This is a blog about things in medicine that I find interesting. I’m both a gynecologist and a pain medicine specialist, so there’s lots of that, but I’m interested in everything and anything in medicine that’s new, controversial, or just plain fascinating.

House rules regarding comments: I am interested in hearing your opinion, but it needs a link/reference to a credible source to be fact. I write about topics that often evoke a lot emotion, but don’t demean your passion with vitriol. Hateful comments don’t advance anyone’s interest and will be deleted or treated as spam. If you make personal attacks on me or on anyone else you’ll probably get your IP address blocked.

I speak for no one but me.

Nothing that is posted here should be taken as a substitute for medical advice. Blogs (and Twitter for that matter) do not constitute the practice of medicine.

The medical cases that I sometimes use to illustrate a point don’t strike me because of their uniqueness, but rather because they are all too common. That is often what I find most devastating. I construct these histories from a lifetime of caring for women and from anonymous cases I have heard along the way from teachers and colleagues. These stories never reflect a specific individual or single case.

I don’t believe in Western medicine. I don’t believe in Alternative medicine. I believe in evidenced based medicine. But I’m also about common sense and practical information that you can actually use.

One more thing.

I wield the lasso of truth.


35 thoughts on “What

  1. Hello, Dr. Gunter – I have followed your posts and even re-posted a couple to my blog….. with a link back to yours. I have a radio show called ‘Holy Hormones Honey!’ and I am wondering if you will consider doing an interview with me on your latest post ‘When abortion is free and legal why does a woman do it at home and die?’ My show airs on Monday nights from 6 to 7 pm MST. Your explanation on why woman still do home abortions is excellent. My email is leslie@holyhormones.com. Glad you are wielding the lasso of truth. Am trying to do the same. Kind regards, Leslie

    Posted by Leslie C. Botha | June 3, 2012, 5:38 pm
  2. Jen! You may not remember me, but we worked together at KU in the Overland Park office back in the early 2000s. Imagine my surprise when I was researching vitamin E for breast pain and came across your blog! The last I heard, you were going to Colorado. Are you still there?

    I’m now running a healthcare company that specializes in services for military and VA facilities. As I’m sure you know, with all of our female veterans now, women’s health is a very big area for the government. I’ve actually thought of you several times when hearing some of the stories from our veterans. I’d love to reconnect with you and see if there may be some possiblity of us working together again in the future. I can be reached at dawn.rice@balsamhgi.com. Take care!

    Posted by Dawn Rice | February 28, 2013, 7:36 am
  3. Hello! I have hit your blog a few times trying to figure out what is wrong with me. I have had 5 csections and have always had a busy healthy lifestyle. With my 4th csection the Dr. was shocked to find my uterus had several large paper thin windows in it and lots of adhesions and scar tissue everywhere. It was a very long surgery and they said they were able to remove the scar tissue and seperate what they could, but my uterus was shot and absolutely out of commission. They strongly suggested an iud, so I got the heavy duty 8-10yr. one and ended up pregnant as soon as I stopped nursing. They monitored me close and took the baby early- which was awful for her, but she is okay now. This time there was more scar tissue and they couldn’t successfully seperate my uterus from my other organs. They once again removed all the scar tissue they could, but I am having a considerable amount of pain and I think it’s getting worse. It is mostly in my lower right, but sometimes radiates to my lower back and down my right leg. I have less range of motion, too- it’s hard to lift my leg more than a foot off the ground. Everyday tasks are daunting and living the active lifestyle we’re used to impossible. I hurt all the time. It’s making me a crappy mom and I hate it! I’ve had nerve blocks, physical therapy, chiropractic work, zoning therapy and accupuncture- to no avail. My doctor wants me to have a hysterectomy and thinks its my uterus causing all of my problems. I am to the point that I am willing to try everything, but am a little nervous to have another surgery. I am not sold that’s the problem Any thoughts would be greatly appreciated!

    Posted by Heather | April 23, 2013, 11:20 am
  4. Am working on a series of posts about abortion and “personhood.” My first post is on tubal ectopic pregnancies. My second one will be about other ectopic pregnancies. I’m really curious about what you think about this little gem on “personhood” and ectopic pregnancies.


