1/ Do you want to know tips & tricks for incorporating technology into teaching? Here are the take home points from my presentation today at #iMed2022.

You know it’s a bad season when infant acetaminophen is out of stock at multiple pharmacies 😟

Super excited to spend the next few days learning everything women’s health related in my favorite city! 😍#TransformWH Mayo Clinic Women's Health MayoClinicGIM

Why does menopause matter? Over 50% of the female population in the US is over the age of 40. Average age of menopause in the US is 52 years old. Over 90% of females will get their final menstrual period (FMP) between ages 45-55. #TransformWH Mayo Clinic Women's Health MayoClinicGIM

Premature menopause‼️physiologic + psychologic burden this life transition brings is HUGE. Pts need: psychological support, HRT (if applicable), symptom control, assistance w/ fertility if desired, ⬇️long term health risks Mayo Clinic Women's Health MayoClinicGIM Ekta Kapoor

💎Clinical pearl: If you need contraception + perimenopause symptom management ➡️ aim for oral contraceptive pills with estrogen concentration ~20 mcg (lower dose estrogen) #TransformWH Mayo Clinic Women's Health MayoClinicGIM

🛑Hormone replacement therapy should never be used for primary or secondary prevention of cardiovascular disease 🛑 #TransformWH Mayo Clinic Women's Health MayoClinicGIM

On 🚺midlife changes Fat and lean mass⬇️ prior to menopausal transition (MT) At start of MT, rate of fat gain ⏫ (doubles) and lean mass ⬇️; gains and losses continue until 2 years after FMP #TransformWH Mayo Clinic Women's Health MayoClinicGIM

1. Menopause does not ⬆️a 🚺’s risk of developing Alzheimer’s dementia (AD). ❌ Lifetime risk of AD for 🚺 in US is 19.5% at age 45 and 21.1% at age 65. 2. Validate a patient’s experiences!! Difficulties in learning + verbal memories are common. #TransformWH Mayo Clinic Women's Health

3. Estrogen in surgical menopause patients may have cognitive benefits when initiated immediately after hysterectomy with BSO #TransformWH Mayo Clinic Women's Health

In summary:

Our mentors have set the bar exceptionally high, and we are so grateful to be trained by the top WH experts in the field! Co-fellowing with Mariam Saadedine #TransformWH Mayo Clinic Women's Health

Wondering about safety of meds & products during #pregnancy & #breastfeeding - #DrKatherineMoore #TransformWH directs us to fantastic #OTIS fact sheets mothertobaby.org/fact-sheets/

In 🚺, there is a relationship b/w adverse childhood experiences (ACE) and risk for depression, schizophrenia or psychosis, substance use disorder, CAD, asthma, arthritis Remember‼️: ACE may travel across generations (violence, mental illness, substance abuse) #TransformWH

Older women are likely more sexually active than women, their same age, were 30 years ago. ‼️Always. Ask. About. Sexual. History. Screen. Everyone. ‼️ #TransformWH Mayo Clinic Women's Health

Before suspecting treatment failure for gonorrhea, make sure you rule out re-infection by taking extensive history. If treatment failure is probable, or in patients with severe B-lactam allergies, consider genta and azithro Mayo Clinic Women's Health #TransformWH

FDA approved GnRH antagonists for fibroid management: 💎elagolix 💎relugolix ⬇️risk of hypo estrogenic sx ⬇️risk of VTE ✅approved for 24 month use ✅oral pills 💊 given w/ low dose estrogen + progesterone #TransformWH Mayo Clinic Women's Health

Hysterectomy with ovarian conservation does NOT common without risks. ⬆️risk of HTN, HLD, cardiac arrhythmias, obesity, CAD. A 🚺 in the US has a 45% lifetime risk of getting her uterus removed. Only 8% are for cancers. ⁉️ #TransformWH Mayo Clinic Women's Health

A broken record in primary care ⚠️ The most common feedback I get about OCPs: side effects ‼️ Beautifully summarized below are common side effects of estrogenic and progestogenic formulations: #TransformWH Mayo Clinic Women's Health

New contraceptives ➡️ 🎯Segesterone acetate/ ethinyl estradiol (vaginal ring) 💜❤️ 🎯Drospirenone (oral pill) 💜 🎯Estetrol/drospirenone (oral pill) 💜❤️ 🎯On demand non hormonal contraceptive gel 🎯35 mcg ethinyl estradiol/ norgestimate (patch) 💜❤️ 💜progestin ❤️estrogen