Archive
Surgical Video: Robotic Endo Resection with Superficial Rectal Resection
Dr Nicholas Fogelson of Northwest Endometriosis and Pelvic Surgery in Portland, OR demonstrates resection of severe bilateral pelvic endometriosis with superficially invasive anterior rectal wall disease.
Dr. Fogelson is a gynecologic surgeon and endometriosis specialist who practices at Northwest Endometriosis and Pelvic Surgery in Portland, OR. Call 503-715-1377 for clinical consultation. http://www.nwendometriosis.com
Birth Control Pills and Depression
This week a study was published in JAMA Psychology drawing a connection between the use of birth control pills and depression. This was picked up in the popular press, and briefly we were hearing about it in the news and radio. I first heard about on my way to work listening to NPR. The message I got was that a study was just published that showed a link between the use of birth control pills and the development of new depression.
Today I read the actual paper that led to this media frenzy, and not surprisingly the media got it at least partially wrong.
Skovlund et al reported the following
“A total of 1 061 997 women (mean [SD] age, 24.4 [0.001] years; mean [SD] follow-up, 6.4 [0.004] years) were included in the analysis. Compared with nonusers, users of combined oral contraceptives had an RR of first use of an antidepressant of 1.23 (95% CI, 1.22-1.25). Users of progestogen-only pills had an RR for first use of an antidepressant of 1.34 (95% CI, 1.27-1.40); users of a patch (norgestrolmin), 2.0 (95% CI, 1.76-2.18); users of a vaginal ring (etonogestrel), 1.6 (95% CI, 1.55-1.69); and users of a levonorgestrel intrauterine system, 1.4 (95% CI, 1.31-1.42). For depression diagnoses, similar or slightly lower estimates were found. The relative risks generally decreased with increasing age. Adolescents (age range, 15-19 years) using combined oral contraceptives had an RR of a first use of an antidepressant of 1.8 (95% CI, 1.75-1.84) and those using progestin-only pills, 2.2 (95% CI, 1.99-2.52). Six months after starting use of hormonal contraceptives, the RR of antidepressant use peaked at 1.4 (95% CI, 1.34-1.46). When the reference group was changed to those who never used hormonal contraception, the RR estimates for users of combined oral contraceptives increased to 1.7 (95% CI, 1.66-1.71).”
In summary, women who used birth control pills were more likely to also use antidepressants. They concluded that women who use birth control use antidepressants more often, and thus they may be more likely to be depressed.
Here’s what I think about this.
Truelearn Question of the Month for October
TrueLearn is a web based platform for learning material to improve performance on standardized medical exams, with platforms for specific specialties as well as general medical boards. In OB/GYN TrueLearn offers question banks for CREOGS, ABOG boards, as well as general OB/GYN question banks. In each case, the online questions exactly simulate the computer environment you will see when you actually take the test as well.
TrueLearn also allows you to track your performance over time, as well as compare you performance to other doctors and students preparing for the same exam, both on a global level and specific to each question. It’s a great too that will no doubt be of tremendous use to the thousands of students and physicians who take OB/GYN related exams each year.
Each month, we do a TrueLearn Question of the Month, both on the blog and on the podcast.
Academic OB/GYN readers and listeners can also get a 10% discount on the product by using the promo code “ACADEMICOBGYN” when they order.
A 37 year old G6P2042 female patients arrives for her annual screening visit. She has no new complaints or problems. She has a family history of breast, uterine, fallopian tube, pancreatic, lung, colon, liver, and prostate cancer. Which of theses cancers listed is NOT associated with BRCA 1 mutation?
A. Breast tumors
B. Fallopian Tube Tumors
C. Lung Tumors
D. Peritoneum Tumors
E. Prostate cancer
Academic OB/GYN 