Three below the belt

A few articles all with a "below the belt" theme - sort of:

*  the first is a bit of a cheat:  Mary Beard has an interesting review of a new book about shopping in ancient Rome, but because part of the material relates to a poet who was making a bit of a joke, she gives it the title "Banter About Dildoes".   It's a very interesting read anyway.

*  Slate had an article a week ago about the history of condoms in the US.  Again all very interesting.  [As an aside, the availability of condoms in Australia is significant for family reasons.  My maternal grandparents were divorced - or maybe permanently separated, I forget which - by the time I was born.  My mother told me that the relationship had gone bad when, on one of his return visits to their country  home  after working down in Brisbane in World War 2, my grandmother was furious to find he had a condom in his pocket.  She took as a sure sign he was up to no good while away.  I wonder if it was a US condom?]

*  Slate also has a fascinating article about the importance to reproductive health of the microbacterial mix in a vagina:

A healthy vaginal microbiome produces lactic acid and hydrogen peroxide, which maintain a level of acidity that keeps troublemaking microbes at bay. When the vaginal community becomes unbalanced, on the other hand, acidity decreases. The wrong microbes may then invade or, if they’re already present, bloom.

This disturbance can cause bacterial vaginosis—not really an infection, but an out-of-whack ecosystem. It sounds like a trifling problem, and half of women with vaginosis may display no obvious symptoms. But this minor-seeming imbalance can have major consequences.

Vaginosis increases the risk of contracting secondary infections, from herpes to HIV. But even on its own, the microbial shift may prompt low-grade inflammation that can derail reproduction. It can prevent fertilization in would-be mothers, prompt spontaneous abortion in pregnant women, and increase the risk of preterm birth later in pregnancy.

If the vaginal microbiome were suddenly to shift across the entire human population, it's not unreasonable to predict that humanity would go extinct.

 Amongst other fascinating details, there is also the question of how far bacteria get into the female reproductive system:

In 2011, a group at Harvard found that 40 percent of placentas from more than 500 preterm children born by C-section contained culturable microbes. In this case, those placentas colonized by vaginosis-associated species were slightly inflamed. But the placentas coated with lactobacilli were not.

Australian fertility specialists have observed that fluid extracted from ovaries wasn’t sterile, either; it also contained bacteria. The study group consisted of women seeking help with conception. Women who harbored lactobacilli, the researchers found, more often had successful outcomes than those who carried other species.  

The microbes may have been introduced during the egg retrieval process, the scientists acknowledged. But they also asked, “Do we really believe that the female upper genital tract is sterile?”

“I think that there's organisms up there all the time, in healthy people,” Reid says. Some of these microbes likely ascend from the vagina.

And, in the last section, the peculiar American obsession with douching comes in for criticism:

When I asked Cottrell about douching, she told me a story. About a decade ago, flummoxed by the high infant mortality rates in some African-American communities in the Florida panhandle—which were more than twice the rate for Caucasian infants—she began looking for explanations.

“I kept seeing bacterial vaginosis present in mothers whose babies died,” she recalls. “That’s when I started reading about vaginosis.”

She happened on statistics suggesting that one in three American women douche and that some African-American cohorts douched nearly twice as often. Showing that douching directly causes infant mortality remains difficult, yet her resulting paper, published in 2010, reads like an anti-douching manifesto.

Douching has been linked to preterm birth, an elevated risk of acquiring HIV, ectopic pregnancies, cervical cancer, and endometriosis, she points out. It may perpetuate the very condition it’s often intended to address: vaginosis. Scientists at Johns Hopkins have found that, after stopping the practice, bacterial imbalances resolved on their own.

“We recommend not doing it, that's the bottom line,” says Cottrell.

 *   is there any other country that has these products advertised on TV?  Do they still advertise them - I haven't been there for some years - but look at this creepy 1980's ad .  I see that they are certainly still used:

An estimated 20% to 40% of American women between ages 15 and 44 say they use a vaginal douche. Higher rates are seen in teens and African-American and Hispanic women. Besides making themselves feel fresher, women say they douche to get rid of unpleasant odors, wash away menstrual blood after their period, avoid getting sexually transmitted diseases, and prevent a pregnancyafter intercourse. 

 I find this very odd.