STD Awareness: Can Older Adults Receive the HPV Vaccine?

female-patient-with-female-doctorWhen the human papillomavirus (HPV) vaccines were introduced, a lot of people were excited about protection from a sexually transmitted virus that could cause cancers, including cervical cancer, anal cancer, and head-and-neck cancer. It wasn’t just any old vaccine, it was a shot that could prevent cancer. Cancer!

In fact, a lot of people were disappointed they were too old to take advantage of an anti-cancer vaccine, which was initially approved for people as old as 26. We were given a lot of reasons why people above that age were “too old,” such as the assumption that anyone older than 26 has probably been sexually active for years and would have already contracted the most common strains of HPV.


While getting vaccinated before becoming sexually active is optimal, the HPV vaccine can still benefit people who have already had sex.


But there are compelling reasons to vaccinate people in their late 20s and beyond. In fact, Gardasil 9 was recently approved for people as old as 45. That’s great news for those of us who missed out on the HPV vaccine the first time around. We might never have had any sexual contact, and therefore were never at risk for catching the sexually transmitted virus. We might have found ourselves widowed or divorced after years or decades of monogamy. We might have been sexually active with multiple partners during that time. Whatever our circumstances, those of us who are 45 or younger can now consider HPV vaccination.

HPV and the “Older” Individual

When Cervarix and Gardasil, the first HPV vaccines, were released, they only protected against two cancer-causing HPV strains, HPV-16 and HPV-18, which are responsible for 70 percent of cervical cancers (Gardasil protects against two additional wart-causing HPV strains). A few years ago, Gardasil 9 hit the market, targeting five additional cancer-causing HPV strains — increasing the chances that even sexually active recipients could be protected from HPV strains they hadn’t encountered. Continue reading

STD Awareness: HPV Testing vs. the Pap Test

I love writing about health and medicine, but I hate going to the doctor. I don’t like taking my clothes off for a dermatological exam, I don’t like rolling my sleeve up for a shot, and I don’t like opening my mouth for a dentist. I don’t even like having my blood pressure taken — it gives me the heebie-jeebies, and probably a case of white-coat hypertension too.


For now, pelvic exams are a mainstay — and an important part of cancer prevention.


So when it comes to something even more invasive, like the Pap test to screen for cervical cancer, I’m one of those people pining for a magic wand — a tool that a health care provider can wave over your fully clothed body to detect disease. The Pap test may have transformed a scourge like cervical cancer into one of the most easily detected and treated cancers — and for that I love it — but I still fervently wish for its demise. As long as it’s replaced by something better, of course.

Last month, an article in JAMA inspired a burst of headlines. “HPV test more effective than Pap smear in cancer screening,” said CNN. Or as WebMD put it more succinctly, “HPV Test Beats Pap.” Then, last week, the U.S. Preventive Services Task Force updated their guidelines to recommend that patients 30 and older can forgo the Pap test in favor of HPV testing alone. This news might be welcome to anyone who dislikes regular Pap tests and wishes to avoid stirrups and speculums. Unfortunately, HPV tests aren’t the noninvasive “magic wand” so many of us hope for. From the patient’s perspective, the experience of undergoing an HPV test is no different from the experience of undergoing a Pap test. They both require a pelvic exam — the stuff of stirrups and speculums. Continue reading

STD Awareness: Eliminating HPV-Related Cancers

Earlier this month, every major cancer center and organization in the country released a joint statement calling for the elimination of cervical cancer, along with all other HPV-related cancers. The elimination of a large swath of cancers might sound like a tall order — so far, we’ve only eradicated two viruses from the planet: smallpox and rinderpest. And we’re on the brink of getting rid of a third, the virus that causes polio.

But doing away with human papillomavirus (HPV) would herald a new chapter in disease eradication, because HPV causes cancer, meaning that eradicating HPV will eradicate the cancers caused by it. And the good news is we have all the tools we need to wipe HPV off the face of the earth — we just need to use them.


The tools to wipe a large class of cancers off the face of the earth are right under our noses — we just have to use them.


A quick rundown on HPV is in order. It’s the most common sexually transmitted infection in the world, and causes multiple cancers — cervical, head and neck, anal, vulvar, vaginal, and penile. While it’s most well-known for causing cervical cancer, here in the United States it is transitioning away from its old job, causing more head-and-neck cancers than cervical cancers. Nearly all sexually active people will be infected with HPV at least once in their lives, and though only a fraction of infections progress to cancer, its ubiquity means it still causes hundreds of thousands of cancers every year. In the United States, around 41,000 HPV-related cancers are diagnosed annually, while more than 600,000 are diagnosed worldwide. Continue reading

STD Awareness: Fighting Cervical Cancer Across the World

Tomorrow kicks off World Immunization Week, a reminder that, just as disease can cross borders, so should our efforts to prevent it. Especially when we have an effective vaccine for one of the world’s top causes of cancer — but the people who need it most are less likely to get it.

