Tag Archives: Chlamydia infection

Straight, No Chaser: STDs – Chlamydia Infections

General Health and Wellness, Infectious Disease, Obstetrics and Gynecology, , , , , , , ,

Chlamydia_image

For most people, NGU isn’t a college in South Carolina. In fact, non-gonococcal urethritis isn’t really even that anymore, meaning it doesn’t need to be defined by the fact that it’s not gonorrhea. Chlamydia (the most common cause of NGU) by itself causes an estimated 3 million sexually transmitted infections a year. It is the most likely reason you’re coming into the emergency department when someone’s been behaving badly, and it was the most common sexually transmitted infection for a long time (prior to the advent of human papillomavirus – HPV). This Straight, No Chaser gives you some essential information about sexually transmitted infections featuring Chlamydia.
chlamydia
1. It’s a real good reason to wear condoms. Chlamydia most commonly presents with no symptoms but may present with burning with urination, having to go more often (that’s the urethritis; the urethra is the tube through which urine flows) and a cloudy discharge. Less commonly, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis).

chlaymdia neonatal

2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (to disastrous effects to the baby, as noted in the lead picture of the newborn; Chlamydia has long been a significant cause of blindness worldwide, though thankfully the rate is decreasing).

Chlamydia-rate

2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner(s) have completed treatment.
Chlamydia stats
4. It causes serious damage to females. PID (pelvic inflammatory disease – a complication of untreated Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility, an increased rate of tubal (ectopic) pregnancies and other complications. This needs to be identified and treated.
5. STDs hang out together. Chlamydia that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Chlamydia should prompt treatment for other STDs and testing for HIV.

chlamydia infection condom

6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with development of signs or symptoms. Discuss the discovery of Chlamydia with all sexual contacts from the last several months. This is an infection you don’t have to catch.
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

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

General Health and Wellness, , , , , , , , , , , , ,

stdstudSTD1in25
As an emergency physician, my first consideration is to eliminate life threats.  Along the way, I cure disease and provide a ton of information.  With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle).  This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

std-statistics-worldwide-infographic

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations.  I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples.  This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina.  I know he’s doing something!
Doctor: Can you tell me what it smells like?  Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything.  She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex.  Now about that discharge…
This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

std red-carpet-celebrities-with-stds

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss.  In this case, what you don’t know can kill you.  No matter what you think about how ‘good’ it is, it’s not worth risking your life over.  Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
If you’re sexually active, you really should follow this series. There’s going to be a lot covered. Might I suggest you cover it as well?
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

Straight, No Chaser: STDs – Chlamydia Infections

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

Chlamydia_image

For most people, NGU isn’t a college in South Carolina. In fact, non-gonococcal urethritis isn’t really even that anymore, meaning it doesn’t need to be defined by the fact that it’s not gonorrhea. Chlamydia (the most common cause of NGU) by itself causes an estimated 3 million sexually transmitted infections a year. It is the most likely reason you’re coming into the emergency department when someone’s been behaving badly, and it was the most common sexually transmitted infection for a long time (prior to the advent of human papillomavirus – HPV). This Straight, No Chaser gives you some essential information about sexually transmitted infections featuring Chlamydia.
chlamydia
1. It’s a real good reason to wear condoms. Chlamydia most commonly presents with no symptoms but may present with burning with urination, having to go more often (that’s the urethritis; the urethra is the tube through which urine flows) and a cloudy discharge. Less commonly, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis).

chlaymdia neonatal

2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (to disastrous effects to the baby, as noted in the lead picture of the newborn; Chlamydia has long been a significant cause of blindness worldwide, though thankfully the rate is decreasing).

