Worldwide and within the United States, research on men’s health has long taken precedence over research on women’s health. Only recently has this inequitable and short-sighted pattern and practice begun to evolve, unevenly.
Magee-Womens Research Institute — the very first research organization established to focus on the health of women and their infants, as well as reproductive biology — was founded 32 years ago in Pittsburgh. It remains the largest American research institute dedicated to women’s health.
By 1994, basic scientists consulting with physicians and working in open labs were being encouraged to cross-disciplinary boundaries, think unconventionally, and creatively pursue solutions to women’s health issues. MWRI has been informing global health care innovation and “changing the way the world treats women” ever since.
In 2022, Dr. Carla Picardo sold her private OB-GYN practice in Erie, Pennsylvania, to the University of Pittsburgh Medical Center. In doing so, she not only joined the UPMC Health System, a highly ranked not-for-profit health enterprise with a global reach that includes MWRI and Magee-Womens Hospital, but she also brought the Magee-Womens Midlife Health Center to Erie.
At 4 p.m. today at the Chautauqua Women’s Club House, Picardo will give a presentation titled “Targeted Towards Menopause.”
Michael Annichine, CEO of Magee-Womens Research Institute and Foundation, will also speak and answer questions, as he did last July when Dr. Mary Ackenbom talked about pelvic health matters at the CWC on behalf of MWRI.
Picardo, who offers specialized care for women in perimenopause and menopause, said that she will discuss myths about menopause and provide clarification about the role of therapy for menopause symptoms, including hormonal and non-hormonal options.
“I think at this time in a woman’s life — because it’s so fraught with symptoms — that women are over-marketed to with quick solutions,” Picardo said. “This is a normal transition that we all go through if we live a long enough life.”
She continued. “We don’t medicalize puberty, or pregnancy. … It’s like it’s something we have to fix, but we don’t need to ‘fix’ menopause. We can help manage the symptoms. It’s called ‘the second puberty — that men don’t have.’ ”
Growing up in Erie, Picardo never dreamt of becoming an obstetrician-gynecologist or even a physician, though she “always liked the sciences.” In middle school, she thought about being a mechanic since she “liked to mess with (her) uncle’s car.” Then she turned to astronomy and read Sky and Telescope magazine, published at Harvard College Observatory.
Arthroscopic surgery was just emerging when she was involved in high school sports, so Picardo leaned toward becoming an orthopedic surgeon and looked at colleges with strong pre-med and engineering programs.
“I thought it was a better fit to go to a great liberal arts school than a technical school,” she said. She chose Harvard over MIT, knowing that she could “cross-register” for engineering courses at MIT, and that “Harvard has the largest collegiate library in the U.S. and probably in the world.”
When Picardo took a linguistics course, however, she said she began asking questions about her older brother, who had been diagnosed with Williams syndrome (also called Williams-Beuren syndrome), a rare genetic disease affecting many parts of the body.
“He developed language late, at age 10,” she said, but typically children who do not develop language by the time they’re 8 don’t develop it. This discrepancy prompted her to do some research at Harvard Medical School.
That’s when Picardo pivoted from orthopedic surgery to pediatric neurology and began studying with an Iranian faculty member who took her under his wing. She said that the summer before her senior year she stayed on campus to work with him on headaches, a project that she turned into her senior thesis before graduating with a Bachelor of Arts in Biology.
After taking a year off for the Medical College Admission Test and medical school applications, Picardo entered Wake Forest University’s School of Medicine in Winston-Salem, North Carolina. Situated in Appalachia, the “stroke/heart/diabetes belt,” she said that Winston-Salem is also the headquarters of R.J. Reynolds, thus “lots of smoking.”
Following her first two years in med school (largely spent in classrooms), Picardo undertook a number of her third-year core “rotations” and fourth-year elective rotations (during which she interacted with patients and medical staff while being monitored and evaluated by senior physicians) in atypical places.
But even before those rotations, between her first and second years in med school, she said she lived in a trailer on a Navajo reservation in Crown Point, New Mexico, that had a population of about 1,000. One of the physicians there was engaged in a project on fetal alcohol syndrome.
