About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received her bachelor’s degree from the University of California and is now back in school studying science. 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.

Is Douching Safe?

This vintage douche ad claims that its product is “safe to delicate tissues” and “non-poisonous.”

Douching is the practice of squirting a liquid, called a douche, into the vagina. Many people believe it helps keep the vagina clean and odor-free, and some are under the impression that it helps prevent pregnancy and sexually transmitted diseases. An estimated 25 percent of American women 15 to 44 years old douche regularly. But just because douching is widespread doesn’t mean it’s safe; indeed, there are two possible mechanisms by which douching might be harmful.

First, douching might alter the pH of the vagina, changing its ecosystem. You might not think of a vagina as an “ecosystem,” but the bacteria and other microscopic organisms that live there sure do — and altering their habitat can harm the beneficial microbes that live there, opening the door for disease-causing microbes to take over the territory. Frequent douching can result in the vagina’s normal microbial population having difficulty reestablishing its population.


Douching increases risk for infections and fertility problems, and has no proven medical benefits.


Second, a douche’s upward flow might give pathogens a “free ride” into the depths of the reproductive tract, granting them access to areas that might have been difficult for them to reach otherwise. In this manner, an infection might spread from the lower reproductive tract to the upper reproductive tract. Douching might be an even bigger risk for female adolescents, whose reproductive anatomy is not fully formed, leaving them more vulnerable to pathogens.

While douching is not guaranteed to harm you, there is no evidence that it is beneficial in any way. Establishing causation between douching and the problems that are associated with it is trickier — does douching cause these problems, or do people who douche also tend to engage in other behaviors that increase risk? So far, the best evidence indicates that douching is correlated with a number of diseases and other problems, including sexually transmitted diseases (STDs), bacterial vaginosis, pelvic inflammatory disease, fertility and pregnancy complications, and more. Continue reading

STD Awareness: Gardasil and Gendered Double Standards

male female teens largeDespite the fact that it’s been approved for males for years, Gardasil is still largely seen as a vaccine for girls, and human papillomavirus (HPV) is still thought of by many as a virus that only impacts the female population. The fact of the matter is that HPV can have serious consequence for boys and men, and Gardasil is an important tool in protecting their sexual health. Why, then, does the association between girls and Gardasil persist?


Let’s stop thinking of Gardasil as the cervical cancer vaccine. Gardasil is a cancer vaccine, period.


Before Gardasil’s introduction, the pharmaceutical company Merck launched an HPV-awareness campaign to get a buzz going for their upcoming vaccine. Their talking points could be boiled down to one simple fact: HPV causes cervical cancer. Outside of the medical field, HPV was a little-known virus, and Merck strove to connect HPV and cervical cancer in the public’s mind so that, after it hit the market, Gardasil’s value would be easily recognized.

So the origins of the association between girls and Gardasil lie in its marketing — and the fact that the Food and Drug Administration (FDA) initially only approved its use in females. From its introduction in 2006 until 2009, Gardasil was only FDA-approved for use in girls and women, and its routine use in males was not recommended by the Advisory Committee on Immunization Practices until December 2011.

While Gardasil’s website is currently gender neutral, archives show that before FDA approval for males, it contained photos of young women and female-specific language. This initial focus on female recipients could have “feminized” Gardasil, entrenching its association with girls and women in the cultural imagination. Some scholars say that, by only recommending it for one sex, the FDA implicitly assigned liability for HPV transmission to females, and advertisers framed the woman as a disease vector in taglines targeting females, such as “spread the word, not the disease.” Although a male’s sexual history is a major predictor of a female partner’s HPV status, girls and women were assigned sole responsibility for their HPV status while boys and men were not similarly burdened. Such messages downplayed the male role in HPV transmission as well as HPV’s effect on males. Continue reading

When Contraception Was a Crime: Griswold v. Connecticut

Estelle Griswold, left, and Cornelia Jahncke, both of Planned Parenthood League of Connecticut, celebrate the Supreme Court's decision in favor of birth control access.

Estelle Griswold, left, and Cornelia Jahncke, of Planned Parenthood League of Connecticut, celebrate the Supreme Court’s decision in favor of birth control access.

The right to access birth control was in the crosshairs last year, when the Supreme Court ruled that certain employers had the right to exclude emergency contraception from their employees’ health plans. But the Hobby Lobby case was just one in a long line of contraception-related cases decided by the Supreme Court, and while that outcome was a setback for the reproductive rights movement, history also is filled with decisions that helped advance the cause. One of those victories came 50 years ago this Sunday, on June 7, 1965, when the Supreme Court handed down a decisive win for contraception access in Griswold v. Connecticut.


Griswold v. Connecticut was a landmark case in expanding access to birth control — but it was only a first step.


When the birth control pill came onto the market in 1960, it was a dream come true for anyone wanting to control her own reproduction. But in 30 states it was illegal to advertise contraception, and in two states, Massachusetts and Connecticut, it was outright banned. In fact, anyone using birth control in Connecticut was at risk for a fine or imprisonment. These draconian laws didn’t stop people from seeking birth control from their doctors, but it did force them to engage in activities that were technically “criminal.”

Connecticut had been the birthplace, in 1844, of one of history’s most relentless anti-contraceptive crusaders, Anthony Comstock, whose Puritan upbringing spurred a nearly lifelong crusade against what he saw as the devices of immorality. Comstock was the driving force behind federal and state laws that banned birth control, and it’s estimated that he initiated as many as 4,000 arrests, one of the last of which was Bill Sanger, husband of Margaret Sanger, for distributing a pamphlet on family planning. Comstock died on September 21, 1915, months after Sanger’s arrest.

Connecticut’s anti-contraception law predated the birth of oral contraceptives by more than 80 years. It was so broadly worded that more old-fashioned family-planning methods, such as diaphragms and condoms, could also see their users fined or sent to jail. There was also equal punishment for anyone “aiding and abetting” would-be contraceptive users, meaning that doctors, pharmacists, and others could be punished for providing patients with birth control or information about it. Continue reading

STD Awareness: Can Genital Warts Lead to Cancer?

HPV from CDCOne of the most confusing sexually transmitted diseases (STDs) out there is human papillomavirus, or HPV. Despite the fact that it’s the most common STD in the United States, most Americans don’t know very much about it. So, whenever I wade into conversations about HPV on Internet message boards, I prepare myself to enter an ocean of misinformation and misunderstandings.


The strains of HPV that cause genital warts are different from those that cause cancer.


This post, in fact, was inspired by some particularly egregious falsehoods spouted by quite confident-sounding message-board denizens who were dispensing advice to a distraught man with genital warts. He had read that the virus responsible for genital warts was also responsible for cervical cancer, and was upset that he might have “given” cancer to his beloved girlfriend. While some commenters gave good advice, others shared ideas that were not factually correct — and in a forum devoid of sources or citations, it would have been difficult for him to distinguish the bad information from the good.

Situations such as these highlight why it’s not a great idea to get medical advice from the “hive mind” of the World Wide Web. I know American health-care access still isn’t all it can be, but dang — I hope most people know to use reputable sources, like the Centers for Disease Control and Prevention (CDC), whenever they take to the ’net in search of health information.

The first thing to know about HPV is that it can be spread by any type of sexual contact — penetrative and non-penetrative. It can be transmitted by vaginal sex and anal sex, as well as by oral sex or rubbing genitals together, even without penetration. Continue reading

Does Douching Work?

illustration of a douching apparatus from an 1882 medical handbook

As a newly minted teenager, I was helping my mother go through some of my recently deceased great-grandmother’s things. I held a mysterious object in my hands and studied it curiously, puzzling over its unfamiliar form, pastel color scheme, and floral pattern. Finally, I gave up: “What is this?” I exclaimed. My mom, instantly uncomfortable, muttered her answer through clenched teeth: “It’s a douche bag,” she replied.

I remember being rather scandalized, but also a bit amused to be holding a piece of ancient misogynist history in my hands. Even as a junior high student, I knew that douching was marketed toward women with the message that their vaginas were “dirty” and in need of “cleansing” — scientifically invalidated ideas to which we surely no longer adhered. It seemed fitting that we were sorting through the belongings of a person born in the 19th century, dividing them into the useful and useless. Surely the douche bag belonged in the latter category.


Just because douching products are available in drugstores doesn’t mean they’re safe or effective.


Little did I know, more than 20 years ago, that douching hasn’t exactly been relegated to a historical footnote. Overall, nearly 25 percent of American women 15 to 44 years old douche regularly — which is down from nearly a third in 2002. Douching rates may vary by ethnic group: CDC data from 2005 found that 59 percent of non-Hispanic black women, 36 percent of Latinas, and 27 percent of white women douche. Socioeconomic status and education level can also be a factor.

For those of you who don’t know, vaginal douching is the practice of flushing the vagina with a liquid, which is administered through a nozzle that is inserted into the vagina. Some people believe that douching cleanses or deodorizes the vagina, or can prevent pregnancy or infections. Some might think their partners expect them to douche, or that douching will “tighten” or “rejuvenate” their vaginas.  Continue reading

STD Awareness: Three Sexually Transmitted Bugs That Will Fascinate and Intrigue You

From creepy crawly pubic lice, which can be seen with a magnifying glass, to minuscule human papillomaviruses, which can be seen with some of the most expensive microscopes in the world, there are many tiny pathogens that we can acquire through sexual contact. And, despite their diminutive sizes, some of them work in complicated ways, or tell stories about our origins that would blow you away. Let’s learn some amazing facts about three sexually transmitted bugs!

Phthirus pubis, the louse that causes scabies. Image from the Public Health Image Library.

Image: Public Health Image Library

Pubic lice: tiny insects that live in pubic hair

Fans of Charles Darwin might like learning about pubic lice, which offer clues about human evolution. While other apes’ bodies are habitat to only one species of louse, human bodies can host three different types of louse: head lice and the closely related body lice, as well as the distantly related pubic lice.

It is thought that when early humans lost their body hair, human lice followed this receding hairline and migrated to their heads to become head lice. At a later date, the gorilla louse colonized early humans’ pubic regions. Since pubic lice can be transmitted by infested bedding, one idea is that an early human caught pubic lice by sleeping in a burrow that had been recently vacated by a lice-ridden gorilla — no sexual contact required.

By examining the number of differences in the genetic codes of the modern gorilla louse and the human pubic louse, we can place their divergence into two separate species at about 3 million years ago, suggesting that our human ancestors lost their body hair at around that time.

A quite frankly weird fact about pubic lice involves the method their young use to hatch from their eggs — by releasing so much gas that the increase in air pressure causes them to burst from their shell. So there’s that. Continue reading

STD Awareness: HIV Testing

HIV testIt’s often been said that young people view HIV as a chronic disease rather than the “life sentence” it was before there were effective treatments. The fact that an HIV infection can be managed with antiretroviral drugs is a boon from modern medicine, and there are hopes for better treatments on the horizon.

But HIV is only a manageable infection if you, well, manage it, and most Americans with HIV aren’t being treated with the medications we have in our arsenal. Only 3 out of 10 Americans who are infected with HIV are controlling the virus with medication — but when you zoom in on that population and look specifically at young people, the numbers are even more dismal, with only 13 percent of youth, ages 18 to 24, receiving treatment.


Knowing your HIV status is easier than it’s ever been.


Much of this problem is due to a lack of access — without adequate health coverage, these medications can be out of reach for many. But that’s not the whole story — it’s estimated that nearly half of 18- to 24-year-olds with HIV don’t know it. If they haven’t been diagnosed, they can’t know to seek treatment; if they don’t seek treatment, they can’t manage their infection; if they can’t manage their infection, their risk of health problems and early death increases — as do the chances of transmitting the virus to someone else.

So, if a 20-year-old tests positive for HIV and begins antiretroviral treatment right away, he or she can expect to live another five decades — to age 71, not bad compared to the average life expectancy of 79. But if that 20-year-old does not take antiretorvirals, he or she can only expect to live another dozen years — to age 32.

That’s why it’s so important to get tested and know your status. Continue reading