Tag Archives: There are 72 Hours in a Day

Straight, No Chaser: Prevention and Treatment of Food Allergies

May 13, 2017Diet and Nutrition, Endocrine/Metabolic, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Behind the Curtain, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Whether or not you personally have a food allergy, it is likely you will find yourself in a situation with someone who does. Food allergies affect approximately 15 million Americans. Given that this could be a life-threatening event, it’s important for you to know some basics about addressing allergic reactions to food as they occur.
Tips to Prevent
Let’s start with some tips for you to better prevent allergic reactions, because once you become aware that you have a food allergy, avoidance means everything. Remember from this post that allergic reactions can occur without you eating the food; simple exposures such as touching or breathing the food can prompt a reaction.

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

Tips to deal with emergencies

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

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

Advances in Food Allergy Treatment

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

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

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

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

Straight, No Chaser: Food Allergies

May 12, 2017Diet and Nutrition, Endocrine/Metabolic, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Allergies, anaphylaxis, Behind the Curtain, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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

Why do I get allergies anyway?
Food and other types of allergies result from your body mistaking harmless substances for potential threats. The resulting immune response is an attempt to defeat that threat. You are caught in the crossfire, and you exhibit symptoms as a result.
Why do I get allergies to foods I’ve eaten before without a problem?
In many instances, the first time you’re exposed to a certain new food, your body is only primed, and you won’t experience symptoms. A subsequent exposure will prompt the full allergic response.
Is there a way to know if I’m at risk?
Food allergies are more likely in those who have a family history of allergies, asthma or eczema. Take a minute today and ask your parents if they have any allergies to foods or medicines. It’s good to be aware.
How do I know my symptoms are an allergic reaction?
We’ll discuss symptoms shortly, but one big clue is the timing of symptoms. Allergic reactions due to food take place within minutes to a few hours after exposure. It’s not as important for you to know the symptoms as to realize that you’re not well and that evaluation is needed.

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

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

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

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

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

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

Straight, No Chaser: About Stuttering

May 11, 2017Neurology844-SMA-TALK, Behind the Curtain, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, stuttering, Stuttering Foundation of America, The American Speech-Language-Hearing Association, the National Stuttering Association, There are 72 Hours in a DayJeffrey Sterling, MD

How do you respond when you hear someone stutter? Are you a stutterer, and if so, how do you handle it? Let’s answer 7 frequency asked questions to facilitate some understanding (and hopefully compassion) about stuttering.
What is stuttering?
Simply put, stuttering is a communication disorder, notable for what’s called disfluencies. These disruptions in speech flow may or may not hinder ability to speak and understand others. There are typically three types of difficulties with the effort to speak in stuttering:

Abnormal stoppages (no sounds produced)
Prolongations: (“llllllike this”)
Repetitions: “li-li-like this”

Why do people stutter?
Causes and/or development of stuttering is typically attributable to four factors:

Genetics/family history (approximately 60% will have another stutterer in the family)
Child development (those other over developmental delays or speech/language disorders are more likely to stutter)
Neurophysiology (stutterers have been shown to have actual differences in how their brains process language and speech from those who do not)
Behavioral considerations (faster-paced lifestyles with high expectations seem to contribute to stuttering)

Who is more likely to stutter?
Appropriately 5% of children go through a stuttering phase that lasts at least six months (About 75% with recover, especially with early intervention).
How many people are affected?
More than 70 million people worldwide stutter (approximately 1% of people). Males stutter more often than females with about a 4:1 ratio among stutterers.

Is stuttering part of a psychological disorder?
No. Stutterers are no more likely to have psychological disorders than non-stutterers.
When should I see help for stuttering?
Whenever the need is felt. As with most health matters, there’s no harm in early evaluation. However, if stuttering persists beyond 3 to 6 months or as somehow disabling socially or impeding the ability to communicate, help should be obtained as soon as possible.
How is stuttering treated?
First off, there are no miracle cures, so don’t fall for any scams suggesting otherwise. Successful treatment involves enlisting a speech-language pathologist. Most treatment programs are designed to teach specific skills or behaviors that lead to improved speaking, such as controlling the rate at which a stuttering speaks.
There are many great organizations that provide assistance, such as The American Speech-Language-Hearing Association, the National Stuttering Association, Stuttering Foundation of America.
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: Addressing Hearing Loss and the Use of Hearing Aids

