Essential Women's Health Guidelines Updates You Might Not Know

In recent years, the American College of Obstetricians and Gynecologists (ACOG) has undertaken a comprehensive review of guidelines, spanning critical areas such as breast cancer screening, postpartum care, and menopause hormone therapy. This overhaul underscores the importance of staying informed about these guidelines to enhance your discussions and decision-making processes during medical consultations.

Breast Cancer Screening Guidelines Revised

In a significant move on March 9, 2023, the U.S. Food and Drug Administration (FDA) announced a pivotal update to mammography standards, as established by the Mammography Quality Standards Act of 1992 and the Federal Food, Drug, and Cosmetic Act. This update mandates the inclusion of breast density information in mammography reports shared with healthcare providers and in easy-to-understand summaries for patients. The importance of this update cannot be overstated, as breast density has implications for breast cancer detection and screening.

Despite the American College of Obstetricians and Gynecologists (ACOG) not routinely recommending additional screening for those with dense breasts without symptoms or additional risk factors, it emphasizes compliance with the FDA's new guidelines and applicable state and federal regulations regarding breast density disclosure. On a personal note, I opt for both mammogram and ultrasound due to having dense breasts, highlighting the individual choices available within these guidelines.

Should you try compounded bioidentical menopause hormone therapy?

The conversation around menopause management has also seen intriguing developments, particularly concerning compounded bioidentical menopause hormone therapy.

Is it safe? While some might consider this custom-tailored approach, it's crucial to understand that high-quality data on its safety and efficacy remains scarce. Therefore, it's advised against routine prescription of these compounded therapies over FDA-approved options.

Do you need hormone testing? Data on the interpretation of adjunct hormone tests for prescribing and dosing compounded bioidentical menopausal hormone therapy are limited; thus, recommendations are against the reliance on adjunct hormone tests for their prescription and dosing.

First postpartum visit is earlier than you think

Another paradigm shift has occurred in postpartum care recommendations. Moving away from the traditional 6-week postpartum visit, ACOG now advises an initial check-up within three weeks of delivery. This approach aims for a more tailored and ongoing postpartum care, culminating in a thorough visit by the 12th week after birth. This change reflects a deeper understanding of postpartum needs and emphasizes the importance of patient advocacy in receiving appropriate care.

If you would like to learn more about this, check out my interview with Dr. Holly Cummings who co-authored ACOG’s book about what to expect each month of your pregnancy and postpartum.

Sources

The U.S. Food and Drug Administration Requires Notification of Breast Density in Mammography Reports, Practice Advisory, April 2023

Compounded Bioidentical Menopausal Hormone Therapy, Clinical Consensus, Number 6, November 2023 (ACOG)

Optimizing Postpartum Care, Committee Opinion, Number 736, May 2018