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

Meet Our Candidates: Rosanna Gabaldón for State Representative, LD 2

The Arizona primary election will be held on August 30, 2016. Reproductive health care access has been under attack, both nationally and statewide, but Planned Parenthood Advocates of Arizona has endorsed candidates who have shown strong commitment to reproductive justice. To acquaint you with our endorsed candidates, we are running a series called “Meet Our Candidates.” In order to vote in the primary election, you need to have been registered to vote by August 1. Missed the deadline? You can still register online for November’s general election. Make your voice heard in 2016!

Photo of Rosanna Gabaldón.When Rosanna Gabaldón and her family moved to Sahuarita in 2004, the town was transforming from a quiet bedroom community of a few thousand people to a town that, six years later, had a population of more than 25,000 people, according to the 2010 Census. Witnessing the evolving needs of her Southern Arizona town — and taking seriously the idea that she should give back to her community — propelled Gabaldón into the political career that she has now. In 2009, she was elected to the Sahuarita Town Council, and in 2012 she took her service to the regional level when she decided to run for Arizona State Legislative District 2, which covers an area from South Tucson to Nogales.


“An ounce of prevention is worth a pound of cure.”


As a State Representative, Rep. Gabaldón has been an advocate for women and reproductive health, earning the endorsements of Arizona List, the Arizona Women’s Political Caucus, and Planned Parenthood Advocates of Arizona.

Rep. Gabaldón is seeking reelection to continue representing LD 2, and she took time for an interview on July 31, 2016, to tell us more about her background and her campaign.

Since we last spoke in 2012, how has your commitment to serving Arizona grown? What has happened during that time to give you hope, and what has happened to strengthen your convictions?

My commitment to serving Arizona has increased. When I was first elected to the House of Representatives, I made a commitment to do my homework on the issues, and to take ideas from Southern Arizona to the Capitol. That is what Arizona needs, some common sense straight from the heart. In my second election in 2014, I recommitted to continue the fight for our values. Continue reading

Meet Our Candidates: Martín Quezada for State Senator, LD 29

The Arizona primary election will be held on August 30, 2016. Reproductive health care access has been under attack, both nationally and statewide, but Planned Parenthood Advocates of Arizona has endorsed candidates who have shown strong commitment to reproductive justice. To acquaint you with our endorsed candidates, we are running a series called “Meet Our Candidates.” In order to vote in the primary election, you must register to vote by August 1 — and can even register online. Make your voice heard in 2016!

The West Valley is home to the 29th legislative district, where our endorsed candidate for Arizona Senate has deep roots. Martín Quezada is a staunch defender of reproductive rights, the LGBTQ community, and comprehensive sex education. He has consistently earned our endorsement since 2010, when he first ran for a seat in the House. As a state representative and then a senator, he has both talked the talk and walked the walk, including most recently when he introduced SB 1019, which would have dismantled the “No Promo Homo” statute that effectively blocks Arizona teachers from mentioning LGBTQ people in sex education curricula.


“Since being first elected I have earned the respect of my colleagues, my constituency, even my opposition.”


Compare his record to that of his challenger in August’s Democratic primary election. Lydia Hernández, his Democratic opponent, made her opposition to reproductive rights known in 2013 when she signed the Center for Arizona Policy’s statement denouncing Roe v. Wade. The stark contrast between Sen. Quezada and Ms. Hernández highlights the critical importance of registering to vote and participating in every election — including the primaries!

With no Republican challengers, the race for the LD 29 Senate seat will be decided in August, so if you skip the primary election and wait until November’s general election to cast your ballot, it will have been too late to throw your support behind Sen. Quezada. We need him in the Senate to continue to stand strong against the bad bills introduced by the opposition — and to continue introducing legislation that would make Arizona a healthier and safer place to live.

Sen. Quezada generously took the time to answer our questions on July 1, 2016.

Two years ago, you prevailed over Lydia Hernández in a very tight primary race, and she is challenging you again this year. How did you do a better job representing your constituents over these past two years than Ms. Hernández would have, and how will you continue to do so?

