Substance use disorder: contraceptive options counseling

What’s New in Contraception?

Contraceptive Technology Conference!

Biologic sexism of STIs

Excess breast cancer deaths after COVID-19

Contraception for patients with medical conditions

Pelvic Floor Dysfunction

Treating vulvodynia

Puzzling Over the Hurt Down-Under

Serious Mental Illness and Contraception

New 13-Cycle Vaginal Contraceptive System

The Future of Family Planning in Post-COVID America

New ASCCP Guidelines: Implications for FP

On the alert: mood disorders during 2020 stressors

Sex in the Time of COVID-19

Challenges old and new during the pandemic

Reproductive health in the time of Covid-19

Talking about toys

Missed Pills: The Problem That Hasn’t Gone Away

Find the “yes! . . . and” rather than “no” or “but”

Digital Family Planning: the Future is Now

Irregular Bleeding Due to Contraceptives

When she’s low on libido…

Ouch! Best approaches to menstrual pain

Contraceptive efficacy: understanding how user and method characteristics play their part

Strategizing treatment for chronic heavy menstrual bleeding


Untangling the literature on obesity and contraception

High tech apps for no-tech FABM

Menstrual exacerbation of other medical conditions

From Princeton University: Thomas James Trussell (1949-2018)

The Short and Long of IUD Use Duration

Selecting a Method When Guidance Isn’t Clear-cut

Healthcare in the Time of Digital Expansion

The Scoop on Two New FDA-Approved Contraceptive Methods

Pregnancy of unknown location—meeting the challenge

Big “yes” (with caveats) to CHCs during perimenopause

The role of IUDs (LNG IUDs, too!) in emergency contraception

Combined pills’ effect on mood disorders

Abortion in the U.S.: safe, declining, and under threat

Hope for ovarian cancer screening test

Breast cancer still a small risk with some hormonal contraceptives

New treatment modality for BV

Record rate of HPV-related throat cancer

Viruses in semen potentially transmissible

Don’t Abstain from Your Role in Abstinence

Teens births declining but geographic ‘hotspots’ defy trend

Online Medical Abortion Service Effective and Safe

Do Women Really Need to Wait That Long?

Reassuring news on depression and OC use

PMDD: Genetic clues may lead to improved treatment

Breast cancer risk when there is a family history

Body weight link to breast and endometrial cancers (and 11 others)

Family Planning in 2017 and Beyond

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm


Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use

Alcohol consumption when pregnancy is unwanted or unintended

Latest Data on Contraceptive Use in the United States

LateBreaker sampler from Contraceptive Technology conference

Emergency Contraceptive Pill Efficacy and BMI/Body Weight

Handout on Unintended Pregnancy and Contraceptive Choice

Ask About Withdrawal (Really!)

Rules to Practice By: Safety First and Cleanliness is Close to. . .

What’s Vanity Fair Got Against the NuvaRing?

Promising New Treatment for Hepatitis C

Numbers matter, so make them simple for patients

The Recession’s Effect on Unintended Pregnancies

Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative

Applying the “New” Cervical Cytology Guidelines in Your Practice

Acute Excessive Uterine Bleeding: New Management Strategies

Medical indications for IUD use in teens

Whatever happened to PID?

Update on Emergency Contraception New and Improved

Record rate of HPV-related throat cancer
November 2017


Have you read the headlines that the incidence of oropharyngeal cancer in men has outpaced the incidence of cervical cancer in women? Further, that the prevalence of oropharyngeal cancer in men has doubled over the past 20 years? All true. But the headlines make the situation appear more dire than it currently is. However, without action, the situation could eventually become a dire public health threat. There is an important role for women’s reproductive health providers to play in containing the threat of an epidemic of HPV-related throat cancer.

The incidence of oropharyngeal squamous cell carcinoma  (OPSCC) associated with human papillomavirus in men is now 7.8 per 100,000.[1] That compares to the 7.4/100,000 incidence of cervical cancer in women.[2] Obviously the first number, for men, is higher than the second number for women. However, keep in mind that the incidence of OPSCC in men is much lower than that for prostate cancer (96/100,000).[3] It’s lower than the incidence in women of ovarian cancer (12/100,000), uterine cancer (26/100,000), and breast cancer (124/100,000).

So why the heightened concern? Because the prevalence has indeed doubled over the past two decades, and researchers expect that trend will likely continue to the year 2060. They base their prediction on the high rate of oral HPV infection in men. HPV infection raises the risk for OPSCC by 7-fold. In a recent study published in the Annals of Internal Medicine, researchers reported that 11.5% of men in the NHANES (National Health and Nutritional Examination Survey) had oral HPV infection.[4] High-risk oral HPV was detected in 7.3% of men in the survey. The respondents, aged 18 to 69 years and identified through a stratified, multistage probability sampling technique, provided specimens by oral rinse and penile swab. They underwent medical examination by a mobile examination center and interviewed in person or by phone.

Certain risk factors increased substantially the prevalence of oral HPV infection in men:

  • 16 or more lifetime oral and vaginal sex partners, especially oral sex
  • 2 or more same-sex oral sex partners (but not anal sex)
  • Smoking >20 cigarettes/day
  • Concurrent genital HPV infection
  • Current marijuana smoking

Smoking is thought to be a risk factor because it is proinflammatory and immunosuppressive. That concurrent genital infection with HPV increases a man’s risk by a factor of 4 suggests a potential element of autoinoculation.

It is the prevalence of oral HPV infection that indicates that the incidence of OPSCC in men will continue to increase for decades to come. Boys are woefully under-immunized against HPV. Despite a recent surge in the numbers of those who have received at least one dose of the vaccine, only 31% of boys have completed all three doses.[5]

So here is where women’s health providers can step in, by encouraging mothers to have their sons vaccinated and by educating young adult women patients about the HPV vaccine, not only for themselves, but for the guys in their lives, too. The HPV vaccine seems to protect against oral subtypes as well as genital ones; in the NHANES study, participants who had been vaccinated had a several times lower prevalence of oral HPV infection. There is no approved screening test to detect HPV-related OPSCC in its early stages.

What about the picture for women? They have significantly lower risks of HPV oral infection: 3.2% overall and 1.4% for high-risk strains. However women who smoked marijuana had an infection prevalence of 7.9%. The same risk factors, mentioned above, that increased the prevalence of oral HPV infection among men was similar for women; however, the increases in women were generally not statistically significant.

[1] Mourad M, et al. epidemiological trends of head and neck cancer in the United States: a SEER population st;udy. J Oral Maxillofac Ssurg 2017; DOI:

[2] Centers for Disease Control and Prevention. Vital signs: cervical cncer incidence, mortality,and screening—United States 2007-2014. MMWR 2014;63:1-6.

[3] Centers for Disease Control and Prevention. Unisted States Cancer Statistics: 2014 top ten cancers. Table 4.1. At Accessed Nov. 6, 2017.

[4] SonawaneK, et al. oral human papillomavirus infection: differences in prevalence between sexes and concordance with genital human papillomavirus infection, NHANES 2011 to 2014. Ann Intern Med 2017;doi:10.7326/M17.1363

[5] Centers for Disease Control and Prevention. National, regional, states, selected local area vaccination coverage among adolescents aged 13-17 years—United States. MMWR 2017;66:874-882.