STD Awareness: Is Gonorrhea Becoming “Impossible” to Treat?

Image: National Institute of Allergy and Infectious Disease

Health authorities have been worried about it for a long time now, and we’ve been following it on our blog since 2012. The boogeyman? Antibiotic-resistant gonorrhea, a strain of the sexually transmitted bacteria that is becoming more and more difficult to treat. Higher doses of the drug will be needed to cure stubborn cases of gonorrhea — until the doses can no longer be increased. Then, untreatable gonorrhea could be a reality.


“Little now stands between us and untreatable gonorrhea.”


The World Health Organization (WHO), in a press release last month, finally used the word “impossible” when describing treatment of antibiotic-resistant gonorrhea, referring to documented cases of gonorrhea that were “untreatable by all known antibiotics.” Worse, these cases are thought to be the proverbial “tip of the iceberg,” as there aren’t good data on antibiotic-resistant gonorrhea in many developing countries, where gonorrhea is more prevalent and epidemics could be spreading under the radar. Adding to this problem is the fact that gonorrhea rates are climbing worldwide, which is thought to be due to a number of factors, including the decline in condom use, the frequent absence of symptoms, inadequate treatment, and increasing urbanization and travel.

What will happen if gonorrhea can’t be cured? Your infection could clear up on its own, after a lengthy battle with your immune system, but we don’t know a lot about how long this could take (weeks? months? never?). Unfortunately, despite your immune system’s best efforts, gonorrhea doesn’t go out without a fight. Gonorrhea can lead to pelvic inflammatory disease, which can cause tissue damage to the reproductive organs resulting in infertility, ectopic pregnancy, and chronic pain. It can also cause scarring that blocks sperm’s movement out of the testes, resulting in epididymitis, which is associated with infertility, chronic scrotal pain, and testicular shrinkage. Furthermore, gonorrhea increases risk for HIV transmission and can be passed to a baby during childbirth. The CDC estimates that, in the United States alone, untreatable gonorrhea could cause 75,000 cases of pelvic inflammatory disease, 15,000 cases of epididymitis, and 222 extra HIV infections over a 10-year period. Worldwide, where gonorrhea and HIV disproportionately affect developing countries, these problems could get even more out of control. Continue reading

STD Awareness: Do IUDs and Implants Prevent STDs?

Highly effective birth control methods, namely intrauterine devices (IUDs) and implants, have received a lot of well-deserved attention in recent years. They are as effective at preventing pregnancy as permanent sterilization, but can be stopped at any time, and can last from three to 12 years. They are the contraceptive of choice for female family-planning providers, who should know a thing or two about choosing an optimal birth control method. They are fantastic options for teenagers and others hoping to delay pregnancy for at least a few years. And the best news is that, for now anyway, these pricey birth control methods are still available at no cost to Americans covered by Medicaid or health insurance.


For the best protection against unintended pregnancy and STDs, combine condoms with IUDs or contraceptive implants.


If IUDs and implants prevented sexually transmitted diseases (STDs), they would pretty much be perfect — but, alas, like most forms of birth control, they don’t protect you from viruses, bacteria, and other bugs that can be passed from person to person through sex. To reduce their risk for STD exposure, sexually active people must employ other strategies, including (1) being in a mutually monogamous relationship with a person who does not have STDs; (2) being vaccinated before becoming sexually active to receive protection from hepatitis B virus and human papillomavirus (HPV), two sexually transmitted viruses; and, last but definitely not least, (3) condoms, condoms, condoms!

A study published this month looked at college students using IUDs and implants and found that most of them didn’t use condoms the last time they had vaginal sex — 57 percent of women who were not using IUDs or implants used a condom, compared to only 24 percent of women who were using IUDs or implants. That’s not too surprising if pregnancy prevention were the only concern, but condoms are an important addition for anyone seeking to reduce their STD risk. Continue reading

STD Awareness: Prevention vs. Punishment

Before antibiotics, syphilis could kill and gonorrhea was responsible for most cases of infertility. Both diseases could spread from husband to wife to baby, potentially destroying families. So you’d think medical breakthroughs in prevention and cures would be welcomed with open arms.

The actual history, like the humans who create it, is much more complicated.


Compassion, rather than fear and guilt, should guide medical practice.


During World War I, sexually transmitted diseases were a huge problem — second only to the 1918 flu pandemic in the number of sick days they caused (7 million, if you’re counting). The Roaring Twenties saw a sexual revolution, and by World War II, the military was once more fretting about losing manpower to debilitating infections that drew men away from the front lines and into the sick bays.

