Patient wants an IUD so we discuss the risks as part of informed consent including: IUDs are >99% effective in preventing pregnancy, but those who do get pregnant are more likely to have an ectopic pregnancy.
"What happens if I get an ectopic, are docs able to take care of me?"
Patients should not have to ask this question. They should not have to wonder if someone will save their life. Ectopic pregnancies can be a life-threatening emergency and are never viable.
Nov 5, 2022 • 6 tweets • 2 min read
Parent: She can't go to school on her period.
Me: 👀
"The school locks the girls bathroom and girls are only allowed 15 bathroom passes per semester."
"Are the boys bathrooms locked?"
"No"
Here's a stack of school notes for the whole class. #MedTwitter#obgyntwitter#MedEd
No one should be regularly missing school (or work) for their period. Heavy periods, painful periods, unpredictable periods, annoying periods, premenstrual symptoms, just hate having periods. There are so many options to make menstrual cycles less daunting.
Aug 6, 2022 • 13 tweets • 5 min read
”She's moody, probably because she's a teenage girl, but could it be the #BirthControl?”
"She's acting so hormonal."
"Her moods are crazy, she's PMSing all the time."
Moods have nothing to do with #gender and sex hormones! These #stereotypes only perpetuate #bias. 🧵 #MedTwitter
Let's start with #hormones. Hormones are chemicals released by certain organs that carry messages to other organs. Everyone has hormones. Changes in hormone levels can affect our moods but having hormones does not make someone moody.
Apr 28, 2022 • 6 tweets • 2 min read
Parent: Is it true birth control pills are made to have monthly periods just to appease the church?
Me (having just read Malcolm Gladwell's book about this): It seems so, yes. There's no reason your child needs to have periods.
Parent: 😡 Why didn't anyone tell me that sooner! 🧵
John Rock, a devout Catholic, was one of the inventors of the Pill, which was FDA-approved in 1960. The Catholic church bans any methods other than the rhythm method as 'mortal sin,' so the only acceptable way to avoid pregnancy is to not have sex during the fertile window.
Apr 13, 2022 • 4 tweets • 2 min read
Myth: "My periods are so painful that I miss a couple days of school each month. Sometimes I think about calling 911 because of the pain. My doctor said this was normal and I'd grow out of them." 😱😱😱
THIS IS NOT NORMAL. 🧵 #MedTwitter#obgyntwitter#tweetorial
Severe period cramps are common but they are absolutely not normal. If someone is missing school or activities because of cramping or heavy bleeding, this is not normal. There are so many options to make periods better and no one needs to have a period if they don't want to.
Apr 13, 2022 • 6 tweets • 2 min read
There's actually nothing special about Sunday. It doesn't matter what day your period starts and you don't have to start your #BirthControl the Sunday after your period starts. 🧵 #MedTwitter#tweetorial#obgyntwitter
Usually I tell people to start the first day of the period or as soon as they pick up the prescription. Starting during the period decreases risk of breakthrough bleeding and starting immediately gets them protected against pregnancy asap (and often makes next period lighter).
Mar 28, 2022 • 10 tweets • 3 min read
Ready for another #PAG mystery?
16yo with primary amenorrhea (never started periods).
What questions do you want to ask? #MedTwitter#MedEd#tweetorial#OBGYNtwitter
There are many reasons someone might not have periods. I usually divide them into sections to make them easier to rule out:
- hormonal: either repro hormones not cycling normally and/or abnormal levels of other hormones
- structural: could be a blockage or underdeveloped organs
Feb 13, 2022 • 9 tweets • 5 min read
During each visit, I always try to talk about the #HPV vaccine if they need it. One mom said, "we don't need that yet, her PCP said she had until age 26 to get it." 🤦♀️
Please start as early as possible (age 11-12). I'll tell you why 🧵 #tweetorial#MedTwitter#MedEd#obgyntwitter#HPV (human papillomavirus) is the most common #STI in the US; 80% of sexually active people will get it. There are 100s of different strains; many asymptomatic, others cause genital warts, abnormal pap smears, and cancer (cervical, vaginal, anal, penile, vulvar, oropharyngeal).