Almost 90 percent of cervical-cancer deaths strike women in developing countries, where it is the second-most common cancer among women. In fact, over vast swaths of Africa, cervical cancer is the No. 1 cause of cancer death in women. (In the United States, it doesn’t even crack the Top 10.) While cervical cancer rates are holding steady in the developed world, in the coming decades they are projected to increase sharply in less developed regions.


More than 9 out of 10 cervical cancers strike women in countries with no HPV vaccination programs.


Since 2006 there has been a vaccine for human papillomavirus (HPV), the virus that causes cervical cancer. Unfortunately, while this vaccine is making impressive strides in the developed world, it is almost out of reach in the developing world, where it could save the most lives. To fully realize this vaccine’s potential, it needs to be distributed worldwide — not just within rich countries that can afford it.

Fighting Cervical Cancer in the Developed World

HPV has been nicknamed “the common cold of STDs” — because pretty much every sexually active person will get it at some point. It can be transmitted by vaginal, anal, and oral sex, as well as by rubbing genitals together, even without penetration. HPV can cause cancers of the throat, anus, vagina, vulva, and penis — but is most “famous” for causing cancer of the cervix (the tissue that connects the vagina to the uterus). If you have a cervix, there are two big things you can do to protect its health: receive regular Pap testing after becoming sexually active, and get vaccinated against HPV before becoming sexually active. When you take both of these steps, you’ll maximize what modern medicine has to offer. Continue reading

Do Birth Control Pills Cause Breast Cancer? The Latest Study

Last month, you might have seen headlines warning you that hormonal birth control increases risk for breast cancer. This news came from a study that examined the medical records of nearly 1.8 million Danish women — and the huge sample size lent heft to the findings, several of which stood in stark contradiction to commonly held beliefs about modern hormonal contraception.


Some types of hormonal contraception could increase breast cancer risk, while others may not. But the Pill also reduces risk for endometrial and ovarian cancers.


Birth control comes in two “flavors” — hormonal and nonhormonal. Hormonal contraception is among the most effective, and includes birth control pills, hormonal IUDs, the shot, the vaginal ring, the implant, and the patch. Nonhormonal contraception ranges from very effective, including surgical sterilization and the copper IUD, to the not-quite-as-effective, including condoms, diaphragms, and withdrawal. (With the exception of condoms, birth control does not provide protection against STDs.)

Hormonal contraception is one of the greatest achievements in the history of medicine, and offers those wishing to control their fertility an array of effective options. However, as with all effective medications, there is potential for side effects. And, because many forms of hormonal birth control contain types of estrogen, and exposure to estrogen is a risk factor for breast cancer, many people wonder if hormonal birth control might increase users’ chances of developing breast cancer later in life.

Most birth control pills contain a combination of two hormones: estrogen and progestin (synthetic progesterone). Other hormonal methods, such as the ring and the patch, also use combinations of these two hormones.

There are also pills that don’t contain estrogen, called POPs, or progestin-only pills — aka the “minipill.” Additionally, hormonal IUDs, the implant, and the shot are progestin-only methods.

What Previous Studies Have Shown

The connection between hormonal contraception and breast cancer is murky, because the association is difficult to study properly. There are so many different types of hormonal contraceptives, each with different dosages, different chemical formulations, and different ways of entering the body. We can’t tease these differences apart on the one hand, but make blanket statements about hormonal contraception as a whole on the other hand. But we can look at the available evidence and see where it points. Continue reading

STD Awareness: Is HPV Now a “Men’s Disease”?

Human papillomavirus, or HPV, is most notorious for causing cervical cancer — making it, in many people’s minds, a “women’s disease.” But this gender-blind sexually transmitted virus can cause cancer in any cell it infects, and is associated with cancers of the cervix, anus, vagina, vulva, penis, and mouth and throat — aka oropharyngeal cancer.

While oropharyngeal cancers used to be caused mostly by tobacco, as people quit smoking an increasing proportion is caused by HPV. In the 1980s, only 15 percent of oropharyngeal cancers were caused by HPV, but nowadays the virus is behind 70 percent of them. A 2011 study predicted that the number of HPV-positive oropharyngeal cancers will surpass cervical cancers by 2020.


HPV is rapidly gaining prominence among men.


It’s only 2017, but we’re ahead of schedule. Earlier this year, researchers reported that, in the United States, oropharyngeal cancer is more common among men than are cervical cancers among women — and oropharyngeal cancer rates are increasing in the male population, while they are relatively stagnant among women. These rates are projected to continue climbing, which will skew oropharyngeal cancer even more heavily toward the male population. But, in the public’s imagination, HPV is most well-known for its association with cervical cancer — while most people haven’t even heard of oropharyngeal cancer.

