STDs

There must be something about the warm weather and sunshine of the summer that causes some young (and some old) minds to become reckless. I say this in awe, as I seem to have been treating many more sexually transmitted diseases (STDs) within the past couple of months than I have all year long! And unfortunately, those that I have been treating for it are my young teenagers and 20-somethings. This inspired and prompted me to do a review of the most common STDs and myths about them. I hope that if you’re a parent with a child in this age group that you remind them of a couple of things.

The first issue is a scary one for me as a doctor is I hear the statement, “But I feel fine and don’t have any problems” as a frequent answer to whether a person wants to be tested for STDs. Let me say that this is an uninformed statement to make, especially for my men out there. STDs often are transmitted and can linger around and inside the body for years before they’re detected with testing. Even though you personally don’t have symptoms doesn’t mean that you can’t pass it to the next person. Don’t ever let the fact that you don’t “feel bad” be your rationale for declining testing.

Statistically, all women between ages 15-25years should have testing for Gonorrhea and Chlamydia every time they have their annual pap smears and physical exams, regardless of whether or not they have any symptoms. Both are bacterial infections of the sexual organs. Typically, women will complain of a different kind of discharge (mucus) than they would normally have. Sometimes, this mucus is of a different color or character (yellow or green, thick) and may cause irritation, itching, or burning with urination or with intercourse. Both men and women can experience these symptoms, but what I’ve noticed is that men may not suffer ANY of these classic symptoms and still have the infection.

But, guess what? These misconceptions don’t only occur in the young population. I had one older male patient, who doesn’t use condoms with his 2 female partners, recently tell me that because he urinated and wiped himself clean after intercourse that he was “fine”. Oh no! He’s putting both himself and his 2 partners at risk for all sorts of infections. Gonorrhea, Chlamydia, Trichomonas, HPV, and Herpes are transmitted the very same way that HIV/AIDs,  Syphilis, and Hepatitis are transmitted. If you’ve never heard of Trichomonas, or “Trich”, it is also an STD. It is characterized as a frothy, greenish discharge that causes irritation in the abdominal and pelvic area that needs antibiotic treatment.

Are all STDs fatal? No, but women in particular can have damage of their female organs to the point they have to have surgery or can’t have children, which can be devastating. Sometimes these diseases, such as Herpes, can cause meningitis. Hepatitis causes liver damage and can lead to death. Syphilis, which still exists, can cause neurological problems. HPV, clearly, is concerning because of its link to cervical cancer. HIV/AIDs goes without saying.

What’s the way to never come into contact with these infections? Never have sex. But because this isn’t realistic in the real world, don’t have sex until you’re ready and for goodness sakes, use a condom. Plain and simple. Ladies, protect yourselves because not everyone is looking out for you and your safety. Men, be smart and protect yourselves as well. If you have any questions, go to the doctor to be tested, and please have regular HIV testing. Don’t be afraid to talk about those things that can potentially save your life.

Be safe and be blessed,

Dr. Swiner (formerly Dr. Price)

 

Advertisements

What is a fibroid tumor?

I went to the Women’s Empowerment Expo for the first time this year, which I enjoyed immensely. There, I met more than one woman that asked me specifically about fibroids. I also have a good many women in the office that seek counseling regarding this topic often.  Fibroids, also known as leiomyomas, are essentially muscle “tumors” of the uterus. They are called tumors, not because they are cancerous, but because they are a collection of cells or muscle that don’t really belong. Fibroids are very common, up to 80% in African‐American women and 70% in Caucasian women. They also appear to be hereditary and occur more often in obese women and those who have never had children.

A fibroid’s growth is affected by the circulation of hormones, namely estrogen and progesterone, which is why they usually diminish after menopause. Fibroids are generally located inside the uterus but can also hang on the outside. Sizes vary and cause enlargement of the uterus. As mentioned above, they can continue to grow up until the time of menopause.

Not all women with fibroids know they have them, or even complain of symptoms. Patients who do have significant fibroids can develop symptoms ranging from increasingly worsened cramping and heavier bleeding during their menses, abdominal pain from pressure of the uterus sitting atop the bladder and pulling the pelvic muscles, more frequent urination or urinary urgency because of the same reason, to increased abdominal girth and weight.

I have felt these muscular masses during physical exams while palpating the uterus and stomach. If and when a woman mentions signs or symptoms that make me suspicious of fibroids, or anytime I feel masses during a pelvic or vaginal exam, the next step is usually to an ultrasound. An ultrasound is a study performed, much like in pregnancy, either on top of the abdomen or through the vagina for visualization of the female organs and abnormalities therein. If a fibroid is found, the size and number can be determined as well, as there is frequently more than one.

In regards to treatments, there are generally 3 categories: those directed only at the symptoms patients complain about, those directed at shrinking the size, and those directed at getting rid of them altogether. But let me also say there is usually a fear once fibroids are diagnosed. There is good news‐‐fibroids do not become cancerous nor are they malignant. So, honestly, one treatment choice is to do nothing at all. If one does want to try something, referring to what was said before, to treat symptoms, we have medicines such as Naprosyn (available over the counter as Aleve) or Ibuprofen. These medicines serve as anti‐inflammatories for pain and heavy menstrual cramping. There are stronger anti‐inflammatories if these don’t work well.

If size reduction is the goal, which can also occur sometimes with the anti‐inflammatories, hormones or birth control can be used. Since fibroids are controlled by our own hormonal cycles, more regulation with things like estrogen and progesterone‐containing pills, help slow growth and even shrink the size of fibroids.

If one doesn’t want to be on hormonal or birth control pills, then there is more definitive treatment involving either removing the fibroid itself with the use of laser or surgery, or even with a hysterectomy. Some women see the surgical options as the last resort, but they are available with OB‐gyn specialists. Feel free to talk to your medical professional if you’re ever worried about any of these things.

Be healthy and be blessed,

Dr. Price