    Posted by wiley | April 29, 2013, 9:29 am
  5. Maybe I am off…I am looking for Dr. Jennifer Gunter who works at Kaiser in SF in the area of pelvic pain. Could you be this person?

    Posted by Melissa | January 3, 2014, 10:36 am
  6. Thank you for sharing such thoughtful and courageous writing.

    Posted by Tong Ginn | January 30, 2015, 6:11 am
  7. Fine work on this site Jen. If you ever decide that you want to shift gears and start blogging on Orthopaedic Surgery, you’re hired!!! We need more intellects like yourself in medicine.
    D. Boyer
    Meds ’99 UWO

    Posted by Dory | February 8, 2015, 7:36 am
  8. Hi, there! Have you heard of Zija, a moringa extract product MHM? My cousin is selling it and is also giving it to his wife and kids. He’s posted photos of rapid and sustained weight loss. I’m concerned for the health of my family members. Could you look into their medical documentation?

    Posted by Madtown Maven | March 30, 2015, 4:55 pm
  9. Dr, Gunter, do you promote CDC’s vaccination schedule? What is your opinion about the safety of these vaccines? Thanks.

    Posted by Lourdes | August 17, 2015, 1:48 am
  10. Please continue to wield that lasso, Dr. Gunter. Your 1/21/2013 post is just as relevant today as it was nearly three years ago.

    Posted by Joseph Peters | December 8, 2015, 6:08 pm
  11. What are your views on pelvic exams by medical students who have introduced themself to the patient pre-op, however, are NOT explicit in stating their role, intention to perform pelvic exam while the patient is sedated?
    I live in The Netherlands. I am an expat. This senario is standard here. My postion of being offended and fierce in not allowing residences or medical students is tolerated but mocked as it denys valuable teaching experience.

    Posted by Expat | January 29, 2016, 6:16 pm
  12. My dad was an innovative GP obstetrician in the 70-80s. Now in his 80s and still intellectually very active, he’s keen to know if there were long term outcomes from the sorts of things he was keen on: early breas-feeding and skin-to-skin contact, delayed cord cutting, avoidance of opiates and where possible caesarean section… I see there’s a Cochrane Collaboration report on early skin to skin contact (viewed as a bizarre and nonsensical idea by many obstetricians when he was in practice; but he wonders if there are data on e.g. school exam results in teenagers…

    Do you know of anybody who he might be able to contact to discuss this?

    Peter English.

    Posted by petermbenglish | February 4, 2016, 5:01 am
  13. Hi Dr. Jen. I keep seeing posts on social media about lawsuits for illnesses caused by hormonal birth control, especially the psuedotumor in the brain (ptc). I think these are made to scare people. I love and respect your blog so I felt you could post about this? I have a hard time finding anything on the NIH about birth control pills causing PTC. Thank you so much!

    Posted by Amanda | March 11, 2016, 9:49 am
  14. I adore your blog and can’t believe the mansplaining BS in that latest goop retaliation. Keep fighting the good fight! Know that your fellow Canadian MD Moms are behind you!

    Posted by fooddrugsandlife | July 14, 2017, 11:30 am
  15. Hello Jen. I was just introduced to you by an article in the Winnipeg Free Press, just today (13 Aug 2017). I am a graduate of UM as well, Class of ’83. I regret that I never met you, as I am sure we would have gotten along! Your defence of science in medicine is powerful and immensely entertaining! I have much to catch up on in your blogs, but if you haven’t set your sights on the “vaccine deniers”, I can hardly wait. I shall follow your writings with pleasure and anticipation.
    PS I must confess that I once nearly succumbed to the lure of great wealth from selling snake oil. I hatched the idea of selling a program of colonic cleansing / sterilisation to be followed by recolonisation with Gwyneth Paltrow’s poop. I am still certain that I could have become very wealthy if I could have solved the problem of obtaining the recolonisation material….

