Clitoris plays a part in reproduction

A recent study claims that the female clitoris is vital for the reproduction process.

The review notes that stimulating the clitoris activates the brain to cause a combination of changes in the female reproductive tract that creates its readiness to receive and process sperm to achieve possible fertilisation of the egg.

These include enhancement of vaginal blood flow, an increase in vaginal lubrication, an increase in vaginal oxygen and temperature, and most importantly a change in the position of the cervix, the entrance to the uterus.

This change brings the cervix away from the semen pool and prevents semen from travelling into the uterus too rapidly, this allowing sperm time to become mobile and activates to fertilise the egg.

Therefore, the clitoris has both procreative ( reproductive( and recreative ( pleasure) functions, reported the study.

Removal of the clitoris- which is performed in some countries and cultures not only a sexual disability but also a possible reproductive disability.

The often repeated mantra, that the sole function of the clitoris is to induce sexual pleasure, is now obsolete, said the review's author.

The concept changes a major sexual belief and the physiological evidence is now obvious, he concluded.

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New treatment strategy brings hope of genital herpes cure

Genital herpes is a sexually transmitted disease. It infects both men and women. It can spread either by having vaginal, anal or oral sex with a person affected by the same. This disease though not life threatening like other forms of STDs, has no cure and one has to live with its consequences for life. Like most other STDs, genital herpes spreads silently without showing any obvious symptoms of the same.

Herpes simplex virus (HSV) type 2, which causes genital herpes, is very common and it affects more than 400 million people globally. Till date there is no cure for this condition and efforts to develop a vaccine have had limited success. Active herpes infection causes painful lesions that are physically and emotionally harmful to affected people.

But now researchers from Yale University say that the combination of a vaccine and a medicated cream may help to dramatically reduce the recurrence of genital herpes. Researchers at the University of Pennsylvania and University of Cincinnati Children’s Hospital Medical Center also participated in this study.

Novel strategy for genital herpes treatment shows promise:

During the course of the study, researchers tested a novel vaccine strategy, known as prime and pull, in guinea pigs infected with genital herpes. The ‘prime’ involves a vaccine that generates a response to the virus from T cells. These are highly specialised immune cells. The ‘pull’ was a cream that contained imiquimod. This is a medication commonly used to treat genital warts. They noticed that when this was applied to the affected area, the cream attracted key immune cells to the site of infection. There they blocked the virus from spreading and causing herpes lesions.

The study demonstrated that the effect of the combination therapy, was greater than either the vaccine or cream alone. The research team gave three rounds of treatment to the animals. The strategy worked rapidly right from the first round itself.

Researchers say that if this strategy is developed into a therapy for humans, it could be a game changer for individuals with recurrent infections or resistance to standard antiviral treatment.

What causes genital herpes?

Genital herpes is caused by two types of viruses called herpes simplex type 1 and herpes simplex type 2. It is most common in people in the age group of 14 to 49 but is also seen in older adults.

With herpes infection, sores or blisters are usually seen on the genitals of the infected person. These sores are filled with fluids that carry the virus. If a healthy person comes in contact with these fluids, the disease can be transmitted. Remember even if the symptoms of the disease are not prominent i.e., the sores aren’t present yet in the infected person, it can still be transmitted to the other partner during a sexual intercourse.

What are the symptoms of genital herpes?

One might not see any visible symptoms soon after being infected with the herpes virus. But as the infection grows and spreads it starts to show some mild symptoms.

The initial symptoms could be ‘pimples’ or ‘zits’ appearing on the genital areas of the one infected with herpes. Sometimes such signs are even seen around the mouth area too. Many times, people with herpes mistake these initial symptoms for a skin condition or as an allergy.

As the infection spreads the sores grow and start to appear more like blisters around the genitals, rectum and the mouth area. There can be one or more blisters at one spot at a time. If neglected and left untreated, the sores can break open and can cause pain. This outbreak is usually followed by flu-like symptoms such as fever, body aches and swelling in the lymphatic glands. Usually the first attack of herpes is the worst and can take a toll on the person infected with it. These outbreaks can take upto several weeks to heal even with treatment.

