March is Endometriosis Awareness Month

You’re busy celebrating Women’s History Month, the Ides of March, Pi(e) Day, St. Patrick’s Day, not to mention Spring Break and numerous lesser known awareness days and months. But don’t let Endometriosis Awareness Month slip away.

Endometriosis — when the uterine lining or endometrium grows outside of the uterus,  most commonly elsewhere in the abdomen on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity — affects at least 6.3 million women and girls in the U.S., 1 million in Canada, and millions more worldwide, according to the Endometriosis Association. It frequently results in very painful menstrual cramps and other symptoms, and is notoriously hard to diagnose. There is no known cause, and while there are many treatments, there is no real cure.

Adapted from a photo by Ben Werdmuller // Creative Commons 2.0
http://www.flickr.com/photos/benwerd/3976375987/

So what can you do this month? Just talking about endometriosis — acknowledging it exists or sharing your own story might help a teenage girl realize that those gut-stabbing cramps aren’t normal or another woman to know that it’s not all in her head.

If you have endometriosis and have found a physician or other health care practitioner who is compassionate and has helped you find ways of coping, tell others — refer your friends. Many doctors don’t know that endometriosis often presents as, or with, gastrointestinal symptoms.

Does your local library have up-to-date books about endometriosis? Recommend materials that have helped you.

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Could use of the pill be linked to insulin resistance?

Adapted from a photo by anna marie-grace // CC 2.0

The pill is one of the most intensely studied drugs in history, and believed to be among the safest – safer than aspirin, as an editorial in the American Journal of Public Health noted twenty years ago. Yet young women seem to be quitting in droves, for a variety of reasons: to restore feelings of psychological and emotional health, regain lost libido, relieve cardiovascular symptoms and disorders, or ease anxiety about these or other health issues.

When women report these side effects of birth control pills, physicians often recommend they try another brand, but many of these side effects are common to hormonal birth control, especially oral contraceptives. A new study published this month in Human Reproduction suggests there may be yet another common side effect: Researchers in Finland found that oral contraceptives may worsen insulin sensitivity and are associated with increased levels of circulating inflammatory markers.

The study was very small and ran only for a short time, so drawing conclusions is premature, but since the beginning of the year, I’ve been following several online discussions of young women quitting the pill. Although I have yet to see development of Type 2 diabetes or insulin resistance cited as a reason to quit the pill, I have seen such a variety of health issues and medical problems described that this study caught my eye immediately. Current estimates indicate that 12.6 million, or 10.8 percent, of all U.S. women ages 20 years or older have diabetes (diagnosed and undiagnosed). Could it be related to their birth control? Perhaps in those already genetically predisposed.

Research from the Guttmacher Institute indicates nearly 60% of pill users take it for non-contraceptive reasons, such as for cramps or other menstrual pain, menstrual regulation, acne, endometriosis, as well as for prevention of unintended pregnancy. Fourteen per cent of US pill users (more than 1.5 million women) take birth control pills solely for non-contraceptive reasons. If the Finland study proves to hold true for larger groups over extended periods, there’s another reason to be more cautious prescribing the pill.

 

When One Less Becomes One More

Abnormal Pap Smears, Cervical Dysplasia and Cervical Cancer Spike Post-HPV Vaccination

Guest Post by Leslie Botha, Women’s Health Freedom Coalition Coordinator, Natural Solutions Foundation,
and Janny Stokvis, VAERS Research Analyst

 

In 2006, the HPV vaccine Gardasil touted to prevent cervical cancer was introduced to a public generally unaware of the Human Papillomavirus or its threat to adolescent girls and women. However, the public was quickly informed of the dangers of the virus when Merck launched an aggressive advertising campaign designed to capture the attention of girls/women ages 9 to 26 with a catchy jingle and their now famous line: “One Less Girl to Get Cervical Cancer.” Adolescent girls were dancing and singing that they will be ‘one less girl’ in unison with the award-winning TV commercial.

According to Neon Tommy, the online publication for the Annenberg School for Communication and Journalism, USC, the promotion was successful. In 2008 Merck’s marketing techniques even earned Gardasil a “pharmaceutical brand of the year” award from Pharmaceutical Executive for its ‘savvy disease education,’ and for building ‘a market out of thin air’.

