Tag Archives: STI

STD Awareness: “Can STDs Lead to Infertility?”

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Being diagnosed with a sexually transmitted disease (STD) can be upsetting. Some take it as evidence that they’ve been cheated on; others wonder if they can ever have sex again. Some people who have long dreamed of having children might worry about what impact, if any, their STD could have on future fertility. The bad news is that certain STDs can make it difficult or impossible to have children. But the good news is that STDs are avoidable — and regular STD screening can ensure that infections are caught and treated before they have time to do damage.

It’s common for STDs not to have symptoms, and infections can cause tissue damage — unbeknownst to you!

Fertility can be impacted in several ways. The ability to become pregnant and bear children can be affected by a condition called pelvic inflammatory disease, which is usually caused by untreated gonorrhea or chlamydia infections. If you have a cervix, an infection with a high-risk strain of HPV can require invasive treatment, which in some cases might affect the ability to carry a pregnancy. If you have a penis, an untreated STD might lead to epididymitis, which in extreme cases can cause infertility.

Pelvic Inflammatory Disease (PID)

Many sexually transmitted infections are localized; for example, the bacteria that cause gonorrhea usually just hang out on the cervix. But untreated infections can spread on their own, and bacteria can also hitch a ride on sperm or the upward flow of a douche, which can take them into the cervix, through the uterus, down the fallopian tubes, and to the ovaries. At any of these locations, microbes can stake claim on your reproductive real estate, establishing colonies deep in your reproductive system. As these colonies grow, the bacterial infections become more widespread, and can cause scarring and other tissue damage. To keep these interlopers from getting through the front door, sexually active people can use barrier methods, such as latex condoms — especially with spermicides. There’s no need to host an open house for sexually transmitted bacteria in your uterus. Continue reading →

AIDS Denialism: Conspiracy Theories Can Kill

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This scanning electron micrograph from 1989 reveals HIV particles (colored green) emerging from an infected cell. Image: CDC’s C. Goldsmith, P. Feorino, E.L. Palmer, W.R. McManus

We’ve all heard various conspiracy theories; we may or may not find them credible, and we might chalk up opposing viewpoints to simple differences in opinion. Sometimes, however, conspiratorial narratives are woven around matters of life and death — and in such cases, the spread of such ideas can influence dangerous changes in behavior and even government policy.

AIDS denialism is based on the idea that human immunodeficiency virus (HIV) does not cause AIDS. Although the existence of HIV and its causal connection to AIDS has been thoroughly demonstrated by scientists, denialists either reject the existence of HIV altogether, or cast it as a harmless virus that doesn’t cause illness. Denialism often relies upon rhetorical strategies that are superficially convincing but intellectually hollow, including the cherry-picking of evidence, appeals to unreliable “experts,” and untestable claims. Denialists also might cite early AIDS research from the mid-1980s while ignoring more up-to-date findings and improved medical procedures. Such rhetoric creates a sense of legitimate debate in an area where there is none, and the only new evidence welcomed into the discourse is that which confirms preconceived notions.

Health decisions must be shaped by the best available evidence, and when denialism misinforms, one cannot make an informed decision.

If AIDS isn’t caused by HIV, what do denialists claim is behind the unique symptoms that characterize it? Some say that conditions such as malnutrition, or diseases that have been around for a long time, are simply being labeled as AIDS. Other denialists cast antiretroviral drugs as the cause, rather than the preventive treatment, of AIDS. Some claim that AIDS is caused by behavior, such as drug use or promiscuity — with some even saying that an accumulation of semen in the anus can cause AIDS. None of the claims is true — while AIDS can leave someone vulnerable to a wide variety of diseases, and while sharing IV equipment and engaging in unprotected sex can increase risk, there is only one cause: HIV. Continue reading →

Can Herpes Be Cured Naturally?

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Many of us are infected with herpes simplex virus, which can be transmitted sexually to cause genital herpes. Although herpes is incurable, there are antivirals that can help reduce symptoms. But, because not everyone wants to take pharmaceuticals, a lot of us might seek alternatives in an attempt to treat or even cure our herpes infections.

“Natural” doesn’t necessarily mean safe or effective, so be critical.

For centuries, we have treated herpes in many ways — though not necessarily successfully! In the early 1800s, a British treatment involved placing lint between the tip of the penis and the foreskin. It was claimed that this would cause herpes lesions to heal within 14 days — not coincidentally, this is about how long it takes for them to heal on their own, untreated. Later that century, a London surgeon promoted an arsenic-based solution as a cure for recurrent herpes outbreaks. He presented the cases of a couple of patients. One had been suffering from outbreaks for six years, and after a course of this treatment he allegedly never experienced them again. Another patient had been experiencing recurring outbreaks for four years, and after taking this treatment for a year, his outbreaks “became less and finally cleared altogether.”

