Dr. Chapa’s OBGYN Clinical Pearls

Nipple discharge is a common breast symptom. Keys and clues to stratify patients as either low risk or high-risk include: the patient’s age, unilateral or bilateral discharge, single duct or multi duct, whether a mass is also present in the breast, and the color of the discharge. Most nipple discharge thankfully is benign, but some require more attention. In this session, we will review the ACOG practice bulletin number 164 regarding nipple discharge.

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Pregnant women and their partners often ask whether or not sex is allowed in pregnancy and what possible consequences may occur. Does sex cause preterm labor? Is PID possible during pregnancy? Is oral sex allowed? Does sex induced labor? Let’s take a look at these questions... and provide answers!

Premature Ovarian Insufficiency (POI) has replaced the previous term of “premature ovarian failure” or “premature menopause”. POI is a stressful and emotional taxing diagnosis for any woman, especially the adolescent and young patient. Other endocrinopathies may be present in patients with POI including thyroid abnormalities and adrenal insufficiency. In this session, we will review the last ACOG Committee Opinion on POI in adolescents and young women (CO 605).

Progestin only contraceptive options include the subdermal implant, Injection, IUS, and pills. Progestin based LARCs provide HIGHLY effective contraception. A common perception in the public community is that these options may result in depression! Do they? Let’s take a look at a systematic review from 2018 on the subject.

Dr. Samuel A. Mudd. Although few in modern times are aware of this physician, many have heard of the unwelcoming statement, “Your name is Mudd!“. In this brief “medicine in history” segment, we will cover the incredible story of Dr. Mudd.

Talc Before Panties? A look at the curious & controversial data on talc and female cancer... The controversy between the use of talc in the female genital area and risk of ovarian cancer dates back to the 1970s. This decades long conundrum still persists with more questions than answers. Recently, Health Canada issued a health advisory warning on the potential development of ovarian cancer after repeated exposure of the female genital area to talc. In this podcast, we will review the ever conflicting data on this subject and review the statements of the American Cancer Society, the FDA, and Health Canada.

An evolving burden of evidence supports the theory that a large majority of high-risk ovarian epithelial cancers have a tubal origin. RRS is growing in practice as the preferred option at time of benign Gyn surgery and sterilization. Although RRSO is still preferred in high-risk women (germline mutation carriers), RRS is a possible alternative option, with delayed oophorectomy after age 40. In this podcast, we will review the pathophysiology of epithelial ovarian cancer, its tubal origin, and the role of RRS.

The “BIG O”!! This podcast will cover the biology of, purpose of, and surprising health benefits of... female orgasm. (Yep...Oh, the topics we cover all in the name of SCIENCE!)

PRES may be associated with Preeclampsia and Eclampsia. The condition is theorized to result from dys-autoregulation of posterior cerebral perfusion. In this session, we will cover the pathophysiology, presentation, workup, and prognosis of PRES.