Category: Women’s Health

FDA Expands HPV Vaccine for People Ages 27 to 45

Earlier last month, the FDA announced it has approved Gardasil 9, a vaccine for Human Papillomavirus (HPV) for people between the ages of 27 and 45. Previously, the FDA approved the HPV vaccine for individuals aged 9 through 26 years.

Gardasil 9 protects against nine types of HPV, a virus that is transmitted sexually and through intimate skin-to-skin contact. HPV is a very common virus and many individuals will get it at some point in their lives. While most HPV infections go away on their own, some may stick around and cause genital warts and cancer. This may be cancer of the cervix, vulva, vagina, penis, or anus, as well as cancer of the back of the throat.

It is recommended that all children aged 11 or 12 receive the HPV vaccine series. The vaccine is most effective at this age, before children are exposed to HPV.

Still, however, individuals up to age 45 years can now get the HPV vaccine. Older individuals can protect themselves against nine types of HPV. And even if one has been exposed to a few types, the vaccine will protect against the other strains they have not been exposed to.

HPV vaccination is cancer prevention. Why not consider protecting yourself?

For more information, check out the following Centers for Disease Control and Prevention resources:

What is HPV? 

HPV and Cancer

HPV Cancer Screening

References

Centers for Disease Control and Prevention. (2018, August 23). Human Papillomavirus: Questions and Answers. Retrieved from https://www.cdc.gov/hpv/parents/questions-answers.html

Centers for Disease Control and Prevention. (2016, December13). What is HPV? https://www.cdc.gov/hpv/parents/whatishpv.html

U.S. Food & Drug Administration. (2018, October 9). FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old. Retrieved from

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM622715.htm?utm_campaign=10052018_PR_FDA%20approves%20expanded%20use%20of%20Gardasil%209%20to%20include%20individuals%2027%20through%2045%20years%20old

Grady, D & Hoffman, J. (2018, October 5). HPV Vaccine Expanded or People Ages 27 to 45. Retrieved from https://www.nytimes.com/2018/10/05/health/hpv-virus-vaccine-cancer.html

Health and the midterm elections

Today is election day. Across the country there are numerous elections which are weighing in on important health issues. There are several important health topics in the ballots, including: abortion rights, Medicaid expansion, marijuana usage, grocery taxes, and laws related to drug use and possession charges. Due to the political leanings of the current national administration, abortion rights are particularly vulnerable during this time.

Alabama, West Virginia, and Oregon are voting on legislation which will seriously affect access to abortion. On Alabama’s ballot, a newly proposed Amendment 2 is trying to change the wording which defines a fetus’ rights on the state Constitution. The amendment is aiming to grant a fetus the same rights and protections as a baby who has been born. If passed, this issue could have serious implications on further legislation which may eventually outlaw abortion in the state. In addition, this ballot measure doesn’t include the right to an abortion in the case of rape, incest, or if the mother’s life is at-risk.

West Virginia and Oregon are voting on measures which attempt to withhold state funding for abortion cases in respect to state employees and Medicaid recipients. However, in contrast to Alabama’s measure, these states do grant the right to victims of rape, incest, or when the mother’s life is in danger.

It is important to consider how our votes can act as determinants for health issues like these and many others. Voting at a state level can have a much larger impact on both national and local issues – especially pertaining to public health and medicine. Go out and vote today!

Look up your registration status, local polling place, and sample ballot here:

https://vt.ncsbe.gov/RegLkup/

 

 

https://www.cnn.com/2018/11/05/health/health-ballot-initiatives/index.html

https://ballotpedia.org/Alabama_Amendment_2,_State_Abortion_Policy_Amendment_(2018)

 

meet the new, self-lubricating condom

It’s no secret that the U.S. still has a long way to go in the field of contraceptives and STI prevention. According to the CDC in 2017, only about one-third of sexually active Americans use condoms, and it has been a long-term public health issue. Abstaining from condom use (or other forms of protection) during sex can lead to a myriad of health concerns, including unwanted pregnancies, bacterial and viral infections. These new troubling statistics beg questions as to why condom use is so low, especially amongst those who aren’t opting for other birth control or protective options.

Scientists at Boston University have acknowledged this issue, and have responded with a new, friction-lowering self-lubricating condom that may up condom usage. Some of the reasons people abstain from use is due to complaints that condoms are uncomfortable, painful and detract from sensation and sexual pleasure. The team at BU has found a way to eliminate some of these negative qualities with their new technology. This new condom has the ability to self-lubricate when it comes into contact with moisture – such as bodily fluids – making sexual experiences more comfortable and enjoyable.

Their study showed that 73% individuals surveyed preferred the texture of their new condom, and also noted that they would be more inclined to use condoms such as this one. The condom still has to be tested during sex, but if introduced to the market, it could increase the prevalence of safe-sex behaviors and contraceptive use.

 

 

 

https://www.cdc.gov/nchs/data/nhsr/nhsr105.pdf

https://consumer.healthday.com/sexual-health-information-32/condom-health-news-154/only-about-one-third-of-americans-use-condoms-cdc-725436.html

https://www.cnn.com/2018/10/17/health/condoms-self-lubricating-prevent-stds-intl/index.html

http://journals.sagepub.com/doi/abs/10.1258/ijsa.2008.008120?journalCode=stda

http://rsos.royalsocietypublishing.org/content/5/10/180291

 

 

 

 

Dr. Leana Wen Selected as New President of Planned Parenthood

Last week, it was announced that Dr. Leana Wen, Baltimore City Health Commissioner, will serve as the new president of Planned Parenthood Federation of America, an organization that provides vital sexual and reproductive health care and education to millions of people around the world. Dr. Wen will be the first physician in almost 50 years to serve in this role. She will succeed Cecile Richards, who has served as president of Planned Parenthood for the past 12 years.

Dr. Wen, an emergency medicine physician, has led the Baltimore City Health Department since January 2015. She is a passionate public health leader and active champion for communities and patients. During her tenure as Baltimore City Health Commissioner, Dr. Wen led a lawsuit against the Trump administration after its abrupt decision to cut funding for teen pregnancy prevention programs, resulting in $5 million of funding being restored to two of these programs in Baltimore. Additionally, Dr. Wen has fought to preserve Title X in Baltimore, which funds a variety of health care services for low-income women.

Dr. Wen is no stranger to Planned Parenthood. After she and her family immigrated to the U.S. from China, they depended on Planned Parenthood for their health care. Dr. Wen also volunteered at a Planned Parenthood health center in St. Louis during medical school.

In a recent statement posted on the Baltimore City Health Department website, Dr. Wen wrote:

“A core principle in public health is to go where the need is. The single biggest public health catastrophe of our time is the threat to women’s health and the health of our most vulnerable communities.”

She continues, in referring to Planned Parenthood, writing:

“I have seen firsthand the lifesaving work it does for our most vulnerable communities. As a doctor, I will ensure we continue to provide high-quality health care, including the full range of reproductive care, and will fight to protect the access of millions of patients who rely on Planned Parenthood.”

Dr. Wen’s last day as Baltimore City Health Commissioner will be Friday, October 12th, where she will then begin her new role as President of Planned Parenthood.

References:

Planned Parenthood. (N.d.). Dr. Leana Wen. Retrieved from  https://www.plannedparenthood.org/about-us/our-leadership/dr-leana-wen

Planned Parenthood. (N.d.). Cecile Richards. Retrieved from  https://www.plannedparenthood.org/about-us/our-leadership/cecile-richards

Zernike, Kate. (2018, September 12). Planned Parenthood Names Leana Wen, a Doctor, Its New President. Retrieved from https://www.nytimes.com/2018/09/12/us/politics/planned-parenthood-president-wen.html?rref=collection%2Fsectioncollection%2Fpolitics

Wen, Leana S. (2018, July 6). Trump’s family planning dystopia. Retrieved from http://www.baltimoresun.com/news/opinion/oped/bs-ed-op-0708-wen-dystopia-20180703-story.html

Baltimore City Health Department. (2018, September 12). Statement from Baltimore City Health Commissioner, Dr. Leana Wen. Retrieved from https://health.baltimorecity.gov/news/press-releases/2018-09-12-statement-baltimore-city-health-commissioner-dr-leana-wen

Soot Happens

A new study released from the Queen Mary University of London has shown for the first time that air pollution exposure can affect a pregnant woman’s placenta. The placenta is a vital organ which develops during a woman’s pregnancy. It is responsible for providing nutrients and oxygen to a developing baby. In addition, it also serves as an immune system barrier for the baby, which is vulnerable during pregnancy. Any injuries inflicted on the placenta can have serious health effects on the unborn child.

