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because I wanted to help women throughout their lifespans. My training in this specialty included considerations for things like hormonal imbalances that result in polycystic ovary syndrome, infertility, early menopause, and even the development of gynecological cancers. I was also trained on how pregnancy is a form of stress test on a woman's body, as conditions like gestational hypertension, diabetes, and even preeclampsia demonstrate. I enjoyed my time in residency and fellowship and felt prepared to begin my career, but when I started seeing patients I realized I didn't have all the tools I needed.
What I don't feel I received enough comprehensive education and training for is how many women in the U.S. enter their pregnancies with existing cardiometabolic challenges. I see women with obesity, high blood pressure and cholesterol, insulin resistance, women who use tobacco, who demonstrate reduced cardiovascular function, and many other factors that contribute to a high-risk pregnancy. These pregnancies have higher maternal and perinatal risk, they require more monitoring and often women have to begin medication they aren't able to discontinue when the pregnancy ends. Then, after the physical toll of pregnancy, I care for women during menopause, when a lifetime of uncontrolled glucose, excess adipose tissue, and cardiovascular strain is exacerbated by hormonal imbalances.
I am looking for a way to improve my patients' outcomes by ensuring they enter every stage of life in peak health. I am worried about how many young women I see with conditions that will complicate their pregnancies and affect their quality and length of life.
