Gardasil, the new vaccine to prevent cervical cancer, is recommended for all 11- and 12-year-old females. The immune response is greater at this young age, and the vaccine should be administered before sexual activity has started.

The three-shot regimen costs about $360, and the Centers for Disease Control advisory committee recommended that it be included in the federal Vaccines for Children program, which provides free shots to about 40 percent of American children. At present, low socioeconomic status is a risk factor for cervical cancer.
[SOURCE: Donya C. Arias, “New vaccine for cervical cancer virus raises access questions: vaccine approved,” Nations Health 2006;36(6)]

AIDS Mortality Rate Still High

The AIDS mortality rate in the United States remains high at about 50 percent. That is double the death rate from AIDS in the European Union and 10 times the rate in the United Kingdom. [SOURCE; Kevin DeCock, Harold Jaffe, “Update on epidemiology of HIV, hepatitis, and STDs, CROI, 14th Conference of Retroviruses and Opportunistic Infections, 2007]

 Circumcision Protects against STDs

Several recent studies have found that male circumcision offers protection from the acquisition of HIV and other sexually transmitted diseases. A randomized study in Kenya found that circumcised men had a 50 percent reduction in HIV incidence. One study found that protective effects occurred 12 to 21 months following circumcision. [SOURCE: Myron S. Cohen, M.D., “Highlights of the 16th biennial meeting of the International Society for Sexually Transmitted Diseases Research,” Medscape Infectious Diseases, August 18, 2005]

Condoms Don’t Always Protect

Human papillomavirus (HPV) is a virus that lives in the skin or mucous membranes and can be transmitted by sexual contact. A few types of HPV are associated with an increased risk of cervical cancer. HPV is common and usually undetected. Genital warts can appear but often there are no symptoms and the virus can be passed on by a person who has no visible warts. Condoms have been shown to reduce the risk of genital warts and cervical cancer. However, HPV can infect skin that is not covered by a condom. [SOURCE: Centers for Disease Control, “Genital HPV infections Fact Sheet,” August, 2006]

 Cycling and Sex-the Good and the Bad 
                                                                                   

Male high-mileage bicyclists have a rate of erectile dysfunction disproportionately high for their age-presumably because of the pressure exerted by the bicycle seat against blood vessels and nerves in the genital area. In other respects, cycling may be the best thing you can do to maintain good sexual function since it builds cardiovascular fitness and improves blood flow, particularly in the lower body. One recent study of older men with congestive heart failure confirmed the benefits of cycling. After eight weeks of biking, 80 percent of these men reported improved sexual function. 
[SOURCE: Brian Good, "Pedal for Sex," Men's Health, April, 2002]

ED, Aging and Depression 
                                                                                                           

The incidence of erectile dysfunction increases with age, affecting nearly 70 percent of men age 70 and over in the Massachusetts Male Aging Study. The risk of depression also increases with age, and many men presenting with erectile dysfunction also have symptoms of depression. The links between aging, depression and erectile dysfunction are complex. One study found that successful treatment of ED reduced symptoms of depression by more than 50 percent-regardless of age. 
[SOURCE: Dominick J. Carbone Jr. and Allen D. Seftel, "Erectile Dysfunction: Diagnosis and Treatment in Older Men," Geriatrics, September, 2002]

ED and Heart Disease-Another Link                                                                                                 


A recent study confirmed the already established link between erectile dysfunction (ED) and heart disease. The most common cause of ED is poor blood circulation in the penis, and this study, published in Circulation, found that ED patients also tend to have poor blood vessel function in their arms. The cause, according to researchers, is probably a defect in smooth muscle cells within arteries-indicating an increased risk of heart disease. 
[SOURCE: "Longevity Facts," The Johns Hopkins Medical Letter, April, 2004]

ED Drugs Not Covered by Medicare
                                                                                   

Erectile dysfunction (ED) drugs are no longer covered by most Medicare-approved prescription drug plans. Up to four pills per month of Viagra, Cialis or Levitra were covered during 2006, but an amendment to the Social Security Act that became effective on January 1, 2007 ended this coverage for what it labeled “lifestyle drugs.” These drugs are still covered for the treatment of pulmonary hypertension and other disorders.
[SOURCE; “Who Pays for ED Drugs?” Johns Hopkins Medical Letter, August, 2007]

 First HPV, Then Cervical Cancer
                                                                                               

At least 99 percent of women who develop cervical cancer have been infected with one of several types of the human papillomavirus (HPV). But the timing may lead a woman to misjudge her risk.

