Wednesday, December 21, 2016
A commercial brand of mouthwash that is readily available from supermarkets and pharmacies can help curb the growth of the bacteria responsible for gonorrhoea, reveals preliminary research published online in the journal Sexually Transmitted Infections.
Daily rinsing and gargling with the product might be a cheap and easy way of helping to control the spread of the infection, suggest the researchers.
New cases of gonorrhoea among men are on the rise in many countries amid declining condom use, with the bulk of cases among gay/bisexual men, say the researchers.
Rising rates of gonorrhoea heighten the risk of the emergence of antibiotic resistant strains of Neisseria gonnorhoeae, the bacteria responsible for the infection, making the need for a preventive measure that doesn't rely on condoms even more urgent, they say.
As far back as 1879, and before the advent of antibiotics, the manufacturer of Listerine, a commercial brand of mouthwash, claimed that it could be used to cure gonorrhoea. But no published research has tested out this claim.
In a bid to rectify this, the researchers assessed whether Listerine could curb the growth of N. gonorrhoeae in laboratory tests and in sexually active gay/bisexual men in a clinical trial.
For the laboratory tests, different dilutions (up to 1:32) of Listerine Cool Mint and Total Care, both of which contain 21.6% alcohol, were applied to cultures of N. gonorrhoeae to see which of any of them might curb growth of the bacteria. By way of a comparison, a salt water (saline) solution was similarly applied to an identical set of cultures.
Listerine at dilutions of up to 1 in 4, applied for 1 minute, significantly reduced the number of N. gonorrhoeae on the culture plates, whereas the saline solution did not.
The clinical trial involved 196 gay/bisexual men who had previously tested positive for gonorrhoea in their mouths/throat, and who were returning for treatment at one sexual health clinic in Melbourne, Australia, between May 2015 and February 2016.
Almost a third (30%; 58) tested positive for the bacteria in their throat on the return visit.
Thirty three of these men were randomly assigned to a rinse and gargle with Listerine and 25 of them to a rinse and gargle with the saline solution.
After rinsing and gargling for 1 minute, the proportion of viable gonorrhoea in the throat was 52% among the men using Listerine compared with 84% among those using saline.
And the men using Listerine were 80% less likely to test positive for gonorrhoea in their throat five minutes after gargling than were the men using the saline solution.
The researchers admit that the monitoring period was short, so the possibility that the effects of the mouthwash might be short-lived can't be ruled out. But the laboratory test results would suggest otherwise, they say.
This research is preliminary, so a larger trial is currently under way to confirm these results and see whether the use of mouthwash could curb the spread of gonorrhoea, they say.
"If daily use of mouthwash was shown to reduce the duration of untreated infection and/or reduce the probability of acquisition of N. gonorrhoeae, then this readily available, condom-less, and low cost intervention may have very significant public health implications in the control of gonorrhoea in [men who have sex with men]," write the researchers.
Thursday, December 15, 2016
Wednesday, December 7, 2016
Pubic hair grooming is linked to a heightened risk of acquiring a sexually transmitted infection, finds research published online in the journal Sexually Transmitted Infections.
The association seems to be strongest among those who groom their pubic hair frequently and intensively--a practice dubbed 'extreme grooming' by the researchers--the findings show.
Pubic hair removal is becoming increasingly common among men and women worldwide amid changing perceptions of the role of body hair in attractiveness, cleanliness, and feelings of masculinity/femininity, say the researchers.
To find out what impact this growing trend might be having on rates of sexually transmitted infections, the researchers polled a nationally representative random sample of US adults about their intimate grooming habits.
Among the 14,000+ sample of 18-65 year olds, some 7580 (56% men) completed the survey, responding to questions about the intensity (trimming or complete removal) and frequency (from daily to annually) of their public hair grooming, as well as the tools they typically used.
'Extreme' groomers were classified as those who removed all their public hair more than 11 times a year, and 'high frequency' groomers as those who trimmed their pubic hair daily or weekly.
Participants were also asked about their sexual history. Some 7470 said they had had at least one sexual partner.
Almost three out of four (74%) respondents said they had groomed their pubic hair before, with more women (84%) than men (66%), saying they had done so.
Among the groomers, 17% were classified as 'extreme' and 22% as 'high frequency', with one in 10 falling into both categories.
Overall, groomers tended to be younger, more sexually active, and to have had more annual and total lifetime sexual partners than those who said they didn't groom their pubic hair.
And the number of sexual partners among extreme groomers was higher than it was for any other category of groomer.
