Tag Archives: Reproductive Health

Straight, No Chaser: STDs – Syphilis, The Great Mimicker

April 30, 2017General Health and WellnessBehind the Curtain, Conditions and Diseases, Disease, health, Infection, Men who have sex with men, MSM, Rash, Reproductive Health, Sexually transmitted disease, Symptom, Syphilis, There are 72 Hours in a Day, TuskegeeJeffrey Sterling, MD

Today, Straight, No Chaser will present two phrases that you may not have previously heard: The Great Mimicker and MSM, and that means we’re discussing what has historically been a devastating disease: syphilis. Historically, syphilis really is the most important sexually transmitted disease (For what it’s worth, it’s thought that Columbus’ crew spread the disease between the Americas and Europe.). The great mimicker nickname as applied to syphilis exists because syphilis has many general symptoms that resemble and are often confused with other diseases. MSM points to the fact that treatment in the early stages is so complete that syphilis had been rapidly in decline – until it’s reemergence in a specific population. It is estimated that well over 60% of reported early stage cases of syphilis occurs in men who have sex with men (MSM).
In this review, I want to specifically address the symptoms, which are impressively and dramatically different depending on the stage.

Stage I – Primary Syphilis: Primary syphilis usually presents with the presence of a single, painless sore (a chancre), located wherever it was contracted. As pictured above, the head (glans) of the penis is a typical site. The sore disappears in 3-6 weeks (with or without treatment), and if treatment wasn’t received, the disease progresses. Herein lies the problems. Because it’s painless, you ignore it, perhaps thinking it was a friction sore, or you never gave it much of a thought. Because it went away on its own, you forget about it, thinking that it got better. So sad, so wrong…

Stage II – Secondary Syphilis: When syphilis returns days to weeks (more typically) after the primary infection, it does so quite dramatically. Rashes can appear everywhere, including across your back (as noted above) and chest to on your palms and soles, in your mouth, groin, vagina, anus, or armpits. The rash could be warts (condyloma lata) or flat. You should be scared, but you might not be because… the rash and the other symptoms again will disappear on its own. Despite what you may think intuitively, you really don’t want that to happen.
Latent Syphilis: Dormant syphilis can stay that way for decades after secondary syphilis has occurred. What you don’t know can hurt you. Syphilis can be transmitted during the earlier portion of latent phases, including to an unborn child.

Tertiary Syphilis: Late stage syphilis is a disturbing thing to see (and obviously experience). The disease can result in death, causing damage to the brain, heart, liver, bones, joints, eyes, the nervous system and blood vessels. Before it kills you, it can result in blindness, paralysis, dementia and loss of motor control. If you don’t know how the research discovering all of this was conducted, for now I’ll just say it was one of the most shameful acts of medical history. I’ll blog on it later. The individuals in the above picture were alive when these pictures were taken, by the way.
A special note: The microorganism causing syphilis is rather aggressive, so much so that it can be transmitted by oral, anal or genital sexual contact. By oral, I also mean kissing. Pay attention to those oral sores. Furthermore, syphilis gets transmitted from mother to unborn child. This is a devastating occurrence – if untreated, a child may be born prematurely, with low birth weight or even stillborn. If untreated, once born, a child may suffer deafness, seizures and cataracts before death.
Prevention and Treatment Considerations: Advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. Remember that treating syphilis at any point can prevent the most severe complications that lead to death.
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: Male Reproductive Health and Workplace Hazards

April 25, 2017Genital/Urinary, Occupational Health844-SMA-TALK, Behind the Curtain, Occupational Health, Reproductive Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Yes, you read that correctly. We’re discussing men’s reproductive health. Of course there is a preoccupation with women’s reproductive health (and we addressed that in another Straight, No Chaser, but men also need to be aware of conditions in their work environment that can have adverse effects on their ability to have healthy children. Knowledge of these conditions is a necessary first step toward implementing workplace changes that can keep you safe and healthy.
Let’s share a brief list of common reproductive hazards up front for you to see.

