BackTable Women's Health

BackTable Inc.
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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.

  1. vor 2 Std.

    Ep. 139 Breastfeeding Support: What OB/GYNs Need to Know with Dr. Janelle Alvarez

    Can I have a glass of wine? Do I have to pump and dump after my CT scan? Will my antidepressant hurt the baby? Did I fail if we need formula? Every OBGYN hears these breastfeeding questions, sometimes at 3 AM on rounds, and the answers are usually more reassuring than patients expect. On this episode of BackTable Women's Health, Dr. Nicole Faulkner is joined by Dr. Janelle Alvarez, an OBGYN who shares women's health education with more than 40,000 followers as Paging Dr. Alvarez, to help OBGYNs feel ready for breastfeeding questions on rounds, at postpartum visits, and in the patient portal. Dr. Alvarez explains why lactation gets lost in a four-year residency and which parts belong to OBGYNs, which she sums up as breast, meds, and moods. The two then clear up common myths, from pumping and dumping after alcohol, contrast, or anesthesia to the strict criteria for lactational amenorrhea, and show how looking up a medication in LactMed in front of the patient builds trust. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:21 - Choosing OBGYN and Educating Patients Online07:11 - Gaps in OBGYN Breastfeeding Training13:06 - Myths About Alcohol, Imaging, Anesthesia, and Medications17:00 - Pump Output, Plugged Ducts, and Lactational Amenorrhea21:29 - Social Media Trends: Supply Hacks, Formula, and Supplements26:23 - Colostrum, Newborn Weight Loss, and a Feeding Plan35:13 - The Mental Load and Why Breastfeeding Is Not Purely Instinctual40:19 - Breastfeeding Pain as a Reason to Stop43:24 - Returning to Work, Pumping Rights, and Advocacy53:53 - Back-to-Work Letters, Milk Storage, and Supply Drops59:04 - Assessing Breast Pain: Flange Fit, Vasospasm, and the Mastitis Spectrum1:06:22 - Examining the Patient and Closing Remarks --- More about this episode They go on to the supply hacks, formula debates, and unregulated supplements patients see on social media, how to set expectations for colostrum and newborn weight loss before delivery, why every family needs a feeding plan as much as a birth plan, and why Dr. Alvarez rejects the idea that breastfeeding is purely instinctual. Dr. Faulkner shares the day she asked a hotel near a national OBGYN meeting for a private place to pump, which leads to a practical review of workplace rights under the federal PUMP Act, back-to-work letters, and milk storage. They close with a stepwise approach to breast pain, from flange fit and vasospasm to the mastitis spectrum and when antibiotics are actually needed. --- Resources Drugs and Lactation Database (LactMed). National Library of Medicinehttps://www.ncbi.nlm.nih.gov/books/NBK501922/ Mitchell KB, et al. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeed Med. 2022https://pubmed.ncbi.nlm.nih.gov/35576513/ ACOG Committee Opinion No. 821: Barriers to Breastfeeding: Supporting Initiation and Continuation of Breastfeeding. Obstet Gynecol. 2021https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/02/barriers-to-breastfeeding-supporting-initiation-and-continuation-of-breastfeeding US Department of Labor: FLSA Protections to Pump at Work (PUMP for Nursing Mothers Act)https://www.dol.gov/agencies/whd/nursing-mothers/faq Dr. Nicole Faulkner, BackTable contributor pagehttps://www.backtable.com/shows/obgyn/contributors/dr-nicole-faulkner Birth Interrupted. Dr. Janelle Alvarez, Substack https://janellealvarez.substack.com/ Breast Milk Storage and Preparation. Centers for Disease Control and Prevention (CDC) https://www.cdc.gov/breastfeeding/breast-milk-preparation-and-storage/handling-breastmilk.htmlInternational Society for the Study of Women's Sexual Health (ISSWSH) https://www.isswsh.org/ --- 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

  2. 3. Nov.