An electric razor was the most common grooming tool among men (42%), while a manual razor was more common among women (61%). Around one in five men and women used scissors.
In all, 13% (943) respondents said they had had at least one of the following: herpes; human papilloma virus (HPV); syphilis; molluscum; gonorrhoea; chlamydia; HIV; or pubic lice.
After factoring in age and the number of lifetime sexual partners, any type of grooming was associated with an 80% heightened risk of having a sexually transmitted infection compared with no grooming.
Intensity and frequency of grooming also seemed to be linked to the magnitude of risk. Among high frequency and extreme groomers, the practice was associated with a 3.5 to 4-fold heightened risk, particularly for infections that arise through skin on skin contact, such as herpes and HPV.
By contrast, low intensity/frequency grooming was associated with a doubling in risk of a lice infestation, suggesting that grooming might make it harder for lice to breed successfully.
This is an observational study, so no firm conclusions can be drawn about cause and effect, added to which the researchers were not able to determine the timing of grooming relative to acquisition of infection, or account for either safer sex practices or indeed risky sexual behaviours.
To explain their findings, the researchers suggest that grooming might be a proxy for higher levels of sexual activity and associated infection risk, or that it might cause tiny skin tears, through which bacteria and viruses can easily pass.
Further research is needed to shed some light on these possibilities, say the researchers. Either way, evidence of grooming could be a useful prompt for clinicians to ask about safer sex practices, or to suggest delaying sex to allow the skin to heal, they add.
Thursday, November 17, 2016
Concerns about weight gain may be driving contraception choices, according to Penn State College of Medicine researchers. Women who are overweight or obese are less likely than women who are not overweight or obese to use the birth control pill and other hormonal contraceptive methods.
Weight gain is one of the most commonly cited reasons why women stop using hormonal contraception, and therefore may play a role in the risk of unintended pregnancies, said Cynthia H. Chuang, professor of medicine and public health sciences. Although oral contraception likely does not cause weight gain, says Chuang, many women attribute increasing weight with the birth control pill. The birth control shot has been associated with weight gain in younger women.
Chuang and her co-researchers wanted to learn if women's weight or their perception of weight influenced the type of birth control they used, if any. To do so, they examined demographic and survey data from almost 1,000 privately insured women in Pennsylvania.
The researchers categorized weight category based on body mass index (BMI), a measure of body size based on height and weight.
They determined that overweight and obese women were more likely than women who are not overweight or obese to choose forms of birth control known as long-acting reversible contraceptives (LARCs), and less likely to use methods like the pill, the shot, the patch and the ring. There was also a trend toward overweight and obese women to be more likely to use non-prescription methods such as condoms, withdrawal and natural family planning, or no method. The researchers will report their results in the journal Contraception.
Long-acting reversible contraceptives include intrauterine devices, commonly known as IUDs, and the contraceptive implant. LARCs do not contain estrogen, which some some women believe causes weight gain.
"What we think may be happening is that women who are overweight and obese may be more likely to choose methods other than the pill or the shot because of fear of weight gain," Chuang said. "As a result, they are choosing both more effective methods (LARCS) and less effective, non-prescription methods."
Researchers found that 23 percent of overweight and 21 percent of obese women used LARCs, which are the most effective forms of birth control. In contrast, only 6 percent of under-weight and normal-weight women used LARCs in the study.
"We were actually glad to see that overweight and obese women were at least more likely to choose LARCs because I was expecting to see these women more likely to use non-prescription methods," Chuang said.
Heavier women also were more likely than normal-weight women to use less-effective non-prescription birth control methods -- such as condoms -- or no method at all. However, these results did not reach statistical significance, Chuang said.
The researchers also evaluated whether perception of weight influenced contraceptive choice. In the study, half of the women perceived themselves to be overweight, although only around 42 percent of them were overweight or obese based on BMI. This perception, however, did not appear to influence birth control choice.
"Women may be worried about weight gain when they're making decisions about birth control, so clinicians need to be aware of that," Chung said. "It could be an opportunity to counsel women about LARCs, which are more effective forms of contraception."
During menopause, levels of estrogen decline in vaginal tissues, which may cause a condition known as VVA, leading to symptoms such as pain during sexual intercourse.
"Pain during sexual intercourse is one of the most frequent symptoms of VVA reported by postmenopausal women," said Audrey Gassman, M.D., deputy director of the Division of Bone, Reproductive, and Urologic Products (DBRUP) in the Office of Drug Evaluation III in the FDA’s Center for Drug Evaluation and Research (CDER). "Intrarosa provides an additional treatment option for women seeking relief of dyspareunia caused by VVA."
Efficacy of Intrarosa, a once-daily vaginal insert, was established in two 12-week placebo-controlled clinical trials of 406 healthy postmenopausal women, 40 to 80 years of age, who identified moderate to severe pain during sexual intercourse as their most bothersome symptom of VVA. Women were randomly assigned to receive Intrarosa or a placebo vaginal insert. Intrarosa, when compared to placebo, was shown to reduce the severity of pain experienced during sexual intercourse.
The safety of Intrarosa was established in four 12-week placebo-controlled trials and one 52-week open-label trial. The most common adverse reactions were vaginal discharge and abnormal Pap smear.
Although DHEA is included in some dietary supplements, the efficacy and safety of those products have not been established for diagnosing, curing, mitigating, treating or preventing any disease.
Intrarosa is marketed by Quebec-based Endoceutics Inc.
Thursday, November 10, 2016
Although many of us don't want to think about grandma still "getting it on," multiple studies show that older women are still sexually active beyond their seventh decade of life. A new study published online today in Menopause, the journal of The North American Menopause Society (NAMS), suggests, however, that at least one in seven women aged 65 to 79 years has hypoactive sexual desire dysfunction (HSDD).
In the questionnaire-based, cross-sectional study, more than 1,500 Australian women were assessed for sexual function and sexual distress as defined by the Female Sexual Function Index and the Female Sexual Distress Scale-Revised. The group consisted of 52.6% partnered women, with a mean age of 71 years. Within this group, 88% were found to have low sexual desire, 15.5% had sexually related personal distress, and 13.6% had HSDD, which is defined as the presence of both low sexual desire and sexually related personal distress. This percentage was higher than what had previously been reported for women in this age group and similar to the prevalence reported for younger women.
Although HSDD was found to be more common in women with partners, the study confirmed that unpartnered older women are still sexually active and may be distressed by low sexual desire. Independent factors included vaginal dryness during intercourse in the past month, having moderate to severe depressive symptoms, and having symptomatic pelvic floor dysfunction.
"This study demonstrates that healthcare providers need to have honest and open discussions with their patients as they age with regard to desire, mood, vaginal dryness, and pelvic floor issues to determine whether these factors are affecting a woman's desire or ability to be sexual," says Dr. JoAnn Pinkerton, NAMS executive director.
Friday, November 4, 2016
Women experience marked decline in sexual function in months immediately before and after onset of menopause
Women experience a notable decline in sexual function approximately 20 months before and one year after their last menstrual period, and that decrease continues, though at a somewhat slower rate, over the following five years, according to a study led by a researcher at Wake Forest Baptist Medical Center.
The study, published ahead of print in the online issue of Menopause: The Journal of the North American Menopause Society, also found that various factors that frequently co-occur with menopause have less direct influence on declining sexual function than menopause itself.
"Sexual functioning in women declines with age, and there has been much debate about how much this is due to menopause, aging or other physical, psychological or social factors," said the study's lead author, Nancy Avis, Ph.D., professor of public health sciences at Wake Forest School of Medicine, part of Wake Forest Baptist. "Our findings support that menopause has a negative effect on sexual functioning in many women."
Additionally, the study found that women who have a hysterectomy before the onset of menopause do not experience a marked decline in sexual function immediately before undergoing the procedure but do so afterward, for as long as five years.
The researchers based their findings on information collected from 1,390 participants in the federally funded Study of Women's Health Across the Nation (SWAN), which began in 1996. These women, who were between the ages of 42 and 52 at the time of enrollment in the study and who had a known date of final menstrual period during their participation, responded to questionnaires dealing with various aspects of sexual function -- including desire, arousal, satisfaction and pain -- between one and seven times over the course of the study. The researchers analyzed 5,798 of these self-assessments (4,932 from the 1,164 women in the natural menopause group and 866 from the 226 women in the hysterectomy group) and tracked the changes in the respondents' scores on the sexual-function questionnaires relative to either their final menstrual period among women who experienced a natural menopause or the hysterectomy. Of note, in the natural menopause group the researchers found that race/ethnicity played a major role in the decline of sexual function, with African-American women experiencing a significantly smaller decline and women of Japanese descent experiencing a much greater decline when compared with white women.
"Sexual functioning is an important component of women's lives. More than 75 percent of the middle-aged women in the SWAN study reported that sex was moderately to extremely important to them when the study began," Avis said. "It is important for women and their health care providers to understand all the factors that may impact women's experience of sex in relation to both the natural menopausal transition and hysterectomy, and we hope our findings will contribute to better understanding in this area."