Chemicals and solvents
Cigarettes
Drugs (legal and illegal)
Heat
Pesticides
Radiation
Traumatic risks

An unfortunate consideration in discussing this topic is most potential hazards have not and will not ever be studied to fully understand their effects on humans; it would simply be unethical to conduct such studies. That said, over 1000 chemicals used in the workplace have been shown to have adverse effects on the reproductive health of animals.

Courtesy of the Centers for Disease Control and Prevention, I’m listing known reproductive problems and workplace hazards demonstrated to cause those problems. Most of you who work in environments featuring any of the aforementioned reproductive hazards are aware of the presence of certain chemicals, pesticides, solvents and others substances being used. Review the hazards. If these are common in your workplace, engage your employee health representative to discuss precautions that are and/or should be in place to minimize your exposure and risk. Make sure you’re fully protected. It is important to note that I’m describing risk here. These effects do not routinely occur in every worker at just any level of exposure. Whether or not an exposure will cause a reproductive problem depends on the amount of time you’re exposed, the amount of the hazard you’re exposed to, how you were exposed and how your body reacts to the hazard. Because every hazard has not been studied for its effects in humans, this list cannot possibly be complete. Always fully engage in workplace safety.
Here are examples of male reproductive hazards and workplace exposures associated with them:

Low hormone levels: insecticides, lead, organophosphate, DDE, manganese, phthalates
Low number of sperm: lead, diesel exhaust, pesticide, bisphenol A, organophosphate, chromium, paraquat/malathion
Irregular sperm shape: insecticides, lead, carbon disulfide, pesticides, bisphenol A, petrochemical, carbofuran, nickel
Irregular sperm genetics: phthalates, styrene, organophosphate, carbaryl, fenvalerate, lead, benzene
Chemicals in semen: lead, trichloroethylene, boron, cadmium
Low amount of semen: lead, organophosphate, paraquat/malathion
Low number of swimming sperm: insecticides, diesel exhaust, lead, carbon disulfide, phthalates, pesticides, bisphenol A, fenvalerate, petrochemical, welding, N, N-dimethylformamide, abamectin, paraquat/malathion
Lower sex drive: carbon disulfide, bisphenol A
Erectile dysfunction (ED): bisphenol A, bicycle saddles
Lower penis sensitivity: bicycle saddles
Lower ejaculation quality: bisphenol A

If you are not familiar with the substances just listed but know that you work in an environment with hazardous materials, consider printing out the page and taking it to your job. Ask your safety officer if your workplace exposes you to any of these substances and if so, what protections are in place for workers.
As a final consideration, be aware that many of these substances can be transported out of the work environment back to your home or other locations, exposing others. Be mindful to take the extra step to protect yourself and others by avoiding prolonged and unnecessary exposures to workplace hazards.
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: Female Reproductive Health and Workplace Hazards

April 24, 2017Genital/Urinary, Obstetrics and Gynecology, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, Occupational Health, Reproductive Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Considerations of female reproductive health are important in the work environment. Many different work settings pose risks to women’s reproductive systems. Generally effects can be divided into those impacting a women’s reproductive system itself and those impacting the well-being of a pregnancy or baby. An additionally important point is these risks to the female reproductive system often bring consequences to one’s overall health.

How do workplace hazards create or worsen women’s reproductive health?

Chemicals such as pesticides, PCBs (polychlorinated biphenyls), carbon disulfide or organic solvents can disrupt the menstrual cycle and female hormone production. If you suffer from irregular periods, consider whether any work-related exposure could be a contributor.
Approximately 10-15% of couples are infertile. Workplace chemical exposures can produce damage to a woman’s eggs (or a man’s sperm), and they can cause changes to female hormones with subsequent drop-offs in the ability to produce a normal menstrual cycle and have normal uterine growth.

How do workplace hazards create or worsen women’s general health as a result of impacting reproductive health?

Remember that hormones affect other parts of your body and health other than your reproductive system. Therefore even if you aren’t concerned with becoming pregnant, cause for concern still exists. Imbalances of estrogen and progesterone caused by some workplace exposures can also increase your risk to:
- Cancers such as endometrial or breast
- Heart disease
- Osteoporosis
- Symptoms of menopause
- Tissue loss or weakening

How do workplace hazards pose risks during pregnancy?

It should come as no surprise that certain exposures can cause birth defects or miscarriages. You should be aware of the timing of exposures and subsequent potential effects. Exposure during the first 3 months of pregnancy might cause a birth defect or a miscarriage. Exposure during the last 6 months of pregnancy could slow the baby’s growth, affect its brain development, or cause premature labor.

How do workplace hazards pose risks to babies?
Some chemicals can get into breast milk and others can be transmitted to infants through contact occurring on a parents clothes, skin or hair. Of course, not all chemicals get into breast milk, and not all chemicals that do will harm your baby. Here are a few chemicals that can get into breast milk:

Chemicals from smoke, fires, or tobacco
Heavy metals (e.g. lead, mercury)
Organic solvents and volatile organic chemicals (e.g. bromochloroethane, dioxane, formaldehyde and perchloroethylene)
Radioactive chemicals used in hospitals for radiation therapy (e.g as Iodine-131)

Some harmful chemicals have been measured in breast milk at levels that could harm the baby. Lead is one example. Lead in breast milk can harm a baby’s brain. If you work with lead, ask your doctor to measure your blood lead level to see if there is too much lead in your body to safely breastfeed your baby.

For all of these considerations, talk to your employer or your workplace safety officer about ways you can reduce or eliminate your exposure. This might include using personal protective equipment (PPE) or changing your work duties. If you use gloves, protective clothing, a respirator, or other PPE, be sure they are right for you and the chemical to which you are exposed.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: STDs – Syphilis, The Great Mimicker

April 30, 2016Genital/Urinary, Infectious Disease, Obstetrics and GynecologyBehind the Curtain, Conditions and Diseases, Disease, health, Infection, Men who have sex with men, MSM, Rash, Reproductive Health, Sexually transmitted disease, Symptom, Syphilis, TuskegeeJeffrey Sterling, MD

Today, Straight, No Chaser will present two phrases that you may not have previously heard: The Great Mimicker and MSM, and that means we’re discussing what has historically been a devastating disease: syphilis. Historically, syphilis really is the most important sexually transmitted disease (For what it’s worth, it’s thought that Columbus’ crew spread the disease between the Americas and Europe.). The great mimicker nickname as applied to syphilis exists because syphilis has many general symptoms that resemble and are often confused with other diseases. MSM points to the fact that treatment in the early stages is so complete that syphilis had been rapidly in decline – until it’s reemergence in a specific population. It is estimated that well over 60% of reported early stage cases of syphilis occurs in men who have sex with men (MSM).
In this review, I want to specifically address the symptoms, which are impressively and dramatically different depending on the stage.

Stage I – Primary Syphilis: Primary syphilis usually presents with the presence of a single, painless sore (a chancre), located wherever it was contracted. As pictured above, the head (glans) of the penis is a typical site. The sore disappears in 3-6 weeks (with or without treatment), and if treatment wasn’t received, the disease progresses. Herein lies the problems. Because it’s painless, you ignore it, perhaps thinking it was a friction sore, or you never gave it much of a thought. Because it went away on its own, you forget about it, thinking that it got better. So sad, so wrong…

Stage II – Secondary Syphilis: When syphilis returns days to weeks (more typically) after the primary infection, it does so quite dramatically. Rashes can appear everywhere, including across your back (as noted above) and chest to on your palms and soles, in your mouth, groin, vagina, anus, or armpits. The rash could be warts (condyloma lata) or flat. You should be scared, but you might not be because… the rash and the other symptoms again will disappear on its own. Despite what you may think intuitively, you really don’t want that to happen.
Latent Syphilis: Dormant syphilis can stay that way for decades after secondary syphilis has occurred. What you don’t know can hurt you. Syphilis can be transmitted during the earlier portion of latent phases, including to an unborn child.

