Tag: HPV

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. 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.

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.

exploring the HEART of women’s health

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2019 Women’s health update- hormones, the heart, and HPV

results of the Nurses Health Study over 18 years shows no increase in incidence of these complications in women who used vaginal estrogen, suggesting this is a safe option for women who elect to use estrogen. (from the journal Menopause)

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Multiple health issues impact women exclusively or differently than men, so new and updated information is important to share. The issues we women face vary with our age, stage of life and health status.

Let’s look at some medical news about women’s health issues, information I picked up recently from several medical journals I follow.

This is current, 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.

I’m illustrating this post with photos of art featuring women. I’ll tell you more about the source at the end.

statue of a woman holding an infant

Human papillomavirus and cancer 

Infection with the human papillomavirus, HPV, can cause  genital warts and cervical cancer.

The percentage of young women with confirmed HPV (human papillomavirus) infection  in the United States fell significantly from 2006 to 2012. Women who had received the HPV vaccine showed the greatest decline in infection rates, compared to those who had not. Even one dose was effective, even though 2 or 3 are recommended.

A new study reported by the New England Journal of Medicine shows that women who become infected with the HPV strains 16 and 18 have a much higher risk of changes in their cervix called CIN-cervical intraepithelial neoplasia-which can be a precursor to cancer. These changes may not be picked up by a Papanicolaou (Pap) test.

Thus, protection against infection with HPV should also provide protection against cancers caused by HPV.

Human papillomavirus vaccine

Gardasil, a vaccine which targets the HPV has been available to females and males from 9 years old to 26 years old. Now the age has been extended through age 45 years for both genders.

Here is a link to detailed information about HPV vaccination from the National Cancer Institute.


Human Papillomavirus (HPV) Vaccines

statue of a pioneer woman with rifle and infant

Long-acting reversible contraception-LARC  

Two forms of long-acting reversible contraception are available to women in the United States.

Nexplanon, a contraceptive implant, slowly releases the hormone progestin and does not have estrogen. It can be used in women who cannot take estrogen, such as those with uterine fibroids or endometrial cancer.

Intrauterine devices, IUDs, containing copper only are appropriate for women with past or present breast cancer, ischemic heart disease, and women at risk for blood clots.

Use of LARCs accounts for 12% of all contraceptive use. Additional benefits include controlling excessive menstrual bleeding, potentially saving women from surgery.

Here is a link to Quick Fact about intrauterine devices and other forms of contraception from the Department of Health and Human Services

Intrauterine Device

statue of woman, holding infant, standing next to a child

Hormone therapy and prevention of heart disease

A 2015 Cochrane review of 40,410 postmenopausal women examined the use of oral hormone therapy (estrogen with or without progesterone) taken for at least six months, compared with placebo (no real drug), to determine the effect on death from any cause, and deaths caused by heart disease, stroke, and blood clot in a leg or lung.

The review found no benefits for preventing heart attack (fatal or nonfatal), or death due to any cause.

In women who took hormones they found 

 
1 in 165 women had a stroke
1 in 118 women had a blood clot in the leg or lung
1 in 242 women had a blood clot in the lung

The women in this study were all older than 60 years old, so it is possible there might be benefit in younger women.

statue of woman with arm raised and holding an infant

Vaginal estrogen and heart health

While estrogen replacement after menopause is effective at controlling the undesirable effects of night sweats, hot flashes, and vaginal dryness, it potentially increases the risk of developing cardiovascular disease-heart attacks and stroke, and some cancers-breast and uterine.

However, results of the Nurses Health Study over 18 years shows no increase in incidence of these complications in women who used vaginal estrogen, suggesting this is a safe option for women who elect to use estrogen. (from the journal Menopause)

The photos- a tribute to women

I took these photos during a recent visit to Woolaroc ,a museum and wildlife preserve located in the Osage Hills of Northeastern Oklahoma. Woolaroc was established in 1925 as the ranch retreat of oilman Frank Phillips. 

These statues displayed there were all models considered for a larger project now known as the Pioneer Woman Statue in Ponca City, Oklahoma.

What do you think? Would you have chosen one of the other statues for the final version?

More women’s health info

exploring the HEART of women’s health

Dr. Aletha

a statue of a woman holding a child, "CROSSING THE PRAIRIE"
“CROSSING THE PRAIRIE” by Glenna Goodacre, Broken Arrow, Oklahoma

AAPTIV- what I’m using to stay fit now.