Six years later, it appears that ‘one less’ is now turning into ‘one more’ as reports of abnormal pap smears, cervical dysplasia and cervical cancer are appearing in the HPV vaccine targeted market.

Table prepared and provided by authors

As of May 12, 2012 the Vaccine Adverse Event Reporting System (VAERS) showed there have been 26,050 reports of adverse events (including 849 reports from boys/men ages nine to 26) post-HPV vaccination. The National Vaccine Information Center (NVIC) estimates only 1 to 10% of the vaccine-injured are reporting.

Of concern is the significant increase in reporting for cervical abnormalities reported to VAERS each month. Of even more concern is that the American College of Obstetrics and Gynecology has raised pap testing guidelines to age 21 leaving many adolescents without proper cervical screening tools post-vaccination. Yet a significant number of events are being reported by an age group that typically does not develop cervical cancer until age 50 or older. According to Stokvis, some of the reports of cervical abnormalities are occurring four to five years post-vaccination.

Abnormal Pap Smears: 490 (greatest number of incident reports age 14 to 26)
Cervical Dysplasia: 195 (greatest number of incident reports age 14 to 26)
Cervical Cancer: 56 (greatest number of incident reports age 16 to 26)

In January 2012, the American Journal of Obstetrics and Gynecology published the ATHENA HPV study announcing the results of a large cervical cancer screening trial, enrolling 47,208 women 21 years of age or older at 61 clinical sites throughout the United States. The authors reported that in a sub group of 12,852 young women, the HPV vaccine reduced HPV-16 infections only 0.6% in vaccinated women vs. unvaccinated women. Most disturbing are the data that showed other high-risk HPV infections were diagnosed in vaccinated women 2.6% to 6.2% more frequently than unvaccinated women. In fact, the study reported that the increased rate of infections by carcinogenic HPV types in vaccinated women (other than those targeted by Gardasil®) is four to ten times higher than the reduction in HPV 16/18 infections.

Why are these numbers of great concern? According to 2005 -2009 data reported by the National Cancer Institute,

The median age at diagnosis for cancer of the cervix uteri was 48 years of age. Approximately 0.2% were diagnosed under age 20; 14.0% between 20 and 34; 25.9% between 35 and 44; 23.9% between 45 and 54; 16.7% between 55 and 64; 10.7% between 65 and 74; 6.1% between 75 and 84; and 2.6% 85+ years of age.

The problem is that the FDA has not recommended a reliable HPV screening assessment prior to the mass vaccination program. In addition, the CDC estimates 25,000,000 people have been previously exposed to HPV.

In September 2011, Norwegian immunologist, Charlotte Haug, M.D., Ph.D. raised the issue of potential HPV virus replacement in her opinion paper in the New Scientist titled: “We Need to Talk about HPV Vaccination Seriously”

There is another serious question that may be answered sooner:  what effect will the vaccine have on the other cancer-causing strains of HPV? Nature never leaves a void, so if HPV-16 and HPV-18 are suppressed by an effective vaccine, other strains of the virus will take their place. The question is, will these strains cause cervical cancer?

Dr. Haug noted that vaccinated women showed an increased number of precancerous lesions caused by strains of HPV other than HPV-16 and HPV-18. She also wrote “…the results are not statistically significant, but if the trend is real – and further clinical trials should tell us in a few years – there is reason for serious concern.”

Even in 2009, a voice of concern by medical researchers about virus replacement was raised:

…However, the biological mechanisms of different HPV types are not yet fully understood, and the significance of cross-protection is limited by a small number of lesions, short study period, and lack of data on ICC. It is worth noting that following HPV vaccine implementation, other high-risk HPV types than HPV 16 and 18 could replace the biological niche of HPV 16 and 18, thereby causing a relatively greater proportion of cervical cancer and cervical cancer precursors cases [9,10]. If this occurs, there is a potential to offset the benefits of vaccination. HPV vaccination evaluation programs should consider this possibility and evaluate changes in HPV type distribution in high-grade lesions and ICC over time relative to HPV types found in the general population with documentation of HPV vaccination history. Long-term follow-up during further vaccine evaluation is expected to address those two issues.

Even though the above published papers raise important questions, this study out of the UK titled, “Potential overestimation of HPV vaccine impact due to unmasking of non-vaccine types: quantification using a multi-type mathematical model“, published on May 14, 2012, cites, “There could be an apparent maximum increase of 3-10% in long-term cervical cancer incidence due to non-vaccine HPV types following vaccination”. The authors, from the Health Protection Agency in London conclude that “[u]nmasking may be an important phenomenon in HPV post-vaccination epidemiology, in the same way that has been observed following pneumococcal conjugate vaccination”.

The data in the age group of the injured girls reporting abnormal pap smears, cervical dysplasia, and cervical cancer indicate that the HPV virus replacement or unmasking is an issue that needs to be examined immediately. An award-winning advertising campaign that ‘created a market out of thin air’ for Gardasil^® use in an uneducated and misinformed demographic is no excuse for the distribution of a ‘cervical cancer’ prevention vaccine that has not been ‘evaluated for the potential to cause carcinogenicity and genotoxicity’. It is obvious that that ‘one less girl to get cervical cancer’ is becoming ‘one more girl’ to get a myriad of adverse reactions including cervical cancer.

 

O Canada! Gardasil® Vaccine May be a Medical Experiment on Older Women

Guest Post by Leslie Botha, Broadcast Journalist

It appears that women ages 27 to 45 in Canada are being subjected to the same type of Gardasil® advertising campaign adolescents and their families are in the United States. The full page advertisements are running continuously in magazine supplements in Sunday newspapers north and south of the border.

‘Now women ages 27 to 45 can benefit from Gardasil®’. Say what? Benefit from what? ‘Talk to your health care professional today.’ Now, I am not sure of what is going on in Canada – but in the U.S., healthcare professionals have nearly become pharmaceutical sales representatives, and women cannot go in for a doctor’s exam without being pressured to go on the birth control pill or get vaccinated. In fact, a stamp is now placed on a patient’s chart to remind doctor’s if the adolescent is in the process of getting the three-shot Gardasil® series or has been ‘counseled and refused’ vaccination.¹

According to the U.S. FDA, there is no health benefit to getting Gardasil® for women ages 27 to 45. Then why is the vaccine being offered to older women in Canada?

Only the Facts Ma’am

In April 2011, after a long awaited decision the U.S. FDA ruled against Merck’s supplemental biologics license application (sBLA) for an indication to use GARDASIL [Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant] in women ages 27-45. This was Merck’s 4th request to expand Gardasil® use to an older population of women.

In a brief statement Merck stated that: “An indication for adult women was not granted; instead, the Limitations of Use and Effectiveness for GARDASIL® was updated to state that GARDASIL® has not been demonstrated to prevent HPV-related CIN 2/3 or worse in women older than 26 years of age.”¹

Within the same month Merck issued a press release announcing Health Canada had approved use of Gardasil® for women ages 27 – 45 for preventing cervical cancer, vulvar and vaginal cancers, precancerous lesions and genital warts caused by HPV strains 6, 11, 16, 18. Health Canada was surprisingly silent on the HPV vaccine issue and did not release a statement of their own.²

This should have been the first red flag for Canadian women. According to Pharmalot, “Although Canada is a smaller market than the U.S., the approval is a notable step for Merck, which has been counting on a larger demographic target to boost sorely needed vaccine revenue.”³

The needed revenue is due to the decreasing uptake and non-completion of the three-shot series in the U.S. Health insurance records have shown that among 19 to 26-year-old women who received their first Gardasil shot, the number of 19 to 26-year-old women completing the 3-shot series dropped from 44 percent in 2006 to 23 percent in 2009. A similar decline was seen in the pre-teen demographic where 57 percent of girls in 2006 completed the vaccine series, compared to 21 percent in 2009.⁴

Perhaps another notable step for Merck will be to go back to the FDA with data from Canada to prove that Gardasil® can be demonstrated to prevent cervical cancer in this older demographic. This is a highly likely scenario, since the CDC has stated: “While there are well-established cancer registries in the United States, it will take decades before the impact of the vaccine on cervical cancer is observed.”⁵

What is potentially wrong with Gardasil® use in older women?

