below the waist

RECENT POSTS

March 21, 2012 | 3:03 PM | By

HuffPost: Hundreds of Genital Injuries, Hidden Toll Of Afghanistan

Source: Wikimedia Commons


The Huffington Post describes here a toll of Afghanistan combat that I’ve never heard mentioned before — hundreds of horrible genital injuries. Of course it stands to reason that IED’s blasting upward would cause such harm, but it surely took special courage by the young men featured in the story to talk about it and its unimaginably difficult emotional aftermath. From the HuffPost:

The decade of U.S. combat in Afghanistan has left Afghans and Americans with a seemingly endless series of woes. But among the most devastating are the blast wounds that have left more than 16,000 young Americans severely wounded.

Several hundred have suffered genital injuries in addition to amputations and burns, leaving them unable to father children and struggling to engage in something resembling the sex they used to have, often without the aid of what many view as the primary symbol of their manhood.

“Who’s going to want to be with me now?” wondered Marine Staff Sgt. Glen Silva, 39, after an IED blast shattered his leg, ripped open his lower torso and severed most of his penis.

Read the full post here.

FILED UNDER: Medicine/Science, below the waist
November 11, 2011 | 9:14 AM | By

What Went Wrong With Vaginal Mesh: The Podcast

Radio Boston ran a short piece on the problems with vaginal mesh earlier this week, but a key voice didn’t make the final cut: Dr. Anne Weber, a urogynecologist, formerly with the NIH, was the lead author of a clinical practice bulletin on pelvic organ prolapse published by the influential professional group, the American College of Obstetricians and Gynecologists.

In the bulletin, published back in 2007 Dr. Weber used the word “experimental” to describe a type of surgery in which synthetic mesh is implanted vaginally to repair prolapse, a condition many women face after childbirth and as they age in which tissues become stretched and weakened and pelvic organs, such as the bladder, can sag or bulge into the vagina. Seven months after the original bulletin was published, it was pulled, and replaced with another bulletin on prolapse, this one with the word “experimental” gone.

Dr. Weber says the revision, which she opposed, was based on some doctors’ fear that insurers would not cover a procedure deemed experimental. “I think ACOG was choosing to protect its clinicians’ insurance incomes over patients’ well being,” she told me in an interview.

You can read more about the controversy, and about why vaginal mesh surgery is now under scrutiny, here.

So, for the record, here’s the full Radio Boston segment, with Dr. Weber’s comments included.

Vaginal Mesh: November 11, 2011
FILED UNDER: Insurance, Medicine/Science, Money, Personal Health, below the waist, prolapse, surgery, urogynecology, vaginal mesh, women's health
November 4, 2011 | 1:46 PM | By

Surgery Under Scrutiny: What Went Wrong With Vaginal Mesh

On a rainy night in early September, six women gathered for dinner at a Macaroni Grill restaurant in Gaithersburg, Maryland. They had come from around the country: Utah, Georgia, Florida, New York, Texas. But their mood wasn’t festive. All six were in town to speak publicly about their personal medical traumas in front of an advisory panel for the U.S. Food and Drug Administration.

Between them, the women figured they had undergone 45 surgical procedures to try to undo the damage resulting from vaginal surgery using synthetic mesh devices. The mesh implants were supposed to free them from the intimate discomforts that millions of women face after childbirth and as they age: pelvic organ prolapse, in which stretched, weakened tissues can allow the bladder or other organs to sag or bulge into the vagina, and stress urinary incontinence, which can lead to involuntary leakage with every laugh or cough. Once implanted, the hammock-like mesh was meant to shore up the supportive pelvic tissues and help keep sagging organs in place.

But rather than fix their problems, the mesh led to a range of far more awful complications. For some, the material eroded through the vaginal lining, causing infections and nerve damage, as well as excruciating pain, the inability to sit down or urinate without a catheter, multiple hospitalizations and a halt to their sex lives.

“I was in the most horrendous pain I’ve ever experienced,” said Amy Gezon, a 43-year-old mother of three and one of the women who testified before the FDA advisory panel. “I finally ended up in the ER after expressing a desire to end my life just to escape the pain. If I knew one-tenth of the information out there in the literature…I would have never consented to this surgery.”

A Higher-Risk Device

The FDA, which has already detailed the serious complications linked to vaginal mesh surgery in a series of public health alerts – one in 2008 and an update this summer – is now considering reclassifying some of the devices into a higher-risk category that would require more evidence of safety and effectiveness, including clinical studies. Continue reading →

FILED UNDER: Insurance, Medicine/Science, Money, Personal Health, below the waist, fda, special report, urogynecology, vaginal mesh, women's health
October 12, 2011 | 12:14 PM | By

CDC: 8 In 10 Teen Boys Use Condoms When Losing Virginity

I know they say that the brain’s planning areas tend to develop particularly late in teen boys, but the latest figures from the CDC on condom use are highly heartening: The number of teen boys who used condoms “at first sex” rose 9 percentage points between 2002 and 2010.

