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.

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Timestamps

00:00 - Introduction
03:05 - Evolving Guidelines and Consensus
10:02 - Lead-Time Bias and Cost Considerations
12:05 - Maintenance Therapy and Surveillance Nuances
14:44 - Ovarian and Endometrial Cancer: Imaging vs Exam
20:24 - Key Takeaways from the TOTEM Trial
24:04 - Future Tools, Lifestyle Counseling, and Shared Care
27:21 - Cytology, HPV Testing, and Post-Radiation Surveillance
31:13 - Hormone Therapy Considerations
34:37 - ctDNA and MRD Testing
37:39 - Emerging Technologies and Limitations
43:22 - Rapid Fire Takeaways
45:33 - Closing Thoughts

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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.

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Resources

TOTEM Trial
https://ascopubs.org/doi/abs/10.1200/jco.22.00471

2010 Ovarian Cancer CA-125 Trial
https://pubmed.ncbi.nlm.nih.gov/20888993/

Society of Gynecologic Oncology Clinical Practice Statement on Surveillance
https://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.

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Are we addressing sexual health in clinical practice? On this episode of BackTable Women’s Health, host Dr. Nicole Faulkner is joined by Dr. Christine Vaccaro, a double board-certified urogynecologist and sexual medicine specialist, to discuss the evaluation and care of women’s sexual health concerns. They highlight the importance of open conversations, patient empowerment, and a multidisciplinary approach to support well-being and improve quality of life.

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Timestamps

00:00 - Introduction
04:01 - What Is Sexual Medicine
07:58 - Understanding Libido, Arousal, and GSM
15:54 - Clinic Visit Structure and Patient Counseling
19:17 - Clitoral Exam, Adhesions, and Anatomy Education
28:17 - Addressing Stigma, Patient Education, and Myths
32:03 - Tools for Patient Empowerment: Apps and Self-Examination
39:55 - In-Office Procedures, Pain Mapping, and Hormonal Considerations
46:37 - Managing Complex Cases and Multidisciplinary Collaboration
53:47 - Closing Remarks

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More about this episode

The conversation explores practical strategies for evaluating and managing issues such as libido, arousal, orgasm, and sexual pain, with a focus on genitourinary syndrome of menopause (GSM) and clitoral anatomy. Dr. Vaccaro shares her approach to assessing clitoral adhesions, pelvic pain, and hormonal changes, as well as effective ways to educate patients about anatomy and self-examination. They discuss the importance of reducing stigma, addressing misconceptions, and using a multidisciplinary approach to improve patient outcomes. The episode also highlights the role of clinician training, patient-centered counseling, and collaborative care in supporting women’s sexual health across the lifespan.

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Resources

International Society for the Study of Women’s Sexual Health: https://www.isswsh.org/

Female Orgasmic Disorder: Current Understanding and Clinical Management: https://pubmed.ncbi.nlm.nih.gov/42314165/

OMGyes: https://www.omgyes.com/join

You Are Not Broken by Dr. Kelly Casperson: https://kellycaspersonmd.com/you-are-not-broken-book/

Retrospective Study of the Prevalence and Risk Factors of Clitoral Adhesions: Women's Health Providers Should Routinely Examine the Glans Clitoris - https://academic.oup.com/smoa/article/6/2/115/6956478?login=false

Clitoral Adhesiolysis: Technique and Patient Selection - https://www.vjsm.info/videos/all/clitoral-adhesiolysis-technique-and-patient-selection

Female Orgasmic Disorder: Current Understanding and Clinical Management - https://pubmed.ncbi.nlm.nih.gov/42314165/

---

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.

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What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients.