May 10, 2017Head/Eyes/Ears/Nose/Throat844-SMA-TALK, Behind the Curtain, hearing aids, hearing loss, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Prevention and protecting your hearing is easy; the decision to do so seems not to be so easy. Remembering this hearing thermometer is a good way to know what activities hurt your hearing.
When it gets to the point that you’re having acute difficulty hearing, assuming you’re a victim of trauma, you may be inclined to flush wax out of your ear or use wax softeners. If you go this route, be careful. Remember that old Q-Tip commercial with the tag line, “You should never place anything in your ear smaller than your elbow.” Unless it’s ridiculous easy, you should have a health provider remove anything from your ear. Importantly, you should never place anything sharp in your ear (e.g., bobby pins, tweezers, etc.).
There are many procedures and surgeries that can help with hearing loss, including the following:

Placing tubes in the eardrum (aka T-tubes, tympanostomy tubes) to remove fluid
Repairing the eardrum or the bones in the middle ear that assist in sound transmission
Wearing heading aids, though only one of five individuals who could benefit from a hearing aid uses one
Using cochlear implants, a final option for those whose hearing impairment is so severe that various types of hearing aids aren’t effective or a viable option (Learn about cochlear implants at www.sterlingmedicaladvice.com.)

Sign language can complement these other methods or aural based communication when other methods don’t work.
Let’s focus on some frequently asked questions about hearing aids.

How do hearing aids work?
Hearing aids consist of a microphone, an amplifier and a speaker. These components convert sound waves to signals you can hear through the speaker. It’s really that simple.
How do experts determine that I need a hearing aid?
When the time comes, a physician who specializes in ear, nose and throat disorders (otolaryngologist) will evaluate possible causes of hearing impairment. An audiologist, a hearing health professional, may also identify and quantify the degree of loss. The results of these evaluations will determine your needs.
What are the different types of hearing aids?
Hearing aids differ in style, placement and means of amplifying sound. You can place them behind the ear, in the ear canal or within the middle ear for this effect. Analog hearing aids convert sound waves into electrical signals, which are amplified. Digital hearing aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. The digital method allows more customization of various frequencies. These simple but important distinctions comprise how hearing aids are individualized.
What questions should I ask when getting a hearing aid?
The most important consideration is your mastery of the device you’ll be taking home with you. You shouldn’t be satisfied with a “plug and play” device. You should be prepared to know how to respond if your voice seems too loud or if you’re getting feedback, buzzing or background noise. You should be aware of cleaning and maintenance needs, as well as repair and service benefits that come with your device.

Information and innovation are available for you. Don’t put it off.
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: Living With An Incurable Sexually Transmitted Infection

May 8, 2017Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, Herpes, HIV, Hiv And Aids, HIV-AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to you life, and this Straight, No Chaser will discuss those.
Even if you were irresponsible in acquiring an STD, you must be learn to be responsible in managing it once it’s known that you have an incurable STD such as HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

A really reasonable way to think about having sex with an incurable STD is to think about kissing someone with a cold or the flu. You could still do it, but you’re likely to be at risk. When the symptoms aren’t there, your partner could still be a carrier of the disease and could still give you the disease. Your better course of action is to wait until all symptoms are gone and then still be careful.

You have to simultaneously appreciate that your life will be approximately normal, even as you’ve had a significant change. Even as you get about living the rest of your life, you should be aware of risks that can cause an outbreak.

Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
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 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

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 © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Cervical Cancer – The Sexually Transmitted Cancer

May 6, 2017Hematology & Oncology/Blood Disorders/Cancer, Infectious Disease, Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Behind the Curtain, Cervical cancer, HPV, Human papillomavirus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Let’s put this take home message up front: here’s a pretty good demonstration of the value of vaccines. I hope that each of you resolves to get any children you care for vaccinated before they become sexually active.
I want to thank my friend and colleague, Dr. Julius Ellis, noted Ob/Gyn physician for contributing to this post. Let’s start this with two simple statements:

Cervical cancer has basically been shown to be caused by an infection.
There soon will be no reason that anyone has to have cervical cancer.

As a reminder, the cervix is the lower and narrow end of the uterus that connects the vagina to the upper part of the uterus (i.e. the womb). Cervical cancer used to be the leading cause of cancer death for women in the US.
In 2011 (the most recent year numbers are available):

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

Fortunately, over the last 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly, largely due to Pap tests. The even better news is the opportunity exists to virtually eradicate the disease. Cervical cancer is highly preventable because screening tests and a vaccine to prevent human papillomavirus (HPV) infections are available. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

Yes, cervical cancer is a sexually transmitted infection (STI), and the most common STI is now known to be caused by the human papillomavirus (HPV). Some of you will recognize HPV as a cause of genital warts. This means if you ever develop warts, go get checked immediately (another good reason to do this is because genital syphilis may also present as warts). Even more importantly, certain HPV strains have been shown to cause virtually all cervical and anal cancers. HPV also causes some cancers of the vagina, penis, and oropharynx (a certain part of the throat—and yes, this is what Michael Douglas was referencing about having obtained throat cancer by performing oral sex).
Early on, cervical cancer may not cause signs and symptoms, but advanced cervical cancer may cause bleeding or discharge from the vagina, either of which may be persistent or abnormal from similar episodes you’ve had in the past. If you have any of these signs, see your physician for an evaluation of this and other possible causes of these symptoms.
Am I at risk for HPV? How do you get this?

