Tag Archives: HPV

Eliminating Cervical Cancer with the HPV Vaccine

March 3, 2017Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Pediatrics/Kids Health, Health Prevention844-SMA-TALK, Behind the Curtain, Cervical cancer, HPV, Human papillomavirus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, vaccinationsJeffrey Sterling, MD

Introduction

This Straight, No Chaser post discusses the success of the HPV vaccine in eliminating cervical cancer.

In the news is information about the human papillomavirus (HPV) vaccine. It prevents the sexually transmitted infections (STIs) that cause genital warts. This is especially important because these warts cause cervical, anal, penile, mouth and throat cancers. Here’s the spoiler alert! The news demonstrates the vaccine is even more effective than originally thought. Eliminating cervical cancer in total may be possible.

A two-thirds reduction already!

Federal researchers from the US Centers for Disease Control and Prevention (CDC) note that existing use of the vaccine has reduced the presence of the virus in teenage girls by approximately two-thirds. This information is especially impressive given the relative novelty and limited use of the vaccine. Only about 40% of girls and 20% of boys between ages 13-17 have been vaccinated. Here is the better news for the future. Public health professionals are making a significant push for greater vaccine use at ages 11-12. The timing for this is key. Immunization at this time for other childhood diseases has a vaccination rate exceeding 80%.

A public health message

Taking the vaccine is not just about preventing a sexually transmitted infection (genital warts). More importantly, it is primarily about cancer prevention. Unfortunately, this message hasn’t fully penetrated the national dialogue. Only the District of Columbia, Rhode Island and Virginia require the HPV vaccine. At this point, it is believed universal use of the vaccine would virtually eradicate cervical cancer. As evidence, several other countries in which HPV vaccine use is mandatory (e.g. Australia) have achieved over 90% reduction in rates of genital warts.

About 14 million Americans become infected with HPV each year. Approximately 27,000 people get cancer as a result of an infection from HPV. Additionally, the American Cancer Society estimates that 4,120 women will die of cervical cancer this year.

If you have a child of either sex, have the conversation with your pediatrician or primary care physician. The HPV vaccine is given as early as age 10. Also, if you’re a female into your mid-twenties and haven’t been vaccinated, you should also discuss this vaccine with your physician. Be encouraged! A simple vaccine can eliminate cervical cancer. Take charge of your health. Reduce the risk. Eliminating cervical cancer is within reach.

Read this post for a general discussion of cervical cancer.

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Straight, No Chaser: Cervical Health Awareness

January 28, 2017Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, CDC, Center For Disease Control and Prevention, Cervical cancer, HPV, Human papillomavirus, Pap smear, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

January is Cervical Health Awareness Month, and to that end, The Center for Disease Control and Prevention (CDC) boldly proclaims “No woman should die of cervical cancer.”
It’s cervical health month in the United States, and this point has a rather simple message: Cervical cancer is highly preventable and can be cured when discovered and treatment early. Here are some quick tips to help you check this off of your list of concerns.

Every child should get vaccinated at age 11 or 12. Even if you’ve reached age 26 and haven’t been vaccinated, you should discuss options with your physician.
The most important thing you can do to help prevent cervical cancer is to get screened regularly starting at age 21.

The Pap test (or smear) should be performed regularly at age 21. It looks for precancerous changes to the cervix that identify the need for early treatment. In many cases a normal test will eliminate the need for another test for the next three years, but your physician will discuss your individual circumstances in this regard.
The HPV test looks for the virus that is now known to be the cause of cervical cancer. Furthermore, human papillomavirus (HPV) is sexually transmitted. The HPV test can be done at the same time as the Pap test from the same examination.

Hopefully knowing these simple tools will convince you to be attentive to preventing and managing your cervical health. This is a public health success story in that cervical cancer could be eliminated if everyone followed the above steps. The rest is up to you.
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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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

May 9, 2016Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, Herpes, HIV, Hiv And Aids, HIV/AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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 you life, and this Straight, No Chaser will discuss those.
Even if you were irresponsible in acquiring an STD, you must be 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.

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.

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.

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.
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: What To Do You If You Suspect a Sexually Transmitted Disease (STD)

May 7, 2016Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, chlamydia, Gonorrhea, Herpes, HPV, PID, STD, Sterling Medical Advice, SterlingMedicalAdvice.com, STI, Straight No Chaser, SyphilisJeffrey Sterling, MD

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.

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.

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.

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.

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.

If a definitive diagnosis is made for certain conditions (e.g. gonorrhea, chlamydia, syphilis 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.
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: Cervical Cancer – The Sexually Transmitted Cancer

May 6, 2016Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, Cervical cancer, HPV, Human papillomavirus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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.

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 2011 (the most recent year numbers are available):

12,109 women in the United States were diagnosed with cervical cancer.
4,092 women in the United States died 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.

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?

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?

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?

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?

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.

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.
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

April 26, 2016General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Behind the Curtain, Chlamydia infection, Gonorrhea, Herpes, HIV/AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SyphilisJeffrey Sterling, MD

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.

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.

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: Success Eliminating Cervical Cancer with the HPV Vaccine

March 3, 2016Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Pediatrics/Kids Health, Health Prevention844-SMA-TALK, Behind the Curtain, Cervical cancer, HPV, Human papillomavirus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, vaccinationsJeffrey Sterling, MD

In the news is information about the human papillomavirus (HPV) vaccine, used to prevent sexually transmitted infections causing genital warts, and more importantly, causing cervical, anal, penile, mouth and throat cancers. Of particular interest is information demonstrating the vaccine developed to prevent HPV infections is even more effective that thought.
Federal researchers from the US Centers for Disease Control and Prevention (CDC) note that existing use of the vaccine has reduced the presence of the virus in teenage girls by approximately two-thirds. This information is especially impressive given the relative novelty and limited use of the vaccine. Only about 40% of girls and 20% of boys between ages 13-17 have been vaccinated. The better news for the future is public health professionals are making a significant push for greater vaccine use at ages 11-12, when the vaccination rates for other childhood diseases exceed 80%.

Here’s a public health message: taking the vaccine is about cancer prevention, not just preventing a sexually transmitted infection (genital warts). Unfortunately this message hasn’t fully penetrated the national dialogue: only the District of Columbia, Rhode Island and Virginia require the HPV vaccine, even though it is believed universal use of the vaccine would virtually eradicate cervical cancer. As a frame of reference, several other countries (e.g. Australia) in which HPV vaccine use is mandatory, has achieved over 90% vaccination rates over 90% reduction in rates of genital warts.
About 14 million Americans become infected with HPV each year, and approximately 27,000 people get cancer as a result of an infection from HPV. The American Cancer Society estimates that 4,120 women will die of cervical cancer this year.
If you have a child of either sex, have the conversation with your pediatrician or primary care physician about the HPV vaccine as early as age 10. If you’re a female into your mid-twenties and haven’t been vaccinated, you should also discuss this vaccine with your physician. You should be encouraged that a simple vaccine can eliminate cervical cancer.
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: Cervical Health Awareness

January 25, 2016Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, CDC, Center For Disease Control and Prevention, Cervical cancer, HPV, Human papillomavirus, Pap smear, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Every child should get vaccinated at age 11 or 12. Even if you’ve reached age 26 and haven’t been vaccinated, you should discuss options with your physician.
The most important thing you can do to help prevent cervical cancer is to get screened regularly starting at age 21.

The Pap test (or smear) should be performed regularly at age 21. It looks for precancerous changes to the cervix that identify the need for early treatment. In many cases a normal test will eliminate the need for another test for the next three years, but your physician will discuss your individual circumstances in this regard.
The HPV test looks for the virus that is now known to be the cause of cervical cancer. Furthermore, human papillomavirus (HPV) is sexually transmitted. The HPV test can be done at the same time as the Pap test from the same examination.

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

December 9, 2014Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Female condom, Herpes, HIV, Hiv And Aids, HIV/AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

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

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.

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.

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.
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. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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

November 8, 2014General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Chlamydia infection, Gonorrhea, Herpes, HIV/AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SyphilisJeffrey Sterling, MD

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.
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Straight, No Chaser: The Sexually Transmitted Cancer

October 18, 2013Hematology & Oncology/Blood Disorders/Cancer, Obstetrics and Gynecology, Health PreventionAnal cancer, Cervarix, Cervical cancer, Food and Drug Administration, Gardasil, HPV, Human papillomavirus, Michael Douglas, Sexually transmitted disease, Sterling Medical Advice, WordPressJeffrey Sterling, MD

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.

The most common sexually transmitted infection is now caused by the human papillomavirus (HPV). Some of you will recognize HPV as a cause of genital warts. (Secondary syphilis is another cause. This means if you ever develop warts, go get checked immediately.)
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).
Let’s address this topic in Q&A format:
1) Am I at risk for HPV? How do you get this?
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.
2) If I get genital warts, will I get cancer?
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 are the concerns.
3) If I do have warts, what increases my risks for these cancers?
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 an HPV infection.
4) How do I get this and how do I prevent it?
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.
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.
5) 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.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Sexually Transmitted Cancer

October 18, 2013General Health and Wellness, Genital/Urinary, Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health PreventionCenters for Disease Control and Prevention, Cervarix, Cervical cancer, Food and Drug Administration, HPV, Human papillomavirus, Michael Douglas, Sterling Medical Advice, WordPressJeffrey Sterling, MD

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.

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.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress