Wednesday, January 08, 2020

Millions of Girls May Be Getting Unnecessary Pelvic Exams, CDC Finds

Millions of girls and young women may have been subjected to invasive pelvic exams and pap smears they didn't need, according to estimates from researchers at the University of California San Francisco and the Centers for Disease Control and Prevention. A new study, states that as many as 1.4 million patients between the ages of 15 and 20 may have had unnecessary pelvic exams within a year.

The  American College of Obstetrics and Gynecology no longer recommends pelvic exams — which involve a physician inserting two fingers into the vagina, to check for abnormalities or infection — for most people under the age of 21, and hasn't since 2009. If a patient presents with particular symptoms, such as pain or the inability to insert a tampon; or if they are pregnant; or if they are getting an IUD, a manual exam could be warranted. But many people find the exams painful or uncomfortable, and given the potential risk of “false-positive test results, over-diagnosis, anxiety, and unnecessary costs,” as the authors point out in the study, there’s not much reason to perform them on people in this age group. There are less invasive STI-testing methods available, and while HPV has long been a concern for young people, pap smears to test for cervical cancer also aren’t recommended until the patients turn 21.

And yet pap smears, according to the study, tended to accompany pelvic exams. The researchers analyzed survey data from 2011 to 2017, sourced from 3,410 girls and young women aged 15 to 20. Very few respondents reported STI treatment (4.5 percent), pregnancy (4.8 percent), or IUD use (2 percent) within a 12-month period. Still, within the same time frame, about 2.6 million girls and young women in the same age bracket reported having received a pelvic exam, and 2.2 million said they’d received pap smears. Based on the data, the researchers concluded that 54.4 percent of those exams, and 71.9 percent of those pap tests, may have been unnecessary.

Dr. George Sawaya — professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco, and the study’s lead author — told that the team didn’t know why these procedures remained so widespread, although it may have something to do with habit.

Nonetheless that researchers “want to empower girls and young women to ask, ‘Why do I need this exam?’” if their gynecologist suggests one. To judge by this data, there’s a good chance they don’t.

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Tuesday, October 22, 2019

Reasons why your periods are missing and you are not pregnant

Reasons why you are missing your periods without being pregnant

 Ladies, what’s the first thought that comes to your mind when you miss your periods? Am I pregnant? Right?
According to experts, the first thing that most women think when they miss their period is if they are pregnant. But allow us to break the news to you, not every missed period means you are pregnant. This could be disappointing for some but happy news for many.
So, before you run to a medical shop to buy the pregnancy test kit, here are six other reasons why your period's cycle might be off.

You're on birth control
Most people think that taking birth control will lead to more regular periods, but women who take extended-cycle birth control pills do not experience a typical 28-day cycle. Some contraceptives delay the time between periods. Some other types of birth control like IUDs can also cause late or irregular period. 

​Polycystic ovary syndrome (PCOS)

Women who have PCOS have additional follicles, which makes the process take longer than the normal. Because no released egg means no periods. Some other PCOS symptoms include an increased level of testosterone levels and weight gain.  

Stress

Stress can cause havoc with your hormones, which in turn can affect the duration between two menstrual cycles. Change in hormones can also affect the part of the brain that is responsible for regulating periods – hypothalamus. Stress can also lead to weight gain or weight loss, which can also impact your menstrual cycle.  

Lower body weight 

Women with eating disorders like bulimia or anorexia nervosa might experience missed periods. Weighing 10 per cent less than the ideal weight can change the way body functions and the dates of ovulation. Putting on some weight and getting back to normal can help you get back your cycle to normal. Sometimes extreme sports can also lead to missed periods, though no study has proven the same. 

Perimenopause

The average at which women experience menopause is 51 but there are many who start getting delayed periods in their late 40s. If you are under 45 years of age and your periods stops completely, you might be going through early menopause or are experiencing premature ovarian failure.  

Diabetes or thyroid

Diabetes and thyroid can be associated with absent or late periods. Thyroid can make your periods light, heavy or even irregular. It can even stop your periods for several months, it’s called amenorrhea. 

 

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Friday, June 14, 2019

Contraceptive injections do not increase risk of contracting HIV

A landmark study has ended 30 years of anxiety that hormonal contraceptive injections may increase women’s chances of infection from HIV.

But the study found a dramatically higher rate of HIV infection among women in southern Africa than was expected, which one leading campaigning organisation said signified a public health crisis”.
In many African countries with high HIV rates, women predominantly use DMPA-IM, known as Depo-provera – three-monthly injections that allow them to keep their use of contraception secret from their partner. 

