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 links to posts I’ve written about women. Please note these usually include 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 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.

Please do not use this information for diagnosis or treatment purposes. Before making health decisions, discuss with your physician or other qualified 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 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.

A Natural Woman- Carole King shares a lifetime of music, a season of pain

Carole King’s memoir, “A Natural Woman,” delves into her remarkable life as a Grammy Award-winning singer/songwriter. Despite her musical success, she faced profound personal challenges, including turbulent marriages and traumatic experiences. King’s resilience and candid account offer a powerful reminder of the complexities behind public personas and the importance of seeking help in times of…

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.

Working Stiff -a book review to remember 9/11

When she applied for a position in New York City at the NYC Office of the Chief Medical Examiner (OCME), Dr. Judy Melinek never imagined that decision would plunge her into the nightmare of September 11, 2001. She was at the ME office that day when the Twin Towers were attacked and fell, killing thousands…

Keep reading

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

The Helpers-a book review

“The Helpers” by Kathy Gilsinan focuses on the untold stories of pandemic heroes. It sheds light on ordinary people who demonstrated extraordinary courage and selflessness during the chaotic times of the SARS-CoV-2 pandemic. The book also highlights the government’s flawed response, emphasizing the resilience and unity of the people despite political divisions.

Keep reading

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.

Dr. Aletha

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We believe bookstores are essential to a healthy culture and they are dedicated to the common good.

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Driving Miss Norma- why saying yes to life matters

When faced with death, Norma chose living. And in doing so, she and her family learned what really matters at the end. Through this book, they share what they learned with us.

a review of Driving Miss Norma

By Tim Bauerschmidt and Ramie Liddle

When I first reviewed this book the tag line was

One Family’s Journey Saying “Yes” to Living

the most recent edition now calls it

An Inspirational Story About What Really Matters at the End of Life

And it’s both of those. When faced with death, Norma chose living. And in doing so, she and her family learned what really matters at the end. Through this book, they share what they learned with us.

(This post contains affiliate links.)

I first learned about Norma Bauerschmidt on Facebook when a friend shared a video about her. She was a 90 year old woman who decided to spend the last months of her life “on the road” travelling with her son in a motorhome. She was diagnosed with cancer but decided to forgo treatment so she could enjoy her remaining time.

I didn’t learn more about her until I saw this book.  I decided to read it, expecting a feel good entertaining read. The story turned out to be far more complex than the little I knew.

Driving Miss Norma tells the story of Norma Bauerschmidt, a WWII WAVE veteran, wife, and mother. She was still in good health at 90 years of age, until she was diagnosed with cancer.

Her doctor recommended surgery to be followed by chemotherapy, and warned her the treatment and recovery would be long and difficult. She told him no, she would rather “hit the road” with her son and daughter-in-law and enjoy her life, seeing and doing things she had not had a chance to do before. And her doctor agreed, saying that is just what he would do.

Tim, her son, and Ramie, his wife, had already been living a nomadic life, travelling the country with their standard poodle Ringo in an Airstream travel  trailer they parked in campgrounds and  Walmart parking lots. They enjoyed travelling, seeing new places, meeting new people. They wondered how adding a 90 year old woman to their wandering lifestyle would work.

By the time they completed arrangements for Norma to join them, she was already frail, and as her illness progressed she needed even more attention and care. Tim and Ramie soon realized that this might be more difficult and complex than they imagined.

In the book, co-written by Tim and Ramie, they tell their stories also; the mid-life challenge of caring for aging parents, making end of life decisions and plans, and coping with parents’ death and  their subsequent grief. Having chosen not to have children, the role of caregivers was foreign to them, and one they had to painstakingly embrace and navigate.

By coincidence, Ramie had recently read the book Being Mortal  “a critical examination of end-of-life medical care.” Until then she had not thought much about the subject. But when she finished the book

“I knew my life had changed. The way I looked at the end of life had been flipped upside down and backward. I knew now it was time to have those tough conversations.”

(I reviewed this book at this link)

As they travelled, Ramie began writing about their adventures and posting on Facebook to close friends and family. She thought that other people might also be interested so she started a Page, Driving Miss Norma. They attracted a handful of followers initially, as she expected.

up close look at a hot air balloon
Norma went on her first and only hot air balloon ride (complimentary stock photo from Pixabay)

But after Norma’s story was reported on the Good News Network, followed by a CBS Evening News Story , the Page began adding  followers by the thousands.

The were alarmed, even fearful, of what they perceived as an intrusion on their privacy. Until now, they had deliberately avoided media in their isolated lifestyle. Then they began noticing how Norma’s story was resonating with people in a way they had not expected.

“We had suddenly and dramatically found ourselves in the middle of an international conversation about the meaning of life, illness, dying and love. We were learning on the fly how to open ourselves to holding so much raw emotion.”

Her story opened their lives to new people and situations they never imagined would happen. Rather than being a burden, Norma’s growing fame became the vehicle for them to grow closer to her, each other, and a whole new set of friends all over the country and the world.

“We had the support of people all over the world and that was breathing new energy into our days. Here were so many people pouring out their deepest fears, losses, and desires to us. They told us of their caregiving struggles. They shared with us their innermost desires- to make peace with their recently deceased father, to tell someone “I love you.”

Throughout the story Tim and Ramie share about the places Norma visited (see map), people she met, from the common to famous, the foods she tried, sometimes for the first time, and activities she tried, also many for the first time, like riding a horse. They and the new friends they made shared food, fun, love, and laughter.

map of the United States
Norma visited all the sites marked on this map

But they also touch on the serious issues we all deal with sooner or later- aging, frailty, complex illness, terminal illness, end of life decisions, palliative care, death, and grief. They learned some important lessons about human relationships which they illustrate beautifully in their transparent writing.

“We learned how to greet people with open minds and open hearts…the lines that separate people into different boxes-religion and politics and race and age-blurred and faded and eventually disappeared. We got to see the truth in people, including in Norma: her glow, her tenacity, her joy, and her confidence.”

Tim and Ramie wrote the book after Norma’s death. They each took turns writing different chapters, and Ramie took all the photographs that illustrate it. But in a way Norma herself wrote the book, since it was the way she faced the final months of her life that produced the lessons her family learned and share with us in this book.

Norma kept a journal during their travels and after she died Tim and Ramie, with close friends, read it, and were somewhat surprised at what she wrote. Or rather, what she didn’t write.

“She did not write about cancer or fame- the two big themes of the trip for us. She did not write about the fear of dying or illness at all. Instead, she talked about life, living, and the things that brought her happiness:a sturdy wheelchair, mama and baby goats, a good hair perm, and her trusty sidekick Ringo.”

I feel sad that Norma’s trip did not bring her though my town so I could have met her. But there will be “Normas” in my life that I will meet, and perhaps someday I will be a Norma myself. When that happens I hope I remember the lessons this book teaches.

“Joy begets joy, love begets love, peace begets peace.”

Continue to follow Norma’s family at the web site Driving Miss Norma

sharing the HEART of living well

I hope you enjoyed this look at Norma’s book and will share this post on the social sites you meet up with friends. Please check out some of my other book reviews. Links are in the menu on the side bar (may be below if on a phone or tablet).Or just search.

Dr. Aletha