Category Archives: Obstetrics and Gynecology

Straight, No Chaser: Living With An Incurable Sexually Transmitted Infection

STD living well

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to your life, and this Straight, No Chaser will discuss those.

Even if you were irresponsible in acquiring an STD, you must learn to be responsible in managing it once it’s known that you have an incurable STD such as HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

std incurable

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

  • You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
  • It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
  • If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
  • Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

A really reasonable way to think about having sex with an incurable STD is to think about kissing someone with a cold or the flu. You could still do it, but you’re likely to be at risk. When the symptoms aren’t there, your partner could still be a carrier of the disease and could still give you the disease. Your better course of action is to wait until all symptoms are gone and then still be careful.

std living facts

You have to simultaneously appreciate that your life will be approximately normal, even as you’ve had a significant change. Even as you get about living the rest of your life, you should be aware of risks that can cause an outbreak.

  • Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
  • Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

STD living

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Genital/Urinary, Infectious Disease, Obstetrics and Gynecology

Straight, No Chaser: STDs – Pubic Lice (Crabs)

Unfortunately, there’s no pleasant way around this topic. I hope the topic doesn’t make you crabby.

public lice_01

There is a story of legend in the medical community regarding the trends to start waxing or shaving pubic hair. It involves crabs (pubic lice). Back in the 1920s, when the clear preference for appearance involved a full “bush,” this was often accompanied with the frequent presence of pubic lice, particularly in the brothels of Las Vegas. Women took to shaving in an effort to relieve themselves from the presence of the lice. However, the newly shaved appearance apparently wasn’t good for business; as a result, these women began wearing pubic toupees.

So why am I telling this story? The toupees were made of beaver hair. That’s the origin of that terminology, in case you didn’t know… On to common questions about pubic lice.

 pubic-lice-hair

What are pubic lice? Pubic lice (aka crabs) a parasitic insects found in the genital and pubic areas of humans.

 pubiclicevsheadlice

Where are pubic lice found? By definition, pubic lice are predominantly found in the genital and pubic areas in one’s hair. However, pubic lice have also been found in other areas of the body with coarse hair, such as the armpits, beard, eyebrows, eyelashes, legs and mustache. In fact, pubic lice on the eyebrows or eyelashes of children are regarded as a prompt to search for sexual abuse. It also is of note that lice on the scalp are head lice, which is a different consideration than pubic lice.

Whom do pubic lice infect? Anyone and everyone seem to be affected. Pubic lice are seen all over the world across all races, classes and ethnicities. Pubic lice are not seen in animals. Pubic lice are most commonly seen in adults, are considered to be a sexually transmitted disease (infection, aka STD or STI) and should prompt a search for other STDs. There have been occasional cases spread through contact with articles such as bed linens, clothing or towels, but this is extremely rare. Lice can’t live away from the warmth of a human body very long, and their feet don’t allow for walking on or attaching to smooth surfaces, so they generally are limited to staying on their hosts.

Can I get public lice by sitting on a toilet? This commonly expressed concern is quite overstated. As noted, lice can’t live away from the warmth of a human body very long, and their feet don’t allow for walking on or attaching to smooth surfaces, so they generally are limited to staying on their hosts.

 pubicLice

What do pubic lice look like? Pubic lice have three forms: the egg (also called a nit), the nymph, and the adult.

  • Nit: Nits are lice eggs. When seen, they are usually found firmly attached to the hair shaft. They are oval and usually yellow to white. Pubic nits hatch in about 6–10 days.
  • Nymph: The nymph is a young, immature louse that just hatched from the nit. Pubic lice nymphs take about 2–3 weeks after hatching to mature into adults capable of reproducing. To live, a nymph must feed on blood.
  • Adult: The adult pubic louse resembles a miniature crab. Pubic lice have six legs; their two front legs are very large and look like the pincher claws of a crab. Pubic lice are tan to grayish-white in color. Females are usually larger than males. In case you’re thinking that doesn’t matter to those infected, it should because females lay eggs, continuing the cycle that causes human discomfort. To live, lice must feed on blood. If the louse falls off a person, it dies within 1–2 days. 

What are the signs and symptoms of pubic lice? The symptoms of pubic lice infestation include genital itching, visible lice eggs (nits) or visible crawling lice.

Pubic-lice

How is a pubic lice infestation diagnosed? The diagnosis of pubic lice is simply made by visualizing a louse or nit (egg) in the pubic hair or elsewhere. It is more common to need a magnifying glass to identify lice or eggs.

How are pubic lice treated? We will go into the treatment of pubic lice in some detail in an additional Straight, No Chaser. It’s too important to simply give a quick answer on this.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Genital/Urinary, Infectious Disease, Obstetrics and Gynecology

Straight, No Chaser: What To Do If You Suspect a Sexually Transmitted Disease (STD)

It’s been a long and productive sex week here at Straight, No Chaser. We’ve run the gamut of common sexually transmitted infections (STIs) and other genital conditions, and links to many are included within this post. However, many of you have rightfully asked a simple question: “What happens if and when I contract a STI?” This and the next post will look at three scenarios around contracting, managing and living with a STIs.

 STD1 tellapartner

What you should do immediately if you suspect you or your partner has a sexually transmitted infection

  • You first job is to stop the denial. STIs don’t go away on their own. Well, actually herpes does, but it’s more accurate to say it goes into hiding, waiting to return another day. At the first suggestion of any abnormality (e.g. vaginal/penile discharge, the presence of bumps, a rash, warts or ulcers, itching or burning when you urinate, or abnormal smells, etc.), get evaluated. This clearly is an example of it’s better to have it (an evaluation) and not need it than to need it and not have it. STIs cause consequences, including PID (pelvic inflammatory disease), birth defects and any increased incidence of cancer. HPV even causes cancer, and without vaccination, virtually 100% of the sexually active population will obtain it at some point in life.

STD1 women-infertile

  • You must get all your sexual partners evaluated and treated. Ping pong is not just a sport. You getting treated without all of your partners doing so as well is pointless. Even your asymptomatic partners can be carriers of the disease. Sorry folks, but guys are much more likely not to have symptoms even if infected. Don’t let that fact change the reality of who needs to be told and treated (or who could have caused the infection). Not telling your female partners about STIs can have devastating consequences.

std1 hiv

  • You should make a commitment to wearing condoms. Either get over the subjective difference in how sexual intercourse feels with and without condoms, or get more creative to adjust for the difference. The issues are common things happen commonly, and the best predictor of future behavior is past behavior. If you have had a STI, you’re more likely to have others in the future. It’s more likely to be in your social network, and you may be the one who is a carrier (of herpes, for example). Given that STIs “hang out” together like a gang (meaning the same individuals infected with one STI are the ones most likely to have others), you want to avoid contract some of the incurable STIs, such as herpes, HIV or HPV.

 std1 testing

What we will do if you suspect you have a STI

  • When you come to your physician’s office or the emergency room with the possibility that a STI exists, or you know you’ve been exposed to one, you will be treated. This is not a situation in which we wait to treat some of the more common conditions, such as gonorrhea or chlamydia. Because of the community, dealing with STIs is more of a “treat now, ask questions later” situation. Besides, many individuals are carriers without the presences of symptoms (particularly those with herpes). I must restate: this is neither the time to be bashful or in denial. If it’s syphilis that’s in question, say so. If you have sufficient symptoms, your medical team will figure it out, but it’s better for you if you already know what the likely culprit is.
  • You should not be offended by the questions you will be asked. Physicians are in the treatment business, not the judging business. Expect to have frank conversations about your sexual habits and preferences, with and without your partner(s) present.

std1 hpv-vaccine

  • If a definitive diagnosis is made for certain conditions (e.g. gonorrheachlamydiasyphilis or PID), you will be treated prior to leaving the emergency room unless you have allergies preventing the use of certain medicines. There are two particular considerations for you after you’ve been treated for a curable STI in an office or ER setting, both regarding your resuming sexual activity. First, if cultures were drawn, you should wait to begin sex until after these results have returned. The cultures will clarify exactly which diseases you have and which antibiotics work against them. Normally this would have been an issue, but antibiotic-resistant gonorrhea is a real thing. Additionally, you should wait to begin sex until all of your current partners have also been treated and cleared. You can and will become reinfected from all STIs on more than one occasion.

The final post in this series discusses managing the presence of an incurable sexually transmitted infection.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Geriatrics/Elderly Care, Health Prevention, Infectious Disease, Obstetrics and Gynecology

Straight, No Chaser: Cervical Cancer – The Sexually Transmitted Cancer

cervical-cancer-awareness

Let’s put this take home message up front: here’s a pretty good demonstration of the value of vaccines. I hope that each of you resolves to get any children you care for vaccinated before they become sexually active.

I want to thank my friend and colleague, Dr. Julius Ellis, noted Ob/Gyn physician for contributing to this post. Let’s start this with two simple statements:

  • Cervical cancer has basically been shown to be caused by an infection.
  • There soon will be no reason that anyone has to have cervical cancer.

female reproductive system

As a reminder, the cervix is the lower and narrow end of the uterus that connects the vagina to the upper part of the uterus (i.e. the womb). Cervical cancer used to be the leading cause of cancer death for women in the US.

In 2018, it is estimated that:

  • 13,240 women in the United States will be diagnosed with cervical cancer.
  • 4,170 women in the United States will die from cervical cancer.

Fortunately, over the last 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly, largely due to Pap tests. The even better news is the opportunity exists to virtually eradicate the disease. Cervical cancer is highly preventable because screening tests and a vaccine to prevent human papillomavirus (HPV) infections are available. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

HPV oral

Yes, cervical cancer is a sexually transmitted infection (STI), and the most common STI is now known to be caused by the human papillomavirus (HPV). Some of you will recognize HPV as a cause of genital warts. This means if you ever develop warts, go get checked immediately (another good reason to do this is because genital syphilis may also present as warts). Even more importantly, certain HPV strains have been shown to cause virtually all cervical and anal cancers. HPV also causes some cancers of the vagina, penis, and oropharynx (a certain part of the throat—and yes, this is what Michael Douglas was referencing about having obtained throat cancer by performing oral sex).

Early on, cervical cancer may not cause signs and symptoms, but advanced cervical cancer may cause bleeding or discharge from the vagina, either of which may be persistent or abnormal from similar episodes you’ve had in the past. If you have any of these signs, see your physician for an evaluation of this and other possible causes of these symptoms.

Am I at risk for HPV? How do you get this?

HPV STD

Everyone having sex or who has ever had sex is at risk for HPV. In fact, nearly all sexually active men and women get it at some point in their lives. HPV is passed on through genital contact, most often during vaginal and anal sex, but also through oral sex and genital-to-genital contact without intercourse. HPV can be passed on between straight and same-sex partners even if and when the infected person has no signs or symptoms. It’s important to know there’s a big difference between obtaining the HPV virus and obtaining cancer from having the HPV virus.

If I get genital warts, will I get cancer?

HPV genital warts

Not necessarily, but the possibility is high enough that you need to get treated. Most HPV infections actually resolve on their own. It’s the ones that linger that pose particular concern.

If I do have warts, what increases my risks for these cancers?

hpv risks

Smoking, a weakened immune system, having had many children (for increased risk of cervical cancer), long-term oral contraceptive use (for increased risk of cervical cancer), and poor oral hygiene (for increased risk of oropharyngeal cancer) all increase the risk for developing cancer after a HPV infection.

How do I get this and how do I prevent it?

