Start of cycle routine and HPV protection

A Milex Omniflex silicone contraceptive diaphragm

My start-of-cycle routine: It’s Thursday June 4, 2009 today and I’m CD28. Tomorrow is a pamper me day. I’ll have my menstrual extraction at the clinic first thing after class then I’ll go to Body Buffers for my Brazilian wax. I have an ME at the first of each menstrual cycle to shorten my periods from about five days to just a bit over two. That way I can wear an Oves cap for about 26 of the 28 days of my menstrual cycle and have deep dive-sex as much as I want. I’ve been calling the proceedure that sucks out my old endometrium a ME but I think it is closer to what is thought of as a electric vacuum aspiration (EVA) because of the special equipment that’s used and since it’s performed by my Gyn. I always take 800 mg of Ibuprofen an hour before my appointment and a pregnancy test is standard before we start so everyone knows where we are. It’s never been positive and I’m certain it won’t be tomorrow because my Oves is screwed so tight onto my cervix!

Even though it’s technically an EVA a small cannula is used so I don’t have to have my cervix dilated. An electric vacuum pump is used and my cervix fits in a cup that locks behind my pubic bone to keep the cervix stable. My cervix isn’t clamped. which could hurt but worse the clamp might cause a tear in the side of the cervix which would affect my ability to wear an Oves cap so I absolutely must avoid that! The proccdure isn’t really uncomfortable - though there is some pressure occasionally - and it’s worth the bother because, as I’ve mentioned, it gives me an additional three days of deep dive-sex.

The whole EVA process takes about 30 minutes and I gossip with my Gyn while she’s working so the time passes quickly. When she’s through I insert one of my Milex Omniflex (the Milex name for a coil spring rim) diaphragms to catch the greatly reduced menstrual flow for the next two days at the end of which I’ve stopped bleeding for that cycle. Then I can go back to wearing Oves again. While wearing my Milex I can have sex, even dive-sex but only down to 10m below which the rim of a D can start to distort due to water pressure.

GARDASIL HPV VACCINE


Merck & Co: Gardasil shows promise in older women

“Jun 03, 2009 A Colombian study has revealed that Merck & Co's cervical cancer vaccine Gardasil has a beneficial effect in women aged 24 to 45. However, following a ruling against the vaccine in June 2008, Merck & Co will first have to present 48 months of continuous study data to the FDA before it can be reconsidered for approval for use within this potentially lucrative market.

Gardasil protects against infection with human papillomavirus (HPV) types 6, 11, 16 and 18. While HPV6 and 11 are associated with genital warts, HPV16 and 18 cause approximately 70% of cervical cancer cases. The peak incidence of HPV generally occurs within five to 10 years of first sexual experience; Gardasil has been approved since 2006 for girls aged nine to 26 years, however, the vaccine does not protect those who have already been infected.

Gardasil is currently the market leader in the cervical cancer vaccine field, with global sales of $2.3 billion in 2008, although growth has slowed after strong initial sales in 2006-07 due to a less-than-expected uptake in the catch-up population. Aiming to extend the vaccine's market potential to additional age groups, Merck is seeking to expand its use to women aged 24 to 45 years. However, the FDA rejected a previous filing for this age group in June 2008, and has requested 48-month efficacy data, which are expected later this year.

Researchers at the National Institute of Cancer in Bogotá, Colombia have now reported data from a study investigating Gardasil in over 3,800 women aged 24 to 45 years. Study results indicate that women aged 24 to 45 years with no history of cancer-causing genital warts or cervical disease were significantly less likely to become infected with HPV if they received Gardasil than women who received placebo injections. After a mean follow-up time of 2.2 years, the efficacy of Gardasil in preventing disease or infection related to the vaccine serotypes was more than 90% in this age group.

Even if this study shows that Gardasil is of medical benefit to older women, full 48-month data will be required for the FDA to reconsider approval for the vaccine in this age group. In addition, more data is needed regarding the cost-efficacy of Gardasil in this population, particularly since screening of patients.

for existing HPV infection may be required, which would further increase the already substantial costs of the vaccine. In light of this, Datamonitor believes that while a future widespread recommendation of HPV vaccination for older women is questionable; this age group may become a promising private sector opportunity.”

Comment: Our clinic has been using Gardasil off label for the last year to protect women between the ages of 26 and 50. Once it has been established that the patient hasn’t been exposed to HPV then the three injection vaccine is very effective in reducing the likelihood of her becoming infected. Of course we have been using Gardasil since its introduction in 2006 for all our entertainers and St Lucy’s students and for male entertainers since last year. Our clinic will also provided it for both female and male UNLV students if they ask for it.