Chlamydia-rate

2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner(s) have completed treatment.
Chlamydia stats
4. It causes serious damage to females. PID (pelvic inflammatory disease – a complication of untreated Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility, an increased rate of tubal (ectopic) pregnancies and other complications. This needs to be identified and treated.
5. STDs hang out together. Chlamydia that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Chlamydia should prompt treatment for other STDs and testing for HIV.

chlamydia infection condom

6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with development of signs or symptoms. Discuss the discovery of Chlamydia with all sexual contacts from the last several months. This is an infection you don’t have to catch.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

General Health and Wellness, , , , , , , , , , , ,

stdstudSTD1in25
As an emergency physician, my first consideration is to eliminate life threats.  Along the way, I cure disease and provide a ton of information.  With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle).  This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

std-statistics-worldwide-infographic

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations.  I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples.  This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina.  I know he’s doing something!
Doctor: Can you tell me what it smells like?  Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything.  She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex.  Now about that discharge…
This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

std red-carpet-celebrities-with-stds

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss.  In this case, what you don’t know can kill you.  No matter what you think about how ‘good’ it is, it’s not worth risking your life over.  Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
If you’re sexually active, you really should follow this series. There’s going to be a lot covered. Might I suggest you cover it as well?
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: STDs – Chlamydia Infections

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

Chlamydia_image

For most people, NGU isn’t a college in South Carolina. In fact, non-gonococcal urethritis isn’t really even that anymore, meaning it doesn’t need to be defined by the fact that it’s not gonorrhea. Chlamydia (the most common cause of NGU) by itself causes an estimated 3 million sexually transmitted infections a year. It is the most likely reason you’re coming into the emergency department when someone’s been behaving badly, and it was the most common sexually transmitted infection for a long time (prior to the advent of human papillomavirus – HPV). This Straight, No Chaser gives you some essential information about sexually transmitted infections featuring Chlamydia.
chlamydia
1. It’s a real good reason to wear condoms. Chlamydia most commonly presents with no symptoms but may present with burning with urination, having to go more often (that’s the urethritis; the urethra is the tube through which urine flows) and a cloudy discharge. Less commonly, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis).

chlaymdia neonatal

2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (to disastrous effects to the baby, as noted in the lead picture of the newborn; Chlamydia has long been a significant cause of blindness worldwide, though thankfully the rate is decreasing).

Chlamydia-rate

2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner(s) have completed treatment.
Chlamydia stats
4. It causes serious damage to females. PID (pelvic inflammatory disease – a complication of untreated Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility, an increased rate of tubal (ectopic) pregnancies and other complications. This needs to be identified and treated.
5. STDs hang out together. Chlamydia that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Chlamydia should prompt treatment for other STDs and testing for HIV.

chlamydia infection condom

6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with development of signs or symptoms. Discuss the discovery of Chlamydia with all sexual contacts from the last several months. This is an infection you don’t have to catch.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

General Health and Wellness, , , , , , , , , , ,

stdstudSTD1in25
As an emergency physician, my first consideration is to eliminate life threats.  Along the way, I cure disease and provide a ton of information.  With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle).  This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

std-statistics-worldwide-infographic

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations.  I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples.  This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina.  I know he’s doing something!
Doctor: Can you tell me what it smells like?  Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything.  She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex.  Now about that discharge…
This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

std red-carpet-celebrities-with-stds

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss.  In this case, what you don’t know can kill you.  No matter what you think about how ‘good’ it is, it’s not worth risking your life over.  Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
If you’re sexually active, you really should follow this series. There’s going to be a lot covered. Might I suggest you cover it as well?
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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 © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser In the News: Abstinence-Only Education and Sexual Health

