Episodios

  • Ep. 88 Hormone Replacement Therapy in Menopause: Risks, Benefits, and Myths Debunked with Dr. Kelly Casperson

    Ep. 88 Hormone Replacement Therapy in Menopause: Risks, Benefits, and Myths Debunked with Dr. Kelly Casperson
    Jul 8 2025
    Menopause isn’t just a diagnosis—it’s a transition, and the way we treat it needs to change. Dr. Kelly Casperson joins Dr. Suzette Sutherland in this urogynecology crossover episode of BackTable to challenge outdated beliefs about menopause and hormone replacement therapy (HRT). They revisit the impact of the 1990s Women’s Health Initiative (WHI) study and explain how its findings—especially around synthetic hormones—were widely misinterpreted and continue to adversely influence patient and provider decisions today. --- SYNPOSIS Dr. Casperson breaks down the differences between the hormones used in WHI and the safer, more targeted options available today. The conversation explores the broad benefits of modern HRT, including reduced risks of cardiovascular disease, osteoporosis-related fractures, and even dementia. Beyond the science, the episode also addresses the urgent need for better medical education and updated guidelines around menopause care.Dr. Casperson and Dr. Sutherland make the case for empowering patients through informed consent and better clinician training. They also discuss Dr. Casperson’s upcoming book, The Menopause Moment, which aims to equip women with the tools and knowledge to navigate this life stage with confidence. --- TIMESTAMPS 00:00 - Introduction02:50 - Focus on Menopause and Hormone Replacement Therapy04:20 - The Women's Health Initiative (WHI) Study05:39 - Understanding Risks and Misconceptions12:43 - Reevaluation of the Women’s Health Initiative Study18:31 - Impact of Media and Physician Education19:58 - Current State of Hormone Therapy22:17 - Broader Implications and Future Directions27:17 - Evaluating FDA Warnings and Gender Bias in Hormone Treatments29:49 - The Impact of Hormone Therapy on Women's Health32:11 - Risks of Not Using Hormones35:44 - Hormones and Brain Health: Debunking Myths40:41 - The Timing Hypothesis and Long-Term Hormone Use46:32 - Advocacy and Education for Menopause Awareness48:04 - Conclusion and Upcoming Resources --- RESOURCES PBS: The M Factor: Shredding the Silence on Menopause:https://www.pbs.org/show/the-m-factor-shredding-the-silence-on-menopause/ The Menopause Moment by Dr. Kelly Casperson: https://kellycaspersonmd.com/the-menopause-moment-book/ Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia:https://pmc.ncbi.nlm.nih.gov/articles/PMC10625913/
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    52 m
  • Ep. 87 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra

    Ep. 87 Evaluating Hormone Therapy in Menopause Management with Dr. Yahir Santiago-Lastra
    Jul 1 2025
    Vaginal estrogen is not the enemy. Outdated data is. In this crossover episode of the BackTable Urology and OBGYN podcasts, Dr. Suzette Sutherland and Dr. Yahir Santiago-Lastra delve into the persistent challenges and ongoing advocacy efforts surrounding the FDA's black box warning on vaginal estrogen. --- SYNPOSIS They explore the historical context and far-reaching influence of the 1990s Women’s Health Initiative (WHI) study, asserting that its misinterpretation continues to shape misconceptions and hinder effective menopause care. The discussion highlights recent data refuting the risks associated with vaginal estrogen therapies and underscores the urgent need for updated, evidence-based guidelines to support women throughout menopause. Dr. Santiago-Lastra also draws attention to gender-based inequities in hormone treatment, the robust evidence contradicting the current black box warning, and the multi-faceted advocacy required to bring about change. This episode is part of a broader series focused on various aspects of menopause. --- TIMESTAMPS 00:00 - Introduction02:01 - Menopause Series Overview03:55 - History of the Black Box Warning on Estrogen07:26 - Understanding the Black Box Warning12:11 - The Citizen's Petition and FDA Process18:11 - Gender Inequity in Medical Treatment22:45 - Factors Resulting in Gender Inequity29:02 - Genital Urinary Syndrome of Menopause (GSM)29:32 - Benefits of Vaginal Estrogen33:33 - Legislative Advocacy and Medicare34:43 - Professional and Patient Advocacy36:35 - Challenges and Progress in Label Change43:35 - Historical Context and Gender Equity45:07 - Recap and Future Directions
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    50 m
  • Ep. 86 Understanding Fetal & Maternal Interventions: Procedures & Outcomes with Dr. Hiba Mustafa