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Timestamps

00:00 - Introduction
04:05 - Case One: Recurrent UTIs
05:19 - Workup Basics
08:50 - Non-Antibiotic Prevention
11:42 - Antibiotic Prophylaxis Options
15:16 - Case Two: Asymptomatic Bacteriuria
19:14 - Case Three: Complex Patients
19:58 - Male vs. Female UTIs
21:22 - Neurogenic Bladder Workup
22:52 - Elderly Patients and ID Consults
25:01 - Case Four: Transplant ESBL
25:23 - Machine Learning for Antibiotics
29:49 - Catheter Biofilms
31:55 - Embedded Bladder Reservoirs
35:23 - Recurrent UTI Vaccine
36:23 - Future of Recurrent UTIs
39:04 - Wrap Up

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More about this episode

The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic.

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Resources

Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)
https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti

---

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.

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Have you ever wondered what role the mind could play in treating women’s health conditions? On this episode of BackTable Women’s Health, host Dr. Nicole Faulkner interviews Dr. Sonia Gupte, a family medicine physician and board-certified clinical hypnotherapist, about how clinical hypnotherapy can help patients access the subconscious, resolve emotional barriers, and rewire patterns that affect both body and mind. Dr. Gupte discusses the use of hypnotherapy for a range of women’s health concerns including PMS, postpartum depression, hot flashes, infertility, and chronic pelvic pain, highlighting the potential for more holistic care.

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Timestamps

00:00 - Introduction
04:40 - Discovering Hypnotherapy
08:59 - What a Session Looks Like
13:02 - Remote Sessions and Results
17:27 - Follow-Up and Maintenance
20:13 - Women's Health Examples
28:05 - Talking to Patients
30:47 - Hypnosis vs. Therapy
33:07 - Pap Smear Trauma Case
37:28 - Breathwork Reset Tool
42:42 - Uncovering Repressed Trauma
46:17 - Burnout and Stress
49:12 - Barriers to Success
53:21 - Call To Action
54:58 - Live Demo Plans
55:50 - Closing Remarks

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More about this episode

Dr. Gupte shares how her mother’s experience with cancer, depression, and a suicide attempt inspired her to explore hypnotherapy and ultimately bring it into her medical practice. She describes what a typical hypnotherapy session involves, including relaxation, guided visualization, identifying emotional roots, and using protocols to help patients “reboot” their mental patterns. The discussion also covers practical aspects of integrating hypnotherapy into women’s health care, such as determining treatment frequency, offering remote sessions, setting patient expectations, and addressing common barriers to success.

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Resources

Within: Finding Yourself, Fixing What's Broken, & Finally Reclaiming True Health https://enso-nia.com/about-sonia/

---

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.

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Every OBGYN, whether in the hospital or community, may face a high-acuity obstetric emergency. On this episode of BackTable Women’s Health, Dr. Nicole Faulkner interviews OB hospitalist Dr. Katie Fung-Yip to explore the evolving role of OB hospitalists and the obstetric emergency department (OB ED) in managing critical situations. They discuss how in-hospital coverage, multidisciplinary teamwork, and dedicated triage protocols can improve emergency response and patient outcomes.

---

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Timestamps
00:00 - Introduction
02:42 - Breaking Down OB Roles
06:01 - MFM and Hospitalist Collaboration
07:35 - Inside the OB ED
12:31 - High Stakes Emergencies Overview
18:02 - Amniotic Fluid Embolism
21:33 - Cardiac Arrest Pearls and Drills
24:44 - Team Leadership Under Pressure
29:19 - Emotions Debrief and Bonding
37:48 - Simulation Practice and Mentorship
40:18 - Early Career Fit and Support
43:10 - Wrap Up

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More about this episode
Dr. Fung-Yip explains how the hospitalist role differs from community OBGYNs, emphasizing the value of continuous in-hospital coverage for urgent and high-risk cases. She describes the spectrum of care, from routine pregnancies to complex emergencies requiring collaboration among hospitalists, maternal-fetal medicine specialists, and multidisciplinary teams. The discussion covers OB ED operations, the Maternal Fetal Triage Index, hospital design for rapid response, and review of critical emergencies such as postpartum hemorrhage and amniotic fluid embolism. Dr. Fung-Yip highlights how these events can escalate to maternal cardiac arrest, requiring immediate ACLS, team coordination, and sometimes resuscitative hysterotomy. She stresses that preparedness depends on ongoing education, simulation, mentorship, debriefing, and strong teamwork.

