STD Awareness: Is Mouthwash a Match for Gonorrhea’s Superpowers?

Since the 1930s, we’ve enjoyed around eight decades of easily cured gonorrhea — at least in places with easy access to antibiotics — but experts fear those days are numbered. In the past year or so, cases of untreatable gonorrhea have occasionally made headlines.

Thanks to the powers of evolution, some bacteria have acquired the multiple genes necessary to withstand the onslaught of the pills and shots administered by doctors. Gonococci, the bacteria that cause gonorrhea, are starting to win this “arms race” with humans, whose antibiotic arsenals are losing effectiveness. And with gonorrhea on the rise, gonococci may be evolving at an ever-quickening clip.


In 1879, Listerine claimed to cure gonorrhea. Today, scientists are finally testing that claim. We await the results.


Oral Gonorrhea: The Silent Scourge

Many experts believe oral gonorrhea is a key driver of antibiotic resistance. These infections usually don’t cause symptoms, and without symptoms people usually don’t seek treatment. Without treatment, gonococci can hang out in a throat for up to three months.

After transmission by oral sex — and possibly even by kissing  — gonococci can set up camp in the throat, which is an ideal environment for acquiring antibiotic resistance. They might not be causing symptoms, but they’re not sitting there twiddling their thumbs, either. If there’s one thing gonococci love to do, it’s collecting genes like some of us collect trading cards, and the throat is a gathering place for closely related bacteria species that hand out antibiotic-resistance genes for their expanding collections.

Gonococci can easily scavenge DNA from their surroundings — say, from a dead bacterium — and patch long segments of these genes into their own DNA, creating genetic hybrids between themselves and other organisms. Last month, scientists from Indiana University caught this phenomenon on video for the first time.

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STD Awareness: Is Chlamydia Bad?

chlamydiaPerhaps your sexual partner has informed you that they have been diagnosed with chlamydia, and you need to get tested, too. Maybe you’ve been notified by the health department that you might have been exposed to chlamydia. And it’s possible that you barely know what chlamydia even is, let alone how much you should be worried about it.

Chlamydia is one of the most common sexually transmitted diseases (STDs) out there, especially among young people. It can be spread by oral, vaginal, and anal sex, particularly when condoms or dental dams were not used correctly or at all. It is often a “silent” infection, meaning that most people with chlamydia don’t experience symptoms — you can’t assume you don’t have it because you feel fine, and you can’t assume your partner doesn’t have it because they look fine. If you’re sexually active, the best way to protect yourself is to know your partner’s STD status and to practice safer sex.


Chlamydia increases risk for HIV, leads to fertility and pregnancy problems, and might increase cancer risk.


The good news about chlamydia is that it’s easy to cure — but first, you need to know you have it! And that’s why it’s important for sexually active people to receive regular STD screening. Left untreated, chlamydia can increase risk of acquiring HIV, can hurt fertility in both males and females, can be harmful during pregnancy, and might even increase risk for a certain type of cancer. So why let it wreak havoc on your body when you could just get tested and take a quick round of antibiotics?

To find out just how seriously you should take chlamydia, let’s answer a few common questions about it.

Can Chlamydia Increase HIV Risk?

Chlamydia does not cause HIV. Chlamydia is caused by a type of bacteria, while HIV is a virus that causes a fatal disease called AIDS. However, many STDs, including chlamydia, can increase risk for an HIV infection, meaning that someone with an untreated chlamydia infection is more likely to be infected with HIV if exposed to the virus. Continue reading

STD Awareness: Can I Use Plastic Wrap as a Dental Dam During Oral Sex?

plastic wrapIf you read this blog — or any sexual health website, really — you’ll probably see dental dams getting a lot of props. A dental dam (not to be confused with a female condom) is a square piece of latex that can cover the vaginal opening or the anus. Anyone wishing to avoid the oral transmission of STDs like herpes, gonorrhea, HPV, syphilis, chlamydia, and intestinal parasites, dental-dam advocates say, should use a latex barrier. Most people, however, have probably never even seen a dental dam, and they are not widely used. Perhaps their unpopularity is related to myths about oral sex being safe sex (it’s not!); perhaps it’s due to dental dams being expensive or difficult to find.


Plastic wrap hasn’t been evaluated by the FDA for STD prevention, and no studies have assessed its effectiveness in reducing disease risk during oral sex.


Some safer-sex aficionados have found ways around that, though. They might cut the tips off of condoms and make incisions along the sides, creating little latex rectangles. An even easier and cheaper option lies in plastic wrap, which many people use as a barrier while performing cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus). It is inexpensive, easy to find, odorless, and tasteless, and can be purchased without even a hint of embarrassment (unless perhaps your other purchases include duct tape, cucumbers, and clothes pins). And it can be pulled off the roll in sheets as long as your heart desires!

Planned Parenthood endorses the use of plastic wrap for oral sex when dental dams aren’t available. The Centers for Disease Control and Prevention and AIDS.gov both recommend plastic wrap for use during rimming. Health authorities, such as AIDS.gov and the Idaho Department of Health & Welfare, recommend non-microwavable Saran Wrap, because microwave-safe Saran Wrap has tiny pores to let out steam — which might also let viruses and bacteria through. Continue reading

STD Awareness: Ceftriaxone-Resistant Gonorrhea

Nestled in the throat of a Japanese woman was a collection of clones that scientists abducted from their temporary habitat and christened H041 — a humdrum moniker for a strain of bacteria that would burn headlines in medical journals. Though the bacteria never caused symptoms in their host, they lingered in her throat from at least January until April of 2009, when a swab finally tested negative. Rather than succumbing to repeated bombardment by an antibiotic called ceftriaxone, the infection probably just went away on its own — as oral gonorrhea infections tend to do.


Resistance to ceftriaxone, our last good gonorrhea drug, has been reported in Japan, Australia, Sweden, France, and Spain.


The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat.” We have one remaining first-line gonorrhea treatment left: extended-spectrum cephalosporins, which include cefixime, which is taken orally, and ceftriaxone, which is administered as a shot. Resistance to cefixime was first documented in 1999, leaving ceftriaxone as our best remaining option, and the CDC’s first choice for treating gonorrhea. There are no good alternatives to ceftriaxone remaining, which is why reports of ceftriaxone-resistant gonorrhea are so deeply troubling.

What made H041 special was that it was the first extensively drug-resistant strain of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. With an unusually high level of resistance to ceftriaxone — four to eight times higher than the previous record holder — the strain was also resistant to a slew of other antibiotics: penicillin and its relatives, fluoroquinolones, macrolides, tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, nitrofurantoin, cefpodoxime, cefixime, ciprofloxacin, and levofloxacin — and had reduced susceptibility to azithromycin to boot.

Another thing that made H041 special — as special as clones can be, anyway — is that it never reappeared. After its discovery, researchers in Kyoto and Osaka intensified their surveillance, trying to uncover it again and track its spread through the population. However, their search for H041 turned up empty handed. But other ceftriaxone-resistant strains have been documented around the world. Continue reading

STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

STD Awareness: Genetics and the Gonococcus

Image: CDC

Ever since the discovery of effective antibacterial therapies less than a century ago, humans have been able to easily cure gonorrhea, the sexually transmitted scourge that laid waste to fallopian tubes and robbed newborns of vision. Most of us in the developed world have forgotten that this disease was once a leading cause of infertility in women and blindness in babies — and still is in much of the developing world.

Unfortunately, gonococci — the species of bacteria that cause gonorrhea — have been evolving resistance to every antibiotic we’ve thrown at them, including sulfonamides, penicillins, tetracyclines, macrolides, fluoroquinolones, and narrow-spectrum cephalosporins. We have one remaining first-line gonorrhea treatment left: extended-spectrum cephalosporins, which include cefixime, which is taken orally, and ceftriaxone, which is administered as a shot — and resistance is emerging to those drugs, as well.


Gonococci don’t swap potato salad recipes at family reunions — they swap genetic material!


The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat,” and indeed, gonorrhea seems to be evolving resistance to drugs at quite a rapid clip. Gonococci can acquire resistance to antibiotics in three ways.

First, a genetic mutation can endow bacteria with special antibiotic-fighting powers, making it harder for a drug like penicillin to attach to their cells and destroy them. Such a mutant is more likely to gain evolutionary traction if it finds itself in an antibiotic-drenched environment in which resistance to that drug allows it to “outcompete” other bacteria. Indeed, antibiotic resistance was first documented in the 1940s, just years after sulfonamides and penicillin were introduced as the first effective cures for gonorrhea. Continue reading

Let’s Talk Contraception: Using Condom Sense — Safe and Sexy!

Photo: somethingstartedcrazy via Flickr

Photo: Flickr/ somethingstartedcrazy

Condoms. You know you should use them to protect against sexually transmitted diseases and unwanted pregnancies, but somehow the thought of possibly reducing pleasure for that protection may stop a lot of people from using condoms as often as they should.

Originally made from animal skins or intestines, condoms have been used for centuries. Not much about them has changed for hundreds of years. The old one-size-rubber-fits-all mentality, however, is a thing of the past. The sheer variety of new condoms on the market can take your sexual enjoyment to a new level, while still keeping you protected.


Condoms can be flavored, colored, or textured. They can glow in the dark or vibrate, or be vegan or custom fitted. Above all, they protect against STDs and pregnancies.


Condoms now come in an assortment of styles, sizes, flavors, colors, and textures. They can be lubricated or non-lubricated and even made to custom fit. Whatever your pleasure, there is probably a condom for you and your partner that will protect your health and enhance your experience. What to choose? Let’s look at some of the options available today.

Most condoms are made of latex. These are probably the least expensive and they also protect really well against sexually transmitted diseases (STDs) and pregnancy. For those with an allergy to latex, there are polyurethane or polyisoprene condoms.  Continue reading