A woman is most susceptible to HPV infection between the ages of 24 and 30, and, since there may be no symptoms, she is unlikely to know she has been infected. Cervical cancer nearly always appears much later in life; in fact, about 20 percent of cases occur after age 60, when a new HPV infection is unlikely.
Only a few types of HPV are associated with cervical cancer, and not all women infected with these types will develop cancer.
[SOURCE: American Cancer Society, “Detailed guide: cervical cancer,” August 4, 2006]

 Hepatitis Often Leads to Cirrhosis 
                                                                                   

Persons who are long-term carriers of hepatitis B or C may not look or feel sick, but they are usually experiencing progressive liver damage. The liver has a great capacity to regenerate itself, but when there is repeated inflammation followed by healing, scar tissue forms. The medical term for this is cirrhosis. When the scarring becomes extensive, the liver becomes unable to carry out its normal functions. Without a liver transplant, the person is at risk of death. 
[SOURCE: Suzy Cohen, "Hepatitis C: A Cause for Concern," Drug Topics, June 16, 2003]

HIV Gets Attention; Hepatitis May Be Greater Threat to Teens 
                                                           

The possibility of HIV/AIDS infection should be enough to encourage adolescents to practice safe sex and avoid use of contaminated needles. But hepatitis B and C are blood-borne illnesses transmitted in the same way, and given current health trends, hepatitis infection is more likely. Of 300,000 new hepatitis B infections each year, about 70 percent occur in youth between the ages of 15 and 39. A hepatitis B vaccine is available, but school-based immunization programs rarely reach homeless adolescents. 
[SOURCE: Bettina M. Beech, Leann Myers, Derrick J. Beech, "Hepatitis B and C Infections Among Homess Adolescents," Family and Community Health, July, 2002]

HPV Test Outperforms Pap Smear
                                                                                               

A test for human papillomavirus (HPV) was found to be nearly twice as effective as a Pap smear in detecting early cell changes that often develop into cervical cancer, according to a study of more than 10,000 Canadian women published in the New England Journal of Medicine [October, 2007]. HPV, usually manifested as genital warts, is a virus found in 99 percent of cervical cancers.

The HPV test found 95 percent of subjects who had precancerous changes in the cervix while the Pap smear detected only 55 percent. Another study published in the same issue of the New England Journal of Medicine concluded that the detection rate could be increased by 51 percent through combining the two types of tests. A vaccine against some strains of HPV was introduced in June of 2007, but vaccination does not reduce the need for screening.
[SOURCE: Gene Emery, “Virus test found to be better than Pap smear for women,” Reuters Health, October 17, 2007; NEJM, October, 2007]


 Menopause Puts Damper on Sex Life
                                                                                   

Menopause causes changes in hormones and sexual function that can put a severe strain on a woman’s sex life and marital relationship, according to a recent survey of more than a thousand American women. About 46 percent of menopausal women reported having sex less than once a month, and most of them felt that their marital relationships were suffering as a result. Reasons cited for lack of sexual activity included vaginal dryness and atrophy that led to painful sex. A spokeswoman for the Red Hot Mamas Menopause Education Project, sponsors of the survey, said that both men and women need menopause education and better communication about sexual matters.
[SOURCE: “Menopause Hard on Couple’s Sex Lives,” Reuters Health, August 16, 2007]

 Mothers Want Daughters Immunized
                                                                                   

A strong majority of mothers in Great Britain want to have their young daughters given a new vaccine to prevent cervical cancer. Health officials are asking that females age 10 to 14 be immunized, and only 12 percent of mothers were worried that vaccination would encourage their daughters to become sexually active. Another 13 percent were concerned about possible side effects, but 75 percent approved of early immunization.
[SOURCE: “UK mothers back cervical cancer vaccine for kids,” Reuters Health, January 24, 2007; survey conducted by Cancer Research UK]

 MS Has Impact on Relationships
                                                                                   

Persons with multiple sclerosis (MS) reported more problems in their marital relationships and sexual functioning than subjects from the general population, according to a recent Australian study. No difference in sexual satisfaction was found, however.

Partners of MS patients were more likely than others to feel a negative impact on physical and emotional support in their relationships. The authors said the results demonstrated the need for support programs for MS patients and their partners.
[SOURCE: Marita P. McCabe and Elizabeth McDonald, “Perceptions of relationship and sexual satisfaction among people with multiple sclerosis and their partners,” Sexuality and Disability, December, 2007]


Neuropathy Causes Sexual Dysfunction

Diabetic neuropathy is a major cause of sexual dysfunction in both men and women. The autonomic nervous system controls the involuntary dilation of blood vessels that lead to the male erection and female sexual arousal. Damage to these nerves causes gradual loss of function. Diabetic nerve damage can also lead to over-active bladder, urinary incontinence and urinary retention. [SOURCE: Jeremiah John Duby, et al, “Diabetic Neuropathy: An Intensive Review,” American Journal of Health System Pharmacy, 61(2):160-176, 2004]

New Benefit for Moderate Drinking 
                                                                                   

Another health benefit of moderate drinking was reported in a recent study published in Alcoholism: Clinical and Experimental Research. Moderate alcohol consumption was associated with increased levels of dehydroepiandrosterone (DHEAS), a sex hormone that is believed to keep blood vessels healthy and declines in most individuals with aging. Middle-aged men and postmenopausal women had 17 percent higher levels of DHEAS and 12 percent higher HDL (good) cholesterol levels after three weeks of drinking regular beer with dinner every night compared to their levels after three weeks of drinking non-alcoholic beer. The increases for both DHEAS and HDL were similar in men and women. 
[SOURCE: Merritt McKinney, Moderate Drinking May Raise Healthy Hormone Levels," Reuters Health, May 14, 2004]

Sex after an MI: Nearly Always Safe            
                                                                       

Although it may provoke anxiety, resumption of sexual activity is nearly always safe a few weeks after a heart attack or stroke.