HPV

The most reliable way to prevent infection with HPV is abstinence, avoiding any skin-to-skin oral, anal, or genital contact with another. If you are sexually active, a long-term, mutually monogamous relationship with an uninfected partner is the strategy most likely to prevent HPV infection. However, because of the lack of symptoms, it’s hard to know whether a partner is currently infected with HPV. Use of condoms reduces the transmission of HPV between partners, although areas not covered by a condom can still be infected.

HPV vaccine

The Food and Drug Administration (FDA) has approved two HPV vaccines, branded as Gardasil (for the prevention of cervical, anal, vulvar, and vaginal cancer, precancerous lesions, and genital warts in these areas) and Cervarix (for the prevention of cervical cancer and precancerous cervical lesions caused by HPV). Both vaccines are highly effective, but neither has been approved for prevention of penile or oropharyngeal cancer. And yes, it’s safe and effective as young as age 9, although the Center for Disease Control and Prevention currently recommends vaccination between ages 11–14. You must contact your physician for additional details on these important medications.

How do I treat HPV infections?

There’s no treatment for HPV itself, but the problems HPV causes can be treated. We’ll address the two major ones:

  • Genital warts may be treated topically by you or a healthcare provider. If not treated, they may multiply, go away, or stay the same.
  • Cervical cancer may be treated by your gynecologist, but be warned: Prevention is best, and early detection gives you the best chance for the best outcomes. Continue those annual exams.

There will soon come a time when all boys and girls are receiving vaccinations at around ages 11–12, and cervical cancer (in particular) will become a rare entity. That only happens if you get your family immunized. The science is in. There’s no good reasons left to wait.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

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Filed under Health Prevention, Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology

Straight, No Chaser: Endometriosis

endowhat

Guys, it’s not condescending to note that it’s really tough to be a woman. There are so many different medical conditions women have to deal with that men don’t. Many of these just don’t even make sense (well, they make medical sense, but not common sense…). Take the example of endometriosis. This is a condition that millions of women suffer from in which cells that are supposed to live and grow in the lining of the womb (uterus), migrate, implant and grow in other parts of the body. What does that mean to the woman? For starters, it means menstrual-type activity that normally occurs in the womb can occur elsewhere. That just seems cruel. In any event, here’s your what, how, why and what to do for endometriosis.

How?

If you understand that every month a woman’s menstrual period represents the shedding of cells from the inner lining of the womb lining, then you’re most of the way to understanding endometriosis. Endometriosis is the result of these shedded cells migrating, implanting and growing outside of the uterus.

Where?

endometriosis

Tissue that migrates from the womb (endometrial lining) most commonly implants onto the ovaries, bladder, intestines, rectum and pelvic lining, although other locations are possible.

Who gets it?

endometriosis-2

You’re more likely to develop endometriosis if someone in your family (e.g., mother or sister) has it, if you started your periods at a young age, if you’ve never had children, if your periods are irregular (i.e., frequent or last more than seven days at a time) of if you have a closed hymen (vaginal opening).

What happens next?

endometlook

One oddity of these endometrial implants is they tend to stay affixed to their new areas in a way that didn’t occur in the womb. Because this is the tissue that is involved in menstruation, they can grow and bleed in conjunction with your menstrual cycle.

What are the symptoms?

Any, all or none of the following may occur. Endometriosis may exist without symptoms, but it’s most typically defined by pain.

  • Pain during or following sexual intercourse
  • Pain with bowel movements
  • Painful periods
  • Pelvic/low back pain at any time during the menstrual cycle
  • Premenstrual and menstrual pain and/or cramping in the lower abdomen
  • Intestines obstruction (blockage) or other abnormal functioning (rarely)

How is this figured out?

Your job is to recognize the symptoms and seek assistance. Tests may include a vaginal ultrasound and direct visualization of your pelvis via a procedure called laparoscopy, which also allows for treatment.

How is this treated?

There’s a wide range of treatment, which depends on your level of health, the presence/significance of symptoms and your desire to have children in the future.

Options range from symptomatic treatment with exercise, relaxation techniques and pain medication to hormonal medications and surgery to remove areas of the endometriosis. The options are assessed and used based on the particulars of each patient. Details of individual medical and surgical options are discussed at www.sterlingmedicaladvice.com.

What’s the end result?

Endometriosis-Awareness

The treatments mentioned are often effective in improving symptoms but not in providing a cure. A cure is most likely to occur by removal of the womb (uterus), fallopian tubes, and both ovaries (a hysterectomy/oophorectomy).

Complications of endometriosis can include infertility, but this is not universal. More commonly, pain interferes with the activities of daily living, there are large cysts in the pelvis (called endometriomas) and post-menopausal cancer presents in the affected areas.

You should get evaluated for endometriosis if a family member has endometriosis or has particularly problematic menstrual periods or if you are having difficulties becoming pregnant (especially after trying for one year).

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Obstetrics and Gynecology

Straight, No Chaser: Bacterial Vaginosis – No, That’s Not a STD

BV1

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always be respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

bv anyone

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier

Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.

Doctor: Ok. Let’s examine you…

bv thrush

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different parts of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

bv causes

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real.  We even have a real thing call a ‘whiff test’ as part of making the diagnosis.

The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome.  There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.

So this couple gets ‘off the hook’, even though they may decide to start using condoms.  Next we will focus on the risks of various sexual activities. Stay tuned.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

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Filed under Genital/Urinary, Obstetrics and Gynecology

Straight, No Chaser: So… You Skipped Your Period? Let’s Discuss Secondary Amenorrhea

missed-periods-300x205

It happens all the time, but one thing that makes both men and women anxious is a missed menstrual period. Everyone’s always worried about being pregnant (and you should be).

amenorrhea

While a missed menstrual period is the defining feature of early pregnancy, it can be due to a number of other factors and conditions.

Skipped periods are a fact of life. Doctors use the term amenorrhea—primary and secondary amenorrhea—to describe the absence of menstruation.

Primary amenorrhea, which is very rare, is when a female has not yet started her monthly periods, though she is older than age 15 and has otherwise completed puberty. We discuss primary amenorrhea over at www.sterlingmedicaladvice.com.

Secondary amenorrhea, which is much more common, is the absence of periods in a previously menstruating woman. Periods may be irregular, with the woman skipping periods for the first few years after she begins menstruating and during perimenopause (the time preceding menopause). However, when the lapse in regular periods last for over six months, it is called secondary amenorrhea. (This designation does not pertain to post-menopausal, pregnant or breast-feeding women.)

Let’s jump right into the risk factors and causes. There are many, and these conditions tend to interfere with the balance and levels of the body’s sex hormones.

Risk factors

You are more likely to have amenorrhea when the following factors are present:

  • Excessive exercise
  • Significant, sudden weight loss (e.g., gastric bypass, extreme diets)
  • Obesity
  • Severe anxiety or emotional distress
  • Very low body fat (less than 15% – 17%)

Other possible causes include the following:

  • Brain tumors (e.g., pituitary tumors)
  • Cancer/chemotherapy treatment
  • Dilatation and curettage (D&C)
  • Drugs used to treat schizophrenia or psychosis
  • Overactive thyroid gland
  • Polycystic ovarian syndrome
  • Reduced function of the ovaries
  • Severe pelvic infections
  • Use of hormone shots (e.g., Depo-provera) and the six-month period after cessation of these shots

Of course, you’re going to get evaluated, and the first question will be whether or not you are pregnant. The good news is for secondary amenorrhea (and even more so for skipped periods), simply addressing the underlying cause resolves the situation in most cases. However, don’t take it lightly. Get evaluated if you have concerns. Of course, you can feel free to contact your SMA expert consultant with any questions you have.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Endocrine/Metabolic, Medical Treatment, Obstetrics and Gynecology

Straight, No Chaser: Twenty Questions on Menopause (Plus One)

Menopause concept.

Menopause (aka “the change of life”) seems to be one of those things that everyone knows about but many don’t understand well. Let’s approach the topic by reviewing a series of frequently asked questions.

1. Why does it occur?
Menopause is the completion of menstruation. It can occur naturally due to the exhaustion of a woman’s supply of eggs or for other reasons such as having a hysterectomy combined with removal of the ovaries that store these eggs.

2. When does it occur?

The average age of menopause is 51. Symptoms may start much earlier, but it’s usually after age 45.

3. How do I know that menopause has started?

The first thing you may notice at the beginning of menopause is irregular periods. Other changes may include alterations in the flow or duration of periods. To actually know that the process has begun, you should discuss your symptoms with your gynecologist.

4. What’s going on with my hormones during menopause?

Many of the symptoms of menopause are related to changing levels of estrogen and progesterone, two prominent female hormones made in the ovaries.

5. What is perimenopause?

Perimenopause is the timeframe between when menopausal symptoms begin and your last menstrual period. You can still have periods and get pregnant during this time.

meno-symptoms-img1

6. What are the common symptoms of menopause?

  • A change in periods (shorter or longer, lighter or heavier, with more or less time between)
  • A change in your sleep patterns, with trouble sleeping
  • Hot flashes and/or night sweats
  • Mood swings
  • Less hair on the head and more on the face
  • Trouble focusing
  • Vaginal dryness

7. What is a hot flash?

A hot flash is a sudden warming sensation in your body, usually in the upper portions. This can result in flushing of your upper skin with redness and sweating, followed by shivering. Hot flashes tend to last between 30 seconds and 10 minutes.

8. How do I best deal with hot flashes associated with menopause?

Here are some tips to help you address those hot flashes and night sweats.

  • Drink cold fluids when symptoms begin.
  • Don’t smoke.
  • Dress in layers so that if symptoms begin, you may comfortably take off some clothing.
  • Dress and sleep in fabrics that allow your skin to “breathe.”
  • Lower the room temperature, especially when you sleep

9. I’ve heard that hot flashes aren’t as bad if I’ve had a hysterectomy. Is that true?

In some cases, yes. Overall, that correlates with age. If you have a hysterectomy without affecting the ovaries, then the ovaries are still able to make estrogen and progesterone (two important female hormones), and hot flashes may not occur or be as prominent early on. Once the ovaries stop making these hormones, symptoms may occur.

10. Why do I have problems with my bladder?

Changes in your hormone levels (i.e., estrogen) cause thinning and dryness of your genital area. This subsequently can lead to imperfect control, resulting in leaking and urinary tract infections.

© Copyright 2010 CorbisCorporation

11. Does sex change after menopause?

Changes in your hormone levels (i.e., estrogen) cause thinning and dryness of your genital area. This subsequently can lead to pain and other types of discomfort during intercourse. It is not uncommon to see a decreased level of interest after menopause. However, in some the feelings of freedom from possible pregnancy and other considerations lead many to feel sexually freer.

12. What causes early menopause?

Early (premature) menopause may be due to several factors, such as chemotherapy or pelvic radiation treatments for cancer, surgeries of the ovaries or uterus, genetics, chromosomal defects and certain autoimmune diseases (e.g., thyroid disease and rheumatoid arthritis–two conditions in which the body’s immune system may attack the ovaries).

13. Can I get pregnant after menopause?

By definition, no. Menopause represents the end of your menstrual periods, and as such you aren’t releasing any eggs that could be fertilized once this has happened. However, you can get pregnant during the perimenopausal period.

14. How is menopause medically managed?

Menopause is an occurrence, not a disease. However, some symptoms of menopause require treatment. More importantly (usually) considerations of and risks for breast cancer, heart disease and osteoporosis must be addressed. Your physician can be expected to have these conversations with you.

15. Can I still have periods after menopause?

By definition, no. “After menopause” is after you’ve had your last menstrual period. During the transition (i.e., the perimenopausal period), you may have a long gap between periods (i.e., irregular periods), but once menopause has occurred, you’re finished with menstruation.

menopausemoods

16. Why do I seem to be more moody?

It is not clear that mood changes are directly related to menopause. Many other circumstances occurring simultaneously may be contributing to these feelings. Such considerations include stress, anxiety related to family changes (e.g., becoming an “empty nester” or having ill parents), depression or diminished physical fitness, all of which may independently cause emotional distress and mood changes.

17. Why do I develop problems with my bones?

Estrogen controls bone loss. The loss of estrogen occurring around the time of menopause contributes to women losing more bone than is being replaced. As this process progresses, bones become weaker or more likely to break.

18. Why do I develop problems with my heart?

This is likely multifactorial. Heart disease simply increases with age. So does obesity and high blood pressure, both of which are risk factors for heart attacks. Estrogen loss may also contribute.

19.  How can I best stay healthy after menopause?

Read this previous Straight, No Chaser post , which specifically answers this question.

20. When is it safe to say I’ve reached menopause?

It’s safe to say a woman has reached menopause when she has not had a period for one year.

andropause_

21. Why don’t men go through this?

Men actually do have a version of menopause called andropause. Stay tuned!

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Obstetrics and Gynecology

Straight, No Chaser: Advanced Maternal Age

advanced-maternal-age-tt

Times have changed. Marriages are increasingly career-focused, and couples more and more choose to have babies later in life. It is helpful that these decisions can now be aided by recent innovations in medicine regarding fertility. Unfortunately, changes in societal norms don’t remove risks inherent in the human condition. Advanced Maternal Age is a medical consideration for any woman considering childbirth after age 35. The bottom line is advanced maternal age comes with risks. If you or a loved one is considering childbirth after age 35, you need to be aware of these risks and how to minimize them. These include the following.

It likely will take longer to get pregnant.

If pregnant, you will have an increased risk of miscarriage.

If successfully pregnant, you’re more likely to have any of several medical conditions, including the following:

  • Gestational diabetes
  • Pregnancy-induced hypertension
  • Placental previa (in which the “afterbirth” material can inadvertently cover all or part of the uterine opening, causing bleeding and a need for C-section)

Halle Berry takes daughter Nahla for her passport photo in Beverly Hills, California. Pictured: Halle Berry Ref: SPL549901 240513 Picture by: Headlinephoto / Splash News Splash News and Pictures Los Angeles:310-821-2666 New York: 212-619-2666 London: 870-934-2666 photodesk@splashnews.com

If you successfully deliver, your child is more likely to be at risk for any of several medical conditions, including the following:

  • Down Syndrome and other chromosomal birth defects, causing abnormalities in the transmission of heredity information via the genes)
  • Low birth weight and prematurity

janetama

Even though you can never eliminate the above risks, you can reduce them. Consider the following among the list of healthy choices you should make to give yourself the best change to have a healthy baby at an advanced maternal age. All of these recommendations should be adapted in conjunction with your obstetrician.

Get prenatal care before you actually get pregnant and keep it during your pregnancy. You will need to discuss your personalized risks, your health profile, the correct strategy for weight gain, and any prenatal testing that may be necessary.

Eat a nutritious diet, including recommended amounts of calcium, folic acid, iron, Vitamin D, and a daily prenatal vitamin. These dietary habits should begin well before you become pregnant.

Stay physically active. Health basics are even more important during this time.

Getting pregnant at an advanced maternal age is a serious decision. Approach it with the consideration and caution it deserves.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Health Prevention, Obstetrics and Gynecology

Straight, No Chaser: In Honor of Mothers and All Women

At Straight, No Chaser, our posts aim to inform and encourage you to manage your health. In doing so, we would do well to learn about early recognition, diagnosis and management of conditions that are beyond our control. In honor of Mothers Day, we welcome Dr. Sheri Prentiss to the blog. If you don’t know Dr. Prentiss, please take the time to do so. As a breast cancer survivor, Susan G. Komen 3-Day Spokesperson and upcoming Commencement Speaker at Northwestern University, she shares a message of hope and empowerment in the face of just one such health challenge. Thank you Dr. Prentiss for contributing to Straight, No Chaser!

power

When you think of the most powerful women you know, who comes to mind? Some of us think of political figures like Hilary Clinton. Perhaps you think of Oprah or Beyonce or other entertainers.

It’s easy to recognize “power” in celebrity or status in the newsworthy, but true power is something much more subtle and sublime. Webster’s Dictionary defines powerful as “having power, authority, influence.” According to this definition, being powerful has nothing to do with being a public figure, a multi-millionaire or a politician.

While the world certainly needs revolutionaries, entertainers and politicians, what it needs MORE are everyday women, not using their power to position themselves over others, to re-write history or to be rich and famous, but who are creating awesome lives for themselves and others, just like the women I meet on every 3-Day event!

power 3-day 2

The world is in desperate need of women who channel their power into touching hearts with their authenticity, stirring emotions with their self-expression, and impacting their worlds with their “regular” lives. In doing these things, we DO change the world, we WILL re-write history, we will be remembered as women who knew and exercised their power.

power woman

What are the secrets of power-full living? How can you invite more power into your life? It’s easier than you think:

1. A powerful woman exercises her authority. This doesn’t this mean you go around bossing people around, but it does mean you stand up for your values, refuse to be a door-mat, take full responsibility for your life, reject the victim role, refuse to settle for less than you deserve in life and love and use your power to speak your mind.

2. A powerful woman spots her leaks and patches them right away. We all have an incredible capacity for power. Think of this capacity as a gas tank, power being the fuel that moves you. When you have a leak—even the tiniest pin-hole—you lose your power. Where in your life do you lose power? What people, activities, obligations or thought processes drain you of your power? When you find them, “patch” them by making whatever changes are necessary.

power women

3. A powerful woman surrounds herself with other powerful women. Truth is, you won’t always feel strong and in control. Troubles, fears, and real-life problems have a way of draining our power. Women who are connected to other women can share their power. When one friend is low on power, another can siphon some of hers to share. When you’re driving on E and putter out on the side of life’s highway, a caring friend can pick you up and bring you to the nearest re-fueling station.

power exercise

4. A powerful woman re-fuels regularly. Like fuel, power gets spent the more you move. The more you exercise your power, the more necessary it is to re-fuel. A powerful woman does this by connecting with inspiration on a regular basis, by expressing her creativity, by reading good books, by praying, meditating or exercising. There are a million different ways you can re-power. Pick what appeals to your heart and do it.

5. A powerful woman shares her power. It seems to go against what we think of as powerful, doesn’t it? The good news is, sharing your power doesn’t diminish yours. You can share your power perhaps by mentoring a teenage girl or by raising your kids to be strong and independent or by putting your arm around someone who’s sad and empty. There are countless ways you can share your power, and, unlike those dreadful fuel-leak energy-drains, this one actually works in reverse. When you share your power, the world becomes a little brighter, a little more beautiful, and YOU become even more power-filled.power wings

So my questions to you today are these: “Where is your point of power? What energizes you? Where do you lose power? How do you re-fill your tank? How can you share your power?”

Today, consider your amazing capacity for a power-full life … and start living it. Today, share my motto with me: L.I.V.E Everyday!TMLove myself and others…Inspire those around me…Voice my dreams and ambitions…Enjoy life.

Please like and share our blog with your family and friends.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under General Health and Wellness, Obstetrics and Gynecology