Once infected the virus stays in the body for the rest of their life despite treatment and care. In such a scenario one can face episodes of repeated outbreaks. However, the outbreaks after the first one are usually shorter in duration and less painful. Also the number of outbreaks tend to decrease over a period of years.

Symptoms that can indicate a herpes infection other than sores or the outbreaks are smelly discharge, a burning sensation during urination and painful intercourse. Apart from this unusual vaginal bleeding between periods among women is also noticed.

How is genital herpes diagnosed and treated?

The diagnosis of genital herpes can be done symptomatically. Sometimes the doctor might even take swabs from the open sores to check for the presence of the virus.

Unfortunately, genital herpes has no cure. However, it can be managed efficiently with treatment. Regular medications can keep the symptoms in check and make it less likely to transmit the same to the partner during an intercourse.

In case of women who are pregnant and infected with herpes, special pre-natal care is necessary. Sometimes the infection can also lead to a miscarriage or premature delivery. A herpes infection can spread from a mother to the child. Medications are given to a pregnant woman during the last trimester to prevent transmitting the disease to the baby. Usually a C-section is performed on a mother who is suffering from herpes to save the baby from getting infected while birthing.

How can you prevent genital herpes?

To save yourself from genital herpes, always practise safe sex. Use latex condoms during sexual intercourse and dental dams during oral sex. Avoid having sex with multiple partners and practise monogamy. This can save you from getting infected with any type of STD. If the infection is already present talk to your partner about your health and the potential risks involved. Remember even if the signs of the disease are suppressed you can still pass the infection to your partner.

Condoms and dams can only cover the sores that are present in the genital areas and the mouth. But the blisters can also appear elsewhere in the body. Coming in contact with the fluids of the sores in case of an outbreak can also contribute in transmitting the disease. Hence, using condoms alone isn’t protection enough to limit the transmission of the disease.

Maintain proper hygiene and always wash hands thoroughly to prevent herpes from spreading to other parts of the body in case there are open sores. Herpes is not curable. So, always talk to your partner and keep your doctor in the loop to know how you can prevent the disease from coming in the way of good health and a happy sex life.

Living with genital herpes

The condition has no cure but can still be managed, though it can erode the quality of life and sexual health badly. Ignoring treatment can make it worse for those who have a suppressed immune system. Prolonged infection without proper care and treatment can also make one vulnerable to other potent forms of STD like AIDS. It is wise to follow proper treatment and guidance given by a sex therapist.

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Every 25th person in the world has a sexually transmitted infection

More than one million new cases of curable sexually transmitted infections are diagnosed everyday in the age group of 15-59. The World Health Organization (WHO) came out with this finding in a new report on four sexually transmitted infections’ (STIs) burden in 2016. The total estimated burden in the year was 376.4 million.

There were 127 million new cases of chlamydia, 87 million cases of gonorrhoea, 6.3 million of syphilis and 156 million of trichomoniasis.

Approximately 13.5 per cent (50.8 million) of these infections occurred in low-income countries, 31.4 per cent (118.1 million) in lower middle-income countries, 47.1 per cent (177.3million) in upper middle-income countries and 8 per cent (30.1 million) in high-income nations, according to the report.

The research also showed that the prevalence of chlamydia, gonorrhoea and trichomoniasis increased more in women than men.

Chlamydia, syphilis and gonorrhoeaare bacterial infections spread through vaginal, anal or oral sex. And trichomoniasis is caused by a parasite called Trichomonasvaginalis.

Like Chlamydia, syphilis and gonorrhoea, trichomoniasis also spreads through sexual contacts. Both males and females are susceptible to all these four infections.

On an average, one in every 25 people in the world has at least one of these infections and some have more than one. And there is no subsequent decline in the condition since the last research in 2012.

“We’re seeing a concerning lack of progress in stopping the spread of sexually transmitted infections worldwide,” said a WHO executive. “This is a wake-up call for a concerted effort to ensure everyone, everywhere can access the services they need to prevent and treat these debilitating diseases.”

STIs spread through unprotected sexual contact and can also be transmitted during pregnancy and or in case of syphilis, through contact with infected blood.

If untreated, STIs can lead to many health problems including infertility, problems in pregnancy, and increased risk of HIV. According to an estimation mentioned in the WHO report, syphilis caused two lakh stillbirth and newborn deaths in 2016.

All bacterial STIs can be treated and cured with widely available medications. However, an article published by WHO stated that recent shortages in the global supply of benzathine penicillin, which is an antibiotic useful for the treatment of a number of bacterial infections, have made it more difficult to treat syphilis.

Rapidly increasing resistance to gonorrhoea treatments is also a growing health threat. The World Health Assembly in 2016 aims to take necessary steps to end STIs as public health concern by 2030.

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A cancer drug may help treat human papillomavirus infections

Pre-clinical experiments by  researchers suggest the cancer drugs vorinostat, belinostat and panobinostat might be repurposed to treat infections caused by human papillomaviruses, or HPVs. 

HPV infections caused an estimated 266,000 deaths from cervical cancer worldwide in 2012, according to the World Health Organization. Routine screening by Pap smears or HPV DNA tests has reduced death rates in developed countries compared to less developed regions of the globe. Still, an estimated 12,200 United States women are diagnosed with cervical cancer each year.

Highly efficacious vaccines against HPV infection exist—including the recently approved Gardasil 9, which immunizes against nine genotypes of HPV known to cause cervical, vulvar, vaginal and anal cancers, and genital warts. But the vaccine needs to be given before a person becomes sexually active, since it has no therapeutic efficacy against existing HPV infections.

"Safe, effective and inexpensive therapeutic agents are urgently needed," said an assistant professor of Biochemistry and Molecular Genetics.

Epithelium of anogenital sites—the cervix, penis and anus—or epithelium of the mouth and throat are sites of HPV infection. But HPVs cannot be propagated in conventional cell culture, hampering the investigation into their pathogenic effects. The researcher has investigated HPV-host interactions for decades. They discovered that the productive program of HPV depends on differentiation of the epithelium into a full-thickness, squamous epithelium. Furthermore, HPV reactivates host DNA replication in these differentiated cells, such that the replication proteins and substrates become available to support viral DNA amplification.

A researcher re-produced a fully differentiated human squamous epithelium by culturing primary human keratinocytes at an air-media interphase for two to three weeks, a growth they call raft culture. In 2009, their lab developed a breakthrough model for a raft culture of HPV-18-infected primary human keratinocytes, allowing a robust amplification of HPV-18 DNA and production of infective viral progeny. This productive raft culture is an ideal model for preclinical investigation of potential anti-HPV agents.
 
The  hypothesized that inhibitors of histone deacetylases, or HDACs, would inhibit HPV DNA amplification because of their known mechanism of disrupting chromosomal DNA replication. Chromosomal replication requires HDAC alterations of histone proteins, the proteins that act like spools that wind DNA to help package and condense chromosomes and the viral genome. Vorinostat inhibits many HDACs, so it might interrupt not only chromosomal replication but also viral DNA replication.

Using the HPV-18 model raft cultures, the researchers found that vorinostat effectively inhibited HPV-18 DNA amplification and virus production. Importantly, vorinostat also induced the programmed cell death called apoptosis in a fraction of the differentiated cells. Cell death could be attributable to DNA breakage when chromosomal DNA replication was interrupted. Similar results were obtained with two additional HDAC inhibitors, belinostat and panobinostat. In contrast, the differentiated cells of uninfected raft cultures, which do not replicate their DNA, were thus largely spared in the presence of the inhibitors.

The team also examined how vorinostat affected levels and functions of viral oncoproteins, and they described the mechanisms that led to programmed cell death in HPV-18-infected cultures. "On the basis of these detailed studies," the Prof. said, "we suggest that HDAC inhibitors are promising compounds for treating benign HPV infections, abrogating progeny production and hence interrupting infectious transmission."

The  team also reported that vorinostat caused extensive cell death in raft cultures of dysplastic and cancer cell lines harboring HPV-16. HPV-16 and HPV-18 are the most prevalent, high-risk HPVs responsible for causing anogenital and oropharyngeal cancers. "But further investigation would be required to verify that these agents could also be useful in treating HPV associated dysplasias and cancers," the Prof. said. 

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Vaginal progesterone treatment may help pregnant women cut preterm birth risk

Treatment with vaginal progesterone in women with a short cervix and a twin pregnancy may reduce the risk of preterm birth, claims a new study.

The results indicated, women who received vaginal progesterone were 31% less likely to deliver before 33 weeks of pregnancy.
The findings come from an Ultrasound in Obstetrics and Gynecology meta-analysis of six studies encompassing 303 women pregnant with twins, all of whom had a cervical length of 25 mm or less in the mid-trimester.

About 159 women received vaginal progesterone and 144 received a placebo or no treatment.

Vaginal progesterone also reduced the rate of preterm delivery before 32 weeks and 34 weeks.

Infants born to patients who received vaginal progesterone had a 30% reduction in the rate of respiratory distress syndrome, the most common complication of prematurity, a 46% reduction in the rate of mechanical ventilation and a 4% reduction in the risk of dying in the neonatal period.

“To date, clinical practice and national recommendations to prevent preterm birth and reduce related adverse outcome in twin pregnancies vary significantly because of a lack of convincing scientific evidence and regional variation in the interpretation of said evidence,” said Basky Thilaganathan, Ultrasound in Obstetrics and Gynecology’s chief.

“The findings of this individual patient data meta-analysis provide scientific evidence that treatment with vaginal progesterone in women with a short cervix and a twin pregnancy reduces the frequency of preterm birth and related serious adverse perinatal outcomes,” Thilaganathan added.

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Novel drug may prevent vaginal, oral transmission of HIV

Researchers have demonstrated the effectiveness of a new anti-HIV drug that has the potential to prevent vaginal and oral transmission of HIV, in pre-clinical animal models.

The findings showed that 4′-Ethynyl-2-fluoro-2’deoxyadenosine or EFdA, can prevent vaginal and oral transmission of HIV.  Each year, nearly 1.5 million women living with HIV become pregnant globally.
Without effective treatment, up to 45 per cent of such mothers transmit the virus to their child, usually through breastfeeding, the researchers said.

“The study discovered that EFdA can prevent vaginal transmission of HIV, which would prevent new infections in women,” said lead author Martina Kovarova, Assistant Professor at University of North Carolina, in the US.

In addition, EFdA can also prevent oral transmission of HIV which would prevent infants who are born to mothers already living with HIV from acquiring the virus during breastfeeding.

In the study, the team tested the efficacy of EFdA in vivo using validated pre-clinical humanised mouse models of vaginal and oral HIV transmission. 

In both studies, a daily dose of EFdA was able to prevent HIV infection in mice that were exposed multiple times to high doses of HIV.

“The availability of an anti-HIV drug that is potent enough to be used as a preventative agent in both women and infants has the potential to make a significant impact on the global HIV epidemic,” added Angela Wahl, Assistant Professor at University of North Carolina’s School of Medicine. 

The results were published in the Journal of Antimicrobial Chemotherapy.

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Good bacteria that protects against HIV identified

Can bacteria keep the deadly Human Immunodeficiency Virus (HIV) at bay? Experts from the University of Texas Medical Branch at Galveston believe so. In an article written in the PLOS ONE journal, they have said that they have identified some good bacteria'' that could protect women from HIV infection and other sexually transmitted infections.

A press release put out online by the university said they had identified the good bacteria after growing vaginal skin cells outside the body and studying the way they interacted with "good and bad" bacteria.

"The health of the human vagina depends on a symbiotic/mutually beneficial relationship with "good" bacteria that live on its surface feeding on products produced by vaginal skin cells. These good bacteria, in turn, create a physical and chemical barrier to bad bacteria and viruses including HIV,'' said the release.

The research team, led by Richard Pyles, said they discovered that certain bacterial communities alter the way HIV infects and replicates. In their current studies, a bacterial community associated with a symptomatic condition called bacterial vaginosis substantially reduced the antiviral activity of one of the leading anti-HIV medicines. Conversely, vaginal surfaces occupied by healthy bacteria and treated with the antiviral produced significantly less HIV than those vaginal surfaces without bacteria treated with the same antiviral.

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