Everyone having sex or who has ever had sex is at risk for HPV. In fact, nearly all sexually active men and women get it at some point in their lives. HPV is passed on through genital contact, most often during vaginal and anal sex, but also through oral sex and genital-to-genital contact without intercourse. HPV can be passed on between straight and same-sex partners even if and when the infected person has no signs or symptoms. It’s important to know there’s a big difference between obtaining the HPV virus and obtaining cancer from having the HPV virus.
If I get genital warts, will I get cancer?

Not necessarily, but the possibility is high enough that you need to get treated. Most HPV infections actually resolve on their own. It’s the ones that linger that pose particular concern.
If I do have warts, what increases my risks for these cancers?

Smoking, a weakened immune system, having had many children (for increased risk of cervical cancer), long-term oral contraceptive use (for increased risk of cervical cancer), and poor oral hygiene (for increased risk of oropharyngeal cancer) all increase the risk for developing cancer after a HPV infection.
How do I get this and how do I prevent it?

The most reliable way to prevent infection with HPV is abstinence, avoiding any skin-to-skin oral, anal, or genital contact with another. If you are sexually active, a long-term, mutually monogamous relationship with an uninfected partner is the strategy most likely to prevent HPV infection. However, because of the lack of symptoms, it’s hard to know whether a partner is currently infected with HPV. Use of condoms reduces the transmission of HPV between partners, although areas not covered by a condom can still be infected.

The Food and Drug Administration (FDA) has approved two HPV vaccines, branded as Gardasil (for the prevention of cervical, anal, vulvar, and vaginal cancer, precancerous lesions, and genital warts in these areas) and Cervarix (for the prevention of cervical cancer and precancerous cervical lesions caused by HPV). Both vaccines are highly effective, but neither has been approved for prevention of penile or oropharyngeal cancer. And yes, it’s safe and effective as young as age 9, although the Center for Disease Control and Prevention currently recommends vaccination between ages 11–14. You must contact your physician for additional details on these important medications.
How do I treat HPV infections?
There’s no treatment for HPV itself, but the problems HPV causes can be treated. We’ll address the two major ones:

Genital warts may be treated topically by you or a healthcare provider. If not treated, they may multiply, go away, or stay the same.
Cervical cancer may be treated by your gynecologist, but be warned: Prevention is best, and early detection gives you the best chance for the best outcomes. Continue those annual exams.

There will soon come a time when all boys and girls are receiving vaccinations at around ages 11–12, and cervical cancer (in particular) will become a rare entity. That only happens if you get your family immunized. The science is in. There’s no good reasons left to wait.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: About Cold Sores and Herpes

May 5, 2017Genital/Urinary, Head/Eyes/Ears/Nose/Throat, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, cold sores, Herpes simplex virus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Some of you are consumed with fear. Maybe for some it’s stricken with guilt. In any event this topic is simply another example of not being adequately armed with the knowledge you need. I know exactly what you fear about the topic, so let’s clarify things for you. Let’s discuss cold sores, aka fever blisters. Since this can be bad news, I’ll answer 13 questions you either have or should have about cold sores. You’re welcome to ask more if you have any.

1. What are cold sores?
Cold sores are those painful little blisters you get on or near your lips. You may have single blisters or a small grouping of them.

2. What causes cold sores?
Cold sores are caused by herpes simplex viruses (HSV). Yes. Herpes. Let’s focus on this, and get it straight for you. There are two types of herpes viruses: HSV-1 and HSV-2.

HSV-1 is the usual cause of oral herpes (cold sores).
HSV-2 is the usual cause of genital herpes.

Yes, HSV-2 can cause cold sores and HSV-1 can cause genital herpes.
Let me repeat that. Both forms of HSV can cause oral and genital herpes, although that is not usually the case.

3. Why do I get cold sores?
Cold sores are transmitted from contact. That usually means kissing, but it could mean oral sex, mouth-finger-mouth contact, shared razors or utensils.

