Family...

Jan 1, 2020 - In October 2019, the FDA released draft guidance offering numerous recommendations to help ensure women have access to breast implant benefit and risk information, including that manufacturers incorporate a boxed warning and patient decision checklist in the device’s labeling, and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0101/p8.html

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ... Restricted content. Login required.

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.html

Screening for Cervical Cancer: Recommendation Statement - U.S. Preventive Services Task...

Feb 15, 2019 - The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0215/od1.html

Elagolix (Orilissa) for Endometriosis Pain - STEPS - American Family Physician

Oct 15, 2019 - Elagolix can decrease pain in women with endometriosis, but it is expensive and has adverse effects similar to those of other medications that decrease estrogen levels.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1015/p502.html

Secnidazole (Solosec) for Bacterial Vaginosis - STEPS - American Family Physician

Aug 15, 2019 - Secnidazole is much more expensive than generic metronidazole and other available treatments. However, it is a safe option for women who desire a single-dose treatment or for patients in whom treatment compliance is a concern.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0815/p242.html

Interpregnancy Care: Guidelines from ACOG and SMFM - Practice Guidelines - American ...

Jul 15, 2019 - The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have published guidelines focusing on interpregnancy care to improve outcomes of future pregnancies and the overall health of women, regardless of their future pregnancy plans.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0715/p121.html

Treatment of Recurrent Vulvovaginal Candidiasis - American Family Physician

Jun 1, 2000 - Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year or at least three episodes unrelated to antibiotic therapy occur within one year. Although greater than 50 percent of women more than 25 years of age develop vulvovaginal candidiasis ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0601/p3306.html

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.html

Screening for Cervical Cancer - Putting Prevention into Practice - American Family ...

Feb 15, 2019 - P.J., a 48-year-old woman, presents to your office for a well-woman examination. She has been married for eight years, has no history of sexually transmitted diseases, and has nothing remarkable in her medical history.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0215/p253.html

Abnormal Uterine Bleeding - American Family Physician

Apr 15, 2004 - Abnormal uterine bleeding is a common presenting symptom in the family practice setting. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable the physician to rule out causes such as pregnancy and pregnancy-related disorders, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0415/p1915.html

Diagnosis and Treatment of Female Sexual Dysfunction - American Family Physician

Mar 1, 2008 - Female sexual complaints are common, occurring in approximately 40 percent of women. Decreased desire is the most common complaint. Normal versus abnormal sexual functioning in women is poorly understood, although the concept of normal female sexual function continues to develop. A ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0301/p635.html

Management of Uterine Fibroids - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2019 - What are the comparative effectiveness and harms of treatments for uterine fibroids, and what is the risk of finding unexpected leiomyosarcoma in women with fibroids?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0301/p330.html

HPV Vaccine for Prevention of High-Grade Precancerous Cervical Lesions - Medicine by ...

Apr 1, 2019 - Data suggest the benefits of HPV vaccination for reducing precancerous lesions outweigh the potential harms. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0401/od1.html

Diagnosis and Treatment of Atrophic Vaginitis - American Family Physician

May 15, 2000 - Up to 40 percent of postmenopausal women have symptoms of atrophic vaginitis. Because the condition is attributable to estrogen deficiency, it may occur in premenopausal women who take antiestrogenic medications or who have medical or surgical conditions that result in decreased levels ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0515/p3090.html

Abnormal Uterine Bleeding Associated with Hormonal Contraception - American Family ...

May 15, 2002 - Millions of women in the United States use some type of hormonal contraception: combination oral contraceptive pills (OCPs), progestin-only pills, medroxyprogesterone acetate injections, or subdermal levonorgestrel implants. Abnormal uterine bleeding is a common but rarely dangerous ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0515/p2073.html

Prophylactic Vaccination Against Human Papillomavirus to Prevent Cervical Cancer and ...

Jan 1, 2019 - HPV vaccination in women 15 to 26 years of age prevents the development of cervical intraepithelial neoplasia (CIN) 2 and CIN 3 in women regardless of previous HPV exposure (number needed to treat [NNT] = 39). No serious adverse effects are associated with administration of the HPV ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p15.html

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