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 This law attempted to mandate how doctors dispense abortion medication according to an outdated, 16-year-old protocol contained in the original drug label.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

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

Over 90 Percent of What Planned Parenthood Does, Part 25: Lost Tampons

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.

tamponPlanned Parenthood Arizona offers a wide variety of services, and someday we hope to cover every last one of them in this series. But today, I’d like to talk about one of the odder services: helping you with a lost tampon.

OK, so “lost” might be a weird word. I mean, you probably know the general area where that tricky tampon is lurking … But it happens even to the best of us: Sometimes, when you go to retrieve a tampon, you just … can’t find it. Maybe it was forgotten about, and then pushed farther up the vaginal canal by a subsequent tampon, or smooshed against the cervix during intercourse, and now you can’t find the string to remove it.


The presence of a certain strain of bacteria in one’s vagina can increase risk for toxic shock syndrome, especially when absorbent tampons are used.


The vagina can be a hiding place for all kinds of things — not just tampons, but sex toys, the remnants of broken condoms, and other foreign objects. And vaginas aren’t the only cavity with magical, or possibly just embarrassing, powers of concealment. When I worked at a medical journal, I came across ample (and very, very detailed!) documentation of all sorts of things getting “lost” in people’s rectums, urethras, ears, and throats. Believe me, a seasoned health care provider has probably seen it all, so if you can’t for the life of you remove something from your vagina on your own, don’t be afraid to ask Planned Parenthood for help. (You might ask about making an emergency, same-day appointment.)

Tampons aren’t designed to be used in a vagina for more than a few hours, and leaving them in for too long might increase risk for certain infections. For example, you might have heard of toxic shock syndrome (TSS), which is probably the No. 1 condition that comes to people’s minds when they think of tampons being left in for way too long. While it’s true that TSS is associated with tampons, tampons aren’t the only cause — they play just one role in the infection process. Continue reading

STD Awareness: Can I Use Plastic Wrap as a Dental Dam During Oral Sex?

plastic wrapIf you read this blog — or any sexual health website, really — you’ll probably see dental dams getting a lot of props. A dental dam (not to be confused with a female condom) is a square piece of latex that can cover the vaginal opening or the anus. Anyone wishing to avoid the oral transmission of STDs like herpes, gonorrhea, HPV, syphilis, chlamydia, and intestinal parasites, dental-dam advocates say, should use a latex barrier. Most people, however, have probably never even seen a dental dam, and they are not widely used. Perhaps their unpopularity is related to myths about oral sex being safe sex (it’s not!); perhaps it’s due to dental dams being expensive or difficult to find.


Plastic wrap hasn’t been evaluated by the FDA for STD prevention, and no studies have assessed its effectiveness in reducing disease risk during oral sex.


Some safer-sex aficionados have found ways around that, though. They might cut the tips off of condoms and make incisions along the sides, creating little latex rectangles. An even easier and cheaper option lies in plastic wrap, which many people use as a barrier while performing cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus). It is inexpensive, easy to find, odorless, and tasteless, and can be purchased without even a hint of embarrassment (unless perhaps your other purchases include duct tape, cucumbers, and clothes pins). And it can be pulled off the roll in sheets as long as your heart desires!

Planned Parenthood endorses the use of plastic wrap for oral sex when dental dams aren’t available. The Centers for Disease Control and Prevention and AIDS.gov both recommend plastic wrap for use during rimming. Health authorities, such as AIDS.gov and the Idaho Department of Health & Welfare, recommend non-microwavable Saran Wrap, because microwave-safe Saran Wrap has tiny pores to let out steam — which might also let viruses and bacteria through. Continue reading

Will St. John’s Wort Affect Birth Control?

Herbal remedies are very popular around the world. Many people prefer them to pharmaceuticals because they believe herbs can elicit positive results without serious side effects. However, plants produce a wide variety of chemicals at varying concentrations, and might have a number of effects on your body, both good and bad. Furthermore, since herbal supplements are not evaluated by the FDA for safety or effectiveness, consumers often don’t have ready access to evidence about herbal products. We can’t even be sure that they contain the ingredients that are listed on the label!


St. John’s wort might decrease the effectiveness of birth control pills, and might be unsafe during pregnancy.


One popular herb is St. John’s wort, or Hypericum perforatum. While the scientific evidence is mixed at best, many people believe that St. John’s wort can be used as an antidepressant. However, people often treat themselves with herbal supplements without guidance from a medical doctor or pharmacist — and without knowing whether or not these herbs are safe to use with any medications they might be taking.

Over the millennia, plants have evolved all sorts of powerful chemicals, such as toxins, to defend themselves against insects and other predators. For this reason, we can’t assume that plants only contain inert chemicals that won’t affect us or interact with the chemicals in other drugs and supplements we use. St. John’s wort, in fact, contains chemicals that interfere with other medications. It has been banned in France, and other countries require or are considering warning labels on St. John’s wort products so consumers can be aware of possible drug interactions. 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

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