4. Are there other symptoms I should expect to get with the cold sores?
There are two considerations here:

The cold sores themselves pass through stages, including tingling and itching, followed by blistering, followed by oozing and crusting.
Additional symptoms may include fever, headache, muscle aches, a sore throat and swollen lymph nodes in your neck.

5. How long do cold sores tend to last?
Even without symptomatic treatment, cold sores are likely to resolve within two weeks.
6. Can I get genital herpes from oral sex?
Yes. Consider using a dental dam or abstaining if you’re uncertain about your partner’s safety.
7. Is there a cure for cold sores?
No, but symptomatic treatment is available.

8. What makes cold sores recur?
Some form of physical or psychological stress may prompt recurrences. Such stressors may include extreme fatigue, fever or infection, menstruation, mental stress and sun exposure.
Additional risk factors for recurrences and complications include severe burns, eczema, cancer chemotherapy, chemotherapy (i.e., anti-rejection drugs) for organ transplants and HIV/AIDS.
9. Can I have problems elsewhere on my body related to cold sores?
Herpes simplex viruses may also create symptoms on the brain, eyes, fingers, liver, lungs and across the skin, particularly in those with weakened immune systems.

10. How can I tell if my partner has this?
You should assume that to be the case. Approximately 90% of adults across the world test positive for herpes simplex virus, which is not the same as saying everyone is in the midst of an active infection. Even still, the virus can be transmitted even when no blisters are present. The presence of a cold sore is suggestive of at least the presence of an active HSV-1 infection.
11. What can I do at home to reduce my risk?

Avoid skin contact with those displaying the blisters of cold sore.
If you have cold sores, limit touching other parts of your body, and wash your hand frequently and thoroughly.
Avoid sharing items, particular those that involve the lips, such as lip balm and utensils.

12. Are there over-the-counter medications and remedies available to help against cold sores?
Docosanol is an over-the-counter cream approved by the Food and Drug Administration for cold sore treatment. It may shorten the duration of symptoms by a day. Other remedies that have shown mixed results in the research include lemon balm, drying agents that include alcohol, lysine stress reduction and simple application of ice or cold water to the blistered area.

13. When should I seek medical assistance for cold sores?
The presence of prolonged (e.g., more than two weeks), especially painful or unusually frequent cold sores or the presence of blistering that occurs in other parts of the body are prompts for seeing your physician. The presence of cold sores, if you have a weakened immune system, is another prompt that should not be ignored.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: STDs – Questions About Herpes

May 4, 2017Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Herpes genitalis, Herpes simplex virus, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

If you’re in a room, look around. Look to your left, then to your right. Look behind and in front of you. Then look deep inside yourself. Statistically, one of the people you’ve just viewed has genital herpes. Different studies suggest between 16-25% of people between ages 14-49 are infected.

Questions You Want Answered Regarding Genital Herpes

1. How common is it? That’s actually a question with two answers. One of five or six individuals have herpes (well over 50 million Americans if you’re keeping count), but it’s estimated that just short of 800,000 new cases occur every year.
2. How do you get it? Herpes is transmitted sexually (genital, oral and/or anal contact) via someone already infected.
3. Can you really get it from a cold sore? Possibly and theoretically yes, but usually not. The Herpes Simplex Virus-1 (HSV-1) is usually found in oral blisters (i.e. ‘cold sores’ or ‘fever blisters’), and its family member HSV-2 is usually found on or near the genitalia, but both can be found in either. Although the Center for Disease Control and Prevention states that “Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection,” many (if not most) emergency physicians have diagnosed herpes based on transmission from oral as well as genital sex.
4. What are the symptoms? Most have no symptoms or symptoms that may be mistaken for the flu (fever, body aches and swollen and tender lymph nodes). The prototypical symptoms are a cluster of blisters (around your genitalia, mouth, fingers or rectum) or painful ulcers.
5. Does it really stay around forever? Yes. Fortunately, the frequency and severity of outbreaks decrease as you age (assuming your immunity is good). If you are immunocompromised, HSV infections can be devastating.
6. If I catch chickenpox or shingles, does that mean I’ll have genital herpes? No. There are many different herpesviruses. HSV-2 is the virus that causes genital herpes. Varicella zoster virus (VZV) is the virus that causes chickenpox and shingles. Varicella zoster does not cause genital herpes.
7. Is it true you can catch herpes in the eye? Yes. Wash your hands. Or else…

8. What was that last picture? That wasn’t just an eye, there was also a finger! Well, how did it get it from the genitals to the eye (Please don’t answer in the comments section…)? That’s called herpetic whitlow. Notice the common theme of grouped clusters of small blisters (vesicles) again. Regarding that eye infection (herpes keratitis), it can cause blindness.