Tertiary Syphilis: Late stage syphilis is a disturbing thing to see (and obviously experience). The disease can result in death, causing damage to the brain, heart, liver, bones, joints, eyes, the nervous system and blood vessels. Before it kills you, it can result in blindness, paralysis, dementia and loss of motor control. If you don’t know how the research discovering all of this was conducted, for now I’ll just say it was one of the most shameful acts of medical history. I’ll blog on it later. The individuals in the above picture were alive when these pictures were taken, by the way.
A special note: The microorganism causing syphilis is rather aggressive, so much so that it can be transmitted by oral, anal or genital sexual contact. By oral, I also mean kissing. Pay attention to those oral sores. Furthermore, syphilis gets transmitted from mother to unborn child. This is a devastating occurrence – if untreated, a child may be born prematurely, with low birth weight or even stillborn. If untreated, once born, a child may suffer deafness, seizures and cataracts before death.
Prevention and Treatment Considerations: Advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. Remember that treating syphilis at any point can prevent the most severe complications that lead to death.
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: Male Reproductive Health and Workplace Hazards

April 22, 2016Genital/Urinary, Occupational Health, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, Occupational Health, Reproductive Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Chemicals and solvents
Cigarettes
Drugs (legal and illegal)
Heat
Pesticides
Radiation
Traumatic risks

Low hormone levels: insecticides, lead, organophosphate, DDE, manganese, phthalates
Low number of sperm: lead, diesel exhaust, pesticide, bisphenol A, organophosphate, chromium, paraquat/malathion
Irregular sperm shape: insecticides, lead, carbon disulfide, pesticides, bisphenol A, petrochemical, carbofuran, nickel
Irregular sperm genetics: phthalates, styrene, organophosphate, carbaryl, fenvalerate, lead, benzene
Chemicals in semen: lead, trichloroethylene, boron, cadmium
Low amount of semen: lead, organophosphate, paraquat/malathion
Low number of swimming sperm: insecticides, diesel exhaust, lead, carbon disulfide, phthalates, pesticides, bisphenol A, fenvalerate, petrochemical, welding, N, N-dimethylformamide, abamectin, paraquat/malathion
Lower sex drive: carbon disulfide, bisphenol A
Erectile dysfunction (ED): bisphenol A, bicycle saddles
Lower penis sensitivity: bicycle saddles
Lower ejaculation quality: bisphenol A

If you are not familiar with the substances just listed but know that you work in an environment with hazardous materials, consider printing out the page and taking it to your job. Ask your safety officer if your workplace exposes you to any of these substances and if so, what protections are in place for workers.
As a final consideration, be aware that many of these substances can be transported out of the work environment back to your home or other locations, exposing others. Be mindful to take the extra step to protect yourself and others by avoiding prolonged and unnecessary exposures to workplace hazards.
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: Female Reproductive Health and Workplace Hazards

April 21, 2016Genital/Urinary, Obstetrics and Gynecology, Toxicology/Drugs844-SMA-TALK, Behind the Curtain, Occupational Health, Reproductive Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Considerations of female reproductive health are important in the work environment. Many different work settings pose risks to women’s reproductive systems. Generally effects can be divided into those impacting a women’s reproductive system itself and those impacting the wellbeing of a pregnancy or baby. An additionally important point is these risks to the female reproductive system often bring consequences to one’s overall health.

How do workplace hazards create or worsen women’s reproductive health?

Chemicals such as pesticides, PCBs (polychlorinated biphenyls), carbon disulfide or organic solvents can disrupt the menstrual cycle and female hormone production. If you suffer from irregular periods, consider whether any work-related exposure could be a contributor.
Approximately 10-15% of couples are infertile. Workplace chemical exposures can produce damage to a woman’s eggs (or a man’s sperm), and they can cause changes to female hormones with subsequent drop-offs in the ability to produce a normal menstrual cycle and have normal uterine growth.

