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Handbook.Of.Women's.Health.Pdf Handbook of WOMEN’S HEALTH An evidence-based approach This practical handbook provides a clear and comprehensive evidence-based primary- care guide to the care of women in ambulatory practice, intended for general and family practitioners, nurses, physicians assistants and all those who practice primary care of women. It emphasizes preventive care and well-woman care throughout the life cycle of a woman, including sexuality, contraception, medical care in pregnancy, and psychological and important medical concerns. It stresses the strength of evi- dence underlying common practices of care of women. ∑ It recognizes and pays heed to the cultural, social and psychological diVerences that impact on women’s health ∑ It conveys a consistently positive message in terms of seeking solutions to women’s health care problems and emphasizes preventive health care ∑ It provides insightful tips and checklists to highlight women’s common health problems and eVective evidence-based treatment ∑ Suitable for health care workers of all levels and specialties who practice primary care of women Dr. Rosenfeld is a family physician, fellow of the American Academy of Family Phys- icians, and Assistant Professor of General Internal Medicine at Johns Hopkins School of Medicine. She graduated from Johns Hopkins School of Medicine and completed a residency in Family Practice at Case Western University Hospitals, Cleveland, Ohio. She practiced on the Eastern Shore of Maryland and then became Associate Program Director of the St. Francis Family Practice Residency in Wilmington, Delaware. She was Professor of Family Medicine, then, at East Tennessee State University and Program Director of the Family Practice Residency in Bristol, Tennessee. She is author and editor of Women’s Health in Primary Care (1997) and coauthor of the American Academy of Family Physicians’ Quick Guide to Women’s Health (2000). She has author- ed over 50 articles and research articles on women’s health. MMMM Handbook of WOMEN’S HEALTH An evidence-based approach Edited by Jo Ann Rosenfeld Johns Hopkins School of Medicine cambridge university press Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge cb2 2ru, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521788335 © Cambridge University Press 2001 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2004 isbn-13 978-0-511-19557-0 eBook (NetLibrary) isbn-10 0-511-19557-5 eBook (NetLibrary) isbn-13 978-0-521-78833-5 hardback isbn-10 0-521-78833-1 hardback isbn-13 978-0-521-54595-2 paperback isbn-10 0-521-54595-1 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Contents List of contributors ix Common abbreviations used in the text xi Normal blood values in women and during pregnancy xiii Introduction 1 Jo Ann Rosenfeld 1 Singular health care of women 2 Jo Ann Rosenfeld Preventive care 13 2 Preventive care of adolescents 15 Rebecca Saenz 3 Preventive care of adults (19 to 65 years) 25 Diane Madlon-Kay 4 Preventive care for older adults 42 Jeannette South-Paul, Deborah Bostock and Cheryl Woodson 5 Cigarette smoking and cessation 72 Jo Ann Rosenfeld 6 Nutrition 84 Jo Ann Rosenfeld 7 Exercise 93 Rebecca JaVe v vi Contents Psychosocial health 109 8 Psychosocial health of well women through the life cycle 111 Cathy Morrow Sexuality 129 9 Sexuality and sexual dysfunction through the life cycle 131 Patricia Lenahan and Amy Ellwood 10 Contraception 153 Kathryn Andolsek 11 Infertility and adoption 184 Jo Ann Rosenfeld 12 Special issues with lesbian patients 197 Laura Tavernier and Pamela Connor 13 Medical care in pregnancy: common preconception and antepartum issues 206 Ellen Sakornbut Genitourinary medicine 233 14 Menstrual disorders 235 Kathy Reilly 15 Sexually transmitted diseases 254 Kay Bauman 16 Vaginitis 281 Mari Egan 17 Chronic pelvic pain, dysmenorrhea, and dyspareunia 292 Jo Ann Rosenfeld vii Contents 18 The Papanicolaou smear and cervical cancer 306 Barbara S. Apgar 19 Endometrial cancer and postmenopausal bleeding 326 Jo Ann Rosenfeld 20 Ovarian cancer and ovarian masses 333 Jo Ann Rosenfeld 21 Urinary incontinence and infections 341 Jo Ann Rosenfeld Breast disorders 365 22 Benign breast disorders 367 Jo Ann Rosenfeld and Kris Pena 23 Breast cancer screening 383 Abenaa Brewster and Nancy Davidson Psychological disorders 399 24 Woman battering 401 Sandra K. Burge 25 Rape and the consequences of sexual assault 422 Jo Ann Rosenfeld, Amy Ellwood, and Patricia Lenahan 26 Depression and premenstrual