    Ep. 86 Understanding Fetal & Maternal Interventions: Procedures & Outcomes with Dr. Hiba Mustafa
    Jun 17 2025
    Step inside the evolving world of fetal therapy where precision, teamwork, and full-spectrum care matter most. In this episode of the BackTable OBGYN Podcast, Dr. Anthony Shanks, Vice Chair of Education in the OB department at Indiana University School of Medicine, interviews Dr. Hiba Mustafa, a distinguished maternal-fetal medicine specialist and fetal interventionalist at Riley Children's Hospital. They discuss Dr. Mustafa's expertise in fetal diagnosis and therapy, her training journey through various fellowships, and her role in directing multiple fetal medicine programs. --- SYNPOSIS Dr. Mustafa elaborates on the intricacies of fetal interventions, including procedures for complications in monochorionic twins, spina bifida repair, and new emerging therapies. They also touch on research methodologies like the Delphi consensus technique and summarize key findings from recent studies on conditions such as hemolytic disease, gastroschisis, lower urinary tract obstructions, and preterm birth in twin pregnancies. Dr. Mustafa shares insights on how to stay sharp in the field, the importance of teamwork in surgical procedures, and advice for those aspiring to enter the field of fetal therapy. --- TIMESTAMPS 00:00 - Introduction02:45 - The Role of a Fetal Interventionalist04:00 - Dr. Mustafa’s Training Journey07:42 - Fetal Surgery Fellowships16:43 - Conditions Treated by Fetal Interventionalists21:17 - Monitoring and Referrals for Monochorionic Twins30:04 - Understanding Percutaneous Procedures31:10 - Navigating the Equator in Fetal Surgery32:31 - Laser Surgery Techniques and Outcomes33:18 - The Importance of Placenta Delivery33:47 - In Utero Spina Bifida Repair36:19 - Minimally Invasive Techniques for Spina Bifida38:28 - Maintaining Skills in Fetal Interventions42:11 - Delphi Consensus Technique in Medical Research46:19 - Key Takeaways from Recent Research51:55 - Future of Fetal Therapy and Personal Insights
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    1 h
  • Ep. 85 Understanding Single Port Laparoscopy: Techniques and Outcomes with Dr. Kevin Stepp

    Ep. 85 Understanding Single Port Laparoscopy: Techniques and Outcomes with Dr. Kevin Stepp
    Jun 3 2025
    Real innovation? It’s not just the tools and techniques you use, it’s how you think. In this episode of the BackTable OBGYN podcast, hosts Dr. Mark Hoffman and Dr. Amy Park welcome Dr. Kevin Stepp, a MIGS surgeon and urogynecologist in Charlotte, North Carolina, and an OBGYN professor at Wake Forest University School of Medicine. Dr. Stepp shares his journey into the field, including his serendipitous start in single-port laparoscopy and the many surgical innovations that he has pioneered. --- SYNPOSIS The conversation highlights the importance of anatomical knowledge, thinking beyond conventional surgical approaches, and the significance of teamwork and efficiency in the operating room. A central focus is placed on the development and application of single-port techniques, highlighting the associated learning curves and the evolving role of robotic surgery. The discussion also explores how surgical team dynamics, effective communication, and ongoing innovation collectively contribute to better patient outcomes and advancement in the medical field. --- TIMESTAMPS 00:00 - Introduction03:50 - Pioneering Single Port Laparoscopy10:10 - Challenges and Advantages of Single Port Surgery13:52 - Cosmetic Considerations and Incision Techniques27:27 - Innovative Approaches and Future Directions30:40 - Understanding 3D Anatomy in GYN Surgery32:10 - Sustaining Innovation in Urogynecology33:53 - Efficiency in Surgical Procedures39:20 - Advancement of Surgical Educational Materials 42:47 - Single Port and Robotic Procedures50:50 - Building a Team through Positive Surgical Culture01:02:13 - Continuous Improvement and Humility in Surgery
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    1 h y 8 m
  • Ep. 84 Personalizing Pelvic Pain Treatment: Tools and Challenges with Dr. Frank Tu