The Queen Mary study examined placenta cells of five women who were exposed to air pollution. Within the samples, researchers found evidence of the presence of soot. Soot is a common air pollutant classified as particulate matter. This type of pollution is made of large damaging particles, and can often be found coming from power plants, manufacturing sites, and motor vehicles. Soot exposure is dangerous, and it is the cause of thousands of premature deaths annually. The findings of this study are novel and alarming – it demonstrates that inhaled particulate matter can travel from the lungs to the placenta.

Placental immune cells are necessary to keep an unborn baby healthy. If the placental immune system is compromised, so is that of the growing baby. It is still unclear what this study’s findings mean for fetal-placental health in the long term. However, researchers on this study are particularly concerned about how soot exposure may disrupt this system.

One thing is clear – this news is disturbing. The study demonstrated that air pollution damage does not stop at the lungs. The conversation about air pollution is not always an environmental one; many pollutants like soot affect human health dramatically. Going forward, it is important to consider how these findings should influence policy. Regulating air pollution is a necessary step to take in order to protect the health of people worldwide.

 

 

https://www.momscleanairforce.org/soot-facts/

https://www.qmul.ac.uk/media/news/2018/smd/first-evidence-that-soot-from-polluted-air-may-be-reaching-placenta.html

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/placenta/art-20044425

https://www.nichd.nih.gov/research/supported/HPP/default

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025805/

 

 

Revised Cervical Cancer Screening Guidelines Offer Women More Options

New recommendation guidelines for cervical cancer screening were published this month in the Journal of the American Medical Association (JAMA). These guidelines are an update to the U.S. Preventive Services Task Force (USPSTF) 2012 recommendations on cervical cancer screening. The new screening guidelines now offer women more options and longer screening intervals when it comes to their preventative care. One of the most notable guideline changes is that women aged 30-65 can now get an HPV test alone every 5 years instead of just a Pap smear alone every 3 years, or in combination with a Pap smear every 5 years.

According to the guidelines:

  • Women aged 21-29 years should get a Pap smear every 3 years
  • Women aged 30-65 years can get:
    • A Pap smear alone every 3 years
    • An HPV test alone every 5 years
    • A combination of a Pap smear and HPV test every 5 years

The USPSTF does not recommend screening for women younger than 21 years as well as women older than 65 years who have received adequate screening before and are not at high-risk for cervical cancer.

Cervical cancer was once a major cause of death among women. However, with the advent of screening tests, such as Pap smears, cervical cancer rates have fallen considerably over the years. Still, the American Cancer Society estimates 13,240 women will be diagnosed with cervical cancer in 2018.

Almost all cervical cancers are caused by the human papillomavirus (HPV), a common sexually transmitted infection. There are many types of HPV, some low-risk and some high-risk. Low-risk HPV types can cause warts that can be treated. High-risk types, however, can cause cancer. While the body can often fight off HPV infection, this is not always the case. Some HPV infections can become chronic, and chronic infections with high-risk HPV types can lead to cancer in both men and women if left untreated. However, there are vaccines that can prevent cancers, like cervical cancer in women, caused by HPV. The Centers for Disease Control (CDC) recommends that all children get vaccinated against HPV at age 11 or 12. For young women in particular, the CDC recommends they get vaccinated through age 26.

Because it can take years for cancer caused by HPV to develop and for symptoms to appear, the CDC encourages women to regularly screen for cervical cancer. This includes both women who have and have not vaccinated against HPV, as the HPV vaccine does not protect against all types of HPV that can cause cancer.

