The Journal of family practice

When a complete metabolic panel offered no clues, we turned to imaging. And that's when we had our diagnosis.

Q: Which medications work best for menorrhagia? Evidence-based answer: Four medications have been shown to reduce menstrual blood loss (MBL) significantly in placebo-controlled randomized controlled trials (RCTs): the levonorgestrel-releasi…

This article reviews the limited evidence for treating chronic pelvic pain and offers recommendations for the primary care physician on providing symptomatic relief in the absence of diagnosed pathology.

Abnormal bleeding is common in women of childbearing . For some insertion of a levonorgestrel-releasing IUD – easily done in a family practice setting – may be all the treatment they need. In response to a case study of a 40-year-old multip…

Irregular or unusually heavy periods are a common complaint. Most often, the condition is benign and can by managed conservatively. Assess postmenopausal women for cancer by endometrial biopsy, transvaginal ultrasound, or saline infusion so…

It may be, if her surgery is not cancer-related.

A.B. is a 14-year-old G0. She is brought to the office by her mother. A.B. says that she experiences severe cramping for 3 to 4 days each month with pain located primarily in her lower abdomen but sometimes causing aching in her thighs. Occ…

The work-up for secondary infertility—the inability to conceive after 1 year of regular unprotected intercourse for a couple who have previously had a child1—should include a history and physical exam for both patients, plus evaluation of o…

Pelvic endometriosis is associated with significant morbidity and decreased quality of life. The diagnosis of this condition is challenging: Symptoms vary considerably often mimicking those of other medical conditions. Laparoscopic visualiz…

M.A. a 31-year-old G2P2 has scheduled an appointment because she is concerned that my endometriosis is back and is experiencing incapacitating low pelvic pain. She is convinced that her endometriosis and adhesions have recurred and requests…

Endometriosis is a common disease that affects up to 5 million women in the United States. Specifically the prevalence of endometriosis is 1 in 15 (7%) women of reproductive age, and there is an associated incidence of infertility in as man…

The diagnosis of acute pelvic pain in the woman of reproductive age represents a major clinical challenge. In approaching such a patient, the clinician must differentiate between pregnancy-related causes, gynecologic disorders, and nonrepro…

Chronic pelvic pain is one of the most challenging gynecologic problems seen in primary care practice. Important causes of this problem include endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, and the syndrome of chroni…

During the past 20 years, contraceptive steroids have undergone significant changes as the result of an increased understanding of their metabolic, pharmacologic, and hormonal activities. During this time, prospective and retrospective epid…

Dysfunctional uterine bleeding (DUB) that occurs between menarche and menopause is often described but poorly understood. Relatively few studies have tried to associate DUB with life change and stress. In this present case-control study, qu…

Accurate diagnosis of the adnexal mass requires knowledge of embryology, anatomy, and physiology. Bimanual pelvic examination remains the primary and most practical means of detecting and evaluating adnexal pathology. Selective use of diagn…

Hysterectomy is the most commonly performed major surgery in the United States. A hysterectomy does not produce significant psychopathology in a psychologically mature woman. Yet a mourning process occurs as a woman reintegrates her gender …