Canadian Women's Health Today

Imaging Considerations for Adnexal Masses

Tanya Chawla, MD — Mon, 11 Nov 2024 00:00:00 +0000

Adnexal masses are commonly found during routine imaging of the pelvis and can be seen in up to 4-5% of asymptomatic women undergoing pelvic ultrasound (US). These masses encompass a range of pathologies from both gynecologic and non-gynecologic origins and can either be benign or malignant.

In Canada the lifetime risk for ovarian cancer is 1.7%. There are approximately 3,100 cases per annum in Canada with 2,000 deaths. Despite its low prevalence, ovarian malignancy is a leading cause of death among gynecological malignancies, with a 5-year survival rate of 47%. Imaging plays an integral role in the detection, characterization, and appropriate triage of adnexal masses.

The majority of adnexal masses are benign and can be managed conservatively. For the smaller minority of malignant lesions, accurate characterization with early triage to a gynecological oncology centre has an impact on oncological outcomes, and reduces the risk of re-operation and the time to initiation of adjuvant chemotherapy. Conversely, inappropriate surgical triage of benign masses can have an adverse impact on patient morbidity, compromise fertility, and increase cause-specific death for a variety of conditions, including a range of malignancies and cardiovascular diseases.

Obstructive Sleep Apnea in Women

Mon, 11 Nov 2024 00:00:00 +0000

Obstructive sleep apnea (OSA) is a common disease with a large public health burden. Due to several anatomical and physiological differences, OSA has traditionally thought to be much less common in women than in men. These differences include variations in craniofacial anatomy, sex hormone differences, greater peripheral fat distribution, as well as women having shorter and less collapsible airways and less respiratory drive instability. However the recruitment bias from clinical samples in early studies has fostered this sex difference to an exaggerated degree.

One large community-based sample of adults aged 21–80 indicated a point prevalence of OSA with clinically significant sleepiness of 3–7% in males and 2–5% of females. Another much larger worldwide community study indicated a lifetime prevalence of OSA of 27.3% in men and 22.5% in women in a narrower population aged 30–69. Both studies show an approximate 1:5–1 ratio which is much lower than that of previous studies showing a ratio of 9 or 10:1. In pediatric and elderly populations, the male to female prevalence ratio is close to equal.

Menopausal Symptoms in the Workplace and an Update on Treatment Options

Kelsey E. Mills, MD, FRCSC, MSc HSEd, MSCP — Mon, 11 Nov 2024 00:00:00 +0000

Women in midlife comprise an integral component of the Canadian workforce. The Menopause Foundation of Canada (MFC) recently completed a landmark cross-national survey of Canadian women aged 40–60. This study found that 46% of surveyed participants felt unprepared for perimenopause/menopause and that 4 in 10 participants felt their symptoms were undertreated by their healthcare provider. Fewer than 25% of respondents said their family physician proactively discussed menopause with them.

The Treatment of Heavy Menstrual Bleeding in 2024

Christine Lett, MD, FRCSC — Mon, 11 Nov 2024 00:00:00 +0000

Heavy menstrual bleeding and iron deficiency are both commonly underrecognized and undertreated conditions. In fact, over 2 billion people globally are iron deficient. Iron deficiency disproportionately impacts reproductive-aged women and negatively impacts their quality of life. The most common etiology of iron deficiency anemia in premenopausal women is excessive menstruation. Heavy menstrual bleeding is defined as excessive menstrual blood loss, which interferes with a woman’s quality of life. Heavy menstrual bleeding is one of the most common reasons for gynecologic consultation, and impacts one-third of reproductive-aged women. Improving the quality of life for women with heavy menstrual bleeding requires recognizing the condition, identifying its cause, ruling out iron deficiency, and tailoring treatment to reduce menstrual blood loss and replenish iron stores.

Hot Topics in Postpartum: Why the Six-week Visit is Outdated

Perle Feldman, MDCM, FCFP, MHPE, Judy Hagshi, MD, CCFP — Mon, 11 Nov 2024 00:00:00 +0000

Gone are the days of the single six-week postpartum visit. Research has shown that healthcare, both physical and mental, must be more robust and comprehensive to adequately address the changes that occur and the ensuing challenges that transpire when welcoming a baby into the world.¹ In this paper, the words woman and mother include all pregnant people and those who give birth.