About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.

Eroding the Birth Control Mandate

The Trump Administration made its boldest move against contraception access on Friday, when it reversed Obama-era policies requiring most employers to include birth control in employee insurance plans. Nonprofit companies, private firms, and publicly traded companies can opt out of providing birth control through employee insurance plans by claiming a “sincerely held religious or moral objection.” This change was made, effective immediately, with no period for public comment.


If you have insurance that still covers contraception, now might be the time to look into IUDs or implants, which can last for at least three years.


Previously, only a small group of religious employers was exempt from the requirement to include birth control in employee insurance plans; the new rule expands the types of businesses that can claim religious exemptions. Furthermore, these employers need not cite any particular religious beliefs, but can simply claim to have moral objections to birth control in order to opt out of including contraception in employee insurance plans.

The ruling drew condemnation from the American Congress of Obstetricians and Gynecologists, Planned Parenthood Federation of America, the American Civil Liberties Union, the National Women’s Law Center, and the Center for Reproductive Rights.

Under the provisions of the Affordable Care Act, contraception is considered a “preventive” service and, therefore, legally must be made available with no out-of-pocket costs to patients. Zero-copay birth control, as this is called, has saved users and their families billions of dollars in the years it has been in effect. Continue reading

STD Awareness: “Sounding the Alarm” Over Another Antibiotic-Resistant STD

In 2012, the New England Journal of Medicine ominously stated, “It’s time to sound the alarm.” What followed was a description of the evolution of gonorrhea to all antibiotics we have used to treat it, including the last ones we had left. They closed the article with a warning: “The threat of untreatable gonorrhea is emerging rapidly.”

This summer, just five years after that alarm bell was sounded, the New England Journal of Medicine’s prediction came true. Reports of untreatable gonorrhea surfaced, shared in a World Health Organization press release: “Data from 77 countries show that antibiotic resistance is making gonorrhoea — a common sexually-transmitted infection — much harder, and sometimes impossible, to treat.”


An STD most people haven’t even heard of is rapidly evolving antibiotic resistance.


So maybe we should listen when a medical journal talks about the need to “sound the alarm.”

Sexually Transmitted Diseases, the medical journal of the American Sexually Transmitted Diseases Association, did just that in an editorial called “Mycoplasma genitalium on the Loose: Time to Sound the Alarm,” which accompanied two studies detailing antibiotic resistance in a little-known STD called mycoplasma genitalium, or MG for short.

“Let me get this straight,” you might be saying. “First you’re telling me there’s an STD called MG, which most people haven’t even heard of, and now you’re telling me I already need to worry about antibiotic resistance?” Continue reading

Some Good News About Three Sexually Transmitted Viruses

Scientists are hard at work finding ways to improve your health!

With so much bad news emblazoned across headlines in every newspaper you look at, the world might seem like a gloomy place. So let’s take one depressing subject — disease — and peel away the sad outer layer to find silver linings of optimism.

When it comes to infections, a lot of us blame one thing: germs, also known as “bugs” — “pathogens” if we’re fancy. Some people might not think of infectious diseases as being that big of a deal — after a round of antibiotics, you’ll be on the mend. Unfortunately, antibiotics only work for bacteria, but a lot of diseases are caused by other types of germs — for which antibiotics are no match. One type of germ is called a virus, and they can’t be cured. Sometimes they can be prevented with vaccines or treated with drugs. For example, the major strains of human papillomavirus (HPV) can be prevented with a vaccine called Gardasil, herpes simplex virus can be suppressed with antiviral drugs, and HIV can be controlled with antiretroviral drugs — but none of these infections can be cured. HPV is usually defeated by the immune system, but herpes and HIV are with you for life.

But it’s not all bad. Around the world, individual scientists have picked their “favorite” viruses and are devoting their lives to finding better prevention strategies, better treatments, and even cures. Let’s check in with some of the latest headlines touting the successes of science.