9. Is it true that women get it more often? Some estimates suggest that 25% of American women and 20% of men have genital herpes. Transmission from males to females is easier than from females to males, but guys, I wouldn’t take any chances.
10. What about the babies? 80-90% of general herpes infections to newborns are transmitted during childbirth as the newborn passes through the birth canal. C-section is recommended for all women in labor with active symptoms or lesions of herpes.
11. How do you treat this anyway? Antiviral medications are used at first sign of outbreaks. These medications don’t cure you of herpes, but they do shorten the frequency and severity of outbreaks. Plus, you’ve got to let your sexual partner know about this. It’s criminal not to.
Overall, my best advice to you is prevention, knowledge about your status, recognition of symptoms and prompt treatment. It is very important to emphasize that many people live quite normal lives with herpes. That still doesn’t mean you should be cavalier or irresponsible about it.
I welcome your questions or comments.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: Bacterial Vaginosis – No, That’s Not a STD

May 3, 2017Genital/Urinary, Obstetrics and GynecologyBacteria, Bacterial vaginosis, Behind the Curtain, Centers for Disease Control and Prevention, Conditions and Diseases, health, Human sexual activity, Infection, Microorganism, PH, Sexual partner, Sexuality, Sexually transmitted disease, There are 72 Hours in a Day, Vagina, Vaginitis, Women's HealthJeffrey Sterling, MD

I try to give you straight talk but never crudely. As I’ve discussed conditions involving the genitalia, I’ve been mindful of the reality that large numbers of you have been affected by sexual transmitted diseases/infections (aka STDs/STIs), and I will always be respectful of that consideration. That doesn’t mean I’m sugar-coating your information, it just means I am aware that you’re suffering and concerned by different scenarios.

One of those is bacterial vaginosis. There is an age after which women invariably start discovering that various things they do can disrupt the appearance, smell and content of their vaginal fluid. It’s certainly human nature to wonder if something has gone terribly wrong. Let’s pick up our Doctor-Couple conversation from earlier…
Patient: Yep! I have this grayish/whitish discharge that only happens after sex. And sometimes it itches around there. And it burns when I pee! No rashes or that other stuff, though.
Doctor: Ok. Let’s examine you…

All humans have various microorganisms that normally reside inside us at relatively low levels; different microorganisms inhabit different part of the body. They’ve set up a delicate balance (like an ecosystem, if you will) that, once settled doesn’t disturb us (their hosts) at all. If external or internal circumstances disturb that balance such that one set of organisms is disproportionately affected, overgrowth of the other organisms may occur. Many of you will recognize this as happening when you get a ‘yeast’ infection. It’s also what occurs when you develop bacterial vaginosis (BV). BV is the most common vaginal infection in the U.S. It’s more likely to be seen when you start having unprotected sex with a new partner, have multiple sex partners, are pregnant or douche (therefore, women who are not sexually active can have BV also). By the way, you don’t get BV from toilet seats or swimming pools.

The question everyone always has is “What’s the role of sex, especially sperm, in it?”. That’s asked because BV is often noticed after unprotected sex that includes ejaculation. Here’s where you learn the difference between ‘sexually transmitted’ and ‘sexually associated’. It is unclear what role sex has in the development of BV, but common thoughts include alterations in the pH of the vaginal fluid based on interactions with sperm/semen. It is known that the pH of women become more alkaline (less acidic) after exposure to semen, and that environment produces compounds causing the ‘fishy smell’. Yes, that’s real. We even have a real thing call a ‘whiff test’ as part of making the diagnosis.
The good news is BV is easily treated. The bad news is it needs to be treated, and it can recur even if it’s treated. Remember, it’s just an overgrowth syndrome. There are complications to not getting BV treated, especially if you’re pregnant. This makes it especially important that medication be taken to completion, even though you may feel better prior to that. Male partners do not need to be treated.
So this couple gets ‘off the hook’, even though they may decide to start using condoms. Next we will focus on the risks of various sexual activities. Stay tuned.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: STDs – Treatment of Pubic Lice (Crabs)

May 2, 2017Genital/Urinary, Infectious Disease844-SMA-TALK, Behind the Curtain, crabs, public lice, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

There’s no dishonor in needing help. A pubic lice infestation is one of many types of conditions that can lead to a complete disruption of your life. These are full-time parasites whose mission is to multiply and inhabit you. If you get infected and either don’t know what to do or incompletely/incorrectly treat these infections, you’ll be in for a long and unpleasant co-existence with pubic lice. Today’s Straight, No Chaser addresses treatment considerations regarding pubic lice and is modified from recommendations from the Centers for Disease Control and Prevention. Non-treatment-related information on pubic lice is available in this post .
Lice-killing over-the-counter products containing 1% permethrin or pyrethrins and piperonyl butoxide can be used to treat pubic (“crab”) lice. These medications are safe and effective when used according to instructions. It never hurts to discuss this with the pharmacist while you’re there or with your SterlingMedicalAdvice.com expert consultant from home.
It is important to appreciate that there are two separate considerations in treating pubic lice: 1) treatment of lice actually in the pubic area and 2) treatment of lice on the eyebrows and/or eyelashes.

Steps for genital pubic lice treatment:

Wash the infested area and towel dry. Set the towel aside, as it will need to be specially cleaned.
Thoroughly saturate the pubic hair and other infested areas with lice medication. Leave the medication on your hair for the time recommended in the instructions. After waiting the recommended time, promptly remove it.
Even at this point, most nits (eggs) will still be attached to hair shafts. Nits may be removed with fingernails or by using a fine-toothed comb.
Put on clean underwear and clothing.
To kill any lice or nits remaining on clothing, towels, or bedding, machine-wash and machine-dry those items used during the two-three days before treatment. Use hot water (at least 130°F) and the hot dryer cycle.
Items that cannot be laundered can be dry-cleaned or stored in a sealed plastic bag for two weeks.
All sex partners from within the previous month should be informed that they are at risk for infestation and should be treated.
Sexual contact must be avoided until all sexual partners have been treated and reevaluated to rule out persistent infestation.
Repeat treatment in nine to 10 days if live lice or nits are still found.
Persons with pubic lice should be evaluated for other sexually transmitted diseases (STDs).

Steps for treatment of lice and nits found on eyebrows or eyelashes:

The lice medications used for the genital region should not be used near the eyes.
If only a few live lice and nits are present, it may be possible to remove these with fingernails or a nit comb.
If additional treatment is needed for lice or nits on the eyelashes, careful application of ophthalmic-grade petrolatum ointment (only available by prescription) on the eyelid margins two to four times a day for 10 days is effective. Regular petrolatum such as Vaseline should not be used, because it can irritate the eyes.

Your physician knows what medications work for treatment of pubic lice, but I do want you to make a note regarding one medicine: lindane shampoo. This medicine is effective but has a bad risk profile. It can be toxic to the brain and central nervous system and is most notably associated with the development of seizures. Because of this, lindane is not a first-line medication and should be restricted to instances in which other medications didn’t work or aren’t tolerated. Lindane is not to be given to anyone under 110 pounds (e.g., children), those with a history of seizures, women who are pregnant or breast-feeding, the elderly or those with sores and/or irritated skin in the areas to be treated.
The point about pubic lice is the same as with any sexually transmitted infection. Your best course is to avoid contracting it. If obtained, your best course is to come clean (no pun intended) and get aggressive with treatment and notification of your sexual partners. Pretending it will go away or that it can’t happen to you is a dangerous prescription that I won’t co-sign.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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Straight, No Chaser: STDs – Pubic Lice (Crabs)

May 1, 2017Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, public lice, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser (composition), There are 72 Hours in a DayJeffrey Sterling, MD

Unfortunately, there’s no pleasant way around this topic. I hope the topic doesn’t make you crabby.

There is a story of legend in the medical community regarding the trends to start waxing or shaving pubic hair. It involves crabs (pubic lice). Back in the 1920s, when the clear preference for appearance involved a full “bush,” this was often accompanied with the frequent presence of pubic lice, particularly in the brothels of Las Vegas. Women took to shaving in an effort to relieve themselves from the presence of the lice. However, the newly shaved appearance apparently wasn’t good for business; as a result, these women began wearing pubic toupees.
So why am I telling this story? The toupees were made of beaver hair. That’s the origin of that terminology, in case you didn’t know… On to common questions about pubic lice.

What are pubic lice? Pubic lice (aka crabs) a parasitic insects found in the genital and pubic areas of humans.

Where are pubic lice found? By definition, pubic lice are predominantly found in the genital and pubic areas in one’s hair. However, pubic lice have also been found in other areas of the body with coarse hair, such as the armpits, beard, eyebrows, eyelashes, legs and mustache. In fact, pubic lice on the eyebrows or eyelashes of children are regarded as a prompt to search for sexual abuse. It also is of note that lice on the scalp are head lice, which is a different consideration than pubic lice.
Whom do pubic lice infect? Anyone and everyone seem to be affected. Pubic lice are seen all over the world across all races, classes and ethnicities. Public lice are not seen in animals. Pubic lice are most commonly seen in adults, are considered to be a sexually transmitted disease (infection, aka STD or STI) and should prompt a search for other STDs. There have been occasional cases of spread through contact with articles such as bed linens, clothing or towels, but this is extremely rare. Lice can’t live away from the warmth of a human body very long, and their feet don’t allow for walking on or attaching to smooth surfaces, so they generally are limited to staying on their hosts.
Can I get public lice by sitting on a toilet? This commonly expressed concern is quite overstated. As noted, lice can’t live away from the warmth of a human body very long, and their feet don’t allow for walking on or attaching to smooth surfaces, so they generally are limited to staying on their hosts.

What do pubic lice look like? Pubic lice have three forms: the egg (also called a nit), the nymph, and the adult.

Nit: Nits are lice eggs. When seen, they are usually found firmly attached to the hair shaft. They are oval and usually yellow to white. Pubic nits hatch in about 6–10 days.
Nymph: The nymph is a young, immature louse that just hatched from the nit. Pubic lice nymphs take about 2–3 weeks after hatching to mature into adults capable of reproducing. To live, a nymph must feed on blood.
Adult: The adult pubic louse resembles a miniature crab. Pubic lice have six legs; their two front legs are very large and look like the pincher claws of a crab. Pubic lice are tan to grayish-white in color. Females are usually larger than males. In can’t you’re thinking that doesn’t matter to those infected, it should because females lay eggs, continuing the cycle that causes human discomfort. To live, lice must feed on blood. If the louse falls off a person, it dies within 1–2 days.

What are the signs and symptoms of pubic lice? The symptoms of pubic lice infestation include genital itching, visible lice eggs (nits) or visible crawling lice.

How is a pubic lice infestation diagnosed? The diagnosis of pubic lice is simply made by visualizing a louse or nit (egg) in the pubic hair or elsewhere. It is more common to need a magnifying glass to identify lice or eggs.
How are pubic lice treated? We will go into the treatment of pubic lice in some detail in an additional Straight, No Chaser. It’s too important to simply give a quick answer on this.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
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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.
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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

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 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.
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Straight, No Chaser: STDs – Gonorrhea

April 28, 2017Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Gonorrhea, Sexually transmitted disease, sexually transmitted infections, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

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

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

1. It’s a real good reason to wear condoms and a just as good of a reason to wash your hands. Gonorrhea most commonly presents with no symptoms (more often the case in women), but it has two symptoms that won’t let you forget it. It’s the STD that may present with burning upon urination so severe that you feel like you are peeing razor blades. It’s also defined by copious discharge. If you’re exuding white, yellow or green pus, think gonorrhea. As was the case with Chlamydia, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis), as well as the throat or eyes. Wash your hands after using the bathroom, gents.

2. It’s contagious. If you’re sexually active with someone infected, odds are you’ll get it. It can be acquired via oral, vaginal or anal sex, and ejaculation isn’t required for transmission. Even worse, that means you can pass it to your newborn child (There’s even a name for the condition: ophthalmia neonatorum, as seen in the above picture.).
2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.

3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner has completed treatment.
4. It causes serious complications. PID (pelvic inflammatory disease – a complication of untreated Gonorrhea and Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility and an increased rate of tubal (ectopic) pregnancies. Gonorrhea also spreads through the blood and joints. Many of these complications are life-threatening.

5. STDs hang out together. Gonorrhea that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Gonorrhea should prompt treatment for other STDs and testing for HIV. It is generally assumed that if you have gonorrhea, you’ve likely been infected with Chlamydia.
6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with the development of signs or symptoms. Discuss the discovery of Gonorrhea with all sexual contacts from the last several months. This is an infection you don’t have to catch.
7. It is now super, but not in a good way. Due to antibiotic resistance, treatment of gonorrhea is becoming more complicated. We are seeing more patients who don’t respond to the first course of treatment. Consider antibiotic resistance if symptoms persists more than three days after completion of treatment.

Now, about The Clap.

Traditionally, there have been three theories about why gonorrhea used to be commonly called the clap, only one of which sound legitimate to me.
1. Treatment (allegedly) used to involved ‘clapping’ a book together around the penis to expel the discharge. Not only does that not make sense, I can’t imagine men letting someone smash their penis in that manner, when you could just ‘milk’ the discharge out (no pun intended). This is a very common explanation, though…
2. The clap may be a mispronunciation of the phrase ‘the collapse’, which is what gonorrhea was called by medics when GIs were being infected with gonorrhea in WWII.
3. Finally, perhaps, clap is derived from the French word for brothel, “clapper.” Makes sense if you’re in Paris, but in NY, why wouldn’t it have been called ‘the broth’, because that’s kind of how it looks… Sorry if you’re reading this during breakfast. Then again, I did spare you a picture of genital gonorrhea.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: STDs – Chlamydia Infections

