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Sexually transmitted diseases: Chlamydia

Should we use condoms until my partner is treated for Chlamydia?

Frequently, patients ask if it is ok to still have intercourse with a partner who has not been treated as long as the couple uses condoms.  A visualization technique to consider would be imagining having intercourse with the partner with a condom right after he has rolled his member around in fresh wet mud mixed with animal droppings.  That romantic image should cause at least some hesitation.

Chlamydia is a sexually transmitted disease (STD)  that can infect both men and women and can cause permanent damage to a woman’s reproductive organs. It is known as a ‘silent’ infection because most infected people have no symptoms.  It can be easily treated and cured with antibiotics.

Persons with Chlamydia should abstain from having sex for seven days after a single dose antibiotic, or until completion of a seven-day course of antibiotic, to prevent spreading the infection to partners.

Even if you have been treated, you can get infected again if you have sex with an infected person. It is a very common STD, especially among young people.

Some infected women have an abnormal vaginal discharge or a burning sensation when urinating. Untreated infections can spread upward to the womb and fallopian tubes (tubes that carry the egg from the ovaries to the womb), causing pelvic inflammatory disease (PID). PID can be silent, or it can cause symptoms such as abdominal and pelvic pain. Even if PID causes no symptoms initially, it can lead to infertility (not being able to get pregnant) or ectopic pregnancies (pregnancies that settle in the fallopian tubes.)

In pregnant women, untreated Chlamydia has been associated with pre-term delivery, and can spread to the baby, causing eye infections or pneumonia.

There are laboratory tests to diagnose Chlamydia. Specimens for testing are obtained from swabbing the cervix or collecting a urine sample.

Persons with Chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their partners were successfully treated.

Using latex condoms correctly, and with each episode of sexual intercourse. can reduce the risk of getting or giving Chlamydia. The surest way to avoid Chlamydia is to abstain from vaginal, anal, and oral sex or to be in a long-term monogamous relationship with a partner who has been tested and is known to be uninfected.

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Sexually transmitted diseases: Herpes

I have what?!   What is genital herpes?

Genital herpes is a STD (sexually transmitted disease) caused by the herpes virus type 1 or type 2. It is quite common as studies have shown 1 in 6 people up to the age of 49 years have type 2 herpes.

Most individuals infected with herpes have little or no symptoms, or they mistake the signs for some other condition.  An outbreak may appear as blisters around the genitals, the anus or the mouth.  The blisters break and leave sores that could take up to two to four weeks to heal.

A first time outbreak, however may present with symptoms such as fever, body aches and swollen lymph glands.  Repeat outbreaks are usually shorter duration and less severe than the first outbreak of genital herpes.

Type 1 herpes infections of the genital area can be caused when someone gives “special attention” to her partner through mouth to genital contact when there is a fever blister present.    If the person with genital herpes touches their sores or the fluids from the sores, the virus may be transferred to another part of the body.

The first outbreak may occur as early as 2 weeks after having sexual contact with an infected person, and symptoms can last from 2 to 3 weeks.

A pregnant woman with genital herpes may be advised to take antiviral medication from 36 weeks gestation through delivery to reduce the risk of an outbreak.  If there is an outbreak present during labor, the pregnant woman may undergo a Cesarean section to reduce exposure of the infant.

If a person feels a recurrent outbreak coming because of tingling or odd sensation in that usual area or there are sores present, he should not have sexual intercourse with his partner until all sores have completely healed.  Even without symptoms, a person can still pass the herpes virus to others.

Although there is no cure for herpes, the antiviral medications may prevent or shorten the outbreak episode.

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Fever during Pregnancy

Is a fever dangerous during a pregnancy?  Will a fever harm the baby?

 

A high fever (over 101 F) for a long period of time during an early pregnancy can be harmful to the fetus.  The exposure to high temperatures is most damaging between the fourth week after the last menstrual period and the fourteenth week.   In the second 3 months and the last 3 months of pregnancy, high temperatures are much less likely to cause any problems for the baby.

A brief episode of high temperature is unlikely to cause any problem and is usually treated with an over the counter medication like acetaminophen (Tylenol.)

Fever may indicate an infection in the womb which could also be harmful to the fetus. Such infections could be from the cytomegalovirus (CMV,) parvovirus, or toxoplasmosis.

