Showing 21-40 of 45 for: Essential Evidence Topics > Gynecologic 
- Human papillomavirus infection
Essential Evidence Topics, 6-Feb-2022
Overall Bottom Line: Human papilloma virus infection (HPV) is mostly sexually transmitted, causing cervical, anogenital and oropharyngeal disease in both males and females. There are approximately 150 genotypes of HPV identified consisting of both oncogen
- Infertility evaluation (female)
Essential Evidence Topics, 21-Oct-2022
Overall Bottom Line: If the patient is not ovulating, correct the cause if possible. Proceed with ovulation induction with letrozole, clomiphene, metformin, or both clomiphene and metformin. If unsuccessful, considero referalr for injectable hormonal th
- Lichen sclerosus
Essential Evidence Topics, 3-Feb-2023
Overall Bottom Line: Common symptoms of lichen sclerosus (LS) include pruritus, pain, and/or dyspareunia. Skin punch biopsy in the most sclerotic area of the lesion is usually diagnostic. Ulcerated or vegetative lesions should also be biopsied to rule o
- Menopause
Essential Evidence Topics, 13-Jan-2023
Overall Bottom Line: The United States Preventive Services Task Force (USPSTF, 2022) recommends against use of combined estrogen and progestin for primary prevention of chronic conditions in postmenopausal women based on moderate certainty of no net benef
- Ovarian cyst
Essential Evidence Topics, 20-Mar-2023
Overall Bottom Line: Ultrasound with cyst morphology and Doppler flow studies are helpful to distinguish benign cysts from ovarian malignancies. Oral contraceptives are not helpful for the treatment of ovarian cysts. They can prevent functional cysts in
- Ovarian teratoma
Essential Evidence Topics, 30-Jul-2021
Overall Bottom Line: Transvaginal ultrasound (TVUS) is the recommended initial imaging study for evaluation of ovarian masses. Most imaged teratomas have the classic dermoid cyst appearance whether they are benign or malignant. Surgical removal of matur
- Ovarian tumor (benign)
Essential Evidence Topics, 21-Feb-2023
Overall Bottom Line: Any palpable adnexal mass in a postmenopausal female must be evaluated for malignancy. The initial study is transvaginal ultrasound; obtain CA-125 with masses larger than 5 cm or if changes occur in size or character at follow-up.
- Ovarian tumor (malignant)
Essential Evidence Topics, 8-Nov-2022
Overall Bottom Line: Women with a family history of BRCA gene mutations and a positive screening should be referred for genetic counselling. They should be counselled on the risks, benefits, and limitations of genetic screening. Routine screening is not
- Pelvic inflammatory disease
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Treat suspected pelvic inflammatory disease (PID) empirically pending the results of cultures. Treat PID based on Centers for Disease Control and Prevention (CDC) recommendations. Parenteral and oral regimens have similar efficacies
- Pelvic mass
Essential Evidence Topics, 9-Dec-2022
Overall Bottom Line: There is no evidence to support ovarian cancer screening by ultrasound or CA-125; there is moderate-quality evidence that harms outweigh benefits. The current evidence is insufficient to assess the balance of benefits and harms of p
- Pelvic organ prolapse
Essential Evidence Topics, 24-Mar-2023
Overall Bottom Line: Although vaginal birth potentially causes weakening of the pelvic ligaments and musculature, most data do not support that cesarean section delivery prevents pelvic organ prolapse (POP). Diagnosis is best suggested by report of a va
- Pelvic pain in women
Essential Evidence Topics, 27-Apr-2021
Overall Bottom Line: Chronic pelvic pain is common in women in the reproductive and older age groups and causes disability and distress resulting in significant personal and healthcare costs. No single test or group of tests is recommended, and laborato
- Polycystic ovary syndrome
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: PCOS is a clinical diagnosis based on the presence of 2 of the following 3 criteria: (1) oligomenorrhea or anovulation, (2) clinical and/or biochemical evidence of hyperandrogenism, and (3) polycystic ovaries on ultrasound. Adolesce
- Premenstrual dysphoric disorder
Essential Evidence Topics, 17-Dec-2019
Overall Bottom Line: Premenstrual dysphoric disorder (PMDD) is a disabling condition with symptoms of irritability, anger, internal tension, dysphoria, and mood lability that interferes with work, school, social activities, and relationships. PMDD symptom
- Puberty (normal)
Essential Evidence Topics, 18-Aug-2021
Overall Bottom Line: Normal pubertal development should begin by age 13 in girls and age 14 in boys. Most patients with pubertal delay have constitutional delay and progress normally into puberty without intervention. Reassurance and repeat physical e
- Puberty (precocious)
Essential Evidence Topics, 24-Mar-2023
Overall Bottom Line: Pubertal development in boys before the age of 9 years is precocious. Pubertal development in girls before the age of 8 years is precocious. Precocious puberty may be a sign of a serious underlying medical condition, potentially l
- Sexual dysfunction (female)
Essential Evidence Topics, 4-Jan-2023
Overall Bottom Line: Obtain a detailed patient history that elicits psychosocial information about individual functioning and interpersonal relationship functioning. Conduct a thorough gynecologic examination. Use patient education as first-line treat
- Sexually transmitted diseases (gonococcal infections)
Essential Evidence Topics, 11-Jun-2022
Overall Bottom Line: The United States Preventive Services Task Force (2014) recommends screening all women age 24 years and younger and those who are older and at high risk for chlamydia or gonorrhea infections using a nucleic acid amplification test (NA
- Syphilis
Essential Evidence Topics, 20-Apr-2021
Overall Bottom Line: Screening is recommended for all pregnant women and any other individuals at high risk for disease. Diagnosis requires positive darkfield microscopy or a positive venereal disease research laboratory (VDRL) test or rapid plasma reag
- Termination of pregnancy
Essential Evidence Topics, 8-Nov-2022
Overall Bottom Line: Abortion is safer the earlier it is performed. If you are unable to provide accurate, empathetic pregnancy options counseling, refer to someone who can provide these services. Medication abortion is a safe, effective option for wo
