Podcast
BackTable Women's Health
Hosted by BackTable · EN
The go-to podcast for OBGYNs, gynecologic surgeons, and healthcare professionals focused on women's health. Tune in every week for practical, physician-led conversations on common and complex clinical topics in women's health. Hear how experienced physicians approach real cases, and get practical advice from your peers in your field.
24episodes
Episodes
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Ep. 118 Comprehensive Bone Health: Diet, Hormones, & Preventative Care with Dr. Pooja Luthra
1w ago00:48:11Tap to summarizeOsteoporosis may present after menopause, but prevention starts decades earlier. In this episode of BackTable Women’s Health, Dr. Carla Gunn, guest host and OBGYN, interviews Dr. Pooja Luthra, an endocrinologist at UConn Health, about osteopenia, osteoporosis, and practical strategies for lifelong bone health. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction03:28 - Why Bone Health Matters Early05:23 - Bone as a Vital Sign08:02 - Amenorrhea and Early Screening09:51 - Calcium, Vitamin D, and Protein15:11 - Menopause Bone Biology Explained21:58 - Metabolic Diseases and Bone Risk25:58 - Early Screening Red Flags27:53 - Hormone Therapy Bone Benefits30:59 - Reading DEXA Scores33:42 - FRAX Scores35:09 - Modern Treatment Sequencing38:02 - Bisphosphonates Mechanism and Concerns41:16 - Secondary Labs and Referrals44:23 - Closing Thoughts --- More about this episode Dr. Luthra explains how peak bone mass is largely established by early adulthood, followed by accelerated loss during the perimenopausal/menopausal transition due to estrogen decline, inflammatory cytokines, altered calcium absorption, and increased bone resorption. She reviews prevention strategies, including adequate calcium, vitamin D, and protein intake, resistance training, and avoiding smoking and excess alcohol use. The discussion also covers high-risk conditions that can negatively impact bone health, including amenorrhea, premature ovarian insufficiency, hyperthyroidism, diabetes, and chronic kidney disease, along with considerations for earlier screening in these patients. Dr. Luthra walks through DEXA interpretation, including T-scores, Z-scores, trabecular bone score (TBS), and FRAX assessment. She closes the conversation by outlining treatment sequencing with anabolic agents before antiresorptives, bisphosphonate safety, alternative therapies, and secondary osteoporosis workup labs. --- Resources FRAX Tool:https://www.fraxplus.org/calculation-tool --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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Ep. 117 Radiation Therapy Advances for Gynecologic Cancers with Dr. Andrew Lim
2w ago00:52:20Tap to summarize"The treatment of cervical cancer is definitely a team sport." Hear how recent radiation advancements are impacting gynecologic cancer care, and how to partner with your radiation oncologist to tailor therapy. This BackTable Women’s Health / Tumor Board episode features hosts Dr. Mona Guo and Dr. Marcia Ciccone joined by USC radiation oncologist and brachytherapy director Dr. Andrew Lim discussing modern radiation techniques, indications for definitive/adjuvant therapy, and toxicity management in gynecologic cancers. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:39 - Modern External Beam IMRT05:47 - Planning With CT And AI08:14 - Daily Setup Imaging Workflow13:30 - Dose and Fractionation Basics18:50 - HDR Image Guided Brachy21:50 - Brachy Vs External Boost Evidence24:54 - Managing Side Effects and Menopause28:49 - Hormone Therapy Benefits30:37 - Dilators and Pelvic Rehab33:12 - Long Term Radiation Effects38:14 - Spacers and Prolapse Planning41:42 - Reirradiation and Plan Review44:05 - Palliative Radiation Choices46:50 - Gamma Knife Explained50:16 - Conclusion --- More about this episode Dr. Lim contrasts historical four-field box radiation with contemporary IMRT, CT-based planning, daily cone-beam verification, and AI-assisted contouring with dosimetrist support. They review pelvic radiation treatment timelines, emerging hypofractionation data, and the essential role of image-guided brachytherapy for cervical cancer, including outpatient workflows and improved tumor coverage with reduced bladder/rectum dose. The group covers patient counseling on expected side effects, radiation-induced menopause, fertility, sexual health, vaginal stenosis prevention with dilators/pelvic floor therapy, late effects, re-irradiation considerations, spacers, palliative regimens, and stereotactic radiosurgery/Gamma Knife for brain metastases. --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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Ep. 116 Understanding the Birth Crisis: A Structural Collapse Perspective with Dr. Yamicia Connor
3w ago00:36:40Tap to summarizeWhat happens when maternity care deserts stop being just a “rural problem” and start impacting your own labor and delivery unit? On this episode of BackTable Women’s Health, host Dr. Nicole Faulkner interviews Dr. Yamicia Connor about the evolving “birth worker crisis.” Dr. Connor reframes the issue as a long-standing structural collapse accelerated by deliberate policy decisions, not simply sudden burnout. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:30 - Structural Collapse Explained05:41 - What Providers Can Do09:40 - Data On Care Deserts14:24 - COVID Like System Failure19:50 - Limits Of Telehealth20:57 - Think Systemwide Care23:52 - Insurance Access Shifts25:04 - Support Midlevel Workforce27:06 - Build Future Infrastructure29:39 - Burnout Is System Failure31:02 - Defunding Surveillance Risks32:51 - Stop Calling It Burnout34:35 - Conclusion --- More about this episode Dr. Connor describes how the systematic decoupling of clinical science from federal and state infrastructure has shifted legal and operational risk onto individual physicians, leading to illogical practice patterns and confusion about the standard of care, especially in settings like emergency departments. A review of the 2024 March of Dimes data showing over 35% of U.S. counties are now maternity care deserts, and JAMA-tracked data in states like Idaho, where nearly a third of OBs left between 2022 and 2024. She warns that as more rural units close, regional and academic hospitals will absorb sicker and less managed patients, straining L&D units, NICUs, staffing, and training pipelines. To address this crisis, Dr. Connor calls for system-level coordination, stronger leadership from professional societies, improved care navigation, expanded mid-level support, and enhanced telehealth infrastructure to extend obstetric expertise. --- Resources Maternity Care Deserts Across the US https://www.marchofdimes.org/maternity-care-deserts-report Change in Number of OB/GYN Physicians Practicing Obstetrics After the Dobbs Decision https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837058 --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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Ep. 115 Women’s Health Care Access, Childcare Challenges, & Advances in Adenomyosis with Dr. Kimberly Kho
May 500:48:28Tap to summarizeFrom surgery to systems to access, medicine is shaped as much by barriers to care as it is by innovation and the latest techniques. In this episode of BackTable OBGYN, Dr. Kimberly Kho, a complex benign gynecologic surgeon, joins host Dr. Amy Park to discuss her work expanding access to women’s healthcare, including building a surgical program in Hawaii, studying childcare as a barrier to care, and exploring the diagnosis and management of adenomyosis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction08:35 - Faculty Development in Hawaii12:26 - Childcare as Access Barrier16:20 - Survey and Trial Findings18:10 - Annie's Place Childcare Center24:23 - Childcare Barrier Example25:43 - Applying Community Solutions 27:04 - What Is Adenomyosis30:22 - Diagnosis Strategies Beyond Hysterectomy34:07 - Risk Factors and Age Myths36:03 - Fertility and Pregnancy Risks38:02 - Medical and Surgical Treatments41:20 - Uterine Sparing Procedures45:59 - Closing Thoughts --- More about this episode Dr. Kho discusses her recent transition to the University of Hawaii, where she is building a complex benign gynecology program to serve patients across the state and broader Pacific region. Her work emphasizes faculty development through mentorship, strengthening research infrastructure for generalists, fostering inter-island collaboration, and implementing surgical coaching. She then reflects on her time at Parkland, where she expanded access to minimally invasive gynecologic surgery, demonstrated by a significant reduction in open hysterectomy rates. She also shares how her team identified unmet childcare needs as a major barrier to care, leading to multiple research initiatives, a clinical trial, and ultimately the creation of a five-year, no-cost, onsite childcare center (Annie’s Place) developed through hospital and community partnerships. The episode concludes with an in-depth discussion of