Episodes

  • Ep. 127 Approaches to Menopause and Hormone Therapy with Dr. James Simon

    Ep. 127 Approaches to Menopause and Hormone Therapy with Dr. James Simon
    Jul 28 2026
    Hormones aren't the problem. Misunderstanding them is. On this episode of BackTable Women’s Health, Dr. Karen Toubi sits down with Dr. James Simon to discuss menopause, sexual medicine, and his career journey from early IVF research to treating aging women. They also unpack his Green Journal paper with Dr. Barbara Levy, challenging common misconceptions about hormone therapy and explaining why treatment should be individualized because not all estrogens and progestogens are the same. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:11 - Why Menopause Medicine07:51 - Hormone Therapy Paper11:48 - Counseling Perimenopause16:14 - Unopposed Estrogen Strategy23:01 - IUDs And Progesterone26:54 - Estrogen Types Explained34:59 - Thrombosis Risk Approach43:11 - Oral Estrogen Use Cases44:48 - Breast Cancer Risk Counseling46:49 - Estrogen Risk Myth48:11 - Pregnancy and Breast Cancer50:09 - Counseling BRCA Patients53:26 - Duavee: Who Benefits?55:32 - Bazedoxifene Access Limits57:47 - Ospemifene for Genitourinary Syndrome of Menopause (GSM)01:00:37 - Dryness Explained01:02:41 - Thrombosis Risk Screening01:05:01 - UTIs and Vaginal Estrogen01:07:18 - Starting HRT After 6001:12:47 - Window of Opportunity01:14:46 - Staying on HRT01:16:43 - Blood Levels and Absorption01:20:13 - Clinician Takeaways --- More about this episode The conversation explores strategies for managing perimenopause, including when hormonal contraception is the best option and when symptom-focused hormone therapy may be more appropriate. They cover practical guidance on using transdermal estradiol, Mirena and Liletta for contraception and endometrial protection, and how thrombosis risk differs depending on the type and route of hormone therapy. The episode wraps up with a discussion on newer treatments for genitourinary syndrome of menopause, when to consider hormone therapy, and why clinical experience is so important in menopause care. --- Resources A Contemporary View of Menopausal Hormone Therapy https://journals.lww.com/greenjournal/abstract/10.1097/aog.0000000000005553~a-contemporary-view-of-menopausal-hormone-therapy?redirectionsource=fulltextview --- 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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    1 hr and 24 mins
  • Ep. 126 Personalized IVF: Optimizing Outcomes in Advanced Maternal Age & Low AMH with Dr. Jennifer Makarov

    Ep. 126 Personalized IVF: Optimizing Outcomes in Advanced Maternal Age & Low AMH with Dr. Jennifer Makarov
    Jul 21 2026
    The standard infertility timeline does not apply to every patient. When should infertility counseling begin, and when is it risky to wait? OBGYN Dr. Nicole Faulkner and REI specialist Dr. Jennifer Kulp Makarov discuss how age, irregular cycles, endometriosis, recurrent pregnancy loss, and male factor infertility should shape counseling and referral decisions on this week’s episode of the BackTable Women’s Health. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:37 - Launching a New Practice04:23 - When to Refer Patients06:23 - Basic Infertility Workup08:39 - Counseling Patients Over 4014:05 - Personalized IVF Protocols17:59 - Embryology and PGT-A23:54 - Egg Preservation Timing28:20 - Using Frozen Embryos Later31:36 - Components of Personalized IVF33:30 - Patient Experience and Education37:25 - Alternative Fertility Options40:46 - Approaching Recurrent Miscarriage42:28 - Key Takeaways --- More about this episode Dr. Kulp Makarov reviews when patients should be referred to an REI based on age, while emphasizing that earlier referral is appropriate for patients with irregular cycles, endometriosis, recurrent pregnancy loss, or known male factor infertility. Although anti-Müllerian hormone (AMH) testing can be a useful initial assessment, it should not delay specialist evaluation. The discussion also explores how advances in reproductive medicine have expanded fertility treatment options. Dr. Kulp Makarov highlights personalized IVF protocols, embryo banking, and preimplantation genetic testing, while emphasizing both the benefits and limitations of these approaches. She also shares practical guidance on egg freezing, pregnancy in the mid-40s, and when donor eggs, gestational carriers, or other fertility treatment options may be appropriate. Finally, she explains how REIs approach the evaluation and management of recurrent pregnancy loss. --- 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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    46 mins
  • Ep. 125 Genetic Carrier Screening Explained: What Every OB/GYN Should Know with Dr. Mary Kate LoPiccolo

