Overview: We’ve long understood cardiovascular disease, hemorrhage, hypertension, and infection as the leading killers of pregnant patients. A recent analysis challenges that, finding the leading causes are now overdose, homicide, and suicide. Join us as we unpack what this means for clinicians, explore racial and age disparities, and discuss how primary care clinicians can better protect maternal health.
Episode resource links:
Identify unintentional drug overdose and violence (homicide and suicide) as the leading causes of maternal death in the United States from 2018–2023, surpassing traditional obstetric complications
Describe racial, ethnic, and age-related disparities in pregnancy-associated mortality due to overdose, homicide, and suicide
Apply an updated, comprehensive approach to screening and counseling pregnant and postpartum patients that incorporates substance use, intimate partner violence, and mental health risk factors
Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos
Overview: Falls in older adults can have devastating consequences; substance use and prescription medications are often-overlooked risk factors. Tune in to explore how screening for substance use in a primary care environment may decrease fall and related injury risk in adults over 55. Come away with stronger identification and prevention practices.
Episode resource links:
Babu KM, Haddad YK, Krotulski AJ, Causey ST, Vargas-Torres CC, Martinez PM, Goldberg EM, Dorfman JD, Bailey M, Chapman BP, Graham P, Lai JT, Saif R, Elhoussan R, Capeta Romero A, Londoño-Barreras R, Walton SE, Thomas DD, Logan BK, Merchant RC. Relationship of ethanol, cannabinoids, benzodiazepines, and opioids to serious injuries from falls in adults aged 55 and older. J Emerg Med. 2026;84:46-58. doi:10.1016/j.jemermed.2025.12.017
Colón-Emeric CS, McDermott CL, Lee DS, Berry SD. Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review. JAMA. 2024;331(16):1397–1406. doi:10.1001/jama.2024.1416
US Preventive Services Task Force. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;332(1):51–57. doi:10.1001/jama.2024.8481
Guest: Jillian Joseph, MPAS, PA-C
Music Credit: Matthew Bugos
LaMonte MJ, Hyde ET, Nguyen S, et al. Muscular Strength and Mortality in Women Aged 63 to 99 Years. JAMA Netw Open. 2026;9(2):e2559367. doi:10.1001/jamanetworkopen.2025.59367
Overview: The renaming of polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS) reflects the true complexity of this diagnosis—a condition that extends beyond ovarian cysts and reproductive health. Listen in as we explore what drove the name change, how it better reflects the condition’s complexity, and what current evidence says about prevalence, risk, and whole-body management strategies for your patients.
Episode resource links:
Teede, H. J., Khomami, M. B., Morman, R., Laven, J. S., Joham, A. E., Costello, M. F., ... & Piltonen, T. (2026). Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. The Lancet.
Tewari, S., Khalua, R. K., & Parida, S. (2026). Redefining polycystic ovary syndrome (PCOS) as Polyendocrine Metabolic Ovarian Syndrome (PMOS): implications for diagnosis, pathophysiology and clinical management. Int J Gynaecol Sci, 8(1), 17-25.
Tewari, S., Pramanik, P., Patra, T., & MK, M. (2026). From Reproductive Disorder to Metabolic Syndrome: The Evolution of Polycystic Ovary Syndrome (PCOS) into Polyendocrine Metabolic Ovarian Syndrome (PMOS). Journal of Pharmacognosy and Phytochemistry, 15(3), 329-337.
Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos
Overview: In this episode, we discuss the American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guidelines, explore where the evidence may support or challenge recommendations, and provide practical frameworks for implementing lifestyle interventions to improve the outcomes of hypertension care.
Overview: In this episode, we discuss how prescribing “food as medicine” can complement hypertension management in primary care. We review the evidence supporting legumes, soy, and DASH-based nutrition for lowering blood pressure, while providing practical counseling strategies to help patients adopt dietary patterns that enhance cardiovascular health alongside standard medical therapy.
Episode resource links:
Metoudi M, et al. bmjnph 2026;0:e001449. doi:10.1136/bmjnph-2025-001449
Brindal E, Baird D. Regular Flatulence Patterns Among Community-Dwelling Individuals in Australia. JAMA Netw Open. 2026;9(5):e2615637. doi:10.1001/jamanetworkopen.2026.15637
Overview: Abdominal obesity can influence both the severity of menopausal symptoms and treatment decisions. Listen in as we discuss how to recognize this important relationship, apply practical screening tools, and individualize menopause management to improve symptom control and overall health outcomes for your patients.
Episode resource links:
Wang, D. , Wang, F. , Zheng, J. , Chen, X. , Lei, Y. & Su, J. (9900). Menopausal symptom network differences between women with and without waist-to-height ratio-defined abdominal obesity. Menopause, Publish Ahead of Print , doi: 10.1097/GME.0000000000002794.
Managing Menopausal Symptoms: Common Questions and Answers.
Chang JG, Lewis MN, Wertz MC. American Family Physician. 2023;108(1):28-39.
Guest: Jillian Joseph, MPAS, PA-C
Music Credit: Matthew Bugos
Overview: Leucovorin has gained growing attention as a treatment for autism spectrum disorder (ASD), despite limited supporting evidence. In this episode, we discuss the rationale behind its use, review the current literature, and examine the American Academy of Pediatrics’ guidance on this treatment for ASD, giving you confidence to counsel families and engage in meaningful shared decision-making.
Episode resource links:
Discuss the rationale for using leucovorin in treatment of autism spectrum disorder (ASD)
Review current evidence and practice guidelines regarding leucovorin and ASD
Examine data and recent national trends in prescription rates of leucovorin for ASD
Guest: Anne Powell, MD
Music Credit: Matthew Bugos
Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast’s earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you’re catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care.
Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN
Music Credit: Matthew Bugos
Zhou H et al. Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4
Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73.
Circulation. 2018 Jul 24;138(4):345-355.
eClinicalMedicine 2025: 103741.
Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884
Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041
Recalculating Risk: Updated Guidelines for Lipid Management - Frankly Speaking Ep 499
Overview: Stay in the know with this breakdown of the latest American College of Cardiology (ACC)/American Heart Association (AHA) recommendations for lipid testing and management. New approaches to evaluating hyperlipidemia, as well as limitations of the updated guidelines, are discussed to provide you with practical strategies for tailoring treatment decisions to individual patient risk.
Episode resource links:
Writing Committee Members, Blumenthal RS, Morris PB, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026;153(17):e1154-e1276.
Guest: Alan M. Ehrlich, MD, FAAFP
Music Credit: Matthew Bugos
Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243
Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010
US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930.
Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946.
Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541.
Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.:
American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022.
Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485.
Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234.
Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463.
Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455
Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666
Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301.
Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015
Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024
Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0
Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575
Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.
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