    Ep. 138 From OB/GYN Generalist to Specialist: Returning to Fellowship with Dr. Jessica Shields

    Within six months of starting general OBGYN practice, one gynecologic surgeon says she felt like “a jack of all trades and a master of none,” and a few years later she left her job to become a fellow again. On this episode of BackTable Women’s Health, Dr. Joseph Chen, a complex benign gynecologic surgeon at Kaiser Permanente East Bay, is joined by Dr. Jessica Shields, program director of the Complex Benign Gynecology Fellowship at Lahey Clinic, to discuss what it takes to return to training after years in practice. They cover why some OBGYNs choose subspecialty training over a high-volume gynecology practice, how to apply to fellowship as a practicing physician, and what changes when an attending becomes a fellow again. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:47 - From Generalist to Fellowship Applicant06:26 - Subspecialty Training Versus a High-Volume Gynecology Practice09:49 - Applying From Practice and How Program Directors Review Applications13:57 - Building a Competitive Application While in Practice16:48 - Returning to Training as a Former Attending19:41 - Finding a Focus in Endometriosis and Chronic Pelvic Pain21:59 - Match Competitiveness and Whether Fellowship Is Necessary25:14 - Resident Readiness for Independent Surgery28:12 - Should OBGYN Residency Be Longer?30:13 - Perseverance and Closing Remarks --- More about this episodeDr. Shields shares the case log lesson from her own interview day, the order in which she now reads applications, and how attendings without protected research time can show commitment through courses, hospital committees, and mentors. The conversation moves through life as a fellow after being an attending, the patient with pelvic pain who steered her toward endometriosis care, why the complex benign gynecology match remains competitive, and whether fellowship is needed for a gynecology-focused practice. Drs. Chen and Shields close on resident readiness for independent surgery, whether OBGYN residency should be longer, why daily repetition sets fellowship apart, and the perseverance that carried her from a missed match to the fellowship she wanted. --- ResourcesGuntupalli SR, et al. Preparedness of Obstetrics and Gynecology Residents for Fellowship Training. Obstet Gynecol. 2015https://doi.org/10.1097/AOG.0000000000000999 Complex Benign Gynecology Fellowship, Lahey Clinic (Dr. Jessica Shields, Program Director)https://www.lahey.org/education-training/graduate/fellowships/complex-benign-gynecology Dr. Joseph Chen, BackTable contributor pagehttps://www.backtable.com/shows/obgyn/contributors/dr-joseph-chen --- 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

    Ep. 138 From OB/GYN Generalist to Specialist: Returning to Fellowship with Dr. Jessica Shields

  3. 27. Okt.

    Ep. 137 Obesity Medicine in Women’s Health with Dr. Taylor Hahn

    Heart disease is still the leading cause of death in women, and for many women the OBGYN is the only doctor they see each year, so how can obesity medicine become a natural part of that visit? On this episode of BackTable Women’s Health, Dr. Nicole Faulkner is joined by Dr. Taylor Hahn, an OBGYN board certified in obesity medicine and founder of VIA Women’s Health Collective, to discuss how general OBGYNs can integrate obesity care into everyday practice. They cover how to raise the weight conversation with and without a patient’s cue, which baseline labs to order, how to counsel patients on GLP-1 medications around pregnancy, and how to build a multidisciplinary team. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:52 - Making Time for the Weight Conversation05:10 - A Cardiometabolic Framework for Discussing Weight09:14 - Baseline Labs: Lipids, Apolipoprotein B, Lipoprotein(a), and Thyroid14:48 - Building a Multidisciplinary Care Team18:35 - Obesity Across Gynecologic Conditions22:36 - GLP-1 Medications Around Conception, Pregnancy, and Postpartum27:46 - Opportunities for OBGYNs and Removing Shame31:37 - Follow-Up, Monitoring, and Barriers to Lifestyle Change36:39 - Advice for OBGYNs New to Obesity Medicine40:53 - Adding Weight to the Health History Questionnaire42:56 - Closing Remarks --- More about this episode Dr. Hahn explains why she frames the conversation around cardiometabolic health rather than the number on the scale, and why she adds apolipoprotein B, lipoprotein(a), and more complete thyroid testing to her baseline workup. The conversation moves through the ways obesity intersects with abnormal uterine bleeding, polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS), fertility, and perimenopause; how to counsel patients who conceive while taking a GLP-1 medication, plan a washout before conception, and restart therapy postpartum; and what follow-up looks like during titration and maintenance. The discussion closes on removing shame from the conversation, adding a weight question to the intake form, and the reminder that OBGYNs do not need a second board certification to make a meaningful difference. --- ResourcesGuideline on the Management of Dyslipidemia. Circulation. 2026https://doi.org/10.1161/CIR.0000000000001423 Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Lancet. 2026https://doi.org/10.1016/s0140-6736(26)00717-8 VIA Women’s Health Collective (Dr. Taylor Hahn)https://www.viawomenshealth.com Dr. Nicole Faulkner, BackTable contributor pagehttps://www.backtable.com/shows/obgyn/contributors/dr-nicole-faulkner --- 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

    Ep. 137 Obesity Medicine in Women’s Health with Dr. Taylor Hahn

  4. 13. Okt.

