Sexually transmitted infections (STIs) Archive

Research we're watching

Transvaginal mesh, which has been used in transvaginal pelvic organ prolapse procedures since the 1990s, can no longer be sold in the United States because of concerns over safety and efficacy, according to the FDA. The number of women reporting problems related to these mesh products has grown over the past several years. The FDA said it made the decision because the companies that manufacture the mesh couldn't demonstrate that surgical procedures with their products work better than those without the mesh. They also failed to submit evidence that the mesh is safe and effective over the long term, said the FDA.

Women who have had procedures using mesh and are experiencing complications such as groin pain, persistent vaginal bleeding, pain during sex, or vaginal discharge should notify their doctor. Women who had procedures using mesh but aren't having any issues don't need to take any action aside from having their usual check-ups, said the FDA.

Q. For two years in a row, the lab that handles my Pap smears has reported "insufficient cell count." My doctor says it's nothing to worry about, but my health insurance company considers these "abnormal" Paps and has put me in a higher-risk category because of it. Should I be concerned?

A. When lab pathologists evaluate Pap tests for abnormal cells, the goals are to identify cancer that should be removed and precancerous conditions that should be followed closely to watch for any changes. Sometimes the results are unclear because the lab sample doesn't contain enough cells to evaluate ("insufficient cell count") — or because the cells are obscured by inflammation, mucus, or blood from a heavy menstrual period. In these cases, the Pap test is not necessarily abnormal; the specimen is simply inadequate to make any determination.

Not long ago, an abnormal PSA reading would be followed right away by a standard biopsy to search for potential cancer in the prostate. During such a procedure, doctors take 10 to 12 samples of the prostate from various locations while looking at the gland with an ultrasound machine. These days, however, men with high […]

The male breast is much smaller than its female counterpart, and it cannot produce milk. Because of this smaller size and simpler structure, breast disease is much less common in men than women. Still, men can develop important breast problems, both benign and malignant. Early detection is the key to a successful outcome, so every man should understand the basic elements of male breast disease.

Vaginal dryness is one of the most irritating symptoms of menopause. Here are some ways to relieve it.

Within a few years of menopause, roughly 50% of women develop symptoms related to vaginal atrophy, also called atrophic vaginitis — the deterioration of vaginal tissues due to loss of estrogen. The most common symptoms of vaginal atrophy are dryness, irritation, and pain during intercourse.

Although menopause is the most common cause, vaginal atrophy can result from anything that lowers estrogen production. That includes chemotherapy, radiation, removal of the ovaries during hysterectomy, and use of anti-estrogenic therapies such as aromatase inhibitors, tamoxifen (Nolvadex), and drugs like leuprolide (Lupron) and nafarelin (Synarel), which are used to treat fibroids and endometriosis. Unlike hot flashes, which usually subside with time, vaginal atrophy is likely to persist and become worse without treatment.

While Father’s Day gets less sentimental build up than Mother’s Day, it may still bring out intense emotions for many men even if they are not parents themselves.

Both married men and unmarried men of a certain age, may remember the tune, if not the words:

Love and marriage, love and marriage,
Go together like a horse and carriage.
This I tell you, brother,
You can't have one without the other.

News briefs

New findings show a dramatic increase in the number of men taking a conservative approach to low-risk prostate cancer. According to a Harvard-led study published Feb. 19, 2019, in JAMA, use of active surveillance — which involves monitoring the cancer and delaying treatment unless it progresses — almost tripled from 2010 to 2015. The data come from the records of 165,000 men with prostate cancer. Researchers found that among men with low-risk prostate cancer (slow-growing cancer that's not considered life-threatening), active surveillance jumped from 15% in 2010 to 42% in 2015, surgery fell from 47% to 31%, and radiation dropped from 38% to 27%. Other studies also have also shown increasing rates of active surveillance in low-risk cases.

Why the shift? The authors point to national guidelines that now recommend active surveillance in such cases, as well as favorable research findings. "Emerging evidence has shown that active surveillance for low-risk prostate cancer is an effective alternative to surgery or radiation, associated with similar and excellent chances at long-term survival," notes Dr. Brandon Mahal, the study's lead author and a radiation oncologist with Harvard-affiliated Dana-Farber/Brigham and Women's Cancer Center.