Picardo worked on preventing FAS by offering non-alcohol-related activities on the reservation and creating a handbook with healthy recipes that soon caught the attention of the state health department.
The summer before her third year, she said she connected with the Native American Lumbee tribe in North Carolina and completed her pediatrics rotation — having received a grant from the Albert Schweitzer Foundation to share her knowledge and recipes.
“I decided I was less excited about pediatrics and (cared) more about what was happening to women and unborn children with fetal alcohol syndrome,” Picardo said. “I returned to that area — to Lumberton Hospital — for an OB rotation … to confirm that OB-GYN was what I wanted to do.”
She added, “It was a very intensive rotation. I was doing everything — delivering babies, helping with surgeries, tubal ligations — and they were there for me.”
At Oregon Health Science University Hospital, Picardo completed her OB-GYN residency and became board-certified.
“In Portland, I met a gentleman from Nepal working at REI whose family was into Ayurvedic Medicine,” Picardo said. “I got connected with a physician from Texas outside Kathmandu and worked at the hospital in Dhulikhel for four months.”
There she researched the hysterectomies that had been done at the hospital, and afterward presented her findings at an international OB-GYN conference in Prague.
After interning for a summer in Anchorage at Alaska Native Hospital, Picardo decided to move closer to her brother and family in Erie. There was a job opening at Community Health Net, which in part provided healthcare for the homeless and is affiliated with Saint Vincent Hospital. She signed a year-long contract.
A few months later, Picardo met her future husband, and before the year was over, extended her contract.
Sometime later, because she wanted to help more people, she looked into public health programs.
As well as undergoing training in epidemiology and earning a Master of Public Health at the University of North Carolina at Chapel Hill, Picardo completed a second clinical residency in General Preventive Medicine and Public Health at UNC, earned her board certification, and ran clinical trials for an OB-GYN fellowship.
“In preventative medicine, you don’t take care of people,” she said. “It’s less intensive than being on-call. I rotated through the Erie County Department of Health. … I shadowed all the divisions, even seeing septic tanks, and got to know (the department).”
During the final year of her preventative medicine residency and research fellowship, in 2006, Picardo found an OB-GYN physician running a health department during the aftermath of Hurricane Katrina. He made it possible for Picardo to conduct research documenting reproductive needs and issues in Louisiana.
Going door-to-door from one Federal Emergency Management Agency trailer to another, she gathered “data to document unmet needs for contraception and the issues of intimate partner violence.”
After earning her MPH and moving back to Erie full-time, Picardo said she wasn’t able to return to Community Health Net because it was no longer offering OB-GYN services.
Instead, she worked for seven years in private practice with Francis Tseng, a well-respected, longstanding OB-GYN physician, and taught family medicine residents at Saint Vincent’s Hospital.
Upon Tseng’s retirement, she opened her own small practice — Women’s Wellness & Gynecology — for outpatient gynecology and some surgery.
“I did everything except the scheduling and nursing,” Picardo said. “… I was able to do a lot of preventative, once-a-year visits. The demographics skewed towards 40 and beyond. (I met) common needs and community needs.”
As she was slowly gravitating towards developing a focus on perimenopause, menopause, and postmenopause, COVID-9 set in.
“UPMC and I approached each other,” Picardo said. “All of their providers were in Pittsburgh. I sold my practice to UPMC, and joined Magee-Womens Research Institute.”
She also became a Menopause Society Certified Specialist trained to manage symptoms for women in menopause.
Picardo now provides clinical care to her patients both remotely and in-person in Erie at Magee-Womens Midlife Health Center.
In addition, she serves as vice chair of the board of the Erie County Department of Health — the one through which she rotated during her preventive medicine residency.
And, she works with the national Women’s Preventive Services Initiative, reviewing scientific evidence and draft recommendations for women’s preventive care. Under the federal Affordable Healthcare Act, approved recommendations are covered for eligible women.
For anyone keen on learning more about women’s health in and after midlife (perimenopause, menopause, postmenopause); in the Pennsylvania, Western/Central New York, and Maryland region; in the United States; or worldwide, the CWC House is the place to be this afternoon.
