Mark Smith, Jr, MD

One of the most publicized papers of the 1999 American Society of Reproductive Medicine/ Canadian Fertility and Andrology Society was the research presented by Dr. Oktay, Dr. Karkujaya, Dr. Gosden and Dr. Schwartz from Cornell University in New York and and from the University of Leeds in the UK. They successfully auto-transplanted frozen-banked ovarian tissue and demonstrated the resumption of ovarian function.

A very common question of perimenopausal women is whether or not they are still able to get pregnant, and this inquiry may originate from one of two concerns. Some women in the perimenopausal range may still want to conceive, either to start a family or to add to an existing one, and are seeking information to help with that decision.

The majority of women in the perimenopausal period have completed their childbearing and resolutely do not want to conceive at this age. This gives rise to the question as to what contraceptive method they should use to prevent an unwanted pregnancy. At this stage in their lives, an unintended pregnancy would be devastating, and it is something they are usually very eager to avoid.

Hot flashes, hot flushes, power surges-- they go by a variety of names and are one of the most common symptoms of the perimenopause and menopause. Often a premenopausal woman will ask, "how will I know if I am having hot flashes"? This can be compared to the question a woman who has never had a baby asks, "how I will know if it's really a contraction"? If a woman is having significant hot flashes, she will not have to ask!

The benefits of using the patch for hormone replacement, with a few exceptions, are not significantly different from those when taken in a pill form. The choice should depend primarily upon the woman's preference, and for those choosing the patch there are a few small tricks for making it easier to use.

In the United States alone, it is conservatively estimated that there are between 10 and 20 million women suffering from the involuntary loss of urine! The large baby boomer population of the United States is now moving through the menopausal transition period when this involuntary loss of urine (urinary incontinence) often becomes worse, and consequently the number of women with incontinence will only increase.

If a doctor or health care professional recommends that a woman should have a hysterectomy and she elects to proceed, then there are certain decisions that need to made in planning the surgery. There are many reasons for deciding to have the uterus removed, and numerous articles and books have been written on this topic.

Recently there have been numerous references in the news about the new types of estrogens that do not cause an increased risk of breast cancer. While studies looking at an increased risk of breast cancer with traditional hormone replacement use still do not show a clear consensus, it is generally accepted that there may an increased, albeit small, risk of breast cancer with the use of traditional replacement hormones.

Dr. John Collins presented a thorough review of the literature concerning the interaction of hormone replacement and breast cancer entitled "HRT and Breast Cancer: The Evidence and the Issues" with the following general conclusions

When performing operative laparoscopy and using bipolar current to achieve hemostasis or desiccate vessels, there are a couple of simple techniques that can make the task easier for the surgeon. The first trick alleviates the frustration when one is attempting to desiccate either vessels or tissue with a bipolar instrument, and the instrument keeps sticking to the tissue and the char. Inevitably then when the surgeon attempts to remove the instrument or pull it from contact with the tissue, the seal is broken and the vessel or tissue begins bleeding again.

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsLas Vegas, Nevada, November, 1999

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsAtlanta, Georgia, November, 1998

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

OBGYN.net Conference CoverageFrom American Association of Gynecological LaparoscopistsOrlando, Florida, November 2000

I would like information on vaginal hysterectomy and adenomyosis

I started skipping periods about two years ago at the age of 40. I have not had a period now for about 4 months and I am having what I believe to be hot flashes.

My doctor put me on Premarin 1.25 for a year. When I went in for my yearly check up she had blood work done and found I had extremely low estrogen and practically no testosterone.

Have recently begun to take Black Cohosh which I purchased over-the-counter. I am 53 years old, and have not had a period since November of 1997.

I'm 49, perimenopausal and on combined est/prog (0.5 estrace daily and 5 cycrin days 1-10). About 45% of time, I experience bleeding before the end of the 10 day cycle of cycrin. Should I be concerned? Also experiencing hot flashes more lately.