Continuing off from my last post, day 3 and 4 of ACOG continued to be full of exciting and informative talks with the added bonus of the opening of the exhibition hall.

Contraception day (day 3) was both treatment and device focused. Starting off the morning was a discussion on whether mitochondrial therapy should be allowed, following the UK being the first country to approve it. While Dr. Keefe argued that mitochondrial therapy lacked clinical evidence to prove efficacy and safety, Dr. Oktay emphasized the severity of mitochondrial dysfunction and how important it is to provide women with treatment options. Both presented excellent points, but the audience poll at the end showed that 65% felt that mitochondrial transfer shouldn't be offered to women with aging oocytes. Another interesting talk I attended was presented by Dr. Eve Espey, where she discussed the newest developments in contraception for 2015. While there are a variety of contraceptive options, IUDs and implants are perceived as the most effective and cost efficient option, with usage growing in recent years to over 8%. And there are new competitors that willl hopefully improve affordability and adoption; one such competitor is Liletta, which was only recently approved in February 2015.

Day 4, or menopause day, included talks on the pathology of endometriosis and the treatment of AUB. The talk on endometriosis by Dr. Christman guided us through the reasons why it causes infertility and how different stages and types of endometriosis require different treatments. In particular, pain is a main reason why endometriosis would require treatment and while drugs are generally considered a first line treatment, IUDs are also being considered an effective and cost efficient method to treat endometriosis. I'm getting the feeling that IUDs can basically treat almost anything. The Mirena IUD is also indicated for AUB and continues to be one of the best options for treatment of both heavy and regular and heavy and irregular bleeding, as Dr. Matteson explained. By comparison, other treatments can be limited in use by the characteristics of the AUB. For example, GEA is only a viable option for regular bleeding whereas dilation and curettage is not good as a first line treatment for acute AUB.

What I've learned overall from all the discussions at ACOG 2015 has been that treatment for gynecological indications continues to improve. And as more treatment options become available, it will be ever more important that the gynecologist can counsel patients on their full range of options and for patients to be knowledgeable and aware of the risks and benefits for their choice of treatment. And as a female who could potentially be faced with these decisions, I am comforted that the future of medicine and the future of women's health are moving in this direction.

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