Tag Archives: Behind the Curtain

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: Prevention and Treatment of Food Allergies

FoodAllergies_enHD

Whether or not you personally have a food allergy, it is likely you will find yourself in a situation with someone who does. Food allergies affect approximately 15 million Americans. Given that this could be a life-threatening event, it’s important for you to know some basics about addressing allergic reactions to food as they occur.

Tips to Prevent

Let’s start with some tips for you to better prevent allergic reactions, because once you become aware that you have a food allergy, avoidance means everything. Remember from this post that allergic reactions can occur without you eating the food; simple exposures such as touching or breathing the food can prompt a reaction.

 Peanut-warning-sign

  1. Develop a habit of carefully checking the ingredient labels of food products. You don’t get to live life casually. You must be diligent and make sure you’re not exposing yourself.
  2. Learn other names for the food or foods that you and your doctor think it best to avoid. Especially when you’re eating out, you should present these names on a list to your kitchen staff to ensure your safety. Have the waiters check with the cook or chef. Depending on the severity of your condition, you may wish to do this before entering restaurants, as vapors may be enough to trigger reactions in some.
  3. Have your physician provide you a list of symptoms and instructions in case of an allergic reaction. Keep it within easy reach, and share it when out and about eating. Yes, you need to be this diligent.

 med bracelet

Tips to deal with emergencies

  • The first consideration is you need a plan. Your life probably isn’t as simple as the movies, where you get to stab yourself with some epinephrine and go about your business five minutes later. Rummaging through a pharmacy looking for Benadryl while your throat is closing isn’t your best course of action.
  • Wearing a medical alert bracelet can be life saving in the event you pass out. It can be the only tip available to a medical professional trying to save you.

epipen

  • If you’ve been instructed by your physician on how to self-administer epinephrine (adrenaline), go for it under the correct circumstances.
  • In the absence of that, or while you’re following your physician’s instructions, calling 9-1-1 (i.e., emergency services, an ambulance) is your best bet. They will have the medicine needed to rescue you and the equipment needed to help you if things go wrong. Because you might not have much time, getting help can be more important that attempting to treat yourself.
  • You should be aware that once in the emergency room, treatment focuses on blunting the immune response with steroids and various medicines called antihistamines (histamines are substances that are released by the body in response to perceived threats; inappropriate histamine release causes many of the symptoms of an allergic reaction).

Advances in Food Allergy Treatment

There is no cure for food allergy. Researchers in food allergy treatments are focusing on new methods of treatment, some of which your primary care physician or allergist may consider.

  • Oral and sublingual immunotherapy: This involves providing small amounts of the allergic substance either by mouth or under the tongue, and treating reactions as they occur. The idea here is to allow you to better tolerate increasing exposures to the allergen.
  • Chinese herbal medicine: An herbal remedy known as FAHF-2 is being studied to assess effectiveness against those serious, life threatening allergic reactions (anaphylaxis).
  • Anti-IgE therapy: IgE is the molecule our bodies use to fight off allergic threats. Anti-IgE molecules bind to IgE in an effort to curb that response and provide possible short-term relief treatment from food allergies.

While these treatments are still in ongoing studies to determine safety and long-term effectiveness, these potential advances represent the best source of optimism in food allergy research in recent memory. If you have any additional questions, certainly contact your Sterling Medical Advice expert consultant or your physician.

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

3 Comments

Filed under Diet and Nutrition, Endocrine/Metabolic, Hematology & Oncology/Blood Disorders/Cancer

Straight, No Chaser: Food Allergies

I often say whatever you put in your mouth either helps or harms you. Today, we discuss food allergies, which sounds like a cruel trick or something out of a horror movie, but unfortunately, they’re all too real. Let’s address questions on the topic.

 food.allergies.101.cnn.640x480

Why do I get allergies anyway?

Food and other types of allergies result from your body mistaking harmless substances for potential threats. The resulting immune response is an attempt to defeat that threat. You are caught in the crossfire, and you exhibit symptoms as a result.

Why do I get allergies to foods I’ve eaten before without a problem?

In many instances, the first time you’re exposed to a certain new food, your body is only primed, and you won’t experience symptoms. A subsequent exposure will prompt the full allergic response.

Is there a way to know if I’m at risk?

Food allergies are more likely in those who have a family history of allergies, asthma or eczema. Take a minute today and ask your parents if they have any allergies to foods or medicines. It’s good to be aware.

How do I know my symptoms are an allergic reaction?

We’ll discuss symptoms shortly, but one big clue is the timing of symptoms. Allergic reactions due to food take place within minutes to a few hours after exposure. It’s not as important for you to know the symptoms as to realize that you’re not well and that evaluation is needed.

 food allergy sx

So what are the symptoms?

Let’s start with the life-threatening considerations. If you have any shortness of breath, mental status changes (e.g. confusion, severe dizziness) or sensation that your throat is closing, get to an emergency room as soon as possible. Other symptoms may include the following.

  • Itching or swelling of your mouth or the tissues between your mouth and throat
  • Hives, wheals, or an eruption of your eczema
  • Abdominal pain or cramping
  • Nausea, vomiting or diarrhea
  • Drop in your blood pressure

food allergy touch

Can you get food allergies from touching foods?

Yes. As an example, those with peanut allergies can have an allergic reaction from breathing in peanut residue, touching peanuts or using skin products that contain peanuts.

 food-allergies

Which foods are most likely to cause allergies?

Here is a partial list of foods commonly causing food allergies.

  • Cow’s mik
  • Eggs
  • Fish/shellfish
  • Peanuts/tree nuts
  • Soy
  • Wheat

Cow’s milk? Is that the same as lactose intolerance? 

No. That’s a different consideration and an upcoming post.

What about treatment?

That’s tomorrow’s post. Obviously knowledge and avoidance are key.

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 Diet and Nutrition, Endocrine/Metabolic, Hematology & Oncology/Blood Disorders/Cancer

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.

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

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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.

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