Some researchers think that when the mother has a high internal temperature from fever or even soaking in the hot tub early in pregnancy there may be a greater chance of development of neural tube defects such as spina bifida-an opening in the spine.

There have been reports that there could be up to 3 times the chance of a child being diagnosed with autism by 3 years old if the mother had fever for a week or the flu during pregnancy.  The Center for Disease control says that there needs to be more research in this area to be certain.

There have been questions about other birth defects resulting from fever and infection but again more research is needed.

An ultrasound after 20 weeks may be used to look for any obvious birth defects.

Of course if the increased temperature is controlled, there would be little risk to the fetus.  If a woman develops a fever during pregnancy she should follow the instructions given to her by her health care provider.  If she is unsure, it is best to call her doctor or her nurse practitioner for further information and instructions.

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Sexually transmitted diseases: HPV

Should I be concerned about HPV and throat cancer that’s all in the news?

 

Well, cancers of a number of areas are linked to HPV: cervix, vagina, vulva, penis, anus, mouth and throat.  In a previous post, we discussed that HPV infections are widespread throughout the US and are transmitted sexually in 99%+ of cases.  Since this is a silent infection, most people infected with HPV do not know they have it.  Most of the time the body’s immune system will clear the high risk and low risk viruses, or they will disappear, or go into hiding, never to be seen again but in some cases the human papilloma viruses will stay and may hang around for years.

There is no way to know  who will go on to develop cancer or other health problems from the high risk human papilloma viruses.  When the high risk viruses causes changes in the cells, these cells go through a pre-cancer stage that can be detected with screening tests such as pap smears. Unfortunately, there is no specific screening test for mouth or throat cancer at this time. Biopsies of abnormal looking areas also can detect the pre-cancer stage as well.

Cancers of the vulva, vagina, penis, anus, mouth and throat are much less common than cervical cancer.  HPV is found in saliva (spit,) semen, and genital secretions.  It can be transmitted through skin to skin contact from genital warts.

It is best that you and your partner discuss your past sexual histories, realizing that most people do not know that they carry a silent infection.  You may be reluctant to even bring up the subject because you are in a special committed relationship.  Since the Head Virus does not know that this is a special person and will not tell the other viruses to stop, wait, don’t jump on this person because he/she is a nice person, Safe Sex is realistically your only protection.

Protection against HPV infections includes using condoms (male and female) and placing a barrier between you and your partner during oral sex such as a dental dam.  Vaccination against HPV would also be protective.  It would be best to be vaccinated prior to sexual activity; thus the push to vaccinate children and young people.  The HPV vaccination may be helpful even after initial sexual activity because it is unlikely a young person has been exposed to all of the 4 most common human papilloma viruses covered by the vaccine.

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Exercise During Pregnancy

 

Is it safe for a woman to exercise while pregnant?  What are some of the benefits of exercise during  pregnancy?

 

Yes, exercise during pregnancy is safe.  Of course a pregnant woman should always check with her health care provider before starting a new program.

The American College of Obstetricians and Gynecologists recommends at least 30 minutes of exercise a day.  A woman can start slowly, by beginning with 5 minutes a day and then build up to 10 minutes, 15 minutes, and so forth until she reaches the 30 minute goal.  If she is already active, she can continue to work out at the same level while pregnant as long as she feels physically comfortable.

A healthy exercise program can boost the energy level, help prevent back ache, strengthen muscles, and help reduce the risk of medical complications such as diabetes or hypertension.

Some activities to consider include walking, swimming, or spin cycling.  If the woman has already been a runner, she may continue during pregnancy but of course slow or stop if she becomes overly tired. Muscle building or strength training is ok to a point, but she should avoid lifting heavy weights.

Any activity that has a high risk of falling should be avoided.  The pregnant woman should not be involved in gymnastics, water or snow skiing, contact sports obviously, or scuba diving.

She should drink plenty of fluids and avoid working out in hot humid conditions to avoid overheating or becoming dehydrated.

She should stop exercising if she becomes dizzy, becomes short of breath, develops abdominal or chest pain, vaginal bleeding or fluid leaking.

After delivery, walking is a good way to become active again.  Once the woman is cleared by her provider, she may return to more strenuous activities.