STD Awareness: “Can STDs Lead to Infertility?”

Being diagnosed with a sexually transmitted disease (STD) can be upsetting. Some take it as evidence that they’ve been cheated on; others wonder if they can ever have sex again. Some people who have long dreamed of having children might worry about what impact, if any, their STD could have on future fertility. The bad news is that certain STDs can make it difficult or impossible to have children. But the good news is that STDs are avoidable — and regular STD screening can ensure that infections are caught and treated before they have time to do damage.


It’s common for STDs not to have symptoms, and infections can cause tissue damage — unbeknownst to you!


Fertility can be impacted in several ways. The ability to become pregnant and bear children can be affected by a condition called pelvic inflammatory disease, which is usually caused by untreated gonorrhea or chlamydia infections. If you have a cervix, an infection with a high-risk strain of HPV can require invasive treatment, which in some cases might affect the ability to carry a pregnancy. If you have a penis, an untreated STD might lead to epididymitis, which in extreme cases can cause infertility.

Pelvic Inflammatory Disease (PID)

Many sexually transmitted infections are localized; for example, the bacteria that cause gonorrhea usually just hang out on the cervix. But untreated infections can spread on their own, and bacteria can also hitch a ride on sperm or the upward flow of a douche, which can take them into the cervix, through the uterus, down the fallopian tubes, and to the ovaries. At any of these locations, microbes can stake claim on your reproductive real estate, establishing colonies deep in your reproductive system. As these colonies grow, the bacterial infections become more widespread, and can cause scarring and other tissue damage. To keep these interlopers from getting through the front door, sexually active people can use barrier methods, such as latex condoms — especially with spermicides. There’s no need to host an open house for sexually transmitted bacteria in your uterus. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 12: Colposcopy

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

When talking about Pap tests — particularly when discussing abnormal Pap results — one procedure that comes up a lot is the colposcopy.

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.


What is a colposcopy, and what should you expect from the procedure?


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.

That said, colposcopies are sometimes performed for other reasons, such as genital warts on the cervix, cervicitis (inflamed cervix), or benign cervical polyps. Continue reading

Interpreting Abnormal Pap Tests

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.


Remember that if you’re confused about your Pap test results, part of your health care provider’s job is to answer your questions and keep you informed.


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

Over 90 Percent of What Planned Parenthood Does, Part 7: Pap Testing

Low-grade lesions of cervical cells, which can be treated before progressing to cancer. Image: National Cancer Institute

Low-grade lesions of cervical cells, which can be treated before progressing to cancer. Image: National Cancer Institute

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

Pap tests are not beloved — there, I said it. Many people who receive them hope for the day that medical science devises an equally effective but noninvasive test, whatever that might entail, as they may find them to be anything from slightly awkward to incredibly traumatizing. However, the evidence overwhelmingly shows that access to Pap testing (also called Pap smears) has transformed cervical cancer from a top killer into something that can be caught early and treated before it can do much damage. As a tool to reduce cancer deaths, Pap tests have been a resounding success.


In countries with widespread access to Pap tests, cervical cancer rates have plummeted.


A Pap test involves an instrument called a speculum being placed into the vagina to hold it open while a health care provider uses a small spatula or a tiny brush to collect cells from the cervix, which is at the opening of the uterus. These cells are analyzed in a laboratory, where a technician can determine if they are precancerous. (Cervical cancer is caused by a sexually transmitted virus called human papillomavirus, or HPV.) When caught in its precancerous stages, cervical cancer can be treated with procedures such as colposcopy and cryotherapy.

Pap testing guidelines have recently changed. Continue reading

HPV Vaccines: Separating Fiction from Fact

Gardasil is one of two HPV vaccines. It protects against two cancer-causing strains of HPV and two wart-causing strains.

You’ve probably heard a lot about the HPV vaccine, which protects against the sexually transmitted pathogen human papillomavirus — which itself can lead to cancers of the cervix, anus, throat, and more. Unfortunately, there is a lot of misinformation about the vaccine, such as Michele Bachmann’s debunked claim that it causes mental retardation. But, even before Bachmann gave us her two cents, there have been plenty of falsehoods flying around about the HPV vaccine.

Myth: Vaccination against HPV will increase sexual promiscuity among vaccine recipients.

Fact: Studies show that this fear is unfounded.

A study published this month in the American Journal of Preventive Medicine contradicts this claim. In a group of more than 4,000 young females, there was no significant difference between the vaccinated and the unvaccinated in terms of number of sexual partners or the age at which sexual activity began.


Together, HPV-16 and HPV-18 cause about 70 percent of cervical cancers.


Besides, the vast majority of teenagers who choose abstinence do so for reasons other than a fear of contracting HPV. Additionally, HPV is one of many sexually transmitted diseases (STDs); if fear of contracting an STD were the only factor in teenagers’ celibacy, a vaccine that protected against only one STD would not remove this fear.

(It might bear pointing out that when the HPV vaccine was approved for boys and men, fears about male promiscuity didn’t seem to run as rampant.)

Myth: Because the HPV vaccine only protects against two cancer-causing strains of HPV, it isn’t useful in cancer prevention.

Fact: The two cancer-causing strains of HPV that the vaccine protects against account for 70 percent of all cases of cervical cancer. Furthermore, Gardasil protects against two additional strains of HPV, which together are responsible for 90 percent of genital warts. Continue reading