    Posted by Greg Doak, MD, FRCPC, PhD | August 12, 2017, 9:40 pm
  16. I have a couple questions for you. First I have fibromyalgia. There is mixed messages out there. What is it exactly. I’ve tried some medication but nothing helped. Do you have any suggestions?
    Second question. What do you know about hydrogen peroxide 35% food grade? Do you think it’s ok in small amounts or will it do any harm? Thank you.

    Posted by Kelly | August 15, 2017, 8:26 pm
  17. I absolutely am avoiding anything “goop.” But I found a website only about vaginal atrophy. I’ve had it for 4 years. I am 65. I cannot take hormones due to bad side effects. So I found this “vaginal dilator” kit with various sized plastic tubes that you insert (using a gel) You lie down, insert the smallest one. Lie there for 10-20 min. 2-3 times/week. Allegedly, as you increase the size of the dilator, the atrophy will be healed.
    You cannot sit up or walk around with the dilator in. You must not keep it in if it is painful. You have to wash it thoroughly after each use.
    Is this safe? It’s called “vuva dilator”
    I appreciate your knowledge & advice.

    Posted by dixiewriter | September 29, 2017, 2:20 pm
  18. Hi Dr. Gunter! I love your blog.

    I was reading the blog of Nicole Naugler (who thinks it’s okay to raise like 11 kids in a tent/shack with no running water or electricity–ACK!!) and in one post she brags about not needing prenatal care (http://blessedlittlehomestead.com/just-let-me-enjoy-my-pregnancy/) then a couple months later she shared the horrific story of labor and delivery of her stillborn son (http://blessedlittlehomestead.com/the-birth-of-william-joseph/). In the birth story, she says something about the placenta had started to calcify and I guess the baby ruptured the placenta (or however the proper way to say this is). Naugler says that her doctors told her that it “was possible [to have caught it] but with all other indicators, I was otherwise healthy. I had not experienced any pains, or any other signs of distress.”

    Ugh. While rereading these posts to cite here, I realized that baby William would have nearly been full term when this shit went down. My question for you, Dr. Gunter, is whether good prenatal care would have caught this condition in time to save his life and to have saved Naugler from nearly dying.

    Thank you,

    Posted by Catherine | November 5, 2017, 6:18 pm
  19. Read your nytimes article. Dead on, and thank you – your frank unapologetic approach to being a woman is much appreciated, in all its messy flabby gross harassed glory.

    Posted by Beth Carter | November 16, 2017, 7:36 pm
  20. Dr Gunter,
    Thank you so much for your brave and honest NYT article about life after losing Aidan. You’ve exquisitely expressed what I’ve fumbled through trying to articulate dozens of times.
    Today I felt so lonely and sad even though I have two gorgeous “rainbow” kids, because my daughter is missing. It’s the holiday weekend and I’m thinking a lot about what family means to me. There’s a gaping hole in my being still.
    Thank you for the reminder that I am not alone. It has lifted me up today to remember someone understands my pain and I’m certain I will go back to reading it again. All the best to you and your family.
    Rebecca Donnelly Peters
    Mom to Axel (2), Viggo (6mo), and Opal

    Posted by Rebecca donnelly Peters | December 24, 2017, 11:39 am
  21. Hi. I’m an ObGyn in private practice in Napa, California, and also a writer. My own blog is actually on the website of my practice, and is more of a chronology on how I came to be an ObGyn. I was a PT prior to going back to medical school, so also interested in physical medicine. Just wanted to say I love your articles, and agree with much of what you write. I have also made it my goal to dispel internet garbage where medical information is concerned, but it is exhausting and quite frustrating to spend so much time trying to explain so many things to so many people. Keep fighting the good fight!

    Posted by REBECCA LEVY | December 24, 2017, 9:14 pm
  22. Hi. I am an ID doc, med/peds trained, EBM geek and with a long standing interest in women’s health. I love your articles, and your much needed lasso of truth.

    I saw that you tackled the safety and benefits of flu and TdAP in pregnancy a few years back. Is it time to get the message out again? Your audience is looking for credible voices and needs you. With the ever increasing chlamydia and MDR gonorrhea infection rate (and syphilis increasing in women), do your readers know that routine STD testing is part of good health care, and not some kind scarlet letter?

    Keep fighting the craziness!