For three decades there have been concerns and in 2011 the Lancet published evidence that women using the progestogen-only injections to avoid pregnancy were twice as likely to become HIV-positive.

In 2012 the World Health Organization advised couples to use condoms as well, which is not always negotiable in some communities. In sub-Saharan Africa, nearly 60% of all new infections occur in women. There were calls for new methods of contraception that would also prevent HIV and be controlled by women themselves.

Further research published in 2015 found that women using the injections for contraception were 40% more likely to get HIV. However, the authors said the dangers had to be balanced against a woman’s risk of an unwanted pregnancy, which could also jeopardise her life. The WHO said in 2017 that women should be advised of the risk.

The new study, called Echo (Evidence for Contraceptive Options and HIV Outcomes),  was designed to put an end to the controversy. It compared the HIV infection rates among women using hormonal injections with those using an IUD (intrauterine device or coil) or an implant. It involved more than 7,800 women in Eswatini, Kenya, South Africa and Zambia.

“Our randomised trial did not find a substantial difference in HIV risk among the contraceptive methods evaluated, and all methods were safe and highly effective at preventing pregnancy,” said one of the study’s co-authors.

The WHO will now review its guidance and is likely to say that women should no longer be concerned about the injectables or have to choose between the possibility of pregnancy and the fear of HIV infection.

But there is alarm at the high rate of HIV infection among the women in the trial – which was 3.8%, and worse in women under 25. The infection rate was higher than the “substantial risk” rate of 3% that the WHO says should trigger the use of PrEP (pre-exposure prophylaxis), a daily antiviral drug which protects against infection.

“The study highlights the need to step up HIV prevention efforts in these high-burden countries, particularly for young women,” said a Dr. , of the WHO’s HIV and Hepatitis department. “These should include providing HIV testing and a range of HIV prevention choices within contraceptive service programmes.”

A member of the study’s management committee, said: “The results on this question are reassuring but our findings are also sobering because they confirm unacceptably high HIV incidence among young African women.”

AVAC, a global HIV advocacy organisation, said there was good news and bad news. The trial had shown that the injectables were safe. On the other hand, it “delivered a sobering reminder that women and girls in east and southern Africa are still at very high risk of HIV infection. An overall HIV infection rate of almost 4% in the study points to a public health crisis for women in the region,” said  AVAC’s executive director.

The trial participants were not considered to be at high risk. “The women in this trial are our sisters and daughters and mothers who were simply seeking contraception,” said executive director of the International Community of Women Living with HIV/AIDS Eastern Africa. “It is a wake-up call to put HIV prevention onsite at every family planning clinic, including PrEP and female condoms with peer support and trained providers.”

A member of the global community advisory group for the Echo study, said women needed more options for contraception combined with HIV protection. “Regardless of the data from the Echo trial, the limited choice of contraceptives that women have is not OK. We hope that this result will prompt action and put women first. Women want more options,” she said.


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Wednesday, November 08, 2017

IUDs may prevent cervical cancer risk

Intrauterine devices (IUDs), considered as a safe and highly effective contraception method, may also offer protection against cervical cancer, says a recent study. According to the World Health Organisation (WHO), approximately 528,000 women were diagnosed with cervical cancer worldwide in 2012, and 266,000 women died from the disease making it the third-most-common cancer in women worldwide.

The WHO projects that by 2035 these numbers will climb to more than 756,000 and 416,000, respectively. The findings showed that using IUD can dramatically decrease the incidence of cervical cancer by a third.

“The possibility that a woman could experience some help with cancer control at the same time she is making contraception decisions could potentially be very, very impactful,” said lead author.

For women in developing countries, where cervical cancer prevention resources such as the human papillomavirus (HPV) vaccine or regular cervical screenings are scarce, a contraceptive that offers protection against cervical cancer could have a profound effect.

“A staggering number of women in the developing world are on the verge of entering the age range where the risk for cervical cancer is the highest — the 30s to the 60s.

“Even if the rate of cervical cancer remains steady, the actual number of women with cervical cancer is poised to explode,” author said. “IUDs could be a tool to combat this impending epidemic,” Dr. noted.

For the study, the team included data from 16 high-quality observational studies involving more than 12,000 women worldwide. As per some scientists, it is the placement of an IUD that stimulates an immune response in the cervix, giving the body an opportunity to fight an existing HPV infection that could one day lead to cervical cancer.

Another possibility may be that when an IUD is removed, some cervical cells that contain HPV infection or pre-cancerous changes may be scraped off.

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