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Normal circulating plasma glucose concentration is maintained by a delicate constant balance between glucose utilization (i.e., glycolysis or storage as glycogen by various tissues) on one hand and glucose production on the other (i.e., glycogenolysis and gluconeogenesis induced in certain tissues, such as liver, muscle, renal parenchyma, and adipose tissue). During the late post-absorptive period or starvation, normal glucose concentration is maintained by facilitating glucose production while inhibiting glucose uptake.
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Consider the many treatment options when presented with the following cases: the perimenopausal woman with prolonged menstrual bleeding due to uterine leiomyomas; the young woman with significant pain from spreading endometriosis; and the mother with menorrhagia. Which options will you choose?
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Access to emergency contraception (EC) has been expanded. Shipments of the new dual-label version of Plan B, the levonorgestrel-only EC drug, are now hitting pharmacy market shelves.
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When using contraception to delay or stop menstrual periods, return to fertility is important to patients. Results of a national survey indicate 58% of women worry that menstrual suppression will affect their ability to have children.
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When is "that time of month" a problem for some women? When symptoms such as depression, wide mood swings, breast tenderness, or muscle pain enter into the picture, a diagnosis of premenstrual syndrome (PMS) may be in order. However, when symptoms are more severe, clinicians may consider a diagnosis of premenstrual dysphoric disorder (PMDD).
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The next patient in your exam room is in her mid-40s. She notes that her last monthly period was 11 months ago. She continues to use condoms for pregnancy prevention. She has a thin body and a small bone frame, and she smokes 15-20 cigarettes a day. Her medical history indicates a family history of osteoporosis. What is your next move?
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Access to Gardasil (Merck & Co., Whitehouse Station, NJ) continues to expand as the shot has been added to the federal Vaccines for Children (VFC) program for young women ages 9 to 18. The program is administered at the national level by the Centers for Disease Control and Prevention (CDC) through its National Immunization Program.
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You have just written a prescription for an adolescent female to treat a chlamydial infection. When you close her file, what are the chances it will reappear in your inbox in the next month or two?
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Your patient is a 29-year-old mother of three active young children. She has had limited success with using birth control pills and says that the daily dosing schedule is a challenge. She shakes her head "no" to the contraceptive patch and vaginal ring, and she doesn't want to limit her options with the choice of tubal sterilization.
