Cervical Cancer Vaccine May Prevent Precancerous Changes on the Cervix

An article published in the May 10th New England Journal of Medicine showed that young women not infected with Human Papilloma Virus HPV 16 and 18 who were vaccinated with the Gardasil vaccine had a lower occurrence of the high grade precancerous diseases on the cervix than those who were vaccinated with placebo.

The study was done on 12,167 women aged 15-26 years who had not been previously infected with the HPV. Thus the vaccine, if given to young women who have not already been exposed to the Human Papilloma Virus, is effective in preventing cervical dysplasia in women that will be apparent within years rather than decades.

"Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide,"

Laura A. Koutsky, PhD, from the University of Washington in Seattle, and colleagues from the FUTURE II study group.

Reference:N Engl J Med. 2007;356:1915-1917.

Polycystic Ovarian Disease-A Common Health Hazard

Question:

I am a 28 year old married woman who has been trying to have a baby for the past 4 years. I have had 2 miscarriages within the first 6 to 8 weeks of my pregnancy. Recently my periods have become irregular and scanty, I am gaining weight at a fast rate. Over the past month I have gained 10 pounds of weight. I am growing hair on my chin and my belly wall. I also have zits on my face. It looks like I have a become a teenager all over again. What is going on with my body? Can I ever have a baby?

Answer:

You may have polycystic ovarian disease. I see many women your age with your symptoms. Most of them have polycystic ovarian disease. Your weight gain, increased hair growth, irregular bleeding and recurrent pregnancy loss are common in people with PCO.

The cause of polycystic ovarian disease is not known for sure. However, many people who are affected by the disease have increased male hormones which lead to insulin resistance. In the presence of adequate insulin levels the muscles for example cannot utilise the insulin available. The muscles need the insulin to help them use the blood sugar. The insulin resistance does not affect every tissue. Some tissues retain their sensitivity to the insulin while others like the muscles develop insulin resistance. The proteins that bind and carry the sex hormones decrease because they have been used to carry the excess male hormones floating in your body.The body compensates by increasing the production of more male hormones.

Women with PCO do not ovulate or if they ovulate they do so infrequently. They therefore have difficulty in getting pregnant. When they get pregnant they tend to have miscarriages, diabetes mellitus and high blood pressure.

I suggest you discuss your condition with your doctor. She may examine you and look for tell tale signs of PCO such as acne, increased facial and body hair, skin tags around your neck, velvety dark discoloration around your neck and under your breasts, increased hair on your anterior abdominal wall and your face, increased body mass index. She may do blood tests to exclude other diseases such as thyroid disease.

If you have polycystic ovarian disease, your doctor may give you metformin, which has been found to help treat PCO and decrease early pregnancy loss. If the metformin alone does not help you get pregnant, your doctor may add clomid. Your doctor may also give you the clomid alone without the metformin. You may have to stay on the metformin for at least 3 months when you get pregnant.