WOMENS-HEALTH Messages for June, 1998: Re: just wondering

Re: just wondering

From: William D. McIntosh, MD (anonymous@obgyn.net)
Sun, 28 Jun 1998 18:11:22 -0500 (CDT)

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At Sun, 28 Jun 1998, eliz wrote: >
>I saw a tv news doc say that cervical cancer was definitely being
>classified as a sexually transmitted disease, that there was no genetic
>correlation for predisposition. The evidence was given as a study
>showing that life-long nuns did not get cervical cancer. I'm disturbed
>by this being catagorized as a sexually transmitted disease with the
>negative connotation therein. However, I have another reason for
>posting. Do life-long nuns come down with any of the other disorders
>that afflict women: cystocele? rectocele? enterocele? uterine prolapse?
>fibroid tumors? ovarian cancer? endometriosis?
>
>I'm certainly not suggesting that all reproductive disorders be
>classified as sexually transmitted diseases. However, if some or all of
>these disorders are realted to sexual activity perhaps we should be
>teaching our daughters the dangers and how to try to avoid problems. If
>Kegals are so good for pelvic muscle support and the prevention of
>incontinence why aren't girls taught about them early on? Is there even
>very much research into preventative or early intervention medicine?
>There are a great many issues in women's health I was never aware of
>until I started having problems.

An apparent prerequisite for cervical cancer is the Human Papilloma Virus (HPV), a sexually transmitted disease. It is almost ubiquitous in the sexually experienced adult population, thus explaining why nuns are relatively immune. The virus remains in the body forever, thus establishing an ongoing risk for cervical cancer. Symptoms of the virus are rare, so Pap smears are performed routinely to screen for the effects of the virus. Most of the problems I see in daily practice have a sexual component. I am a physician specializing in women's reproductive health. "Female" and "sex" are the common threads of my professional life. Starting with childbirth and moving on through the tissue damage that results from childbirth, to blocking pregnancy, to pain from sex, to loss of libido, all have sex as the common theme. From one perspective, all of OB/GYN is management of sexually related conditions. There is vastly more research into preventative medicine than there is committment to adhere to the results of that research in the American population. Are the 5000 deaths each year that are the result of cervical cancer really the grain of rice that tips the scale in favor of practicing safe sex, or more effectively, mutual monogamy for life? Are the effects of smoking on fertility the deciding factor in not smoking? We know much, hypothesize more, and are wrong about many things. The data is all in the public domain.

-- William D. McIntosh, MD

This is not intended to replace consultation and examination by a medical practitioner.

Next message: William D. McIntosh, MD: "Re: molar pregnancy?Please Help!"
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In reply to: eliz: "just wondering"
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