New Hope for a Herpes Vaccine

A herpes vaccine would be a blockbuster — given how common this sexually transmitted infection is, a preventive shot could help a lot of couples discuss their herpes status without as much fear of judgment and stigma.

Herpes might cause an “outbreak” — unpleasant symptoms that include genital sores — but afterward the virus goes dormant in the nerve cells, hiding from the immune system. In some people, the virus can come out of its dormancy to cause flare-ups of symptoms, but once it’s had its fun it retreats back to the nerve cells.

Earlier this year, media reported on a promising new candidate for a herpes vaccine. Using a completely different strategy than previous, failed herpes vaccines, the researchers behind this breakthrough targeted the part of the virus that allows it to hide from our immune systems. If this vaccine works as hoped, recipients will be able to mount an immune defense when exposed to the virus, blocking it from establishing a permanent home in nerve cells. It might even suppress outbreaks in people who already have herpes. Continue reading

Celebrating Mexico’s Contributions to the Birth Control Pill

September 15 to October 15 is National Hispanic Heritage Month. We’re celebrating by shining the spotlight on Mexico’s role in developing the birth control pill, one of the most important medical breakthroughs of the 20th century.


Humanity cannot fully unlock its potential until we release the bonds of oppression from all marginalized groups.


Underneath the surface of a large swath of Southern Mexico’s jungles lay the enormous roots of a wild yam, Dioscorea composita, known locally as barbasco. Mostly it was considered a nuisance, as it could get in the way of subsistence agriculture, but it did have its uses in traditional medicine — and it would change history forever when scientists figured out how to wrest valuable chemical compounds from it, a discovery that led directly to the development of the birth control pill.

Russell Marker. Image: Penn State University ArchivesIn the 1940s, hormones held an untapped potential for research, but there was no cost-effective method of producing large quantities of them — including progesterone, the Pill’s essential ingredient. An American chemist named Russell Marker set out to find a way to synthesize progesterone in abundance, hypothesizing that plants from the genus Dioscorea, which includes yams and agaves, would be a good source for starting material. After some research, he set his sights on wild-growing yams that were found only in Mexico.

Marker’s hunch brought him south of the U.S. border, where locals helped him find and gather these yams, enabling him to develop a method for synthesizing large batches of progesterone — more than had ever been in one place. When pharmaceutical companies would not invest in further research in Mexico, Marker relocated to Mexico City and put his money where his mouth was. In January 1944, he co-founded a lab named Syntex — a portmanteau of “synthesis” and “Mexico” — devoted to finagling hormones from wild Mexican yams. That yam was called barbasco by the indigenous population, and it was the industry’s choice for the raw material in hormone synthesis. Continue reading

STD Awareness: The Curious Case of Chancroid

Haemophilus ducreyi arrange themselves in parallel rows, which researchers have called “railroad tracks,” “schools of fish,” and “fingerprints.” Image: Mike Miller, CDC

Earlier this year, I asked a room full of scientists and medical professionals to raise their hands if they’d ever heard of chancroid. Everyone sat there, motionless, confused by the odd syllables I had uttered — shan kroyd. If you’ve never heard of chancroid, you’re not alone.

Chancroid is a sexually transmitted disease (STD) brought to you by Haemophilus ducreyi, a type of bacteria that can pass through microscopic tears in the skin during sexual contact. When one partner is infected, there is a 1 in 3 chance the other will become infected. An infection can cause painful sores and swollen lymph nodes, most often in the genital region. About half of people with chancroid infections will experience “buboes,” or swollen lymph glands that might rupture. Before it could be cured with antibiotics, a persistent infection could cause permanent skin damage.


Humanity can make chancroid the first STD to go extinct.


One reason you probably haven’t heard of chancroid is that, in the developed world at least, it has mostly disappeared. In fact, researchers believe chancroid can be completely wiped off the planet — which would make it the first STD ever to be forced into extinction. How amazing would that be?

Chancroid has been hopping from loin to loin since at least the days of the ancient Greeks, and was common until the 20th century, when rates began to decline. Thanks to antibiotics, U.S. chancroid rates decreased 80-fold between 1947 and 1997, all but vanishing by the late 1950s. It was virtually unheard of until there was another spike in the 1980s, correlating with the crack epidemic. But, since 1987, cases have been steadily declining. Continue reading

No, the Morning-After Pill Is Not the Abortion Pill

The other week, I was talking to a family member about the threats to contraception access in this country, “thanks” to our new president and his fanatical administration. He thought it was ridiculous that abortion opponents also fight tooth and nail to put obstacles in front of birth control — after all, reliable contraception prevents unintended pregnancies, which itself prevents untold abortions. It seems like a win-win for everyone, regardless of where their opinion on abortion falls.


The morning-after pill prevents pregnancy. The abortion pill ends pregnancy.


Then he said, “Of course, I understand them not wanting tax dollars going toward the morning-after pill, since that causes abortion.”

I had to stop him right there: “Nope.” A bit self-conscious of appearing to be a persnickety know-it-all, I summarized the vast differences between the morning-after pill and the abortion pill — differences that many people, even full supporters of reproductive rights, don’t understand. Opponents of abortion and contraception exploit this misunderstanding, pretending these two pills are one and the same, hoping to elicit “compromise” from “reasonable” people. Compromises that harm real people with real lives and real families. Just as women’s health opponents have been so successful at chipping away at abortion access, so too do they hope to erode access to contraception.

The morning-after pill and the abortion pill are completely different medications, used for different purposes and made up of different ingredients. Let’s look at a quick rundown of the two. Continue reading

STD Awareness: Is Gonorrhea Becoming “Impossible” to Treat?

Image: National Institute of Allergy and Infectious Disease

Health authorities have been worried about it for a long time now, and we’ve been following it on our blog since 2012. The boogeyman? Antibiotic-resistant gonorrhea, a strain of the sexually transmitted bacteria that is becoming more and more difficult to treat. Higher doses of the drug will be needed to cure stubborn cases of gonorrhea — until the doses can no longer be increased. Then, untreatable gonorrhea could be a reality.


“Little now stands between us and untreatable gonorrhea.”


The World Health Organization (WHO), in a press release last month, finally used the word “impossible” when describing treatment of antibiotic-resistant gonorrhea, referring to documented cases of gonorrhea that were “untreatable by all known antibiotics.” Worse, these cases are thought to be the proverbial “tip of the iceberg,” as there aren’t good data on antibiotic-resistant gonorrhea in many developing countries, where gonorrhea is more prevalent and epidemics could be spreading under the radar. Adding to this problem is the fact that gonorrhea rates are climbing worldwide, which is thought to be due to a number of factors, including the decline in condom use, the frequent absence of symptoms, inadequate treatment, and increasing urbanization and travel.

What will happen if gonorrhea can’t be cured? Your infection could clear up on its own, after a lengthy battle with your immune system, but we don’t know a lot about how long this could take (weeks? months? never?). Unfortunately, despite your immune system’s best efforts, gonorrhea doesn’t go out without a fight. Gonorrhea can lead to pelvic inflammatory disease, which can cause tissue damage to the reproductive organs resulting in infertility, ectopic pregnancy, and chronic pain. It can also cause scarring that blocks sperm’s movement out of the testes, resulting in epididymitis, which is associated with infertility, chronic scrotal pain, and testicular shrinkage. Furthermore, gonorrhea increases risk for HIV transmission and can be passed to a baby during childbirth. The CDC estimates that, in the United States alone, untreatable gonorrhea could cause 75,000 cases of pelvic inflammatory disease, 15,000 cases of epididymitis, and 222 extra HIV infections over a 10-year period. Worldwide, where gonorrhea and HIV disproportionately affect developing countries, these problems could get even more out of control. Continue reading