References

U.S. Preventive Services Task Force. (2018). Cervical Cancer Screening. Retrieved from  https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening2

Centers for Disease Control and Prevention. (2017, December 16). The Link Between HPV and Cancer. Retrieved from https://www.cdc.gov/hpv/parents/cancer.html

National Institutes of Health. (2018, June 30). Cervical Cancer. Retrieved from

https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76

American Cancer Society. (2017, November 1). What Are the Risk Factors for Cervical Cancer? Retrieved from

https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html

U.S. Preventive Services Task Force. (2012). Archived: Cervical Cancer: Screening. Retrieved from

https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening

Centers for Disease Control and Prevention. (2018, August 23). HPV Vaccines: Vaccinating Your Preteen or Teen. Retrieved from

https://www.cdc.gov/hpv/parents/vaccine.html

American Cancer Society. (2015, February 19). HPV and Cancer. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

American Cancer Society. (2017, October 9). HPV and Cancer. Retrieved from

https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html

Discrimination and Health Part I: LGBTQ+ Americans

Past research has suggested that discrimination can impact health outcomes – perhaps through vehicles such as stress of daily interactions and negative experiences with the healthcare system. One group whose experiences with discrimination can be linked to negative health outcomes is LGBTQ+ Americans. A study found that over half of LGBTQ people have experience slurs and offensive comments, and over half have been sexually harassed or experienced violence, or had an LGBTQ friend or family member experience such trauma.

We can make the connection between discrimination and trauma through various factors. One is through microaggressions –  seemingly harmless daily interactions with others who express, in this case, homophobic or transphobic views. These have been found to negatively impact health. Another is through discrimination within the healthcare system that lead LGBTQ Americans to seek healthcare less frequently. 18% of this population has avoided necessary medical care. Various forms of discrimination they face at the hands of medical professionals, police, and community members are much worse for those of color and those who are transgender.

Unfortunately, we can already see the health outcomes of discrimination to this population – they have higher rates of psychiatric disorders, substance dependence (including higher tobacco use), and suicide; lesbian women are less likely to get preventative services for cancer, and gay men are at higher risk for certain STIs.

How can we work to eliminate these gaps, even when interpersonal discrimination may take longer to tackle as our culture continues to evolve? HealthyPeople2020 provides several recommendations. First, healthcare providers should discuss sexual orientation and gender identity (SOGI) respectfully with patients, and collect data on it. Medical students should be trained in LGBTQ culturally-responsive care. In addition, we must be spokespeople against legal discrimination of this population in social services such as employment, housing, and health insurance.

Sources:

https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

https://www.npr.org/documents/2017/nov/npr-discrimination-lgbtq-final.pdf

https://www.centerforhealthjournalism.org/2017/11/08/how-racism-and-microaggressions-lead-worse-health

https://www.psychologytoday.com/us/blog/microaggressions-in-everyday-life/201011/microaggressions-more-just-race

http://www.apa.org/topics/health-disparities/fact-sheet-stress.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747726/pdf/nihms134591.pdf

What’s going on with the HPV vaccine?

HPV is the most common STI, and 9 of every 10 people will have an infection at some point in their lives (1).  This virus can cause cancers in the cervix, penis, mouth, and oropharynx (2), and it also causes genital warts (3).  Even though a vaccine exists against HPV, less than half of teens are up to date on all of their doses of these shots (2).

Part of the reason behind these low vaccination rates are due to parents concerns regarding vaccine safety and fear that vaccination will encourage sexual activity (4).  Though all vaccines, including this one, have potential side effects, the HPV vaccine is considered safe (4). Additionally, studies have shown that the HPV vaccine does not make teens more likely to start having sex (4).

The way providers approach talking about the HPV has also influenced vaccine rates, and strong provider endorsement seems to improve vaccinations (5).  On Monday, March 19, Chris Noronha spoke with the Interdisciplinary Health Communications Class about the work he is doing with Noel Brewer on provider communication regarding the HPV vaccine.  They have found that when providers mention the HPV vaccine in the same list as other vaccines that are due at age 11, vaccination rates increase.