The CDC estimates approximately 20 million Americans are currently infected with HPV. Another six million people become newly infected each year. HPV is so common that at least 50% of sexually active men and women get it at some point in their lives. ⁶

Gardasil® was not designed to treat pre-existing HPV infections – and therefore it was tested on women who were not exposed to HPV. This type of pre-screening prior to vaccination is not available to medical consumers in the U.S. or in Canada and was actually discouraged by the FDA.

This alone gives rise to a major concern because women are mostly unaware they have been exposed to HPV. In addition, women who are not aware they have the virus but get the vaccine could suffer outbreaks of genital warts or abnormal precancerous lesions. Both conditions require extensive treatment. ⁷

Why is this happening? A chart in the May 2006 FDA Vaccines and Related Biological Products Advisory Committee’s report clearly shows that women who have been previously exposed to HPV and who are vaccinated with Gardasil® have a vaccine efficacy rate of -44.6%, and -32.5% post Cervarix, placing those vaccinated at an increased risk of developing cervical cancer, as well as suffering from other adverse reactions. ⁸

According to American Cancer Society estimates, deaths from cervical cancer fell by 74% between 1955 and 1992, mostly due to Pap smear screening. The rate continues to fall 4% annually without Gardasil®. Hopefully, there will not be an increase in cervical rates due to the HPV vaccines. That unfortunately will remain to be seen, although reports of cervical dysplasia and cervical cancer are being reported by young women post vaccination.

One thing is clear – women are the only ones who can protect their pelvic goldmines from exploitation. Meanwhile, unsuspecting women of all ages, all over the world are receiving a vaccine that will no doubt be become known as the great travesty of the 21st century. Our sisters in Canada need to be paying attention to what is happening in the U.S. before they partake in what may be a potential medical experiment with dire consequences for them and more profit for Merck.

References

1. Ob. Gyn News, May 17, 2012

2. Pharmalot, FDA Rejects Gardasil For Use In Most Adult Women, April 6, 2011

3. Pharmalot, Canada Approves Gardasil For Use In Most Women, April 28, 2011

4. Fox News, Fewer girls completing all three HPV shots, May 18, 2012

5. Post-licensure monitoring of HPV vaccine in the United States, Centers for Disease Control and Prevention, Vaccine. 2010 Jul 5;28 (30):4731-7. Epub 2010 Feb 25.

6. Cervical Cancer Prevention, Health Professional Version, National Cancer Institute (NCI)

7. Judicial Watch Special Report on Gardasil: How Safe And Effective Is It?, September 22, 2011

8. FDA Vaccines and Related Biological Products Advisory Committee Report, May 2006

It’s National Women’s Health Week — Celebrate and Reminisce with the FDA

I admit, I didn’t know that this is National Women’s Health Week until I received a reminder in my inbox from a U.S. FDA mailing list, letting me know about the Food & Drug Administration’s role in promoting Women’s Health. They’ve published a brochure (available in both HTML and PDF versions) commemorating 100 Years of Protecting and Promoting Women’s Health.

Image Source: Public Domain

Society for Menstrual Cycle Research members and other women’s health advocates and activists will want to look through the list of the accomplishments the FDA claims responsibility for and lists as unequivocal improvements in women’s health.

For instance, we’ve had many discussions at re:Cycling about the FDA approval of the pill in 1960 as one holding mixed benefits for women, and not always the best choice for women’s health. The brochure also asserts that in 1970, “FDA initiated the first package insert written for consumers to explain to women the benefits and potential risks of oral contraceptives.” That happened in 1970, but Barbara Seaman, Alice Wolfson, and the other founding mothers of the National Women’s Health Network had more to do with its initiation than the FDA.

