STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

STD Awareness: Why Should You Care About Oral Gonorrhea?

Image: CDC

An illustration of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. Image: CDC

When I say “gonorrhea,” you might think of genitals that feel as though they have been set ablaze, or perhaps a viscous fluid oozing from the urethra. But gonococci, the bacteria that cause gonorrhea, can also set up camp in the pharynx after being transmitted into a mouth and down a throat when its new host gave oral sex to its old host. Indeed, performing oral sex on multiple partners has been found to increase risk for an oral gonorrhea infection (more properly called pharyngeal gonorrhea).

If you read our September 2012 article on gonorrhea of the throat, you might remember these fun facts: Oral gonorrhea goes away within three months, even without treatment! Plus, these infections rarely have symptoms. Why, then, should you care about a gonorrhea infection in your throat? You’re not likely to notice it’s there, and it’ll go away on its own anyway.

Many researchers believe that the throat is an incubator for antibiotic-resistant gonorrhea.

Well, aside from the possibility of transmitting a gonorrhea infection from your throat to someone’s genitals, there’s one other thing to care about: the development of antibiotic resistance.

The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat,” and indeed, gonorrhea seems to be evolving resistance to drugs at quite a rapid clip. If gonorrhea evolves complete resistance to the drugs we use to cure it, we could find ourselves sent back in time, to the days when gonorrhea was untreatable — and responsible for infertility, blindness, and chronic pain. While scientists figure out how to address this emerging threat, you can do your part by avoiding gonorrhea in the first place — and that includes using condoms and dental dams to prevent oral gonorrhea infections.

So, while it sounds like a blessing that gonorrhea of the throat rarely has symptoms, there’s actually a drawback: An oral gonorrhea infection probably won’t be effectively treated — or even identified in the first place. And these hidden throat infections are likely to be helping to drive the development of antibiotic resistance. Continue reading

Teen Talk: Gardasil, a Shot of Prevention

pink vaccine cartoonOne of my least-favorite medical memories must have happened when I was 5 years old, give or take. All I remember is that I was very small, surrounded on all sides by my mom, my pediatrician, and a nurse, and shrinking into a corner as the nurse came at me with a needle. I was squirming and protesting and cringing, but she grabbed my arm and pierced it with a syringe, quick as lightning. Before I could howl in protest, it was over.

Arm yourself against genital warts with Gardasil!

But here’s the thing: It hurt. A lot. And for days afterward, I went about my business feeling as if I had been punched in the arm. When I complained to my mom about how sore I was, she said that my muscles were completely tensed up, and shots hurt more when your muscles are tense. That fact only compounded my annoyance — why had that mean old nurse pricked me at the height of my freakout? If someone had just explained it to me, maybe I could have calmed down enough to relax my muscles and minimize the pain.

That incident made a mark on me, and once I hit adulthood I saw no reason to continue inviting the painful sting of immunization if I didn’t have to. It wasn’t until vaccine-preventable diseases like pertussis and measles started making a comeback that I had to admit to myself that avoiding immunization wasn’t anything to be proud of, and I started getting all my booster shots and yearly influenza vaccinations. Continue reading

STD Awareness: Genetics and the Gonococcus

Illustration: CDC

Illustration: CDC

Ever since the discovery of effective antibacterial therapies less than a century ago, humans have been able to easily cure gonorrhea, the sexually transmitted scourge that laid waste to fallopian tubes and robbed newborns of vision. Most of us in the developed world have forgotten that this disease was once a leading cause of infertility in women and blindness in babies — and still is in much of the developing world.

Unfortunately, gonococci — the species of bacteria that cause gonorrhea — have been evolving resistance to every antibiotic we’ve thrown at them, including sulfonamides, penicillins, tetracyclines, macrolides, fluoroquinolones, and narrow-spectrum cephalosporins. We have one remaining first-line gonorrhea treatment left: extended-spectrum cephalosporins, which include cefixime, which is taken orally, and ceftriaxone, which is administered as a shot — and resistance is emerging to those drugs, as well.

Gonococci don’t swap potato salad recipes at family reunions — they swap genetic material!

The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat,” and indeed, gonorrhea seems to be evolving resistance to drugs at quite a rapid clip. Gonococci can acquire resistance to antibiotics in three ways.