We now know that, even without treatment, herpes outbreaks generally become less severe over time, and often stop flaring up completely. When outbreaks do occur, they clear on their own, without treatment. This phenomenon is called “regression to the mean,” and many promoters of bogus remedies rely on it for the appearance that their products work. Because we often think that two things that happen at the same time are related, and that one causes the other, we might attribute the clearing of our herpes lesions to whatever “treatment” we were taking, regardless of whether or not it actually benefited us.

The only way we can know if treatments actually work is to compare them with standard medications or placebos (such as identical-looking sugar pills) in well-designed clinical trials. In such studies, patients are assigned to either medication or placebo at random, which is called “randomization” and is like flipping a coin. And, to protect against introducing bias into the study’s outcomes, trials should be “double-blinded,” meaning that neither researchers nor patients know whether the placebo or the medication under study is being administered. The “miracle cures” you hear about usually haven’t been subjected to such scientific rigor — if they have, the results usually aren’t promising. Continue reading →

April Is STD Awareness Month: Get Yourself Talking, Get Yourself Tested

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GYT2013April is upon us, and you know what that means. It’s STD Awareness Month, so it’s time to GYT. Time to what?

Get
Yourself
Tested

GYT is a national campaign collaboration between Planned Parenthood, Centers for Disease Control and Prevention (CDC), MTV, and Kaiser Family Foundation, which aims to bring greater awareness to STD testing. As part of GYT, Planned Parenthood Arizona wants to make it as easy as possible for you to be screened for sexually transmitted diseases. That’s why participating PPAZ locations are offering a $35 discount on full STD screenings throughout the month of April. Visit us at select health centers in the Phoenix metro area, Tucson, Flagstaff, and Prescott Valley.

In April, participating Planned Parenthood Arizona locations offer discounted full STD screening.

STDs can be transmitted by sexual activity — vaginal, anal, or oral sex, as well as activities that involve skin-to-skin contact. You might think you don’t need to be tested for STDs, but if you are sexually active, STD screening is an important part of maintaining your sexual health — in fact, the CDC recommends it. Most people with STDs don’t have symptoms — no telltale sores, blisters, bumps, warts, or discharge; no itching or burning — which means that it’s possible to have an STD without being aware of it:

  • 3 out of 4 women with chlamydia have no symptoms, and half of men with chlamydia have no symptoms
  • 80 percent of women who have gonorrhea have no symptoms
  • HIV symptoms usually take around a decade to appear

Continue reading →

Does Waxing Get Rid of Crabs?

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5266_lores croppedEver since I started writing this blog’s monthly STD Awareness column, I’ve kept my eye out for news related to sexually transmitted diseases. And, while some might find my enthusiasm for STD-related items to be slightly odd, I have been intrigued by what has been splashed across headlines so far this year.

First, in January, the claim surfaced that pubic lice (colloquially known as crabs) are being driven to extinction as their natural habitat is felled by razors and waxes. Then, just last month, a little-known STD called molluscum contagiosum got its 15 minutes when it was associated with the increased popularity of hairless pubic regions.

Some say hair removal is causing a decline of pubic lice; others say it increases virus risk. So what’s the deal?

These headlines might raise some questions: Does waxing or shaving my pubic area decrease my risk of crabs, but increase my risk of molluscum contagiosum? Should I shave or not? The answers to these questions aren’t quite as simple as the headlines make them out to be. Let’s take them one by one.

Does Waxing Prevent Pubic Lice Infestations?

The claim: As reported in the media, pubic lice are disappearing, and the Brazilian wax is the culprit. Articles cite statistics that pubic-hair removal is more popular among young people, and then jump to the conclusion that this trendy hairlessness is spurring a decrease in pubic-lice prevalence.

What the science says: The problem with this claim is that it isn’t backed by solid scientific data — it’s supported by anecdotes from doctors who have noticed a decline in pubic lice among their patients. As the saying goes, though, the plural of anecdote is not data: Without well-designed population studies spanning many years, we can’t actually know if there are fewer pubic lice today than there were before our groins were subjected en masse to depilation techniques. Furthermore, as that other saying goes, correlation does not equal causation: Even if there were a correlation between the Brazilian’s popularity and a decline in public lice, we would need more specialized data to determine if pubic-hair removal actually caused the lowly louse’s depopulation. Continue reading →

Can Oral Herpes Be Spread to Genitals?

