One of the goals of the Affordable Care Act (ACA) is to improve women’s access to health care. In the past, women could be denied insurance coverage because they were women or could be charged more for insurance than their male counterparts.
Women with bipolar disorder or history of postpartum psychosis are at high risk for postpartum psychosis; appropriate interventions significantly decrease this risk.
Given the prevalence of postpartum OCD and obsessive symptoms in women with postpartum depression, we should devote more time to this topic. This is an informative and well-written article by Alice Wolton on postpartum OCD in Forbes. In this piece, she mentions a recent study from Timpano and colleagues at the University of Miami where cognitive behavioral therapy (CBT) was used to prevent postpartum OCD.Â
Wouldn’t it be nice if we could identify women who were at risk for postpartum depression (PPD)? Maybe if we could do that, we could actually prevent the depression from occurring. Or at least, we could intervene in some way so that the depression would not significantly affect the mother and her family.Â
The American Psychiatric Association is now considering the possibility of including premenstrual dysphoric disorder (PMDD) in the DSM-V as a new category, rather than listing a set of criteria for PMDD in the appendix (as in DSM-IV). The diagnostic criteria remain relatively unchanged. Many feel that the Inclusion of PMDD as a distinct diagnostic category will lead to greater legitimacy for the disorder and will encourage the growth of evidence-based research in this area.
Ever since 2002 when several large-scale studies called into question the safety of long-term hormone replacement therapy (HRT), there has been confusion and conflicting opinions regarding the management of menopausal symptoms. Initially there was a movement to avoid HRT altogether; now it is becoming clearer that certain women may safely use and benefit from hormonal interventions.
More than half of all women initiating treatment with hormone therapy will stop within the first year of treatment, most often because of side effects. Mood disturbance is a relatively common side effect that occurs with hormone therapy, and previous studies have suggested that progestins in the combined hormone preparations are responsible for these negative mood effects.
While phytoestrogens have gained attention as possible alternatives to hormone therapy for the treatment of menopausal symptoms, placebo-controlled studies have yielded mixed results. Pomegranate seed oil is a very rich source of phytoestrogens.  In this prospective randomized, placebo-controlled, double-blinded trial, 81 postmenopausal women received two daily doses of either 30 mg pomegranate seed oil (PGS) or placebo. The frequency of hot flashes decreased by 38.7% (P < 0.001) after 12 weeks of treatment with pomegranate seed oil and by 25.6% in the placebo group (P < 0.01). However, the difference between the two groups was not statistically significant (P = 0.17).  The authors suggest that it may take a longer period of observation to demonstrate a difference between pomegranate seed oil and placebo.
The FDA will require Yaz, Yasmin and several other newer oral contraceptives to carry new warning labels that detail the potential risk of venous thromboembolism (VTE or blood clots). All oral contraceptives increase the risk of blood clots; however, recent studies have suggested that birth control pills containing drospirenone, a synthetic form of the hormone progesterone, may carry a slightly increased risk of VTE, compared with older birth control pills. The FDA estimates that over a one year period, 10 in 10,000 women taking an oral contraceptive with drospirenone would develop a blood clot , as compared to about 6 in 10,000 women taking older contraceptives.
Menstrual irregularity is a common side effect of antipsychotic treatment in women, occurring more commonly in those treated with risperidone and the older antipsychotic medications. New research presented at the APA earlier this month indicated that the addition of metformin at 500 mg bid resolved menstrual irregularities in most women treated with antipsychotic medications. (Metformin is a medication used alone or with other medications, including insulin, to treat type 2 diabetes.) In addition, women receiving metformin lost an average 2.4 kg of weight after 6 months of treatment.
