Tag Archives: PID

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

May 22, 2018Geriatrics/Elderly Care, 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, Syphilis, There are 72 Hours in a DayJeffrey 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.
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: Pelvic Inflammatory Disease (PID)

April 17, 2018Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Black widow spider, PID, sexually transmitted infections, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Straight, No Chaser has discussed several sexually transmitted infections (STIs) at length, including gonorrhea, chlamydia and herpes. 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 (assuming you’re female). If you’re not familiar with the term PID, commit it to memory, as this is a relatively common condition.

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 affects 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 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 – Multidrug Resistant Gonorrhea

April 14, 2018Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

This post is the second of two discussing gonorrhea. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.
The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 468,500 cases of gonorrhea in the U.S. alone in 2016. That represents an increase of 48.6% since the record low in 2009. (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).
Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

Even more so than other instances of gonorrhea resistance, this instance poses especially concerning dangers. Treatment of multi-drug resistant gonorrhea infections (particularly those resistant to the standard of care medicine ceftriaxone) will be much more complicated that it had been previously. Specifically, there is no ready replacement on standby that can be administered in emergency rooms, offices and clinics as easily as a simple shot of ceftriaxone is. Our most recent magic bullet is going by the wayside. Other available treatments also have varying degrees of emerging resistance and thus are likely to be sporadically ineffective. Until on-site testing is put in place that allows determination of susceptibility to various treatment regimens, patients infected with gonorrhea will run the risk of receiving medicines that are no longer effective. Current and future treatment regimens will involve the use of more than one medicine and higher doses of medicine than had previously been effective.

This brings to mind two important points. Gonorrhea is not just an infection that affects sexual organs. It produces devastating consequences throughout the body, including the facilitation of human immunodeficiency virus (HIV) transmission (i.e. the presence of gonorrhea makes acquiring HIV easier). It also causes serious reproductive complications in women, such as pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. It causes eye infections in newborns (they pick it up from mom) and infected persons who rub their eyes or otherwise place their fingers in their eyes without appropriate hand washing. Either failure to get treated or receiving ineffective treatment is a precarious situation.

Of course, this also creates and reinforces the urgency of practicing safe sexual behaviors. Straight, No Chaser has multiple postings on safe sex and best practices of preventing sexually transmitted infections. Here is a summary post for your review. Of course you can type any topic in the search engine for greater ability to explore these topics.
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: What To Do If You Suspect a Sexually Transmitted Disease (STD)

May 7, 2017Genital/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, Syphilis, There are 72 Hours in a DayJeffrey Sterling, MD

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.
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: Pelvic Inflammatory Disease (PID)

April 29, 2017Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Black widow spider, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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 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: 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

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: Pelvic Inflammatory Disease (PID)

April 29, 2016Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Black widow spider, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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 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: STDs – Multidrug Resistant Gonorrhea

April 28, 2016Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This post is the second of two discussing gonorrhea. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.
The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 300,000 cases of gonorrhea in the U.S. alone in 2011. It is estimated that over 800,000 infections are currently present (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).
Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

Even more so than other instances of gonorrhea resistance, this instance poses especially concerning dangers. Treatment of multidrug resistant gonorrhea infections (particularly those resistant to the standard of care medicine ceftriaxone) will be much more complicated that it had been previously. Specifically, there is no ready replacement on standby that can be administered in emergency rooms, offices and clinics as easily as a simple shot of ceftriaxone is. Our most recent magic bullet is going by the wayside. Other available treatments also have varying degrees of emerging resistance and thus are likely to be sporadically ineffective. Until on-site testing is put in place that allows determination of susceptibility to various treatment regimens, patients infected with gonorrhea will run the risk of receiving medicines that are no longer effective. Current and future treatment regimens will involve the use of more than one medicine and higher doses of medicine than had previously been effective.

Of course, this also creates and reinforces the urgency of practicing safe sexual behaviors. Straight, No Chaser has multiple postings on safe sex and best practices of preventing sexually transmitted infections. Here is a summary post for your review. Of course you can type any topic in the search engine for greater ability to explore these topics.
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

May 8, 2015General Health and Wellness, Genital/Urinary, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, abstinence-only education, Chlamydia infection, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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.

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.”

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.

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: Pelvic Inflammatory Disease (PID)

November 16, 2014General Health and Wellness844-SMA-TALK, Black widow spider, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of 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, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: STDs – Multidrug Resistant Gonorrhea

November 11, 2014Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This post is the second of two discussing gonorrhea. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.
The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 300,000 cases of gonorrhea in the U.S. alone in 2011. It is estimated that over 800,000 infections are currently present (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).
Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of 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, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight, No Chaser: Introducing "Superbugs" – Multidrug Resistant Gonorrhea

May 16, 2014General Health and Wellness844-SMA-TALK, Conditions and Diseases, ectopic pregnancy, healthcare disparities, HIV, human immunodeficiency, infertility, multidrug resistant gonorrhea, neisseria gonorrhea, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This post is the first of two that identifies relatively new and massive occurrences in medicine. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.
The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 300,000 cases of gonorrhea in the U.S. alone in 2011. It is estimated that over 800,000 infections are currently present (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).
Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

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

March 9, 2014Genital/Urinary, Obstetrics and Gynecology844-SMA-TALK, CDC, Centers for Disease Control and Prevention, Chlamydia infection, ectopic pregnancy, Gonorrhea, infertility, Pelvic inflammatory disease, PID, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

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.

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