How do workplace hazards create or worsen women’s general health as a result of impacting reproductive health?

Remember that hormones affect other parts of your body and health other than your reproductive system. Therefore even if you aren’t concerned with becoming pregnant, cause for concern still exists. Imbalances of estrogen and progesterone caused by some workplace exposures can also increase your risk to:
- Cancers such as endometrial or breast
- Heart disease
- Osteoporosis
- Symptoms of menopause
- Tissue loss or weakening

How do workplace hazards pose risks during pregnancy?

It should come as no surprise that certain exposures can cause birth defects or miscarriages. You should be aware of the timing of exposures and subsequent potential effects. Exposure during the first 3 months of pregnancy might cause a birth defect or a miscarriage. Exposure during the last 6 months of pregnancy could slow the baby’s growth, affect its brain development, or cause premature labor.

Chemicals from smoke, fires, or tobacco
Heavy metals (e.g. lead, mercury)
Organic solvents and volatile organic chemicals (e.g. bromochloroethane, dioxane, formaldehyde and perchloroethylene)
Radioactive chemicals used in hospitals for radiation therapy (e.g as Iodine-131)

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 – Syphilis, The Great Mimicker

November 19, 2014Genital/Urinary, Infectious Disease, Obstetrics and GynecologyConditions and Diseases, Disease, health, Infection, Men who have sex with men, MSM, Rash, Reproductive Health, Sexually transmitted disease, Symptom, Syphilis, TuskegeeJeffrey Sterling, MD

Today, Straight, No Chaser will present two phrases that you may not have previously heard: The Great Mimicker and MSM, and that means we’re discussing what has historically been a devastating disease: syphilis. Historically, syphilis really is the most important sexually transmitted disease (For what it’s worth, it’s thought that Columbus’ crew spread the disease between the Americas and Europe.). The great mimicker nickname as applied to syphilis exists because syphilis has many general symptoms that resemble and are often confused with other diseases. MSM points to the fact that treatment in the early stages is so complete that syphilis had been rapidly in decline – until it’s reemergence in a specific population. It is estimated that well over 60% of reported early stage cases of syphilis occurs in men who have sex with men (MSM).
In this review, I want to specifically address the symptoms, which are impressively and dramatically different depending on the stage.

Stage I – Primary Syphilis: Primary syphilis usually presents with the presence of a single, painless sore (a chancre), located wherever it was contracted. As pictured above, the head (glans) of the penis is a typical site. The sore disappears in 3-6 weeks (with or without treatment), and if treatment wasn’t received, the disease progresses. Herein lies the problems. Because it’s painless, you ignore it, perhaps thinking it was a friction sore, or you never gave it much of a thought. Because it went away on its own, you forget about it, thinking that it got better. So sad, so wrong…

Stage II – Secondary Syphilis: When syphilis returns days to weeks (more typically) after the primary infection, it does so quite dramatically. Rashes can appear everywhere, including across your back (as noted above) and chest to on your palms and soles, in your mouth, groin, vagina, anus, or armpits. The rash could be warts (condyloma lata) or flat. You should be scared, but you might not be because… the rash and the other symptoms again will disappear on its own. Despite what you may think intuitively, you really don’t want that to happen.
Latent Syphilis: Dormant syphilis can stay that way for decades after secondary syphilis has occurred. What you don’t know can hurt you. Syphilis can be transmitted during the earlier portion of latent phases, including to an unborn child.

Tertiary Syphilis: Late stage syphilis is a disturbing thing to see (and obviously experience). The disease can result in death, causing damage to the brain, heart, liver, bones, joints, eyes, the nervous system and blood vessels. Before it kills you, it can result in blindness, paralysis, dementia and loss of motor control. If you don’t know how the research discovering all of this was conducted, for now I’ll just say it was one of the most shameful acts of medical history. I’ll blog on it later. The individuals in the above picture were alive when these pictures were taken, by the way.
A special note: The microorganism causing syphilis is rather aggressive, so much so that it can be transmitted by oral, anal or genital sexual contact. By oral, I also mean kissing. Pay attention to those oral sores. Furthermore, syphilis gets transmitted from mother to unborn child. This is a devastating occurrence – if untreated, a child may be born prematurely, with low birth weight or even stillborn. If untreated, once born, a child may suffer deafness, seizures and cataracts before death.
Prevention and Treatment Considerations: Advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. Remember that treating syphilis at any point can prevent the most severe complications that lead to death.
For a historical lesson on what happens with untreated syphilis, review this Straight, No Chaser post on The Tuskegee Experiments.
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: Male Reproductive Health and Workplace Hazards

