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.

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

Over 90 Percent of What Planned Parenthood Does, Part 24: Miscarriage Management and Counseling

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

holding handsMiscarriage. It’s a common occurrence — at least 10 to 15 percent of all pregnancies end this way — but one that is not often spoken about. When carrying a wanted pregnancy, its sudden loss can trigger a range of emotions. During this time, Planned Parenthood can help.


There is no “right” or “wrong” way to feel after having a miscarriage.


What Is Miscarriage?

When a pregnancy ends before it has reached the 20-week mark, a miscarriage has occurred; most miscarriages occur within the first eight weeks of pregnancy. Pregnancy loss after the 20-week mark is called stillbirth, and while it isn’t as common as miscarriage, stillbirth occurs in 1 out of 160 pregnancies.

Signs of a miscarriage include vaginal bleeding or spotting, severe abdominal pain or cramping, pain or pressure in the lower back, or a change in vaginal discharge. These symptoms aren’t specific to miscarriage — they could indicate other problems, so visit a health-care provider if you experience them during your pregnancy.

After a miscarriage, you might have pregnancy-related hormones circulating in your body for one or two months. Your period will most likely return within 4 to 6 weeks. While you may be physically ready to get pregnant again after you’ve had a normal period, you might want to consult with a health-care provider about the need for medical tests. You also might need to think about when you will be emotionally ready to try for another pregnancy. Continue reading

What Do We Know About Herbal Remedies and Menstrual Cramps? (Spoiler Alert: Not Much.)

herbalWhen I was entering adulthood and suffering from severe menstrual cramps, I suffered without relief for far too long. And I am certainly not alone in this experience. The most common gynecological disorder is dysmenorrhea — painful menstrual cramps — which strikes an estimated 90 percent of reproductive-age females. Furthermore, around 40 percent of American women use some form of complementary and alternative medicine, or CAM. “CAM” is a catchall for approaches to health care that fall outside of the mainstream. Given the popularity of CAM and the ubiquity of dysmenorrhea, it was no surprise that I experienced painful cramps, nor was it shocking that I tried a few herbal remedies, which are a type of CAM.


“Natural” doesn’t necessarily mean safe or effective, so be critical.


During my second year of college, at the age of 19, a friend recommended a couple of herbal remedies to add to my cramp-fighting arsenal. I tried them, but it was difficult to know if they really worked. My pain varied so wildly cycle to cycle that I had no way of knowing if I was just having a “good month” when I initially tried these products. Although I thought they worked at first, after I had accumulated more menstrual cycles under my belt, I started to wonder if my cramps were really any less painful. On average, I still seemed to be missing just as much school and work as before — but I wasn’t sure.

The problem was that I never collected any before-and-after data — I didn’t spend years ranking the severity and duration of my cramps, or keeping track of the hours spent in bed away from school, work, or other obligations. Furthermore, my initial sense of optimism could have colored my perceptions. Since we can be tricked by our own expectations and biases, it is important to have access to quality evidence — gathered in large, methodologically powerful studies.

Raspberry leaf tea was the first herbal remedy I tried. It tasted OK, and the ritualistic nature of drinking a hot beverage from a steaming mug was soothing. But is there any actual evidence that raspberry leaf can help relieve the pain of dysmenorrhea? Although it’s been used therapeutically since at least the 1500s, the only human studies I can find for any gynecological condition examine its use during pregnancy or labor — not for treating menstrual cramps. The only claims for raspberry leaf’s efficacy in treating cramps come from biased sources, like the manufacturers themselves. It seems the tea I drank during my late teen years had word of mouth and marketing going for it, but not much else. Continue reading

STD Awareness: The History of Syphilis

syphilisHave you ever heard that syphilis originated in the New World, and was imported to Europe by unwitting explorers? Some say it’s a fitting revenge for Europeans, who brought deadly diseases like smallpox and measles to the Americas. Others say that, while it’s an interesting hypothesis, it’s mostly speculation backed by some intriguing circumstantial evidence.

The predominating theory of syphilis’ origin is that it was transmitted from the Americas to Europe via sailors on Christopher Columbus’ ships — sailors who, in addition to other horrific acts, probably raped the natives of Hispaniola, from whom they could have contracted the infection. Historical records show that syphilis popped up in Europe in the last decade of the 1400s, coinciding with the return of Columbus and his crew — when Europe was deeply mired in war. With war came the far and wide travel of troops, who could have introduced the pathogen to prostitutes and other members of local populations.


In the era before antibiotics, syphilis was the world’s most feared sexually transmitted disease.


But we don’t know for certain that Columbus’ crew brought syphilis back from the West Indies in 1493. Some scholars point to ancient writings, from Biblical texts to Chinese records, that contain descriptions of diseases that are consistent with syphilis — though they might merely have described tuberculosis or leprosy. There are also pre-Columbian skeletons from Europe, Africa, and Asia that seem to exhibit evidence of syphilis infection — though diagnosing syphilis based on bone samples is problematic at best. Is it possible that syphilis had existed in the Old World all along, but didn’t become an epidemic until the wars of the Renaissance era allowed syphilis to conquer the continent?

Or perhaps the New World was home to a mild strain of the disease that mutated once it hit European soil. One team of researchers, studying Guyana’s remote Akwio tribe, discovered a disease that was a lot like syphilis, but was not an STD — it spread by skin-to-skin contact and infected about 1 in 20 children. Genetic analysis showed that it was caused by a bacteria that was closely related to the same bug that causes syphilis. Could Columbus’ men have picked up this transitional strain of bacteria and brought it back to Europe, where it mutated to evolve into the virulent pathogen we know today? Continue reading

STD Awareness: The Next Generation of Gardasil Is Coming!

noisemakersIt’s January, which means it’s time to festoon our surroundings with streamers, throw around the confetti, break out the noisemakers, and shout Happy Cervical Health Awareness Month!

And, in 2015, we have something huge to celebrate: Last month, the Food and Drug Administration (FDA) approved Gardasil 9, the next-generation HPV vaccine, which provides broader protection than the current version. Next month, the new and improved vaccine will start to be shipped to health care providers, and the Advisory Committee on Immunization Practices is expected to give the Centers for Disease Control and Prevention the green light to recommend the vaccine, after which insurance plans and the Vaccines for Children program should start covering it.


The newest version of Gardasil protects against the seven strains of human papillomavirus that together cause 90 percent of cervical cancers.


Why is this news so exciting for people who care about cervical health? Because, while the current version of Gardasil, which debuted in 2006, protects recipients from the two HPV strains that cause 70 percent of cervical cancers, Gardasil 9 will protect against seven strains of HPV that collectively cause 90 percent of cervical cancers. On top of that, both versions of Gardasil protect against the two HPV strains that are together responsible for 90 percent of genital warts.

Gardasil 9 has been shown to be highly effective in clinical studies, and it is safe to use, which means Gardasil just became an even more potent weapon against cancers caused by HPV. Not only that, but vaccination against HPV will also reduce the frequency of precancerous lesions, which are cellular abnormalities that can be treated before progressing into full-fledged cancer. Less pre-cancer means less time, money, and anxiety spent dealing with followup procedures after an abnormal Pap test, for example. Continue reading