Women’s health update-relieving migraine and other pain

In this post I review some new drugs that treat conditions exclusive to or common in women.

I illustrated this post with covers of books written by women; I have reviewed all of these books on my blog, so I’ll include those links also. Please note these are affiliate links, so if you do happen to use them for a purchase you will help me fund this blog.

This information is current as of the publication date; it is general medical information that helps doctors and patients make decisions about what is right for them. Medical recommendations and practice changes as we learn new things. Discuss with your physician or appropriate healthcare provider .

Photo by rawpixel.com on Pexels.com

Relieving the pain of endometriosis

Women with endometriosis can suffer infertility, heavy menstrual bleeding, painful periods, and pelvic pain unrelated to their periods. In endometriosis, uterine tissue grows outside the uterus; laparoscopy, an invasive procedure us used to diagnose it. Treatment depends on the goal, whether pregnancy, pain relief, or both. Short of surgery, hormonal therapy has been the mainstay of treatment.

A new hormonal drug released in 2018, elagolix, brand name Orilissa, is the first of its kind specifically developed and approved to treat “moderate to severe” endometriosis pain, but not infertility. AbbVie, the pharmaceutical company which developed the drug,priced it at $844 per month, or about $10000 per year, retail.( per Reuters report) Patients may pay less depending on insurance.

 

Easing dyspareunia

After menopause many women develop atrophy of the vagina, making it thin, dry, and easily irritated, leading to painful sex, or dyspareunia. A new intravaginal medication, prasterone,brand name Intrarosa, can help relieve the discomfort. Studies show it may also help improve sexual desire and arousal, but it is not labeled for this.

Manufactured by AMAG Pharmaceuticals, it is for “moderate to severe” symptoms. Also known as DHEA, a steroid, it transforms into estrogen in the vagina; administered as a once daily vaginal insert at bedtime, applied with an applicator. According to goodrx.com, a 30 day supply costs about $213.

DHEA can be purchased as an over-the-counter, non-regulated product, whose effectiveness and safety are unknown. A one-month supply of 50 mg tablets may cost $5.

Other options for treating vaginal atrophy symptoms are oral or vaginal estrogen and/or vaginal lubricants.

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Prevention of migraine pain and disability

Migraine, although not exclusive to women,occurs more frequently in them than men. For infrequent headaches,doctors recommend non-prescription pain relievers since they are effective, safe, and have few side effects. For more severe and disabling headaches, prescription meds designed specifically for migraine are tried next, usually those in the triptan class of drugs.

But when headaches are severe, frequent, or persistent, patients should also consider preventive medication to improve quality of life. In addition to several effective oral meds there are two injectable drugs which work differently

The Food and Drug Administration has approved several new drugs in the past two years.

a new use for Botox

Yes the same drug used to treat wrinkles,Botox, can prevent migraine

Botox, onabotulinumtoxin A, treats chronic migraine, meaning patients with frequent headaches and other migraine symptoms for at least 3 months.

Manufactured by Allergan, a vial containing 200 units costs $1452, per goodrx.com. For migraine, the drug is injected in the upper facial muscles by a physician specifically trained in its use.

It’s in the genes

Another novel therapy uses the immune system to fight migraine.

Monoclonal antibodies bind to a calcitonin gene-related peptide receptor which transmits migraine pain. The antibodies are produced in a laboratory but work like antibodies naturally produced by the body. They are used to treat cancers and some forms of arthritis. They are called calcitonin gene-related peptide (CGRP) receptor antagonists.

These drugs are used to prevent migraine . (generic name-brand name)

  • Erenumab-Aimovig
  • Fremanezumab-Ajoovy
  • Galcanezumab-Emgality
  • Eptinezumab-Vyepti

 

Administered as subcutaneous injections (under the skin) monthly, according to Medscape, the average cost is $600 per month.

Two similar drugs, rimegepant (Nurtec ODT)and ubrogepant (Ubrelvy) treat migraine pain and are taken by mouth (orally).

You may want to review my previous post about non-drug ways to manage migraine.

