Women's Sexual Health Archive

Research we're watching

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Anti-inflammatory medications may play a role in ovarian cancer risk. A study by researchers at the Harvard T.H. Chan School of Public Health found that taking low-dose aspirin regularly appears to reduce the risk of ovarian cancer by 23%. However, long-term heavy use of ibuprofen (Advil), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs (NSAIDs) seems to increase risk.

The study, published online October 4 by JAMA Oncology, looked at data on more than 200,000 women who participated in the Nurses' Health Study and Nurses' Health Study II. Among the group studied, 1,054 women went on to develop ovarian cancer. Researchers then looked at what type of medications the women took on a regular basis. They found that women who took at least 10 doses of NSAIDs a week for multiple years had an increased risk of ovarian cancer. Women who took low-dose aspirin regularly seemed to have a reduced risk — but the same was not true among women who took a standard-dose aspirin.

Ask the doctors

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Q. I just saw that the FDA issued a warning on vaginal laser procedures. Are these procedures dangerous?

A. More study of these laser procedures is needed to conclusively determine if they're safe and effective for vaginal conditions. If you're considering one of these procedures, have a detailed conversation with your doctor about traditional medical therapies as well as the pros and cons of laser treatments. The FDA issued a warning on July 30 about energy devices (laser therapy).

Research we're watching

A test that screens for human papillomavirus (HPV) beat a commonly used cervical cancer screening method in detecting changes that may lead to cervical cancer, according to a study published July 3 in The Journal of the American Medical Association. Some 19,000 women were screened for cervical cancer using either the HPV test or a more traditional and commonly used liquid-based cytology test. After 48 months, all the women were tested again using both tests. Researchers found that among women who'd had a normal initial screening, those who'd been screened with the HPV test had significantly fewer grade 3 or worse precancerous cervical changes at the final testing compared with those screened with liquid-based cytology.

In response, the U.S Preventive Services Task Force now recommends either HPV testing only once every five years or liquid-based cytology once every three years for women ages 30 to 65.

Vaginal discharge can change with age. Here's how to spot signs of a problem that might warrant a trip to the doctor.

Vaginal discharge and bleeding can change during different stages of life, and what's typical for you might not be typical for your sister, your daughter, or your friend. "When it comes to vaginal discharge, a wide range of 'normal' can be considered," says Dr. Kristin Hung, instructor in obstetrics, gynecology, and reproductive biology at Harvard Medical School.

Not only is there natural variation between women, but what's normal for your own body may also change over time. So how can you tell when something is wrong, or if the changes you're noticing are just the result of aging or hormonal shifts? "Typically, most women know their own bodies, and anything new, unusual, or persistent is a reason to seek evaluation," says Dr. Hung. That said, she adds, there are some changes that are pretty typical and others that might warrant a little more scrutiny through a visit to your doctor. Here's how to tell the difference.

Increasingly, doctors are turning to prevention for this hard-to treat cancer.

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Ovarian cancer is a challenging foe. It's often found at an advanced stage when it's difficult to treat.

In recent years, researchers have learned that many cases of ovarian cancer don't even start in the ovaries. "It turns out that ovarian cancer is a bit of a misnomer. We think a portion of ovarian cancers actually arise from cells in the fallopian tubes," says Shelley Tworoger, adjunct associate professor of epidemiology at Harvard Medical School and associate center director of population science at the Moffitt Cancer Center.

Overall risk is very small, and older women who used hormonal contraceptives many years ago aren't likely to have a higher risk.

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Hormonal birth control — whether it comes as pills, injections, a ring, an intrauterine device (IUD), or an implant — may raise your risk of breast cancer, according to a study published Dec. 7, 2017, in The New England Journal of Medicine.

If you're like many women who currently use one of these contraceptive methods, or if you used one for years in the past, should you be worried?

There's an upswing in cases of chlamydia, gonorrhea, and syphilis in the United States, and it includes older adults.

For as long as humans have engaged in sex, there have been sexually transmitted diseases (STDs). The term STD (which has replaced the older "venereal disease") generally refers to infections that can be transmitted by vaginal, anal, or oral sex. Among them are genital herpes, human papillomavirus, chlamydia, gonorrhea, syphilis, and human immunodeficiency virus (HIV). The CDC estimates there are about 20 million new STD cases every year, but only a fraction of them get reported.

STDs are on the rise in people of all ages. There were more than two million reported cases of chlamydia, gonorrhea, and syphilis in 2016. While the vast majority occurred in teenagers and young adults, there also were significant increases in cases among middle-aged and older adults (see "STDs reported among older adults").

The procedure can improve symptoms such as vaginal dryness, mild urinary incontinence, and discomfort during sex.

Many postmenopausal women suffer from a number of nagging symptoms, ranging from vaginal dryness and atrophy to mild urinary incontinence and pain with intercourse. Specialists refer to this collection of symptoms as genitourinary syndrome of menopause (GSM), which can result in general discomfort and a loss of sexual intimacy, says Dr. Roger Lefevre, an instructor in obstetrics, gynecology, and reproductive biology at Harvard Medical School. You don't have to resign yourself to live the rest of your life in a state of perpetual discomfort, he says. Today there are multiple options — including laser treatments like those long used to rejuvenate skin on the face and body — that can help.

A laser, where?

Let's be honest: the thought of getting a laser treatment on the most sensitive and intimate part of your body might make you reflexively cross your legs. But the results of the three-minute treatment, which most women report causes only mild pain and discomfort (some say it feels like the snap of a rubber band), makes the procedure worthwhile for many women. The laser treatment activates the body's own healing mechanism by making a series of tiny holes in the tissue, which then stimulate the body to grow new tissue to heal these tiny wounds. The therapy is intended to boost collagen levels and elasticity. It can also increase the blood supply to the area, which can help restore lost sensation.

By Hope Ricciotti, M.D., Editor in Chief

If you've come to expect a pelvic exam as a routine part of your annual well-woman physical, you may be surprised to learn that health experts disagree over whether it is necessary. The exam — in which the clinician inserts gloved fingers into the vagina to examine the cervix, uterus, and ovaries — has been routine for decades, but recently its benefits have been called into question.

In 2014 the American College of Physicians — an influential group of internal medicine specialists — issued a recommendation against routine pelvic examinations for women who aren't pregnant and have no unusual risk for or symptoms of pelvic diseases. However, the American College of Obstetricians and Gynecologists (ACOG) has stood by its longstanding policy recommendation — annual pelvic exams for women ages 21 and older — based on expert opinion. In March 2017, the U.S. Preventive Services Task Force — the pre-eminent medical guidelines organization — ruled that there is insufficient evidence to recommend either for or against annual screenings.