Caledonia Buckheit, MD

Caledonia Buckheit, MD Understand your pregnancy and gynecologic health. Evidence based information from an OBGYN and mom.

11/18/2025

So you’re in perimenopause and we’re thinking about treating with hormone therapy, but:

1. What do we do about the periods?
2. How do we prevent pregnancy?

A good perimenopause hormone therapy plan must manage periods and ensure reliable contraception—if pregnancy is a risk.

If pregnancy is a possibility, a progesterone-containing IUD (Mirena or Liletta are best) plus systemic estrogen is an excellent solution. The IUD keeps the uterine lining thin—meaning light or absent periods—while estrogen manages symptoms. Another strategy is Slynd (a progesterone-only pill) taken daily, plus an estrogen product. And of course, combined hormonal birth control pills can provide both reliable contraception and stable daily hormones to keep the perimenopause chaos in check.

11/18/2025

So you’re in perimenopause and we want to treat you with hormone therapy, but:

1. What do we do about the periods?
2. How do we prevent pregnancy?

A good perimenopause hormone therapy plan must manage periods and ensure reliable contraception—if pregnancy is a risk.

If pregnancy isn’t a concern—because you’re not s*xually active, have permanent sterilization, or don’t have a uterus—the focus is on estrogen replacement and cycle regulation.

In these cases, a continuous estrogen product (pill, patch, gel) plus cyclic oral progesterone (if needed) can work very well. The estrogen helps symptoms, and the cyclic progesterone forces a predictable withdrawal bleed, whether or not you ovulate. Daily progesterone with continuous estrogen is another option, though breakthrough bleeding can be more common.

Blog coming to the .mckenzie.obgyn website soon. Check out the highlights here! Written by Caledonia Buckheit, MD — Meno...
11/17/2025

Blog coming to the .mckenzie.obgyn website soon. Check out the highlights here!

Written by Caledonia Buckheit, MD — Menopause Society Certified Provider .mckenzie.obgyn 👩‍⚕️

11/16/2025

Part 2!

For years, the black box warning on vaginal estrogen products has created unnecessary fear and confusion, even though vaginal estrogen:
✨ uses low, localized doses
✨ does not meaningfully raise estrogen levels in the bloodstream
✨ is considered safe even for many people who cannot use systemic hormone therapy
✨ effectively treats dryness, painful s*x, recurrent UTIs, and vulvovaginal atrophy

The data for local estrogen therapy has been solid for a long time. The black box never matched the actual evidence — and its removal is a big win for women’s health and for evidence-based care 💪🏼

If vaginal dryness, discomfort, or recurrent infections are impacting your quality of life, know that you have safe and effective options. 💛

11/16/2025

This past week, the FDA announced plans to remove the black box warning from menopause hormone therapy—and as a gynecologist, here’s how I’m thinking about it.

This change reflects what decades of data have already shown: for healthy, recently menopausal women, hormone therapy is generally safe, effective, and often life-changing for symptoms like hot flashes, sleep disruption, and vaginal dryness.

The black box warning was originally added after WHI data suggested increased risks—but those risks were over-generalized, especially for younger women starting therapy near the time of menopause.

Removing the black box warning doesn’t mean hormone therapy is safe for everyone. But it does help providers and patients talk about menopause care without outdated fear overshadowing the facts.

If you’re struggling with symptoms or have questions about whether hormone therapy is right for you, this is the moment to have that conversation with your clinician.
Your quality of life matters. 💛

10/30/2025

HPV and “high-grade dysplasia” sound intimidating — but they’re treatable, and catching them early works. 💪

HPV is a super common virus that can cause precancerous changes on the cervix called CIN (cervical intraepithelial neoplasia). When graded CIN 2 or CIN 3 (that’s what “high-grade dysplasia” means), treatment is typically required. These are not cancer — they’re changes we can remove before cancer ever develops.

🩺 Treatment options:
Most often a LEEP (loop excision) or cone biopsy — quick, outpatient procedures that remove the abnormal cells while preserving your cervix and fertility.

📋 Follow-up matters:
After treatment, you’ll have repeat Pap and HPV testing at regular intervals to make sure the HPV and abnormal cells are gone and the cervix stays healthy.

The goal is to prevent cervical cancer entirely. And with good screening and follow-up, we do that every day. 💛

On Wednesdays we wear PINK! Breast cancer awareness day during spirit week .mckenzie.obgyn 💕💕💕 Drs Bass and Yoon sported...
10/29/2025

On Wednesdays we wear PINK! Breast cancer awareness day during spirit week .mckenzie.obgyn 💕💕💕
Drs Bass and Yoon sported tutus 👯‍♀️ and looked 🔥

10/29/2025

Let’s talk PCOS treatment — especially if your goal is to get your periods back and restore ovulation. 💪🩸

PCOS is all about ovulation, disrupted ovulation often leads to extra androgens (testosterone) and insulin resistance—and vice versa. Treatment depends on your goals:

✨ If you’re trying to restore ovulation:
• Lifestyle changes (nutrition, exercise, weight management) can help rebalance insulin and hormone levels.
• Letrozole (Femara) is the current first-line medication to trigger ovulation if your goal is pregnancy.
• Metformin can help if insulin resistance is a factor.
• In some cases, clomiphene citrate or injectable fertility meds are used, again, if getting pregnant is the goal.

💊 If you want to AVOID pregnancy:
• Birth control pills, patch, ring or even an IUD can be good options for managing symptoms while also preventing pregnancy.
• Spironolactone and inositol supplements can also help manage symptoms like acne and hair growth.

PCOS isn’t one-size-fits-all — treatment should match your goals, whether that’s regular cycles, fertility, or symptom control.

When it’s “dress like the era you grew up in” day during spirit week, and the GYN triage team understood the assignment ...
10/29/2025

When it’s “dress like the era you grew up in” day during spirit week, and the GYN triage team understood the assignment 👌💅🏼👯‍♀️🦋🏆 .mckenzie.obgyn

10/28/2025

“What’s the difference between a spinal and an epidural for a C-section?” 🤔

Both are types of regional anesthesia — meaning you’re numb from the chest down but awake for delivery. Here’s the breakdown:

💉 Spinal:
• One-time injection into the spinal fluid
• Works fast (within minutes)
• Usually lasts about an hour
• Often used for a planned C-section
• No catheter left in place

🧷 Epidural:
• Medicine goes just outside the spinal fluid (epidural space)
• A thin catheter stays in, so medication can be continuously dosed
• Often used for labor — and can be “dosed up” to a surgical block if a C-section becomes necessary

✨ CSE (Combined Spinal-Epidural):
• Best of both worlds — quick relief from the spinal, plus an epidural catheter for continued anesthesia if needed

So in short: spinal = quick and single dose, epidural = slower but adjustable, and CSE = combo approach.

10/27/2025

“Ever since my tubes were tied, my periods are so different!”
Let’s talk about that one. 🩸

The fallopian tubes connect the ovaries to the uterus — they’re the pathway for the egg, but they don’t make hormones and they don’t control your period.

So when you have your tubes tied or removed (tubal ligation or salpingectomy), your ovaries and uterus keep working the same way. You’ll still ovulate, make hormones, and shed your uterine lining each month — just like before.

If your periods seem different afterward, it’s usually from coming off hormonal birth control, normal hormone fluctuations, or the natural changes that happen over time — not from the tubes themselves.

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