    Ep. 136 Managing Adnexal Masses in GYN Practice with Dr. Mona Guo and Dr. Marcia Ciccone

    It is 4:50 on a Friday, and an ultrasound report lands in your inbox: six centimeter complex right ovarian mass, neoplasm cannot be excluded. What happens next? On this episode of BackTable Women’s Health, Dr. Mona Guo and Dr. Marcia Ciccone team up to discuss how general obstetrician gynecologists should evaluate, follow, and operate on adnexal masses and when to refer to gynecologic oncology. They walk through reading the imaging yourself, understanding what “complex” means on a report, ultrasound features and O-RADS, tumor marker selection, and when an MRI adds value beyond ultrasound. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:57 - Incidental Ultrasound Report on a Friday Afternoon05:57 - Ultrasound Features, ACOG Bulletins and O-RADS08:44 - Red Flag Findings and Urgent Evaluation10:58 - Tumor Marker Selection and the Limits of CA 12514:31 - Markers by Age, Tumor Type and New Assays in Development19:38 - When MRI Adds Value23:15 - Surveillance Versus Surgery27:05 - Cystectomy, Oophorectomy and the Consent Conversation31:10 - Preventing Rupture and Containing the Specimen35:42 - Closing Remarks --- More about this episode The conversation separates true emergencies like torsion, hemorrhage, and abscess from imaging findings that require faster evaluation, then breaks down the tumor marker panel, including the limits of CA 125, the value of hormonal and GI markers, and how thresholds shift by age and presentation. They review evidence supporting surveillance of simple cysts under ten centimeters, surgical choices between cystectomy and oophorectomy, and the consent and extraction plans that prevent upstaging from a cyst rupture. The episode closes with practical pearls for preventing spill, managing tubo-ovarian abscess, and the value of a quick call to a colleague when the next step is unclear. --- Resources ACOG Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses. Obstet Gynecol. 2016https://doi.org/10.1097/AOG.0000000000001768 Andreotti RF, et al. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee. Radiology. 2020https://doi.org/10.1148/radiol.2019191150 ACR Ovarian-Adnexal Reporting and Data System (O-RADS)https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/O-Rads Modesitt SC, et al. Risk of malignancy in unilocular ovarian cystic tumors less than 10 centimeters in diameter. Obstet Gynecol. 2003https://doi.org/10.1016/s0029-7844(03)00670-7 Im SS, et al. Validation of referral guidelines for women with pelvic masses. Obstet Gynecol. 2005https://doi.org/10.1097/01.AOG.0000149159.69560.ef Society of Gynecologic Oncologyhttps://www.sgo.org Moore RG, et al. Assessing the risk of ovarian malignancy algorithm for the conservative management of women with a pelvic mass. Gynecol Oncol. 2015https://doi.org/10.1016/j.ygyno.2015.09.010 Widschwendter M, Salhia B, et al. OvaPrint, A Cell-free DNA Methylation Liquid Biopsy for the Risk Assessment of High-grade Serous Ovarian Cancer. Clin Cancer Res. 2023https://doi.org/10.1158/1078-0432.CCR-23-1197 Dr. Bodour Salhia, Keck School of Medicine of USChttps://keck.usc.edu/faculty-search/bodour-salhia/ Dr. Mona Guo, Keck Medicine of USChttps://keck.usc.edu/faculty-search/xiaoyue-mona-guo Dr. Mona Guo, BackTable contributor pagehttps://www.backtable.com/shows/obgyn/contributors/dr-mona-guo Dr. Marcia Ciccone, Keck Medicine of USChttps://keck.usc.edu/faculty-search/marcia-ciccone/ Dr. Marcia Ciccone, BackTable contributor pagehttps://www.backtable.com/shows/obgyn/contributors/dr-marcia-ciccone --- 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

  5. 29. Sept.

