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   Sexual Health  
 

Contraceptives  


Condoms

It is recommended to use condoms during each sexual encounter, as it is highly effective in preventing pregnancy as well as STDs. The latex condom offers better protection against STDs than any other birth control method. It blocks the exchange of body fluids that may be infected.


Female Condom

The female condom is the same type of contraceptive device as the male condom, except that it fits inside of the vagina with an inner ring over the cervix and an outer ring over the vulva. This keeps the condom from being pushed up into the vagina, and puts a protective covering  over the outside of the vagina, preventing sperm from contacting the area.


Spermicides (foams)

Spermicides are inserted in the vagina before intercourse and act by blocking the cervix and killing the sperm. The various types of spermicides include foams, creams, jellies, suppositories and foaming tablets and all are available from a drugstore without a prescription. Foam is considered to be the most effective of these preparations.

Spermicides must be inserted just before each act of intercourse. For extra protection, they may be used in combination with a condom, a diaphragm or a cervical cap.


Diaphragm & Cervical Cap

The cervical cap and diaphragm are both flexible rubber barriers used with spermicidal cream or jelly. The barrier and spermicide block and kill sperm moving toward the uterus. The diaphragm or cap is placed in the vagina to cover the cervix and is inserted before intercourse. However, the cap can be left in place longer and additional contraceptive cream or jelly is not needed for repeated intercourse during that time. Cervical cap is a small cap made of soft rubber. The woman puts spermicide (which kills sperm) into the cap and then places it up into her vagina and onto her cervix (the opening of the uterus or womb.) Suction keeps the cap in place so sperm cannot enter the uterus.


Hormonal Contraceptives

Birth control pills are a series of pills taken three out of four weeks.  It contains synthetic hormones, estrogen and progesterone, which are similar to those normally produced by a woman.  It suppresses ovulation (the release of an egg from the ovary).   It also creates a thick mucous in the cervix and a thin endometrium (lining in tissue of the uterus) which interfere with sperm motility and implantation.       


Depo-vera

This progesterone "shot", is given every three months.  The dosage is like the combined birth control pill and  it suppresses ovulation (release of egg from the ovary). It also creates a thick mucous in the cervix and a thin endometrium (lining tissue of the uterus) which interfere with sperm motility and implantation.


How to protect yourself:

Since Chlamydia is transmitted during sexual intercourse here are some tips for Chlamydia prevention:

  • Practice Abstinence

  • Practice Safer Sex

  • Use a male or female condom every time you have sexual intercourse

  • Have a monogamous relationship with an uninfected person

To prevent complications of untreated Chlamydia infections, including infertility and tubule pregnancy, sexually active women at risk for Chlamydia should have a routine Pap smear with a Chlamydia test every year. 

 


 

Chlamydia

According to the Center of Disease Control an estimated 4 million annual cases of chlamydia among adolescents and adults initiate each year. Up to 85 percent of women and 40 percent of men with chlamydia are don't have any symptoms. If left untreated in women, infections can progress to the upper reproductive tract and may result in serious complications. In women, the infection usually begins in the cervix and can spread to fallopian tubes or ovaries.  It may also cause PID, Pelvic Inflammatory Disease, which causes scarring and blockage of the fallopian tubes.  This causes sterility and the inability for a women to get pregnant.  In such cases, fertilized eggs may not reach the uterus because of tubal blockage, causing ectopic pregnancy, the fertilization of eggs and development in the tubes. Sterility in men can also be a problem as well, with more than 250,000 cases are diagnosed annually. This condition is called epididiymitus, which happens when chlamydia spreads from the urethra to the testicles. When symptoms do occur they may occur in as little as 5 -10 days after infection.  

Such symptoms that women may experience are:

  • bleeding between menstrual periods

  • vaginal bleeding after intercourse

  • abdominal pain

  • pain during intercourse

  • low grade fever

  • painful urination


Genital Warts

Genital Warts are caused by the types of sexually transmitted Human Papillomavirus (HPV). Approximately 60 varieties of human papillomavirus are known. Most genital HPV infections do not cause warts and are asymptomatic, they don't have any symptoms. Genital HPV is transmitted through vaginal, anal or oral sexual contact with an infected person. It is passed through skin contact, through any open tears and abrasions during sexual activity and may also be passed through contact with bodily fluids. Those who are exposed to the virus will not always develop genital warts, in fact, there is a 60 percent to 90 percent chance that his/her sexual partner is possibly infected with the virus. Genital warts are similar to other viruses that remain in your system if you are infected. It does not necessarily confer immunity to infections with different strains of HPV.  

Symptoms

Usually Genital Warts can be seen and felt in the outer genitalia, but can grow inside the anus, vagina, urethra, and cervix, or throat making detection more difficult. They are usually small, soft, flesh-colored (pink or brown), cauliflower-like growths that may be found by themselves or in clusters. They are usually painless, but can be associated with itching and irritation. 

Seek treatment if: 

  • any unusual growths, bumps, skin changes on or near your penis, vagina, vulva, or anus are noticed

  • any unusual itching, pain, bleeding in/around the genital area occurs

  • your partner has genital warts


 

Gonorrhea

Gonorrhea is caused by the gonococcus, a bacterium that grows and multiplies quickly in moist, warm areas of the body such as the cervix, urethra, mouth, or rectum.  These bacteria can be passed from person to person during sexual activity (vaginal, oral, and anal intercourse) leading to infections of the cervix, vagina, and urethra. If untreated, these "lower" gonorrhea infections can spread to higher portions of the reproductive tract, causing prostatitis (prostate inflammation) and epididymo-orchitis (inflammation of the epididymis and testes) in men, and pelvic inflammatory disease (PID) in women.


Symptoms

The early symptoms of gonorrhea often are mild, and most women who are infected have no symptoms of the disease. If symptoms of gonorrhea develop, they usually appear within 2 to 10 days after sexual contact with an infected partner, although a small percentage of patients may be infected for several months without showing symptoms.

Men Women
discharge from the urethra abnormal vaginal discharge
redness of the urethra burning sensation during urination
frequent urination more advanced progression PID may develop, including abdominal pain, bleeding between menstrual period, vomiting, & fever
pain or "burning" during urination  

 


Hepatitis B

The Hepatitis B virus (HBV) was originally recognized as the source of hepatitis caused by contaminated blood transfusions, however, exposure to any body fluids -- especially semen and saliva -- can transmit the virus. In the U.S., HBV is typically spread during intimate sexual activity, as well as through needle sharing among intravenous drug users.

 

HBV infection can cause a silent infection with no symptoms, or it can result in acute hepatitis or chronic hepatitis. In addition, some people can become chronic "carriers" of HBV without ever developing hepatitis. This latter group, which includes over 200 million people worldwide, does not have signs and symptoms of hepatitis. However, they serve as walking reservoirs of hepatitis infection and can pass HBV to others.

Symptoms

First stage of Hepatitis (acute)

Second Stage of Hepatitis (chronic)

nausea

swelling of lymph nodes "swollen glands"

vomiting

liver damage

stomach pain

stomach pain

headache and or fever

yellowing of eyes and skin (jaundice)

Other symptoms may include:

  • vomiting of blood

  • dark and bloody stool                                      

  • generalized itching

  • weight loss

  • abdominal pain

  • sleep disturbance

Prevention of Sexual Transmission of HBV

Immunization                                         

Immunization programs are expected to have a significant effect on the incidence of HBV infection in the next decade. Because those young people who are immunized now will be protected from HBV infection during adolescent and young adulthood, a period when sexual activity is likely occurred.

 

Safer Sex

STD prevention education programs that emphasize the reduction of high risk behaviors and promote the consistent use of condoms, may be beneficial in preventing the spread of HBV.

 


Syphilis

A sexually transmitted or congenital infection caused by the bacterium Treponema pallidum which penetrated broken skin or mucous membranes. Transmission is most often caused by sexual contact. It can also be transferred to the fetus via placenta after the 10th week of pregnancy 

Syphilis Occurs in three stages:

  1. In the primary stage, painless sores, called chancres, appear 10 days to six weeks after exposure which can disappear on their own.

  2. The secondary stage, begins a week to 6 months after the primary stage. A skin rash is the hallmark of this stage and lesions may appear again. The lesions are very infectious in this stage.

  3. The tertiary phase or latent phase follows during which no symptoms are present, but can be found by blood tests.

  • If it is not treated, bacteria continue to invade the body, and there will be relapse.

Symptoms (of untreated syphilis)
Primary symptoms

  • painless sores on genital, rectum, mouth, or fingers

  • enlarged lymph nodes in the area containing the sores

  • sore heals in 4 - 8 weeks

 Secondary symptoms

  • skin rash, diffuse including palms and sores

  • extensive lymph node enlargement

  • mucous patches (painless silvery ulcerations of mucous membranes)

  • headache

  • aches and pains in bones

  • loss of appetite

  • fever

  • fatigue

  • secondary stage persisting for a year

 Latent  symptoms (Tertiary stage)

  • infiltrative tumors of skin, bones, or liver

  • cardiovascular syphilis, which affects the aorta causing aneurysms or valve disease

  • central nervous system disorders

 Additional symptoms that may be associated with this disease:

  • skin rash or sores on palms and soles

  • vaginal bleeding between periods

  • swallowing difficulty (swollen lymph nodes)

  • nosebleed - symptom

  • mouth sores

  • hearing loss

  • groin lump

  • genital lesions (female)

  • limited range of motion (aching of muscles and joints)

  • fatigue

  • fever

  • hair loss

 

Complications

If gonorrhea is not treated, the bacteria can spread to the bloodstream and infect the joints, heart valves, or the brain. The most common consequence of gonorrhea, however, is PID, a serious infection of the female reproductive organs, that occurs in an estimated 1 million American women each year. PID can scar or damage cells lining the fallopian tubes, resulting in infertility in as many as 10 percent of women affected. In others, the damage prevents the proper passage of the fertilized egg into the uterus. If this happens, the egg may implant in the tube; this is called an ectopic or tubal pregnancy and is life-threatening to the mother if not detected early.

An infected woman who is pregnant may give the infection to her infant as the baby passes through the birth canal during delivery. Most states require that the eyes of newborns be treated with silver nitrate or other medication immediately after birth to prevent gonococcal infection of the eyes, which can lead to blindness. Because of the risk of gonococcal infection to both mother and child, doctors recommend that a pregnant woman have at least one test for gonorrhea during her pregnancy.


STD Facts

  • Sexually transmitted diseases affect more than 12 million men and women in the  United States each year. Many are teenagers of young adults.

  • Using drugs or alcohol increases your chances of getting STD's because these substances can interfere with your judgment and your ability to use a condom properly.

  • The more sexual partners you have, the higher your chance of being exposed to HIV or other STD's. This is because it is difficult to know whether a person is infected, or has had sex with people who are more likely to be infected due to intravenous drug use or other risk factors.

  • Sometimes, early in the infection, there may be  no symptoms, or symptoms may be easily confused with other illnesses

  • Sexually transmitted diseases include HIV, chancroid, chlamydial infections, trichomoniasis, genital herpes, pubic lice, genital warts, gonorrhea, lymphogranuloma venereum, syphilis, viral hepatitis, scabies, candidiasis, molluscum contagiosum and others.

Prevention

  • To lessen the chance of being infected with AIDS or other STD's, people who take part in risky sexual behavior should always use a condom.

  • Use of a condom is also important for an uninfected pregnant woman because it can help protect her and her unborn child from STD's.

Staying Healthy                          

Practice "Outercourse"

The only sure way to prevent STDs is to avoid contact between the penis, vagina, mouth, and anus. You can touch, cuddle, massage, or  tell each other your  fantasies. In general, using your  hands to give pleasure is safe.

Use a condom

Use a condom from start to finish every time you have sex.  Female condoms and male condoms are now available. For extra protection, use a spermicidal jelly or foam during vaginal sex.  Use it with condoms, not in place of them.


Be Prepared

Have condoms on hand and be ready to use them.  Be aware that people often don't make good decisions in the heat of the moment esp. if they are under the influence of alcohol or drugs.

Limit the Number of Partners

The more people you have sex with, the greater your risk of getting an STD. If your partner has sex with others, you are also at risk.


Get Tested

If you think you have an STD, go to your health care provider or clinic right away.  Ask your partner to get tested too, so you won't pass a disease back and forth. If you have sex, get a check up at least once a year.

 


 

References/Resources

Planned Parenthood  www.plannedparenthood.org/sti-safesex/stifacts.htm 

Centers for Disease Control & Prevention www.cdc.gov/od/owh/whstd.htm 

MayoClinic www.mayohealth.org

HealthCentral  www.healthcentral.com

Intellihealth www.intellihealth.com 

"Safer Sex" www.springnet.com

American College Health Association online www.acha.org 

"Choosing a Contraceptive" http://www.emory.edu/WHSC/MED/FAMPLAN/choices.html

 

 

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