And here’s another inspiring quote from the FDA brochure:

1980: Making Tampon Use Safer

Problem: In 1980, there were 814 confirmed cases of menstrual related Toxic Shock Syndrome (TSS) and 38 deaths from the disease.
Response: FDA began requiring all tampon packages to include package inserts educating women about the risk of TSS and how to prevent it. In 1997, there were only five confirmed menstrually-related TSS cases and no deaths. The tampon package inserts with TSS information continue to be used today.

Sure, the FDA is proud of those safety rules now, but in 1982 the agency asked the industry to come up with their own voluntary standards because they did NOT want to regulate tampon safety. After years of pressure and organizing from Boston Women’s Health Collective members Esther Rome and Judy Norsigian, activist Jill Wolhander, researcher Nancy Reame, and others to standardize tampon absorbency ratings, the FDA finally enacted regulations in 1989, by court order. Nine years after 38 women died from a tampon-related illness.

Just last year, the FDA could have made another decision that would almost certainly save women’s lives, by removing birth control pills containing the synthetic progesterone drospirenone from the market, but instead the advisory panel voted by a four-person margin that the drugs’ benefit outweighed the risks.

You know what else isn’t on the list? Emergency contraception, a.k.a. the Morning After Pill and Plan B. The agency hemmed and hawed and delayed unconscionably for years, until finally approving it for limited over-the-counter availability in 2006 — a year after Susan Wood walked out of the FDA Office of Women’s Health for good over what she believed to be “willful disregard of scientific evidence showing Plan B to be safe.”

Celebrating organizational achievements that advance and protect women’s health is a fine thing. I’m glad Frances Kelsey withheld approval of Thalidomide in 1960, and for the most part, I’m glad the FDA is on the job. But while we’re celebrating women’s health and reminding everyone to be active, eat healthy, and get preventive health care (if they are so fortunate to have access to health care), let’s also celebrate the activists and advocates that keep agencies like the FDA in line.

Off the Pill, Off the Magazines

Guest Post by Holly Grigg-Spall

“Less stressed, thinner and more interested in sex.” – but not buying magazines.

In a recent issue of the UK’s Stylist magazine — a weekly women’s glossy that is available for free at tube stations and selected clothing stores — there was an article headlined ‘What does 10 Years On The Pill Do To You?‘ As a result of my on-going blog, Sweetening the Pill, which documents my experience of coming off the contraceptive pill, I was contacted by the writer to provide some quotes for this piece. Unfortunately, I was edited out. As a journalist myself, I understood this situation has little to do with the writer’s choice of content and more to do with the magazine editor’s final say on what was most fitting for the feature. Yet the title question is the very crux of my blog: having taken the Pill for 10 years, stopping as a result of discovering the answer to this very question.

 

Photo Credit: Anthony Easton // CC 2.0

According to the Stylist piece the answer is that the Pill changes your memory skills, lowers your libido, makes you attracted to the wrong kinds of men for you, changes weight distribution, prevents you building muscles, make you retain water, make you depressed and jealous…and how can you tell if this all is just you or the Pill? You can’t and you shouldn’t try to find out, is the message here. We are advised to not take a break from the Pill, not even for a week, and if you are concerned, just ask for a different brand from your doctor. There is no discussion of non-hormonal alternatives. There is also no discussion of the benefits of not taking the Pill, of allowing your body to ovulate once a month.

 

My answer to this question was: “The Pill has a whole body impact. Taking the Pill shuts down a woman’s hormone cycle — and the ovulation and menstruation that is an essential part of this cycle — and replaces it with a low stream of synthetic hormones. This has an affect on every organ in the body — the impact is wide-reaching and crudely administered. The peaks, troughs, and plateaus of a woman’s ‘natural’ cycle are wiped out. The monthly hormone cycle is integral to many of the body’s central functions, including the metabolic, immune, and endocrine systems. This changes everything — from your sense of smell to your libido to your ability to absorb vitamins from your food.