The armed forces did what it could to suppress prostitution and distract soldiers with recreational activities. But the human sex drive could not be contained: The vast majority of U.S. soldiers were having sex — even an estimated half of married soldiers were not faithful to their wives during WWII. Victory depended on soldiers’ health, so during both WWI and WWII, the military provided its sexually active soldiers with “prophylaxis,” medical treatments that could reduce risk for venereal disease — or VD, as sexually transmitted diseases were called back then.

Anyone who thinks condoms are a hassle or “don’t feel good” should read medical historian Allan M. Brandt’s description of a WWI-era prophylactic station, which soldiers were instructed to visit after sexual contact: Continue reading

Pro-Choice Friday News Rundown

  • Deja Foxx

    Let’s kick this thing off with some good news — two states have passed laws making it easier for women to access birth control! Yay! (Elite Daily)

  • If you live in the Phoenix metro area, you may wanna check out this handy map on the prevalence of STDs in your ZIP code! (ABC 15)
  • In other local news, Tucson teen Deja Foxx is a fearless powerhouse. She courageously advocates for others, heroically stood up to Sen. Jeff Flake, and sings the praises of Planned Parenthood every chance she gets. We are SO in awe of her and SO thankful for her advocacy! (WaPo)
  • Extensive research by the National Bureau of Economic Research shows there are broad economic benefits of increased contraception use — not just for women but for society overall. (Salon)
  • Of course sexism played a huge role in Hillary’s 2016 election loss. (XX Factor)
  • Rewire‘s Yamani Hernandez explains why framing abortion as an economic issue that affects our survival may be the only way to make people understand how crucial our right to this choice is. (Rewire)
  • Texas’ maternal mortality rate doubled over a two-year period. Not coincidentally, this was the same two-year period of time in which the state gutted Planned Parenthood and forced most of our health centers in the state to close. Additionally, more than half of all births in Texas are paid for by Medicaid, but coverage for new mothers ends just 60 days after childbirth. The majority of the 189 maternal deaths the task force looked at from 2011 to 2012 occurred after the 60-day mark. (Texas Observer)
  • Texas also has the highest birth rate in the U.S. (more than half paid for through Medicaid), and one of the highest teen pregnancy rates in the country. Medicaid births — most likely unintended pregnancies — rose in areas where access to PP was barred. (Austin Chronicle)
  • And in case you were wondering, Texas is not done clobbering reproductive options and rights. Their governor just signed what is being described as a “sweeping anti-abortion law.” (The Cut)
  • The latest medical science discovery: A vaginal gel containing tenofovir, an antiretroviral drug used to treat HIV infection, was three times as effective at preventing HIV in women who had healthy vaginal bacterial communities as it was in women with a less beneficial mix. (Science News)
  • Gotta love this headline: “President Who Bragged About Extramarital Sex Appoints Top Abstinence Advocate to HHS” (XX Factor)

Pro-Choice Friday News Rundown

  • The POTUS, who is so pro-life he hasn’t fostered or adopted any children in need, has signed legislation that allows states to withhold federal Title X funds for family planning services from clinics that also provide abortions. But thankfully, the change won’t impact Arizona. (AZ Central)
  • For women in other states: Please know, we are listening and we know what’s at stake for all of you. We’re fighting. (Bustle)
  • Impoverished minority women will be ESPECIALLY endangered by this legislation: 80 percent of women who rely on Title X funding are well below the poverty line, and 21 percent are black and 32 percent are Latina. (Ebony)
  • Will absolutely all of my rundowns during this bleak era of GOP dominion include yet another story about how they’re trying their best to dismantle the Affordable Care Act and make us all poorer and sicker and closer to death so rich people can have tax cuts? Signs point to “yes.” (WaPo)
  • The list of the 25 cities with the highest STD rates doesn’t include anywhere in Arizona. Let’s keep it that way? (Insider Monkey)
  • California could be the first state in the country to require its public universities to offer abortion pills on campuses. (Mercury News)
  • Attorneys general from 16 states came out Thursday in support of a Planned Parenthood lawsuit challenging an Ohio law that would deny state and federal funds to organizations providing abortions. (HuffPo)
  • The zero-copay birth control we’ve come to enjoy via Obamacare is still the “law of the land,” but for how much longer? (Rewire)
  • Why does America offer only five versions of the IUD when Britain has 22??? (The Atlantic)
  • Arizona Sen. Jeff Flake, who is so pro-life he hasn’t fostered or adopted any children in need, got his you-know-what handed to him by constituents at his town hall last week! (AZ Central)
  • Television is a treasure trove of lies. Abortion depicted on the small screen is 20 times deadlier than in real life, where it’s actually safer for the woman than childbirth. (Slate)
  • New Maryland Bill Would Require Domestic Abusers to Wear GPS Trackers. (NY Mag)
  • Maryland is on a roll! Victims In Maryland No Longer Have To Prove They “Fought Back” For Their Rapes To Be Crimes. (HuffPo)
  • With all of the “out and proud” anti-choice zealots in our government who are proud to admit they think women should be forced to give birth whether they wish to or not, the last thing we need is a phony, wolf-in-sheep’s-clothing turncoat like Illinois Gov. Bruce Rauner. He claimed to be pro-choice on the campaign trail in 2013, so why in the hell is he now indicating he will veto a bill protecting the right to choose and permitting coverage of abortion in state health plans and Medicaid? Can the pro-choice voters of Illinois spearhead a gubernatorial recall over this? (Rewire)
  • It would do Gov. Rauner a lot of good to remember that abortion is a matter of economic life or death for women and use the power of his office to help rather than hurt the economic fates of women. (Rewire)
  • “Dystopian” doesn’t even BEGIN to describe how the world would look without Planned Parenthood. (HuffPo)