Oropharyngeal Cancer and HPV

Oropharyngeal cancer can strike the inside of your mouth and throat. Risk factors include tobacco (including cigarettes, snuff, and chewing tobacco), marijuana use, alcohol, and oral infection with HPV. HPV can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as “French kissing” and rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancer. Continue reading

Pro-Choice Friday News Rundown

  • I love to start the rundowns off with happy news, and the departure of an anti-choice zealot from office is always a happy occasion!

    When news broke last week that AZ Rep. Trent Franks was resigning from Congress, it sent shock waves through the state of Arizona. To hear that he had reportedly been hounding female members of his staff to serve as pregnancy surrogates for him and his wife was stunning for many reasons:

    1. Ewwwww, this is your boss asking you to have his baby. ACK! NOT NORMAL! AND GROSS!

    2. Surrogacy contracts are illegal in Arizona.

    3. Trent Franks is “pro-life” and surrogacy is almost surely not in line with “pro-life ideals.”

  • All of that aside, we should mark the demise of this horrible man by reminding you all of just how terrible he truly was. The one instance that sticks out most in my mind? When he said that more black babies are “devastated” by abortion than slavery. What a repulsive, malicious, and sickening thing to suggest. That blacks are better off suffering through a lifetime of brutality, torture, and subjugation than never having been born. Adios, Trent, you will NOT BE MISSED, fella! (Rewire)
  • We think this is great news, but for some reason, the teen abortion rate dropping in Colorado by 64 percent isn’t causing jubilation among the anti-choice crowd. Anyone else find that weird? (HuffPo)
  • I don’t know about you, Dear Readers, but yesterday’s plea from that creepy little GOP weasel, Paul Ryan, for Americans to “have more babies” for economic reasons REALLY ticked me off.

    This rich pipsqueak (who whines incessantly about people sometimes needing to draw upon government “entitlements”) sits in total opposition to EVERY policy that would entice people to have more children: universal health care, free or low-cost access to higher education, better funding for public schools, paid family leave, extended social services, a livable minimum wage for all, subsidized childcare, etc. … He and his Republican cohorts are literally opposed to ALL of that which makes having a family less insurmountable.

    It’s hypocritical and callous to try to shame people into having “more babies” when he and his party go to extreme lengths to ensure people have NO financial safety net or governmental aid to rely on when they need it. Let’s hope the rumors of this jerk leaving the Senate in 2018 are true. Maybe he can find it in his icy heart to fund the Children’s Health Insurance Program before he goes. It’s in danger of leaving millions of children without insurance otherwise. I mean, come on. The health of all the babies he wants us to have has to matter to him, right? (Splinter News)
  • There have been a lot of headlines lately about the correlation between birth control pills and cancer. But left out of many of these news stories is the fact that hormonal birth control can also protect against certain cancers. Like everything, have conversations with actual medical professionals to figure out what’s best for you! (NY Times)
  • There may be hope that 45’s attempts to overturn Obamacare’s birth control mandate will fail! (Reuters)
  • As an Ohio native, I must say I’m horrified at how virulently anti-choice the state seems to have become in the 12 years since I left. Currently, a bill is headed to the governor’s desk that would ban abortion in the event a fetus is diagnosed with Down syndrome. Doctors who perform an abortion while aware of the diagnosis would lose their medical licenses in the state and face a fourth-degree felony charge. Is there any chance that maybe the men behind this bill are parents or adoptive parents of children with Down syndrome? I’m guessing no, but it’s nice to know they value the lives of these children. We can only hope that since they are taking families’ choices away, they will somehow provide meaningful support each time one is born rather than adopted. (Scientific American)
  • Remember how all the lying liars in the GOP claimed that they could defund Planned Parenthood and  “community health centers” could easily absorb our clientele and do our work better than us? Welp, the lie detector determined that was a lie. Planned Parenthood will have to start taking on more patients in a suburb near St. Louis because St. Charles County will no longer offer treatment and exams for sexually transmitted diseases through its public health department. And mind you, this is despite increasing STD rates in that county. Unfortunately, the county’s clinic is closing now and re-opening in 2018 with a reorganized clinic model “formulated to reduce expenditures and generate opportunities to increase revenues …” So basically, STD testing and treatment, while a public good, hasn’t been good for their bank account so they’re giving the job to us. Planned Parenthood is here and ready for you STL folks. (STL Today)
  • And lastly, I just want to shout out to my peers and fellow black women in Alabama. They turned OUT in the special election this week and helped Democrat Doug Jones win a seat in the Senate! To quote Cosmo, “White women preferred the accused child molester.” And I have nothing further to add. (Cosmopolitan)