 

Many women have said to me that coming off the Pill was ‘life-changing’ and, as someone now two years off the Pill after ten years on, I have to agree with the description. The life-threatening potential effects of the Pill get publicity — the blood clots and strokes — but the quality of life-threatening and the emotional and mental effects are barely discussed. Fatigue, muscle loss, urinary tract infections, bleeding gums, stomach disorders, flu-like symptoms, hair loss — relatively minor physical issues caused by the Pill that together can make life very hard. Depression, anxiety, panic attacks, rage, paranoia — all issues brought on by the Pill, due to a combination of switching off the hormone cycle and vitamin B deficiency. I experienced the whole package and when I wasn’t bordering on nervous breakdown I was flatlining, barely able to feel anything at all.”

 

The whole body impact, although alluded to in the Stylist piece, is not considered head-on. What does it mean to take such a powerful drug every day for years when you are not sick? And when there are as effective alternatives for pregnancy prevention? On a second, and third reading of the piece I cannot see mentioned an unequivocal benefit of taking the Pill other than pregnancy prevention until we reach the last refuge of the worried magazine editor — the box-out — in which ‘the benefits of taking the Pill’ are listed. These include pregnancy prevention (of course), protecting women from the already very rare ovarian cancer in a very minimal way, and cutting the risk of iron deficiency anemia. Then cited is that bizarre piece of research that surfaced last year which claimed women on the Pill are 12% less likely to die, of any cause. As though Pill-taking were a key to eternal life. To a studied reader, it’s a paltry gathering of research – even I, as anti-Pill as I am, could come up with a better list. And so why this pushiness in the feature itself when it comes to keeping women on the Pill?

 

Women’s magazines are happy to provide endless advice regarding all elements of women’s lives — from what we should eat to what we should wear to how we should have sex — but when it comes down to the Pill, which at least in the UK the majority of their readers will be on, they are uniformly nervous about passing judgment. We are bombarded with the supposed best and the only and the top ten ways to make every element of our lives better, happier, sexier and more fulfilling, but when it comes to the Pill any tentative dip into the potential negative effects is quickly qualified by a zealous idolatry. This despite the fact that most of the magazines’ preoccupation with improving their readers sex lives would suggest they would be very much against women being sexually dissatisfied and having low libido, as the research cited claims of those who take the Pill. If 50% of women, and so therefore their readers, do experience negative mood changes as a result of the Pill, as is also mentioned here, why not dedicate some time to what these might be and how to notice them? Even better, why not interview some real women about this? Considering the magazines are otherwise full of personal experiences of cancer, domestic abuse, drug addiction, and infidelity, this would seem a natural choice.

 

In the US this jumpiness could be put down to the proliferation of advertising for birth control Pills that pay for the features to be published. But in the UK, direct-to-consumer advertising for drugs is against the law. The one exception I noticed of a brand being discussed encouragingly in a British magazine was on the release of Yaz. It’s skin-clearing and weight loss promises were too much to ignore. In this piece two brands are mentioned and only to reference their relative cheapness in comparison to other Pills and as a consequence their promotion by NHS doctors in the UK. Although I have to say, when I was on the Pill the most expensive one out there was all the rage in doctor’s surgeries – Yaz – which suggests someone somewhere was benefiting monetarily from this.

 

Dr. Erika Schwatz is quoted as saying in response to the question of who a woman would be if she hadn’t taken the Pill for a decade, that “She’d probably be less stressed, thinner and more interested in sex.”

 

A woman who is less stressed, thinner and more interested in sex is, I would guess, less likely to buy a magazine. I buy magazines to make myself feel better, because in my feelings of deficiency I expect a magazine to hold the answers I need to be happier. When you’re stressed and depressed you buy more stuff – because you think that stuff will improve your life. That’s why we call it ‘retail therapy.’ The answer to many questions posed in magazines is to buy more stuff. I doubt this is a conscious understanding by magazine editors, although they do know they only exist because of product advertising. Yet the Pill is part of the agenda of women’s magazines whether they are aware of it or not.

Endometriosis and the Mysteries of Pelvic Pain

Endometriosis in abdominal wall. Photo by Ed Uthman, MD. Public domain.

I’ve recently developed a whole new understanding of why it takes so long for women to receive a diagnosis of and treatment for endometriosis. It’s not just the constraints of menstrual etiquette or the belief that painful periods are normal, especially for young women.

 

It’s about poop. No one wants to talk about that, least of all me.