If you’re interested in the HPV vaccine, it may not be too late.  You can receive the series through age 26 (1).  Contact your provider if you’re interested.

 

Works Cited
  1. Centers for Disease Control and Prevention. Human Papillomavirus (HPV) Vaccine Safety. Centers for Disease Control and Prevention. [Online] January 30, 2018. https://www.cdc.gov/vaccinesafety/vaccines/hpv-vaccine.html.
  2. Aubrey, Allison. This Vaccine Can Prevent Cancer, But Many Teenagers Still Don’t Get It. National Public Radio. [Online] February 19, 2018. https://www.npr.org/sections/health-shots/2018/02/19/586494027/this-vaccine-can-prevent-cancer-but-many-teenagers-still-dont-get-it.
  3. Centers for Disease Control and Prevention. What is HPV. Centers for Disease Control and Prevention. [Online] December 20, 2016. https://www.cdc.gov/hpv/parents/whatishpv.html.
  4. —. Talking to Parents About HPV vaccine. Centers for Disease Control and Prevention. [Online] December 2016. https://www.cdc.gov/hpv/hcp/for-hcp-tipsheet-hpv.pdf.
  5. Narula, Tara. HPV vaccine: Why aren’t children getting it? CBS News. [Online] July 23, 2017. https://www.cbsnews.com/news/hpv-vaccination-cancer-prevention-dr-tara-narula/.

 

 

“The Angelina Effect”

In this day of age celebrities dominate our world. They hold elected office, they are activists, they are social media entrepreneurs, they are everywhere. Whether we like to believe it or not they have influence over our behaviors and how we make decisions. I’m guilty that most of the accounts I follow on Instagram are former Bachelor contestants and catch myself wanting to mimic their fashion and fitness routines. In fact, there has been research that has examined this phenomenon. Back in 2013, esteemed actress Angelina Jolie announced that she carries the a genetic mutation that greatly increases your risk of breast and ovarian cancer (BRCA1). In her New York Times opt ed piece, Jolie reveals that she lost her mom, aunt and grandmother to cancer and that influence her decision to undergo preventive surgery to remove both of her breasts (mastectomy) and ovaries. After this announcement, several researchers explored what came to be known as “The Angelina Effect” and how her decision influenced other women’s decisions about their own health. In a study published in Health Services Research journal, hospital data from both New York and the UK revealed that three months after Jolie’s announcement there was a significant increase in preventive mastectomies prior to the announcement. This trend has been seen with other celebrities after announcements of diagnoses and provides incentives for both public figures and healthcare providers to use these instances as teachable moments and bring awareness to employ preventive healthcare.

To learn more about the BRCA1 gene visit the following site: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1

 

 

 

Pollution and Pregnancy: A Match Made in Hell

A recent study in the journal Biological Psychiatry has found that mothers exposed to air pollution during pregnancy have children at higher risk of cognitive health problems, due to brain alteration during fetal development. Such abnormalities resulted in issues such as impulse control and behavioral problems. Researchers believe that long-term impacts could include high-risk activity, such as addiction, as well as mental health disorders and low academic achievement.

Previous research has associated high levels of pollution with poor development in the womb, but this study found that these risks occur even when pregnant mothers were living in places with air pollution levels deemed acceptable. This raises questions of whether our air quality measurement standards are adequate and accurate.

Researchers compare this troubling finding with the field’s existing knowledge of the dangers of smoking during pregnancy – Dr. John Krystal, editor of the journal that published the study, draws the parallel that both scenarios involve “inhaling toxins.” We already know that other environmental factors (like stress, lead exposure, and pesticides) can lead to adverse outcomes during pregnancy, but it seems that regulatory policies for some environmental risks fall short of others. Translating research findings to the public – and focusing on productive solutions instead of instilling fear in those with no choice of residence – are key roles for public health moving forward.

Sources:

https://www.usnews.com/news/national-news/articles/2018-03-14/air-pollution-within-levels-considered-safe-changes-brain-development-leads-to-cognitive-impairment

http://time.com/3757864/air-pollution-babies/

http://www.biologicalpsychiatryjournal.com/article/S0006-3223(18)30064-7/fulltext