adenomyosis, covering its pathophysiology, imaging-based diagnosis, common symptoms, and fertility implications. In the absence of formal guidelines or FDA-approved therapies, Dr. Kho reviews current management strategies, including medical therapy, uterine artery embolization (UAE), and endometrial ablation techniques. --- Resources Childcare needs as a barrier to healthcare among women in a safety-net health systemhttps://pubmed.ncbi.nlm.nih.gov/38886715/ Addressing childcare as a barrier to healthcare access through community partnerships in a large public health systemhttps://pubmed.ncbi.nlm.nih.gov/36261213/ Adenomyosis Pathophysiology, Diagnostic Advances, and Therapeutic Optionshttps://pubmed.ncbi.nlm.nih.gov/41926770/ --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
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Ep. 114 Endometriosis Surgery Techniques & Challenges with Dr. Laura Ramirez
Apr 2800:54:19Tap to summarizeImaging, incisions, and Instagram: Dr. Ramirez on the cutting edge of endometriosis management. In this episode of BackTable OBGYN, host Dr. Mark Hoffman interviews Atlanta-based Complex Benign Gynecology (CBG/MIGS) surgeon Dr. Laura Ramirez about how her practice has shifted toward predominantly endometriosis care, driven in part by social media referrals bringing patients nationwide. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:57 - Introduction02:22 - Mentorship Mission and Career Focus06:13 - Social Media Referrals08:10 - What Is Endo Surgery and Targeted Excision13:27 - Multidisciplinary Care16:53 - Lesions and Adhesions Approach 22:20 - Imaging and Case Triage24:07 - Hysterectomy Expectations27:28 - Going Solo on Bowel Endo31:25 - Team Support and Mentors34:27- Residency Training Gaps40:39 - Call for Help Culture43:07 - Challenging Surgeries 48:10 - Noninvasive Tests and Therapy Limits51:26 - Conclusion --- More about this episode Dr. Ramirez discusses why endometriosis surgery varies by patient, pathology, and surgeon experience. She emphasizes careful symptom-based assessment, recognizing atypical lesions, and setting realistic expectations. The conversation contrasts radical peritoneal stripping with her preference for targeted excision to reduce complications, highlights multidisciplinary management for central sensitization and overlapping bowel/bladder symptoms, and covers imaging triage, robotic vs. laparoscopic approaches, collaborating with colorectal specialists, and diaphragmatic endometriosis as an ongoing surgical challenge. --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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Ep. 113 Managing Surgical Complications with Surgical Coaching & Emotional Resilience with Dr. Joseph Chen
Apr 2100:50:49Tap to summarizeWhat if we trained surgeons to recover from complications, not just avoid them? In this BackTable OBGYN episode, Dr. Joseph Chen, a complex benign gynecologic surgeon at Kaiser Permanente and certified surgical coach, joins host Dr. Nicole Faulkner to explore how surgeons process and recover from complications. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:15 - Dr. Chen’s Origin Story06:34 - Coaching Framework08:08 - Second Victim Phenomenon10:10 - Four Phases Of Stress15:07 - Managing OR Chaos19:22 - Delegation as Surgeons22:11 - Peer Review Programs25:09 - How Coaching Programs Work30:52 - Timeline After Complications33:16 - Avoiding The Advice Trap35:37 - Debriefing With Residents40:51 - Future of Coaching and AI47:13 - Resolution of Complic --- More about this episode Dr. Chen reflects on a serious complication during his fellowship that exposed an “emotional gap” in surgical training beyond technical solutions. This experience shaped his focus on psychological safety, crisis-management frameworks, and supportive coaching. He outlines the phases following an adverse event, from the initial chaos and cognitive overload to reflection, identity challenges, and resolution. Do these factors influence whether one experiences burnout, survival or growth. This episode also recommends practical strategies such as focused breathing, effective delegation, and simulation training to improve performance under pressure. Dr. Chen discusses the “second victim” phenomenon, reviews data on surgeons’ emotional responses after complications, and emphasizes the importance of allowing time before debriefing. They advocate for peer support, non-punitive systems, and coaching programs to improve surgeon well-being, patient safety, and operating room efficiency. Finally, they explore future roles for AI and video review in surgical learning. --- Resources Medical error: the second victim. The doctor who makes the mistake needs help toohttps://pubmed.ncbi.nlm.nih.gov/10720336/ Dare to Lead by Brené Brownhttps://brenebrown.com/book/dare-to-lead/ Atlas of the Heart by Brené Brownhttps://brenebrown.com/book/atlas-of-the-heart/ The Advice Trap by Michael Bungay Stanierhttps://www.mbs.works/advice-trap-book/#purchase-options --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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Ep. 112 Overactive Bladder Management: Updates and Guidelines with Dr. Jason Kim
Apr 1400:44:40Tap to summarizeWhat if we’re waiting too long to offer our OAB patients the treatments that actually work? In this episode of BackTable Urology, Dr. Jason Kim joins host Dr. Anjali Kapur to discuss updates in overactive bladder management and evolving guidelines, including a shift away from rigid stepwise care toward shared decision-making. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:06 - 2024 AUA/SUFU Idiopathic OAB Guideline07:32 - Patient Experience with OAB11:59 - Beta-3 Agonists vs Anticholinergics15:15 - Botox Counseling and Dosing18:11 - Tibial Nerve Stimulation25:47 - Sacral Neuromodulation32:09 - Cost Burden of OAB39:38 - Evolution of OAB Care41:39 - Future Research Directions --- More about this episode The conversation positions OAB as a clinical diagnosis, supported by focused initial evaluation and selective use of advanced testing, with attention to the emerging role of ambulatory urodynamics. Dr. Kim and Dr. Kapur review management across the care continuum, including behavioral strategies, pelvic floor physical therapy, and pharmacologic options, with consideration of beta-3 agonists in older patients. The discussion also focuses on earlier use of minimally invasive therapies such as intradetrusor Botox and neuromodulation, and how introducing these options sooner may improve follow-up, reduce delays, and help patients achieve symptom control more efficiently. --- Resources The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder (2024)https://www.auanet.org/guidelines-and-quality/guidelines/idiopathic-overactive-bladder Anticholinergic Drug Exposure and the Risk of Dementiahttps://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353 Randomized trial of percutaneous tibial nerve stimulation versus Sham efficacy in the treatment of overactive bladder syndrome: results from the SUmiT trial https://pubmed.ncbi.nlm.nih.gov/20171677/ Trends in Utilization of Sacral Neuromodulation for Overactive Bladder: Insight From the AUA AQUA Registryhttps://www.auajournals.org/doi/10.1097/UPJ.0000000000000916 A retrospective longitudinal evaluation of new overactive bladder patients in an FPMRS urologist practice: Are patients following up and utilizing third-line therapies?https://pubmed.ncbi.nlm.nih.gov/33197059/ --- BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
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Ep. 111 Digital Contraceptives in Reproductive Health Care with Dr. Kerry Krauss
Apr 700:30:25Tap to summarizeAre your patients looking for a nonhormonal option? Digital contraception could be the answer. In this episode of the BackTable Podcast, urologist Dr. Ruchika Talwar sits down with Dr. Kerry Krauss, an OBGYN and Senior Medical Advisor at Natural Cycles, to discuss the evolving landscape of digital health tools in women's reproductive care. --- Get the BackTable app https://www.backtable.com/app --- This podcast is supported by Natural Cycleshttps://www.naturalcycles.com/ --- Timestamps 01:29 - Introduction03:02 - Contraception Pain Points06:16 - Natural Cycles Origin09:46 - How The App Works12:44 - Effectiveness And Variability15:18 - Ideal Users And Red Days17:34 - Modes Beyond Birth Control19:19 - Clinical Insights From Data22:04 - Future And Privacy24:31 - Counseling And Adoption Tips27:19 - Conclusion --- More about this episode Dr. Krauss shares her journey into tech and wearables and provides insights into the functionality, effectiveness, and future prospects of Natural Cycles, a digital contraceptive app. The discussion covers the utility of basal body temperature tracking, the unique features of the Natural Cycles algorithm, and real-world applications and user experiences. They also explore the broader implications and potential surrounding the integration of digital health tools into patient care, emphasizing the importance of meeting patients where they are.