 

I have endometriosis, and I’ve known it known for years. My doctors know it, too. It was seen through the laparoscope during a procedure for something else when I was about 35. But I’m still having trouble getting a diagnosis and treatment.

 

A flare-up of pain began two months ago, and I went to the clinic for relief and told the responding physician, “I think it might be my endometriosis”, pointing to the low area on my pelvis where it hurts. He asked a lot of questions about my bowels — I’ll spare you the grisly details — and ordered blood tests and an abdominal x-ray. After studying the results, he prescribed treatment for constipation, and urged me to call or return if my pain was not soon resolved.

 

Since that October afternoon, I’ve seen three additional physicians and continue to experience daily pelvic pain. I’ve had more blood tests, another x-ray, and a contrast CT scan, which showed normal bowel function. Perhaps because I had a hysterectomy a few years ago for adenomyosis, my doctors* continued to focus their attention on my ‘bowel problem’, rather than reproductive health issues, even though I retain healthy, functioning ovaries.

 

Until this week, when I finally saw the gastroenterologist. He listened to my description of the pain and its location, and more detail about my bowel habits than I’ve ever had to report since my mother toilet-trained me. And after a brief examination, he referred me back to the gynecologist who performed my hysterectomy. That’s right — he found nothing wrong with my bowels. My appointment with the gynecologist is early next week, and I’m optimistic that I will finally have an answer about the source of my pain, and even better, a means to resolve it.

 

For me, a well-educated, 48-year-old ciswoman with good health insurance who already knows she has endometriosis, this has been only two months of dealing with pain and the annoyance of waiting and medical bureaucracy. I can only imagine what kind of torment this might be for women with more severe symptoms without these resources, and without the knowledge that endometriosis frequently presents as, or with, gastrointestinal symptoms. Doctors who don’t specialize in women’s reproductive health may not even know this. Frequently, the symptoms of endometriosis are bowel symptoms:

• Painful bowel movements
• Constipation
• Diarrhea
• Alternating constipation and diarrhea
• Intestinal cramping
• Nausea and/or vomiting
• Abdominal pain
• Rectal pain
• Rectal bleeding

I’m reminded again of my friend and colleague Laura Wershler’s frequent calls for body literacy; we need to know our own bodies, and know how to talk about them. I can talk about menstrual cycles until the cows come home, but it has been a real challenge to observe and talk about the details of bowel habits, even with my trusted physician.

 

Good health requires good communication.

 

P.S. I’m still in pain, and it’s really hard to say this in public, but thank you, Dr. S., for recommending the daily dose of MiraLax.

 

 

*I’m compelled to note that, Dr. S., my primary care physician, or ‘PCP’, as my health insurance plan refers to him, is a wonderful doctor. I really don’t have complaints about his care, and I have pretty good health insurance, and I’m lucky to have both.

Have You Had HPV? Tweet It Today!

The Village Voice has declared today, Friday, September 16, ‘Tweet That You Have Had HPV Day’.

U.S. readers probably know that on Monday, Congresswoman Michele Bachmann upbraided Texas governor Rick Perry for requiring girls in his state to have the vaccine during a Tea Party sponsored debate among Republican candidates for the presidential nomination, and then claimed the HPV vaccine causes ‘mental retardation’.

One dramatic response came on Twitter from writer Ayelet Waldman, who wrote that she got HPV from her husband in a monogamous marriage, and had to have cervical lesions removed. She was promptly told to keep that to herself, it was TMI, and that it was probably her fault for being slutty. (For an excellent critical summary of the whole kerfuffle, read Jill’s post at Feministe.)

HPV is easy to spread and hard to detect. From the CDC:

HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners–even when the infected partner has no signs or symptoms.

A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.

HPV is easily spread, but can be prevented and treated. As the Village Voice article asserts, “Perhaps the greatest danger in the battle against HPV is one of PR. People are ashamed (after all, it’s an STD), and women in particular are shamed. No one wants to admit it, no one talks about it, and when people do, it’s in whispers and there’s a lot of misinformation.”

So talk about it, tweet about it, and don’t be ashamed. Fight sex negativity.