STD Awareness: Shaving, Waxing, and Trimming, Oh My!

Last month, the connection between body-hair removal and sexually transmitted diseases (STDs) once again gave rise to a flurry of headlines. Media had previously reported on “studies” purporting that the popularity of waxing is leading to the extinction of pubic lice, or that shaving increases risk for a little-known STD called molluscum contagiosum.

The idea that waxing one’s nether regions is tantamount to habitat destruction for the lowly pubic louse makes a certain amount of sense. But was it really true that waxing was leading to diminished pubic-lice populations, or just a case of the media blowing an obscure medical factoid out of proportion? Ditto with the claims about molluscum contagiosum — though they were based on perfectly plausible premises, having to do with shaving causing microscopic skin injuries that create openings for infectious viruses, the average reader might not have been able to rely on a journalist’s ability to translate a scientific article from “medical-ese” into an easy-to-understand, yet fully nuanced, magazine blurb.


The case isn’t closed on the link between body-hair removal and STDs.


As we’ve written before, the reporting in the popular media left out important details — such as the fact that these weren’t studies at all, but rather educated guesses based on observations, published as letters to the editor. No one was comparing pubic lice infestations or sexually transmitted infections between groups of people with and without pubic hair.

Until now.

The medical journal Sexually Transmitted Infections recently published a study based on a survey of 7,470 American adults who had had at least one sexual partner. The salient point the media pounced on was that removing pubic hair increases STD risk by 400 percent: NPR screamed that “Going Bare Down There May Boost The Risk Of STDs,” Time proclaimed “Grooming is linked to a higher risk of STIs,” and The Guardian spooked readers with a rather tasteless piece about “the health dangers of bikini waxing.” Even Saturday Night Live’s Weekend Update got in on the action, albeit with a crude joke about old men’s genitals.

But let’s leave headlines behind and delve right into the medical journal itself. Continue reading

STD Awareness: Fully Antibiotic-Resistant Gonorrhea Is on the Horizon

shot-in-armWe’ve been anticipating its arrival for years now, but earlier this fall, the Centers for Disease Control and Prevention (CDC) finally made an announcement: Cases of gonorrhea resistant to the last drugs we use to cure it are emerging.

Over the years, gonorrhea has evolved resistance to every drug we’ve thrown at it — sulfonamides, penicillins, tetracyclines, macrolides, fluoroquinolones, and narrow-spectrum cephalosporins. The last line of defense we have is a one-two punch of a pair of antibiotics: azithromycin and ceftriaxone. By using two drugs, we can delay the inevitable evolution of antibiotic resistance by attacking the bacteria in two vulnerable locations, rather than just one, making it more difficult for the bug to mount a defense and pass on its superior survival skills to subsequent generations.


Prevention is paramount: Stop the spread of antibiotic resistance by practicing safer sex!


Unfortunately, we could only stave off the inevitable for so long. At their conference in September, the CDC announced a cluster of gonorrhea infections that are highly resistant to azithromycin, and that fall prey only to high doses of ceftriaxone. As gonorrhea’s tolerance to ceftriaxone increases, the infection will get more and more difficult to cure.

This cluster of drug-resistant cases was identified in Honolulu in April and May of this year, with five infections showing “dramatic” resistance to azithromycin, as well as reduced vulnerability to ceftriaxone. The good news is that these cases were cured with higher-than-usual doses of antibiotics, but the bad news is that dosages can only climb so high before a drug is no longer considered to be an effective treatment. Continue reading