Simple and effective ways to manage chronic pain

exploring the HEART of health through books

Thanks for joining me to review new steps in women’s health and review some fine women authors. I hope you will follow the links to my reviews and read some or all of these books. When you do, I would love to know your reaction. I might use your comments in an update.

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

Dr Aletha

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Joe Biden’s Plan to Combat Coronavirus (COVID-19)

For this and a previous post I reviewed statements about the United States’ coronavirus pandemic response from the President candidates’ official campaign websites.

update November 12, 2020

This post was originally based on candidate Biden’s coronavirus plan presented during the presidential campaign. As of today, he is the presumptive President-elect as called by the Associated Press. The link below now points to the updated proposal on the Biden campaign website.

The year 2020 looked to be historic even prior to the coronavirus pandemic, police involved shootings, riots, and Black Lives Matter protests. The USA will choose the next president, impacting the economy, security, defense, education, and healthcare.

In two previous posts I reviewed the healthcare plans of each candidate-Republican incumbent President Donald Trump and Democratic challenger former Vice President Joe Biden.

In this and a previous post I review statements about the United States’ coronavirus pandemic response from the candidates’ official campaign websites. I encourage you to read the entire documents yourself by follow the links provided.

This post will review Mr. Biden’s page. You may want to review the previous post now, or after reading this one.

Joe Biden’s Plan for Healthcare

The sitting President heads the Executive Branch of the U.S. Government.

The Department of Health and Human Services through the President’s cabinet member head manages the response to COVID-19. Other Cabinet members and their Departments are involved as well.

The agencies most involved in the COVID-19 response include

  • Health and Human Services-HHS
  • Federal Emergency Management Agency-FEMA
  • Centers for Disease Control-CDC
  • National Institutes of Health-NIH
  • Federal Drug Administration-FDA
  • Small Business Administration-SBA
  • Veterans Administration-VA
  • Department of Defense -DOD
  • Treasury Department
  • State Department

The President leads the Executive Branch of the government, including all of the departments and agencies headed by the Cabinet members, including the Department of Health and Human Services.

Joe Biden and Kamala Harris-7 point plan to beat COVID-19 and get our country back on track

I plan to write a summary post of their plan as it develops. Follow my blog for updates.

an electron microscope image of the coronavirus
the Coronavirus SARS-CoV-2, responsible for causing COVID-19- photo used with permission, CDC.GOV

December 31, 2019-China reports the coronavirus to WHO-the World Health Organization.

RESTORING TRUST, CREDIBILITY, AND COMMON PURPOSE 

We must immediately put scientists and public health leaders front and center in communication with the American people in order to provide regular guidance and deliver timely public health updates, including by immediately establishing daily, expert-led press briefings.

Ensure that public health decisions are made by public health professionals and not politicians

Immediately restore the White House National Security Council Directorate for Global Health Security and Biodefense, which was established by the Obama-Biden Administration 

MOUNTING AN EFFECTIVE NATIONAL EMERGENCY RESPONSE THAT SAVES LIVES, PROTECTS FRONTLINE WORKERS, AND MINIMIZES THE SPREAD OF COVID-19

Ensure that every person who needs a test can get one – and that testing for those who need it is free. 

Task all relevant federal agencies to take immediate action to ensure that America’s hospital capacity can meet the growing need

Prepare to stand up multi-hundred-bed temporary hospitals in any city on short notice

Expand CDC surveillance programs

Instruct the CDC to establish real-time dashboards tracking

  • (1) hospital admissions related to COVID-19, especially for ICUs and emergency departments, and
  • (2)supply chain information for essential equipment and personal protective equipment (PPE). 

Give all frontline workers high-quality and appropriate personal protective equipment . Issue guidance to states to prioritize first responders to receive PPE, and educate the public on reserving equipment for professionals. 

Ensure the National Institutes of Health (NIH) and the Biomedical Advanced Research and Development Authority are swiftly accelerating the development of rapid diagnostic tests, therapeutics and medicines, and vaccines. NIH must be responsible for the clinical trial networks and work closely with the U.S. Food and Drug Administration (FDA) on trial approvals.

