Category: Obstetrics & gynecology

Hormone Replacement Therapy for Menopausal Symptoms: Setting the Record Straight

Whether you call them hot flashes or “power surges,” the symptoms of menopause can be very distressing. They were routinely treated with hormone replacement therapy (HRT) until the Women’s Health Initiative study in 2002 persuaded many patients and doctors to abandon that treatment. The results of that study were misunderstood by some and questioned by others, and there continues to be confusion...

/ May 17, 2016

Prenatal Multivitamins and Iron: Not Evidence-Based

When I was pregnant, I obediently took the iron pills and prenatal vitamins prescribed by my obstetrician. And I prescribed them for every pregnant patient I took care of as a family physician. I never questioned the practice. It seemed intuitively obvious that it was a good thing; we know pregnancy makes extra nutritional demands and depletes iron stores. It never occurred...

/ February 2, 2016

Vaginal Birth After C-Section: How Safe Is It?

Doctors used to insist “once a C-section, always a C-section.” Today it is standard practice to allow vaginal births after C-section (VBAC) for appropriately selected patients. The American Congress of Obstetricians and Gynecologists (ACOG) has issued a Practice Bulletin to guide obstetricians in determining which patients are appropriate candidates for VBAC. We frequently hear criticisms of practice guidelines like these. The doctors...

/ January 12, 2016

Home birth tragedies lead to changes in Oregon

Oregon Health Plan (OHP), the state’s Medicaid insurer, will no longer cover planned home and birth center births for women whose pregnancies aren’t classified as low risk, based on newly-established criteria. The Health Evidence Review Commission (HERC), a group of experts designated by the state, came up with criteria that will exclude women with a substantial list of conditions, such as high...

/ December 10, 2015

Dubious MTHFR genetic mutation testing

Naturopaths, along with some chiropractors, acupuncturists and a few “integrative” physicians, are advising patients that they should be tested for MTHFR genetic mutations. Typically, the naturopath will start with the pitch that “conventional” medical doctors are ignoring your genes as a possible source of your health problems. (And it is mostly naturopaths who are doing this – just Google “naturopath MTHFR genetic mutation”...

/ June 11, 2015

Escharotic Treatment for Cervical Dysplasia: A New Incarnation of Black Salve?

Bloodroot (Sanguinaria canadensis) and black salve (which contains bloodroot) are promoted and sold as a cure for many things, including cervical dysplasia. While it does kill cancer cells, it does so just like a flamethrower - indiscriminately, killing lots of normal cells along the way.

/ May 26, 2015

The Human Mold: Another Example of Self-Deception

José Jarimba believes that our bodies are physically molded into an asymmetric form by our mothers’ sleeping positions during pregnancy, that this has lifelong adverse impacts on health, and that shoe inserts can eliminate pain and other health problems by realigning the body. This is a silly untested hypothesis by a single individual. As such, it would be too minor to merit...

/ September 16, 2014

Chiropractic “pediatrics” firmly in the anti-vaccination camp

Who would you invite to speak at your conference if you wanted to show the world you are firmly in the anti-vaccination camp? Barbara Loe Fisher, head of the National Vaccine (Mis) Information Center (NVIC)? How about Andrew Wakefield, the thoroughly disgraced British physician who, having been stripped of his medical license, continues his despicable anti-vaccination campaign? How about both? The International...

/ September 4, 2014

Antibiotics vs. the Microbiome

In 1850, one in four American babies died before their first birthday, and people of all ages died of bacterial infections that could have been successfully treated today with antibiotics. Unfortunately, treatments that have effects usually have side effects, and we are seeing problems due to the overuse of antibiotics. They are given to people with viral infections for which they are...

/ August 12, 2014

Chiropractic scope of practice includes . . . well, you won’t believe it

Ladies, how would you like a chiropractor to deliver your baby? How about perform your annual well-woman exams, such as breast exam, bi-manual pelvic exam, speculum exam, recto-vaginal exam and Pap smear? Sound out of their league? I thought so too. Way out. But, in some parts of the U.S., the law allows chiropractors to do all of these things and a...

/ August 7, 2014