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Ep. 110 Integrated Healthcare & Minimally Invasive Hysterectomies with Dr. Eve Zaritsky
Mar 3100:48:39Tap to summarizeWhat happens when a fully integrated healthcare system aligns training, data, and access to improve surgical outcomes? In this BackTable OBGYN episode, Dr. Eve Zaritsky joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss how Kaiser’s integrated health system enables rapid care coordination, large-scale quality improvement, and population-level research using one of the largest US datasets. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 01:17 - Introduction 03:35 - How Kaiser Works07:24 - Research Using Big Data09:19 - Changing Hysterectomy Culture13:36 - Ending Racial Disparities15:22 - Handling Large Uteri17:52 - Vaginal Hysterectomy Trends20:38 - Myomectomy Reintervention Rates24:23 - Shared Decision Making26:30 - Mini Lap Versus Robotic27:41 - Hybrid Extraction Strategy29:08 - Credentialing Robotic Myomectomy30:19 - MIG Referral Pathways32:03 - Fibroids Across Asian Subgroups34:55 - Mentoring Research Pipeline36:44 - Funding Analysts Through GME40:49 - Endometriosis Disparities Findings43:59 - Mentorship Mindset --- More about this episode Dr. Zaritsky describes how a coordinated, system-wide effort transformed hysterectomy care, shifting from 80% open procedures to nearly 90% minimally invasive within five to eight years through focused training, reducing low-volume practice, and tracking system metrics, ultimately decreasing racial disparities once minimally invasive rates exceeded 90%. She also highlights Kaiser-based research on variation in vaginal hysterectomy by service area and surgeon volume, long-term reintervention rates for fibroids across procedures, increasing use of minimally invasive myomectomy, and a JAMA analysis showing differences in fibroid diagnosis among Asian subgroups with the highest rates in South Asians. The episode concludes with Dr. Zaritsky calling attention to how Kaiser’s research infrastructure creates robust opportunities for meaningful mentorship across all levels of training, supporting the development of physicians, residents, and medical students. --- Resources Minimally Invasive Hysterectomy and Power Morcellation Trends in a West Coast Integrated Health System https://pubmed.ncbi.nlm.nih.gov/28486359/ Racial Disparities in Endometriosis and Pelvic Pain Treatment Within an Integrated Health Care Delivery System https://pubmed.ncbi.nlm.nih.gov/40839882/ Uterine Fibroid Diagnosis by Race and Ethnicity in an Integrated Health Care Systemhttps://pubmed.ncbi.nlm.nih.gov/40172885/
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Ep. 109 Hereditary GYN Cancer Syndromes: Practical Screening & Risk-Reduction Guide with Dr. Marcia Ciccone
Mar 2401:05:42Tap to summarizeWhen to test, how to prevent, and what you need to know about hereditary gynecologic cancer syndromes. Two USC gynecologic oncologists, Dr. Mona Guo and Dr. Marcia Ciccone, go in-depth in this BackTable OBGYN x Tumor Board crossover episode. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:37 - Why Hereditary Cancer Matters04:51 - Family History Red Flags09:01 - Who Should Order Genetic Testing11:32 - Variants and Counseling Pitfalls13:30 - Access and Remote Testing Options19:27 - BRCA1 Positive Patient Walkthrough24:52 - Risk-Reducing Surgeries29:11 - Prevention and Screening Limits32:38 - Why Ovarian Cancer Is Hard34:04 - Combining Breast and Gyn Surgery35:41 - Preop Ultrasound and CA-12536:27 - BRCA Timing and HRT Nuance42:32 - Nonhormonal Menopause Options47:14 - Lynch Syndrome Screening Basics54:22 - Endometrial Biopsy Debate56:43 - Insurance and Coverage Pitfalls59:00 - Fertility Preservation and REI01:01:41 - Cascade Testing01:02:45 - Conclusion --- More about this episode Dr. Guo and Dr. Ciccone discuss how careful family history can identify patients who may benefit from genetic evaluation and highlight key red flags, including a family history of ovarian cancer, breast cancer at age 50 or younger, and metastatic prostate cancer. They explain the role of genetic counseling, including pre- and post-test discussions and how to approach variants of uncertain significance. They then cover BRCA counseling and risk-reduction strategies, including the timing of risk-reducing bilateral salpingo-oophorectomy, ongoing salpingectomy trials, and considerations for hysterectomy. Additionally, they touch on pathology protocols, breast cancer screening, and the potential protective effect of hormonal contraception. The doctors address the limitations of ovarian cancer screening and outline patterns suggestive of Lynch syndrome, such as endometrial cancer occurring alongside gastrointestinal or urinary tract cancers. They review the Lynch workup, including tumor mismatch repair immunohistochemistry and MLH1 hypermethylation testing. Finally, they discuss practical considerations like barriers to access, Medicare coverage challenges, fertility preservation referrals, menopause management, and cascade testing in families, including the timing of testing in children. --- Resources NCCN Guidelines: Detection, Prevention, and Risk Reductionhttps://www.nccn.org/guidelines/category_2
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