Instruct the CDC to provide guidance and resources about containment and mitigation to schools, health care facilities, higher education, and school administrators, and the general public. 

Work with businesses to expand production of personal protective equipment, including masks and gloves, and additional products such as bleach and alcohol-based hand sanitizer.

Establish and fund a U.S. Public Health Service (PHS) Reserve Corps to expand medical and public health capacity. 

Expand staffing for the Adequate Fire and Emergency Response (SAFER) grant program for fire departments can increase staffing. As Vice President he secured an expansion of the SAFER Act. 

Increase federal resources to cover all necessary federal costs, and create a State and Local Emergency Fund to meet critical health and economic needs to combat this crisis 

ELIMINATING COST BARRIERS FOR PREVENTION OF AND CARE FOR COVID-19.

Amend the PHS Act to cover all testing, treatment, and preventive services necessary to address a public health emergency for an infectious disease. All commercial plans and public plans-Medicare, Medicaid, VA, etc- would be required to cover services. 

Fund and expand authority for the National Disaster Medical System (NDMS) to reimburse health care providers for COVID-19-related costs not covered by insurance.

Secure maximum Medicaid enrollment for currently eligible populations 

Provide explicit authority for the HHS Secretary to approve the commercial price of vaccines developed in conjunction with federally funded research

PURSUING DECISIVE ECONOMIC MEASURES TO HELP HARD-HIT WORKERS,FAMILIES, AND SMALL BUSINESSES AND TO STABILIZE THE AMERICAN ECONOMY 

The immediate economic measures in Biden’s plan include 

Comprehensive 12 weeks of paid family and medical leave envisioned in the FAMILY Act and 7 days of paid sick leave in the Healthy Families Act. The paid leave plan will cover 100% of weekly salaries or average weekly earnings up to $1400.00 weekly. 

Reimbursements to employers up to 14 days of paid sick leave, in addition to existing employer paid leave

Ensure unemployment benefits are available to those who would be denied due to rules that should not apply in a crisis 

Employment relief for reduced hours, work-sharing arrangements, domestic workers, caregivers, gig workers or independent contractors with reduced pay and hours 

Expanded food relief for hard-pressed families and children, creating a federal-state partnership to expand SNAP (Supplemental Nutrition Assistance Program) relief

Increase Federal Medical Assistance Percentage (FMAP) for the state administered Medicaid program 

Establish a temporary small and medium size loan program to address unanticipated shortfalls in revenue 

Support for child care and remote student learning by expanding assistance to federal child care enters and Title 1 schools 

Relief or forbearance of federal student loans and federally backed mortgages 

Protect union health funds

A state and local emergency fund for governors and mayors to respond to their communities’ needs including  

  • Mortgage and rental relief for impacted workers
  • Employer assistance for job maintenance
  • Interest free loans for small businesses 
  • Cash assistance or refundable tax relief

RALLYING THE WORLD TO CONFRONT THIS CRISIS WHILE LAYING THE FOUNDATION FOR THE FUTURE 

Direct the U.S. Agency for International Development (USAID) in coordination with the State Department, DOD, HHS, and the CDC, to mobilize an international response to assist vulnerable nations to address COVID-19

Empower the State Department to ensure the U.S. plays a major role in all global decisions about the outbreak

Create a Global Health Emergency Board to harmonize crisis response for vulnerable communities, ensuring a coordinated health and economic response globally

Bolster CDC and DOD’s disease detection and protections programs to protect America’s troops and deployed citizens, providing testing and treatment, and evacuation when necessary 

Expand the Global Health Security Agenda to mobilize the world against the threat of infectious diseases (established under the Obama-Biden administration)

Fully staff all federal agencies, task forces, and scientific and economic advisory groups focused on health security.

Build a global health security workforce by investing in the education of public health professionals, including the CDC’s training programs Fight climate change as a driver of health threats;  fully integrate climate change into our foreign policy and global health security

Exploring the HEART of health

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

By following this blog, you’ll know when I post the additional pieces reviewing the COVID-19 pandemic as well as other topics that explore the HEART of health.

Dr Aletha

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