    Ep. 125 Genetic Carrier Screening Explained: What Every OB/GYN Should Know with Dr. Mary Kate LoPiccolo
    Jul 14 2026
    How can OBGYNs navigate the complexities of modern prenatal carrier screening? In this episode of BackTable Women’s Health, host Dr. Nicole Faulkner interviews Dr. Mary Kate LoPiccolo, a pediatrician and medical geneticist at Mount Sinai, to break down the essentials of prenatal carrier screening in OBGYN practice. They discuss what carrier screening is, when to order it, and how to manage and interpret results in real-world clinical settings. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:03 - Understanding Carrier Screening04:40 - Partner Testing: When and Why06:22 - Selecting the Right Panel Size08:27 - Managing Time Constraints and Making Referrals 10:52 - Pretest Counseling Essentials16:44 - Decoding Results and Effective Reporting 20:52 - Limits of OB Counseling26:19 - Navigating Common X-Linked Pitfalls 30:11 - Equity, Costs, and Over-Testing36:11 - Tele-Genetics and Lab Resources43:43 - Final Takeaways --- More about this episode Dr. LoPiccolo reviews the evolution from Tay-Sachs screening in Ashkenazi Jewish populations to today’s pan-ethnic expanded panels, emphasizing carrier screening as a blood-based screening test for recessive and X-linked conditions ideally performed preconception and for both partners. The conversation covers panel size selection, best practices for pre-test counseling, common pitfalls with X-linked results, documentation and report interpretation, cost and equity barriers, and the value of referrals, telegenetics, lab genetic counselors, and resources like GeneReviews to optimize care. --- Resources GeneReviews - https://www.ncbi.nlm.nih.gov/books/NBK1116/ Open Evidence - https://www.openevidence.com/ --- 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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    47 mins
  • Ep. 124 Continuous Glucose Monitoring in OBGYN: Practical Counseling & Clinical Applications with Dr. Nicholas Canelo

    Ep. 124 Continuous Glucose Monitoring in OBGYN: Practical Counseling & Clinical Applications with Dr. Nicholas Canelo
    Jul 7 2026
    As over-the-counter continuous glucose monitors (CGMs) become more common, clinician guidance matters more than ever. In this episode of BackTable Women’s Health, Dr. Nicole Faulkner welcomes Dr. Nicholas Canelo, a family medicine physician and founder of the Perlman Wellness CGM program, to discuss how to effectively guide CGM use in OBGYN practice, from preconception and PCOS to pregnancy and perimenopause. They highlight the importance of interpreting data trends, setting realistic glucose targets, and supporting patients through the practical and emotional challenges of CGM use. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:58 - CGMs in Women’s Health07:33 - OTC Data Sharing Issues09:52 - Pregnancy Glucose Targets16:20 - Accuracy and Variability20:10 - Anxiety and Eating Disorders24:41 - Counseling and Follow-Up28:29 - Prescription and OTC CGM Picks37:24 - False Lows and Sensor Errors41:23 - Alarm Settings and Logging44:06 - Interpreting Metrics and Limits46:44 - Provider Dashboards 48:42 - Final Thoughts --- More about this episode Given the lack of well-established blood glucose targets outside of type 1 diabetes, Dr. Canelo reviews commonly used ranges for individuals without diabetes, those with prediabetes, and pregnant patients with type 1 or 2 diabetes. He explains how to interpret CGM data, including the time in tight range, coefficient of variation, and the importance of focusing on overall trends rather than isolated glucose spikes. They also discuss the potential drawbacks associated with CGM use, including anxiety and eating-disorder risks. Practical considerations include sensor inaccuracies, false lows readings, and optimizing alarm settings. Dr. Canelo emphasizes the importance of having patients log meals and other events while wearing the sensor and scheduling follow-up after the initial 15-day wear period to ensure accurate interpretation and effective counseling. Finally, they compare OTC and prescription CGM options, including costs, clinician access to patient data, and insertion tips. --- Resources Stelo - Over the Counter CGM Optionhttps://www.stelo.com/en-us --- 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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    52 mins
  • Ep. 123 Entrepreneurship in Medicine: Bridging Healthcare & Business with Dr. Nneka Una