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A cold sore on the lower lip on the second day after onset. Image: CDC

Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.

It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-1 and HSV-2. HSV-1 is associated more with oral herpes, which can cause “cold sores,” a type of blister that appears on the lips or face. HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area. It used to be standard to describe HSV-1 as an “above-the-waist” infection and HSV-2 as a “below-the-belt” infection — but now many researchers are pointing out that it’s more appropriate to say that HSV-1 is both an orally and genitally transmitted infection while HSV-2 is a predominantly genitally transmitted infection. If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection.

Using condoms and dental dams during oral sex reduces risk of herpes transmission.

What exactly is a cold sore, anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth. Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.

Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought. They might have a lot of questions, and if they’ve sought answers to those questions, they might have heard a lot of conflicting answers. Let’s see what the scientific literature has to say.

  • Can I get genital herpes if someone with cold sores performs oral sex on me?

Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection. Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: Yes! Continue reading →

STD Awareness: Oral Herpes

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A transmission electron micrograph reveals HSV particles. Image: Fred Murphy, CDC

One of the most common sexually transmitted diseases is herpes, which most people associate with “outbreaks” in the genitals. In actuality, most cases have no symptoms, and the majority of people with genital herpes don’t know they have it. Herpes simplex virus, which causes genital herpes, can also infect facial nerves around the mouth, and its “outbreaks” include blisters called cold sores.

A cold sore outbreak involves an “eruption” of blisters around the mouth, which slowly heal as the virus returns to dormancy. Most cold sores are caused by herpes simplex virus type 1, or HSV-1. Around 60 percent of Americans are infected with HSV-1, and most of these infections are oral, asymptomatic, and acquired in childhood through nonsexual contact. Despite how common this infection is, only 20 to 40 percent of us actually get cold sores — and an even smaller percentage experience cold sores more than once a year. The rest of us don’t get cold sores at all, even if we are infected with HSV-1. That’s one quirk about HSV — an infection is permanent and incurable, but most people never have symptoms!

The virus that causes oral herpes can also cause genital herpes.

Making matters more confusing, there’s a related virus called HSV-2, which most people associate with genital herpes. However, HSV-1 can also cause genital herpes, and anyone with an HSV-1 infection in the facial area has the potential to transmit the virus to a partner’s genitals while performing oral sex — whether or not cold sores are present. However, when HSV-1 strikes the genitals, the infection is usually milder, with fewer (if any) recurring outbreaks. Additionally, a previous HSV-1 infection in the facial area might make you more resistant to acquiring an HSV-1 infection in the genital area — but it doesn’t confer total immunity. Continue reading →

STD Awareness: 10 Myths About Sexually Transmitted Diseases

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The Internet is brimming with contradictory claims about sexual health, and you don’t know what to believe. Your friends give you advice, but you’re not sure if it sounds right. To make things worse, you might not have had evidence-based, medically accurate sex education in your school. In this edition of our STD Awareness series, we’ll take on a few myths about sexually transmitted diseases to help you sort fact from fiction.

1 MYTH: You can tell if someone has an STD by looking at them.
You might expect that if someone has an STD, their genitals would have blisters, warts, or noticeable discharge. But your partner looks fine, so you might think there’s no need to ask when his or her last STD test was.

However, while many people with STDs do have visible symptoms, they’re the exception rather than the rule. For example, three out of four women and half of men with chlamydia have no symptoms. Herpes is often spread when there are no symptoms present. Someone can be infected with HIV — and capable of transmitting it to others — and go years without showing any signs. A quick visual inspection can’t tell you very much about someone’s STD status.

2 MYTH: You can’t get an STD from oral sex.
While it is generally true that oral sex presents less of a risk for contracting STDs, this risk is not trivial. Most STDs can be passed along by oral sex, including chlamydia, gonorrhea, syphilis, hepatitis B, herpes, human papillomavirus (HPV), and HIV. You can reduce your risk by using barrier methods like condoms and dental dams consistently and correctly.

3 MYTH: Condoms can’t prevent the spread of HIV.
Many proponents of abstinence-only education state that condoms don’t protect against HIV, claiming that latex condoms have holes that are large enough for viruses to pass through. This claim isn’t backed by evidence. An intact latex condom dramatically reduces your risk of being exposed to sexually transmitted viruses such as HIV. (It is true that a lambskin condom does not provide adequate protection against HIV.) Continue reading →