    Ep. 84 Personalizing Pelvic Pain Treatment: Tools and Challenges with Dr. Frank Tu
    May 20 2025
    What if surgery isn’t the only answer to pelvic pain? In this episode of the BackTable podcast, host Dr. Mark Hoffman and co-host Dr. Amy Park welcome Dr. Frank Tu, Vice Chair for Quality at Endeavor Health and Director of the Division of Gynecological Pain and Minimally Invasive Surgery. The episode explores the complexity of chronic pelvic pain, emphasizing its multifactorial origins and individualized treatment approaches.---SYNPOSISDr. Tu shares insights into the persistence and treatment of chronic pelvic pain, the role of trauma, and the evolving understanding of endometriosis and other gynecological conditions. The discussion covers patient treatment modalities, the potential of artificial intelligence in medical diagnostics, and the significant role of non-surgical interventions like physical therapy. Dr. Tu's reflections on interdisciplinary collaborations, preventative approaches, and the future directions of gynecologic pain management provide a comprehensive overview of this complex field.---TIMESTAMPS00:00 - Introduction05:21 - Mentorship and Influences07:01 - Research and Innovations in Pelvic Pain09:21 - Preventative Approaches to Chronic Pain14:15 - Exploring Pain Mechanisms and Treatments26:32 - The Role of Sensory Reintroduction30:20 - The Importance of Mental Health30:49 - Challenges in Treating Chronic Pelvic Pain31:24 - The Role of Surgery and Mental Health in Pain Management34:00 - Barriers to Effective Pelvic Floor Physical Therapy35:40 - The Complexity of Treating Dysmenorrhea44:11 - Exploring Personalized Medicine and AI in Pain Management51:22 - The Future of Pain Management and AI54:25 - The Role of Big Data and AI in Medical Research59:25 - Final Thoughts
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    1 h y 3 m
  • Ep. 83 Promoting Parity in Maternal Care and Academia with Dr. Ebony Carter

    Ep. 83 Promoting Parity in Maternal Care and Academia with Dr. Ebony Carter
    May 6 2025
    Equity is not just a box to check; it is the framework for lasting change. In this week's BackTable podcast, guest host Dr. Veronica Lerner speaks with Dr. Ebony Carter, a high-risk obstetrician and Division Director for Maternal-Fetal Medicine at the University of North Carolina at Chapel Hill. Dr. Carter shares insights into her career journey, which was influenced by her mother's activism in health equity, her work on reproductive health disparities, and community engagement projects. ---SYNPOSISThe conversation underscores the importance of patient participation and agency in clinical decision-making. Dr. Carter and Dr. Lerner also discuss the development of an equity rubric for peer-reviewed journals, highlighting the need for inclusive and intentional research practices. They explore practical applications of the rubric, including the proper acknowledgment of contributors to foundational concepts. The episode further delves into Dr. Carter’s mentorship initiatives at the Green Journal and her guiding philosophy of pursuing impactful, community-driven work rooted in passion and purpose.---TIMESTAMPS00:00 - Introduction02:06 - Dr. Carter's Journey and Inspiration05:19 - Community Engagement and Health Equity06:19 - Patient Advocacy and Shared Decision Making08:54 - Collaborative Research and Community Partnerships16:58 - Addressing Bias in Medical Practice22:12 - Equity in Academic Publishing28:26 - Diversifying the Peer Review Pool30:33 - Creating and Implementing the Equity Rubric31:17 - The Impact and Application of the Equity Rubric33:31 - Personal Reflections on Equity and Research35:25 - Citing Foundational Work38:48 - Mentorship and Training Future Leaders47:05 - Career Transitions and Future Goals52:36 - Final Thoughts and Advice for Aspiring Professionals---RESOURCESFull Equity Rubric:https://journals.lww.com/greenjournal/Documents/OnG_Equity_Rubric_1.pdf ​Equity Rubric Introduction Video:https://youtu.be/Jh5_L-pYkuE?si=JREjSSCr98jqjVVB Equity Rubric Introduction Video Slide Deck:https://journals.lww.com/greenjournal/Documents/Green%20Journal%20Equity%20Rubric%20YouTube_final_2022_01_16%20(Slides).pdf
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    1 h
  • Ep. 82 Building Effective Endometriosis Case Conferences with Dr. Peter Movilla and Dr. Anu Shenoy-Bhangle

    Ep. 82 Building Effective Endometriosis Case Conferences with Dr. Peter Movilla and Dr. Anu Shenoy-Bhangle
    Apr 22 2025
    Curious how cross-specialty teamwork is reshaping endometriosis care? In this episode of BackTable OBGYN, host Dr. Mark Hoffman speaks with Dr. Peter Movilla, Associate Medical Director at Newton Wellesley Hospital, and Dr. Anuradha Shenoy-Bhangle, Assistant Professor of Radiology at Harvard Medical School, about their collaborative efforts in advancing endometriosis care. --- SYNPOSIS The discussion covers the development and benefits of monthly multidisciplinary conferences that include gynecologists, radiologists, colorectal, urologic, and thoracic surgeons. The conferences aim to improve preoperative planning, intraoperative accuracy, and postoperative care through detailed imaging techniques, primarily MRI. They also highlight the importance of educating fellows and colleagues, the role of ultrasound screening, and future directions like AI and PET imaging. The episode emphasizes the challenges and rewards of treating endometriosis and fostering better patient outcomes through teamwork and innovation. --- TIMESTAMPS 00:00 - Introduction 01:55 - The Journey to Specialization 07:02 - Building a Multidisciplinary Team 15:07 - The Value of Postoperative Reviews 22:49 - Patient Counseling and Personalized Care 29:36 - Challenges in Endometriosis Treatment 31:00 - Educating Beyond the Clinic 33:05 - Innovations in Imaging 46:22 - Future Directions in Endometriosis Research 53:15 - Conference Highlights and Final Thoughts --- RESOURCES Recommendations for MRI technique in the evaluation of pelvic endometriosis: consensus statement from the Society of Abdominal Radiology endometriosis disease‑focused panel: https://drive.google.com/file/d/1VRBpw5V3AH-rWGEG43K1CMCx2flCXl2M/view?usp=sharing
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    57 m
  • Ep. 81 Surgical Considerations in Chronic Pelvic Pain with Dr. Mark Dassel

    Ep. 81 Surgical Considerations in Chronic Pelvic Pain with Dr. Mark Dassel
    Apr 8 2025
    When should you consider surgical management of chronic pelvic pain conditions? In this episode of the BackTable OBGYN podcast, Dr. Mark Dassel, a MIGS surgeon at Intermountain Health in Salt Lake City, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss medical and surgical management strategies for chronic pelvic pain, particularly endometriosis. --- SYNPOSIS Dr. Dassel emphasizes the importance of stopping the hormonal triggers associated with pain and explores various medical treatments, including hormonal therapies and the role of contraceptives. He also highlights his approach to surgical interventions such as endometriosis excision, endometrioma removal, and hysterectomy, and the importance of holistic treatment plans involving pelvic floor physical therapy and central pain modulators. The episode also covers the complexities of diagnosing and treating pelvic pain, the role of early intervention, and the value of multidisciplinary care. --- TIMESTAMPS 00:00 - Introduction 07:55 - Differentiating Causes of Chronic Pelvic Pain 10:13 - Multidisciplinary Care and Costs 14:26 - Acute vs Chronic Pain 17:00 - Centralized Pain 18:46 - When to Offer Surgery 23:42 - Fertility and Endometriosis 33:25 - Hormonal Suppression Post-Surgery 37:24 - Pelvic Floor Botox and Physical Therapy 44:42 - Hysterectomy for Pelvic Pain 51:53 - Nerve Ablation and Pain Management 57:10 - Final Thoughts
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    1 h