STD Awareness: Trichomoniasis, the Pear-Shaped, Blood-Sucking, Silent Scourge

What’s shaped like a pear, hangs with a posse of bacteria, and is a silent scourge upon millions of urogenital tracts? I hope you guessed Trichomonas vaginalis, the single-celled parasite that causes trichomoniasis, or trich (pronounced “trick”). Trich is the most common curable sexually transmitted disease out there — currently afflicting around 3.7 million Americans and 156 million Earthlings.


These single-celled creatures pack a punch, but the body fights back.


When trich causes symptoms, sufferers might experience vaginal discharge (which sometimes has a bad odor), penile burning or discharge, spotting, and itching or swelling in the genital area. But around 70 percent of infections have no symptoms at all, making it a mostly “silent” disease. Based on the totality of the evidence, the Centers for Disease Control and Prevention (CDC) doesn’t currently recommend routine screening for trich in people without symptoms.

But it’s the subject of some debate. Since both symptoms and screenings are rare, and the disease isn’t reportable, some health experts worry that trich could be doing a lot of damage right under our noses. An infection during pregnancy could increase risk for preterm labor or low birth weight. It can increase risk for both acquiring and transmitting HIV from or to a partner. Women with trich are more likely to acquire an HIV infection when sexually exposed to the virus — in fact, one study estimated that 6.2 percent of all HIV infections among U.S. women could be attributed to trich. It’s also easier to catch HIV from a man with trich than from a man without trich. Continue reading

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

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

STD Awareness: Confronting Sky-High STD Rates

For the past five years, Americans have been breaking records left and right — a good thing when we’re talking about athletic feats or scientific breakthroughs, but not so great when we’re shattering records for catching sexually transmitted diseases (STDs). Chlamydia, gonorrhea, and syphilis are all on the upswing, with a combined 2.3 million cases in 2017 — and those are just the cases that were reported. Since most people with these infections don’t know they have them, the real number is thought to be much higher. The United States has the dubious honor of boasting the highest STD rates of all industrialized countries — though rates are also climbing in England and Western Europe.

The good news is that these three STDs are preventable and curable. Sexually active people can dramatically reduce their risk by using condoms and dental dams, or by being in mutually monogamous relationships in which partners test negative for these infections. And, because many STDs don’t show symptoms, it’s important for them to receive regular STD screening to ensure infections are caught and cured before they can do any damage.

But there’s also bad news. First, while the symptoms of these infections can be awful, they compel you to seek prompt treatment — making these awful symptoms a good thing, in a weird way. Unfortunately, most people with these infections don’t have symptoms, allowing the bacteria that cause them to spread silently from person to person. If not caught, chlamydia and gonorrhea can lead to chronic pain and fertility problems, and syphilis can lead to organ damage and even death. These infections can also increase HIV risk and be passed to a baby during childbirth. Continue reading

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.

Continue reading

STD Awareness: UK Announces “Worst-Ever” Case of Gonorrhea

In late March, the BBC reported a story that was widely repeated in headlines across the world: “Man has ‘world’s worst’ super-gonorrhoea.”

The article told the story of a British man whose symptoms started in early 2018, about a month after he had picked up the bug during a visit to Southeast Asia. Once back home, his doctors were unable to cure it with the standard combination of azithromycin and ceftriaxone — “the first time the infection cannot be cured with first choice antibiotics,” the author wrote.


In most of the world, we don’t have a good picture of antibiotic resistance in gonorrhea.


Actually, a similar case of multidrug-resistant gonorrhea had been documented in the United Kingdom in late 2014, as noted in the New England Journal of Medicine. It was the first verified case to fail to be cured by the azithromycin/ceftriaxone combo — the infection didn’t go away until after the patient was given a double dose of both antibiotics, but by then it had been 112 days and the infection could have cleared on its own. By July 2017, the World Health Organization (WHO) had noted that there had been multiple documented cases of gonorrhea that were “untreatable by all known antibiotics.”

What was different about the man in the BBC story was that his case of ceftriaxone-resistant gonorrhea had a higher level of azithromycin resistance than those that came before. While it may not have truly been the first case of multidrug-resistant gonorrhea that couldn’t be treated with the standard dual therapy of azithromycin and ceftriaxone, it was the “most serious.” Continue reading

Dental Dams Help Spread Intimacy, Not STDs

It’s that time of the year when people focus on intimacy and romance. Most people think jewelry and roses are good gifts to give for Valentine’s Day. They’re nice, but you know what’s even better? Dental dams.

What’s a dental dam, you ask? Like condoms, dental dams are a way to prevent the spread of sexually transmitted diseases (STDs) by covering the vagina or anus during oral sex. Dental dams are usually made of latex, and some are made from polyurethane. Since they’re used for oral sex, dental dams often come in different flavors, and they’re flexible enough to fit in your purse.


Dental dams are an essential component of protecting your sexual health.


Dental dams are particularly useful for lesbian partners, since oral sex is a common form of sexual activity, but anyone who engages in cunnilingus (the oral stimulation of female genitals) can use them. Dental dams are also beneficial for consenting partners who enjoy anal play (aka “rimming”). Dental dams serve as a barrier against most STDs, since many sexually transmitted diseases, such as syphilis, human papillomavirus (HPV), and herpes, can be passed simply by skin-to-skin contact. Gonorrhea, chlamydia, and hepatitis A and B viruses can also be spread through oral sex. HIV can be transmitted through oral sex if blood is present.

Unfortunately, dental dams aren’t distributed as widely as condoms are. You’re not likely to find a dental dam dispenser in a public restroom, and many community organizations provide dental dams on a request-only basis because they’re more expensive than condoms. And most drug stores don’t carry dental dams in the same aisle as condoms and lube because dental dams were originally created to be used during dental procedures. (Get it — dental dams.) Continue reading