CME Information

It is not unusual to see mature female patients who, having spent many years in a monogamous relationship, suddenly find themselves dating again. For many of these women, they discover that there are more contraceptive choices and greater risks for sexually transmitted infections. In addition, menopausal symptoms may need to be considered in the choice of contraception. This case reviews the counseling priorities and strategies a clinician can use to address these issues so as to provide the patient a method that meets her needs and with which she can be successful.

At the conclusion of this activity, the participant should be able to:

• Identify the risks for unintended pregnancy for women more than 40 years of age.

• List contraceptive methods, which also provide noncontraceptive benefits of perimenopausal symptom relief

• Counsel mature women about prevention of sexually transmitted infections

• Aid a patient unfamiliar with how to negotiate a sexual relationship

This CME activity is designed to meet the educational needs of OB/GYN physicians, family physicians, internists, pediatricians, nurse practitioners, and other heath care providers involved in women’s health issues.

This clinical case is in text format accompanied by references linked to PubMed.

To receive a certificate you should:

• View the presentations in this CME activity and evaluate the content presented

• Complete and submit the posttest, CME registration and activity evaluation forms

The estimated time to complete this activity, including review of the materials, is 0.5 hour(s).

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.    

ACCME accredited providers may issue credit to both U.S. and international physicians for any activity that has been designated for AMA PRA Category 1 Credit(s)™ in accordance with PRA requirements.

Nursing credit approved: June 27, 2007

This activity has been evaluated and approved by the Continuing Education Approval Program of the National Association of Nurse Practitioners in Women’s Health for 0.5 contact hours of continuing education credit including 0.5 pharmacology contact hours.
Offering no. 06-28V.

August 2008 through August 2009. Original release date: August 2007

In June 2007, this continuing medical education activity was peer reviewed by Paula Amato, MD, associate professor in the Department of Obstetrics and Gynecology at Oregon Health & Science University, Portland, Oregon. In order to ensure the continued scientific relevance of this enduring material, it is reviewed annually. Following the latest review by Dr. Amato in August 2008, the term of approval was extended through August 2009.

Disclosure: nothing to disclose.

Paula Amato, MD
Assiociate Professor,
Department of Obstetrics and Gynecology
Oregon Health & Science University
Portland, Oregon
Houston, Texas

Disclosure: nothing to disclose.

Director of the Reproductive Endocrinology Service
University of Houston

Disclosure: non-public support of research – Duramed, Warner Chilcott, Wyeth Labs.

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Alfred Poindexter, MD, Activity Director: non-public support of research – Duramed, Warner Chilcott, Wyeth Labs.

Susan Wysocki, Contributor: speakers bureau member – Berlex, Duramed, Organon, Ortho-McNeil, Wyeth; advisory committee member – Berlex, Digene, Duramed, Lilly, Merck, Organon, Wyeth; honorarium recipient – Berlex, Digene, Duramed, Lilly, Merck, Novogen, Organon, Wyeth.

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Paula Amato, MD, Activity Director and Peer Reviewer: nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

This CME activity is supported by an educational grant from Wyeth Pharmaceuticals, Inc.