Category: infections, vaccination, and hygiene

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

This post reviews drugs for women’s health issues. Elagolix treats endometriosis pain but not infertility. Elagolix and ulipristal may help with uterine fibroids. Prasterone relieves dyspareunia and improves sexual desire. Botox and monoclonal antibodies prevent migraine pain. HPV vaccine prevents cervical cancer, and Shingrix prevents shingles more effectively.

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 but may have changed by the time you read this. Do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with a qualified healthcare professional.

Photo by rawpixel.com on Pexels.com

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 

I also discuss migraine in this post.

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.

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6 Tips to Cope During a Flu Epidemic

The post discusses influenza, emphasizing its symptoms, diagnosis, and prevention, particularly through vaccination. It acknowledges the similarities between influenza and COVID-19 symptoms. Antiviral medications like Tamiflu and Xofluza are mentioned for treatment. The article promotes awareness of complications, especially for high-risk individuals, and encourages preventive measures to protect oneself and others.

updated January 27, 2026

This post was originally written and posted 2 years before we had even heard of SARS-CoV-2, aka COVID-19. Four years later, “flu” symptoms are just as likely to be due to COVID as influenza, maybe more so. Still, we need to be vigilant because neither has disappeared. This post focuses on influenza.

To many people “the flu” is any respiratory illness characterized by some combination of fever, cough, congestion, headache, fatigue,  and body aches. That term has become so nonspecific even we doctors use it that way.

But, correctly, it refers to influenza, one of many viruses that cause illness. The illnesses caused by the other viruses are “colds”, upper respiratory infections, aka URIs, bronchitis, pharyngitis, sinusitis, and pneumonia.

The human respiratory system
The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay)

Before the rapid flu test, using a nasal swab, we doctors diagnosed influenza by the characteristic symptoms, confirmatory findings on exam, and knowing there was an outbreak in the community.

The test is not absolutely necessary but is helpful for confirmation in the event the illness doesn’t progress as expected or to differentiate it from other illnesses, especially COVID.

Vaccination-key to prevention

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) , the National Foundation for Infectious Disease and every other reputable medical organization recommends vaccination against influenza.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, as is the case for any medical procedure, or other things we do in life. In this case we have decided the benefit outweighs the risk.

Other tips to stay well and protect others

  • Stay home if you are sick, and ask your family, co-workers and employees to do the same.
  • If you absolutely must go out among other people, put an effective mask over your nose and mouth.
  • Cover your nose and mouth when coughing or sneezing
  • Wash your hands frequently.
  • Clean frequently touched surfaces.
Hand hygiene saves lives.
a common sight now in public restrooms

    Antiviral (influenza) medications

    Tamiflu

    The antiviral drug Tamiflu, generic oseltamivir,  will “shorten the duration and severity of symptoms” by 1-2 days, if started early (within 24-48 hours). There is some evidence that it will also lessen the risk of serious complications , especially in higher risk people (see below ).

    I warn people that even with Tamiflu they will still feel miserable for a few days. But if it gets you back to school or work a day earlier, it may be worth the cost.

    Oseltamivir can also be prescribed for prevention, if you know you have had close contact with someone with confirmed influenza, such as a household member. It’s only effective though for that episode, a 10 day course taken as soon as possible after exposure.

    Xofluza

    Xofluza, generic baloxavir, is for treatment of uncomplicated influenza for children and adults 12 years and older, who have been sick for no more than 48 hours. Patients take 2 tablets as a single dose. It can also be used post exposure .

    Relenza

    Relenza, generic zanamivir, is a dry powder that is inhaled twice daily for 5 days or daily for prevention

    Peramivir

    Peramivir (Rapivab): A single-dose intravenous (IV) injection for 6 months and older, typically only used for patients needing admission to a hospital . 

    Home care of influenza

    • Rest; eat and drink as normally as possible; extra fluids if running a fever 
    • Non-prescription cough/congestion /pain/fever meds

    Don’t confuse Tamiflu (generic oseltamivir) a prescription anti-viral drug with Theraflu, an over the counter drug that treats symptoms.Theraflu does not affect the course of the illness.

    Here are more  general guidelines  on what to do if you get a respiratory illness from FamilyDoctor.org.

    Flu complications

      Influenza causes uncomfortable disabling symptoms but most people recover fairly quickly and fully. In some cases influenza can progress rapidly and overwhelm the respiratory and/or nervous systems,  leading to death.

      People also die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung.

      Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

      an xray of healthy lungs with no signs of pneumonia.
      Healthy lungs with no signs of pneumonia.

      High risk persons-take influenza seriously

      Persons with chronic illnesses like diabetes, lung disorders, chronic liver or kidney disease, depressed immune systems and cancer , as well as infants and persons of advanced age are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.

      Exploring the HEART of Health

      I’d love for you to follow this blog and follow me on social media.

      I share information and inspiration to help you transform challenges into opportunities for learning and growth.

      Add your name to the subscribe box to be notified of new posts by email. Click the link to read the post and browse other content. It’s that simple. No spam.

      I enjoy seeing who is new to Watercress Words. When you subscribe, I will visit your blog or website. Thanks and see you next time.

      Dr. Aletha