    Posted by Andrew Pavia | January 22, 2018, 11:17 am
  23. I am an LA-based clinical sexologist who trains medical and mental health professionals globally in the broad discipline of sexology. I just read your NYT commentary on dyspareunia (and oversized penises) and I love your spunk, spirit and brilliance. Keep at it! I hope to meet you one day when I’m up in the Bay Area, where I teach occasionally at California Institute of Integral Studies in sexology. xo, Patti

    Posted by Patti Britton | February 24, 2018, 8:35 am
  24. I just read your piece in The New York Times, When the Cause of a Sexless Relationship Is — Surprise! — the Man. It brought me to tears. Finally, justification for all my feelings regarding the sexual issues in my 21 year marriage. Thank you. Not sure if it will help with the issues as I fear we are one of those couples where too much time has passed, but it did make me feel justified and not alone.

    Posted by Christy Cowan | March 16, 2018, 8:23 am
  25. Hello Dr. Gunter, I discovered you months ago and I think that you are a amazing woman‼ I’m really intrigued with your opinions and studies on medical and health issues. May I ask for you help or your opinion; I have a friend that has had a reoccurring yeast infection with itching, abnormal bleeding and bloating for over 2 years and it is getting worse. She has seen 3 different ob-gyn doctors and an ob-gyn specialist. She has tried over the counter yeast infection meds, Diflucan, steroid creams, birth control pills to help with her PH balance and antibiotics. None of these medicine methods have made any progress on her and she is desperate for relief from this dilemma. I would also like to say that she dabbles with cannabis. Anything you could help me with would be greatly appreciated and I hope I have not wasted your valuable time or gotten myself in any trouble for sharing this. Sincerely, Marie

    Posted by tunisa101 | April 20, 2018, 7:00 am
  26. I had a very tramatic accident to my vagina several years ago and now have difficulty reaching climax. Is it possible to sustain some kind of nerve damage to my vagina?

    Posted by Jessica Ehling | April 22, 2018, 8:11 am
  27. Hello Dr. Jen, do you believe that alignment of the human structure, and balance of the body produces optimal health? These two must function in harmony for us to maintain, and it is now possible. Please, invest 10 minutes of your time and visit my “evidenced based fact” website: http://www.jarimbanomorepain.com your comments are welcome.956 502 9668 thank you.

    Posted by Jose A Jarimba | April 22, 2018, 5:33 pm
  28. Thank you for the information posted here. I was recently told that I have the Hsv1 within the last few weeks but am really skeptical because I have not been displaying any signs or symptoms what so ever. I really don’t understand what the results mean when it says 11.60 (H) on my paperwork. If someone could really explain this would be helpful.

    Posted by Brian | May 23, 2018, 7:37 am
  29. I listed to and loved the recent Recode Decode podcast featuring you and and am now trolling your blog for all sorts of information. There are a couple of topics I would personally love to know more about and am posting here in case they are also possible ideas for future posts on your blog. They are as follows:

    (1) Placenta accreta and c/s prevalence: My third, and final, pregnancy was complicated by placenta percreta with invasion to the bladder (well and the bowel but we didn’t realize that until 18 months later). You know the drill with how these deliveries work. It took 89+ units of blood products and a multi-disciplinary and well-planned surgical team to get me through. I know some of the factors that contributed to my survival were (1) delivering in California (2) at a trauma hospital with a mass transfusion protocol (3) early diagnosis at 20 week ultrasound via high def that is standard in my area for all pregnancies (4) being familiar enough with medicine to do good research (5) good underlying health.

    I followed the ProPublica series on U.S. maternal death with great interest and I am glad they brought attention to the issue of the high rate of maternal M& M in the U.S. However, I feel like they never crossed the finished line of bringing to the table some solutions. In particular, I am curious to know whether or not there is a good consensus on the best approach to managing placenta accreta? I had mine via planned cesarean hysterectomy at 35 weeks all in one long procedure. It’s true that it was a very close call, but I only spent 10 days in the ICU and recovered fairly quickly all things considered. I spoke to another mom who delivered not far from me at Stanford with an accreta program who’s hysterectomy was delayed and she ended up with a longer and worse hospital course in the end. Is it standard of care for all women who are s/p c/s to have high-def u/s for subsequent pregnancies? Or should it be??

    And what does the research say about vbacs to help reduce the incidence? For me in was never an option as pregnancy #2 had partial previa. There is a lot of criticism around c/s frequency. Curious to know of the number of post-c/s pregnancies, in how many is a vbac actually even an option?

    (2) Elective hysterectomy: Second only to the baby, the best part of my experience above was the planned ovarian sparing hysterectomy done at the time of delivery. With 3 kids no desire to spawn more mini me’s and on and off fibroids I was beyond done with my uterus. Prior to my pregnancy my OB scoffed at the idea of a hyst. Menopause sounds sucky and I do not look forward to it. However, to have all the hormones with none of the hassle and exhaustion of monthly bleeding is beyond wonderful. I have spoken to other young(ish) women my age who are done having kids and have had hysterectomies for various reasons ( ex. endometriosis) and they feel the same. I often wonder if there really is good evidence to suggest that cons outweigh the benefits of elective hysterectomies? Vs. is it a byproduct of medicine being dominated by males who have no idea what its like to live with heavy, long, painful periods?

    Again,I don’t expect a reply and am just throwing these ideas out there in case you ever want to address.

    Posted by Sarah | August 13, 2018, 8:10 am
  30. Here’s the latest Wellness Scam to hit the Quackosphere; Parsley Health. This particularly egregious site is run by someone who should know better; a Columbia trained MD. The business model, which recently received 10M in Series B funding, extracts monthly payments from subscribers promising “access” to the finest providers in Functional Medicine. Essentially it is a Goop Platform which gets involved in actual Medical Treatment and is overseen by someone who constantly and quite publicly bashes western medicine. Here’s a small sample of some of the b.s. one encounters on their site and from the quacks they have aligned themselves with: https://www.instagram.com/p/BlsYULJApAN/?taken-by=robinberzinmd

    Posted by No Victim | August 14, 2018, 10:24 am
  31. Hello Dr. Jen Gunter. Any chance you could provide some truth regarding the craze around the ketogenic diet? I am not a convert simply because I feel eliminating things like apples, grapes, tomatoes and swapping them out for huge amounts of bacon is not likely to be healthy.I see so many happy looking keto-ers who are almost manic when they start telling you about their new “lifestyle”. What’s even more interesting is many of the keto “experts” are not scientifically qualified. There’s on girl who recently announced to her 100K Facebook followers that she’s going back to school to get a degree in #science. This is a person who has written a few keto books and has gone on a book tour and speakers circuit. I find that while these people tend to interview each other (thus perpetuating the same “truths” that are not scientifically backed up) and get super excited using terms like “biohacking” and “nutritional ketosis”, there’s probably a lot more to this keto story.

    Posted by Pat Tucker | August 21, 2018, 11:17 am
  32. Hello Dr. Gunter-
    I have followed your blog for some time.
    I would like to bring your attention to an aspect of medicine that may be affecting patients worldwide.
    It relates to radiation protection regulations.
    Recent and not so recent scientific articles indicate that the present regulations are based on a now disproven hypothesis, that which postulates that there is a linear, no threshold effect of ionizing radiation on living things.
    The result is fear of radiation and exorbitant costs associated with decreasing dose.
    There are some that indicate that there may be a hormetic effect at low dose. Obviously, high doses are of great concern, but diagnostic examinations are orders of magnitude below this.
    While there are several sites that can be accessed for information, that of Scientists for Accurate Radiation Information, S.A.R.I.
    have a very comprehensive compilation.
    Hopefully, reassurance of people that they are not at risk from CT scans. mammograms, etc., will improve health.

    Posted by Robert Warshawski, MD | August 24, 2018, 9:24 am
  33. Loved your Recode Decode episode. Here’s an idea for you to write about: the PBS fundraising medical specials. In my opinion, they are spewing a lot of misinformation, not supported by fact. I find it more troubling than, for example, Goop because I tend to believe that anything aired on PBS is factual.

    Posted by Susan Kistler | September 18, 2018, 10:15 am

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