First, a genetic mutation can endow bacteria with special antibiotic-fighting powers, making it harder for a drug like penicillin to attach to their cells and destroy them. Such a mutant is more likely to gain evolutionary traction if it finds itself in an antibiotic-drenched environment in which resistance to that drug allows it to “outcompete” other bacteria. Indeed, antibiotic resistance was first documented in the 1940s, just years after sulfonamides and penicillin were introduced as the first effective cures for gonorrhea. Continue reading

Pro-Choice Friday News Rundown

  • teddy bearImagine being 10 years old and pregnant as a result of rape by your stepfather. Imagine being forced to carry that pregnancy to term and give birth — all because your government says so. This is what’s happening to a child in Paraguay. It’d be remiss of me not to mention the fact that pregnancy can be extremely hazardous to this child’s health and can endanger her future fertility, and that girls under the age of 15 are FIVE times more likely to die during pregnancy or childbirth than those over age 20. Again, this child is 10. (Think Progress)
  • Democratic presidential candidate Hillary Clinton says (correctly) that the religious zealots who don’t believe in abortion are infringing upon the rights of the rest of us. (Jezebel)
  • In contrast, two of the candidates from the Republican side, Rand Paul and Ted Cruz, want support allowing employers to fire their employees based on birth control usage, terminating a pregnancy, and other private decisions that have have less than nothing to do with an employee’s job performance. (MSNBC)
  • Meanwhile, Oklahoma has become the fourth state to enact a 72-hour waiting period for women seeking abortions. Gov. Mary Fallin said, “This legislation will help women get the information they need before making a decision they can’t take back.” Um, don’t they already have the information??? That they’re pregnant and no longer wish to be???!! (WaPo)
  • A prolific chlamydia outbreak at a Texas high school that only teaches abstinence? Who would’ve ever thunk it? (Slate XX Factor)
  • Dr. Keith Ablow, a medical blowhard of the Republican persuasion who practically lives on Fox News, thinks men should be able to “veto” a woman’s abortion. Because why should the final decision on that belong to a woman? It’s not like pregnancy is in any way “risky” or could have life-long effects on her health or life in general. He hates that women have “all the control” … over what happens with their bodies and health and lives and all that petty nonsense. Boo friggity hoo. I’ll tell ya what, Ablow, the day an embryo can be transferred from a woman’s body to a man’s to carry to term, I’ll be on board with men having a say. Mmmkay? (Raw Story)
  • Dr. Ablow’s commentary was mostly in reference to the shenanigans of Nick Loeb, the ex-fiance of Modern Family actress Sofia Vergara, and the brouhaha over frozen embryos created during their relationship. Sofia is not interested in those embryos becoming people since she broke up with Nick, so Nick went on an epic faux pro-life shaming rant/tantrum that disgusted most people with any common sense or critical thinking skills. (RH Reality Check)
  • One writer illustrates why it’s important to be pro-abortion in addition to being pro-choice. (Salon)


guys“Hey man, when was the last time you were screened?” Never have I heard those words from any of my male friends.

Unlike my female friends, who I have overheard discussing the safety and health of their sex lives, men seem to avoid conversations like that. The Centers for Disease Control and Prevention’s most recent studies on some of the most common sexually transmitted diseases (chlamydia, gonorrhea, and syphilis) show that while female rates for these STDs either remained the same or declined, men’s infection rates increased, especially with syphilis. Men made up 91 percent of all reported primary and secondary syphilis cases reported during the study.

Don’t stick your head in the sand: Get yourself tested!

Though women are at higher risk of contracting STDs due to their anatomy, their infection rates are dropping while men’s are rising. So what is causing the increase in male STD incidence, and what can we do to fix it?

One of the possible issues is that, on average, women see the doctor more often than men. Young people are notorious for not getting their annual checkups with their primary care physicians since they are usually healthy. That, combined with the lack of gender-specific male doctors, really leaves no incentive for men to go to the doctor. Continue reading

STD Awareness: Three Sexually Transmitted Bugs That Will Fascinate and Intrigue You

From creepy crawly pubic lice, which can be seen with a magnifying glass, to minuscule human papillomaviruses, which can be seen with some of the most expensive microscopes in the world, there are many tiny pathogens that we can acquire through sexual contact. And, despite their diminutive sizes, some of them work in complicated ways, or tell stories about our origins that would blow you away. Let’s learn some amazing facts about three sexually transmitted bugs!

Phthirus pubis, the louse that causes scabies. Image from the Public Health Image Library.

Image: Public Health Image Library

Pubic lice: tiny insects that live in pubic hair

Fans of Charles Darwin might like learning about pubic lice, which offer clues about human evolution. While other apes’ bodies are habitat to only one species of louse, human bodies can host three different types of louse: head lice and the closely related body lice, as well as the distantly related pubic lice.

It is thought that when early humans lost their body hair, human lice followed this receding hairline and migrated to their heads to become head lice. At a later date, the gorilla louse colonized early humans’ pubic regions. Since pubic lice can be transmitted by infested bedding, one idea is that an early human caught pubic lice by sleeping in a burrow that had been recently vacated by a lice-ridden gorilla — no sexual contact required.

By examining the number of differences in the genetic codes of the modern gorilla louse and the human pubic louse, we can place their divergence into two separate species at about 3 million years ago, suggesting that our human ancestors lost their body hair at around that time.

A quite frankly weird fact about pubic lice involves the method their young use to hatch from their eggs — by releasing so much gas that the increase in air pressure causes them to burst from their shell. So there’s that. Continue reading