Update in Women’s Health

Abstract

Women’s health occupies much of the General Internist’s ambulatory practice. We sought to summarize recent women’s health articles and reports that could potentially change practice. We defined “women’s health” broadly, including symptoms and conditions of the female reproductive tract and breast, conditions that preferentially or differentially affect women in a significant way (such as osteoporosis or heart disease in women using postmenopausal hormones), and prevention and screening of these conditions. We excluded surgical and obstetrical aspects but included medical conditions of pregnancy. This update was presented at the 29th annual session of the Society of General Internal Medicine, and the search strategy thus focused on publications from April 1, 2005 to February 28, 2006. Because the topic area was broad, the time period short, and the goal to identify important reports, the initial method of locating potential articles was the review of 10 pertinent journals (ACP Journal Club, Annals of Internal Medicine, Archives of Internal Medicine, JAMA: the Journal of the American Medical Association, Journal of General Internal Medicine, Journal of Women’s Health and Gender-Based Medicine, Lancet, New England Journal of Medicine, Obstetrics and Gynecology, and Women’s Health Watch). All study designs and populations were considered. With this strategy, we identified nearly 200 articles and Federal Drug Administration (FDA) advisories with potential relevance. In conferences, a team of academics with clinical and research experience in women’s health discussed each item, delineating the degree of impact on the practice of General Internists, the degree to which its content was generally known (we wished to include articles that the public might question their Internists about), the study quality, and the degree of focus on women’s health. Major reports are discussed here; minor reports are tabulated in the Appendix. A summary of relevant guidelines is in Table 1. A summary of practice changes stemming from the articles reviewed here is in Table 2. Table 1 Important women’s health guidelines in 2005–2006 Table 2 Summary of Changes in Women’s Health Practice Stemming from Important 2005–2006 Reports