As my ever-creative title suggests, March is Endometriosis Awareness Month. I have endometriosis (“endo” for short), and I like this month because I know plenty of people in my life who could definitely use some more awareness as to what endometriosis is and how it impacts the lives of those who have it.
So what is endometriosis, anyway?
Endometriosis is a condition where the endometrium, the lining of the uterus, grows outside the uterus — often on the ovaries, bladder, bowel, and/or lining of the pelvic area. This can be a problem for two reasons. One is that during menstruation, there’s nowhere for this “rogue endometrium” (not a technical term) to go, not having a way to the cervix and vagina and all. This can cause pain — most often pain during menstruation — as well as a buildup of tissue that remains throughout subsequent cycles, where even more “rogue endometrium” is added to it. The other is that the endometrial lesions can contribute to infertility, particularly if the endo obstructs the ovaries or fallopian tubes.
That doesn’t sound like fun. Is endometriosis rare?
Surprisingly, no. Exact numbers are hard to come by because a lot of cases are thought to go undiagnosed (which is part of the reason for this whole “awareness month” thing). But the estimate is that endo affects just over 10 percent of people with ovaries during their reproductive years — and about 30 to 50 percent of such people who have problems with infertility or pelvic pain. Odds are pretty good that you personally know someone with endometriosis, even if you don’t (or they don’t!) know they have it. Continue reading →
The Internet is brimming with contradictory claims about sexual health, and you don’t know what to believe. Your friends give you advice, but you’re not sure if it sounds right. To make things worse, you might not have had evidence-based, medically accurate sex education in your school. In this edition of our STD Awareness series, we’ll take on a few myths about sexually transmitted diseases to help you sort fact from fiction.
1 MYTH: You can tell if someone has an STD by looking at them. You might expect that if someone has an STD, their genitals would have blisters, warts, or noticeable discharge. But your partner looks fine, so you might think there’s no need to ask when his or her last STD test was.
However, while many people with STDs do have visible symptoms, they’re the exception rather than the rule. For example, three out of four women and half of men with chlamydia have no symptoms. Herpes is often spread when there are no symptoms present. Someone can be infected with HIV — and capable of transmitting it to others — and go years without showing any signs. A quick visual inspection can’t tell you very much about someone’s STD status.
3 MYTH: Condoms can’t prevent the spread of HIV. Many proponents of abstinence-only education state that condoms don’t protect against HIV, claiming that latex condoms have holes that are large enough for viruses to pass through. This claim isn’t backed by evidence. An intact latex condom dramatically reduces your risk of being exposed to sexually transmitted viruses such as HIV. (It is true that a lambskin condom does not provide adequate protection against HIV.) Continue reading →
In 1970, just a few years after receiving her master’s degree, Faye Wattleton left the Dayton Health Department and the Visiting Nurses Association to serve as executive director for Planned Parenthood of Miami Valley in Ohio. While she was there, the Roe v. Wade decision was handed down, and when a local reporter asked for a comment, Ms. Wattleton realized that her affiliate had no prepared statement. As she wrote in her autobiography, “The national offices had communicated no strategy for addressing the implications of such a landmark decision.”
At the time, no one had known what to expect from the Supreme Court, and the ruling came as a shock to Wattleton and her colleagues. But the Roe v. Wade decision would eventually thrust Planned Parenthood into the highly politicized abortion debate, despite the fact that their mission was — and is — broader than that, focusing most of their energies on contraception, preventive care, and education.
When Ms. Wattleton became Planned Parenthood Federation of America’s president in 1978, the organization had become, according to a 1979 Time Magazine article, “as all-American as the Girl Scouts and debutante parties.” But Ms. Wattleton restructured the national office staff in preparation for increasing political challenges, while continuing to expand medical and education services. During her first year, more than 60 percent of the national managerial staff left the organization.
Reflecting on the restructuring, Ms. Wattleton says that had she known then what she knows now, she would have begun her tenure at PPFA differently. “I had been the executive director of a Planned Parenthood [affiliate] for seven years before I became president [of the national organization]. I felt like I really knew the organization, but what I learned [is that] anyone who has the privilege to ascend to national or international responsibilities can’t quite appreciate what it’s like, until you’re actually in the seat. Perhaps I really overestimated my perspective on some of the nuances of the importance of touching base with a number of the elements within the organization; like any other organization, Planned Parenthood has its factions.” Continue reading →
Last year, we shared the fascinating and frightening story of the emergence of increasingly antibiotic-resistant gonorrhea, an STD caused by the gonococci bacteria. The sexually transmitted scourge, which we only so recently reined in with the development of antibiotics, has been performing some genetic gymnastics to defeat almost every drug we’ve thrown at it. We douse it with certain drugs, and the bacterium literally spits them back out at us, and it inactivates other drugs by snapping the active molecules in half. Sulfa drugs, penicillins, tetracyclines, fluoroquinolones — they all make a gonococcus heave a bored sigh. Luckily, cephalosporins were still an effective treatment, but recently there have been reports of stubborn gonorrhea infections caused by the latest and greatest (and some might say most hated) strain of gonococci.
