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About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.

STD Awareness: Syphilis Treatment Through the Ages

The spiral-shaped bacteria that causes syphilis.

When syphilis first descended upon Europe, questions surrounded this mysterious scourge. Was it a punishment from God? Was it introduced by a hated Other? Was it caused by the stars’ alignment or the presence of “bad air”? We now know that syphilis is not caused by supernatural forces, foreigners, or a harmful atmosphere, but rather by a species of corkscrew-shaped bacteria called Treponema pallidum, which is spread by sexual contact — vaginal, anal, or oral sex — in which one person comes into contact with a syphilis sore.


Thanks to penicillin, we don’t have to go back to the “good old days” of puke chalices, antivenereal underpants, and rat poison.


Before good treatments were developed in the 20th century, syphilis was the most feared STD out there. Its initial symptoms can include a painless sore filled with a highly infectious liquid. As the infection spreads, lesions and rashes might appear on the soles of the feet or the palms of the hand. After these first waves of symptoms, the infection enters a latent phase, which can lull people into a false sense of security, thinking the disease has disappeared. Unfortunately, 15 percent of people with untreated syphilis reach the late stage, which can occur up to 20 years after initial infection, and includes severe damage to the nervous system, brain, heart, or other organs, and can be fatal.

These days, a shot of penicillin is all it takes to cure syphilis. Back in the day, though, there were myriad “treatments” for syphilis — but they were highly toxic and ineffective. Unfortunately, thanks to the latent phase of syphilis, it often seemed like these treatments did work, which probably explains why folks tortured themselves with them for centuries. If only penicillin had been around: Countless people would have been spared the unpleasant — and often fatal — quackery that syphilis attracted. Continue reading

Why Periods? False Hopes, Popes, and the “Grandfathered” Withdrawal Bleed

The birth control pill and other hormonal contraception are popular. Menstrual periods are not. Hormonal contraception can be used to suppress menstruation — so why isn’t this method, called “continuous contraception,” more popular?

For decades, packets of birth control pills have typically contained 21 “active” pills and seven “placebo” pills. These placebos — sugar pills — trigger bleeding (which most people think of as a menstrual period, even though it’s technically called a withdrawal bleed). Because menstruation is natural, some people think this withdrawal bleed must somehow be healthier. But there are actually no health benefits — and it might also increase risk for pregnancy.


There is no reason to have a period when on the birth control pill — unless you want one.


Last month, British medical guidelines were revised to recommend continuous use of the birth control pill — that is, with no week-long “break” designed to trigger a withdrawal bleed. We could have been skipping our periods since the Pill was introduced in 1960 — so why is it only now that we are coming to see them as optional?

A flurry of recent articles has touted a rather conspiratorial claim: that the monthly bleed was included in an attempt to make the Pill more palatable to the pope. The Telegraph quoted reproductive health expert John Guillebaud: “John Rock devised [the week of placebo pills] because he hoped that the pope would accept the Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.”

Many journalists, pundits, and bloggers have expressed outrage that we’ve been putting up with decades of unnecessary bleeding (and all the attendant pain, headaches, and missed work) just because of an unsuccessful attempt to appease the pope before most women of reproductive age were even born. But the history of the placebo week is more complicated. Continue reading

STD Awareness: How Common Is Herpes?

Those of you with an eye for weird news might have noticed recent headlines about wild monkeys in Florida suffering from a herpes epidemic.

Two things in that sentence might have tripped you up. One, Florida has wild monkeys? Yup. In the late 1930s, after a Tarzan movie was wrapped, three male and three female rhesus monkeys were released into the Florida wilds, giving rise to an estimated 1,000 monkeys roaming the Sunshine State today.


Both oral herpes and genital herpes are on the decline.


The second thing that might have given you pause: Monkeys can get herpes? Yes again! The Herpesviridae family is huge, with at least 100 members infecting mammals, birds, reptiles, bony fish, amphibians, and oysters — even dinosaurs are thought to have been infected by herpesviruses! The virus has been evolving alongside us since before the dawn of humanity, so it knows us like the back of its hand (metaphorically speaking), allowing it to stow away in our bodies and hide from the immune system.

The “Tarzan” monkeys suffer from a type of herpesvirus called herpes B, which can be deadly in humans, though it’s rare — just try not to find yourself on the receiving end of a monkey bite or scratch. Not so rare in humans are human herpesviruses, of which there are eight types. Types 1 and 2 — aka herpes simplex virus (HSV) 1 and 2 — can both cause genital herpes, one of the most common sexually transmitted diseases (STDs). HSV-1 mostly causes cold sores, but can also infect the genitals to cause genital herpes, while HSV-2 mostly causes genital herpes, but can also infect the facial area to cause cold sores. (A little confusing, I know.) Continue reading

STD Awareness: The Long Road to a Chlamydia Vaccine

Earlier this year, television personality John Oliver was the butt of an elaborate prank orchestrated by actor Russell Crowe. It started with an auctioned jock strap, and ended with Crowe funding the John Oliver Koala Chlamydia Ward at the Australia Zoo. If you want the full story, check out the video below (beware explicit language).

