Tag Archives: diagnosis

STD Awareness: Genital Herpes

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Herpes viruses inside a cell. Image: CDC

In the most recent Planned Parenthood annual report, a Tucson mother describes her daughter’s mysterious ailment, which stumped doctors at the hospital. Her symptoms included an itchy, tender genital area with painful lesions — but the physicians who “pored over her poor vulva” decided it was nothing to worry about and sent her home. A few days later, though, she called her mother in the middle of the night, sobbing, her condition now worse. “There were lesions, pustules, and the area was deep red,” her mother wrote. So this time, she called the experts: Planned Parenthood.

If you have symptoms, get checked out! An accurate diagnosis is more likely when symptoms are present.

The condition wasn’t nothing — it was genital herpes, and the mother praised Planned Parenthood for “spot[ting] something other pros missed.” Indeed, sexual and reproductive health is what we do — day in and day out! Whether you’re young or old, sexually active or celibate, insured or paying out of pocket or eligible for sliding-scale fees, we’re here to share our expertise with you.

The word “herpes” comes from an ancient Greek word that means “to creep,” after the “creeping” nature of skin lesions that might spread across areas of one’s body. We now know that the herpes simplex virus can “creep” up and down nerves, retreating to nerve cells to go dormant and returning back to the surface of the skin to cause symptoms or “shed” new virus particles. (Like a cat sheds fur, so too can people shed viruses.) Continue reading →

STD Awareness: Gonorrhea, Women, and the Pre-Antibiotic Era

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Penicillin, the first cure for gonorrhea, was developed for mass production in the 1940s.

Penicillin, the first reliable cure for gonorrhea, was mass produced in the 1940s.

It’s Women’s History Month, a time to reflect on the achievements of women worldwide — like Margaret Sanger, Rosalind Franklin, and Florence Nightingale, or contemporary heroes like Wangari Maathai. But it may also be a time to examine some of the sadder aspects of womanhood, including the increased burden gonorrhea imposes on women. While gonorrhea is no picnic for anyone, it wreaks the most havoc in female reproductive tracts. In fact, before antibiotics, gonorrhea was a leading cause of infertility — one 19th century physician attributed 90 percent of female infertility to gonorrhea. Not only that, but the effects of gonorrhea could seriously reduce a woman’s overall quality of life.

With gonorrhea becoming more resistant to antibiotics, the CDC warns of a return to the pre-antibiotic era.

Gonorrhea is described by written records dating back hundreds of years B.C. Ancient Greeks treated it with cold baths, massage, “cooling” foods, and vinegar. In the Middle Ages, Persians might have recommended sleeping in a cool bed with a metal plate over the groin. A bit to the west, Arabs tried to cure gonorrhea with injections of vinegar into the urethra. Kings of medieval England might have had their gonorrhea treated with injections of breast milk, almond milk, sugar, and violet oil.

Although gonorrhea is as ancient an STD as they come, because women rarely have symptoms while men usually do, for much of history it was mostly discussed in terms of men. The name gonorrhea itself derives from the ancient Greek words for “seed flow” — gonorrhea was thought to be characterized by the leakage of semen from the penis. This confusion inspired many misguided notions throughout the millennia, such as the idea that almost all women carried gonorrhea and transmitted it to their unwitting male partners. Continue reading →

“That’s Just Your Sickness Talking”: Psychiatry, Homophobia, and the Turning Point in 1973

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John E. Fryer, MD, dressed as Dr. H. Anonymous at the 1972 APA conference

It wasn’t his high blood pressure or high cholesterol that caught Matthew Moore by surprise when he went to his new physician earlier this year. Moore, a Southern California man in his mid-40s, described those conditions as “normal for me.” Nor was Moore, who is openly gay, shocked to see that his doctor noted his sexual orientation on his medical paperwork — until he saw the way that she noted it.

“The sickness label was used to justify discrimination, especially in employment, and especially by our own government.”

Listed as a chronic condition, Moore noticed “homosexual behavior” on his paperwork, followed by the medical code 302.0. As unsettling as the notation already was, Moore decided to research what the code meant, and he was left wondering how the diagnosis could happen today: “When I look[ed] up code 302.0 [I learned that it meant] sexual deviancy or mental illness, and that code has been removed or suggested heavily not to be used since 1973.”

“My jaw was on the floor,” Moore recounted. “At first, I kind of laughed, [and then] I thought, ‘Here’s another way that gay people are lessened and made to feel less-than,’ and then as I thought about it and as I dealt with it, it angered me,” he told a local news station.

Moore complained to his physician, and, dissatisfied with her response when she defended the diagnosis, he wrote a letter to the parent company of the Manhattan Beach office where his physician practiced medicine. Moore received a written apology and a refund of his co-pay.

Moore’s story made the news earlier this year because of how anomalous — and appalling — it was. But prior to 1973, Moore’s experience would have been almost inevitable, unless he took precautions to keep his sexual orientation as private and secret as possible.

Until a decision by the American Psychiatric Association (APA) changed the course of history 40 years ago this Sunday, on December 15, 1973, gay and lesbian people couldn’t escape the perception that their sexuality was a sickness. Continue reading →

Arm Yourself Against Genital Warts and Cancer!

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RosieVaccineBWVaccines are pretty nifty: Injecting a few tiny particles stimulates your immune system to build antibodies, which can bind to and help destroy harmful pathogens. A well-oiled immune system can neutralize these invaders before they have a chance to make you sick! In the war against infectious disease, we should be boosting our immune systems at every opportunity, and vaccines are one of the best weapons in our arsenal.

You’ve probably heard of HPV, or human papillomavirus, which causes genital warts and certain cancers. HPV has the dubious honor of being the most common sexually transmitted pathogen — some call it “the common cold of STDs.” According to the Centers for Disease Control and Prevention, “HPV is so common that nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime.”

You might not know how easy it is to contract HPV — vaccination allows you to take charge of your health.

There are many strains of HPV. “Low-risk” strains can cause genital warts, which aren’t usually harmful but might be upsetting. “High-risk” strains can cause cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The good news is that a vaccine called Gardasil protects against HPV-6 and HPV-11, which cause 90 percent of genital warts, and HPV-16 and HPV-18, which cause 70 percent of cervical cancers and 90 percent of anal cancers.

With protection available against a common virus that can cause upsetting warts or fatal cancer, you’d think that everyone would be lining up for Gardasil shots — but, unfortunately, vaccination rates are very low in the United States. Many of us opt out of vaccination for ourselves or our children because we don’t realize how easily HPV is acquired, or we minimize its potential to harm.

HPV is easier to contract than you might think, so if you think the risk is too small to outweigh other justifications against immunization, read on — you might not be aware of just how easy it is to acquire this wily virus. Vaccination is an empowering option for those of us who want to do all we can to take our health into our own hands. And, by being immunized, we can play a role in driving cancer-causing viruses into extinction, which would be feasible with sufficiently improved vaccination rates. Continue reading →

Over 90 Percent of What Planned Parenthood Does, Part 14: Rapid HIV Testing

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HIVtestingdayWelcome 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 never knew about.

It’s important to be tested for HIV, the sexually transmitted virus that causes AIDS. For some people, periodic HIV testing is part of their regular health care, while others might be experiencing a scare after a high-risk encounter (for example, having unprotected vaginal or anal intercourse or sharing IV equipment with someone whose HIV status you don’t know). No matter what boat you’re in, waiting a week or more to get your results from a standard HIV test might be nerve-wracking. If that sounds like you, then a rapid HIV test — which can give you results in just 40 minutes or less — might be just what the doctor ordered.

Today is National HIV Testing Day, and HIV testing has never been easier!

Here’s a quick rundown on rapid HIV testing: A negative result on a rapid HIV test is just as accurate as a negative result from a standard test — you just don’t have to wait as long to get it. However, positive results are considered “preliminary” and another blood sample must be sent to a lab for confirmation. If that result comes back negative, you will probably be asked to come back for retesting to verify that negative result.

The rapid test, just like the standard test, is an antibody test, which means it detects the presence of antibodies in your bloodstream. Antibodies are molecules produced by your immune system, and are specially designed to attach to viruses and other invaders. Each type of antibody is shaped in such a way that they can interlock with just one type of pathogen; some antibodies might specialize in attaching to a certain strain of a cold virus while others might be shaped especially for attachment to the surface of an E. coli bacterium. So, if you’re infected with HIV, your immune system will produce antibodies that are uniquely shaped to target HIV. An HIV antibody test can sort through the many types of antibodies in your bloodstream and identify only the antibodies that are shaped specifically for targeting HIV. Continue reading →

Diagnosing Endometriosis

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If you missed it, you can read the previous post explaining the basics of endometriosis here. In this post, we’ll look a little more at how endometriosis is diagnosed as well as some current barriers to diagnosis.

Wait. So you’re telling me that killer cramps of doom aren’t normal? If I did suspect I had endo, how would I go about getting diagnosed?

Endometriosis diagnosis is a tricky thing in that there’s no in-office procedure that can definitively determine whether someone has the condition or not. However, because the “gold standard” test is laparoscopy with biopsy — a surgical procedure — many health care providers prefer to do some in-office tests before recommending laparoscopy. The most common such procedures are pelvic exams and ultrasounds, which may allow a provider to see or feel if the endometrial lesions have formed cysts (known as “endometriomas”), but won’t pick up on smaller lesions.

Another complicating factor is that endometriosis isn’t the only cause of either dysmenorrhea or chronic pelvic pain. Other causes can include uterine fibroids, pelvic floor dysfunction, pelvic inflammatory disease, irritable bowel syndrome, and interstitial cystitis.

Even with laparoscopy, diagnosis isn’t necessarily straightforward. Not only is it a surgical procedure, which carries with it extra expense and risk, but even then, presence of the disease is often missed or underestimated. Seeking out a doctor who specializes in endometriosis can minimize this, but of course, due to geographic, cost, or other access issues, this isn’t always possible. Continue reading →