Teen Talk: What Is Kissing Disease?

kissing diseaseIf you’re a total dork like me, you might have some plush microbes hanging out on your desk or in your bedroom. The one that represents Epstein-Barr virus is especially adorable (look to your right and try not to coo in delight!). I just want to grab it, cuddle up to it, and fall asleep in its pillowy purple-pink embrace.

In reality, Epstein-Barr virus, or EBV for short, is not the most warm-and-fuzzy microbe of the bunch. I’d way rather have a cold. Why? Because EBV causes mono, which is more whimsically known as the kissing disease. And, despite that cute moniker, kissing disease can be most unpleasant.


Take it from one mono survivor: “Mono stinks!”


First, an explanation of why mono is also called the kissing disease. Merely being in the presence of someone with mono won’t put you at risk, even if you’re both in the same room — you need to be actively swapping spit with them to be exposed to the virus. Kissing is probably the most famous way for two people to exchange saliva, but sharing cups, eating utensils, or toothbrushes can do it, too. After exposure to the virus, symptoms could show up in 4 to 6 weeks.

Second, an explanation of why mono can be so terrible. While not all teenagers and young adults who are infected with EBV will develop symptoms, those who do probably won’t enjoy the experience. Symptoms include extreme fatigue, head and body aches, sore throat, and fever. It’s bad enough to have those symptoms for a few days, but mono might seem to go on and on with no end in sight. Most people are better in 2 to 4 weeks, but even then it could take another few weeks to get back to 100 percent. And some unlucky people can experience these symptoms for six months or even longer! In addition to these nasty symptoms, serious complications are possible. Continue reading

Let’s Talk Contraception: Birth Control Pills — Not Just for Preventing Pregnancy

pillThere has been a lot of political posturing recently about whether the government should require health insurance to provide birth control without a co-pay as part of a preventive health care package. So many people, including politicians, can only “see” the contraceptive side, which is pretty important, by the way. Approximately 15.8 in 100,000 women in the United States die from pregnancy or pregnancy-related issues yearly, and that number has doubled in the past 25 years. We have one of the worst maternal death rates of all developed nations, right near the bottom of the list.


Birth control pills can be used to treat a variety of conditions, including painful periods, acne, endometriosis, and uterine fibroids.


But putting all that aside, let’s look at the how oral contraceptives pills (OCPs) are actually used in this country, and for what reasons besides contraception. You may argue that many birth control pills are only approved for contraception purposes by the Food and Drug Administration (FDA), so other uses are not valid. But many drugs that may have narrow conditions of approved use are often prescribed off-label by physicians when they have data and information about how effective they can be for other conditions where not much else works.

According to a 2011 study using data from the 2006–2008 National Survey for Family Growth, the Guttmacher Institute reported that 14 percent of all women using birth control pills — that’s 1.5 million women — use them for purposes other than preventing pregnancy. Granted, 86 percent of OCP users report using them for birth control. But over the years, these OCPs have helped many people as treatments for dysmenorrhea, menorrhagia, endometriosis, menstrual-related migraines, acne, uterine fibroids, and polycystic ovarian syndrome. Continue reading

STD Awareness: Does Gardasil Have Side Effects?

Teen_GroupIn 2006, a vaccine called Gardasil made its debut. Its ability to protect against two of the most widespread strains of human papillomavirus (HPV) means that it doesn’t just protect against an infectious disease — it protects against cancer, too. A persistent HPV infection can trigger cell changes that could lead to cancers of the mouth, throat, cervix, vulva, anus, or penis. Gardasil also protects against two additional strains of HPV that cause most genital warts.


The most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site.


Cervical cancer is not as common in the developed world as it once was, thanks to an effective screening test. The Pap test catches “precancerous” cell changes, allowing the precancer to be treated before it develops into full-fledged cancer. So, while HPV vaccines have the potential to save hundreds of thousands of lives if they can be distributed in countries without widespread access to Pap testing, they have utility in the United States, too. Gardasil has spurred declines in high-risk HPV infections and genital wart incidence among American girls — which means less “precancer” and all the invasive, possibly expensive or painful, treatments that they entail, and a lot fewer genital warts. What’s not to like about that?

Despite this, a lot of people are curious about Gardasil’s side effects. If you enter a few key search terms into Google, you can easily find all kinds of websites warning you of Gardasil’s alleged dangers. So, you might be wondering: Is Gardasil safe?

What are Gardasil’s side effects?

Despite Gardasil’s relatively recent debut, many studies have already been conducted to evaluate its safety — and research continues so that we can consistently reassess its risks and benefits. So far, the consensus is that Gardasil is safe, with very few side effects. According to the Centers for Disease Control and Prevention, the most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site. These reactions are not considered to be serious, some people don’t experience any of them, and they are only temporary. Continue reading

Gardasil and Mortality

womenVaccination is one of public health’s greatest achievements, but today’s sociopolitical climate promotes unfounded fears. In turn, this fear-mongering has led to outbreaks of otherwise rare infectious diseases, such as measles and whooping cough. Human papillomavirus (HPV) vaccines protect against two HPV strains that cause 70 percent of cervical cancers, which itself is the second-most common type of cancer in women worldwide. Immunization has the potential to eliminate these viral strains, which would save lives and reduce health care costs — but, unfortunately, vaccine horror stories are a dime a dozen on the Internet, and HPV vaccines like Gardasil are popular targets for vaccine opponents.


Of 57 million Gardasil doses given in the United States, 40 confirmed deaths have occurred in recipients. However, these deaths were not caused by vaccination.


There are many claims flying around that Gardasil causes serious side effects, including death. However, claims that Gardasil can lead to death aren’t supported by good evidence. Generally speaking, people who make these accusations obtain their information from a publicly accessible database called the Vaccine Adverse Event Reporting System (VAERS), which collects claims of adverse events from anyone — including health care providers, patients, or family members.

What is an adverse event?

Most people don’t realize that the phrase “adverse event” cannot be used interchangeably with the term “side effect.” An adverse event is something that occurs after a vaccination — such as a headache, seizure, depression, or death. It could happen one second after being injected with a vaccine or more than a year afterward. It could be a coincidence, or it might be caused by vaccination. For example, if two weeks after receiving a flu shot I get a headache, I could legitimately claim it is an “adverse event,” even if my headache had nothing to do with the shot. An adverse event is only called a side effect if it is found to have been caused by vaccination.

What is VAERS?

Despite its occasional misrepresentation in print media, social media, and the blogosphere, VAERS is not a source of information about verified side effects — it is a database of adverse events that have been self-reported by the public. Anyone can submit a report to VAERS — heck, I could claim that the flu shot gave me telekinetic powers in addition to that headache, and it would be recorded in the database. That doesn’t mean that you should worry about coming down with a nasty case of telekinesis after getting a flu shot at the corner drug store. Continue reading

Let’s Talk Contraception: Can I Use Birth Control to Skip a Period?

In 2003, the FDA approved Seasonale, an extended-cycle birth control pill. This pill, a combination of estrogen and progestin, is taken daily for 84 days followed by one week of inactive (placebo) pills, allowing a woman to have her period once every three months — four times per year.

Since that time, several other extended-cycle birth control pills have been marketed, including Lybrel, released in 2007, which offers women continuous contraception coverage with only one period per year.


Using birth control to skip periods doesn’t result in side effects quite this exaggerated.

Prior to Seasonale’s debut, certain types of birth control pills could be taken back to back, allowing users to have period-free weddings and honeymoons, or to treat certain conditions, such as endometriosis. But there was no consensus about how to use birth control pills this way, and no actual product marketed specifically for this type of use. Early studies on extended-cycle pills reported that users were highly satisfied using pills to have fewer periods — and wanted to continue using these pills to reduce periods after the study was completed.

Can skipping periods be beneficial or harmful? Is this a lifestyle choice that’s not “natural”? How many “normal” periods do you need in a lifetime? 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

Let’s Talk Contraception: Depo-Provera Injections, Another Progestin-Only Option

Progestin-only birth control pills (POPs), also called the mini-pill, are good options for those who cannot take estrogen. But for those who have lots of trouble remembering to take a pill every day at the same time, Depo-Provera shots may be the way to go. Depo-Provera is medroxyprogesterone, a hormone similar to progesterone. It is given as a shot in a doctor’s office or a health center such as Planned Parenthood, and lasts for three months to prevent pregnancy. Sometimes it is used to treat other conditions, like endometriosis.


One Depo-Provera shot lasts for three months.


The first shot is given five days after you start your period or, if you do not plan to breastfeed, in the first five days after giving birth. You must not be pregnant when you get the shot because its effects may damage the developing fetus. But it’s OK to use Depo-Provera when breastfeeding, as long as you wait six weeks after giving birth before getting the shot. It’s given in your buttock or upper arm. You need to use a backup method like a condom for seven days after getting your first shot. And if you miss getting your regular 12-week injection by only a few days, you may need to get a pregnancy test before getting your next shot.

While you are on Depo shots, your period may change. You may have spotting, bleeding, or even no bleeding. Fifty percent of people who have been on Depo-Provera for one year have no bleeding at all. After stopping the shots, menstrual bleeding returns. Also, after stopping the shots, it may take nine to 10 months to get pregnant. Continue reading