Women’s Health in Midlife: Evaluation, Initial Management, and Indications for Referral

Live – Virtual, on Zoom
July 31, 2026  |  10:00am-12:00pm

Target Audience:

This activity is intended for primary care physicians, obstetrician-gynecologists, nurse practitioners, physician assistants, and other healthcare professionals involved in the care of midlife women.

Activity Description:

This continuing medical education activity is designed to enhance clinician knowledge and competence in the evaluation and management of common gynecologic and sexual health concerns in midlife patients. Using a patient-centered, biopsychosocial framework, this seminar will provide evidence-based guidance on the assessment, initial management, and appropriate referral of frequently encountered conditions.

Content areas will include the evaluation and classification of urinary incontinence, with emphasis on distinguishing subtypes and identifying indications for referral. Participants will review foundational principles of sexual health, incorporating biologic, psychological, and social contributors to sexual function and dysfunction.

The activity will address the menopause transition, including symptom recognition and management strategies, with discussion of both hormonal and non-hormonal treatment options. Evidence-based approaches to abnormal uterine bleeding in perimenopausal patients and postmenopausal bleeding will be reviewed, including initial diagnostic evaluation, risk stratification, and criteria for specialty referral.

Additionally, the seminar will cover vulvar conditions commonly diagnosed in patients aged 45–60, including benign dermatoses and other prevalent disorders. Participants will learn key components of the vulvar examination, initial treatment strategies, and indications for referral to subspecialty care.

Educational Objectives:

At the conclusion of this activity, participants should be able to:

  1. Apply evidence-based approaches to the evaluation of urinary incontinence, including differentiation of common subtypes and identification of red flag symptoms requiring referral.
  2. Integrate the biopsychosocial model into the assessment and management of sexual health concerns.
  3. Describe the clinical features of the menopause transition and implement appropriate management strategies, including non-hormonal therapies.
  4. Determine with initial evaluation and risk stratification abnormal uterine bleeding and postmenopausal bleeding.
  5. Identify common vulvar conditions in midlife patients and initiate first-line management.
  6. Recognize clinical scenarios that warrant referral to gynecology, urogynecology, or vulvar specialty care.

 

Presenters:

Associate Professor Obstetrics and Gynecology, University of Michigan

Natalie Saunders | About | University of Michigan
Natalie A. Saunders | Faculty | University of Michigan Medical School

Dr. Saunders is a board-certified gynecologist with a comprehensive focus on women’s health across all stages of life. With extensive experience in general gynecology, she provides compassionate, evidence-based care for a wide range of reproductive health concerns. She has a particular clinical interest and advanced training in the diagnosis and management of vulvar diseases, offering thoughtful, individualized care for conditions that are often underdiagnosed and misunderstood. Dr. Saunders is also deeply committed to guiding patients through the transitional phases of perimenopause and menopause, helping them navigate hormonal changes with expertise and empathy. Known for her attentive listening and patient-centered approach, Dr. Saunders partners with each patient to develop care plans that reflect their personal goals, values, and health needs. Whether managing routine gynecologic care or addressing more complex conditions, she strives to create a safe, supportive environment where every patient feels heard and respected. Outside of the clinic, Dr. Saunders enjoys staying active through regular exercise and exploring new places through travel. Most of all, Dr. Saunders values quality time with family and friends, believing that meaningful relationships are key to a well-rounded life.

Social Worker, Michigan Medicine

Amy Elizabeth Raad MSW | University of Michigan Health

Amy Raad is a Licensed Master Social Worker and Certified Sex Therapist at Michigan Medicine. She is a clinical supervisor in the Department of Social Work and a sex therapist with the center for sexual health, the Center for Vulvar Diseases, and the menopause clinic. She specializes in supporting women, trauma survivors, and anyone seeking to feel more empowered and at home in their bodies, hearts, and sexual selves.

Amy is a member of the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) and the International Society for the Study of Vulvovaginal Diseases. She is dedicated to helping others feel safe, strong, and joyful. She is immensely grateful to be able to do the work that has built her career.

Physician, University of Michigan

Kathryn Welch | About | University of Michigan
Kathryn Welch | Faculty | University of Michigan Medical School

Dr. Kathryn Welch is an Associate Professor of Obstetrics and Gynecology at the University of Michigan.

She is a Michigan native who earned her undergraduate degree at Michigan State University. Dr. Welch then pursued her medical degree at Wayne State University School of Medicine and completed her residency training in Obstetrics and Gynecology at Wayne State University/Detroit Medical Center. Her practice encompasses general gynecology, with a focus on vulvar dermatoses, lower genital tract disease, and menopause.

Clinical Associate Professor of Obstetrics and Gynecology Medical School, University of Michigan

Mary Ackenbom | About | University of Michigan
Mary F. Ackenbom | Faculty | University of Michigan Medical School

Continuing Education

This activity has been approved for 2.00 continuing education units for nurses. See the Purpose, Objectives, and Disclosures (POD) document for more details on how to claim credits.

Women’s Health in Midlife: Evaluation, Initial Management, and Indications for Referral – Purpose, Objectives, and Disclosures

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