• Talk to your doctor first.


• Take all your medications as prescribed.


• Avoid excessively stressful situations.
•

Stop if you have heart symptoms such as fatigue, nausea or shortness of breath.


[SOURCE: Richard C. Wilson, M.D., “Can your heart handle sex?” thirdage.com, March, 2006]

SSRIs Have Positive Effects Too
                                                                                       

Among the sexual side effects of SSRI antidepressant medications (selective serotonin reuptake inhibitors) is a tendency to delay or inhibit orgasm. Rat studies have confirmed that these drugs have an effect on neurotransmitters involved in the central control of ejaculation. 
    While this effect can be a problem for persons being treated for depression, it can be an advantage for males who have a problem with premature ejaculation. One SSRI, dapoxetine, was developed specifically as a treatment for premature ejaculation.
[SOURCE: B. Fallon, “‘Off-label’ drug use in sexual medicine treatment,” International Journal of Impotence Research, April, 2008]


Teens at High Risk for STDs

About a quarter of all new cases of sexually transmitted diseases each year occur among sexually active teenagers. Adolescents are particularly likely to engage in high-risk sexual behaviors and have unprotected sex and multiple partners. Because of biological changes that occur during adolescence, they are also more vulnerable to STDs. [SOURCE: “Exposure to sexually transmitted diseases–topic overview,” WebMD Medical Reference from Healthwise, last updated February 9, 2007]

Vaccine against Cervical Cancer?                                                                                                 


A new vaccine may one day eradicate cervical cancer, according to research conducted at Brigham and Women's Hospital in Boston. The vaccine targets a high-risk strain of the human papilloma virus, type 16. Researchers know that HPV is responsible for almost all cases of cervical cancer. The viral strain, type 16, is responsible for about half of cervical cancer cases. In a first stage clinical trial, 7,658 women were vaccinated. After 18 months, none showed signs of infection with HPV type 16. Among a control group of 765 women who were given a dummy vaccine, 41 developed persistent viral infections. The success of the vaccine against this aggressive viral type gives researchers reason to hope that a successful vaccine against cervical cancer may be developed in the near future. 
[SOURCE: New England Journal of Medicine, November 21, 2002]

Vaccine Reduces Hepatitis A Threat 
                                                                                   

Before widespread use of the hepatitis A vaccine, outbreaks of hepatitis were common in some areas of the country, particularly in American Indian and Alaska Native communities. Immunization is now recommended for all American Indian and Native Alaska children and all persons living in communities with historically high rates of hepatitis A. Hepatitis A virus is found in the feces of infected persons and is passed along by close personal contact and food or water that has been contaminated. In contrast to hepatitis B and C, hepatitis A causes mostly short-term illness but can lead to severe problems in someone with existing liver disease. 
[SOURCE: "Hepatitis A: A Vaccine-Preventable Disease," Indian Health Service, National Epidemiology Program; "Viral Hepatitis Markers Found in a Canadian First Nations Community, Hepatitis Weekly, December 8, 2003]

Viagra Better than Ginkgo for Medication-Related Sexual Problems
                           

The erectile dysfunction drug Viagra has been found an effective treatment for antidepressant-related sexual dysfunction in both men and women. A study published in the Journal of the American Medical Association [July 23/30, 2008] found that 72 percent of women being treated for depression with SSRI drugs reported improvement in sexual problems when they took Viagra one to two hours before sexual activity. 
    The herbal supplement ginkgo biloba has also been mentioned as a possible remedy, but it’s important to remember that supplements are not regulated for quality, purity and potency. Like all supplements, ginkgo has unknown as well as known side effects; don’t use it without consulting your doctor.
 
[SOURCE: Johns Hopkins Health Alerts, “Combating sexual dysfunction caused by antidepressants”; Marlene Busko and Desiree Lie, “Sildenafil may improve women’s antidepressant-related sexual dysfunction,” Medscape Medical News CME, July 23, 2008]


Washing Helps but No Protection Against Food-borne Hepatitis A 
                                               

Several outbreaks of food-borne hepatitis A in late, 2003 were traced to green onions from a Mexican supplier who may have washed them with contaminated water. Experts recommend washing fresh vegetables with cold water to reduce the risk of food-borne illness. When they have been grown in soil or washed with water containing hepatitis A or E. coli, however, washing offers no protection and the vegetables must be thoroughly cooked to be safe. 
[SOURCE: "Cooking Ensures Safe Vegetables, CDC Says," Hepatitis Weekly, December 22, 2003]

Who Benefits from 'Potency' Exercises?                                                                                    

Studies have found that many men with erectile dysfunction benefit from pelvic floor and other exercises that improve blood flow in the area of the hips, thighs and pelvis. These exercises are most likely to be effective for men who have nightly erections during sleep and do not have hormonal deficiencies or nerve problems related to diabetes, trauma or surgery. 
[SOURCE: Frank Sommer, M.D., VigorRobic: Increased Potgency through Specific Fitness Training, Meyer & Meyer Sport, 2002]