Clearly, when it matters, they’re planning ahead.

The full release from the CDC is below — including the latest snapshot of teen sex nationwide — and the full study is here.

More teen males using condoms

The percentage of teen males aged 15-19 years in the United States who used a condom the first time they had sex increased between 2002 and 2006-2010, according to a report from the Centers for Disease Control and Prevention.

The report, “Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2006-2010 National Survey of Family Growth,” from CDC’s National Center for Health Statistics, found that 8 in 10 teen males used a condom at first sex, an increase of 9 percentage points from 2002. The study also found that 16 percent of teen males used a condom in combination with a female partner’s hormonal method, a 6 percentage point increase from 2002.

Other findings include:
In 2006-2010, about 43 percent of never-married female teens (4.4 million), and about 42 percent of never-married male teens (4.5 million) had had sexual intercourse at least once (were sexually experienced). These levels of sexual experience have not changed significantly from 2002, though over the past 20 years there has been a decline in the percentages of those who were sexually experienced. Continue reading →

FILED UNDER: Personal Health, adolescent health, below the waist, contraception
September 26, 2011 | 12:32 PM | By

Did ‘Our Bodies Ourselves’ Change Your Life?


One after another, the women of all ages came to the audience microphone and instead of discussing the film they’d just seen, they paid homage and offered heartfelt thanks to Judy Norsigian for a book that changed their lives.

At least, that’s my memory from a screening and panel discussion I attended a few months ago — and the film was quite a provocative one, too. It’s just that women whose eyes have been opened by Our Bodies, Ourselves, which is written by a collective that Judy helped found, tend to feel a burning sense of gratitude — and this was a rare chance to express it.

This weekend offers another chance: A celebration and conference on global women’s health at Boston University, marking the iconic book’s 40th anniversary and the release of its latest version. I see from the Website that the event is already full, but there’s a waiting list and it will be Webcast here.

Readers, did Our Bodies Ourselves change your life? Let us know how, below (and you can email your account to the book’s blog, as well, here.) I’d share more if my own memory weren’t such a sieve, but my recollection is that it was my most important source of information about sex and my own anatomy when I was a teenager and beyond.

Radio Boston aims to air a segment with Judy Norsigian sometime soon, and USA Today does a wonderful job today of summing up the era that spawned OBOS, as it’s widely known, and the book’s sweeping impact. It also shares the disturbing news that the OBOS collective is ever on the verge of going under, and now is no exception:

More than 4 million copies of the book have been sold; an additional 300,000 have been donated to women’s groups worldwide. It has been published in more than 20 languages and updated in nine incarnations, yet the collective struggles, Norsigian says.

“We’re always on the edge of going under,” she says. “Part of the problem is we have all these principles — we won’t take drug company money, or advertising, plus we’re about raising consciousness. … We’re too radical for some funders and not radical enough for others. We’re facing possibly going under next year.”

FILED UNDER: Medicine/Science, Money, Personal Health, below the waist, our bodies ourselves, women's health
July 7, 2011 | 2:51 PM | By

Are Romance Novels Bad For Your Health?


The scorn among tweeters is already mounting, as word spreads that a new journal article suggests that romance novels are unhealthy: “Come on!” “Really.” “Puh-leeze.”

But I don’t care. I don’t know about my health, but I have no doubt that romance novels were hideously bad for my psyche when I read them as a teenager. I remember emerging from “Sweet Savage Love,” staring into the mirror and grieving the fact that I would never, ever look anything like the exquisite heroine with her long auburn locks and green gypsy eyes. And the sex scenes! It takes decades to get over the false ideas conveyed, the effortless simultaneous orgasms and uncontrollable passions…

So I’m happy to pass along the article that’s raising the Twitter hubbub: It’s here in the “Journal of Family Planning and Reproductive Health Care,” under the title ““He seized her in his manly arms and bent his lips to hers…’. The surprising impact that romantic novels have on our work.” It describes the typical fare of romance novels, including the “beautiful but passive virgins whose sexual desire was awakened by their perfectly-choreographed seduction at the hands of a highly-skilled alpha male.” Then it warns:

Clearly, these messages run totally counter to those we try to promote. We don’t condone non-consensual sex. We want women to be aware of their own desires rather than be ‘awakened’. We aim to reassure our female clients that their first time may not be utterly joyful and that they may not gain reliable orgasms through penetration, but that they themselves are none the less existentially valid and that with affection and good humour things can improve immensely. We warn of the stresses of pregnancy and child-rearing, and we discourage relentless baby-making as proof of a relationship’s strength. Above all, we teach that sex may be wonderful and relationships loving, but neither are ever perfect and that idealising them is the short way to heartbreak. But are our lessons falling on deaf ears when compared to the values of the Regency heroine gazing adoringly across the Assembly Rooms to catch a glimpse of her man?

There’s a final, worrying difference between sexual health professionals and the producers of romantic fiction. To be blunt, we like condoms – for protection and for contraception – and they don’t. In one recent survey, only 11.5% of romantic novels studied mentioned condom use, and within these scenarios the heroine typically rejected the idea because she wanted ‘no barrier’ between her and the hero. Even more worryingly, while the romance readers interviewed said that they knew that such episodes were fiction, and that spontaneous sexual encounters are never risk-free, nevertheless there was a clear correlation between the frequency of romance reading and the level of negative attitude towards condoms and the intention to use them in the future. Continue reading →

FILED UNDER: Personal Health, below the waist, sexuality, women's health
May 13, 2011 | 12:52 PM | By

Podcast Friday: Sex After Cancer, New Cystic Fibrosis Drug

In this week’s podcast, audio versions of two recent CommonHealth hits:

  • Sex After Cancer: Among the nearly 12 million cancer survivors in the U.S., many suffer from sexual problems related to their cancer of the treatment to fight it. Rachel Zimmerman details the problems, talks to patients and tracks one psychologist’s efforts to bring pleasure back to patients.
  • New Drug For Cystic Fibrosis: A still-experimental drug, called VX-770, while not a cure, is being called a “major advance” in CF research. VX-770 attacks the basic defect in cystic fibrosis, and right now helps only 4 percent of those living with cystic fibrosis. Carey Goldberg explains what VX-770 does, and how it’s helped one woman do things she’s never done before — like shovel snow.
    • CommonHealth Podcast: May 13, 2011
    FILED UNDER: Personal Health, Podcasts, below the waist, cancer, cystic fibrosis
    April 22, 2011 | 2:36 PM | By

    Why You Should Assume Everyone Has Herpes

    A lab image of herpes virus

    I’m sure my boyfriend doesn’t have herpes, a patient recently told Dr. Lydia Shrier, an adolescent medicine specialist at Children’s Hospital Boston.

    How could she be so sure? Dr. Shrier asked. Because, the patient replied, she had scoped out his body and “there’s nothing irregular about him.”

    Dr. Shrier, a researcher on sexually transmitted infections, goes through this kind of conversation all the time. Patients tell her that they’ve never had blisters or lesions or sores, and so cannot possibly have genital herpes. The same for their sexual partners.

    It falls to her to disabuse them of these notions, saying: “You can have lesions or not, you can have symptoms or not, you should basically be operating the same way, which is to assume that everyone has herpes.” That means taking precautions, from limiting sexual contact to using condoms.

    Dr. Lydia Shrier

    Though this is her longstanding message, she now has better evidence to back it up than ever before. Last week, a pre-eminent researcher on the genital herpes virus, known as Herpes Simplex Virus 2 or HSV-2, published a landmark paper documenting the striking rate at which people with no herpes symptoms can nonetheless “shed virus,” potentially infecting partners.

    The study, led by Dr. Anna Wald of the University of Washington, found that people who’d had symptoms of herpes shed virus on about 20 percent of days, while people who test positive for herpes antibodies but have never had symptoms shed virus on only about 10 percent of days.

    But here’s the kicker: When they’re shedding, people who’ve never had symptoms shed roughly the same amount of virus as people who’ve had symptoms. So it’s clearer than ever that lack of symptoms is no guarantee against infection. And in fact, Dr. Wald said, “Asymptomatic shedding may be the central phenomenon of transmission.”

    In the old days, doctors would warn herpes patients to avoid sexual contact mainly when they had active lesions, believing that was the only time they were really contagious.

    But evidence has long been growing that herpes can be transmitted even when no lesions are visible. The new study, by quantifying how much virus is shed even in the absence of symptoms, “is a real ‘aha!’ moment,” said Fred Wyand, spokesman for the American Social Health Association. “It’s really robust in terms of the number of subjects they enrolled and the length of time they were followed,” he said.

    The study also helps explain how genital herpes has become so wildly common, infecting nearly one-fifth of the American adult population, given that it’s hard to imagine many people would want sex while they had the painful nether-regions equivalent of cold sores. Consider this stunning fact from the American Social Health Association:

    In the United States, more people have genital herpes than all other sexually transmitted infections combined -– 50 million people in total.

    There are more mind-boggling statistics. Continue reading →

    FILED UNDER: Medicine/Science, Personal Health, 2011 favorites, below the waist, children's hospital boston, herpes, sexually transmitted diseases
    December 20, 2010 | 10:11 AM | By

    The Great Tampon Mystery: Where Have All The o.b.’s Gone?

    o.b. update: J&J Say Stores Are Restocking; Are They? One Writer’s Tale

    It’s decidedly odd. In drugstores around Boston — and apparently around the country — the shelves that normally hold o.b.’s, the no-applicator tampons, are yawningly empty. I tried CVS. I tried Walgreens. Nothing but gaps that remind me of the years I spent reporting in the old Soviet Union, with its unstocked food stores. (Some may also recall a classic Seinfeld episode in which Elaine hears that the Today contraceptive sponge is going off the market, and buys out the supply in all of her neighborhood stores.)

    My crack-reporter friend, who alerted me to the situation, writes:

    I called Johnson and Johnson yesterday, and they said that only the Ultra has been discontinued but the others are having some sort of mysterious manufacturing delay and will be back on the shelves eventually. What? Do they contain a secret ingredient that is only available from Somalia? Anyway, I lodged a formal, semi-crazed PMS-induced protest with J&J. They are really pissing off the wrong group of women, don’t you think?

    Yes, she may be a little hormonal these days, but if anything that makes her more dogged. She adds:

    After being unable to find them at any normal place, I checked Drugstore.com, etc – no dice. Then I went on Amazon and eBay, because I thought maybe there was just a weird shortage in MA. So yesterday they were $75+ a box and when I called J&J the lady told me that she had seen them on ebay for $130. That’s more than $3 a tampon! J&J lady also told me they were getting “a flood” of complaints. No pun intended! Ha ha.

    Naturally, I had to take up the baton from her. First, it’s just strange. Second, o.b.s are not just tampons. They’re iconic, representative of the branch of the feminist movement that encouraged women to become comfortable with their own bodies. (Because o.b.s have no applicator, women need to get a little more intimate with themselves when inserting them.) And they’re appealingly no-frills, adding no applicator plastic to the landfills. When a blogger on the Jezebel site bemoaned the discontinuation of the Ultra, many other users chimed in, agreeing.

    I have a call in to the Johnson & Johnson spokeswoman who handles the o.b. brand. I checked with the Consumer Product Safety Commission to see if there had been a recall, but they sent me over to the FDA, which determined that tampons are considered a medical device. Still waiting to hear back from them. Please stay tuned.

    (And here’s an update: No official word yet, but reports of empty o.b. shelves nationwide.)

    And yet another update here.

    FILED UNDER: Personal Health, below the waist, female health, johnson & johnson, o.b. tampons, tampons
    October 8, 2010 | 10:30 AM | By

    Pain During Sex? There’s Hope In A Little-Known Treatment Option

    About one-third of women experience pain during sex, says a new report. But treatment is available.

    About one-third of women say they have pain during sex, according to a comprehensive new series of reports on the sexual lives of Americans published this week in the Journal of Sexual Medicine.

    Debby Herbenick, one of the study’s authors, told me that number “surprised” her — she didn’t think so many women would report that kind of pain.

    But it doesn’t surprise me — because I’m one of them.

    Here’s my story:

    Earlier this year, to put it bluntly, I started having pain during sex. For a while, I ignored it, telling myself it was probably just a passing problem that would resolve on its own. It didn’t.

    I went to see my fantastic ob/gyn, Beth Hardiman, the woman who delivered my two children, and whom I trust with the most intimate details of my life. She did an exam and told me my vaginal muscles were locked in permanent spasm, like if you gripped your shoulders up to your ears and never let go.

    “You need pelvic floor massage,” she said. (You can imagine what I envisioned.) “I’m giving you a prescription for pelvic floor physical therapy.”

    Now, I thought I was a savvy health care consumer, having written on the topic as a journalist for the past 10 years. Plus, I’ve had two babies, so I thought I was fairly familiar with the pelvis. Wrong. I had never, ever heard of pelvic floor physical therapy. And I never realized how many complex systems — reproductive, urinary, gastrointestinal, neurological, psychological, and musculoskeletal — can be involved in pelvic pain.

    Dr. Hardiman told me that many doctors hadn’t heard of it either. And if they did, they pooh-poohed the field as a bunch of amateurs blithely assigning kegel exercises to their patients. But she said so many of her patients complain of painful sex and related problems that pelvic floor physical therapy, as a specialty, should be far more recognized and respected. She gave me a list of 25 pelvic floor physical therapists in the region. The first five I called were completely booked and not taking new patients.

    Then I found Rachael Maiocco, a pelvic floor physical therapist in Chestnut Hill, at the Brigham and Women’s Hospital Department of Rehabilitation Services. There was a three-month wait to see her, but eventually, I was scheduled for eight visits. Continue reading →

    FILED UNDER: Medicine/Science, Personal Health, below the waist, chronic pain, listening to patients, pain during sex, pelvic floor physical therapy, research, women's health