Bros and Cons: A Glimpse into a Dystopic Present

Must admit, upon first viewing the Saturday Night Live sketch about The Handmaid’s Tale, I found it appalling. OK, so I’m old, but I can’t believe how those guys got it on so easily with women. Sounds like one big party, with “epic blowouts” where people of both sexes hung out and had fun together naturally. In my time, you really had to work at meeting women, making the rounds of smoke-filled flesh palaces or joining some social club to feign shared interest, only to be shot down most of the time.

But what really got me was the utter cluelessness and insensitivity of the guys toward a member of the “girl squad” who just had her eye cut out for not playing by the rules. In their world of the not-too-distant American future — a dystopian society based on religion — women have lost all rights, including control of their own bodies, existing only to be impregnated like cattle by their owner-husbands. The hard-partying boys feign concern, offering lame suggestions and offers to help. But you know they won’t, for they don’t see a problem. Instead, they blame the woman, asking why she doesn’t just leave the guy if he’s so cruel to her, completely ignoring the fact that she can’t.

Thankfully, The Handmaids Tale is pure fantasy. It could never happen here. America is nothing like that. Unlike in Margaret Atwood’s book, women today hold down jobs and spend their own money. They can marry or not marry whomever they choose and have complete control of their bodies. Religion doesn’t tell us what to do. And don’t forget, women can vote now. Continue reading

STD Awareness: Is Chlamydia Bad?

chlamydiaPerhaps your sexual partner has informed you that they have been diagnosed with chlamydia, and you need to get tested, too. Maybe you’ve been notified by the health department that you might have been exposed to chlamydia. And it’s possible that you barely know what chlamydia even is, let alone how much you should be worried about it.

Chlamydia is one of the most common sexually transmitted diseases (STDs) out there, especially among young people. It can be spread by oral, vaginal, and anal sex, particularly when condoms or dental dams were not used correctly or at all. It is often a “silent” infection, meaning that most people with chlamydia don’t experience symptoms — you can’t assume you don’t have it because you feel fine, and you can’t assume your partner doesn’t have it because they look fine. If you’re sexually active, the best way to protect yourself is to know your partner’s STD status and to practice safer sex.


Chlamydia increases risk for HIV, leads to fertility and pregnancy problems, and might increase cancer risk.


The good news about chlamydia is that it’s easy to cure — but first, you need to know you have it! And that’s why it’s important for sexually active people to receive regular STD screening. Left untreated, chlamydia can increase risk of acquiring HIV, can hurt fertility in both males and females, can be harmful during pregnancy, and might even increase risk for a certain type of cancer. So why let it wreak havoc on your body when you could just get tested and take a quick round of antibiotics?

To find out just how seriously you should take chlamydia, let’s answer a few common questions about it.

Can Chlamydia Increase HIV Risk?

Chlamydia does not cause HIV. Chlamydia is caused by a type of bacteria, while HIV is a virus that causes a fatal disease called AIDS. However, many STDs, including chlamydia, can increase risk for an HIV infection, meaning that someone with an untreated chlamydia infection is more likely to be infected with HIV if exposed to the virus. Continue reading

STD Awareness: Sexual Transmission of Zika Virus

Zika

Zika virus. Image: Cynthia Goldsmith, CDC

I first heard of Zika virus in an epidemiology class, when another student made on offhand remark: “Did you know Zika virus can be transmitted sexually?” Ever vigilant for material for the STD Awareness column, I excitedly scribbled the name of the virus in my notes. But upon further investigation, I found that there were only a couple of documented cases of the sexual transmission of this virus that no one had heard of, and decided there was no reason to freak people out about yet another potential STD when rates of more common STDs, like chlamydia and gonorrhea, were on the upswing.

A year later, Zika virus was splashed across headlines on a daily basis, mostly for its newfound association with birth defects, but also in light of revelations that it could be transmitted by sex.


Access to condoms and reliable contraception is more vital than ever.


While Zika virus is usually transmitted by mosquito bites, the discovery that it can be sexually transmitted made it the only known virus that could be spread both sexually and by mosquitoes. It’s also the only known mosquito-borne virus that can cross the placenta to harm a fetus. Like several other viruses, including CMV and rubella, Zika is implicated in serious birth defects. But many health authorities worry that its potential as a sexually transmitted pathogen is dangerously underestimated. As of August 31, there have been 23 confirmed sexually transmitted cases of Zika virus in the United States — but sexual transmission will rise as the virus jumps into local mosquitoes, which will also make it difficult or impossible to tell if a sexually active Zika patient got the virus from sex or directly from a mosquito.

Earlier this year, sexually transmitted Zika virus in Texas made headlines, with many journalists incorrectly proclaiming it the first known case of sexual transmission. In fact, Zika’s sexual transmission was first documented in 2008, before “Zika” was a household name and the married couple who published their experience in a scientific paper thought they could share their STD status in relative obscurity. Despite referring to themselves as “Patient 1” and “Patient 3,” a science reporter quickly figured it out and (with their permission) revealed their identities in a 2011 article — still years before Zika-bearing mosquitoes would hit the Americas and trigger a microcephaly epidemic that propelled the virus to infamy. 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

Image of Mycoplasma genitalium adapted from American Society for Microbiology.

“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

Let’s Talk Contraception: Dispelling Myths About Emergency Contraception

EmergencyContraceptionSince 1998, when the Food and Drug Administration first approved the morning-after pill, there have been controversies about its sale and use. Initially, age restrictions were enforced to regulate its sale, and some hospitals and pharmacies refused to provide it to their patients. After considerable pressure from public and medical groups, emergency contraception (EC) is available for sale to anyone at their local pharmacy, with the exception of ella and the copper IUD, both of which require prescriptions.


Emergency contraception is widely available, easy to use, and safe!


And yet, after almost 20 years of remarkably safe use, there are still myths regarding its safety, actions and use. Let’s look at some of those myths right now!

First, there are misunderstandings regarding EC’s availability:

Myth: EC is hard to get and you need a prescription.

Since 2013, most ECs are available to buy in pharmacies over the counter to anyone, regardless of age or gender. There are two exceptions: If you need ella, another morning-after pill, you do need a prescription, and the copper IUD requires placement by a health care provider.

Myth: There is only one type of EC available.

There are several different pills available, such as Plan B One-Step or generic equivalents. These all contain levonorgestrol, a progesterone hormone that is also in many other contraceptives. Ella contains ulipristal acetate and works effectively and evenly up to five days after unprotected sex. Ella is dispensed with a prescription. The copper IUD also needs a prescription but is the most effective EC when placed within five days of unprotected sex. It is recommended for obese women or women who have had several episodes of unprotected sex, and its contraceptive effect lasts 10 years. Continue reading

Pro-Choice Friday News Rundown

  • ribbonsThe imbeciles in the state of Kentucky are trying to say that a ban on gay marriage isn’t discriminatory because it bars both gay and straight people from same-sex unions. To me, this is akin to saying you’re going to ban breastfeeding in public places, but you’re going to ban both men and women from breastfeeding, and thus, it’s not discrimination against women! See, magical thinking! No logic necessary!! (ABC News)
  • Arizona Republicans are such big fans of lying that they’ve passed a law that requires doctors to lie to women about abortions being reversible. (The Guardian)
  • Tampons may one day help detect endometrial cancer. (Smithsonian Mag)
  • Why settle for No. 3 when you can strive for No. 1? Apparently, Texas isn’t satisfied having *only* the third highest HIV infection rate in the country, so they’ve cut funding for HIV screenings in favor of abstinence education. Makes all the sense in the world, doesn’t it? #CompassionateConservatism (RH Reality Check)
  • Looks like the fate of Texas will soon be very similar to that of Scott County, Indiana. Planned Parenthood was the county’s sole provider of HIV testing, but the state cut funding and several clinics were forced to close. They’re now suffering an HIV outbreak that its governor has called “an epidemic.” (HuffPo)
  • Speaking of Indiana, their ”religious freedom” bill caused a huge ruckus this week. But instead of just repealing the stupid thing, they’ve “revised it” to ban businesses from denying services to people on the basis of sexual orientation and gender identity. (IndyStar)
  • Wow, so Indiana just keeps on delivering the worst of the worst, don’t they? Purvi Patel has been sentenced to 20 years in prison for feticide and “neglect of a dependent” for having a miscarriage that may have been caused by an abortion pill. She’s not the first woman to face such charges, and these predatory, intrusive laws pretty much guarantee she won’t be the last. (MSNBC)
  • We often hear about what miscarriages cost women emotionally, but what about the financial cost? It’s pretty steep. One woman’s miscarriage cost her tens of thousands of dollars in medical bills. (Slate)
  • Maryland has opened an abortion clinic that’s being compared to a “spa.” Naturally, women being able to receive kindness and comfort while undergoing a completely legal medical procedure has some people outraged. (WaPo)
  • The Navajo Nation is being referred to as a “condom desert.” (Al Jazeera America)
  • Hard to express how heartbreaking a read this last piece is — women in abusive relationships suffer in ways many people just can’t fully grasp. They are more likely to contract HIV and less likely to use birth control. And when they do use birth control, it often has to be done via “secret” methods. (Jezebel)