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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What more doctor bloggers are writing about COVID-19

Perhaps one of the greatest lessons we are learning from this pandemic is our need for social connection and community. Perhaps we can ask ourselves, what does it mean to build real community in care communities?

I’ve been reading what some other physician bloggers are writing about the COVID-19 pandemic. Here I share some of them with you. While I believe they are all reliable and honest sources of information, my sharing does not imply endorsement,complete agreement, or advice. This is a topic in which information changes daily if not more often, so all information is subject to change. Always consult the CDC and your state and local health departments for the most recent information that pertains to you.

What to do if you think you have COVID-19

Dr. Linda, a family doctor, explains what to do and what not to do if you think you have caught the coronavirus.

Don’t Panic. The majority of patients will get better without any treatment. I’ve seen many patients, even among those with no symptoms, with very high levels of anxiety. When we turn on the TV these days, it’s all about COVID-19. Remember that the news always shows the worst case scenarios. If watching it makes you more fearful, switch it off. You still need to get updates but limit your exposure to all the negativity aimed at you. Maybe, just check your state’s department of health sites to know what you need to be aware of.

Don’t Go to the ER Because You Think You Have COVID-19/

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A COVID-19 Overview

Dr. Andrew Weil, well known as an integrative medicine proponent, wrote this overview of what we know about the coronavirus. He also offers his recommendations for vitamins and supplements that might be safe to take during the pandemic (although not known to prevent or treat the infection) and what substances you should avoid. I reviewed one of Dr. Weil’s books at this link.

Dr. Weil considers the following natural immune stimulating and antiviral agents as likely safe to take before and during a COVID-19 virus infection. However, we don’t know for sure whether any of them will affect the symptoms or severity of the infection.

COVID-19: What You Should Know About Coronavirus

illustration showing the coronavirus which causes COVID-19
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Changing our view of nursing homes

Sonja Barsness is not a physician but she wrote a guest post for Dr. Bill Thomas’ blog, Changing Aging.

Perhaps one of the greatest lessons we are learning from this pandemic is our need for social connection and community. Perhaps we can ask ourselves, what does it mean to build real community in care communities?

Covid and Culture Change

If you are depressed and thinking about or planning suicide, please stop and call this number now-1-800-273-8255

cover photo

Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center (EOC) to coordinate with the World Health Organization (WHO), federal, state and local public health partners, and clinicians in response to the coronavirus disease 2019 (COVID-19) outbreak. CDC is closely monitoring the situation and working 24/7 to provide updates.

credit: CDC/James Gathany-public domain

exploring the HEART of health in a pandemic

I shared other COVID-19 blogs in another post . I hope you check out other posts from these physician bloggers.

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 

2 bandaids crossed on a world globe
photo from the Lightstock collection (affiliate link)

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