PCOS: Erasing the Stigma

two womenUntil I encountered health-related issues of my very own, I had never heard of PCOS. There are no PSAs, no health class curricula, and it is not uncommon for many physicians to be unfamiliar with the seemingly unrelated symptoms that can be a detriment to the life of a woman who is affected.

Irregular menstrual cycles, weight gain, sluggishness, thinning hair, depression, acne, infertility, and sometimes (but not always) cysts on the ovaries are what a woman with PCOS may have to battle on a daily basis. Not only must a woman endure the physical effects of this disorder, but also the psychological effects that come with these changes. To be clear, that is by no means a comprehensive list of symptoms.

This is polycystic ovarian syndrome, and it affects more than 5 million women in the United States alone. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 22: Expedited Partner Therapy for Chlamydia

200373577-001Welcome 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.

So, you got chlamydia. It happens. In fact, it happens to an estimated 2.86 million Americans every year, and is the most common bacterial sexually transmitted disease (STD) in the country.


After testing positive for chlamydia, you can receive extra antibiotics to hand-deliver to your partner.


Your infection didn’t come out of thin air — you got it from somewhere. Maybe you have a new sex partner who wasn’t tested and treated for any STDs before you got together. Perhaps you’re in a non-monogamous relationship. You also could have had it for a while before you found out about it, during which time a partner might have unknowingly caught it from you. One reason chlamydia can spread so easily — by vaginal, anal, or oral sex — is because it usually doesn’t come with symptoms. Amazingly, most people with chlamydia don’t know they have it unless they take an STD test to screen for it.

But the fact remains: You got chlamydia. Now what? Continue reading

STD Awareness: Gonorrhea, Women, and the Pre-Antibiotic Era

Penicillin, the first cure for gonorrhea, was developed for mass production in the 1940s.

Penicillin, the first reliable cure for gonorrhea, was mass produced in the 1940s.

It’s Women’s History Month, a time to reflect on the achievements of women worldwide — like Margaret Sanger, Rosalind Franklin, and Florence Nightingale, or contemporary heroes like Wangari Maathai. But it may also be a time to examine some of the sadder aspects of womanhood, including the increased burden gonorrhea imposes on women. While gonorrhea is no picnic for anyone, it wreaks the most havoc in female reproductive tracts. In fact, before antibiotics, gonorrhea was a leading cause of infertility — one 19th century physician attributed 90 percent of female infertility to gonorrhea. Not only that, but the effects of gonorrhea could seriously reduce a woman’s overall quality of life.


With gonorrhea becoming more resistant to antibiotics, the CDC warns of a return to the pre-antibiotic era.


Gonorrhea is described by written records dating back hundreds of years B.C. Ancient Greeks treated it with cold baths, massage, “cooling” foods, and vinegar. In the Middle Ages, Persians might have recommended sleeping in a cool bed with a metal plate over the groin. A bit to the west, Arabs tried to cure gonorrhea with injections of vinegar into the urethra. Kings of medieval England might have had their gonorrhea treated with injections of breast milk, almond milk, sugar, and violet oil.

Although gonorrhea is as ancient an STD as they come, because women rarely have symptoms while men usually do, for much of history it was mostly discussed in terms of men. The name gonorrhea itself derives from the ancient Greek words for “seed flow” — gonorrhea was thought to be characterized by the leakage of semen from the penis. This confusion inspired many misguided notions throughout the millennia, such as the idea that almost all women carried gonorrhea and transmitted it to their unwitting male partners. Continue reading

STD Awareness: Chlamydia trachomatis

A colony of C. trachomatis (colored green) is nestled inside a human cell. Image: V. Brinkmann, Max Planck Institute for Infection Biology

A colony of C. trachomatis (colored green) is nestled inside a human cell. Image: V. Brinkmann, Max Planck Institute for Infection Biology

In the microscopic world of germs, organisms called Chlamydiae are dwarfed by their fellow bacteria. An E. coli bacterium can hang out with 100,000 of its closest friends on the head of a pin, but Chlamydiae are smaller still. Infectious particles are about one-tenth the length of an E. coli, rivaling the size of a large virus. And, just like a virus, Chlamydiae can still pack quite a punch, proving that sometimes, not-so-good things can come in small packages.

There are many types of Chlamydiae bacteria, but one species, Chlamydia trachomatis, is responsible for not one, but two sexually transmitted diseases (STDs) in humans: chlamydia and lymphogranuloma venereum (LGV). (Humans aren’t the only ones affected by sexually transmitted Chlamydiae. A different species, Chlamydia pecorum, is devastating wild koalas in Australia, which has got to be one of the biggest bummers ever.)


Chlamydia is a case study for the importance of safer sex and regular STD testing.


Chlamydia is one of the most common STDs in the United States — there were almost 1.5 million diagnoses in 2011 alone, but experts estimate that there were around another 1.5 million cases of chlamydia that went undiagnosed. How can this be? Chlamydia is often a “silent” infection, meaning that symptoms are rare, allowing people to harbor these bacteria without even knowing it. (When symptoms do occur, they might include swelling in the genital region; vaginal, cervical, or penile discharge; or painful urination.)

It might seem like a small mercy that this common infection is unlikely to torture us with harrowing symptoms — but, in actuality, those of us who have to deal with discharge or burning urination should try to appreciate the heads up: Left untreated, chlamydia can cause serious complications. When it spreads along the female reproductive tract, it can cause pelvic inflammatory disease, which can severely compromise fertility and cause chronic pain. Rarely, in a male reproductive tract, it can cause epididymitis, which can also spell bad news for future fertility. Continue reading

Gardasil and Fertility

girlsThere is currently a lot of fear about vaccines out there, and if you pay attention to the news, you’ve probably caught a whiff of it. This panic was launched by a 1998 Lancet article authored by Andrew Wakefield, who claimed that the MMR vaccine causes autism. Much ink was spilled unpacking that fiasco, but, in a nutshell, Wakefield falsified data and conducted unethical, invasive procedures on children, and was consequently stripped of his medical license. Researchers couldn’t duplicate his findings, The Lancet retracted his article, and Wakefield was thoroughly discredited.


One case report asserting a link between Gardasil and premature ovarian failure was authored by an anti-abortion activist.


But vaccine fears still linger. For example, there are some scary stories floating around about Gardasil, the vaccine that protects against the four most common strains of human papillomavirus (HPV), the sexually transmitted virus that can cause genital warts or certain types of cancer. These stories include claims that it has caused premature ovarian failure leading to infertility. About 57 million doses of HPV vaccines have been given in the United States, however, and in such a large group there are going to be some unexplained phenomena. Without good evidence, we can’t jump to the conclusion that a vaccine caused them.

According to the Centers for Disease Control and Prevention, the most common Gardasil side effects are fainting; dizziness; nausea; headache; fever; hives; and pain, redness, or swelling at the injection site. These reactions aren’t considered to be serious, most people don’t experience any of them, and they’re only temporary. However, while surfing the Internet or scrolling through your Facebook wall, you might have come across claims that Gardasil causes infertility — specifically, premature ovarian failure in girls and young women. What should you make of these horror stories?

A couple of medical journals have described unexplained ovarian failure in four patients who also received HPV vaccines. Medical journals publish many kinds of articles, and a “case report” is a description of one or a few patients’ experiences. Unlike an article that summarizes the results of a rigorous scientific study involving hundreds or thousands of subjects, a case report might just highlight an unusual situation. They aren’t considered to be sources of “definitive” statements about much of anything. Nevertheless, in 90 percent of patients with premature ovarian failure, doctors can’t find clear genetic or physiological causes for the condition, making it an interesting topic for a medical journal to cover — and ripe for speculation. Continue reading

Pro-Choice Friday News Rundown

  • handcuffsOh, brother, fetuses have actual rights over the rights of the woman carrying them. And these women are being put in the slammer. The reproductive rights of women are becoming non-existent. (Salon)
  • Arizona is trying to eliminate the rights of pregnant women as well. Not that this is extraordinarily out of character for this state. (RH Reality Check)
  • By the way, Ohio sucks too. (Think Progress)
  • Add Texas to the list as well. (NPR)
  • Et tu, Alabama? (ABC News)
  • And lest you think these injustices are limited to the United States, the European Union is on the anti-woman train as well. (The Washington Times)
  • We might be looking at another government shutdown. This time over contraception. *Heavy sigh* (The Daily Beast)
  • Things you should know about the pill and its potential effects on your skin. (HuffPo)
  • Birth control is awesome and you won’t have fertility issues after you stop taking it. (Care2)
  • 2015 will be a banner year for male contraception! Only 14 months away! Not that I’m counting or anything … (Collegian)

STD Awareness: The Latest on Gonorrhea

Neisseria gonorrhoeae, the bacterium that gangs up on your body to give it gonorrhea. Image: CDC

Gonorrhea is that guy with the funny name who’s always up to something new and mischievous. Last year, the New England Journal of Medicine declared that it’s “time to sound the alarm” in response to emerging strains of gonorrhea that are increasingly resistant to antibiotics. Then, earlier this year, the medical journal JAMA reported the first North American sightings of gonorrhea that failed treatment with cefixime, one of the last drugs we have in our anti-gonorrhea arsenal. It’s a great time to be a gonococcus — the type of bacteria that causes gonorrhea — but the humans they infect probably don’t see it that way.

Last month, this bad boy rose to the top of the Most Wanted list when the Centers for Disease Control and Prevention proclaimed antibiotic-resistant gonorrhea an “urgent threat” — the highest threat level, which gonococci share with only two other bacteria types. To give you some context, the much more famous superbug MRSA was categorized as a “serious” threat, one notch below “urgent.”


Antibiotic-resistant gonorrhea is an “urgent” threat; meanwhile, researchers develop a gonorrhea vaccine that works — on mice.


Antibiotic-resistant gonorrhea is especially insidious for two reasons. One, gonorrhea often doesn’t have symptoms, which allows it to jump from one sexual partner to another, the hosts often none the wiser. Two, unless health care providers actually test the bug’s DNA, they have no way of knowing whether or not they’re dealing with a drug-resistant strain. This opens up the possibility for treatment failure — and for the antibiotic-resistant bacteria to be further propagated into the community.

The CDC estimates that the United States sees 246,000 cases of antibiotic-resistant gonorrhea infections annually — that’s about 30 percent of all gonorrhea infections in the country. For now, we seem to be able to cure them with higher doses or different combinations of drugs. So why does antibiotic-resistant gonorrhea deserve the “urgent” designation? While gonorrhea isn’t associated with a body count — unlike other drug-resistant pathogens, which collectively kill at least 23,000 Americans a year — it can have terrible consequences. Gonorrhea can cause pelvic inflammatory disease (PID) when it advances up the female reproductive tract, and epididymitis when it invades the male reproductive tract; both conditions can cause infertility. Also, gonorrhea infections make us more vulnerable to HIV. The CDC estimates that if the most resistant gonorrhea strain gains ground over the next decade, the country could see an additional 75,000 cases of PID, 15,000 cases of epididymitis, and 222 HIV infections, costing us $235 million. Continue reading