    Ep. 135 Building the Career You Want in OB/GYN with Dr. Chitra Akileswaran

    What does it take to design a career in medicine that truly fits your values, your life, and your goals? On this episode of BackTable Women’s Health, Dr. Nicole Faulkner welcomes Dr. Chitra Akileswaran, board-certified OBGYN and founder of Avaiyar Private Care, for a candid discussion on building a career that breaks the mold. Dr. Akileswaran traces her path from global public health and a joint MD-MBA to leadership in county health systems, digital health startups, and now direct pay practice, sharing how each chapter reflected her changing priorities. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction06:19 - Public Health and Global Work10:33 - Residency and Early Career Choices15:04 - Founding a Digital Health Company19:48 - Ambulatory Operations Leadership24:36 - Leading a County Medical Group29:32 - Physician Needs and Retention34:25 - Physician Compensation Overhaul41:47 - Physician Unionization and Employment46:25 - Pregnancy Loss and Perspective49:09 - Launching a Direct Pay Practice57:10 - Mentorship in Private Practice01:03:28 - Closing Remarks --- More about this episode The conversation explores lessons learned leading hundreds of physicians, overhauling compensation and benefits, and navigating unionization and administrative change. Dr. Akileswaran speaks openly about personal milestones, including pregnancy loss, and how it drove her to redesign her life and practice. Topics include mentorship, apprenticeship, work-life integration, and the practical steps and mindset shifts needed to carve out a fulfilling, sustainable career in medicine. --- Resources Avaiyar Private Care, Dr. Akileswaran's direct pay OBGYN practicehttps://avaiyarprivatecare.com/Cleo, the digital health company she co-foundedhttps://hicleo.com/ ACOG Well-Being and Physician Support Resourceshttps://www.acog.org/career-support/well-being AMA Physician Practice Benchmark Survey: Smaller Share of Doctors in Private Practice Than Ever Beforehttps://www.ama-assn.org/practice-management/private-practices/smaller-share-doctors-private-practice-ever MGMA Provider Compensation Data Reports, the benchmarking source referenced on airhttps://www.mgma.com/mgma-data-reports Dr. Chitra Akileswaran, UCSF OBGYN Residency Alumni Profilehttps://obgyn.ucsf.edu/residency-program/chitra-akileswaran-md-mba --- 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

  6. 15. Sept.

    Ep. 134 Shared Decision-Making in Overactive Bladder Care with Dr. Jannah Thompson

    Can shared decision-making and patient support change the treatment journey for overactive bladder? On this episode of BackTable Urology, host Dr. Suzette Sutherland and OAB expert Dr. Jannah Thompson discuss how patient education, clear counseling, and ongoing follow-up improve care for patients with overactive bladder and urge incontinence. They cover practical strategies for building an effective OAB care pathway, staff training for better patient navigation, and proactive approaches that increase adherence and access to advanced therapies. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Medtronic Pelvic Healthhttps://urgencyisreal.com/ --- Timestamps 00:00 - Introduction04:00 - Shared Decision-Making06:51 - Clinic Efficiency10:38 - Expanding OAB Therapy Options12:27 - Long-Term OAB Care17:41 - Building an OAB Program18:18 - Staff Training and Follow-Up25:32 - OAB Navigator Implementation27:14 - Navigation Outcomes28:39 - Scaling with Staff and Epic30:35 - Algorithm Resources34:08 - Neuromodulation Advances38:37 - New Tibial and Battery-Free Devices40:56 - Quality of Life in OAB Care46:11 - Access and Adoption51:22 - Streamlining Therapy Discussions52:47 - Closing Remarks --- More about this episode The conversation explores the diverse landscape of OAB treatment options, the evolving role of neuromodulation, and how new technologies are enabling more personalized care. Dr. Thompson shares insights on empowering staff as part of the clinical team, leveraging patient navigators to boost follow-up and advanced therapy uptake, and the importance of integrating patient preferences and lifestyle factors into every decision. They emphasize that quality of life, not just symptom control, should be central to OAB management, and discuss how to engage patients as partners throughout their treatment journey. --- Resources Patient navigation for overactive bladder improves access to carehttps://link.springer.com/article/10.1007/s00192-019-04085-7 --- 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

  7. 8. Sept.

    Ep. 133 Advances in Endometriosis: Diagnosis & Management with Dr. Hugh Taylor

    Advances in endometriosis research are reshaping how clinicians diagnose, understand, and treat this complex multisystem condition. On this episode of BackTable Women’s Health, Dr. Nicole Faulkner welcomes Dr. Hugh Taylor for an in-depth discussion of the systemic nature of endometriosis, including its metabolic, psychological, and cardiovascular effects, as well as central pain sensitization and bowel and bladder symptoms. They also explore how animal models and biomarkers like microRNAs are deepening our understanding of these connections. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:26 - Endometriosis Beyond the Pelvis05:17 - Understanding Systemic Symptoms10:35 - Why Diagnosis Takes Years12:54 - Key Clues to Endometriosis14:35 - Emerging Noninvasive Diagnostics18:13 - Pain Versus Disease Stage19:33 - Precision Medicine Approaches24:04 - Treatment Strategies and Follow-Up27:17 - GnRH Antagonists and Add-Back Therapy29:45 - Danazol and Surgical Options34:26 - Future of Immune-Based Therapies37:49 - Fertility Counseling and Egg Freezing40:17 - Wrap-Up and Key Takeaways --- More about this episode Given that many patients wait years for a diagnosis, Dr. Taylor emphasizes the importance of presumptive clinical diagnosis and selective imaging to expedite treatment. He highlights emerging biomarkers that may offer more noninvasive diagnostic options and help clarify pain mechanisms. The conversation reviews current management strategies, including continuous oral contraceptives, the challenge of progestin resistance, and the promise of blood-based tests to predict treatment response. They also discuss GnRH antagonists, Danazol, surgery for refractory cases, and future directions such as immune-based therapies targeting the inflammation and immune dysfunction at the root of endometriosis. --- ResourcesClinical evaluation of the oral gonadotropin-releasing hormone-antagonist elagolix for the management of endometriosis-associated pain: https://pubmed.ncbi.nlm.nih.gov/31434540/ Circulating microRNAs as potential biomarkers for endometriosis: https://pubmed.ncbi.nlm.nih.gov/25772772/ ---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

  8. 1. Sept.

    Ep. 132 Gynecologic Cancer Surveillance: Best Practices & Updates with Dr. Ritu Salani

    Does catching cancer earlier with surveillance always translate to better outcomes for gynecologic cancer patients? On this episode of BackTable Women’s Health, hosts Dr. Mona Guo and Dr. Marcia Ciccone interview Dr. Ritu Salani, Professor of OBGYN at UCLA and lead author of the updated SGO surveillance clinical practice statements. They discuss how post–curative-intent surveillance has evolved amid limited prospective evidence, review the latest guidelines, and highlight the real-world challenges of balancing early detection, patient safety, and cost. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:05 - Evolving Guidelines and Consensus10:02 - Lead-Time Bias and Cost Considerations12:05 - Maintenance Therapy and Surveillance Nuances14:44 - Ovarian and Endometrial Cancer: Imaging vs Exam20:24 - Key Takeaways from the TOTEM Trial24:04 - Future Tools, Lifestyle Counseling, and Shared Care27:21 - Cytology, HPV Testing, and Post-Radiation Surveillance31:13 - Hormone Therapy Considerations34:37 - ctDNA and MRD Testing37:39 - Emerging Technologies and Limitations43:22 - Rapid Fire Takeaways45:33 - Closing Thoughts --- More about this episode The conversation explores practice variability, the lack of clear survival benefits from routine imaging and tumor markers, and the risks of cascade testing and lead-time bias. Dr. Salani reviews the TOTEM trial data for endometrial cancer, the importance of symptom review and pelvic exams (especially for lower genital tract cancers), and the reduced role of cytology, even in cervical cancer after radiation. They also discuss shared-care models, lifestyle counseling, hormone therapy considerations, and the promise and limitations of emerging technologies like ctDNA and MRD testing during maintenance therapy. --- Resources TOTEM Trialhttps://ascopubs.org/doi/abs/10.1200/jco.22.00471 2010 Ovarian Cancer CA-125 Trialhttps://pubmed.ncbi.nlm.nih.gov/20888993/ Society of Gynecologic Oncology Clinical Practice Statement on Surveillancehttps://pubmed.ncbi.nlm.nih.gov/41308226/ --- 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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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.

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    2022 - 2026
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