September 6, 2014Genital/Urinary, Occupational Health, Toxicology/Drugs844-SMA-TALK, Occupational Health, Reproductive Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Chemicals and solvents
Cigarettes
Drugs (legal and illegal)
Heat
Pesticides
Radiation
Traumatic risks

Low hormone levels: insecticides, lead, organophosphate, DDE, manganese, phthalates
Low number of sperm: lead, diesel exhaust, pesticide, bisphenol A, organophosphate, chromium, paraquat/malathion
Irregular sperm shape: insecticides, lead, carbon disulfide, pesticides, bisphenol A, petrochemical, carbofuran, nickel
Irregular sperm genetics: phthalates, styrene, organophosphate, carbaryl, fenvalerate, lead, benzene
Chemicals in semen: lead, trichloroethylene, boron, cadmium
Low amount of semen: lead, organophosphate, paraquat/malathion
Low number of swimming sperm: insecticides, diesel exhaust, lead, carbon disulfide, phthalates, pesticides, bisphenol A, fenvalerate, petrochemical, welding, N, N-dimethylformamide, abamectin, paraquat/malathion
Lower sex drive: carbon disulfide, bisphenol A
Erectile dysfunction (ED): bisphenol A, bicycle saddles
Lower penis sensitivity: bicycle saddles
Lower ejaculation quality: bisphenol A

Straight, No Chaser: Female Reproductive Health and Workplace Hazards

September 5, 2014Genital/Urinary, Obstetrics and Gynecology, Toxicology/Drugs844-SMA-TALK, Occupational Health, Reproductive Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Considerations of female reproductive health are important in the work environment. Many different work settings pose risks to women’s reproductive systems. Generally effects can be divided into those impacting a women’s reproductive system itself and those impacting the wellbeing of a pregnancy or baby. An additionally important point is these risks to the female reproductive system often bring consequences to one’s overall health.

How do workplace hazards create or worsen women’s reproductive health?

Chemicals such as pesticides, PCBs (polychlorinated biphenyls), carbon disulfide or organic solvents can disrupt the menstrual cycle and female hormone production. If you suffer from irregular periods, consider whether any work-related exposure could be a contributor.
Approximately 10-15% of couples are infertile. Workplace chemical exposures can produce damage to a woman’s eggs (or a man’s sperm), and they can cause changes to female hormones with subsequent drop-offs in the ability to produce a normal menstrual cycle and have normal uterine growth.

How do workplace hazards create or worsen women’s general health as a result of impacting reproductive health?

Remember that hormones affect other parts of your body and health other than your reproductive system. Therefore even if you aren’t concerned with becoming pregnant, cause for concern still exists. Imbalances of estrogen and progesterone caused by some workplace exposures can also increase your risk to:
- Cancers such as endometrial or breast
- Heart disease
- Osteoporosis
- Symptoms of menopause
- Tissue loss or weakening

How do workplace hazards pose risks during pregnancy?

It should come as no surprise that certain exposures can cause birth defects or miscarriages. You should be aware of the timing of exposures and subsequent potential effects. Exposure during the first 3 months of pregnancy might cause a birth defect or a miscarriage. Exposure during the last 6 months of pregnancy could slow the baby’s growth, affect its brain development, or cause premature labor.