Well, the story isn’t over — just like the bacteria that cause gonorrhea, the tale is rapidly evolving. The latest class of antibiotics that the gonococci are chipping away at is the cephalosporin family, which includes several chemically related drugs that work in similar ways — and that can likewise be defeated by microbes in similar ways. Cephalosporin-resistant gonorrhea was first reported in Japan and documented in a few European countries. The Japanese case that inspired the New England Journal of Medicine to declare last year that it was “time to sound the alarm” was an oral gonorrhea infection that was resistant to one member of the cephalosporin family: ceftriaxone.
Earlier this month, the prestigious medical journal JAMAreported the first North American sightings of gonorrhea that failed treatment with another cephalosporin: cefixime. Yeah, I know, you’d rather hear about Big Foot or UFO sightings, not evidence that something as real and unmythical as Gonorrhea 5.0 has landed in your back yard. Luckily, there’s plenty you can do to protect yourself from it, and we’ll tell you all about it toward the end of this article. (Spoiler alert: It involves using condoms!) Continue reading →
It can sound intimidating and clinical on its own. And if you’re anything like me, you may have — ahem — occasionally confused it with the significantly more internal colonoscopy. For the sake of everyone’s anxiety levels, it may be best to set the record straight.
Why am I getting a colposcopy?
The most common reason for undergoing a colposcopy is having an abnormal Pap test result, particularly one that, when tested for DNA of human papillomavirus, yielded a positive result. Effectively, there are some abnormal cervical cells with HPV present. Because this could potentially progress to cervical cancer down the line, this combination makes health care providers want to get a closer look at what’s going on.
Planned Parenthood Arizona treats epididymitis.This statement might raise a few questions:
Q: What’s epididymitis? A: Epididymitis is the inflammation, or swelling, of the epididymis, resulting in pain in the scrotum. Q: That’s great, but what the heck is an epididymis? A: The epididymis is a tube that is connected to the testicle, and is where sperm are stored before ejaculation. The epididymis is 12 to 15 feet long, but is coiled tightly enough to fit inside the scrotum alongside the testes!
So, basically, epididymitis is a condition that can strike anyone whose reproductive anatomy features an epididymis. It is generally caused by a bacterial infection — which may be sexually transmitted, such as gonorrhea and chlamydia, or may not be sexually transmitted, such as tuberculosis. Very rarely, epididymitis can be caused by other pathogens, such as viruses, fungi, or parasites. Inflammation of the epididymis can also be caused by the heart medication amiodarone (also known as Pacerone).
Epididymitis most commonly affects males between the ages of 14 and 35. Riskfactors, regardless of age, include being uncircumcised, a history of prostate or urinary tract infections, having had surgery in the urinary tract, having a history of a neurogenic bladder, an enlarged prostate, regularly using a catheter, and not using condoms during vaginal or anal intercourse.
The symptoms of epididymitis usually develop over one or two days and can include: Continue reading →
Because a Pap test screens for abnormal cervical cells and because those cell changes can be associated with cervical cancer, being on the receiving end of an abnormal Pap test result can be frightening, intimidating, and confusing.
On the “frightening” aspect: Some people assume that an abnormal Pap means that cervical cancer is imminent. On the contrary, the National Cancer Institute not only states that cervical cancer, when it develops, takes “many years” to do so, but also that “[t]he majority of infections with high-risk HPVs [human papillomaviruses] clear up on their own.” This is not to suggest that regular screenings aren’t important — but rather, that they do their job and detect cervical changes in plenty of time to prevent cancer from developing in the first place.
On the “confusing”: It’s true. There are a lot of different letter codes. Though some of them look awfully similar, they each mean a different thing. Moreover, the clinical recommendations for how to follow up with an abnormal Pap can depend not only on the code — in other words, the specific abnormal result — but also on one’s age and medical history.
Ready to sort them out?
Most labs in the United States use a classification system called the Bethesda System in order to have some standard terminology when reporting results. The Bethesda System uses the term squamous intraepithelial lesion to describe changes on the surface of the cervix. It categorizes those changes in these ways: Continue reading →
Our immune systems are beautiful things, refined through millions of years of evolution. The immune system’s complexity is testament to the “arms race” that has been taking place between our species and the harmful pathogens that surround us. Last century, a virus called human immunodeficiency virus (HIV) emerged, and it found a weak spot in our immune system’s armor. HIV has been exploiting this weakness ever since, and an HIV infection can eventually progress to a disease called AIDS, or acquired immune deficiency syndrome. AIDS is a condition that disables our immune system’s ability to function properly, rendering us vulnerable to a host of opportunistic infections and cancers.
HIV is transmitted via bodily fluids: blood, semen, pre-seminal fluid (which can be present without ejaculation), breast milk, vaginal fluids, and rectal mucus. (It can also be present in bodily fluids like amniotic fluid, cerebrospinal fluid, and synovial fluid, to which health-care workers might be exposed.) The virus is not transmitted by fluids like snot, saliva, sweat, tears, and urine — unless blood is present.
Activities that can bring you into contact with HIV-infected bodily fluids include injection drug use and sexual activities like anal, vaginal, or oral sex. It can also be transmitted to a fetus or baby during pregnancy, childbirth, or breastfeeding. In the early days of HIV, many infections occurred as a result of blood transfusions or organ transplants — though nowadays this is a rarity thanks to tissue screening. Lastly, health-care workers might be exposed to HIV through accidents involving needlesticks or cuts. Continue reading →
The above image, with lively yellow splotches against a pale green background, is not a long-lost Jackson Pollack piece, and the dark squiggly lines aren’t strands of paint haphazardly splattered onto a canvas. In 8fact, those squiggly lines are magnified images of the spiral-shaped bacteria species Treponema pallidum. You might not have heard of T. pallidum, but you’ve probably heard of syphilis, the sexually transmitted disease (STD) that these bacteria cause. While syphilis isn’t as common as other STDs, like chlamydia and HPV, it’s still out there, and occasionally communities experience outbreaks. It’s always best for sexually active people to be screened for STDs and practice safer sex.
Syphilis can inflict serious long-term damage — in fact, before the introduction of antibiotics, syphilis was the worst STD out there! Known as the Great Pox when it descended upon Europe 500 years ago, it could cause large and painful boils. Eventually, natural selection led to T. pallidum’s evolution into a form with milder symptoms, which benefited the bacteria by enabling its less boil-ridden (and presumably more attractive) human hosts to spread it farther and wider. Nevertheless, the symptoms of syphilis, if present, still include infectious sores, and when the disease goes untreated, it can cause severe, possibly fatal, damage to the nervous system.
Back in the day, there were myriad inadequate “treatments” for syphilis, ranging from straight-up quackery to the use of partially effective but toxic chemicals such as mercury. But a century ago, in 1912, a new arsenic-based chemical called Neosalvarsan was hailed as a “magic bullet.” Unfortunately, this treatment took weeks or even more than a year to administer — and had dangerous side effects. Quack treatments continued to flourish, and it wasn’t until the widespread adoption of penicillin in the 1940s that an effective cure with few side effects was available.
But natural selection endures; in fact, by flooding T. pallidum’s habitat with certain antibiotics, we’ve created an environment that favors the organism’s evolution against us. While not as immediately threatening as antibiotic-resistant gonorrhea, syphilis has been quietly evolving resistance to some of the antibiotics we use to treat it. This underscores the importance of using antibiotics correctly and emphasizing safer-sex practices, such as using latex condoms during vaginal or anal intercourse and during oral contact with a penis. Continue reading →
My fellow Generation Xers might remember an episode of Chicago Hope in which a very young Jessica Alba portrays a teenage girl with a gonorrhea infection in her throat — also called pharyngeal gonorrhea. The actress later reported being shunned by members of her church, disillusioning her from the religion she grew up with. It is a testament to the power of taboo that even a fictional association with a sexually transmitted disease (STD) can elicit such negative reactions.
Taboos can affect the ways we relate to one another sexually, as well. Many of us conceptualize of disease as “dirty,” and the flip side to that is to think of people without disease as “clean.” This kind of stigmatizing language can be found in phrases like “She looked clean” and “Don’t worry, I’m clean” — all to describe people who are perceived to be or who claim to be free of STDs. With all the baggage we put on STD status, it can be difficult to ask a partner to use a condom or dental dam during oral sex. Some people might think we don’t trust them or are underhandedly questioning their “cleanliness.” These sorts of fears can cloud our judgment when it comes to protecting our health, but there is nothing wrong with asking your partner to use protection during oral sex — especially if you don’t know one another’s STD status. There are many good reasons to use barrier methods when engaging in oral sex, and pharyngeal gonorrhea is just one of them.
Gonorrhea is most famous as an infection of the cervix or the urethra. But gonococci, the bacteria that cause gonorrhea, can thrive in other warm, moist areas of your body — not just the reproductive tract, but also the mouth, throat, eyes, and anus. Gonococci can be transmitted to your mouth or throat via oral sex — most likely via unprotected oral sex. Symptoms might include a sore throat, but 90 percent of the time there are no symptoms at all. Continue reading →
What is Title X (Title 10)? And why should I care?
The short answer: Title X may mean that some people qualify for free or reduced-cost family planning services, which could impact their ability to meaningfully access health care. In a time of rising health care costs and precarious employment, that is no small thing.
The longer explanation: Title X is a federal family planning program that was enacted in 1970. For anyone keeping historical tabs, this means that Republican President Richard Nixon signed this piece of legislation into action. According to the U.S. Department of Health and Human Services Office of Population Affairs, “The Title X program is designed to provide access to contraceptive services, supplies and information to all who want and need them. By law, priority is given to persons from low-income families.” While there are other federally funded health care sources for people with low incomes, Title X remains the only source dedicated specifically to family planning services.
In Arizona, the Arizona Family Health Partnership uses Title X funds to provide services to approximately 40,000 people each year. Most of these people have incomes at or below the federal poverty line and may not otherwise have access to health care. Four Arizona Planned Parenthood health centers receive Title X funds through the Arizona Family Health Partnership to provide reduced cost sexual and reproductive health care. Continue reading →
Whether it’s worries over Gardasil making girls go wild, or it’s somber discussion about cervical cancer, discourse about human papillomavirus (HPV) centers around its impact on females. But who are most of these females getting HPV from? For the most part, they’re getting it from male partners. And despite the fact that cervical cancer is the most common cancer associated with HPV, it is not the only one. A high-risk strain of HPV can lead to cancers of the penis, anus, mouth, and throat; additionally, there are strains of HPV that cause genital warts, which affect males and females equally. So why don’t males figure very prominently in discussions of HPV and the preventive vaccine, Gardasil?
Recent challenges to contraceptive access make the scenario all too easy to imagine: A woman goes to her health care provider to get her annual check-up and to renew her prescription for birth-control pills. She’s been going to the same health center and using the same birth control pills for years, but this time a nurse practitioner refuses to renew her prescription.
The scenario is easy to imagine when we’ve seen the concept of religious liberty stretched beyond its limits. The concept has been used to trump other liberties, to excuse organizations from compliance with health care mandates that ensure access to the contraceptives that many struggle to afford. But, the scenario just described is exactly what happened to a woman in Iowa, whose clinic refused to renew her prescription for birth control pills, not because of bills passed by lawmakers, but because of her age, 42, and the fact she smoked. Those two factors made use of birth control pills risky for her — and a liability for her provider.
Today is World No Tobacco Day, so this installment of our “Over 90 Percent” series takes a look at the toll smoking takes on sexual health, and what Planned Parenthood health centers can do to help people quit. The World Health Organization launched World No Tobacco Day in the late 1980s to encourage tobacco users around the world to quit tobacco for at least 24 hours. It has also served as a day to promote other anti-tobacco initiatives and raise awareness about the effects of tobacco use.
Hepatitis viruses infect the liver. Hepatitis A, B, and C can be transmitted sexually, and hepatitis B is the most likely to be spread this way. HBV is present in vaginal fluids, semen, and blood. It is highly contagious and can be transmitted by most sexual activities, such as vaginal or anal intercourse, as well as oral sex. HBV can also be spread by exposure to infected blood, and an HBV-infected mother can pass the virus onto her infant during birth.
To protect yourself from HBV, make sure to use latex barriers, such as condoms and dental dams, if you are sexually active. Also, don’t use unsterilized needles; don’t share hygiene items that could have infected blood on them, such as razors and toothbrushes; and consider being vaccinated against hepatitis B.
Sexually transmitted infections can be caused by viruses, bacteria, protozoans, and even animals. Bacterial vaginosis and chancroid are both infections caused by bacteria, which means that they can be treated with antibiotics. While bacterial vaginosis only affects people with vaginas, chancroid disproportionately affects people with penises. You can seek diagnosis and treatment for bacterial vaginosis and chancroid at a Planned Parenthood health center, as well as health clinics, private health-care providers, and health departments.