One Simple Kit

A community health worker teaches how to make cloth pads. Photo: Nyaya Health

A community health worker teaches how to make cloth pads. Photo: Nyaya Health

Last week, I texted a friend of mine and told her: I have a hard choice before me. When she asked what that was, I smiled as I replied: I must choose between replenishing the MAC mascara that I just ran out of and buying the new Harry Potter book. We both laughed. But really, even as a single mom who falls beneath the poverty level, this was my choice of the day.

I have known hard times. I have lived in my car with my two dogs and I have had to volunteer my time cleaning my son’s school to ensure that he gets an education because I couldn’t afford the monthly tuition. I have taken hits by the ones I love, both physical and metaphorical, and I have had my innocence stolen from me by a boy I hardly knew.


One simple kit is combating poverty, hunger, and gender inequality.


Yet somewhere across a sea, a young girl sits in her room, blood gushing from her for reasons unbeknownst to her. Fear brings tears to her eyes as she struggles to understand why God has cursed her. That is what her mother has taught her. That if such a thing occurs, it is a curse from her creator for being a filthy creature. A girl her age tells her that she has contracted a disease, something she couldn’t remember the three letters to reference, but she knew was deadly.

In a rural region in southern Malawi, a girl who has had her first period may be expected to undergo a “sexual cleansing” ritual, in which she is made to have unprotected sex with a man called a hyena — a risky proposition in a country in which nearly 1 in 10 adults has HIV. Her choice to deny such an offer could result in her entire family being stricken ill or even dead — at least that is what she is told. 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

Diagnosing Endometriosis

If you missed it, you can read the previous post explaining the basics of endometriosis here. In this post, we’ll look a little more at how endometriosis is diagnosed as well as some current barriers to diagnosis.


Wait. So you’re telling me that killer cramps of doom aren’t normal? If I did suspect I had endo, how would I go about getting diagnosed?

Endometriosis diagnosis is a tricky thing in that there’s no in-office procedure that can definitively determine whether someone has the condition or not. However, because the “gold standard” test is laparoscopy with biopsy — a surgical procedure — many health care providers prefer to do some in-office tests before recommending laparoscopy. The most common such procedures are pelvic exams and ultrasounds, which may allow a provider to see or feel if the endometrial lesions have formed cysts (known as “endometriomas”), but won’t pick up on smaller lesions.

Another complicating factor is that endometriosis isn’t the only cause of either dysmenorrhea or chronic pelvic pain. Other causes can include uterine fibroids, pelvic floor dysfunction, pelvic inflammatory disease, irritable bowel syndrome, and interstitial cystitis.

Even with laparoscopy, diagnosis isn’t necessarily straightforward. Not only is it a surgical procedure, which carries with it extra expense and risk, but even then, presence of the disease is often missed or underestimated. Seeking out a doctor who specializes in endometriosis can minimize this, but of course, due to geographic, cost, or other access issues, this isn’t always possible. Continue reading