syndrome 437 Jo Ann Rosenfeld 27 Addiction 458 Jo Ann Rosenfeld 28 Eating disorders 471 Janet Lair viii Contents Common medical problems 481 29 Coronary heart disease 483 Valerie Ulstad 30 Diabetes mellitus type II 508 Ann Brown 31 Thyroid disorders 529 William Hueston 32 Hypertension and stroke 545 Jo Ann Rosenfeld 33 Osteoporosis, osteoarthritis, and rheumatoid arthritis 569 Jo Ann Rosenfeld Index 595 Contributors Kathyrn Andolsek, MD Sandra Burge, PhD Duke University Medical Center University of Texas Health Science Center, PO Box 2914 Department of Family Practice Durham, NC 27710 7703 Floyd Curl Drive USA San Antonio, TX 78284-7701 USA Barbara S. Apgar, MD, MS 883 Sciomeadow Drive Pamela Connor, PhD Ann Arbor, MI 4810 1127 Union Avenue USA Memphis, TN 38104 USA Kay Bauman, MD. MPH University of Hawaii Nancy Davidson, MD Wahiawa Hospital Johns Hopkins Oncology Center 95–390 Kuahelani Avenue 422 North Bond Street Mililani, HI 96789 Baltimore, MD 21231 USA USA Deborah Bostock, MD Mari Egan, MD Uniformed Services University Northwestern University Medical School Dept of Family Practice Morton Bldg 4301 Jones Bridge Rd 303 East Chicago Avenue Bethesda, MD 20814-4799 Chicago, IL 61611 USA USA Abenaa Brewster, MD Amy Ellwood, MSW Johns Hopkins Oncology Center Dept of Family Medicine and Community 422 North Bond Street Medicine Baltimore, MD 21231 6375 Charleston Boulevard USA Las Vegas, NV 89146 USA Ann Brown, MD Box 3611 William Hueston, MD Duke University Medical Center Medical University of South Carolina Durham, NC 27710 Department of Family Medicine USA 295 Calhoun Street Charleston, SC 29403-8702 USA ix x List of contributors Rebecca Jaffe, MD Rebecca Saenz, MD 3105 Limestone Road University of Mississippi Medical Center Suite 200 2500 North State Street Wilmington, DE 19808-2151 Jackson, MS 39216 USA USA Janet Lair, MD Ellen Sakornbut, MD Box 3886 University of Tennessee at Memphis Duke University Medical Center Department of Family Practice Durham, NC 27710 1121 Union Avenue USA Memphis, TN 38104-6646 USA Patricia Lenahan, PhD Dept of Family Medicine and Community Jeannette South-Paul, MD Medicine Uniformed Services University 6375 Charleston Boulevard Dept of Family Practice Las Vegas, NV 89146 4301 Jones Bridge Rd USA Bethesda, MD 20814-4799 USA Diane Madlon-Kay, MD Regions Hospital Laura Tavernier, MD 640 Jackson Street, Suite 8 1127 Union Avenue St Paul, MN 55101 Memphis, TN 38104 USA USA Cathy Morrow, MD Valerie Ulstad, MD Maine-Dartmouth Family Practice 10551 Morgan Ave South 4 Sheridan Road Bloomington, MN 55431 FairWeld, ME 04937 USA USA Cheryl Woodson, MD Kris Pena, MD Uniformed Services University 9101 Franklin Square Drive Dept of Family Practice Suite 205 4301 Jones Bridge Road Baltimore, MD 21237 Bethesda, MD 20814-4799 USA USA Kathy Reilly, MD 900 Northeast 10th Street Oklahoma City, OK 73104 USA Jo Ann Rosenfeld, MD 1112 Nicodemus Road Reisterstown, MD 21136 USA Common abbreviations used in the text AIDS acquired immune deWciency syndrome b.i.d. twice daily BMI body mass index CDC Centers for Disease Control and Prevention CHD coronary heart disease CT computed tomography FDAUS Food and Drug Administration HDL high density lipoprotein HIV human immunodeWciency virus HRT hormone replacement therapy i.m. intramuscular IU international unit i.v. intravenous IUD intrauterine device LDL low density lipoprotein MPAmedroxyprogesterone acetate MRI magnetic resonance imaging NSAIDs nonsteroidal antiinXammatory drugs OCPs oral contraceptive pills OR odds ratio p.o. by mouth Pap smear Papanicolaou smear PCOS polycystic ovary syndrome PID pelvic inXammatory disease q.d. daily q.h.s. before sleep q.i.d. four times daily RCT randomized controlled trial RR relative risk STD sexually transmitted disease t.i.d. three times daily UTI urinary tract infection xi MMMM Normal blood values in women and during pregnancy Physiological change Pregnancy value, Laboratory value during pregnancy Prepregnancy value third trimester Hematology ESR No change Westegren 0–20 mm/h Same Hematocrit Decreased 39.8% 33.5% MCV No change 80–96 m3 Same Platelet count No change 150 000–300 000/mm2 Same Platelet concentration Unchanged or slightly 150 000–300 000/L : 100 000/L abnormal decreased RBC count Reduced 4.2–5.4 million/mm2 4.0 million/mm2 Red cell volume Increased 30% 1400 ml 1600 mL Total blood volume Increased 4000 ml 5430 mL WBC count Increased 6000–9000 cells/mm2 Variable Chemistry Albumin Decreased 3.3–5.2 g/dL 2.5–4.5 g/dL Alkaline
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