Significant clinician or administrative barriers may exist to offering FABMs to patients. Incorporating up-to-date information on a range of FABMs-rather than treating them as one method-into contraceptive counseling represents an opportunity to increase the contraceptive offering for clients who want them, leading to increased patient satisfaction and successful family planning outcomes.Background Evidence suggests that women have increased health care costs; however, little is known about expenditures for women with diabetes compared with men with diabetes. The objective of this study was to calculate expenditures for men and women and to identify factors associated with increased costs in women. Materials and Methods Adults with diabetes (n = 2,078) from the 2011 Medical Expenditure Panel Survey (MEPS) were identified. A generalized linear model with gamma distribution and log link was used to estimate incremental expenditure in women compared with men and to identify reasons for this difference. Sequential models were analyzed by entering variables in blocks (demographics, medical comorbidities, mental comorbidity and disability, and functional limitation). IRB approval was waived for this secondary data analysis. Results Unadjusted mean total expenditures were $12,485 for women with diabetes compared with $10,828 for men (p = 0.04). In the model with demographic variables and medical comorbidities, expenditures for women increased to $1,720 (p = 0.03) (95% confidence interval [CI] 164-3,266) compared with men. With a comorbid mental health disorder, expenditures for women decreased slightly, but they remained significantly higher than for men at $1,668 (p = 0.04) (95% CI 104-3,222). In the final analysis with all variables, incremental expenditures increased by $1,314 for women compared with men and were no longer statistically significantly higher than for men (p = 0.10; 95% CI -257 to 2,933). Conclusions Our findings show that women with diabetes have increased expenditures for health care compared with men with diabetes. Increased functional limitation and disability in women account for incremental increases in costs, which suggest a need for more efforts to manage disability burden in women with diabetes.Persistent genital arousal disorder (PGAD) is a clinical syndrome characterized by persistent unwanted feelings of sexual arousal that are not associated with any specific sexual arousal or stimulus. The severity of symptoms range from mild to severe distress that interrupts daily life for patients. We present a 44-year-old previously healthy woman who developed PGAD after involvement in a motor vehicle accident in 2018. After sustaining lower spinal trauma, 3 months later, she began to experience intermittent tingling feelings in her clitoris. GDC-0068 Akt inhibitor She noticed that exacerbations in back pain were also associated with PGAD symptoms. These symptoms progressively worsened to which she was constantly feeling as if she was on the verge of an orgasm. Her quality of life was severely diminished for 3 months, after which she presented to gynecology. Treatment of lidocaine patches applied to the sacrum were found to completely eliminate the feelings of clitoral stimulation. She also began physical therapy for the residual back pain. One year after initiation of treatment, she has experienced significant improvement in both the back pain and PGAD symptoms. Her quality of life is much improved and plans on continuing a treatment plan of lidocaine patches and physical therapy. Recognition of PGAD in women is important for clinicians as that it can go undiagnosed for long periods of time and can interfere with quality of life for patients.Background Reproductive-age women with type I diabetes require preconception counseling, contraceptive counseling, and access to long-acting reversible contraception (LARC) to better support peri-conception glycemic control and decrease rates of unplanned pregnancies and adverse pregnancy outcomes. Materials and Methods This retrospective cohort study identified women (16-49 years old) with an ICD-9/ICD-10 code for type I diabetes and documented hemoglobin A1c (HbA1c) level in a tertiary referral center between January 1, 2010 and October 30, 2017. We abstracted 2 years of data centered on the time of the highest recorded HbA1c. We identified preconception counseling, contraceptive counseling, LARC use, provider type, and the presence of advanced vascular complications or disease >20 years duration. Multivariable logistic regression related disease severity and provider type to counseling and LARC documentation when controlling for patient age and race. Results Among 541 women, only 5% received preconception counseling, 25% received contraceptive counseling, and 13% used LARC. Younger age and more visits were associated with documented preconception or contraceptive counseling (p  less then  0.01). Maternal fetal medicine specialists most frequently documented preconception counseling (16%, p = 0.01), whereas gynecologists most frequently documented contraceptive counseling (73%, p  less then  0.01). Contraceptive counseling was highly associated with LARC use (adjusted odds ratio 9.87, 95% confidence interval 5.09-19.12). Conclusions Reproductive-age women with type I diabetes have infrequent documentation of preconception counseling and contraceptive counseling. Educating primary care providers and endocrinologists could avoid missed opportunities to improve pregnancy planning and outcomes.Background The impact of rural-urban residence on stroke risk and poor stroke outcomes among postmenopausal women is unknown. Methods We used data from the Women’s Health Initiative (WHI) (1993-2014; n = 155,186) to test the hypothesis that women who live in rural compared with urban areas have higher stroke risk and worse stroke outcomes than urban women. We used rural-urban commuting area codes to categorize geocoded participant addresses into urban, large rural, or small rural areas. Incident strokes during follow-up were adjudicated by neurologists who used standardized criteria for reviewing brain imaging reports and other medical records and determining stroke subtype. Stroke functional recovery was measured with the Glasgow Stroke Outcomes Scale ascertained from the hospital record. We used univariable and multivariable-adjusted Cox proportional hazards models as well as logistic regression models to test whether rural-urban residence predicted stroke risk and odds of poor stroke outcome. Results Among the 155,186 women in our cohort, 2.