    Ep. 123 Entrepreneurship in Medicine: Bridging Healthcare & Business with Dr. Nneka Una
    Jun 30 2026
    Are you building a business that can thrive without you, or just creating a job you can never leave? In this episode of BackTable Women’s Health, host Dr. Karen Toubi sits down with Dr. Nneka Una (Unachukwu), a board-certified pediatrician, founder of Ivy League Pediatrics, and creator of EntreMD, to discuss the mindset and skills needed to build a truly sustainable medical practice. The conversation explores why physician entrepreneurship is essential in today’s evolving healthcare landscape, the difference between building yourself a job and building a resilient business, and practical strategies for long-term growth. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:47 - From Employee to Owner05:53 - Skills That Changed Everything07:35 - The Wake Up Call10:44 - Why Doctors Resist Business15:06 - Profit as Patient Care18:20 - Job vs. Business Entity21:13 - CEO Hat and Team Systems25:14 - Exit Value and Sellability29:00 - More Profit: More Time Off30:24 - Fear Before Breakthrough35:32 - Choose Service Over Perfection39:11 - Invest in Your Potential46:26 - MEAT Week Priorities48:40 - Three-Part Daily Rhythm55:02 - Advice for Burned-Out Docs59:29 - Wrap Up --- More about this episode Dr. Una shares how doctors can overcome resistance to “business,” why every practice needs a strong business engine, and how to balance profitability with ethical, people-centered care. She explains how to shift from employee to physician-CEO, tackle imposter syndrome, and develop systems that give your practice true staying power. The discussion provides actionable advice on hiring, team management, building exit value, and creating the freedom to take more time off without sacrificing patient care or financial stability. --- Resources EntreMD https://entremd.com/about-us/ The Profitable Private Practice Playbook https://entremd.com/method-book/ --- 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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    1 hr and 3 mins
  • Ep. 122 Exploring the OB Hospitalist Model in Obstetrics with Dr. Maliha Sayla

    Ep. 122 Exploring the OB Hospitalist Model in Obstetrics with Dr. Maliha Sayla
    Jun 23 2026
    Lower C-section rates, faster deliveries, and less physician burnout: could the OB hospitalist model deliver all three? In this episode of BackTable Women’s Health, host Dr. Nicole Faulkner interviews Dr. Maliha Sayla, a board-certified OBGYN and medical director of labor and delivery at Northwestern Medicine Delnor Hospital, to explore how the OB hospitalist model is reshaping care for physicians, patients, and healthcare systems. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 03:27 - Why Hospitalists Matter05:33 - How Their Model Works07:15 - Managing Pushback10:18 - Measuring Better Outcomes15:58 - Drills and Emergencies19:50 - Staffing and Transition24:33 - ROI and OB-ED26:33 - Residents and Teaching30:52 - Future Flexible OB Careers34:14 - Patient Acceptance of Model36:47 - Collaboration and Lifestyle Balance40:00 - Conclusion --- More about this episode Dr. Sayla shares her journey from traditional private practice to full-time OB hospitalist work, explaining how this model reduces physician burnout by making labor and delivery a dedicated role rather than one juggled alongside clinic visits, surgeries, and administrative responsibilities. She details her institution’s staffing structure, where hospitalists provide continuous labor and delivery coverage, allowing generalist OBGYNs to focus on outpatient care. Dr. Sayla highlights the benefits of having dedicated physicians available for bedside counseling, fetal monitoring, and real-time decision-making. The episode explores improvements in communication, collaboration, and patient outcomes, including lower NTSV (Nulliparous, Term, Singleton, Vertex) cesarean rates and shorter induction-to-delivery times after adopting the hospitalist model. Additionally, she discusses the hospitalist role in obstetric emergency preparedness and interdisciplinary collaboration, patient perspectives, and the potential of hospitalist programs to address OBGYN workforce shortages. --- 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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    42 mins
  • Ep. 121 Urogynecology Surgical Trends and Training Insights with Dr. John Occhino

    Ep. 121 Urogynecology Surgical Trends and Training Insights with Dr. John Occhino
    Jun 16 2026
    Get an inside look at prolapse surgery, from technique to training to team-based care. In this episode of BackTable Women’s Health, Dr. Amy Park talks with Mayo Clinic urogynecologist and pelvic reconstructive surgeon Dr. John Occhino about the art and strategy behind prolapse repair. They explore why Dr. Occhino favors vaginal approaches, when robotics come into play, and how he frames staged treatment strategies, particularly for younger patients at risk of recurrence. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction02:09 - Choosing Vaginal vs. Robotic Approach10:24 - Why Vaginal Skills Declined13:20 - OR Setup and Positioning16:32 - Anterior Entry Technique20:05 - Ureter Safety and Suspension28:14 - Robotic Hysteropexy Considerations31:47 - Collaborative Training Culture35:41 - Beyond See One Do One46:13 - Anatomy Keeps You Safe49:46 - Leadership Authenticity53:45 - Team Support and Wrap Up --- More about this episodeThe conversation covers how to counsel patients about prolapse as a dynamic condition, the trade-offs between durability and mesh aversion, and the importance of prioritizing symptoms and quality of life in decision-making. They share practical tips on vaginal hysterectomy technique and ergonomics, discuss why vaginal surgery skills are declining, and highlight best practices in surgical education, including apprenticeship-style training, promoting psychological safety, setting targeted goals, fostering collaboration among program directors, and grounding surgical judgment in anatomy and authenticity in leadership. --- 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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    58 mins
  • Ep. 120 Understanding Vulvar Disorders in Gynecology with Dr. Chailee Moss

    Ep. 120 Understanding Vulvar Disorders in Gynecology with Dr. Chailee Moss
    Jun 9 2026
    Can a “normal” pelvic exam mask life-altering pain? On this episode of BackTable Women’s Health, host Dr. Karen Toubi interviews board-certified OBGYN Dr. Chailee Moss about why common vulvovaginal pain and skin conditions are frequently missed or dismissed as “normal” exams. Dr. Moss explores how gaps between gynecology and dermatology, limited training, and the under-recognition of non-life-threatening but highly morbid pain contribute to these diagnostic challenges, including mental health impact and even suicidality in some cases. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:56 - Why Pain Gets Missed08:58 - Building Trust With Time10:51 - Vulvodynia Workup Basics16:02 - Hormonal Vestibulodynia Clues21:21 - New Treatments On Horizon23:07 - Lichen Steroid Maintenance26:25 - Biopsy Decisions And Mimics30:30 - Multimodal Treatment Planning33:00 - Pelvic Floor PT Done Right35:55 - When To Consider Surgery37:33 - Clinical Trials Ketotifen Botox40:40 - Conclusion and Resources --- More about this episode They discuss rebuilding trust through time, attentive listening, and clear communication, along with a detailed evaluation process that includes medication review, targeted symptom questions, Q-tip mapping, vulvoscopy, cultures, and selective biopsy. The approach informs an individualized, multimodal treatment plan. Additional topics include lichen steroid counseling,differentiating mimickers like yeast and irritant dermatitis, and connecting patients to resources such as ISSWSH, ISSVD, and support groups. --- Resources Experiences of Care and Gaslighting in Patients With Vulvovaginal Disorders https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711 ISSWSH https://www.isswsh.org/ Pudendal Hope https://www.pudendalhope.info/ Tight Lipped https://www.tightlipped.org/ The National Vulvodynia Association https://www.nva.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
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    44 mins