Vulvo-what-ia???

Sex and the City repeats are on and this episode was yesterday. Don’t lie to me – you probably recognize this phrase! It’s only one of the best episodes (Carrie falls on her face during the fashion show).

 

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Charlotte sees her obgyn for “burning, stinging, itching” and is diagnosed with vulvodynia. She is prescribed an antidepressant and goes on her way. When she’s explaining her diagnosis later – that her “vagina is depressed” – the ladies have no idea what she is talking about. but now you will

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stuff that gets up around the sides of condoms

If a question like this comes up twice in one week, it’s a sign.

First, my brother … recently single and “ready to mingle”. I gently remind him to use condoms, but more importantly, make smart choices. He asks me “but if you use condoms you can’t get STDs, right?”

Second, watching reruns of the HBO show Girls, the phrase “What about the stuff that gets up around the sides of condoms?” is asked of friends, googled, and eventually asked of an obgyn.

So, yes, what about that “stuff”? Can any of that “stuff” get you if you use condoms?

That “stuff” is sexually transmitted infections, or sexually transmitted diseases. The two terms are used interchangeably.

As a reminder – the “sex” I’m talking about with sexually transmitted infections is not only standard intercourse. It can basically include any activity that involves contact with the genitals. For (a descriptive – sorry) example: when someone with herpes of the mouth performs oral sex on someone else, that person (the recipient) can get genital herpes.

Also, condoms were invented to protect against pregnancy. There is still skin to skin contact, even when a condom is used correctly.

STDs can be separated into 2 different categories, based on how they are transmitted from one person to the next:

*** FIRST WAY***

Infected secretions come in contact with mucosal surfaces. To flush this out a bit: secretions come from a woman’s vagina or urethra, or a man’s urethra. If this person has the infection, it gets in these secretions, ready to infect someone else’s mucosal surface. A mucosal surface is a woman’s vagina or cervix, or a man’s urethra.
These are the STDs that can usually be prevented using a condom. Seems pretty obvious. If you put a barrier between a woman’s vagina and a man’s urethra, and that’s the way the infection spreads, you are preventing that spread.

These STDs include:
chlamydia
gonorrhea
trichomonas
HIV

 

*** SECOND WAY***

Transmitted through contact with infected skin or mucosal surface. So this is the skin on skin action I was talking about above. Or it can be skin on mucosal surface action also.
These are the STDs that condoms can’t always protect against.

These STDs include:
HPV (human papilloma virus) – causes warts and cervical cancer
HSV (herpes simplex virus) – otherwise known as herpes
syphillis
chancroid

I wish there were statistics and studies to show how using condoms helps prevent STDs, versus not using condoms. Unfortunately there is no way to study this precisely. You can’t exactly prove a condom was used correctly.  You have to ask. People may report using condoms, but use them incorrectly. People may say they used a condom because they are embarrassed to say they forgot. People might not know to use condoms for foreplay as well as intercourse.

The closest I could get to knowing how effective condoms are at preventing an STD? The Center for Disease Control says condoms are “highly effective” in preventing the spread of HIV and other STDs. So use one, but also understand the limitations.

Do you think that answers my brother’s question? If he would ever read my blog I could find out.

 

Source: Center for Disease Contol website (www.CDC.gov)

That’s not chardonnay

Is anyone else watching VEEP? There was so much press around the show, but I don’t know anyone else who watches it. Two weeks ago we find out Selina Meyers – the VEEP – is pregnant. She pees in a cup and makes her assistant test about 20 urine pregnancy tests to find the answer. The answer is yes.  In my head, the next scene is her freaking out and demanding to know that the test is wrong. I should be a TV writer. It was a good scene.

What is the chance that that yes is really a no, and the test is a mistake?
I can tell her the answer: very very low.

What is the false positive rate on home pregnancy tests?
There isn’t an exact number in the literature … but basically it almost never happens.

First, know that a home pregnancy test is a test for the hormone BhCG (human chorionic gonadotropin). This is the “pregnancy hormone”. You need to follow instructions on the test. If it tells you to check the test in 2 minutes, check the test in 2 minutes. Sometimes waiting a few extra minutes can make the yes/no line appear faintly positive when it’s really just the saturation of the urine, not the pregnancy hormone. Besides straying from the instructions, if you don’t have BhCG in your body, and subsequently in your urine, the test should be negative.

There are only rare circumstances when you will have BhCG in your body and not be pregnant:

1. If you had a recent pregnancy, the hormone can stay in your system for up to 2 months. You can get pregnant again within weeks of giving birth though. If you take a pregnancy test a month after you gave birth and want to know if you are pregnant again, there is a chance the old pregnancy will be the “yes”. In cases like these, see your doctor for more definitive testing.

2. You may be pregnant, but with an abnormal pregnancy. This needs to be a totally separate post. Your doctor will likely be the one to diagnose you with an abnormal pregnancy.

3. Infertility treatments often use BhCG. If you are injecting BhCG into your system, it will be in your system. That’s obvious.

4. Rare types of ovarian cysts may produce the hCG hormone. The symptoms might be the same as early pregnancy: bloating, abdominal discomfort, nausea or vomiting. You will make an appointment to see a doctor when your home test comes back positive anyway, and these cysts are very rare.

5. Rare types of cancer can cause a positive pregnancy test too.

There may be one or two much rarer reasons I am forgetting. But for all these reasons, if you have a positive pregnancy test, make an appointment to see your doctor. It’s most likely true!

And, not to ruin the surprise, but the VEEP has a miscarriage. That story line closed. If only they asked me to contribute … I could have made a whole series around her pregnancy 🙂