Women’s health – meds to control pain and prevent disease

updated May 2, 2024

In this post, I review drugs that treat conditions exclusive to or common in women. These are broad topics so I have linked to several authoritative sources.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

This information is not intended for diagnosis or treatment. Before making health decisions, discuss with your physician or other qualified healthcare provider to decide what is right for you.

Relieving the pain of endometriosis

Women with endometriosis suffer infertility, excessive bleeding, painful periods, and pelvic pain unrelated to periods. In endometriosis, uterine tissue grows outside the uterus.

Endometriosis can be difficult to diagnose, requiring invasive procedures to discover. Treatment depends on the goal, whether pregnancy, pain relief, or both. Short of surgery, hormonal therapy has been the mainstay of treatment.

A hormonal drug, elagolix, brand name Orilissa, is the first of its kind specifically developed and approved to treat “moderate to severe” endometriosis pain. It does not help with infertility.

 

Stop bleeding fibroids

Researchers are studying elagolix and another hormonal drug ulipristal for treating uterine fibroids. Fibroids are growths within the uterine that can cause pain and excessive bleeding. Initial trials show both of these drugs can significantly decrease bleeding and pain. However, neither is currently FDA-approved for treating fibroid.

Easing dyspareunia

After menopause many women develop atrophy of the vagina, making it thin, dry, and easily irritated, leading to painful sex, or dyspareunia. An 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, it is a steroid that transforms into estrogen in the vagina, administered as a once-daily vaginal insert at bedtime, applied with an applicator.

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

Prevention of migraine pain and disability

Migraine, although not exclusive to women, occurs more frequently in them than in men. For infrequent headaches, non-prescription pain relievers are effective and recommended. But for severe, frequent, or persistent symptoms prevention is recommended to improve quality of life.

Botox, onabotulinumtoxin A, has been FDA-approved for treating chronic migraine, meaning patients with frequent headaches and other migraine symptoms for at least 3 months.

Yes the same drug used to treat wrinkles, Botox, can prevent migraine. For migraine, the drug is injected into the upper facial muscles by a physician specifically trained in its use.

A calcitonin gene-related peptide (CGRP) receptor is responsible for transmitting migraine pain. Monoclonal antibodies bind to the receptor, blocking the pain.

The antibodies are produced in a laboratory but work like antibodies naturally produced by the body. These drugs are given by injection.

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

Gepant drugs also block the CGRP receptors, both preventing and relieving migraine. These are in pill form so are taken by mouth.

• Rimegepant-Nurtec ODT
• Ubrogepant-Ubrelvy 

Preventing cervical cancer with the HPV vaccine

Infection with the HPV, human papillomavirus, causes genital warts and changes in the cervix called CIN which can lead to cervical cancer.

According to a review of clinical trials by Cochran, vaccination against this virus effectively prevents infection and thus fewer cases of CIN. Since a significant percentage of CIN progresses to cancer, we can expect fewer women will develop invasive cervical cancer, the 4th most common cancer in women worldwide.

The vaccine, Gardasail 9, originally approved for use in females ages 9 to 26 years, received FDA approval for use up to age 45 years.

Stopping shingles with the zoster vaccine

And speaking of vaccines, a new zoster (shingles) vaccine, Shingrix, prevents the painful rash much more effectively than the original vaccine Zostavax. It ranges in effectiveness from 91% to 97% at preventing shingles, depending on age. The first vaccine was 51% effective.

Zoster is a reactivation of the varicella virus that causes chickenpox. It causes a painful rash known as shingles; the pain may continue after the rash is gone. It can happen at any age, but symptoms tend to be worse in older persons.

exploring the HEART of women’s health

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