To be clear, I have prevailed over Lydia Hernández in each attempt she has made to challenge me. I knocked her off the ballot in 2010 after discovering nomination petition forgeries, I defeated her in the 2012 appointment process to fulfill the LD 13 House vacancy. I defeated her in the 2012 Primary, finishing in first place in the House race, and I defeated her in 2014 as you mentioned above.

Since being first elected I have earned the respect of my colleagues, my constituency, even my opposition in the political world. I have remained true to the values of the people of LD 29 and been a consistent voice for the issues most important to them at the Capitol. Hernández has gone further down a path of being an outsider and an agitator and has grown more and more extreme in her views and has openly and proudly betrayed the values of our constituency by endorsing such extreme politicians as Gov. Doug Ducey and Secretary of State [Michele] Reagan. Continue reading

Telling the Truth About Abortion Politics

Sens. Yee and Barto asked. We answered. It’s Our Turn to share the truth behind abortion politics. We have submitted the following op-ed to the Arizona Republic, but they have not (yet?) published it.

Thank You PP croppedAs a medical professional, I am dismayed at the recent “Our Turn” published in the Arizona Republic titled, “Make doctors tell the truth on abortion drug.” I would like to do just that — tell the truth and correct the record, because the opinion by legislators Barto and Yee was laden with revisionist history, misstatements of legal fact, and most important, non-medical junk science.

Doctors practice up-to-date, evidence-based medicine. I appreciate lawmakers repealing their intrusive foray into the practice of medicine, SB 1324. This law attempted to mandate how doctors dispense abortion medication according to an outdated, 16-year-old protocol contained in the original drug label. SB 1324 was an attempt to re-start a legal case that Arizona was losing. Despite the FDA’s update of the drug label to reflect current medical practice, policymakers and the governor stubbornly insisted on enacting SB 1324. Why, I cannot imagine. The repeal of this legislation was certainly welcome.

Real doctors reject junk science. More disturbing than the FDA label issue is Sens. Yee and Barto’s assertion that “at least 170 healthy babies have been born when medication abortions were reversed.” There is no scientific support for this assertion, just as there is no peer-reviewed medical evidence for the whole notion of “abortion reversal.” A handful of doctors with a moral agenda have attempted to use progesterone to “stop” a medication abortion. However, there is nothing in the literature to justify this practice, save for one report of six informal clinical anecdotes. No significant sample size, no control group, no oversight, no peer review. Regardless, last year these same legislators passed SB 1318, violating physicians’ and patients’ constitutional rights by forcing physicians to inform their patients that it is possible to reverse a medication abortion, which is untrue. Continue reading

“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

STD Awareness: Mycoplasma genitalium

“I’m not small, I’m just streamlined!” Image of Mycoplasma genitalium adapted from American Society for Microbiology.

In November and December of last year, headlines touting a “new” STD made an ever-so-minor flurry across the Internet. CNN referred to it as “mycoplasma genitalium, or MG” — Mycoplasma genitalium is the name of the teardrop-shaped bacteria that can cause several diseases in the urinary or reproductive tracts, such as urethritis and pelvic inflammatory disease.

M. genitalium is the smallest living organism known to science, having “devolved” from more complex organisms — but that doesn’t mean it can’t pack a punch! While these bacteria have surely been around for millennia, we only discovered them in the 1980s. Since then, we’ve known that M. genitalium fits the profile of a sexually transmitted pathogen — the only reason it made the news last year was that a team of British researchers published further evidence that this bug is indeed sexually transmitted and capable of causing disease.


Genital mycoplasmas can be cured — but a doctor needs to know what she’s looking for in order to prescribe the correct antibiotic!


An infection with M. genitalium could more generally be called a “genital mycoplasma.” The term “genital mycoplasmas” refers to a category of several different species of sexually transmitted bacteria, most notably Mycoplasma genitalium, but also less common species, such as Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. M. genitalium is considered an “emerging pathogen,” because it is only over the past couple of decades that technology has allowed us to study these bacteria, along with other genital mycoplasmas.

Risk factors for infection include multiple sexual partners and not using condoms during sex. It is thought that most people with an M. genitalium infection don’t have immediate symptoms — 94 percent of infected men and 56 percent of infected women won’t notice anything amiss. That doesn’t mean it can’t do damage. Continue reading