Despite Oliver playing it for laughs, koala chlamydia is very real and very serious. At least half of wild koalas are infected with a chlamydia type that’s related to the human version. As in humans, koalas can transmit these bacteria through sexual contact. And, similar to the havoc it wreaks in our species, in koalas chlamydia can cause blindness, urinary tract infections, and female infertility — and can be passed from mother to infant. Along with other factors, chlamydia is said to be responsible for plummeting koala populations in many parts of Australia. Continue reading

The Scoop on IUDs: Busting Myths About a Highly Effective Form of Birth Control

One of the most misunderstood forms of birth control is the IUD — short for intrauterine device. This contraption is inserted through the cervix and into the uterus to provide years of no-fuss pregnancy protection, making it a reliable and cost-effective method for anyone not planning to have kids any time soon.

Thanks to the zero-copay birth control mandate, an IUD should be free to most people with health insurance, and it’s about as effective as getting your tubes tied — with the option to remove it if you decide to start trying to get pregnant. Regardless, it’s not as popular as condoms or the pill. There are many reasons for that, but the fears and rumors surrounding IUDs might be one of them.


IUDs are highly effective birth control options.


In response, Planned Parenthood Arizona’s family planning and primary care director, Deanna Wright, NP, shed some light on some of these fears surrounding IUDs.

Can I have an IUD if I’ve never given birth before?

Even some physicians won’t provide IUDs to patients who have never given birth, based on the idea that only people who have already had children can handle IUD insertion.

“This is completely untrue,” says Wright. “In fact, the American College of Obstetrics and Gynecology encourages clinicians to offer LARCs, including IUDs, as the first method of contraception to all patients. They recently reaffirmed this position in May 2018.” Continue reading

STD Awareness: The Good, the Bad, and the Ugly

Sexually transmitted diseases (STDs) have been with us since the dawn of time — or at least since the dawn of sex. And, as we continue to hone our approach to preventing and treating them, STDs will always grab headlines, whether the news is bad or good.

The Good

Can the HIV epidemic be stopped?

For more than a decade, AIDS, the illness caused by HIV, was seen as a death sentence. It wasn’t until the mid-’90s that antiretroviral drugs kept the virus in check, prolonging lifespans for people with access to these medications and transforming the infection into a chronic disease. Now, those dreaming of an end to HIV are seeing reasons for optimism. No, a cure isn’t in the works — but many researchers believe we can end the epidemic through prevention.

Ending HIV transmission will take money and an efficient health care infrastructure, but we have the tools to do it. It starts with expanding access to HIV testing — an estimated 15 percent of Americans with HIV are unaware of their status. The next step is to ensure that everyone testing positive has access to antiretroviral drugs. When used correctly, these medications keep viral levels so low that the chances of transmission are virtually nonexistent. More recently, medications called PrEP — pre-exposure prophylaxis — enable people without HIV to protect themselves from infection. Condoms, of course, are a time-tested prevention tool. Gathered together, we have a pretty mighty arsenal. Here in the United States, we could stop HIV transmission in its tracks in just a handful of years. Of course, people all around the world will need access to testing and treatment to halt this scourge on a global level. Continue reading

STD Awareness: Can Older Adults Receive the HPV Vaccine?

female-patient-with-female-doctorWhen the human papillomavirus (HPV) vaccines were introduced, a lot of people were excited about protection from a sexually transmitted virus that could cause cancers, including cervical cancer, anal cancer, and head-and-neck cancer. It wasn’t just any old vaccine, it was a shot that could prevent cancer. Cancer!

In fact, a lot of people were disappointed they were too old to take advantage of an anti-cancer vaccine, which was initially approved for people as old as 26. We were given a lot of reasons why people above that age were “too old,” such as the assumption that anyone older than 26 has probably been sexually active for years and would have already contracted the most common strains of HPV.


While getting vaccinated before becoming sexually active is optimal, the HPV vaccine can still benefit people who have already had sex.


But there are compelling reasons to vaccinate people in their late 20s and beyond. In fact, Gardasil 9 was recently approved for people as old as 45. That’s great news for those of us who missed out on the HPV vaccine the first time around. We might never have had any sexual contact, and therefore were never at risk for catching the sexually transmitted virus. We might have found ourselves widowed or divorced after years or decades of monogamy. We might have been sexually active with multiple partners during that time. Whatever our circumstances, those of us who are 45 or younger can now consider HPV vaccination.

HPV and the “Older” Individual

When Cervarix and Gardasil, the first HPV vaccines, were released, they only protected against two cancer-causing HPV strains, HPV-16 and HPV-18, which are responsible for 70 percent of cervical cancers (Gardasil protects against two additional wart-causing HPV strains). A few years ago, Gardasil 9 hit the market, targeting five additional cancer-causing HPV strains — increasing the chances that even sexually active recipients could be protected from HPV strains they hadn’t encountered. Continue reading