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 a doctor and patient make decisions about what is right for her. Medical recommendations and practice changes as we learn new things. If you deal with any of these issues , please discuss with your doctor before taking any action.

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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 being used to treat cancers and some forms of arthritis. They are called calcitonin gene-related peptide (CGRP) receptor antagonists.

Three of these drugs are available for migraine prevention. (generic name-brand name)

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

 

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

In early 2020 the FDA approved another drug that works the same way but is taken by mouth, rimegepant (Nurtec ODT). But unlike the others, Nurtec treats acute migraine pain rather than preventing it. ODT means it is orally dissolvable.

A single 75-mg dose of rimegepant provided rapid migraine pain relief with patients returning to normal activities within 1 hour, with sustained benefit lasting up to 2 days in many patients. The majority of patients (86%) treated with a single dose did not need a migraine rescue medication within 24 hours.

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 follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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How Lilies of the Field challenged the fallacy of racism

That actor went on to have one of the most successful acting careers in history, winning numerous more awards, but more importantly appearing in productions that explored issues of race, discrimination, human rights, and justice.

“Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing?

 Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they?

 And which of you by being anxious can add a single hour to his span of life?

 And why are you anxious about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin, yet I tell you, even Solomon in all his glory was not arrayed like one of these. (In the Old Testament, Solomon was a King, who was the richest man in the world at that time.)

 But if God so clothes the grass of the field, which today is alive and tomorrow is thrown into the oven, will he not much more clothe you, O you of little faith? 

 Therefore do not be anxious, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ For the Gentiles seek after all these things, and your heavenly Father knows that you need them all. 

But seek first the kingdom of God and his righteousness, and all these things will be added to you.

Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble.”

Matthew 6, ESV

The Holy Bible, English Standard Version. ESV® Text Edition: 2016. Copyright © 2001 by Crossway Bibles, a publishing ministry of Good News Publishers.

“Lilies of the Field”

Although his acting ability had already won critical acclaim, a young actor made movie history in 1963 in a film based on this Bible text. In Lilies of the Field , he portrayed an itinerant handyman who meets a group of German-speaking nuns living in rural Arizona. After performing a small repair on a roof for them, he naturally asks to be paid. To which the Mother Superior replies,

“Consider the lilies of the field, how they grow; they toil not, neither do they spin. And yet I say unto you that even Solomon in all his glory was not arrayed like one of these.”

That actor went on to have one of the most successful acting careers in history, winning numerous more awards, but more importantly appearing in productions that explored issues of race, discrimination, human rights, and justice.

Sidney Poitier, now 93 years old, won the Academy Award for Best Actor for his role in Lilies of the Field. He was the first black man to win the best actor award, and the second black person to win any Academy award. ( Hattie McDaniel won Best Supporting Actress for her role in 1939’s Gone with the Wind, making her the first black person to be nominated for and receive an Oscar. In June 2020 HBO planned to add “historical context” to the streaming version of the movie.)

In a post on the website The New Lyceum, Joey Barretta wrote this about the actor.

Sidney Poitier was the first black actor to win the Best Actor Oscar in 1964, the same year that the Civil Rights Act was passed and a year prior to the Voting Rights Act. He rose to be a star at a time in which racism was common and his career began before segregation was abolished. This man is a true hero, albeit one who played some compelling fictional characters setting an example for the fallacy that is racism. By portraying decent men, he set an example of excellence in character that even the prejudiced whites of his day could not ignore.

J. Baretta, March 5, 2018

Some of Mr. Poitier’s other works which delved into social issues include

  • Cry, the Beloved Country-based on the novel about apartheid in South Africa
  • To Sir, With Love-social and racial tensions in an inner city school
  • Guess Who’s Coming to Dinner – interracial marriage
  • A Patch of Blue and The Defiant Ones -interracial friendships
  • In the Heat of the Night and They Call Me Mister Tibbs!– racial bias among law enforcement professionals
  • Separate but Equal– portrayal of Thurgood Marshall, future Supreme Court Justice
  • Mandela and deKlerk-portrayal of Nelson Mandela, future President of South Africa
The affiliate links in this post help me fund this blog to continue providing content and to support projects that share the heart of health.
from story to novel to movie

The movie was based on a 1962 novel, The Lilies of the Field , by William Edmund Barrett. He in turn used the true story of the Sisters of Walburga as his inspiration.

Why not read a post I wrote about another novel that used this Bible verse. Here’s an excerpt-

In The Narrow Corner, W. Somerset Maugham tells a story about Dr. Saunders, an English physician who lives and practices in China. He is quite in demand among wealthy Chinese; we never learn exactly why he left England but the author hints that he was more highly regarded in the Far East than he had been in Britain. 

Dr. Saunders is summoned away from his home  to a South Pacific island to attend to a wealthy man who requests his medical care. He boards a small ship with a salty captain and a young man who keeps his reason for travelling a guarded secret.

What was supposed to be a pleasant and uneventful trip to a tropical island, turned into an uncomfortable and shocking adventure when they meet four people whose lives proved more complicated that they initially appeared.  Dr. Saunders and his travelling companions soon find themselves sucked into their intrigue. 

continue reading at

The Narrow Corner

exploring the HEART of life through literature and media

I’ll hope you’ll watch Lilies of the Field if you’ve never seen it before. And also watch some of Mr. Poitier’s other films, which I think you will find add revealing context to the social justice issues our country is confronting and correcting in the 21st century. Check out this article for some suggestions .

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha