Monday, March 16, 2009

Silent but deadly

Chlamydia is now the most commonly reported notifiable disease in the United States, with annual cases reaching over a million for the first time in 2006, and now the recently released 2007 statistics show an increase to 1.1 million. Chlamydia is actually very easily treated and CURED with antibiotics, so what's the big deal? Well, the big deal is that you have to know it is there to treat it, and Chlamydia is silent in half of men and 75% of women! Chlamydia will happily remain in your reproductive tract, setting up shop and potentially scarring your tubes and impairing your fertility for years if not treated. It is estimated that if we physicians started screening every woman who is sexually active, we would annually prevent 60,000 cases of pelvic inflammatory disease, 8,000 cases of chronic pelvic pain and over 7,000 cases of infertility! Talk about saving heart ache, pain, and not to mention countless health care dollars!
So, what's the myth? The myth is that you will KNOW if you have an STD. The FACT is that most STDs are silent, and Chlamydia is one where silence is deadly.
BOTTOM LINE: If you have had a new sexual partner, please go to your physician and ask to be tested for all STDs, especially Chlamydia. Do NOT wait for symptoms to worry about STDs!!

Monday, March 9, 2009

Summer lovin'...

Happened so fast! Okay, I'm still on a "Grease" theme, but hey, the music fits the topic! So, what's next? HPV- the Human Papilloma Virus. Did you know over 20 million Americans have active HPV infections as I type this? That over a million Americans have genital warts at any given time? HPV is VERY COMMON. The good news is that now we have Gardasil, which will protect young women against both genital warts and cervical cancer. The bad news is that people are nervous about giving their daughters the vaccine. Remember, we give all babies the hepatitis B vaccine in the first day of life. Hepatitis B is spread through IV drug use and sex, but we give to everyone so we can prevent the end stage disease, which is liver cancer. Similarly, while it's great to prevent genital warts, the larger purpose of Gardasil is to prevent cervical cancer. The safety studies on Gardasil are in (see my earlier post "and she's safe") and so yes, I will be vaccinating my daughters.
So, what's the biggest myth about HPV? I'd have to say that people believe you have to have sex to catch it. HPV is spread from direct skin-to-skin contact- no sex of any kind needed. Condoms can't cover all the area that can harbor HPV, so they can't fully protect against it. Genital warts can show up anywhere that there was direct contact- from the upper thighs, to the anus, to the standard "private parts", and they are no fun to have treated. Having said that, don't wait to come in if you think you have a wart, because the smaller and fewer they are, the easier they are to treat!
Second biggest myth is that genital warts turn into cancer- NOT TRUE! The types of HPV that cause 90% of genital warts do NOT cause cancer.
BOTTOM LINE: HPV is VERY COMMON in the United States. I recommend Gardasil (and no, I'm not on Merck's payroll in any way, shape or form!). Warts do NOT turn into cancer, but untreated silent HPV might- get those Pap smears!

Monday, March 2, 2009

"Tell me more, tell me more..."

Was it love at first site? Okay, that's a Grease reference, for those of you who may not recognize it. Can you believe John Travolta has thrilled another generation of girls- and this time, HE is a MOM?? Gotta love Hairspray...
But I digress! What I want to talk about this month is STD myths. While I could tell you to go buy and read Seductive Delusions for all the answers, I find that people frequently ask me to "tell them more". So, for the next few blog entries, I'll try to hit the highlights on some of the major sexually transmitted diseases.
Herpes, from it's sheer numbers, must go first! Somewhere between half and 75% of Americans test positive for herpes, meaning that they carry antibodies to herpes as a result of being infected- whether or not they get blisters. It is believed that 90% of people with genital herpes, for example, are completely unaware that they have it. While that is GOOD news for them (they are lucky that they don't experience painful blisters) it's BAD news for their unknowing partners who might contract herpes from them. There is no correlation with the severity of disease from one partner to the next, even though it is the same virus. Put another way, you may break out once per year, but the partner you gave it to might break out every month! Not the gift you want to give. The biggest myth about herpes is that people believe cold sores are NOT herpes, and perhaps that is why they do not believe that oral sex can transmit herpes.
BOTTOM LINE: Herpes is COMMON. It is spread whether or not you know you have it, whether or not you can see any blisters. Herpes is VERY OFTEN spread from one person's mouth ("cold sores" or "fever blisters") to another person's genitals through oral sex.