April 27, 2017Genital/Urinary, Infectious Disease, Obstetrics and Gynecology844-SMA-TALK, Behind the Curtain, Chlamydia infection, Non-gonococcal urethritis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

For most people, NGU isn’t a college in South Carolina. In fact, non-gonococcal urethritis isn’t really even that anymore, meaning it doesn’t need to be defined by the fact that it’s not gonorrhea. Chlamydia (the most common cause of NGU) by itself causes an estimated 3 million sexually transmitted infections a year. It is the most likely reason you’re coming into the emergency department when someone’s been behaving badly, and it was the most common sexually transmitted infection for a long time (prior to the advent of human papillomavirus – HPV). This Straight, No Chaser gives you some essential information about sexually transmitted infections featuring Chlamydia.

1. It’s a real good reason to wear condoms. Chlamydia most commonly presents with no symptoms but may present with burning with urination, having to go more often (that’s the urethritis; the urethra is the tube through which urine flows) and a cloudy discharge. Less commonly, it can affect the rectum (proctitis) or a portion of the testicles (epidydimitis).

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

2. Treatment doesn’t prevent you from reacquiring it. If you don’t change the behavior, you won’t change the future risk.
3. If both partners aren’t treated, then neither is treated. This can just get passed back and forth like a ping-pong ball. If you have several sexual partners, you’ll manage to introduce a lot of drama into a lot of lives. If you are treated, you should not engage in sexual activity until one week after your partner(s) have completed treatment.

4. It causes serious damage to females. PID (pelvic inflammatory disease – a complication of untreated Chlamydia) is a serious enough topic to warrant its own post, but untreated infections lead to infertility, an increased rate of tubal (ectopic) pregnancies and other complications. This needs to be identified and treated.
5. STDs hang out together. Chlamydia that goes untreated increases the chances of acquiring or transmitting HIV/AIDS. An infection with Chlamydia should prompt treatment for other STDs and testing for HIV.

6. It is easily prevented and treated. Wear condoms each time, every time. Get evaluated early with development of signs or symptoms. Discuss the discovery of Chlamydia with all sexual contacts from the last several months. This is an infection you don’t have to catch.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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

April 26, 2017General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Behind the Curtain, Chlamydia infection, Gonorrhea, Herpes, HIV-AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Syphilis, There are 72 Hours in a DayJeffrey Sterling, MD

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

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

Chlamydia

Gonorrhea

Syphilis

Herpes

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

April 24, 2017Obstetrics and Gynecology, Health Prevention844-SMA-TALK, Advanced maternal age, Behind the Curtain, c-section, caesarean section, Down syndrome, gestational diabetes, Low Birth Weight, placenta previa, pregnancy-induced hypertension, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Times have changed. Marriages are increasingly career-focused, and couples more and more choose to have babies later in life. It is helpful that these decisions can now be aided by recent innovations in medicine regarding fertility. Unfortunately, changes in societal norms don’t remove risks inherent in the human condition. Advanced Maternal Age is a medical consideration for any woman considering childbirth after age 35. The bottom line is advanced maternal age comes with risks. If you or a loved one is considering childbirth after age 35, you need to be aware of these risks and how to minimize them. These include the following.
It likely will take longer to get pregnant.
If pregnant, you will have an increased risk of miscarriage.
If successfully pregnant, you’re more likely to have any of several medical conditions, including the following:

Gestational diabetes
Pregnancy-induced hypertension
Placental previa (in which the “afterbirth” material can inadvertently cover all or part of the uterine opening, causing bleeding and a need for C-section)

If you successfully deliver, your child is more likely to be at risk for any of several medical conditions, including the following:

Down Syndrome and other chromosomal birth defects, causing abnormalities in the transmission of heredity information via the genes)
Low birth weight and prematurity

Even though you can never eliminate the above risks, you can reduce them. Consider the following among the list of healthy choices you should make to give yourself the best change to have a healthy baby at an advanced maternal age. All of these recommendations should be adapted in conjunction with your obstetrician.
Get prenatal care before you actually get pregnant and keep it during your pregnancy. You will need to discuss your personalized risks, your health profile, the correct strategy for weight gain, and any prenatal testing that may be necessary.
Eat a nutritious diet, including recommended amounts of calcium, folic acid, iron, Vitamin D, and a daily prenatal vitamin. These dietary habits should begin well before you become pregnant.
Stay physically active. Health basics are even more important during this time.
Getting pregnant at an advanced maternal age is a serious decision. Approach it with the consideration and caution it deserves.

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.

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