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STD Awareness: Syphilis Treatment Through the Ages

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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 →

Five Things to Know About the Morning-After Pill on Its 20th Anniversary

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Medication portion of PREVEN Emergency Contraceptive Kit. Photo: Smithsonian Institution

In 1993, the New York Times Magazine posited that the morning-after pill might be “the best-kept contraceptive secret in America.” Even many doctors had no idea there was a fallback contraceptive that could be used shortly after unprotected sex or cases of rape.

In many ways, the morning-after pill had been right in front of U.S. doctors for decades. In terms of chemical composition, it was not much different from standard birth control, using the same main ingredients — synthetic hormones — in higher doses. Moreover, many of their colleagues in Europe and Asia had already been prescribing morning-after pills for years.

In 1998, years of research and advocacy led to the first FDA-approved morning-after pill.

Here, however, the secret was still largely intact. A 1994 study by the Kaiser Family Foundation revealed that two-thirds of American women had never heard of the morning-after pill or other forms of emergency contraception (EC). Less than 1 percent had ever used them.

There was an information shortfall in large part because there was no contraceptive that was approved by the U.S. Food and Drug Administration (FDA) specifically for emergency use. Some providers worked around that absence by using the chemically similar estrogen and progestin medications that were approved for regular birth control. By upping the dosage, they created a suitable morning-after pill on their own. But drug makers couldn’t label or market those birth-control pills for emergency, post-coital use, since they weren’t FDA-approved for that purpose. It also spelled problems for federally funded clinics. Federal dollars couldn’t pay for an off-label medication hack, a makeshift morning-after pill that wasn’t officially approved. Continue reading →

Let’s Talk Contraception: Emergency Contraception

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The Centers for Disease Control and Prevention (CDC) recently reported that 1 in 9 American women — 11 percent — has used the “morning-after pill.” This means that in the United States, 5.8 million sexually active women between the ages of 15 and 44 have used emergency contraception, an increase in use of 4.2 percent from 2002. Most women say their reasons for using emergency contraception are because they engaged in unprotected sex or feared that their method of contraception failed.

The best way to prevent pregnancy is reliable birth control. But sometimes we need a back-up method.

It has also been reported that half of all pregnancies in the United States are unintended. For that reason, the availability of a range of contraceptive options is very important. Emergency contraception is the last choice for a woman to decrease her chance of becoming pregnant after unprotected sex. There are several products available for emergency contraception in the United States. There are many options, and they include:

  • regular birth control pills in specific doses
  • PlanB One-step
  • Next Choice
  • ella
  • copper IUD or intrauterine device (Paragard)

The Yuzpe regimen, which used ordinary birth control pills in specific combinations, was named after a Canadian physician who developed the method in the 1970s. Several brands of birth control pills are approved for this use to prevent pregnancy. This method uses the combined estrogen and progesterone hormones in your regular birth control pills in certain prescribed combinations.

Research showed the progesterone component of contraceptive pills was most effective at preventing pregnancy, so Plan B was developed as a two-pill regimen of levonorgestrel (a type of progesterone). When Plan B was first released, it consisted of one pill taken as soon as possible and another taken 12 hours later. Plan B One-Step, the newest version of Plan B, now has the same dosage of levonorgestrel in just one pill. It should be taken as soon as possible after unprotected sex. This one-dose regimen has been shown to be more effective with fewer side effects. Continue reading →