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Resources
Maternal Fetal Triage Index (MFTI)
https://www.awhonn.org/education/hospital-products/maternal-fetal-triage-index-mfti/

---

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.
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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.

---

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---

Timestamps

00:00 - Introduction
03:11 - Why Menopause Medicine
07:51 - Hormone Therapy Paper
11:48 - Counseling Perimenopause
16:14 - Unopposed Estrogen Strategy
23:01 - IUDs And Progesterone
26:54 - Estrogen Types Explained
34:59 - Thrombosis Risk Approach
43:11 - Oral Estrogen Use Cases
44:48 - Breast Cancer Risk Counseling
46:49 - Estrogen Risk Myth
48:11 - Pregnancy and Breast Cancer
50:09 - Counseling BRCA Patients
53:26 - Duavee: Who Benefits?
55:32 - Bazedoxifene Access Limits
57:47 - Ospemifene for Genitourinary Syndrome of Menopause (GSM)
01:00:37 - Dryness Explained
01:02:41 - Thrombosis Risk Screening
01:05:01 - UTIs and Vaginal Estrogen
01:07:18 - Starting HRT After 60
01:12:47 - Window of Opportunity
01:14:46 - Staying on HRT
01:16:43 - Blood Levels and Absorption
01:20:13 - Clinician Takeaways

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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.

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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.

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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.

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Timestamps

00:00 - Introduction
02:37 - Launching a New Practice
04:23 - When to Refer Patients
06:23 - Basic Infertility Workup
08:39 - Counseling Patients Over 40
14:05 - Personalized IVF Protocols
17:59 - Embryology and PGT-A
23:54 - Egg Preservation Timing
28:20 - Using Frozen Embryos Later
31:36 - Components of Personalized IVF
33:30 - Patient Experience and Education
37:25 - Alternative Fertility Options
40:46 - Approaching Recurrent Miscarriage
42:28 - Key Takeaways

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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.

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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.

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Timestamps

00:00 - Introduction
03:03 - Understanding Carrier Screening
04:40 - Partner Testing: When and Why
06:22 - Selecting the Right Panel Size
08:27 - Managing Time Constraints and Making Referrals
10:52 - Pretest Counseling Essentials
16:44 - Decoding Results and Effective Reporting
20:52 - Limits of OB Counseling
26:19 - Navigating Common X-Linked Pitfalls
30:11 - Equity, Costs, and Over-Testing
36:11 - Tele-Genetics and Lab Resources
43:43 - Final Takeaways

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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.

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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.

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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.

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---

Timestamps

00:00 - Introduction
04:58 - CGMs in Women’s Health
07:33 - OTC Data Sharing Issues
09:52 - Pregnancy Glucose Targets
16:20 - Accuracy and Variability
20:10 - Anxiety and Eating Disorders
24:41 - Counseling and Follow-Up
28:29 - Prescription and OTC CGM Picks
37:24 - False Lows and Sensor Errors
41:23 - Alarm Settings and Logging
44:06 - Interpreting Metrics and Limits
46:44 - Provider Dashboards
48:42 - Final Thoughts

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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.

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Resources

Stelo - Over the Counter CGM Option
https://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.

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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.

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Timestamps

00:00 - Introduction
04:47 - From Employee to Owner
05:53 - Skills That Changed Everything
07:35 - The Wake Up Call
10:44 - Why Doctors Resist Business
15:06 - Profit as Patient Care
18:20 - Job vs. Business Entity
21:13 - CEO Hat and Team Systems
25:14 - Exit Value and Sellability
29:00 - More Profit: More Time Off
30:24 - Fear Before Breakthrough
35:32 - Choose Service Over Perfection
39:11 - Invest in Your Potential
46:26 - MEAT Week Priorities
48:40 - Three-Part Daily Rhythm
55:02 - Advice for Burned-Out Docs
59:29 - Wrap Up

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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.

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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