Chemicals from smoke, fires, or tobacco
Heavy metals (e.g. lead, mercury)
Organic solvents and volatile organic chemicals (e.g. bromochloroethane, dioxane, formaldehyde and perchloroethylene)
Radioactive chemicals used in hospitals for radiation therapy (e.g as Iodine-131)

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Straight, No Chaser: Straight Talk About Vasectomies

December 29, 2013Genital/Urinary, Surgical Carehealth, National Institutes of Health, Pregnancy, Reproductive Health, Semen analysis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Surgery, Vas deferens, VasectomyJeffrey Sterling, MD

A couple’s conversation about having a vasectomy can either be a tense one or it can be a display of trust and cohesion. The decision by a man to have a vasectomy can be a soul-searching “moment of truth.” In this Straight, No Chaser, let’s look at seven of the issues surrounding vasectomies. At the end there’s an illustration of the procedure. Yes, it involves a clip.
A vasectomy is a surgical procedure that involves cutting the tube (the vas deferens) that carries sperm from the scrotum to the testes. The vasectomy prevents sperm from leaving the testes so that the man can’t impregnate a woman.
Issue 1: Why would you want it?
The answer to this is relatively straightforward. You’d want a vasectomy if you don’t want any, or any more, children. This is a form of sterilization.
Issue 2: When would it be a good option?
If you’re in a relationship and both partners agree that you’ve either had all the children you want or don’t want the risk of having any children, a vasectomy would be a reasonable option. Other considerations may include if you can’t use other forms of birth control, if pregnancy would be medically unsafe, or if the risk of genetic disease or a birth defect in your offspring is greater than you’re willing to accept.
Issue 3: When wouldn’t it be a good option?
This gets a little dicey and relates to levels of instability, either in your relationship or other personal situations. A decision to have a vasectomy to please your partner or salvage a relationship may not be the best choice. If you’re young or unmarried, you are subject to many life changes that may prompt reevaluating whether you really want a child. For example, if you marry/remarry, children may become more important than they currently are. A vasectomy is a surgical procedure with risks. A decision to have it done as a convenience (e.g., because you are unreliable or don’t want to use other forms of birth control) is irresponsible.
Issue 4: How successful is the procedure?
Vasectomies are very successful and have a failure rate of approximately 1 in 2,000. Comparatively speaking, the analogous procedure in females (tubal ligation) has a failure rate of 1 in 200-300. Typical failure rates are due to having sex too soon after the procedure. It takes time for existing sperm to be cleared from both ends of the vas deferens; that existing sperm can still impregnate a woman. This is a major reason why men should wait a week after the surgery and until the sperm count has been documented to be zero in the seminal fluid. To a much lesser extent, rare spontaneous reconnection of the clipped portions of the vas deferens may produce failures.
Issue 5: What complications exist?
Vasectomies are generally very safe, and the complications associated with it are those seen with any surgery. These include pain, swelling and infection. Remember, as we just discussed, the circumstances under which post-vasectomy pregnancies can occur.
Issue 6: What happens should I choose to have it reversed?
It is important for men considering a vasectomy to read and fully understand the next sentence. If you have a vasectomy, you should not consider it reversible. That said, you can spend a lot of money for a microsurgical reversal procedure that is successful about 50% of the time if done within 10 years of the vasectomy and approximately 25% of the time if done after 10 years. Be advised that such reversals are associated with a higher level of birth defects.
Issue 7: About what other considerations should I be concerned?

Men seemingly are most often concerned about post-vasectomy ability to have an erection or orgasm. Vasectomies do not diminish a man’s ability to have either.
You should be concerned about the spread of sexually transmitted infections (STIs), which a vasectomy does not prevent. A false sense of confidence may exist after a vasectomy knowing that pregnancy is extremely unlikely, but that has nothing to do with STIs. In fact the greater inclination to have unprotected sex after a vasectomy may put men at greater risk for transmitting or receiving STIs.
Vasectomies do not increase the risk of testicular or prostate cancer.

Most men are satisfied with vasectomies, because most men who have vasectomies do so in the context of a stable and healthy relationship. Men who are most likely to seek reversals do so in the context of unexpected life events (e.g., new partner/marriage with a desire for kids). Sometimes their reconsideration is in response to a tragedy. If you are considering a vasectomy, please only do so after a solemn view of the rest of your life. If you believe it to be stable, you will likely be satisfied with the outcome.
The following clip (click the link) is courtesy of the National Institutes of Health and demonstrates the logistics of the various approaches to the procedure. Feel free to leave any comments or ask any questions you may have.
Vasectomy
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Straight, No Chaser: Syphilis – The Great Mimicker

September 25, 2013Genital/Urinary, Obstetrics and GynecologyConditions and Diseases, Disease, health, Infection, Men who have sex with men, MSM, Rash, Reproductive Health, Sexually transmitted disease, Symptom, SyphilisJeffrey Sterling, MD

Today, you will learn two phrases that you may not have previously heard: The Great Mimicker and MSM. Regarding another word you definitely should know, I’ll touch on it and will save for a separate post: Tuskegee.
Historically, syphilis really is the most important sexually transmitted disease (For what it’s worth, it’s thought that Columbus’ crew spread the disease from the Americas to Europe.). The great mimicker nickname as applied to syphilis exists because syphilis has many general symptoms that resemble and are often confused with other diseases. MSM points to the fact that treatment in the early stages is so complete that syphilis had been rapidly in decline – until it’s reemergence in a specific population. It is estimated that well over 60% of reported early stage cases of syphilis occurs in men who have sex with men (MSM).
In the first part of this review, I want to specifically address the symptoms, which are impressively and dramatically different depending on the stage.

Stage I – Primary Syphilis: Primary syphilis usually presents with the presence of a single, painless sore (a chancre), located wherever it was contracted. As pictured above, the head (glans) of the penis is a typical site. The sore disappears in 3-6 weeks (with or without treatment), and if treatment wasn’t received, the disease progresses. Herein lies the problems. Because it’s painless, you ignore it, perhaps thinking it was a friction sore, or you never gave it much of a thought. Because it went away on its own, you forget about it, thinking that it got better. So sad, so wrong…

Stage II – Secondary Syphilis: When syphilis returns days to weeks (more typically) after the primary infection, it does so quite dramatically. Rashes can appear everywhere, including across your back (as noted above) and chest to on your palms and soles, in your mouth, groin, vagina, anus, or armpits. The rash could be warts (condyloma lata) or flat. You should be scared, but you might not be because… the rash and the other symptoms again will disappear on its own. Despite what you may think intuitively, you really don’t want that to happen.
Latent Syphilis: Dormant syphilis can stay that way for decades after secondary syphilis has occurred. What you don’t know can hurt you. Syphilis can be transmitted during the earlier portion of latent phases, including to an unborn child.

Tertiary Syphilis: Late stage syphilis is a disturbing thing to see (and obviously experience). The disease can result in death, causing damage to the brain, heart, liver, bones, joints, eyes, the nervous system and blood vessels. Before it kills you, it can result in blindness, paralysis, dementia and loss of motor control. If you don’t know how the research discovering all of this was conducted, for now I’ll just say it was one of the most shameful acts of medical history. I’ll blog on it later. The individuals in the above picture were alive when these pictures were taken, by the way.
A special note: The bacteria causing syphilis is rather aggressive, so much so that it can be transmitted by oral, anal or genital sexual contact. By oral, I also mean kissing. Pay attention to those oral sores. Furthermore, syphilis gets transmitted from mother to unborn child. This is a devastating occurrence – if untreated, a child may be born prematurely, with low birth weight or even stillborn. If untreated, once born, a child may suffer deafness, seizures and cataracts before death.
All of the pictures in this posts are typical representations of the various stages of syphilis, and I’ve seen them all. These are not meant to provide any shock value other than demonstrating what occurs with progression of the disease. Later, I will discuss treatment, risks and other considerations. I don’t think you’ll want to miss the rest of the story. That really is shocking – and horrible.
Feel free to offer comments or ask questions.
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