General Health and Wellness, Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, Health Prevention, , , , , ,

sexed

In my capacity as a physician, when it comes to patients, I often say it’s not my job to judge but to treat. However, as a public health consideration it would be nothing short of unethical not to speak on certain matters that affect communities and entire nations.
For a long time, matters of health weren’t subject to the whims of politicians. As examples, matters of women’s health, immunizations and issues pitting corporate interests against the public’s health were generally settled in favor of science and health prevention and promotion. The United States not only valued education and science but led the way for the rest of the world to follow. The U.S. generally ascribed to the notion that “knowledge is power.” Unfortunately, whether due to religious, “freedom” or political considerations, recent trends have substantially altered this stance. The reasons why a change has occurred isn’t as important of a public health consideration as much as the fact that a change has occurred.
For example, you may or may not be aware of the presence of abstinence-only schools. Perhaps it would be one thing to promote an agenda-based education (or lack thereof) on the strict basis of religious preference, but in those examples in which people are actually attempting to argue opinions as if they’re facts is a bridge too far to cross (e.g. claims that abstinence-only educations are more effective than comprehensive sexual education). The problem with simply acquiescing those with the loudest screams in these matters is that neither science nor health is a matter of opinion. These decisions have consequences, and failure to follow the science has predictable consequences.

sexedgirls

 
So here we are with news this week from a rural town in Texas that features an abstinence-only school. The U.S. Centers for Disease Control and Prevention has announced an outbreak of chlamydia – 20 of the 300 students have tested positive for chlamydia (review this Straight, No Chaser post on Chlamydia for details on this sexually transmitted infection). In fact, the CDC is calling the outbreak “a health issue at epidemic proportions.”

YouthLogo

It’s an admirable goal to promote abstinence. It’s also admirable to promote sexual responsibility. It’s not admirable to deny education or to be oblivious to the fact that the average age of initial sexual activity is 12 years old. A posture of “if kids are not having any sexual activity, they can’t get this disease…that’s not a bad program” is unbecoming of an educator or school superintendent, particularly for a disease that leaves up to 20% of untreated women sterile if they develop pelvic inflammatory disease (PID) as a result of contracting chlamydia. Sexual health prevention and promotion are not the same as promoting illegal or immoral behavior. Considerations of promoting abstinence and sexual education are not mutually exclusive.

sexualhealthteaching

It is past time to acknowledge that the consequences of denying education in the pursuit of abstinence are as consequential as promoting promiscuity. For the record, it is a matter of fact, not opinion, that those educated in abstinence-only schools have higher rates of sexual activity, teen pregnancy and sexually transmitted infections.

Shouldn’t facts matter?

I’ll leave you with this thought: is it a greater sin for a teenager to be human or for adults to knowingly expose children to conditions that could leave them scarred for a lifetime?
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 © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: STDs – Chlamydia Infections

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

 

Chlamydia_image

For most people, NGU isn’t a college in South Carolina. In fact, non-gonococcal urethritis isn’t really even that anymore, meaning it doesn’t need to be defined by the fact that it’s not gonorrhea. Chlamydia (the most common cause of NGU) by itself causes an estimated 3 million sexually transmitted infections a year. It is the most likely reason you’re coming into the emergency department when someone’s been behaving badly, and it was the most common sexually transmitted infection for a long time (prior to the advent of HPV). This Straight, No Chaser gives you some essential information about sexually transmitted infections featuring Chlamydia.
chlamydia
1. It’s a real good reason to wear condoms. Chlamydia most commonly presents with no symptoms but may present with burning with urination, having to go more often (that’s the urethritis; the urethra is the tube through which urine flows) and a cloudy discharge. Less commonly, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis).

chlaymdia neonatal

2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (to disastrous effects to the baby, as noted in the lead picture of the newborn; Chlamydia has long been a significant cause of blindness worldwide, though thankfully the rate is decreasing).

Chlamydia-rate

2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner(s) have completed treatment.
Chlamydia stats
4. It causes serious damage to females. PID (pelvic inflammatory disease – a complication of untreated Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility, an increased rate of tubal (ectopic) pregnancies and other complications. This needs to be identified and treated.
5. STDs hang out together. Chlamydia that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Chlamydia should prompt treatment for other STDs and testing for HIV.

chlamydia infection condom

6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with development of signs or symptoms. Discuss the discovery of Chlamydia with all sexual contacts from the last several months. This is an infection you don’t have to catch.

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

General Health and Wellness, , , , , , , , , ,

stdstudSTD1in25
As an emergency physician, my first consideration is to eliminate life threats.  Along the way, I cure disease and provide a ton of information.  With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle).  This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

std-statistics-worldwide-infographic

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations.  I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples.  This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina.  I know he’s doing something!
Doctor: Can you tell me what it smells like?  Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything.  She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex.  Now about that discharge…
This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

std red-carpet-celebrities-with-stds

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss.  In this case, what you don’t know can kill you.  No matter what you think about how ‘good’ it is, it’s not worth risking your life over.  Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
While you’re waiting for the next post, go back and reread another of the most common sexually transmitted diseases: this post on ‘The Sexually Transmitted Cancer”.  It definitely should be considered required reading for everyone who is sexually active or about to become active, and I would have addressed it first had I not already covered it.  Might I suggest you cover it as well?
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com(SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Pelvic Inflammatory Disease (PID) – A Really Good Reason Not to Get a Sexually Transmitted Disease

Genital/Urinary, Obstetrics and Gynecology, , , , , , , , , , ,

PID1

We’ve previously discussed sexually transmitted infections (STIs) at length, including gonorrhea and chlamydia. One thing that often gets overlooked or not given enough consideration is the risk of complications that occur when contracting a STI. Pelvic inflammatory disease (PID) is one consideration that should be up front and center as a consideration in your mind. If you’re not familiar with the term PID, commit it to memory, as this is a relatively common condition.

PID

Pelvic inflammatory disease (PID) refers to an infection of the upper genital tract in women. It is usually sexually transmitted. PID is the single most common preventable cause of infertility in the U.S. According to the Center for Disease Control and Prevention (CDC), over 750,000 cases of PID occur in the U.S. every year.
Here’s your concern: PID can negatively affect your reproductive organs, including the uterus (womb), fallopian tubes (tubes that carry eggs from the ovaries to the uterus) and ovaries. The inflammation caused by PID scars affected organs and can result in infertility, tubal (ectopic) pregnancy, chronic pelvic pain, abscesses (pus pockets, aka “boils”) and other serious gynecological problems.  Most ominous is the fact that up to 20% of women may become infertile as a result of PID.
As mentioned, PID typically begins as an STI. Among STIs, gonorrhea and chlamydia are the most common causes. Here are additional risk factors for PID.

  • Prior episode of PID
  • Under age 25 – The cervix (opening to the uterus) has greater susceptibility to STIs and thus to PID in this age group.
  • Douching — This can force bacteria from the vagina into the upper reproductive organs.
  • IUD use — In some women, using an intrauterine device (IUD) to prevent pregnancy can also cause PID.
  • Medical care — PID may rarely result from gynecological procedures or surgeries.

There is a pretty significant range in the way PID shows up. You may not have symptoms, or symptoms could be quite severe. Symptoms may include lower abdominal pain, fever and foul-smelling vaginal discharge. You may notice pain with sex or while urinating. Your menstruation may become abnormal.
This may sound odd, but the treatment of PID is much more important than its diagnosis. This is because a diagnosis may be difficult to reach due to the subtlety of symptoms, and the consequences of missing the diagnosis are severe enough that presumptive treatment is commonly done. Early treatment can prevent or limit long-term complications such as infertility and chronic pelvic pain. According to the CDC, without adequate treatment, 20-40% of women with chlamydia and 10-40% of women with gonorrhea may develop PID. Among those with PID, fully one in five (20%) may develop infertility and one in 10 (10%) may develop a tubal (ectopic) pregnancy. Chronic pelvic pain occurs in approximately 18% of cases of PID.
If you are thought to have or are diagnosed with PID, you will need antibiotics. It is critical that you take these until they are all gone. This is not an instance where you should stop taking the pills once you start feeling better. More specifics on the treatment of PID are provided at www.sterlingmedicaladvice.com.
What you really want to remember is that prevention is key. The best way to avoid STIs is to abstain from sex or to be in a long-term, mutually monogamous relationship with a partner who has been tested and isn’t infected. In addition, correct and consistent use of condoms further reduces your risk of STIs, including chlamydia and gonorrhea.
One more crucial means of protection from PID is early detection. If you think you or your sexual partner may have an STI, get evaluated and treated promptly.
Feel free to ask your SMA personal healthcare consultant any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Sexually Transmitted Disease Summary and The Week In Review, Sept. 29th, 2013

Infectious Disease, The Week In Review, , , , , , , , , , , ,

in-case-you-missed-it

Based on your responses to the pictures posted this week, I should have renamed the blog, Scared Straight, No Chaser. The irony of it all is without exception, those pictures were very typical representations of the various sexually transmitted infections (STIs). Some of you didn’t like it, but I do appreciate that large numbers of you read it all. I hope you learned a lot and even more importantly were moved into (in)action. In case you missed anything:

On Sunday, we began the week with a look at bacterial vaginosis (BV), which may be associated with sex but is not an STI. It’s important for women to take an active effort to learn their bodies and the effects various activities have. Remember, BV is easily treated, but it’s always fair to take the opportunity to ensure that STIs aren’t also present.

On Monday, we reviewed the most common bacterial STI, chlamydia. Chlamydia is a really typical disease in that it’s contagious, easily transmitted and has substantial complications if not treated.

On Tuesday, we reviewed gonorrhea, which very often occurs in tandem with Chlamydia. Like chlamydia, it’s contagious, easily transmitted and has substantial complications if not treated. Think of gonorrhea when copious discharge is present, and don’t forget this includes the eyes, throat and joints.

On Wednesday, we reviewed the various stages of syphilis. This easily treatable yet very dangerous disease has the nasty habits of mimicking many other disease and spontaneously disappearing – which is not the same as it being cured. Instead, it progresses to more harmful stages if not identified and treated. Remember the association of syphilis with rashes involving the palms and soles.

On Thursday, we reviewed the treatment of syphilis. It is so important to understand how easily this is treated, so get checked. We also reviewed the story of the Tuskegee Experiment of Untreated Syphilis and how that (unethically) led to the knowledge we have about syphilis and the mandatory protections now in place for humans participating in medical experiments.

On Friday, we reviewed herpes. Many were shocked to learn these groups of small blisters (vesicles) can be found wherever an infection occurs, including the fingers, eyes and mouth. Think of herpes when you get a painful genital ulcer, and get checked ASAP.

On Saturday, we discussed the cauliflower ear, a too common, very preventable and apparently sought after (by certain athletes) condition seen in those with trauma to the ear. The trauma results in the accumulation of blood and clots, which damages and deforms the ear into its prototypical appearance. This leads to a life of pain and deformity.

Here are three final considerations on sexually transmitted infections.

1. They all tend to coexist. Your exposure to one places you at risk for acquiring others, including HIV/AIDS. What you don’t know can hurt you; in fact it can kill you.

2. Remember that until your partner is treated, you’re not treated.

3. Most of these diseases lead to conditions that physiologically make acquiring HIV/AIDS more likely. I didn’t discuss HIV/AIDS this week because it’s involved enough that it is its own topic with several different considerations. We’ll address these another time.

If you’re not prudent enough to practice safe sex, please be diligent enough to get tested and treated based on any suspicion. Even better – do both. The life you save will be your own.

Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Gonorrhea (No Clapping)

General Health and Wellness, Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, , , , , , ,

GonorrheaPHIL_3766
Some of you are old enough to remember when Gonorrhea was called ‘The Clap’, but do any of you know why it was called that? Read on for the answer. In the meantime, realize how disgusting a disease this is. The Center for Disease Control and Prevention (CDC) estimates that well over 800,000 cases of gonorrhea occur yearly. To make matters worse, have you heard about the new ‘Super Gonorrhea’? Don’t let this happen to you.

Here’s what I want you to know about Gonorrhea:

1. It’s a real good reason to wear condoms and a just as good of a reason to wash your hands. Gonorrhea most commonly presents with no symptoms (more often the case in women), but it has two symptoms that won’t let you forget it. It’s the STD that may present with burning upon urination so severe that you feel like you are peeing razor blades. It’s also defined by copious discharge. If you’re exuding white, yellow or green pus, think gonorrhea. As was the case with Chlamydia, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis), as well as the throat or eyes. Wash your hands after using the bathroom, gents.
2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (There’s even a name for the condition: ophthalmia neonatorum, as seen in the lead picture.).
2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner has completed treatment.
4. It causes serious complications. PID (pelvic inflammatory disease – a complication of untreated Gonorrhea and Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility and an increased rate of tubal (ectopic) pregnancies. Gonorrhea also spreads through the blood and joints. Many of these complications are life-threatening.
5. STDs hang out together. Gonorrhea that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Gonorrhea should prompt treatment for other STDs and testing for HIV. It is generally assumed that if you have gonorrhea, you’ve likely been infected with Chlamydia.
6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with the development of signs or symptoms. Discuss the discovery of Gonorrhea with all sexual contacts from the last several months. This is an infection you don’t have to catch.
7. It is now super, but not in a good way. Due to antibiotic resistance, treatment of gonorrhea is becoming more complicated. We are seeing more patients who don’t respond to the first course of treatment. Consider antibiotic resistance if symptoms persists more than three days after completion of treatment.

Now, about The Clap.

Traditionally, there have been three theories about why gonorrhea is called the clap, only one of which sound legitimate to me.
1. Treatment (allegedly) used to involved ‘clapping’ a book together around the penis to expel the discharge. Not only does that not make sense, I can’t imagine men letting someone smash their penis in that manner, when you could just ‘milk’ the discharge out (no pun intended). This is a very common explanation, though…
2. The clap may be a mispronunciation of the phrase ‘the collapse’, which is what gonorrhea was called by medics when GIs were being infected with gonorrhea in WWII.
3. Finally, perhaps, clap is derived from the French word for brothel, ‘clapier’. Makes sense if you’re in Paris, but in NY, why wouldn’t it have been called ‘the broth’, because that’s kind of how it looks… Sorry if you’re reading this during lunch. Then again, I did spare you a picture of genital gonorrhea.
Let me know if you have any questions or comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Most Common STD – Chlamydia

Genital/Urinary, Medical Treatment, Obstetrics and Gynecology, Health Prevention, , , , , , , ,

chlamydiachlaymdia neonatal
For most people, NGU isn’t a college in South Carolina. In fact, non-gonococcal urethritis isn’t really even that anymore, meaning it doesn’t need to be defined by the fact that it’s not gonorrhea. Chlamydia (the most common cause of NGU) by itself causes an estimated 3 million sexually transmitted infections a year. It is the most likely reason you’re coming into the emergency department when someone’s been behaving badly.
Here’s what I want you to know about Chlamydia:
1. It’s a real good reason to wear condoms. Chlamydia most commonly presents with no symptoms but may present with burning with urination, having to go more often (that’s the urethritis; the urethra is the tube through which urine flows) and a cloudy discharge. Less commonly, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis).
2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (to disastrous effects to the baby, as noted in the lead picture of the newborn; Chlamydia has long been a significant cause of blindness worldwide, though thankfully the rate is decreasing).
2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner(s) have completed treatment.
4. It causes serious damage to females. PID (pelvic inflammatory disease – a complication of untreated Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility, an increased rate of tubal (ectopic) pregnancies and other complications. This needs to be identified and treated.
5. STDs hang out together. Chlamydia that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Chlamydia should prompt treatment for other STDs and testing for HIV.
6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with development of signs or symptoms. Discuss the discovery of Chlamydia with all sexual contacts from the last several months. This is an infection you don’t have to catch.
Let me know if you have any questions or comments.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress