A&P LAB 11

Combating the Threat of Antibiotic-Resistant Gonorrhea

Antibiotic-Resistant Gonorrhea: A Public Health Threat Gonorrhea is the second most commonly reported notifiable disease in the United States. There are more than 500,000 reported cases of gonorrhea per year, yet CDC estimates 1.14 million new infections may actually occur each year. Half of all infections each year are resistant to at least one antibiotic. Today, the U.S. has just one recommended gonorrhea treatment option remaining. The National Strategy: A Roadmap for Combating Antibiotic Resistance In 2013 CDC released Antibiotic Resistance Threats in the United States, 2013, the first report to look at the burden and threats posed by antibiotic resistance on human health. This report named antibiotic-resistant gonorrhea among the three most urgent threats of its kind in the country. One year later, the President released an Executive Orderexternal icon and the White House developed the National Strategy to Combat Antibiotic-Resistant Bacteria (CARB), both of which call for the prevention, detection, and innovation against antibiotic resistance.. In March 2015, the White House released the five-year National Action Planpdf icon for CARB, which outlines steps for implementing the National Strategy. To meet these national goals, and through federal funding for CARB in fiscal year 2016, CDC's Division of STD Prevention (DSTDP) is supporting a number of new and continuing activitiespdf icon that aim to slow the development of antibiotic-resistant gonorrhea and prevent its spread. Gonorrhea control in the U.S. relies on our ability to detect and treat each case of gonorrhea quickly and effectively with the right antibiotic; because of this, DSTDP is taking a multipronged, capacity-building approach to tackle the problem. Determining the Best Way to Treat Gonorrhea In large part, DSTDP makes decisions about national treatment recommendations using data from the Gonococcal Isolate Surveillance Project (GISP). Gonorrhea specimens from men with symptoms of urethritis in 26 STD clinics in selected U.S. cities are collected each month for culture and sent to their local laboratory for isolation of the bacteria. Regional laboratories in the AR Lab Network then test these isolates for resistance to the different antibiotics that are, or were, used to treat gonorrhea. All clinical, epidemiologic, and laboratory results are then sent to CDC and used to determine the most effective treatment to recommend for gonorrhea, based on nationwide susceptibility and resistance patterns and trends. Ensuring Individuals Receive Recommended Treatment To make sure individuals with gonorrhea are receiving CDC's recommended treatment, DSTDP monitors a representative sample of reported gonorrhea cases from the STD Surveillance Network (SSuN). SSuN is a sentinel network of 10 geographically diverse state and local health department STD prevention programs. Directly-funded STD programs also receive support to monitor gonorrhea treatment practices in their jurisdiction. Improving Laboratory Work Central to the Threat Response CDC's AR Solutions Initiative funds the Antibiotic Resistance Laboratory Network (AR Lab Network)—a network of public health laboratories that provide cutting-edge antibiotic resistance laboratory testing for existing and emerging threats. Since gonorrhea is an important part of CARB activities, four regional labs in the AR Lab Network are funded to build robust capacity for culture-based antibiotic susceptibility testing and genomic sequencing. These labs process up to 20,000 isolates per year from GISP and rapid detection and response activities. The public health data generated by the AR Lab Network helps DSTDP better monitor antibiotic resistance in gonorrhea and inform treatment recommendations and prevention interventions. A select number of isolates tested by the AR Lab Network are archived in the CDC and FDA Antibiotic Resistance Isolate Bank. These isolates can be used for developing diagnostics, antibiotics, and vaccines for gonorrhea, as well as support other future antibiotic-resistant gonorrhea studies. Preparing to Rapidly Detect and Respond to Resistant Gonorrhea Strains Click for larger map CDC's AR Solutions Initiative is also supporting the multisite activity, Gonorrhea Rapid Detection and Response, which will develop and strengthen local and state health department epidemiological, laboratory, and informatics capacity to more rapidly detect, and quickly and effectively respond to antibiotic resistance through network analysis of transmission dynamics and novel interventions. The AR Investment Map shows CDC's key investments to combat antibiotic resistance, including resistant gonorrhea, across the nation. This work is done in many ways, as illustrated by the following key examples: (1) Hiring and training state and local public health personnel so they have better tools and systems to respond to emerging threats;(2) Increasing epidemiological investigations of gonorrhea cases and their sexual and social networks to help local jurisdictions better understand gonorrhea-related transmission dynamics in their area;(3) Expanding the use of culture beyond male urethritis in STD clinics, so that extragenital specimens and specimens from women with gonorrhea are routinely collected, as well as test-of-cure specimens as needed;(4) Exploring different ways to expand gonorrhea culture to sexual and social networks, populations, and funded jurisdictions where nucleic acid amplification tests (NAATs) without antimicrobial susceptibility testing markers are the current gonorrhea diagnostic testing method;(5) Establishing Etest capacity as a rapid way to detect susceptibility and resistance until novel rapid molecular tests are in place; and(6) Rapidly providing lab results on resistance to providers and public health personnel to quickly identify, treat, and stop the spread of resistant gonorrhea strains. For 30 years, CDC has monitored antibiotic-resistant gonorrhea trends to help ensure that the recommended drug treatment for gonorrhea is working. With support from Congress, we arm state and local health departments with the tools they need to stay a step ahead of resistant gonorrhea - one of the nation's most urgent public health threats. We also work together with health departments to enhance their capacity to monitor and test for resistant gonorrhea and develop rapid response strategies if resistance is detected. See below for a brief overview of current activities. Established in 1986, the Gonococcal Isolate Surveillance Project (GISP) monitors U.S. antibiotic resistance trends in gonorrhea. Through the collaborative effort of selected STD clinics and their local laboratories, regional laboratories, and CDC, GISP's collected data helps ensure patients with gonorrhea receive the right antibiotic treatment. GISP monitors antimicrobial susceptibility of approximately 5,000 male gonococcal urethritis cases seen in 27 STD clinics. The enhanced Gonococcal Isolate Surveillance Project (eGISP) strengthens surveillance of resistant gonorrhea and increases state and local capacity to detect and monitor it. In select STD clinics, eGISP not only collects samples from men with gonococcal urethritis but also from women and from extragenital sites. These specimens are sent to regional laboratories for susceptibility testing. The STD Surveillance Network (SSuN) is a collaborative network of state, county and/or city health departments funded by CDC to conduct sentinel and enhanced STD surveillance activities. The purpose of SSuN is to improve the capacity of national, state and local STD programs to detect, monitor, and respond to trends in STDs through enhanced collection, reporting, analysis, visualization, and interpretation of disease information. Strengthening the United States Response to Resistant Gonorrhea (SURRG) began in 2016 with three goals: 1) enhance domestic gonorrhea surveillance and infrastructure; 2) build capacity for rapid detection and response to resistant gonorrhea through increased culturing and local antibiotic susceptibility testing; and 3) rapid field investigation to stop the spread of resistant infections. The project also aims to gain a better understanding of the epidemiological factors contributing to resistant gonorrhea. Nine jurisdictions collect and analyze data, helping guide national recommendations for the public health response to resistant gonorrhea. The Antibiotic Resistance Laboratory Network (AR Lab Network) is a network of public health laboratories equipped to respond to emerging health threats and provide cutting-edge antibiotic resistance laboratory support. Since gonorrhea is an important part of these activities, four regional labs in the AR Lab Network receive funding for culture-based antimicrobial susceptibility testing and genomic sequencing.

herpes screening FAQ

Genital herpes is a common sexually transmitted disease (STD). It is caused by herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). Most people who have HSV-1 or HSV-2 don't have symptoms. There are a lot of questions about herpes tests, and this page will help you understand CDC's herpes testing recommendations. For basic information about Genital Herpes, see the Fact Sheet. Genital herpes is common. Why doesn't CDC recommend testing everyone for this STD? CDC does not recommend herpes testing for people without symptoms. This is because diagnosing genital herpes in someone without symptoms has not shown any change in their sexual behavior (e.g., wearing a condom or not having sex) nor has it stopped the virus from spreading. Also, false positive test results (test results that say you have herpes when you do not actually have the virus) are possible. Even if you do not have symptoms, you should talk openly and honestly about your sexual history with your doctor to find out if you should be tested for any STDs, including herpes. Although CDC does not recommend that everyone get tested for herpes, herpes testing may be useful in some situations. Herpes blood tests (also called type-specific HSV serologic tests) might be useful If you have genital symptoms that could be related to herpes, If you have (or have had) a sex partner with genital herpes, or If you want a complete STD exam, especially if you have multiple sex partners. Please note that while a herpes blood test can help determine if you have herpes infection, it will not be able to tell you who gave you the infection. Why is testing for genital herpes only recommended for people who have symptoms? CDC recommends herpes testing for people who have genital symptoms for herpes to confirm that they are infected. These events are called "having an outbreak," and they appear as blisters on or around the genitals, rectum, or mouth. The blisters break and leave painful sores that may take weeks to heal. Testing allows a doctor to talk with you about what to expect in the future, which medications are available to help manage any symptoms, and how you can lower your risk of spreading the infection to your sex partner(s). If you have a partner with genital herpes, testing can tell if you also have the virus. If you are not infected, your doctor can talk to you about ways to lower your risk of getting genital herpes. If you are a pregnant woman and have a partner with genital herpes, it is very important to get tested. If you get genital herpes during pregnancy your baby could also become infected. Herpes infections in babies can be life-threatening. If you are infected, your doctor will talk to you about your diagnosis and the possible symptoms of genital herpes. In addition, herpes blood testing may be useful if you are seeking a complete STD exam, especially if you have multiple sex partners. Is a blood test for genital herpes included when I ask to be tested for "everything" (all STDs)? Why does CDC recommend testing for other STDs, but not herpes? Herpes blood tests may or may not be included. Your doctor chooses STD tests based on your sexual behaviors (number of sex partners, if condoms are used every time, etc.), as well as how common the infection is in the area that you live in. This is why you should have an open and honest discussion with your doctor about your sex practices and history. When you go in for STD testing, it is important to ask your doctor which infections you are and are not being tested for, and why. STD tests are usually done for infections that have serious outcomes if they are not treated. For example, finding and treating curable STDs like chlamydia can stop them from causing serious complications like infertility (the inability to get pregnant) in women. Genital herpes does not usually result in serious outcomes in healthy, non-pregnant adults. More often, the stigma and shame from a genital herpes infection can be more troubling to someone who is infected than the disease itself. If you are worried about genital herpes, you should talk with your doctor about whether you should be tested. Wouldn't testing everyone stop the spread of genital herpes? We don't know. There is no evidence that diagnosing genital herpes with a blood test in someone without symptoms would change their sexual behavior and stop the virus from spreading. In addition, without knowing the benefits of testing, the risk of shaming and stigmatizing people outweighs the potential benefits. For these reasons, testing everyone for herpes is not recommended at this time. If a pregnant woman gets genital herpes is there a chance her baby can get infected? Yes. Even though adults with genital herpes may not have any symptoms, herpes infections in babies can be life-threatening. Women who get genital herpes during late pregnancy have a very high risk for having a baby with herpes infection, and these women may not even know they are infected. Women who get herpes during early pregnancy, or who are infected before they get pregnant can also spread herpes to their babies. Most babies with herpes get infected as they come into contact with the herpes virus while passing through the birth canal, but infection can also occur before birth (congenital infection) or in the weeks after birth. If you are pregnant and think that you or your partner may have genital herpes, tell your doctor. Your doctor can order testing and can talk to you about ways to lower your baby's risk for infection. Are people with genital herpes at increased risk of getting infected with HIV? Yes, studies show that HSV-2 infection increases the risk of getting HIV infection, even when there are no symptoms of genital herpes. HSV-2 infection can cause tiny breaks in the genital and anal area that allow HIV to enter into the body. Herpes infection also attracts the type of cells that HIV infects ("target cells") to the genital area. This increases the chance of getting HIV, if exposed. Can testing and treating genital herpes decrease the risk for HIV infection? No. Studies show that testing for genital herpes and treating with herpes medications does not lower the risk of getting HIV. Why are there state-by-state data for common STDs, but not for genital herpes? Syphilis, gonorrhea, and chlamydia are "notifiable" diseases in the United States, but herpes is not. A disease is "notifiable" if healthcare providers in all 50 states are required by law to report the diagnosis to their state or local health departments. CDC is also notified, and publishes state-by-state data for these infections. Because herpes infections are not notifiable infections by law, CDC is not able to provide state-by-state data. Public health surveillance for herpes infections is mainly done through population-based, national surveys, such as the National Health and Nutrition Examination Survey (NHANES). Who decides which diseases are notifiable and why? The Council of State and Territorial Epidemiologists (CSTE) works with CDC to determine if a particular disease should be nationally notifiable. To make this decision, they follow a number of public health principles, for example, (1) whether or not it is treatable; (2) whether or not it is preventable; (3) how common it is; (4) whether or not a public health response is needed; (5) whether or not there is a good source of information on the number of cases; and (6) whether or not it represents a significant public health threat (For example, how severe it is). Information on HSV-1 and HSV-2 infections already exists in NHANES, so herpes infections have not been classified as notifiable diseases. Why have false positive tests been used as an argument against routine testing for genital herpes, but not for other STDs, which can also have false positives? False positive test results are test results that say a person has a disease or condition when they do not actually have it. False positive results can occur with many diagnostic tests, including STD tests. The chances of false positive results increase as the likelihood of the infection decreases in the person being tested. False positive HSV-2 results can happen, especially in people who are at low risk for a herpes infection. Also, we do not know if people who test positive for herpes will change their sexual behavior as a result of a positive test. This tells us that the harm of a possible false positive test may be a greater concern than the benefits of an actual diagnosis. Unlike curable STDs, such as chlamydia, herpes infections are life-long, so it is especially important to avoid a false positive test. Is Alzheimer's disease related to HSV-1 infection? Alzheimer's disease is a progressive brain disease that develops as a result of a complex series of events occurring in the brain over a long period of time. The causes of Alzheimer's disease may include genetic, environmental, and other factors. Several different factors have been statistically linked to Alzheimer's disease, including HSV-1 infection. However, some investigations suggest that viruses other than HSV-1 may influence Alzheimer's disease. More research is needed to determine whether or not there is a causal link between HSV-1 infection and Alzheimer's disease. I tested positive for genital herpes. Where can I find the latest information about ongoing genital herpes research, including clinical trials? The U.S. National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) supports research to develop prevention methods and treatments for genital herpes. Details about current research efforts can be found on the NIAID websiteExternal. NIH also maintains a database with information about clinical trials around the worldExternal. This database includes information on all genital herpes studies that are actively recruiting volunteers

herpes statistics

Genital herpes is a common STD, and most people with genital herpes infection do not know they have it. STD Surveillance 2017 - Other Sexually Transmitted Diseases - Herpes (September 25, 2018)Figure 53. Herpes Simplex Virus Type 2 — National Estimates of Trends in Age-Adjusted Seroprevalence Among Persons Aged 14-49 Years by Race and Hispanic Ethnicity, National Health and Nutrition Examination Survey (NHANES), 1999-2000 through 2015-2016 Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United StatesCdc-pdf (February 13, 2013) Figure 53. Herpes Simplex Virus Type 2 — National Estimates of Trends in Age-Adjusted Seroprevalence Among Persons Aged 14-49 Years by Race and Hispanic Ethnicity, National Health and Nutrition Examination Survey (NHANES), 1999-2000 through 2015-2016

nipple

A nipple is located near the tip of each breast, and it is surrounded by a circular area of pigmented skin called the areola. A mammary gland is composed of fifteen to twenty irregularly shaped lobes, each of which includes alveolar glands, and a duct (lactiferous duct) that leads to the nipple and opens to the outside.

what gay and bisexual men can do about syphilis

And Syphilis Is...? Syphilis is a sexually transmitted disease that doesn't get a whole lot of media attention. But that doesn't mean you shouldn't have it on your radar. Even though it's simple to prevent and can be cured with the right treatment, it can cause very serious health problems if not treated. Untreated syphilis can eventually spread to the brain and nervous system or to the eye. This can cause problems like hearing loss, stroke, and blindness. And there's another big concern: Having syphilis can increase a person's risk for getting HIV or giving it to others. Here's Why You'll Be Hearing More About Syphilis Syphilis awareness efforts around the country have been ramping up because recent data show that syphilis rates are on the rise. Rates of primary and secondary (P&S) syphilis—the most infectious stages of the disease—increased a troubling 14.4% between 2017 and 2018. Even though men who have sex with men (MSM) account for only 4% of the U.S. male population, they account for about two thirds of reported P&S syphilis cases. The current situation is stark— reported syphilis among MSM increased 52% from 2014 to 2018. What is the link between syphilis and HIV? In the United States, 36% of MSM with P&S syphilis are also reported to be HIV-positive. The troubling reality is that if you are an HIV-negative gay man who is diagnosed with P&S syphilis, you are more likely to be infected with HIV in the future. Having a sore or break in the skin from an STD like syphilis may allow HIV to more easily enter your body. You may also be more likely to get HIV because the same behaviors and circumstances that put you at risk for getting other STDs can also put you at greater risk for getting HIV. WHAT CAN I DO TO MAKE SURE I DON'T GET SYPHILIS? If you are a sexually active gay or bisexual man, here's what you can do: Talk to Your Doctor. Have an honest and open talk with your health care provider about your sexual history and ask to be tested for syphilis and other STDs at anatomic sites of exposure. Many men don't have symptoms so testing is the only way to be sure that you do not have syphilis. If you are HIV negative and have syphilis, ask your health care provider about PrEP. Protect Yourself and Your Partner. If you are sexually active, doing the following can lower your chances of getting syphilis: (1) being in a long-term, mutually monogamous relationship with a partner who has been tested and has negative STD test results, and (2) using latex condoms the right way every time you have sex. If you have sex with more than one partner, don't use condoms, or engage in risky sex behaviors, then you should get tested more frequently (e.g., every 3 to 6 months). What CDC Will Do To reverse this increasing trend of syphilis among MSM, CDC will: Work to harmonize STD/HIV screening recommendations and prevention messages related to sexual health services for MSM. Support health care providers to implement recommended STD screening, treatment, and vaccination services through training, guidelines, tools, and resources. Improve syphilis surveillance among gay, bisexual, and other MSM. Conduct epidemiologic studies to better understand factors associated with syphilis adverse outcomes, such as neurosyphilis and ocular syphilis, and transmission networks. Identify and share best practices.

HPV vaccine for young women

CDC now recommends 11 to 12 year olds get two doses of HPV vaccine—rather than the previously recommended three doses—to protect against cancers caused by HPV. The second dose should be given 6-12 months after the first dose. For more information on the updated recommendations, read the press release: https://www.cdc.gov/media/releases/2016/p1020-hpv-shots.html A vaccines is available to prevent the human papillomavirus (HPV) types that cause most cervical cancers as well as some cancers of the anus, vulva (area around the opening of the vagina), vagina, and oropharynx (back of throat including base of tongue and tonsils). The vaccine also prevents HPV types that cause most genital warts. Why is the HPV vaccine important? Genital HPV is a common virus that is passed from one person to another through direct skin-to-skin contact during sexual activity. Most sexually active people will get HPV at some time in their lives, though most will never even know it. HPV infection is most common in people in their late teens and early 20s. There are about 40 types of HPV that can infect the genital areas of men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and other less common cancers — like cancers of the anus, penis, vagina, and vulva and oropharynx. Other types of HPV can cause warts in the genital areas of men and women, called genital warts. Genital warts are not life-threatening. But they can cause emotional stress and their treatment can be very uncomfortable. Every year, about 12,000 women are diagnosed with cervical cancer and 4,000 women die from this disease in the U.S. About 1% of sexually active adults in the U.S. have visible genital warts at any point in time. Which girls/women should receive HPV vaccination? HPV vaccination is recommended for 11 and 12 year-old girls. It is also recommended for girls and women age 13 through 26 years of age who have not yet been vaccinated or completed the vaccine series; HPV vaccine can also be given to girls beginning at age 9 years. CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. For more information on the recommendations, please see: https://www.cdc.gov/hpv/parents/questions-answers.html Will sexually active females benefit from the vaccine? Ideally females should get the vaccine before they become sexually active and exposed to HPV. Females who are sexually active may also benefit from vaccination, but they may get less benefit. This is because they may have already been exposed to one or more of the HPV types targeted by the vaccines. However, few sexually active young women are infected with all HPV types prevented by the vaccines, so most young women could still get protection by getting vaccinated. Can pregnant women get the vaccine? The vaccine is not recommended for pregnant women. Studies show that the HPV vaccine does not cause problems for babies born to women who were vaccinated while pregnant, but more research is still needed. A pregnant woman should not get any doses of the HPV vaccine until her pregnancy is completed. Getting the HPV vaccine when pregnant is not a reason to consider ending a pregnancy. If a woman realizes that she got one or more shots of an HPV vaccine while pregnant, she should do two things: Wait until after her pregnancy to finish any remaining HPV vaccine doses. Call the pregnancy registry [800-986-8999 for Gardasil and Gardasil 9, or 888-825-5249 for Cervarix]. Should girls and women be screened for cervical cancer before getting vaccinated? Girls and women do not need to get an HPV test or Pap test to find out if they should get the vaccine. However it is important that women continue to be screened for cervical cancer, even after getting all recommended shots of the HPV vaccine. This is because the vaccine does not protect against ALL types of cervical cancer. How effective is the HPV Vaccine? The HPV vaccine targets the HPV types that most commonly cause cervical cancer and can cause some cancers of the vulva, vagina, anus, and oropharynx. It also protects against the HPV types that cause most genital warts. The HPV vaccine is highly effective in preventing the targeted HPV types, as well as the most common health problems caused by them. The vaccine is less effective in preventing HPV-related disease in young women who have already been exposed to one or more HPV types. That is because the vaccine prevents HPV before a person is exposed to it. The HPV vaccine does not treat existing HPV infections or HPV-associated diseases. How long does vaccine protection last? Research suggests that vaccine protection is long-lasting. Current studies have followed vaccinated individuals for ten years, and show that there is no evidence of weakened protection over time. What does the vaccine not protect against? The vaccine does not protect against all HPV types— so they will not prevent all cases of cervical cancer. Since some cervical cancers will not be prevented by the vaccine, it will be important for women to continue getting screened for cervical cancer. Also, the vaccine does not prevent other sexually transmitted infections (STIs). So it will still be important for sexually active persons to lower their risk for other STIs. How safe is the HPV vaccine? The HPV vaccine has been licensed by the Food and Drug Administration (FDA). The CDC has approved this vaccine as safe and effective. The vaccine was studied in thousands of people around the world, and these studies showed no serious safety concerns. Side effects reported in these studies were mild, including pain where the shot was given, fever, dizziness, and nausea. Vaccine safety continues to be monitored by CDC and the FDA. More than 60 million doses of HPV vaccine have been distributed in the United States as of March 2014. Fainting, which can occur after any medical procedure, has also been noted after HPV vaccination. Fainting after any vaccination is more common in adolescents. Because fainting can cause falls and injuries, adolescents and adults should be seated or lying down during HPV vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries. Why is HPV vaccination only recommended for women through age 26? HPV vaccination is not currently recommended for women over age 26 years. Clinical trials showed that, overall, HPV vaccination offered women limited or no protection against HPV-related diseases. For women over age 26 years, the best way to prevent cervical cancer is to get routine cervical cancer screening, as recommended. What about vaccinating boys and men? HPV vaccine is licensed for use in boys and men. It has been found to be safe and effective for males 9 -26 years. ACIP recommends routine vaccination of boys aged 11 or 12 years with with a series of doses. The vaccination series can be started beginning at age 9 years. Vaccination is recommended for males aged 13 through 21 years who have not already been vaccinated or who have not received all recommended doses. The vaccine is most effective when given at younger ages; males aged 22 through 26 years may be vaccinated. CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. For more information on the recommendations, please see: https://www.cdc.gov/hpv/parents/questions-answers.html Is HPV vaccine covered by insurance plans? Health insurance plans cover the cost of HPV vaccines. If you don't have insurance, the Vaccines for Children (VFC) program may be able to help. How can I get help paying for HPV vaccine? The Vaccines for Children (VFC) program helps families of eligible children who might not otherwise have access to vaccines. The program provides vaccines at no cost to doctors who serve eligible children. Children younger than 19 years of age are eligible for VFC vaccines if they are Medicaid-eligible, American Indian, or Alaska Native or have no health insurance. "Underinsured" children who have health insurance that does not cover vaccination can receive VFC vaccines through Federally Qualified Health Centers or Rural Health Centers. Parents of uninsured or underinsured children who receive vaccines at no cost through the VFC Program should check with their healthcare providers about possible administration fees that might apply. These fees help providers cover the costs that result from important services like storing the vaccines and paying staff members to give vaccines to patients. However, VFC vaccines cannot be denied to an eligible child if a family can't afford the fee. What vaccinated girls/women need to know: will girls/women who have been vaccinated still need cervical cancer screening? Yes, vaccinated women will still need regular cervical cancer screening because the vaccine protects against most but not all HPV types that cause cervical cancer. Also, women who got the vaccine after becoming sexually active may not get the full benefit of the vaccine if they had already been exposed to HPV. Are there other ways to prevent cervical cancer? Regular cervical cancer screening (Pap and HPV tests) and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. The HPV test looks for the virus that can cause these cell changes. Screening can detect most, but not all, cervical cancers at an early, treatable stage. Most women diagnosed with cervical cancer in the U.S. have either never been screened, or have not been screened in the last 5 years. Are there other ways to prevent HPV? For those who are sexually active, condoms may lower the chances of getting HPV, if used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases (genital warts and cervical cancer). But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV. People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That's why the only sure way to prevent HPV is to avoid all sexual activity.

Chlamydia statistics

Chlamydia is the most commonly reported STD in the United States.

PID statisitics

1 in 8 women with a history of PID experience difficulties getting pregnant. Most Recent Data STD Surveillance 2018 - Pelvic Inflammatory Disease (PID) (October 8, 2019) Prevalence of Pelvic Inflammatory Disease in Sexually Experienced Women of Reproductive Age — United States, 2013-2014 - MMWR January 27, 2017 Click for larger image SOURCE: Kreisel, K, Flagg, EW, Torrone E. Trends in pelvic inflammatory disease emergency department visits, United States, 2006-2013. Am J Obstet Gynecol 2018; 218(1): 117.e1-117.e10. Figure F. Pelvic Inflammatory Disease — National Estimates of Lifetime Prevalence Among Sexually Experienced Women Aged 18-44 Years by Race/Hispanic Ethnicity and Previous STD Diagnosis, National Health and Nutrition Examination Survey (NHANES), 2013-2014 Click for larger image NOTE: Error bars indicate 95% confidence intervals. Prevalence estimates among non-Hispanic Black women with a previous STI diagnosis have a relative standard error >40% but <50%. SOURCE: Kreisel, K, Torrone, E, Bernstein, K, et al. Prevalence of pelvic inflammatory disease in sexually experienced women of reproductive age — United States, 2013-2014. MMWR Morb Mortal Wkly Rep 2017; 66(3):80-83.

Gonhorrea treatment and care

Antibiotics have successfully treated gonorrhea for several decades; however, the bacteria has developed resistance to nearly every drug used for treatment. Gemifloxacin Erythromycin (0.5%) Ophthalmic Ointment What is the treatment for gonorrhea? Gonorrhea can be cured with the right treatment. CDC recommends a single dose of 250mg of intramuscular ceftriaxone AND 1g of oral azithromycin. It is important to take all of the medication prescribed to cure gonorrhea. Medication for gonorrhea should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult. If a person's symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. Treatment Guidelines and Updates 2015 STD Treatment Guidelines - Gonococcal Infections (June 4, 2015) Expedited

Normal Birth vs. Breech Birth

At birth, the baby may be in the normal or breech position. Five percent of newborns are born breech where the fetus has not rotated to a headfirst presentation at the cervix, but rather, where the buttocks are the presenting part. The principal concern of a breech birth is the increased time and difficulty during the expulsion stage of birth. Any attempts at realigning the fetus through the use of forceps could injure the infant. If an infant cannot be delivered breech perhaps due to the mother's pelvis being too small or a leg-first presentation, a cesarean section may be necessary. This is a surgical procedure where delivery of the fetus is achieved through an incision into the abdominal wall and uterus.

STDs and Infertility

CDC Recommends Chlamydia and Gonorrhea Screening of All Sexually Active Women Under 25 Chlamydia and gonorrhea are important preventable causes of pelvic inflammatory disease (PID) and infertility. Untreated, about 10-15% of women with chlamydia will develop PID. Chlamydia can also cause fallopian tube infection without any symptoms. PID and "silent" infection in the upper genital tract may cause permanent damage to the fallopian tubes, uterus, and surrounding tissues, which can lead to infertility. An estimated 2.86 million cases of chlamydia and 820,000 cases of gonorrhea occur annually in the United States.* Most women infected with chlamydia or gonorrhea have no symptoms. CDC recommends annual chlamydia and gonorrhea screening of all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. Highlights 2015 STD Treatment Guidelines Expedited Partner Therapy Chlamydia Screening, HEDIS and Managed Care * Chlamydia and gonorrhea are the first and second most commonly reported notifiable disease in the United States. In 2018, a total of 1,758,668 cases of chlamydia and 583,405 cases of gonorrhea were reported to CDC from 50 states and the District of Columbia. The number of reported cases is lower than the estimated total number because infected people are often unaware of, and do not seek treatment for, their infections and because screening for chlamydia is still not routine in many clinical settings.

other STDs

Chancroid STD Surveillance 2018 - Other Sexually Transmitted Diseases - Chancroid (October 8, 2019)Figure 50. Chancroid — Reported Cases by Year, United States, 1941-2018Table 1. Sexually Transmitted Diseases — Reported Cases and Rates of Reported Cases per 100,000 Population, United States, 1941-2018Table 43. Chancroid - Reported Cases and Rates of Reported Cases by State/Area in Alphabetical Order, United States and Outlying Areas, 2014-2018 2015 STD Treatment Guidelines - Chancroid - Includes diagnosis, treatment, and special considerations for chancroid. (June 4, 2015) Lymphogranuloma Venereum (LGV) Notes from the Field: Cluster of Lymphogranuloma Venereum Cases Among Men Who Have Sex with Men — Michigan, August 2015-April MMWR September 2, 2016 2015 STD Treatment Guidelines - Lymphogranuloma Venereum (LGV) - Includes diagnosis, treatment, and special considerations for LGV. (June 4, 2015)Proctitis, Proctocolitis, and Enteritis Mycoplasma genitalium 2015 STD Treatment Guidelines - Emerging Issues - Mycoplasma genitalium - Includes a new section that describes the association of Mycoplasma genitalium with urethritis and cervicitis, as well as diagnostic considerations and treatment implications (June 4, 2015) Pubic Lice Infestation Pubic "Crab" Lice - Risk factors, control and prevention, fact sheet and more 2015 STD Treatment Guidelines - Pediculosis Pubis - Includes treatment and special considerations for public lice. (June 4, 2015) Scabies Scabies - risk, symptoms, prevention and control, and more 2015 STD Treatment Guidelines - Scabies - Includes treatment and special considerations for scabies. (June 4, 2015)

chlamydia treatment and care

Chlamydia is easily cured but can make pregnancy difficult if left untreated. What is the treatment for chlamydia? Expedited Partner Therapy (EPT) Infographic: A Patient Resource Chlamydia can be easily cured with antibiotics. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV-negative. Persons with chlamydia should abstain from sexual activity for 7 days after single dose antibiotics or until completion of a 7-day course of antibiotics, to prevent spreading the infection to partners. It is important to take all of the medication prescribed to cure chlamydia. Medication for chlamydia should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. If a person's symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. Repeat infection with chlamydia is common. Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple chlamydial infections increases a woman's risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated. Infants infected with chlamydia may develop ophthalmia neonatorum (conjunctivitis) and/or pneumonia. Chlamydial infection in infants can be treated with antibiotics.

pregnancy

During pregnancy, the uterus or womb is a hollow, muscular organ in which a fertilized egg, called the zygote, becomes embedded. The egg is nourished and allowed to develop until birth. It lies in the pelvic cavity behind the bladder and in front of the bowel. The uterus usually tilts forward at a ninety-degree angle to the vagina, although in about 20% of women, it tilts backwards. The uterus is lined with tissues that change during the menstrual cycle These tissues build under the influence of hormones from the ovary. When the hormones withdraw after the menstrual cycle, the blood supply is cut off and the tissues and unfertilized egg are shed as waste. The endometrium is the membrane that lines the uterus. It is a glandular mucous membrane, and is formed during the menstrual cycle, then expelled from the body during each menstruation. This occurs in females on average every twenty-eight days, but varies with each person. As the endometrium is expelled, the blood vessels which connect the endometrial lining to the uterus break, causing bleeding and usually a small degree of pain. The endometrium is what a fertilized egg attaches to upon fertilization, so it is not shed if a fertilized egg is implanted. The endometrium also supplies blood for the fetus and allows it to receive oxygen. During pregnancy, the uterus stretches from three to four inches in length to a size that will accommodate a growing baby. During this time, muscular walls increase from two to three ounces to about two pounds and these powerful muscles release the baby through the birth canal with great force. The womb shrinks back to half its pregnant weight before a baby is a week old. By the time the baby is a month old, the uterus may be as small as when the egg first entered.

Fetus (First Trimester)

During the first trimester, the fetus goes through a huge developmental process. For the first eight weeks of its life, the fertilized egg is called the embryo. The embryo develops from an egg fertilized by the sperm. It begins as one cell, which divides into two cells by the time it descends from the fallopian tube into the uterus. These cells divide further until they form two groups - one making up the wall lining of the embryo to become the placenta and the second becoming the embryo itself.Early in the third week, the embryo becomes pear-shaped. The head forms at the rounded end and the spine at the pointed end. These two halves grow toward each other until they fuse to form the neural tube. During the fourth week, the embryo becomes recognizable as a mammal. Inside, buds of tissue form what will later develop into the lungs, pancreas, liver and gallbladder. A broad fold in the head becomes visible to later develop into the brain. Ears appear as pits; eyes develop as stalks, and folds of tissue, which will become the jaws and other structures of the neck, appear. On the sides, cartilage, bone and muscle of the back emerge in paired bulges. Just beneath the head, in the front, the heart develops. It is during this period that the embryo is at the greatest risk of birth defects. During the fifth week, external ears become visible, pits appear to mark the nose, the upper and lower jaws form, and the limb buds extend into flippers that will develop into hands and feet. Two folds of tissue meet and fuse in the front of the embryo to form the front wall of the chest and abdomen, and the umbilical cord develops. From six to eight weeks, the face becomes readily recognizable as a human. The neck forms, the torso and head become more erect, the tail disappears and the limbs become jointed, forming fingers and toes. At this time, the embryo is about one inch in length and most of the internal organs have developed along with the external features.

Fetus (second trimester)

During the second trimester, a fetus begins to take the shape of a baby. At eight weeks, the embryo is a full-formed, tiny baby, now called a fetus. Bodily proportions change as the limbs and trunk grow, reducing the head from one-half to one-fourth of the body length. By fifteen weeks, the fetus can kick, curl its fingers and toes, and squint its eyes. Genitals have developed so it can be seen to be either a male or female child, and the kidneys work. A fine, downy hair covers all the limbs and trunk, the At about the twentieth week, or in the fifth to the sixth months, secondary hair begins to replace the down, but some babies are born with smooth hair on the shoulders, chest or ears that disappears within a short time. Hair, eyebrows and eyelashes grow during the twentieth week, followed by fingernails and toenails. Within the sac of fluid, the fetus begins to move and swallow, taking in amniotic fluid. A fetus may begin thumb-sucking during the fifth month and in the sixth, the fetus gains the grasping reflex, which is familiar in newborn babies. By the twentieth week, the heartbeat can be heard through a stethoscope and at twenty-four weeks, the fetus can survive outside the womb if placed in an intensive care unit. Until it is bathed, a newborn baby looks and feels a little oily. A whitish material called vernix caseosa protects the skin of the fetus and keeps it from getting waterlogged. The waxy substance appears in about the fifth month and is like the grease used by long-distance swimmers.

gay, bisexual, and other MSM

Gay, bisexual, and other men who have sex with men (MSM) represent an incredibly diverse community. However, these men are disproportionately impacted by syphilis, HIV, and other sexually transmitted diseases (STDs). The resources on this page provide an overview of the impact of STDs on MSM as well as prevention and treatment information New CDC analysis suggests gay, bisexual, and other men who have sex with men (MSM) are at increased risk for extragenital STDs [i.e., chlamydia or gonorrhea in the throat or rectum] (April 11, 2019)

Gonorrhea statisitcs

Gonorrhea is a very common disease, especially among young people ages 15-24 years. GISP is a collaborative project between selected STD clinics, five regional laboratories, and the CDC, established to monitor trends in antimicrobial susceptibilities of strains of N. gonorrhoeae in the United States. Click for larger image Image Source: Figure 19 from Sexually Transmitted Disease Surveillance, 2018

hepatitis C symptoms and treatment

HEPATITIS C SYMPTOMS & TREATMENT FAST FACTS • Hepatitis C is found in infected blood (it's very unlikely, but not impossible, that it can be passed on in semen). • Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It's also a sexually transmitted infection (STI) that can be passed on through unprotected sex, although this is less common. • Hepatitis C can be prevented by never sharing needles and syringes; practising safer sex including using male and female condoms, dental dams and latex gloves; and avoiding unlicensed tattoo parlours and acupuncturists. • A simple blood test carried out by a healthcare professional will show whether you have hepatitis C. • Most people don't need treatment for acute hepatitis C. If it develops into chronic hepatitis C, treatment is available to reduce the risk of further complications such as liver damage. If you've had unprotected sex, or you're worried about hepatitis C or other STIs, get tested as soon as possible - even if you don't have symptoms. What is hepatitis C? Hepatitis C - hep C or HCV - is part of a group of hepatitis viruses that causes inflammation of the liver - which is when your liver becomes swollen and painful. Is hepatitis C serious? Hepatitis C can be serious and, without appropriate treatment and care, can cause liver disease and liver cancer leading to death. How do you get hepatitis C? Hepatitis C can be passed on easily and you can get it if you: share contaminated needles and syringes during recreational drug use are exposed to unsterilised tattoo, body-piercing or medical/dental equipment (occasionally you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them) have unprotected sex (sex without a condom or dental dam), including vaginal, anal and oral sex with someone who has hepatitis C (even if they don't have symptoms) share sex toys that aren't washed or covered with a new condom each time they are used practise anal sex, rimming, fingering or fisting without condoms, dental dams or latex gloves receive a transfusion of unscreened blood and blood products are a pregnant woman with hepatitis C you can pass the virus on to your unborn baby. Hepatitis C, HIV and sexual health Having an STI, including hepatitis C, increases your risk of getting HIV. This is because most STIs cause sores or lesions that make it easier for HIV to enter the body. Because they are passed on in similar ways, some people have both viruses, which is known as co-infection. If you're living with HIV and also have hepatitis C, your viral load is likely to increase because your immune system is weaker. This will make you more likely to pass on HIV if you have sex without a condom. Hepatitis C is rarely passed on during heterosexual sex - it's more common for it to be spread sexually among men who have sex with men who are living with HIV. If you're taking antiretrovirals, it's important to discuss with your doctor how treatment for hepatitis c may interact with your HIV drugs. If you're worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section How do you protect yourself against hepatitis C? Never share needles and syringes or other items that may be contaminated with infected blood, such as razors, toothbrushes, towels or manicure tools (even old or dried blood can contain the virus). Only have tattoos, body piercings or acupuncture in a professional setting, and ensure that new, sterile needles are used. Practise safer sex:Know the status of any sexual partner.Male (or external) or female (or internal) condoms and/or dental dams aren't usually necessary to prevent hepatitis C for long-term heterosexual couples, but it's a good idea to use them when having anal sex (in case there is minor bleeding), or if blood such as menstrual blood is present; or for sex with a new partner.for men who have sex with men - use condoms, dental dams and latex gloves for anal sex, rimming, fingering and fisting. There is no vaccine for hepatitis C. Note - apart from condoms - other types of contraception such as the contraceptive pill offer no protection against sexually transmitted infections. Ask your healthcare professional if you need further advice on how to protect yourself and your partner(s) from HIV and other STIs. What do hepatitis C symptoms look like? Hepatitis C infection can go through two stages: acute and chronic. In the early - acute -stage most people don't have any symptoms and don't know they have it until the liver has been significantly damaged. For women and men acute (or short-term) symptoms include: flu-like symptoms, including tiredness, fever and aches and pains feeling and/or being sick loss of weight/appetite itchy skin tummy (abdominal) pain mental confusion (often called 'brain fog') and depression - these are specific to hepatitis C. Acute hepatitis C infection doesn't always become chronic, but if it does, you often don't notice any symptoms until the virus has damaged the liver enough to cause the signs and symptoms of liver disease including: bleeding and/or bruising easily tiredness loss of weight/appetite jaundice, meaning your skin and the whites of your eyes turn yellow dark urine (pee) Itchy skin fluid build-up in your tummy (abdomen) swollen legs confusion, drowsiness and slurred speech spider-like blood vessels on your skin. Can I get tested for hepatitis C? Yes - a simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given an extra test to see if your liver is damaged. If you've got hepatitis C you should be tested for other STIs. It's important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on; and it can also stop you from getting the infection again. How is hepatitis C treated? The majority of people with hepatitis C don't need treatment. However, you will need regular check-ups for three months to see if your body is fighting the virus. For people who develop a chronic infection, there is treatment, and people with chronic infection do not necessarily develop liver damage. If you've already got hepatitis C, it's advisable to have the vaccination against hepatitis A and B to protect your liver from further damage. Whether you have symptoms or not, don't have sex until your healthcare professional says you can. It's usually possible to cure hepatitis C, but you're not immune to future infections - which means you can get it again. You can also still get other types of hepatitis, and having hepatitis C together with another type is more serious. Complications of hepatitis C As with most STIs, hepatitis C puts you at risk of other STIs, including HIV. Without treatment a pregnant woman with hepatitis C can pass it on to her unborn baby. Without treatment, chronic hepatitis C can cause scarring of the liver (cirrhosis), which can cause the liver to stop working properly. A small number of people with cirrhosis develop liver cancer and these complications can lead to death. Other than a liver transplant, there's no cure for cirrhosis. However, treatments can help relieve some of the symptoms.

PID treatment and care

How is pelvic inflammatory disease treated? Several types of antibiotics can cure PID. Antibiotic treatment does not, however, reverse any scarring caused by the infection. For this reason, it is critical that a woman receive care immediately if she has pelvic pain or other symptoms of PID. Prompt antibiotic treatment can prevent severe damage to the reproductive organs. The longer a woman delays treatment for PID, the more likely she is to become infertile or to have a future ectopic pregnancy because of damage to the fallopian tubes. PID is usually treated with antibiotics to provide empiric, broad spectrum coverage of likely pathogens. Recommended regimens can be found in the 2015 STD Treatment Guidelines. Health care providers should emphasize to their patients that although their symptoms may go away before the infection is cured, they should finish taking all of the prescribed medicine. Additionally, a woman's sex partner(s) should be treated to decrease the risk of re-infection, even if the partner(s) has no symptoms. Although sex partners may have no symptoms, they may still be infected with the organisms that can cause PID. In certain cases, clinicians may recommend hospitalization to treat PID. This decision should be based on the judgment of the health care provider and the use of suggested criteria found in the 2015 STD Treatment Guidelines. If a woman's symptoms continue, or if an abscess does not resolve, surgery may be needed.

fetus (third trimester)

In the third trimester of pregnancy, the fetus becomes capable of life outside the womb. Fat begins to accumulate, filling out a scrawny body and preparing the baby for warmth in the outside world. The normal fetus gains three to four pounds during the eighth and ninth months. At the time of birth, a normal fetus is so big that it has almost outgrown its food supply, since the placenta has stopped growing and cannot keep up with the growing need for nourishment. In the last three months, the brain develops very rapidly. In the last two months, a fatty substance called myelin develops. This speeds up the transmission of nervous impulses and forms a sheath around the nerve fibers. All this time, the baby is gaining more weight. It sheds the down which covers most of the body and the hair on its head may grow very long - long enough, in fact, that the mother may tie a ribbon in a baby's hair right after birth.

lactation

Lactation is the production and release of milk to feed an infant. The production of milk begins prior to birth under the control of the hormone prolactin. Prolactin is produced in response to the suckling of an infant on the nipple, so milk is produced as long as active breastfeeding occurs. As soon as an infant is weaned, prolactin and milk production end soon after. The release of milk by the nipples is known as the "milk-letdown reflex" and is controlled by the hormone oxytocin. Oxytocin is also produced in response to infant suckling so that milk is only released when an infant is actively feeding.

Syphilis Statistics

Men account for the most cases of syphilis, with the vast majority of those cases occurring among men who have sex with men (MSM). STD Surveillance 2018 - Syphilis (October 8, 2019)FiguresTables Increase in Incidence of Congenital Syphilis — United States, 2012-2014 MMWR November 13, 2015Dear Colleague Letterpdf icon Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United Statespdf icon (February 13, 2013) STD Health Equity

Newborns and syphillis

New analysis finds 1 in 2 newborn syphilis cases occur due to gaps in testing and treatment during prenatal care. (June 4, 2020)

Providing Non-Vaccine Injectables

STD clinics may need to find alternate ways to deliver non-vaccine injectables such as ceftriaxone and benzathine penicillin G. Where allowed, clinics may want to consider referring STD patients to pharmacists for the delivery of these injectables.

syphilis treatment and care

Syphilis can be cured with the right antibiotics. However, treatment will not undo any damage that the infection has already caused. media iconLow Resolution Video What is the treatment for syphilis? There are no home remedies or over-the-counter drugs that will cure syphilis, but syphilis is easy to cure in its early stages. A single intramuscular injection of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) will cure a person who has primary, secondary or early latent syphilis. Three doses of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) at weekly intervals is recommended for individuals with late latent syphilis or latent syphilis of unknown duration. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done. Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Combinations of some penicillin preparations (e.g., Bicillin C-R, a combination of benzathine penicillin and procaine penicillin) are not appropriate treatments for syphilis, as these combinations provide inadequate doses of penicillin. Although data to support the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, ceftriaxone. These therapies should be used only in conjunction with close clinical and laboratory follow-up to ensure appropriate serological response and cure. Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

fallopian tubes according to barclay

The Fallopian tubes, also known as the uterine tubes, are a pair of 4-inch (10 cm) long narrow tubes connecting the ovaries to the uterus. Ova (egg cells) are carried to the uterus through the fallopian tubes following ovulation. The ova may also be fertilized while in the Fallopian tubes if sperm is present following sexual intercourse. The Fallopian tubes are located in the pelvic cavity extending laterally from the corners of the superior edge of the uterus and passing superior to the ovaries.The broad ligament of the uterus and suspensory ligaments support the Fallopian tubes and hold them in place relative to the uterus and ovaries. Each Fallopian tube begins as a very narrow tube at the uterus and gradually widens as it extends towards the ovary. The isthmus of the Fallopian tubes is the narrowest and thickest walled region of the fallopian tube bordering on the uterus. From the isthmus the Fallopian tube widens into the ampulla, which makes up the bulk of its length. Finally, the Fallopian tube widens greatly into the funnel-shaped infundibulum before ending superior and lateral to the ovary. Many finger-like projections known as fimbriae extend from the infundibulum to reach the surface of the ovary. Being continuous with the uterus, the Fallopian tubes contain many of the same tissue layers as the womb. The thin, outermost covering of the Fallopian tubes, the serosa, is made of a serous membrane of simple squamous epithelial tissue supported by areolar connective tissue. Thin serous fluid secreted from the serosa lubricates the Fallopian tubes and protects them from friction with neighboring organs. Deep to the serosa is the muscularis layer that contains the visceral muscle tissue responsible for movement of the Fallopian tubes. The innermost layer, the mucosa, lines the hollow lumen and is mostly made of ciliated columnar epithelial tissue. The Fallopian tubes are far from passive tubes in the female reproductive system; on the contrary, they play an extremely active role in the process of fertilization. Just prior to ovulation, smooth muscle tissue in the fimbriae responds to the changing levels of female sex hormones and begins producing slow, steady contractions. These contractions result in the sweeping of the surface of the ovary by the fimbriae in anticipation of the release of the ova. Once the ovum is released, the fimbriae pick it up and carry it into the infundibulum. Next, cilia in the mucosal lining and peristaltic waves of the muscularis carry the ovum through the infundibulum, ampulla, and isthmus toward the uterus. Sperm deposited into the vagina during sexual intercourse may enter the Fallopian tubes from the uterus and fertilize the ovum as it travels toward the womb.

female breasts

The breasts are a pair of milk-producing organs of the female reproductive system located on the left and right sides of the anterior thoracic (chest) region. Each breast projects outward from the anterior of the chest as a mass of skin-covered soft tissue. At the tip of the breast is a small cylindrical projection of erectile tissue called the nipple. The nipple is bordered by a ring of thickened, bumpy skin called the areola. Both the nipple and areola are highly pigmented compared to the surrounding skin of the breast, resulting in a darkened appearance Internally, each breast is made of many mammary glands arranged into a radial pattern around the nipple. Narrow mammary ducts connect the mammary glands to the nipple. Adipose tissue containing collagen and elastin fibers surrounds the mammary glands to provide strength and protection to the delicate glands and to project the glands outward from the chest. Within the adipose layer are bands of connective tissue called Cooper's ligaments (suspensory ligaments). These ligaments give the breasts support by connecting the skin of the breasts to the pectoralis muscles below them. The function of the breast is to provide milk to feed infants. Milk is produced and stored by the mammary glands and released through the mammary ducts and nipple. Sensitive nerve endings in the nipple send signals to the brain to produce the hormone oxytocin and initiate the release of milk. Other stimuli, such as manual stimulation, hearing a baby crying, or even just seeing a baby, can also cause oxytocin to be produced. Oxytocin causes the smooth muscle tissue surrounding the mammary glands to contract, forcing the milk out of the mammary glands. The breasts also contain many sensitive nerve endings and play a role in human sexual arousal. Stimulation of the breasts, and especially the nipples and areola, sends signals of pleasure to the brain. The erectile tissue of the nipples fills with blood in response to the stimuli of breastfeeding, sexual arousal, and even cool temperatures. Breast Cancer Breast cancer is second only to lung cancer as a cause of cancer death in women. Early detection is critical. Women should engage in regular self-exams (monthly) and a routine of clinical breast exams. Breast cancer can also occur in men. When men develop breast cancer, it is often a sign that they carry genetic variants that predispose them to developing it. Women and men can learn through DNA health tests whether they possess mutations in their BRCA1 and BRCA2 genes, which are associated with genetically higher risk of developing breast cancer.

cervix of uterus

The cervix of the uterus is the tapered inferior region of the uterus. Its name, cervix, comes from the Latin word meaning "neck" due to its role as the narrow connection between the larger body of the uterus above the vagina below. The cervix plays vital roles in the control of movement into and out of the uterus, protection of the fetus during pregnancy, and the delivery of the fetus during childbirth. The cervix makes up the lower one-third of the uterus and its tissues are continuous with the tissues that make up the rest of the uterus.Its outer covering is made of a simple squamous epithelium known as the perimetrium. Inside the perimetrium is the myometrium, a thick region of smooth muscle tissue that gives the cervix its ability to expand and contract. Compared to the rest of the uterus that contracts forcefully during childbirth, the myometrium of the cervix is thinner and used only as a sphincter to regulate the opening of the uterus. Lining the inside of the cervix is a thin layer of endometrium containing the epithelial cells that constantly produce cervical mucus. The cervix can be broken down into several anatomically distinct regions. The cervical canal is the hollow orifice through the cervix that connects the uterine cavity to the hollow lumen of the vagina. Connecting the cervical canal to the lumen of the vagina is the external os, a small circular opening surrounded by the external tissue of the cervix. The tissue of the cervix surrounding the external os is rounded and convex, causing the external os to protrude slightly into the vagina. Connecting the cervical canal to the uterine cavity is the internal os, a small circular opening where the cervical canal narrows before opening into the uterus. The cervix of the uterus acts as the gatekeeper of the uterus by controlling when substances can pass into and out of the uterus. To assist in this role, the epithelial lining of the cervix produces thick cervical mucus that fills the cervical canal and forms a mucus plug blocking the flow of material between the uterus and the vagina. Around the time of ovulation, the consistency of the cervical mucus becomes much thinner, allowing the passage of sperm into the uterus for fertilization. During pregnancy the cervix and its mucus plug protect the developing fetus by sealing the uterus from possible contamination by external pathogens. During menstruation, the smooth muscle tissue in the myometrium of the cervix dilates to allow the passage of menstrual flow and may cause sensations of pain and discomfort known as menstrual cramps. The process of childbirth requires the cervix to dilate to around ten centimeters in diameter in order to accommodate the head of the fetus as it passes into the birth canal. To achieve this feat, the cervix begins to dilate several days prior to the formal start of labor.

reproductive cycle

The female reproductive cycle is the process of producing an ovum and readying the uterus to receive a fertilized ovum to begin pregnancy. If an ovum is produced but not fertilized and implanted in the uterine wall, the reproductive cycle resets itself through menstruation. The entire reproductive cycle takes about 28 days on average, but may be as short as 24 days or as long as 36 days for some women.

female reproductive system

The female reproductive system includes the ovaries, fallopian tubes, uterus, vagina, vulva, mammary glands and breasts. These organs are involved in the production and transportation of gametes and the production of sex hormones. The female reproductive system also facilitates the fertilization of ova by sperm and supports the development of offspring during pregnancy and infancy.

Female Reproductive System (Posterior View)

The female reproductive system includes the ovaries, fallopian tubes, uterus, vagina, vulva, mammary glands and breasts. These organs are involved in the production and transportation of gametes and the production of sex hormones. The female reproductive system also facilitates the fertilization of ova by sperm and supports the development of offspring during pregnancy and infancy. Female Reproductive System Anatomy Ovaries The ovaries are a pair of small glands about the size and shape of almonds, located on the left and right sides of the pelvic body cavity lateral to the superior portion of the uterus. Ovaries produce female sex hormones such as estrogen and progesterone as well as ova (commonly called "eggs"), the female gametes. Ova are produced from oocyte cells that slowly develop throughout a woman's early life and reach maturity after puberty. Each month during ovulation, a mature ovum is released. The ovum travels from the ovary to the fallopian tube, where it may be fertilized before reaching the uterus. Fallopian Tubes The fallopian tubes are a pair of muscular tubes that extend from the left and right superior corners of the uterus to the edge of the ovaries. The fallopian tubes end in a funnel-shaped structure called the infundibulum, which is covered with small finger-like projections called fimbriae. The fimbriae swipe over the outside of the ovaries to pick up released ova and carry them into the infundibulum for transport to the uterus. The inside of each fallopian tube is covered in cilia that work with the smooth muscle of the tube to carry the ovum to the uterus. Uterus The uterus is a hollow, muscular, pear-shaped organ located posterior and superior to the urinary bladder. Connected to the two fallopian tubes on its superior end and to the vagina (via the cervix) on its inferior end, the uterus is also known as the womb, as it surrounds and supports the developing fetus during pregnancy. The inner lining of the uterus, known as the endometrium, provides support to the embryo during early development. The visceral muscles of the uterus contract during childbirth to push the fetus through the birth canal. Vagina The vagina is an elastic, muscular tube that connects the cervix of the uterus to the exterior of the body. It is located inferior to the uterus and posterior to the urinary bladder. The vagina functions as the receptacle for the penis during sexual intercourse and carries sperm to the uterus and fallopian tubes. It also serves as the birth canal by stretching to allow delivery of the fetus during childbirth. During menstruation, the menstrual flow exits the body via the vagina. Vulva The vulva is the collective name for the external female genitalia located in the pubic region of the body. The vulva surrounds the external ends of the urethral opening and the vagina and includes the mons pubis, labia majora, labia minora, and clitoris. The mons pubis, or pubic mound, is a raised layer of adipose tissue between the skin and the pubic bone that provides cushioning to the vulva. The inferior portion of the mons pubis splits into left and right halves called the labia majora. The mons pubis and labia majora are covered with pubic hairs. Inside of the labia majora are smaller, hairless folds of skin called the labia minora that surround the vaginal and urethral openings. On the superior end of the labia minora is a small mass of erectile tissue known as the clitoris that contains many nerve endings for sensing sexual pleasure. Breasts and Mammary Glands The breasts are specialized organs of the female body that contain mammary glands, milk ducts, and adipose tissue. The two breasts are located on the left and right sides of the thoracic region of the body. In the center of each breast is a highly pigmented nipple that releases milk when stimulated. The areola, a thickened, highly pigmented band of skin that surrounds the nipple, protects the underlying tissues during breastfeeding. The mammary glands are a special type of sudoriferous glands that have been modified to produce milk to feed infants. Within each breast, 15 to 20 clusters of mammary glands become active during pregnancy and remain active until milk is no longer needed. The milk passes through milk ducts on its way to the nipple, where it exits the body. Female Reproductive System Physiology The Reproductive Cycle The female reproductive cycle is the process of producing an ovum and readying the uterus to receive a fertilized ovum to begin pregnancy. If an ovum is produced but not fertilized and implanted in the uterine wall, the reproductive cycle resets itself through menstruation. The entire reproductive cycle takes about 28 days on average, but may be as short as 24 days or as long as 36 days for some women. Oogenesis and Ovulation Under the influence of follicle stimulating hormone (FSH), and luteinizing hormone (LH), the ovaries produce a mature ovum in a process known as ovulation. By about 14 days into the reproductive cycle, an oocyte reaches maturity and is released as an ovum. Although the ovaries begin to mature many oocytes each month, usually only one ovum per cycle is released. Fertilization Once the mature ovum is released from the ovary, the fimbriae catch the egg and direct it down the fallopian tube to the uterus. It takes about a week for the ovum to travel to the uterus. If sperm are able to reach and penetrate the ovum, the ovum becomes a fertilized zygote containing a full complement of DNA. After a two-week period of rapid cell division known as the germinal period of development, the zygote forms an embryo. The embryo will then implant itself into the uterine wall and develop there during pregnancy. Menstruation While the ovum matures and travels through the fallopian tube, the endometrium grows and develops in preparation for the embryo. If the ovum is not fertilized in time or if it fails to implant into the endometrium, the arteries of the uterus constrict to cut off blood flow to the endometrium. The lack of blood flow causes cell death in the endometrium and the eventual shedding of tissue in a process known as menstruation. In a normal menstrual cycle, this shedding begins around day 28 and continues into the first few days of the new reproductive cycle. Pregnancy If the ovum is fertilized by a sperm cell, the fertilized embryo will implant itself into the endometrium and begin to form an amniotic cavity, umbilical cord, and placenta. For the first 8 weeks, the embryo will develop almost all of the tissues and organs present in the adult before entering the fetal period of development during weeks 9 through 38. During the fetal period, the fetus grows larger and more complex until it is ready to be born. Lactation Lactation is the production and release of milk to feed an infant. The production of milk begins prior to birth under the control of the hormone prolactin. Prolactin is produced in response to the suckling of an infant on the nipple, so milk is produced as long as active breastfeeding occurs. As soon as an infant is weaned, prolactin and milk production end soon after. The release of milk by the nipples is known as the "milk-letdown reflex" and is controlled by the hormone oxytocin. Oxytocin is also produced in response to infant suckling so that milk is only released when an infant is actively feeding. Related genetic science If you're planning to start a family, you may be interested in finding out if you're a carrier of hereditary conditions that are recessive in you but could become dominant in your child. In the process, you can also find out if you're possibly more at risk of breast and ovarian cancers as well as hereditary hemochromatosis (one of most common hereditary disorders, which can lower libido). Learn more about DNA health testing, which can help you explore these concerns so that you can discuss with your healthcare provider or genetic counselor. Innerbody Research is the largest home health and wellness guide online, helping over one million visitors each month learn about health products and services. Our mission is to provide objective, science-based advice to help you make more informed choices.

fetus inside the womb

The fetus inside the womb is actually called an embryo four weeks after it comes into existence. Around the time of implantation, certain cells within the blastocyst (an early stage of embryonic development) organize themselves into a group that will give rise to the body of the offspring. This marks the beginning of the embryonic period of development. The offspring is called an embryo until the end of the eighth week, after which it is a fetus. Eventually, the outer cells of the embryo together with cells of the maternal endometrium (wall of the uterus) form a complex vascular structure called the placenta. This organ serves to attach the embryo to the uterine wall, to exchange nutrients, gases, and wastes between the maternal blood and the embryonic blood, and to secrete hormones. The embryo is shaped like a tadpole and is one-fifth of an inch long, about the size of a pea. Its heart has been beating for about a week. The head is defined, with eyes and rudiments of ears visible, and inside there is the beginning of a brain. So far, there are no bones. Tiny bumps are beginning to bulge where arms and legs will form. A week later, the embryo has grown to the size of a bean; the limb buds will have grown into little paws. The head has enlarged to accommodate the rapidly growing brain. The arms and hands become recognizable before the legs. From the third month on, all sorts of finishing touches will be put on. Fingernails appear around the ninth week. Eyelids, formed at the beginning of the third month, seal the eyes shut like a newborn kitten's until their development is completed. Facial features gradually shift: the eyes move closer together and the ear lobes move up where they belong from the earlier position low on the head. Lips form, cheeks fill out, taste buds develop on the tongue, and salivary glands come into being. The sex organs begin to produce the primitive eggs and male germ cells that are the seeds of the next generation - even as a woman is becoming a mother, her baby is preparing to make her a grandmother. Innerbody Research is the largest home health and wellness guide

Infant Skull and Fontanelles (Superior View)

The infant skull's bones are separated by fontanelles, or soft spots. At birth, the skull is incompletely developed, and fibrous membranes separate the cranial bones. These membranous areas are called fontanels. They permit some movement between the bones, so that the developing skull is partially compressible and can slightly change shape. This action enables an infant's skull to pass more easily through the birth canal. The infant skull is different from an adult skull by the distinct separation of plates making up the skull. With this comes an element of malleability resulting in the infant skull's temporary image of the mother's pelvic opening. Equally noticeable is the soft spot at the top of the skull, which will remain until the plates grow together. The anterior fontanelle and posterior fontanelle are the two areas of an infant's head where the skull bones have not completely covered the brain. The anterior fontanelle is located towards the front of the head. The posterior fontanelle is located at the upper back part of the head. The posterior fontanelle is no longer obvious when the infant is four months old. The anterior fontanelle can normally be felt until 9-16 months of age. Eventually the fontanelles close as the cranial bones grow together. The posterior fontanelle usually closes about two months after birth; the sphenoid fontanelle closes at about three months, the mastoid fontanelle closes near the end of the first year, but the anterior one may not close until the middle or end of the second year.

Infant Skull and Fontanelles (Lateral View)

The infant skull's bones are separated by fontanelles, or soft spots. At birth, the skull is incompletely developed, and fibrous membranes separate the cranial bones. These membranous areas are called fontanels. They permit some movement between the bones, so that the developing skull is partially compressible and can slightly change shape. This action enables an infant's skull to pass more easily through the birth canal. The infant skull is different from an adult skull by the distinct separation of plates making up the skull. With this comes an element of malleability resulting in the infant skull's temporary image of the mother's pelvic opening. Equally noticeable is the soft spot at the top of the skull, which will remain until the plates grow together. The anterior fontanelle and posterior fontanelle are the two areas of an infant's head where the skull bones have not completely covered the brain. The anterior fontanelle is located towards the front of the head. The posterior fontanelle is located at the upper back part of the head. The posterior fontanelle is no longer obvious when the infant is four months old. The anterior fontanelle can normally be felt until 9-16 months of age. Eventually the fontanelles close as the cranial bones grow together. The posterior fontanelle usually closes about two months after birth; the sphenoid fontanelle closes at about three months, the mastoid fontanelle closes near the end of the first year, but the anterior one may not close until the middle or end of the second year. Innerbody Research is the largest home health and wellness guide online, helping over one million visitors each month learn about health products and services. Our mission is to provide objective, science-based advice to help you make more informed choices.

labia majora

The labia majora (singular: labium majus) are a pair of rounded folds of skin and adipose that are part of the external female genitalia. Their function is to cover and protect the inner, more delicate and sensitive structures of the vulva, such as the labia minora, clitoris, urinary orifice, and vaginal orifice. The word "labia" comes from the Latin word for lips, which corresponds to the function of the labia majora surrounding the vaginal orifice like lips surround the mouth. The labia majora are homologous to the scrotum in males and develop from the same embryological tissue.The labia majora are located in the pubic region on the surface of the body lateral to the labia minora, clitoris, and vagina. They arise gradually from the skin of the pelvis and extend the mons pubis beyond the pelvic bones to the anus. Adipose tissue deep to the skin supports the labia majora and provides cushioning and flexibility to the pubic region. Together, the labia majora form the lateral borders of the pudendal cleft, the vertical fissure of the vulva. Anterior to the pudendal cleft, they join to form the anterior commissure of the labia majora, just inferior to the mons pubis. On the posterior end, the labia majora gradually merge with the surrounding skin in the perineal region at their posterior commissure. The major function of the labia majora is protection of the softer tissues of the vulva. Unlike the inner structures of the vulva, the labia majora contain many pubic hairs that help to protect the rest of the vulva from mechanical stress and friction. The adipose tissue of the labia majora also helps to cushion the vulva from exterior stresses. Many exocrine glands are associated with the hair follicles of labia majora, including apocrine sudoriferous glands, eccrine sudoriferous glands, and sebaceous glands. Eccrine sweat glands assist in thermoregulation by producing watery sweat, while sebaceous glands produce oil to lubricate the hair shafts and skin. Apocrine sweat glands produce a fatty secretion that is consumed by bacteria living on the skin, producing a particular form of body odor. It is believed that the odor produced by apocrine sweat glands once acted as a pheromone to attract mates.

labia minora

The labia minora are a pair of thin cutaneous folds that form part of the vulva, or external female genitalia. They function as protective structures that surround the clitoris, urinary orifice, and vaginal orifice. The labia minora are found within the vulva inferior to the mons pubis and medial to the labia majora within the pudendal cleft. They extend from the floor of the pudendal cleft to the top of the labia majora or beyond, depending on the individual. In fact, the labia minora show a considerable amount of variation in length, width, shape, and pigmentation between individuals.Unlike the surrounding mons pubis and labia majora, the labia minora are covered with hairless skin and contain very little adipose tissue. At their anterior end they meet at the clitoral hood, or prepuce, where they surround the lateral sides of the clitoris. From the clitoral hood, the labia minora extend inferiorly toward the anus, where they gradually decrease in size before merging with the skin of the perineum. The middle region of the labia minora covers and protects the urethral orifice and vaginal orifice from the exterior environment. The labia minora are organs made of several distinct layers of tissue. The outermost layer is made of non-keratinized stratified squamous epithelium continuous with the surrounding skin. The lack of keratin makes the labia minora less tough and waterproof than the surrounding skin, but also makes them smoother and softer. Deep to the epithelium is a layer of fibrous connective tissue continuous with the dermis of the skin. Collagen and elastin protein fibers present in the connective tissues provide strength and elasticity to the labia minora, while vascular and nervous tissues support the cells of the outer epithelial layer. Blood flowing through many tiny capillaries in the connective tissue layer gives the labia minora their pinkish color. Many sebaceous glands are also present in the connective tissue and extend to the surface of the labia minora via ducts. Sebum, or oil, produced by the sebaceous glands coats the surface of the labia minora to lubricate and protect the underlying tissues.

syphilis what you can do

The nation is facing an increase in syphilis rates among both men and women in every region of the country. Of utmost concern is the continued high rates among gay and bisexual men, as well as a devastating surge in congenital syphilis. Click on an image below to learn what healthcare providers, gay and bisexual men, and pregnant women can do to prevent syphilis. Call to Action Let's Work Together to Stem the Tide of Rising Syphilis in the United States:pdf icon CDC issues a call to action for communities impacted by the STD and other groups who have the power to reduce the burden of infection through research, treatment, and outreach. The document also lists how CDC will contribute to reducing syphilis burden. For printing, you might prefer this higher resolution version. pdf icon[PDF - 27 MB] Dear Colleague Letterpdf icon

ovarian ligament

The ovarian ligament is a rounded, cord-like thickening of the broad ligament, located at its lower end, where it is attached to the uterus. It, along with the other ovarian ligaments, attaches to the ovaries and help hold them in position. The largest of these ligaments, formed by a fold of peritoneum, is called the broad ligament. It is also attached to the uterine tubes and to the uterus. At its upper end, the ovary is held by a small fold of peritoneum called the suspensory ligament, which contains the ovarian blood vessels and nerves. At its lower end, it is attached to the uterus by a rounded, cord-like thickening of the broad ligament, called the ovarian ligament. The peritoneum is a two-layered membrane that supports the abdominal organs, produces lubricating fluid that allows the organs to flow smoothly over each other, and protects against infection.

ovaries according to Barclay

The ovaries, a pair of tiny glands in the female pelvic cavity, are the most important organs of the female reproductive system. Their importance is derived from their role in producing both the female sex hormones that control reproduction and the female gametes that are fertilized to form embryos. Each ovary is a small glandular organ about the shape and size of an almond. The ovaries are located on opposite sides of the uterus in the pelvic cavity and are attached to the uterus by the ovarian ligament. The open ends of the fallopian tubes rest just beyond the lateral surface of the ovaries to transport ova, or egg cells, to the uterus. The tissues of the ovaries are arranged into several distinct layers: The outmost layer of simple epithelium, known as the germinal epithelium, forms a soft, smooth covering for the ovary. The tunica albuginea is a thick band of tough fibrous connective tissue just below the germinal epithelium. It supports and protects the delicate underlying tissues. Deep to the tunica albuginea is the ovarian cortex, which contains follicles and their supporting connective tissues. The follicles contain oocytes that mature into ova throughout a woman's reproductive years. The innermost layer, the ovarian medulla, contains most of the vascular tissue that supports the other layers of the ovary. Function of the Ovaries The ovaries play two central roles in the female reproductive system by acting as both glands and gonads. Acting as glands, the ovaries produce several female sex hormones including estrogens and progesterone. Estrogen controls the development of the mammary glands and uterus during puberty and stimulates the development of the uterine lining during the menstrual cycle. Progesterone acts on the uterus during pregnancy to allow the embryo to implant and develop in the womb. At birth the ovaries contain anywhere from several hundred thousand to several million circular bundles of cells known as follicles. Each follicle surrounds and supports a single oocyte that has the ability to mature into an ovum, the female gamete. Despite this large number of potential ova, only around 4,000 oocytes survive to puberty and only 400 oocytes mature into ova in a woman's lifetime. During each menstrual cycle around 10-20 follicles and their oocytes begin to develop under the influence of the pituitary hormone follicle-stimulating hormone (FSH). Of these follicles, only one cell completes its development and becomes a mature ovum. Around the middle of the menstrual cycle the mature ovum is released to the surface of the ovary. Fingerlike projections of the fallopian tubes, known as fimbriae, sweep the ovum from the surface of the ovary and into the fallopian tube to be transported to the uterus. Health Concerns Polycystic ovary syndrome (PCOS) is a very common disorder that causes a variety of symptoms in women, including disruption of a woman's normal menstrual cycle. Ovarian cancer is the fifth highest cause of cancer death among American women. DNA health tests can help you discover if you are at a genetically higher risk of developing ovarian and breast cancers.

Birth (postpartum)

The postpartum part of birth is the last stage of labor. Labor is divided into three stages and the last of these stages is called the placental stage, or delivery of the afterbirth. It occurs generally within ten to fifteen minutes after the actual childbirth is complete. The placenta is separated from the uterine wall and expelled as the afterbirth. Forceful contractions of the uterus characterize this stage. Constriction of uterine blood vessels occurs to prevent hemorrhage. In a normal delivery, blood loss does not exceed 350 milliliters, or roughly three-quarters of a pint of blood.

uterus

The uterus is a hollow, muscular, pear-shaped organ located posterior and superior to the urinary bladder. Connected to the two fallopian tubes on its superior end and to the vagina (via the cervix) on its inferior end, the uterus is also known as the womb, as it surrounds and supports the developing fetus during pregnancy. The inner lining of the uterus, known as the endometrium, provides support to the embryo during early development. The visceral muscles of the uterus contract during childbirth to push the fetus through the birth canal.

uterus according to barclay

The uterus, also commonly known as the womb, is a hollow muscular organ of the female reproductive system that is responsible for the development of the embryo and fetus during pregnancy. An incredibly distensible organ, the uterus can expand during pregnancy from around the size of a closed fist to become large enough to hold a full term baby. It is also an incredibly strong organ, able to contract forcefully to propel a full term baby out of the body during childbirth The uterus is approximately the shape and size of a pear and sits in an inverted position within the pelvic cavity of the torso. It is located along the body's midline posterior to the urinary bladder and anterior to the rectum. The narrow inferior region of the uterus, known as the cervix, connects the uterus to the vagina below it and acts as a sphincter muscle to control the flow of material into and out of the uterus. The body (or corpus) of the uterus is the wider region of the uterus superior to the cervix. The body is an open and hollow region where the fertilized egg, or zygote, implants itself and develops during pregnancy. The walls of the body are much thicker than those of the cervix as they provide for the protection and support of the developing fetus and contain the muscles that propel the fetus out of the mother's body during childbirth. Superior to the body is a domed region known as the fundus of the uterus. The fallopian tubes extend laterally from the corners of the fundus. Three distinct tissue layers make up the walls of the uterus: The perimetrium is the outermost layer that forms the external skin of the uterus. It is a serous membrane continuous with the peritoneum that covers the major organs of the abdominopelvic cavity. The perimetrium protects the uterus from friction by forming a smooth layer of simple squamous epithelium along its surface and by secreting watery serous fluid to lubricate its surface. Deep to the perimetrium layer, the myometrium forms the middle layer of the uterus and contains many layers of visceral muscle tissue. During pregnancy the myometrium allows the uterus to expand and then contracts the uterus during childbirth. Inside the myometrium is the endometrium layer that borders the hollow lumen of the uterus. The endometrium is made of simple columnar epithelial tissue with many associated exocrine glands and a highly vascular connective tissue that provides support to the developing embryo and fetus during pregnancy. Around the time of ovulation the uterus builds a thick layer of vascular endometrial tissue in preparation to receive a zygote, or fertilized egg cell. If the egg cell does not become fertilized by the time it reaches the uterus, it will pass through the uterus and trigger the blood vessels of the endometrium to atrophy and the uterine lining to be shed. The shedding of the egg cell and uterine lining is known as menstruation and occurs approximately every 28 days for most women. In the case of successful fertilization of the ova, a zygote will implant itself into the endometrial lining, where it begins to develop over many weeks into an embryo and eventually a fetus. As the embryo develops into a fetus, it triggers changes within the endometrium that lead to the formation of the placenta. The placenta provides the developing fetus with vital nutrients and oxygen from the mother's blood, while transferring carbon dioxide and metabolic waste products to the mother's blood for disposal. At the end of pregnancy, the uterus plays a critical role in the process of childbirth. Prior to delivery, hormones trigger waves of smooth muscle contraction in the myometrium that slowly increase in strength and frequency. At the same time, the smooth muscle tissue of the cervix begins to efface, or thin, and dilate from less than a centimeter in diameter to around ten centimeters at full dilation. Once the cervix is fully dilated, the uterine contractions drastically increase in intensity and duration until the fetus is pushed out of the uterus, through the vagina, and out of the mother's body. Women's Reproductive Healthcare Access to reproductive health care and related products is changing dramatically. Many women are discovering new ways to access healthcare and order products and tests online or via apps. To learn more about these opportunities and whether they're right for you, visit our reviews: Hers review. We tested out a website offering virtual doctor's visits, contraception and other services. Uqora review. Find out what we think about this service, which focuses strictly on treating and preventing UTIs. Nurx review. We'll tell you the pros and cons of this service, which offers testing and treatment for many common STIs as well as contraception.

vagina according to barclay

The vagina is an elastic, muscular tube connecting the cervix of the uterus to the vulva and exterior of the body. The vagina is located in the pelvic body cavity posterior to the urinary bladder and anterior to the rectum. Measuring around 3 inches in length and less than an inch in diameter, the vagina stretches to become several inches longer and many inches wider during sexual intercourse and childbirth. The inner surface of the vagina is folded to provide greater elasticity and to increase friction during sexual intercourse. The inner lining of the vagina is made of non-keratinized stratified squamous epithelial tissue. This tissue provides protection from friction to the underlying layers of the vagina. Watery secretions produced by the vaginal epithelium lubricate the vagina and have an acidic pH to prevent the growth of bacteria and yeast. Sometimes yeast infections occur, which require treatment. See our Hers review for information about a service that provides easy access to yeast infection treatment. The acidic pH also makes the vagina an inhospitable environment for sperm, which has resulted in males producing alkaline seminal fluid to neutralize the acid and improve the survival of sperm. Deep to the epithelial layer is the lamina propria, a layer of connective tissue with many elastin fibers that allow the vagina to stretch. A layer of smooth muscle tissue located deep to the lamina propria allows the vagina to expand and contract during sexual intercourse and childbirth. Surrounding the smooth muscle is the outermost layer of the vagina known as the tunica externa. The tunica externa is a layer of dense irregular connective tissue that forms the outer protective shell of the vagina. During sexual intercourse, the vagina functions as the receptacle for the penis and carries sperm to the uterus and fallopian tubes. The elastic structure of the vagina allows it to stretch in both length and diameter to accommodate the penis. During childbirth, the vagina acts as the birth canal to conduct the fetus from the uterus and out of the mother's body. Once again, the vagina's elasticity allows it to greatly increase its diameter to accommodate the fetus. Finally, the vagina provides a passageway for menstrual flow from the uterus to exit the body during menstruation. Sexual activity can also lead unfortunately to STIs. Treatments and preventative methods have improved, and a growing number of people are finding it more convenient to access these health services and products in non-traditional ways, via websites and apps. Read our Nurx review to learn more about this new kind of health service experience.

vagina

The vagina is an elastic, muscular tube that connects the cervix of the uterus to the exterior of the body. It is located inferior to the uterus and posterior to the urinary bladder. The vagina functions as the receptacle for the penis during sexual intercourse and carries sperm to the uterus and fallopian tubes. It also serves as the birth canal by stretching to allow delivery of the fetus during childbirth. During menstruation, the menstrual flow exits the body via the vagina.

vulva according to barclay

The vulva is the collective name for the external female genitalia in the pubic region, including the labia, clitoris, and urethral and vaginal openings. These organs work together to support urination and sexual reproduction. The exterior of the vulva begins as a mound of skin-covered adipose known as the mons pubis that arises from the skin covering the pubis bone in the pubic region. As it continues inferiorly, the mons pubis divides laterally into the two parallel labia majora. The labia majora are wide folds of skin and adipose that rise beyond the mons pubis and surround the pudendal cleft, a deep vertical furrow in the center of the vulva. Both the mons pubis and labia majora are covered in pubic hair following puberty and serve to protect the delicate structures of the vulva found in the pudendal cleft. Medial to the labia majora in the pudendal cleft are a pair of hairless folds of skin known as the labia minora. Compared to the labia majora, the labia minora are much thinner and longer structures, extending from the pudendal cleft beyond the top of the labia majora. Nestled within the labia minora from anterior to posterior are the clitoris, the external urethral orifice, and the vaginal orifice. The labia minora meet anteriorly just above the clitoris at a small fold of tissue known as the prepuce (or clitoral hood) and merge posteriorly just below the vaginal orifice. The clitoris is a small mass of highly sensitive erectile tissue that receives mechanical stimulation during sexual contact and transmits sensations of sexual pleasure to the brain. Thousands of touch and pressure sensitive nerve endings are packed into the clitoris, making it the most sensitive erogenous organ of the vulva. During sexual stimulation, erectile tissue in the clitoris fills with blood, causing it to enlarge, extend beyond the prepuce, and become more susceptible to stimulation. The clitoris also extends into the internal tissues of the vulva and is sensitive to mechanical stimulus inside of the vagina as well. The external urethral orifice is a small hole in the vulva surrounded by a ring of slightly raised skin. It provides the connection for the urethra to the body's exterior and permits the release of urine during the process of urination. Pathogenic bacteria present on the skin covering the vulva may enter the urethra through the external urethral orifice, resulting in urinary tract infections. The vaginal orifice is the external connection between the vagina and the body's exterior. It is much larger and more elastic than the external urethral orifice and allows for penetration during sexual intercourse as well as the passage of the fetus during childbirth.

vulva

The vulva is the collective name for the external female genitalia located in the pubic region of the body. The vulva surrounds the external ends of the urethral opening and the vagina and includes the mons pubis, labia majora, labia minora, and clitoris. The mons pubis, or pubic mound, is a raised layer of adipose tissue between the skin and the pubic bone that provides cushioning to the vulva. The inferior portion of the mons pubis splits into left and right halves called the labia majora. The mons pubis and labia majora are covered with pubic hairs. Inside of the labia majora are smaller, hairless folds of skin called the labia minora that surround the vaginal and urethral openings. On the superior end of the labia minora is a small mass of erectile tissue known as the clitoris that contains many nerve endings for sensing sexual pleasure.

Testing for STDs Outside of Healthcare Settings/Clinics

There are currently no FDA-cleared self-tests for chlamydia, gonorrhea or syphilis, the most commonly reported STDs in the U.S. However, there are options for "at-home specimen collection," which allows a patient to collect their own vaginal, rectal or oral specimen or blood sample and take or mail it to a lab for testing. There is an FDA-approved HIV self-test. These options could be useful when in-person services are not available or feasible. Please see the Dear Colleague Letters linked above for other STD prevention and care telehealth services and innovative approaches that may be useful to consider.

Herpes treatment and care

There is no cure for herpes, but medication is available to reduce symptoms and make it less likely that you will spread herpes to a sex partner. Is there a cure or treatment for herpes? There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy (i.e. daily use of antiviral medication) for herpes can reduce the likelihood of transmission to partners. Several clinical trials have tested vaccines against genital herpes infection, but there is currently no commercially available vaccine that is protective against genital herpes infection. One vaccine trial showed efficacy among women whose partners were HSV-2 infected, but only among women who were not infected with HSV-1. No efficacy was observed among men whose partners were HSV-2 infected. A subsequent trial testing the same vaccine showed some protection from genital HSV-1 infection, but no protection from HSV-2 infection.

bacterial vaginosis treatment and car

Treatment is especially important for pregnant women. Pregnant women with BV may deliver premature (early) or low birth-weight babies. Can bacterial vaginosis be cured? BV will sometimes go away without treatment. But if you have symptoms of BV you should be checked and treated. It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may recur even after treatment. Treatment may also reduce the risk for some STDs. Male sex partners of women diagnosed with BV generally do not need to be treated. BV may be transferred between female sex partners.

syphilis lab information

Treponema pallidum Requests by Commercial Companies CDC's Division of STD Prevention is making available a Treponema pallidum subspecies pallidum (T. pallidum) strain propagated in rabbits for research and development purposes. The cultures are intended solely for companies developing and/or seeking FDA approval of syphilis diagnostic tests in the United States. Spirochete Request For Training CDC's Division of STD Prevention offers T. pallidum spirochetes in aliquots of 0.5 ml - 1.0 ml for training on the use of dark field microscopy. This is offered specifically to public health laboratories and institutions within the United States for training purposes only. Please contact Dr. Allan Pillay at 404-639-2140 or [email protected] to request live cryopreserved spirochetes. Be sure to include required information as outlined on the Spirochete Request for Training page. Syphilis Serum Repository CDC's Division of STD Prevention and the Association of Public Health Laboratories have developed a Syphilis Serum Repository. The repository is composed of residual syphilis positive serum samples which may be requested to facilitate research and development of syphilis diagnostic tests. This section includes more information about the Syphilis Serum Repository, how it may be used, and the process to request specimens. For any questions about this form, please contact Dr. Allan Pillay at 404-639-2140 or [email protected]. Clinical Advisory: Ocular Syphilis in the United States If you are planning on collecting clinical specimens for molecular typing and need assistance with the collection procedure or shipment of samples, please contact Dr. Allan Pillay at 404-639-2140 or [email protected].

trichomoniasis treatment and care

Trichomoniasis can be cured with a single dose of prescription antibiotics. What is the treatment for trichomoniasis? Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth. It is okay for pregnant women to take this medication. Some people who drink alcohol within 24 hours after taking this kind of antibiotic can have uncomfortable side effects. People who have been treated for trichomoniasis can get it again. About 1 in 5 people get infected again within 3 months after treatment. To avoid getting reinfected, make sure that all of your sex partners get treated too, and wait to have sex again until all of your symptoms go away (about a week). Get checked again if your symptoms come back.

Oogenesis and ovulation

Under the influence of follicle stimulating hormone (FSH), and luteinizing hormone (LH), the ovaries produce a mature ovum in a process known as ovulation. By about 14 days into the reproductive cycle, an oocyte reaches maturity and is released as an ovum. Although the ovaries begin to mature many oocytes each month, usually only one ovum per cycle is released.

clinical advisor: ocular syphilis in the united states

Updated March 24, 2016 Between December 2014 and March 2015, 12 cases of ocular syphilis were reported from two major cities, San Francisco and Seattle. Subsequent case finding indicated more than 200 cases reported over the past 2 years from 20 states. The majority of cases have been among HIV-infected MSM; a few cases have occurred among HIV-uninfected persons including heterosexual men and women. Several of the cases have resulted in significant sequelae including blindness. Ocular syphilis can involve almost any eye structure, but posterior uveitis and panuveitis are the most common. Additional manifestations may include anterior uveitis, optic neuropathy, retinal vasculitis and interstitial keratitis. Ocular syphilis may lead to decreased visual acuity including permanent blindness. Ocular syphilis can be associated with neurosyphilis. Both ocular syphilis and neurosyphilis can occur at any stage of syphilis, including primary and secondary syphilis. While previous research supports evidence of neuropathogenic strains of syphilis, it remains unknown if some Treponema pallidum strains have a greater likelihood of causing ocular infections. Clinicians should be aware of ocular syphilis and screen for visual complaints in any patient at risk for syphilis (MSM, HIV-infected persons, others with risk factors and persons with multiple or anonymous partners). All patients with syphilis should receive an HIV test if status is unknown or previously HIV-negative Patients with positive syphilis serology and early syphilis without ocular symptoms should receive a careful neurological exam including all cranial nerves. Patients with syphilis and ocular complaints should receive immediate ophthalmologic evaluation. A lumbar puncture with cerebrospinal fluid (CSF) examination should be performed in patients with syphilis and ocular complaints. Ocular syphilis should be managed according to treatment recommendations for neurosyphilis Cases of ocular syphilis should be reported to your state or local health department within 24 hours of diagnosis. Ocular syphilis cases diagnosed since December 1, 2014, should be reported to your local or state health department. The case definition for an ocular syphilis case is as follows: a person with clinical symptoms or signs consistent with ocular disease (i.e. uveitis, panuveitis, diminished visual acuity, blindness, optic neuropathy, interstitial keratitis, anterior uveitis, and retinal vasculitis) with syphilis of any stage. Pre-antibiotic clinical samples (whole blood in EDTA tubes, primary lesions and moist secondary lesions, CSF or ocular fluid) should be saved and stored at -80°C immediately upon collection for molecular typing. If you are a healthcare provider and need advice from CDC regarding the clinical management of ocular syphilis, contact Dr. Kimberly Workowski at 404-639-1898 or [email protected]. If you are planning on collecting clinical specimens for molecular typing and need assistance with the collection procedure or shipment of samples, please contact Dr. Allan Pillay at 404-639-2140 or [email protected]. Related Content Ocular Syphilis — Eight Jurisdictions, United States, 2014-2015 MMWR November 4, 2016 Keep an Eye Out For Ocular Syphilisexternal icon - Tom Peterman, MD, MSc; Kimberly Workowski, MD discuss the recent increase in ocular syphilis cases and provide physicians with information on diagnosis and treatment in this Medscape CDC Expert Commentary (Requires free membership to access commentary) (February 8, 2016) Notes from the Field: A Cluster of Ocular Syphilis Cases — Seattle, Washington, and San Francisco, California, 2014-2015 MMWR October 16, 2015

HIV/AIDS and STDs treatment and care

Will treating STDs prevent me from getting HIV? No, STD treatments will not prevent HIV infection. If you get treated for an STD, this will help to prevent its complications, and prevent spreading STDs to your sex partners. Treatment for an STD other than HIV does not prevent the spread of HIV. If you are diagnosed with an STD, talk to your doctor about ways to protect yourself and your partner(s) from getting reinfected with the same STD, or getting HIV.

15-24 year olds

account for half of all new STD infections While sexually transmitted diseases (STDs) affect individuals of all ages, STDs take a particularly heavy toll on young people. CDC estimates that youth ages 15-24 make up just over one quarter of the sexually active population, but account for half of the 20 million new sexually transmitted infections that occur in the United States each year. The resources on this page provide information about the impact of STDs on youth as well as resources for reaching this population.

PID

pelvic inflammatory disease can cause infertility untreated STDs can cause PID Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious condition, in women. 1 in 8 women with a history of PID experience difficulties getting pregnant. You can prevent PID if you know how to protect yourself. Basic Fact Sheet | Detailed Version Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated (added to your web site). Print versionpdf icon What is PID? Pelvic inflammatory disease is an infection of a woman's reproductive organs. It is a complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that are not sexually transmitted can also cause PID. How do I get PID? You are more likely to get PID if you Have an STD and do not get treated; Have more than one sex partner; Have a sex partner who has sex partners other than you; Have had PID before; Are sexually active and are age 25 or younger; Douche; Use an intrauterine device (IUD) for birth control. However, the small increased risk is mostly limited to the first three weeks after the IUD is placed inside the uterus by a doctor. How can I reduce my risk of getting PID? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting PID: Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results; Using latex condoms the right way every time you have sex. How do I know if I have PID? There are no tests for PID. A diagnosis is usually based on a combination of your medical history, physical exam, and other test results. You may not realize you have PID because your symptoms may be mild, or you may not experience any symptoms. However, if you do have symptoms, you may notice Pain in your lower abdomen; Fever; An unusual discharge with a bad odor from your vagina; Pain and/or bleeding when you have sex; Burning sensation when you urinate; or Bleeding between periods. You should Be examined by your doctor if you notice any of these symptoms; Promptly see a doctor if you think you or your sex partner(s) have or were exposed to an STD; Promptly see a doctor if you have any genital symptoms such as an unusual sore, a smelly discharge, burning when peeing, or bleeding between periods; Get a test for chlamydia every year if you are sexually active and younger than 25 years of age. Have an honest and open talk with your health care provider if you are sexually active and ask whether you should be tested for other STDs. Can PID be cured? Yes, if PID is diagnosed early, it can be treated. However, treatment won't undo any damage that has already happened to your reproductive system. The longer you wait to get treated, the more likely it is that you will have complications from PID. While taking antibiotics, your symptoms may go away before the infection is cured. Even if symptoms go away, you should finish taking all of your medicine. Be sure to tell your recent sex partner(s), so they can get tested and treated for STDs, too. It is also very important that you and your partner both finish your treatment before having any kind of sex so that you don't re-infect each other. You can get PID again if you get infected with an STD again. Also, if you have had PID before, you have a higher chance of getting it again. What happens if I don't get treated? If diagnosed and treated early, the complications of PID can be prevented. Some of the complications of PID are Formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage; Ectopic pregnancy (pregnancy outside the womb); Infertility (inability to get pregnant); Long-term pelvic/abdominal pain. What is pelvic inflammatory disease? Pelvic inflammatory disease (PID) is a clinical syndrome that results from the ascension of microorganisms from the cervix and vagina to the upper genital tract. PID can lead to infertility and permanent damage of a woman's reproductive organs. How do women get pelvic inflammatory disease? Women develop PID when certain bacteria, such as chlamydia or gonorrhea, move upward from a woman's vagina or cervix into her reproductive organs. PID is a serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. What causes pelvic inflammatory disease? A number of different microorganisms can cause or contribute to PID. The sexually transmitted pathogens Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been implicated in a third to half of PID cases.1,2 However, endogenous microorganisms, including gram positive and negative anaerobic organisms and aerobic/facultative gram positive and negative rods and cocci, found at high levels in women with bacterial vaginosis, also have been implicated in the pathogenesis of PID 3,4 Newer data suggest that Mycoplasma genitalium may also play a role in PID and may be associated with milder symptoms 5,6 although one study failed to demonstrate a significant increase in PID following detection of M. genitalium in the lower genital tract.7 Because of the polymicrobial nature of PID, broad-spectrum regimens that provide adequate coverage of likely pathogens are recommended. What are the signs and symptoms of pelvic inflammatory disease? Women with PID present with a variety of clinical signs and symptoms that range from subtle and mild to severe. PID can go unrecognized by women and their health care providers when the symptoms are mild. Despite lack of symptoms, histologic evidence of endometritis has been demonstrated in women with subclinical PID.8 When present, signs and symptoms of PID are nonspecific, so other reproductive tract illnesses and diseases of both the urinary and the gastrointestinal tracts should be considered when evaluating a sexually active woman with lower abdominal pain. Pregnancy (including ectopic pregnancy) must also be excluded, as PID can occur concurrently with pregnancy. When symptoms are present, the most common symptoms of PID are Lower abdominal pain Mild pelvic pain Increased vaginal discharge Irregular menstrual bleeding Fever (>38° C) Pain with intercourse Painful and frequent urination Abdominal tenderness Pelvic organ tenderness Uterine tenderness Adnexal tenderness Cervical motion tenderness Inflammation What are the complications of pelvic inflammatory disease? Complications of PID include Tubo-ovarian abscess (TOA) Tubal factor infertility Ectopic pregnancy Chronic pelvic pain Recurrent episodes of PID and increased severity of tubal inflammation detected by laparoscopy are associated with greater risk of infertility following PID.9 However, even subclinical PID has been associated with infertility.10 This emphasizes the importance of following screening and treatment recommendations for chlamydia and gonorrhea to prevent PID when possible, and promptly and appropriately treating cases of PID that do occur. Tubo-ovarian abscess (TOA) is a serious short-term complication of PID that is characterized by an inflammatory mass involving the fallopian tube, ovary, and, occasionally, other adjacent pelvic organs. The microbiology of TOAs is similar to PID and the diagnosis necessitates initial hospital admission. Treatment includes broad-spectrum antibiotics with or without a drainage procedure, with surgery often reserved for patients with suspected rupture or who fail to respond to antibiotics. Women infected with HIV may be at higher risk for TOA. Mortality from PID is less than 1% and is usually secondary to rupture of a TOA or to ectopic pregnancy. How is pelvic inflammatory disease diagnosed? The wide variation in symptoms and signs associated with PID can make diagnosis challenging. No single historical, physical, or laboratory finding is both sensitive and specific for the diagnosis of PID. Clinicians should therefore maintain a low threshold for the diagnosis of PID, particularly in young, sexually active women. Criteria have been developed for the diagnosis of PID.11 Presumptive treatment for PID should be initiated in sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more of the following minimum clinical criteria are present on pelvic examination: cervical motion tendernessor uterine tendernessor adnexal tenderness. The requirement that all three minimum criteria be present before the initiation of empiric treatment could result in insufficient sensitivity for the diagnosis of PID. After deciding whether to initiate empiric treatment, clinicians should also consider the risk profile for STDs. More elaborate diagnostic evaluation frequently is needed because incorrect diagnosis and management of PID might cause unnecessary morbidity. For example, the presence of signs of lower-genital-tract inflammation (predominance of leukocytes in vaginal secretions, cervical exudates, or cervical friability), in addition to one of the three minimum criteria, increases the specificity of the diagnosis. One or more of the following additional criteria can be used to enhance the specificity of the minimum clinical criteria and support a diagnosis of PID: oral temperature >101°F (>38.3°C); abnormal cervical mucopurulent discharge or cervical friability; presence of abundant numbers of WBC on saline microscopy of vaginal fluid; elevated erythrocyte sedimentation rate; elevated C-reactive protein; and laboratory documentation of cervical infection with N. gonorrhoeae or C. trachomatis. Most women with PID have either mucopurulent cervical discharge or evidence of WBCs on a microscopic evaluation of a saline preparation of vaginal fluid (i.e., wet prep). If the cervical discharge appears normal and no WBCs are observed on the wet prep of vaginal fluid, the diagnosis of PID is unlikely, and alternative causes of pain should be considered. A wet prep of vaginal fluid also can detect the presence of concomitant infections (e.g., BV and trichomoniasis). The most specific criteria for diagnosing PID include: endometrial biopsy with histopathologic evidence of endometritis; transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex, or Doppler studies suggesting pelvic infection (e.g., tubal hyperemia); or laparoscopic findings consistent with PID. A diagnostic evaluation that includes some of these more extensive procedures might be warranted in some cases. Endometrial biopsy is warranted in women undergoing laparoscopy who do not have visual evidence of salpingitis, because endometritis is the only sign of PID for some women. A serologic test for human immunodeficiency virus (HIV) is also recommended. A pregnancy test should always be performed to exclude ectopic pregnancy and because PID can occur concurrently with pregnancy. When the diagnosis of PID is questionable, or when the illness is severe or not responding to therapy, further investigation may be warranted using other invasive procedures (endometrial biopsy, transvaginal ultrasonography, magnetic resonance imaging, or laparoscopy). How is pelvic inflammatory disease treated? PID is treated with broad spectrum antibiotics to cover likely pathogens. Several types of antibiotics can cure PID. Antibiotic treatment does not, however, reverse any scarring that has already been caused by the infection. For this reason, it is critical that a woman receive care immediately if she has pelvic pain or other symptoms of PID. Prompt antibiotic treatment could prevent severe damage to the reproductive organs. Recommended treatment regimens can be found in the 2015 STD Treatment Guidelines. Health care providers should emphasize to their patients that although their symptoms may go away before the infection is cured, they should finish taking all of the prescribed medicine. Additionally, a woman's sex partner(s) should be treated to decrease the risk of re-infection, even if the partner(s) has no symptoms. Although sex partners may have no symptoms, they may still be infected with the organisms that can cause PID. In certain cases, clinicians may recommend hospitalization to treat PID. This decision should be based on the judgment of the health care provider and the use of suggested criteria found in the 2015 STD Treatment Guidelines. If a woman's symptoms continue, or if an abscess does not resolve, surgery may be needed. What should a patient do after being diagnosed with pelvic inflammatory disease? A patient should abstain from sexual intercourse until she and her partner(s) have completed treatment. Female latex condoms are also an option if a woman prefers them or if her male partner chooses not to use male condoms. Women who are told they have an STD and are treated for it should notify all of their recent sex partners so they can see a health care provider and be evaluated for STDs. The diagnosis of PID provides an opportunity to educate adolescent and young women about prevention of STDs, including abstinence, consistent use of barrier methods of protection, immunization, and the importance of receiving periodic screening for STDs and HIV. How can pelvic inflammatory disease be prevented? Latex condoms may reduce the risk of PID by preventing STDs. Since STDs play a major role in PID, screening of women at risk for infection and treatment of infected women and their sex partners can help to minimize the risk of PID. Screening of young sexually active women for chlamydia has been shown to decrease the incidence of PID.12, 13 CDC recommends that providers screen the following populations for chlamydia and gonorrhea: all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. What are the risk factors for developing pelvic inflammatory disease? Risk factors for PID include factors associated with STD acquisition, such as younger age, having a new or multiple sex partners, having a sex partner who has other concurrent sex partners, and inconsistent use of condoms during sex. Other factors that have been associated with PID include a history of STDs or prior PID, and vaginal douching.15 A small increased risk of PID associated with intrauterine device (IUD) use is primarily confined to the first three weeks after IUD insertion.16 Is the number of women in the United States being diagnosed with pelvic inflammatory disease increasing? No. Over the last decade, there have been several studies published suggesting overall declines in PID diagnosis in both hospital and ambulatory settings.17-20 While no single explanation exists for this declining trend, some have suggested that changes in sexually transmitted disease rates, increases in chlamydia screening coverage, availability of antimicrobial therapies that increase adherence to treatment, and more sensitive diagnostic technologies, could be impacting PID rates.21 How common is pelvic inflammatory disease in the United States? Despite declining trends, PID is a frequent and important infection that occurs among women of reproductive age. Based on data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle, the estimated prevalence of self-reported lifetime PID was 4.4% in sexually experienced women of reproductive age (18-44 years). 15 This equates to an estimated 2.5 million women in the United States with a reported lifetime history of PID diagnosis . The prevalence was highest in women at increased risk, such as those with previous sexually transmitted infections (STIs). 15 The significant burden of disease attributed to PID comes predominantly from the long-term reproductive sequelae of tubal infection: tubal factor infertility, ectopic pregnancy, and pelvic adhesions, which can lead to chronic pelvic pain. Our knowledge of the longitudinal outcomes for affected women who experience PID is primarily derived from data published using a Scandinavian cohort of inpatients diagnosed with PID. 22, 23 Data from this study indicated that those women with PID were more likely to have ectopic pregnancy (6 times increased rate), tubal factor infertility (ranging 8% after first episode to as high as 40% after three episodes) and chronic pelvic pain (18% following 1 episode). What is the economic burden of pelvic inflammatory disease in the United States? A decline in incidence of PID is also reflected in the most recent cost estimates of PID and its sequelae. Direct medical expenditures for PID and its sequelae were estimated at $1.88 billion in 199824, compared to approximately $2.7 billion estimated in 1990.25 Based on NHANES 2013-2014 data, an estimated 2.5 million women aged 18-44 years in the United States reported a lifetime history of PID diagnosis , with each case of PID having an estimated cost of $3,202 .26 How can clinicians manage PID? A critical component to the outpatient management is short-term follow-up, especially in the adolescent population. Since many adolescent women rely on outpatient services for the evaluation and treatment of STD symptoms, the need for a low diagnostic and management threshold for PID is even more critical, as the likelihood for additional follow-up care is low.

Bacterial Vaginosis (BV)

Any woman can get bacterial vaginosis. Having bacterial vaginosis can increase your chance of getting an STD. What is bacterial vaginosis? Bacterial vaginosis (BV) is a condition that happens when there is too much of certain bacteria in the vagina. This changes the normal balance of bacteria in the vagina. How common is bacterial vaginosis? Bacterial vaginosis is the most common vaginal condition in women ages 15-44. How is bacterial vaginosis spread? Researchers do not know the cause of BV or how some women get it. We do know that the condition typically occurs in sexually active women. BV is linked to an imbalance of "good" and "harmful" bacteria that are normally found in a woman's vagina. Having a new sex partner or multiple sex partners, as well as douching, can upset the balance of bacteria in the vagina. This places a woman at increased risk for getting BV. We also do not know how sex contributes to BV. There is no research to show that treating a sex partner affects whether or not a woman gets BV. Having BV can increase your chances of getting other STDs. BV rarely affects women who have never had sex. You cannot get BV from toilet seats, bedding, or swimming pools. How can I avoid getting bacterial vaginosis? Doctors and scientists do not completely understand how BV spreads. There are no known best ways to prevent it. The following basic prevention steps may help lower your risk of developing BV: Not having sex; Limiting your number of sex partners; Not douching; and Using latex condoms the right way every time you have sex. I'm pregnant. How does bacterial vaginosis affect my baby? Pregnant women can get BV. Pregnant women with BV are more likely to have babies born premature (early) or with low birth weight than pregnant women without BV. Low birth weight means having a baby that weighs less than 5.5 pounds at birth. Treatment is especially important for pregnant women. How do I know if I have bacterial vaginosis? Many women with BV do not have symptoms. If you do have symptoms, you may notice: A thin white or gray vaginal discharge; Pain, itching, or burning in the vagina; A strong fish-like odor, especially after sex; Burning when urinating; Itching around the outside of the vagina. How will my doctor know if I have bacterial vaginosis? A health care provider will examine your vagina for signs of vaginal discharge. Your provider can also perform laboratory tests on a sample of vaginal fluid to determine if BV is present. Can bacterial vaginosis be cured? BV will sometimes go away without treatment. But if you have symptoms of BV you should be checked and treated. It is important that you take all of the medicine prescribed to you, even if your symptoms go away. A health care provider can treat BV with antibiotics, but BV may return even after treatment. Treatment may also reduce the risk for some STDs. Male sex partners of women diagnosed with BV generally do not need to be treated. BV may be transferred between female sex partners. What happens if I don't get treated? BV can cause some serious health risks, including: Increasing your chance of getting HIV if you have sex with someone who is infected with HIV; If you are HIV positive, increasing your chance of passing HIV to your sex partner; Making it more likely that you will deliver your baby too early if you have BV while pregnant; Increasing your chance of getting other STDs, such as chlamydia and gonorrhea. These bacteria can sometimes cause pelvic inflammatory disease (PID), which can make it difficult or impossible for you to have children.

Gonorrhea

Anyone who is sexually active can get gonorrhea. Anyone who is sexually active can get gonorrhea. Gonorrhea can cause very serious complications when not treated, but can be cured with the right medication. Basic Fact Sheet | Detailed Version Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated (added to your web site). Print Versionpdf icon What is gonorrhea? Gonorrhea is a sexually transmitted disease (STD) that can infect both men and women. It can cause infections in the genitals, rectum, and throat. It is a very common infection, especially among young people ages 15-24 years. How is gonorrhea spread? You can get gonorrhea by having vaginal, anal, or oral sex with someone who has gonorrhea. A pregnant woman with gonorrhea can give the infection to her baby during childbirth. How can I reduce my risk of getting gonorrhea? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting gonorrhea: Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results; Using latex condoms the right way every time you have sex. Am I at risk for gonorrhea? Any sexually active person can get gonorrhea through unprotected vaginal, anal, or oral sex. If you are sexually active, have an honest and open talk with your health care provider and ask whether you should be tested for gonorrhea or other STDs. If you are a sexually active man who is gay, bisexual, or who has sex with men, you should be tested for gonorrhea every year. If you are a sexually active woman younger than 25 years or an older woman with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection, you should be tested for gonorrhea every year. I'm pregnant. How does gonorrhea affect my baby? If you are pregnant and have gonorrhea, you can give the infection to your baby during delivery. This can cause serious health problems for your baby. If you are pregnant, it is important that you talk to your health care provider so that you get the correct examination, testing, and treatment, as necessary. Treating gonorrhea as soon as possible will make health complications for your baby less likely. How do I know if I have gonorrhea? Some men with gonorrhea may have no symptoms at all. However, men who do have symptoms, may have: A burning sensation when urinating; A white, yellow, or green discharge from the penis; Painful or swollen testicles (although this is less common). Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Women with gonorrhea are at risk of developing serious complications from the infection, even if they don't have any symptoms.Symptoms in women can include: Painful or burning sensation when urinating; Increased vaginal discharge; Vaginal bleeding between periods. Rectal infections may either cause no symptoms or cause symptoms in both men and women that may include: Discharge; Anal itching; Soreness; Bleeding; Painful bowel movements. You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD, such as an unusual sore, a smelly discharge, burning when urinating, or bleeding between periods. How will my doctor know if I have gonorrhea? Most of the time, urine can be used to test for gonorrhea. However, if you have had oral and/or anal sex, swabs may be used to collect samples from your throat and/or rectum. In some cases, a swab may be used to collect a sample from a man's urethra (urine canal) or a woman's cervix (opening to the womb). Can gonorrhea be cured? Yes, gonorrhea can be cured with the right treatment. It is important that you take all of the medication your doctor prescribes to cure your infection. Medication for gonorrhea should not be shared with anyone. Although medication will stop the infection, it will not undo any permanent damage caused by the disease. It is becoming harder to treat some gonorrhea, as drug-resistant strains of gonorrhea are increasing. If your symptoms continue for more than a few days after receiving treatment, you should return to a health care provider to be checked again. I was treated for gonorrhea. When can I have sex again? You should wait seven days after finishing all medications before having sex. To avoid getting infected with gonorrhea again or spreading gonorrhea to your partner(s), you and your sex partner(s) should avoid having sex until you have each completed treatment. If you've had gonorrhea and took medicine in the past, you can still get infected again if you have unprotected sex with a person who has gonorrhea. What happens if I don't get treated? Untreated gonorrhea can cause serious and permanent health problems in both women and men.In women, untreated gonorrhea can cause pelvic inflammatory disease (PID). Some of the complications of PID are Formation of scar tissue that blocks fallopian tubesexternal icon; Ectopic pregnancy (pregnancy outside the wombexternal icon); Infertility (inability to get pregnant); Long-term pelvic/abdominal pain. In men, gonorrhea can cause a painful condition in the tubes attached to the testicles. In rare cases, this may cause a man to be sterile, or prevent him from being able to father a child.Rarely, untreated gonorrhea can also spread to your blood or joints. This condition can be life-threatening. Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS. Basic Fact Sheet | Detailed Version Detailed fact sheets are intended for individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more in depth. What is gonorrhea? Gonorrhea is a sexually transmitted disease (STD) caused by infection with the Neisseria gonorrhoeae bacterium. N. gonorrhoeae infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men. N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and rectum. How common is gonorrhea? Gonorrhea is a very common infectious disease. CDC estimates that approximately 1.14 million new gonococcal infections occur in the United States each year, and as many as half occur among young people aged 15-24.1 In 2018, 583,405 cases of gonorrhea were reported to CDC.2 How do people get gonorrhea? Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Gonorrhea can also be spread perinatally from mother to baby during childbirth. People who have had gonorrhea and received treatment may be reinfected if they have sexual contact with a person infected with gonorrhea. Who is at risk for gonorrhea? Any sexually active person can be infected with gonorrhea. In the United States, the highest reported rates of infection are among sexually active teenagers, young adults, and African Americans 2. What are the signs and symptoms of gonorrhea? Many men with gonorrhea are asymptomatic 3, 4. When present, signs and symptoms of urethral infection in men include dysuria or a white, yellow, or green urethral discharge that usually appears one to fourteen days after infection 5. In cases where urethral infection is complicated by epididymitis, men with gonorrhea may also complain of testicular or scrotal pain. Most women with gonorrhea are asymptomatic 6, 7. Even when a woman has symptoms, they are often so mild and nonspecific that they are mistaken for a bladder or vaginal infection 8, 9. The initial symptoms and signs in women include dysuria, increased vaginal discharge, or vaginal bleeding between periods. Women with gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms. Symptoms of rectal infection in both men and women may include discharge, anal itching, soreness, bleeding, or painful bowel movements 10. Rectal infection also may be asymptomatic. Pharyngeal infection may cause a sore throat, but usually is asymptomatic 11, 12. What are the complications of gonorrhea? Untreated gonorrhea can cause serious and permanent health problems in both women and men. In women, gonorrhea can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). The symptoms may be quite mild or can be very severe and can include abdominal pain and fever 13. PID can lead to internal abscesses and chronic pelvic pain. PID can also damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. In men, gonorrhea may be complicated by epididymitis. In rare cases, this may lead to infertility 14. If left untreated, gonorrhea can also spread to the blood and cause disseminated gonococcal infection (DGI). DGI is usually characterized by arthritis, tenosynovitis, and/or dermatitis 15. This condition can be life threatening. What about gonorrhea and HIV? Untreated gonorrhea can increase a person's risk of acquiring or transmitting HIV, the virus that causes AIDS 16. How does gonorrhea affect a pregnant woman and her baby? If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness, joint infection, or a life-threatening blood infection in the baby 17. Treatment of gonorrhea as soon as it is detected in pregnant women will reduce the risk of these complications. Pregnant women should consult a health care provider for appropriate examination, testing, and treatment, as necessary. Who should be tested for gonorrhea? Any sexually active person can be infected with gonorrhea. Anyone with genital symptoms such as discharge, burning during urination, unusual sores, or rash should stop having sex and see a health care provider immediately. Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with an STD should see a health care provider for evaluation. Some people should be tested (screened) for gonorrhea even if they do not have symptoms or know of a sex partner who has gonorrhea 18. Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for gonorrhea or other STDs. CDC recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. People who have gonorrhea should also be tested for other STDs. How is gonorrhea diagnosed? Urogenital gonorrhea can be diagnosed by testing urine, urethral (for men), or endocervical or vaginal (for women) specimens using nucleic acid amplification testing (NAAT) 19. It can also be diagnosed using gonorrhea culture, which requires endocervical or urethral swab specimens. If a person has had oral and/or anal sex, pharyngeal and/or rectal swab specimens should be collected either for culture or for NAAT (if the local laboratory has validated the use of NAAT for extra-genital specimens) 20. What is the treatment for gonorrhea? Gonorrhea can be cured with the right treatment. CDC now recommends dual therapy (i.e. using two drugs) for the treatment of gonorrhea. It is important to take all of the medication prescribed to cure gonorrhea. Medication for gonorrhea should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult 21. If a person's symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. What about partners? If a person has been diagnosed and treated for gonorrhea, he or she should tell all recent anal, vaginal, or oral sex partners (all sex partners within 60 days before the onset of symptoms or diagnosis) so they can see a health provider and be treated 20. This will reduce the risk that the sex partners will develop serious complications from gonorrhea and will also reduce the person's risk of becoming reinfected. A person with gonorrhea and all of his or her sex partners must avoid having sex until they have completed their treatment for gonorrhea and until they no longer have symptoms. For tips on talking to partners about sex and STD testing, visit http://www.gytnow.org/talking-to-your-partnerexternal icon. How can gonorrhea be prevented? Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea 22. The surest way to avoid transmission of gonorrhea or other STDs is to abstain from vaginal, anal, and oral sex, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Bacterial vaginosis statistics

Bacterial vaginosis is the most common vaginal condition in women ages 15-44. Prevalence Bacterial vaginosis is the most common cause of vaginal symptoms among women, but it is not clear what role sexual activity plays in the development of BV. The prevalence in the United States is estimated to be 21.2 million (29.2%) among women ages 14-49, based on a nationally representative sample of women who participated in NHANES 2001-2004. The following are other findings from this study. Most women found to have BV (84%) reported no symptoms. Women who have not had vaginal, oral, or anal sex can still be affected by BV (18.8%), as can pregnant women (25%), and women who have ever been pregnant (31.7%). Prevalence of BV increases based on lifetime number of sexual partners. Non white women have higher rates (African-American 51%, Mexican Americans 32%) than white women (23%).

reproductive health

For many women access to health services via traditional means isn't as convenient as accessing it via an app or website. Check out our unbiased reviews to learn more about these new avenues and whether they may help you access reproductive health care products and services: Hers review - Hers connects you with healthcare professionals and offers everything from skincare and hair care to contraception and treatment for yeast infections. Uqora review - Uqora focuses on UTIs - find out if it can make your life easier. Nurx review - Nurx may be able to help you with access to testing and treatment for common STIs.

prostate

Found only in men, the prostate is a walnut-sized gland that grows throughout a man's life and may eventually interfere with or prevent urination by blocking the urethra. The prostate makes a significant contribution to the production and ejaculation of semen during sexual intercourse. Prostate cancer is a common disorder of the prostate that often necessitates the surgical removal of the prostate. Evidence suggests that some men are at genetically higher risk of developing prostate cancer than others. Learn more about DNA health testing to decide if you'd like to find out your own genetic risk. Anatomy of the Prostate Gross Anatomy The prostate is a small muscular gland located inferior to the urinary bladder in the pelvic body cavity. It is shaped like a rounded cone or a funnel with its base pointed superiorly toward the urinary bladder. The prostate surrounds the urethra as it exits the bladder and merges with the ductus deferens at the ejaculatory duct. Several distinct lobes make up the structure of the prostate: On the anterior end of the prostate are the two lateral lobes, which are rounded and shaped like orange slices when viewed in a transverse section. The lateral lobes are the largest lobes and meet at the midline of the prostate. Posterior and medial to the lateral lobes is the much smaller anterior lobe, a triangle of fibromuscular tissue just anterior to the urethra. The fibromuscular tissue of the anterior lobe contracts to expel semen during ejaculation. The median lobe is found just posterior to the urethra along the midline of the prostate. The median lobe contains the ejaculatory ducts of the prostate. The posterior lobe forms a thin layer of tissue posterior to the median lobe and the lateral lobes. Microanatomy The prostate contains two main types of tissue: exocrine glandular tissue and fibromuscular tissue. Exocrine glandular tissue in the prostate is epithelial tissue specialized for the secretion of the components of semen. Most of the prostate is made of exocrine glandular tissue, as the prostate's primary function is the production of semen. Fibromuscular tissue is a mixture of smooth muscle tissue and dense irregular connective tissue containing many collagen fibers. The collagen fibers of the tissue provide strength to the tissue while the smooth muscle permits the tissue to contract to expel fluids. Fibromuscular tissue forms the outermost layer of the prostate and the tissue surrounding the urethra. Physiology of the Prostate Secretion The prostate produces a secretion that makes up a large portion of semen volume. The prostatic secretions are a milky white mixture of simple sugars (such as fructose and glucose), enzymes, and alkaline chemicals. The sugars secreted by the prostate function as nutrition for sperm as they pass into the female body to fertilize ova. Enzymes work to break down proteins in semen after ejaculation to free sperm cells from the viscous semen. The alkaline chemicals in prostatic secretions neutralize acidic vaginal secretions to promote the survival of sperm in the female body. Ejaculation The prostate contains the ejaculatory duct that releases sperm during ejaculation. The ejaculatory duct opens to allow semen to pass from the ductus deferens into the urethra and eventually out of the body. During orgasm, smooth muscle tissue in the prostate contracts in order to push semen through the urethra. Urination Urine released from the urinary bladder is carried by the urethra to the body's exterior. Under normal conditions, urine in the urethra passes through the prostate with no complications whatsoever. The prostate enlarges slowly throughout a man's lifetime, potentially leading to the restriction or blockage of the urethra by the time a man reaches his fifties or sixties. An enlarged prostate can lead to difficulty urinating or eventually even an inability to urinate. There are many treatments for an enlarged prostate including medications, lifestyle changes, and prostatectomy, the surgical removal of the prostate.

HPV symptoms and treatment

HPV SYMPTOMS & TREATMENT FAST FACTS Human papilloma virus (HPV) is the name for a group of viruses that affect your skin. Genital HPV infections are those affecting areas around the vagina, penis and anus. Genital HPV infections are passed on through genital skin-to-skin contact including sex without a condom, and can be passed from one person to another even if there are no symptoms. Symptoms and effects of HPV infections vary. Most strains do not cause any problems but some cause genital warts, while other types can lead to cancer. Using male and female condoms, dental dams and latex gloves can prevent genital HPV infection. Having regular cervical screenings (smear tests) where available will help to identify abnormal cells on the cervix caused by HPV, which could lead to cancer. What is the human papilloma virus (HPV)? Human papilloma virus (HPV) is the name for a group of viruses that affect your skin, and the moist membranes of your body, for example, the cervix (entrance to the womb), anus, mouth and throat. There are a number of different strains of HPV - most have no symptoms, go away by themselves and don't cause any health problems, while other strains can cause cancer. There are two main genital HPV infections that you should be aware of. those that can cause genital warts - small growths around the genitals that usually aren't painful and can be treated each time they appear. They are not cancer and don't cause cancer. those that can lead to cervical, anal and other cancers. Most cases of cervical cancer are linked to an infection with certain types of HPV. What do HPV symptoms look like? Not all cases of HPV will have symptoms. Symptoms vary depending on the strain of HPV. Genital HPV symptoms include: Genital warts (called low-risk HPV) - read our genital warts page. Cancer-causing HPV (called high-risk HPV) - in most cases these don't cause any symptoms and you can have HPV for many years without it causing health problems. As well as cervical cancer HPV can also cause other cancers such as anal cancer, cancer of the penis, vagina, vulva and back of the throat, although these are very rare. How do you get HPV? HPV infections are passed on through skin-to-skin contact - often through a cut, abrasion or small tear in your skin. Genital HPV infections are very common and are often easily passed on through: vaginal, anal or oral sex without a condom (or dental dam), with someone who has an HPV infection (even if they don't have symptoms) sharing sex toys that aren't washed or covered with a new condom each time they are used close genital contact - this means HPV can be passed on even if there's no penetration, orgasm or ejaculation. How do you protect yourself from HPV? Use a new condom or dental dam every time you have vaginal, anal or oral sex. Remember HPV can affect areas not covered by a condom, so this may not offer full protection. Use a new dental dam or latex gloves for rimming and fingering (exploring your partner's anus with your fingers, mouth or tongue) or use latex gloves for fisting. Cover sex toys with a new condom for each partner and wash them after use. Remember, the virus is not just passed on through penetrative sex and can be transmitted through any genital skin-to-skin contact. Get vaccinated Vaccines are available to prevent certain types of HPV that can cause cancers and warts. These are often offered to adolescent girls, men who have sex with men and people living with HIV. It's best to have the vaccine before you start having sex, although it's sometimes possible to get the vaccine later in life. Ask a healthcare worker to find out if you can get the HPV vaccine where you are. Remember, the vaccine only protects against certain strains of HPV, and does not guarantee that you will not develop genital warts or cancer in the future. So it's important to use condoms and go for cervical screening (smear tests) regularly where available. Talk to your partner It's important that you're able to talk about your sexual health with your partner/s. This way you can let each other know about any symptoms or infections, and discuss how you will have safer sex together. If you are having sex with multiple partners, it's even more important to use condoms and to have regular STI tests. Remember that condoms are the best form of protection against STIs and pregnancy. Other contraceptives including the contraceptive pill will not prevent HPV, neither will PrEP. Can I get tested for HPV? Different strains of HPV are tested for in different ways. Genital warts (low-risk HPV) A healthcare professional can quickly examine you to tell if you have genital warts. Cancer-causing HPV (high-risk HPV) For women - genital HPV testing is often a part of cervical screening, which checks for abnormal cells on the cervix (entrance to the womb). Cervical screening isn't a test for cancer - it's a test to check the health of the cells of the cervix. If you have changes in the cells on your cervix, this doesn't mean you have cervical cancer but in some cases the abnormal cells need to be removed so they can't develop into cancer. For men - there's currently no reliable test for HPV infection and it's often very difficult to diagnose, as there are no symptoms for high-risk HPV. Some people who are at a high risk of having anal HPV and of developing anal cancer (for example men who have sex with men or people living with HIV) may be offered an anal smear which checks for abnormal cells in the anal canal. How is HPV treated? Cancer-causing HPV (high-risk HPV): if a cervical screening test shows you have abnormal cells on the cervix, it may be necessary to remove them so that they don't develop into cancer. If cervical cancer does develop and is found early, it's usually possible to treat it using surgery. Genital warts (low-risk HPV): there's no cure for genital warts, but it's possible for your body to clear the virus over time. The warts can be removed using creams, freezing or heating. Read our genital warts page for more information. HPV and pregnancy If you are a pregnant woman with HPV, it can be passed to your baby at birth, but this is rare. Talk to your healthcare worker if you are pregnant and worried about HPV, they will be able to advise you on your options. HPV, HIV and sexual health Having an STI, including genital warts, can increase your risk of getting HIV. This is because having an STI makes it easier for HIV to get into your body and cause an infection. People living with HIV are more likely to get HPV because of their weakened immune system. If someone living with HIV also has HPV, their viral load will increase, which will make them more likely to pass on HIV during unprotected sex, even if they are taking HIV drugs (antiretrovirals). However, if they have an undetectable viral load there is no evidence that HPV makes you more likely to pass on HIV. The risk of developing HPV-related cancers is higher in people living with HIV who are not on effective treatmeant. This is because their immune system is often weaker. Being on HIV treatment (antiretrovirals), with an undetectable viral load, and having a higher CD4 cell count (over 200) can reduce the risk of developing HPV-related cancers. If you are taking antiretrovirals it is important to discuss with your healthcare professional how treatment for HPV may interact with your HIV drugs.

HIV/AIDS and STDS

Having an STD can increase your chances of getting HIV If you have an STD, you are more likely to get HIV or transmit it to others. Basic Fact Sheet | Detailed VersionBasic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated. Print Versionpdf icon Are some STDs associated with HIV? Yes. In the United States, people who get syphilis, gonorrhea, and herpes often also have HIV, or are more likely to get HIV in the future. Why does having an STD put me more at risk for getting HIV? If you get an STD, you are more likely to get HIV than someone who is STD-free. This is because the same behaviors and circumstances that may put you at risk for getting an STD also can put you at greater risk for getting HIV. In addition, having a sore or break in the skin from an STD may allow HIV to more easily enter your body. If you are sexually active, get tested for STDs and HIV regularly, even if you don't have symptoms. What activities can put me at risk for both STDs and HIV? Having anal, vaginal, or oral sex without a condom; Having multiple sex partners; Having anonymous sex partners; Having sex while under the influence of drugs or alcohol can lower inhibitions and result in greater sexual risk-taking. What can I do to prevent getting STDs and HIV? The only 100% effective way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting STDs and HIV: Choose less risky sex activities; Use a new condom for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish); Reduce the number of people with whom you have sex; Limit or eliminate drug and alcohol use before and during sex; Have an honest and open talk with your healthcare provider and ask whether you should be tested for STDs and HIV; Talk to your healthcare provider and find out if either pre-exposure prophylaxis, or PrEP, or post-exposure prophylaxis, or PEP, is a good option for you to prevent HIV infection. If I already have HIV, and then I get an STD, does that put my sex partner(s) at an increased risk for getting HIV? It can. If you already have HIV, and then get another STD, it can put your HIV-negative partners at greater risk of getting HIV from you. Your sex partners are less likely to get HIV from you if you Get on and stay on treatment called antiretroviral therapy (ART). Taking HIV medicine as prescribed can make your viral load very low by reducing the amount of virus in your blood and body fluids. HIV medicine can make your viral load so low that a test can't detect it (an undetectable viral load). If your viral load stays undetectable, you have effectively no risk of sexually transmitting HIV to HIV-negative partners. Choose less risky sex activities. Use a new condom for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish). The risk of getting HIV also may be reduced if your partner takes PrEP after discussing this option with his or her healthcare provider and determining whether it is appropriate. When taken daily, PrEP is highly effective for preventing HIV from sex. PrEP is much less effective if it is not taken consistently. Since PrEP does not protect against other STDs, use condoms the right way every time you have sex. Will treating STDs prevent me from getting HIV? No. It's not enough. If you get treated for an STD, this will help to prevent its complications, and prevent spreading STDs to your sex partners. Treatment for an STD other than HIV does not prevent the spread of HIV. If you are diagnosed with an STD, talk to your doctor about ways to protect yourself and your partner(s) from getting reinfected with the same STD, or getting HIV. People who have STDs are more likely to get HIV, when compared to people who do not have STDs. Basic Fact Sheet | Detailed Version Detailed fact sheets are intended for physicians and individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more in depth. STDs and HIV. People who have an STD may be at an increased risk of getting HIV.1-3 One reason is the behaviors that put someone at risk for one infection (not using condoms, multiple partners, anonymous partners) often put them at risk for other infections. Also, because STDs and HIV tend to be linked, when someone gets an STD it suggests they got it from someone who may be at risk for other STDs and HIV. Finally, a sore or inflammation from an STD may allow infection with HIV that would have been stopped by intact skin. STDs can increase the risk of spreading HIV. People with HIV are more likely to shed HIV when they have urethritis or a genital ulcer.4, 5 When a person with HIV gets another STD, such as gonorrhea or syphilis, it suggests that they were having sex without using condoms. If so, they may have spread HIV to their partners. Antiretroviral treatment for HIV can prevent the transmission of HIV even from persons who have other STDs.6 Some STDs are more closely linked to HIV than others. In the US, both syphilis and HIV are highly concentrated epidemics among men who have sex with men (MSM).7, 8 In 2018, MSM accounted for 77.6% of all primary and secondary syphilis cases among males in which sex of sex partner was known.9 In Florida, in 2010, among all persons diagnosed with infectious syphilis 42% were also HIV infected.10 Men who get syphilis are at very high risk of being diagnosed with HIV in the future; among HIV-uninfected men who got syphilis in Florida in 2003, 22% were newly diagnosed with HIV by 2011.2 HIV is more closely linked to gonorrhea than chlamydia (which is particularly common among young women).11 Herpes is also commonly associated with HIV; a meta-analysis found persons infected with HSV-2 are at 3-fold increased risk for acquiring HIV infection.12-14 Some activities can put people at increased risk for both STDs and HIV. Having anal, vaginal, or oral sex without a condom; Having multiple sex partners; Having anonymous sex partners; Having sex while under the influence of drugs or alcohol can lower inhibitions and result in greater sexual risk taking. Does treating STDs prevent HIV? Not by itself. Given the close link between STDs and HIV in many studies, it seems obvious that treating STDs should reduce the risk of HIV. However, most studies that have treated STDs to prevent HIV have not lowered the risk of HIV.6, 15-23 Screening for STDs can help assess a person's risk for getting HIV. Treatment of STDs is important to prevent the complications of those infections, and to prevent transmission to partners, but it should not be expected to prevent spread of HIV. What can people do to reduce their risk of getting STDs and HIV? The only 100% effective way to avoid STDs is to not have vaginal, anal, or oral sex. If people are sexually active, they can do the following things to lower their chances of getting STDs and HIV: Choose less risky sexual behaviors; Use a new condom for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish); Reduce the number of people with whom they have sex; Limit or eliminate drug and alcohol use before and during sex; Have an honest and open talk with their healthcare provider and ask whether they should be tested for STDs and HIV. Talk with their healthcare provider and find out if either pre-exposure prophylaxis, or PrEP, or post-exposure prophylaxis, or PEP, is a good option for them to prevent HIV infection. If someone already has HIV, and subsequently gets an STD, does that put their sex partner(s) at an increased risk for getting HIV? If the person living with HIV is taking antiretroviral treatment, then an STD does not increase the risk of transmitting HIV.6 However, HIV-infected persons who are not taking antiretroviral treatment may be more likely to transmit HIV when they have another STD. The HIV-negative sex partners of people who are HIV-positive are less likely to get HIV if: HIV-positive people use antiretroviral therapy (ART). ART reduces the amount of virus (viral load) in blood and body fluids. ART can keep HIV-positive persons healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently. Sex partners take PrEP after discussing this option with their healthcare provider and determining whether it is appropriate. Partners choose less risky sex activities. Partners use a new condom for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish). Will treating someone for STDs prevent them from getting HIV? No. It's not enough. Screening for STDs can help assess a person's risk for getting HIV. Treatment of STDs is important to prevent the complications of those infections, and to prevent transmission to partners, but it should not be expected to prevent spread of HIV. If someone is HIV-positive and is diagnosed with an STD, they should receive counseling about risk reduction and how to protect their sex partner(s) from getting re-infected with the same STD or getting HIV.

STDs during pregnancy

If you are pregnant, you can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnant women should ask their doctors about getting tested for STDs, since some doctors do not routinely perform these tests. Basic fact sheet | Detailed Version Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated (added to your web site). Print Versionpdf icon I'm pregnant. Can I get an STD? Yes, you can. Women who are pregnant can become infected with the same STDs as women who are not pregnant. Pregnancy does not provide women or their babies any additional protection against STDs. Many STDs are 'silent,' or have no symptoms, so you may not know if you are infected. If you are pregnant, you should be tested for STDs, including HIV (the virus that causes AIDS), as a part of your medical care during pregnancy. The results of an STD can be more serious, even life-threatening, for you and your baby if you become infected while pregnant. It is important that you are aware of the harmful effects of STDs and how to protect yourself and your unborn baby against infection. If you are diagnosed with an STD while pregnant, your sex partner(s) should also be tested and treated. How can STDs affect me and my unborn baby? STDs can complicate your pregnancy and may have serious effects on both you and your developing baby. Some of these problems may be seen at birth; others may not be discovered until months or years later. In addition, it is well known that infection with an STD can make it easier for a person to get infected with HIV. Most of these problems can be prevented if you receive regular medical care during pregnancy. This includes tests for STDs starting early in pregnancy and repeated close to delivery, as needed. Should I be tested for STDs during my pregnancy? Yes. Testing and treating pregnant women for STDs is a vital way to prevent serious health complications to both mother and baby that may otherwise happen with infection. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby. The Centers for Disease Control and Prevention's 2015 STD Treatment Guidelines recommend screening pregnant women for STDs. The CDC screening recommendations that your health care provider should follow are incorporated into the table on the STDs during Pregnancy - Detailed CDC Fact Sheet. Be sure to ask your doctor about getting tested for STDs. It is also important that you have an open, honest conversation with your provider and discuss any symptoms you are experiencing and any high-risk sexual behavior that you engage in, since some doctors do not routinely perform these tests. Even if you have been tested in the past, you should be tested again when you become pregnant. Can I get treated for an STD while I'm pregnant? It depends. STDs, such as chlamydia, gonorrhea, syphilis, trichomoniasis and BV can all be treated and cured with antibiotics that are safe to take during pregnancy. STDs that are caused by viruses, like genital herpes, hepatitis B, or HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to your baby. If you are pregnant or considering pregnancy, you should be tested so you can take steps to protect yourself and your baby. How can I reduce my risk of getting an STD while pregnant? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting chlamydia: Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results; Using latex condoms the right way every time you have sex.

pregnancy

If the ovum is fertilized by a sperm cell, the fertilized embryo will implant itself into the endometrium and begin to form an amniotic cavity, umbilical cord, and placenta. For the first 8 weeks, the embryo will develop almost all of the tissues and organs present in the adult before entering the fetal period of development during weeks 9 through 38. During the fetal period, the fetus grows larger and more complex until it is ready to be born.

related genetic science

If you're planning to start a family, you may be interested in finding out if you're a carrier of hereditary conditions that are recessive in you but could become dominant in your child. In the process, you can also find out if you're possibly more at risk of breast and ovarian cancers as well as hereditary hemochromatosis (one of most common hereditary disorders, which can lower libido). Learn more about DNA health testing, which can help you explore these concerns so that you can discuss with your healthcare provider or genetic counselor.

HPV and Men

Nearly all sexually active people will get human papillomavirus (HPV) at some time in their life if they don't get the HPV vaccine. Although most HPV infections go away on their own without causing problems, HPV can cause genital warts, or cancer. Getting vaccinated against HPV can help prevent these health problems. Print Versionpdf icon What is HPV? HPV is a very common virus that can be spread from one person to another person through anal, vaginal, or oral sex, or through other close skin-to-skin touching during sexual activity. 79 million Americans, most in their late teens and early 20s, are infected with HPV. Nearly all sexually active people who do not get the HPV vaccine get infected with HPV at some point in their lives. It is important to understand that getting HPV is not the same thing as getting HIV or HSV (herpes). How do men get HPV? You can get HPV by having sex with someone who is infected with HPV. This disease is spread easily during anal or vaginal sex, and it can also be spread through oral sex or other close skin-to-skin touching during sex. HPV can be spread even when an infected person has no visible signs or symptoms. Will HPV cause health problems for me? Most HPV infections go away on their own and don't cause any health problems. However, if an infection does not go away, it is possible to develop HPV symptoms months or years after getting infected. This makes it hard to know exactly when you became infected. Lasting HPV infection can cause genital warts or certain kinds of cancer. It is not known why some people develop health problems from HPV and others do not. What are the symptoms of HPV? Most men who get HPV never develop symptoms and the infection usually goes away completely by itself. However, if HPV does not go away, it can cause genital warts or certain kinds of cancer. See your healthcare provider if you have questions about anything new or unusual such as warts, or unusual growths, lumps, or sores on your penis, scrotum, anus, mouth, or throat. What are the symptoms of genital warts? Genital warts usually appear as a small bump or group of bumps in the genital area around the penis or the anus. These warts might be small or large, raised or flat, or shaped like a cauliflower. The warts may go away, or stay the same, or grow in size or number. Usually, a healthcare provider can diagnose genital warts simply by looking at them. Genital warts can come back, even after treatment. The types of HPV that cause warts do not cause cancer. Can HPV cause cancer? Yes. HPV itself isn't cancer but it can cause changes in the body that lead to cancer. HPV infections usually go away by themselves but , when they don't, they can cause certain kinds of cancer to develop. These include cervical cancer in women, penile cancer in men, and anal cancer in both women and men. HPV can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). All of these cancers are caused by HPV infections that did not go away. Cancer develops very slowly and may not be diagnosed until years, or even decades, after a person first gets infected with HPV. Currently, there is no way to know who will have only a temporary HPV infection, and who will develop cancer after getting HPV. How common are HPV-related cancers in men? Although HPV is the most common sexually transmitted infection, HPV-related cancers are not common in men. Certain men are more likely to develop HPV-related cancers: Men with weak immune systems (including those with HIV) who get infected with HPV are more likely to develop HPV-related health problems. Men who receive anal sex are more likely to get anal HPV and develop anal cancer. Can I get tested for HPV? No, there is currently no approved test for HPV in men. Routine testing (also called 'screening') to check for HPV or HPV-related disease before there are signs or symptom, is not recommended by the CDC for anal, penile, or throat cancers in men in the United States. However, some healthcare providers do offer anal Pap tests to men who may be at increased risk for anal cancer, including men with HIV or men who receive anal sex. If you have symptoms and are concerned about cancer, please see a healthcare provider. Can I get treated for HPV or health problems caused by HPV? There is no specific treatment for HPV, but there are treatments for health problems caused by HPV. Genital warts can be treated by your healthcare provider, or with prescription medication. HPV-related cancers are more treatable when diagnosed and treated promptly. For more information, visit www.cancer.orgexternal icon. How can I lower my chance of getting HPV? There are two steps you can take to lower your chances of getting HPV and HPV-related diseases: Get vaccinated. The HPV vaccine is safe and effective. It can protect men against warts and certain cancers caused by HPV. Ideally, you should get vaccinated before ever having sex (see below for the recommended age groups). CDC recommends HPV vaccination at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. For more information on the recommendations, please see: https://www.cdc.gov/vaccines/vpd/hpv/public/index.html Use condoms the correct way every time you have sex. This can lower your chances of getting all STIs, including HPV. However, HPV can infect areas that are not covered by a condom, so condoms may not give full protection against getting HPV. Can I get the HPV vaccine? In the United States, HPV vaccination is recommended for: Preteens at age 11 or 12 years (or can start at age 9 years) Everyone through age 26 years, if not vaccinated already. Vaccination is not recommended for everyone older than age 26 years. However, some men age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination. At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection. What does having HPV mean for me or my sex partner's health? See a healthcare provider if you have questions about anything new or unusual (such as warts, growths, lumps, or sores) on your own or your partner's penis, scrotum, anus, mouth or throat. Even if you are healthy, you and your sex partner(s) may also want to get checked by a healthcare provider for other STIs. If you or your partner have genital warts, you should avoid having sex until the warts are gone or removed. However, it is not known how long a person is able to spread HPV after warts are gone. What does HPV mean for my relationship? HPV infections are usually temporary. A person may have had HPV for many years before it causes health problems. If you or your partner are diagnosed with an HPV-related disease, there is no way to know how long you have had HPV, whether your partner gave you HPV, or whether you gave HPV to your partner. HPV is not necessarily a sign that one of you is having sex outside of your relationship. It is important that sex partners discuss their sexual health and risk for all STIs, with each other.

syphilis and MSM fact sheet

Once nearly eliminated in the U.S., syphilis is increasing, especially among gay, bisexual, and other men who have sex with men (MSM). MSM Fact Sheet | View Images of Symptoms The content here can be syndicated (added to your web site). Print Version pdf icon[PDF - 418 KB] What is syphilis? Syphilis is a sexually transmitted infection that can cause serious health problems if it is not treated. Syphilis is divided into stages (primary, secondary, latent, and tertiary), and there are different signs and symptoms associated with each stage.. Should I be concerned about syphilis? Most cases of syphilis in the United States are among gay, bisexual, and other men who have sex with men. (MSM), and syphilis has been increasing among MSM for more than a decade. If syphilis is not treated, it can cause serious health problems, including neuralgic (brain and nerve) problems, eye problems, and even blindness. In addition, syphilis is linked to an increased risk of transmission of HIV infection. How could I get syphilis? Any sexually -active person can get syphilis. Syphilis can be transmitted during anal sex and oral sex, as well as vaginal sex. Syphilis is passed from person to person through direct contact with a syphilis sore. In men, sores can occur on or around the penis, around the anus, or in the rectum, or in or around the mouth. These sores can be painless, so it is possible to have them and not notice them. Correct use of condoms can reduce the risk of syphilis if the condom covers the sores. However, sometimes sores occur in areas not covered by a condom. It is still possible to get syphilis from contact with these sores. You cannot get syphilis through casual contact with objects such as toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils. What does syphilis look like? Syphilis is divided into stages (primary, secondary, latent, and tertiary), and there are different signs and symptoms associated with each stage. A person with primary syphilis generally has a sore or sores at the original site of infection. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually (but not always) firm, round, and painless. Symptoms of secondary syphilis include skin rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed. During the latent stage, there are no signs or symptoms. Tertiary syphilis is associated with severe medical problems and is usually diagnosed by a doctor with the help of multiple tests. It can affect the heart, brain, and other organs of the body. A detailed description of each stage of syphilis can be found on CDC's syphilis fact sheet. How common is syphilis among MSM? Between 2017 and 2018, the number of reported primary and secondary (P&S) cases in the United States increased by 14.4%, and there were 35,063 P&S syphilis cases reported in 2018. Most (64%) of these cases were among MSM. How can I reduce my risk of getting syphilis? The only way to avoid getting syphilis or other STDs is to not have anal, oral, or vaginal sex. If you are sexually active, doing the following things will lower your chances of getting syphilis: Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis Using latex condoms the right way every time you have sex. Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores can occur in areas not covered by a condom. Contact with these sores can still transmit syphilis. How do I know if I have syphilis? The only way to know is by getting tested. Many men who get syphilis do not have any symptoms for years, yet they remain at risk for health problems if they are not treated. Additionally, the painless sores that show up during the early stages of syphilis often go unrecognized by the person who has them. Individuals who are unaware of their infection can spread it to their sex partners. How will my doctor know if I have syphilis? Have an honest and open talk with your healthcare provider about your sexual history and ask whether you should be tested for syphilis or other STDs. Your doctor can do a blood test to determine if you have syphilis. Sometimes, healthcare providers will diagnose syphilis by testing fluid from a syphilis sore. If you are a sexually active man who has sex with men, who is living with HIV, and/or who has partner(s) who have tested positive for HIV or syphilis, you should get tested regularly for syphilis. What is the link between syphilis and HIV? In the United States, approximately half of MSM with primary and secondary (P&S) syphilis were also living with HIV. In addition, MSM who are HIV-negative and diagnosed with P&S syphilis are more likely to be infected with HIV in the future. Having a sore or break in the skin from an STD such as syphilis may allow HIV to more easily enter your body. You may also be more likely to get HIV because the same behaviors and circumstances that put you at risk for getting other STDs can also put you at greater risk for getting HIV. Can syphilis be cured? Yes, syphilis can be cured with the right medicine from your healthcare provider. However, treatment might not undo damage that the infection has already done. I've been treated. Can I get syphilis again? Having syphilis once does not protect you from getting it again. Even after you've been successfully treated, you can still be reinfected. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is recommended to make sure that your treatment was successful. Because syphilis sores can be painless and hidden in the vagina, anus, under the foreskin of the penis, or in the mouth, it may not be obvious that a sex partner has syphilis. Unless you know that all of your sex partner(s) have been tested and treated, you may be at risk of getting syphilis again from an infected partner.

fertilization

Once the mature ovum is released from the ovary, the fimbriae catch the egg and direct it down the fallopian tube to the uterus. It takes about a week for the ovum to travel to the uterus. If sperm are able to reach and penetrate the ovum, the ovum becomes a fertilized zygote containing a full complement of DNA. After a two-week period of rapid cell division known as the germinal period of development, the zygote forms an embryo. The embryo will then implant itself into the uterine wall and develop there during pregnancy.

semen

Semen is the fluid produced by males for sexual reproduction and is ejaculated out of the body during sexual intercourse. Semen contains sperm, the male reproductive gametes, along with a number of chemicals suspended in a liquid medium. The chemical composition of semen gives it a thick, sticky consistency and a slightly alkaline pH. These traits help semen to support reproduction by helping sperm to remain within the vagina after intercourse and to neutralize the acidic environment of the vagina. In healthy adult males, semen contains around 100 million sperm cells per milliliter. These sperm cells fertilize oocytes inside the female fallopian tubes.

urethra

Semen passes from the ejaculatory duct to the exterior of the body via the urethra, an 8 to 10 inch long muscular tube. The urethra passes through the prostate and ends at the external urethral orifice located at the tip of the penis. Urine exiting the body from the urinary bladder also passes through the urethra.

Physiology of the Male Reproductive System

Spermatogenesis Spermatogenesis is the process of producing sperm and takes place in the testes and epididymis of adult males. Prior to puberty, there is no spermatogenesis due to the lack of hormonal triggers. At puberty, spermatogenesis begins when luteinizing hormone (LH) and follicle stimulating hormone (FSH) are produced. LH triggers the production of testosterone by the testes while FSH triggers the maturation of germ cells. Testosterone stimulates stem cells in the testes known as spermatogonium to undergo the process of developing into spermatocytes. Each diploid spermatocyte goes through the process of meiosis I and splits into 2 haploid secondary spermatocytes. The secondary spermatocytes go through meiosis II to form 4 haploid spermatid cells. The spermatid cells then go through a process known as spermiogenesis where they grow a flagellum and develop the structures of the sperm head. After spermiogenesis, the cell is finally a sperm cell, or spermatozoa. The spermatozoa are released into the epididymis where they complete their maturation and become able to move on their own. Fertilization Fertilization is the process by which a sperm combines with an oocyte, or egg cell, to produce a fertilized zygote. The sperm released during ejaculation must first swim through the vagina and uterus and into the fallopian tubes where they may find an oocyte. After encountering the oocyte, sperm next have to penetrate the outer corona radiata and zona pellucida layers of the oocyte. Sperm contain enzymes in the acrosome region of the head that allow them to penetrate these layers. After penetrating the interior of the oocyte, the nuclei of these haploid cells fuse to form a diploid cell known as a zygote. The zygote cell begins cell division to form an embryo.

Ejaculatory Duct

The ductus deferens passes through the prostate and joins with the urethra at a structure known as the ejaculatory duct. The ejaculatory duct contains the ducts from the seminal vesicles as well. During ejaculation, the ejaculatory duct opens and expels sperm and the secretions from the seminal vesicles into the urethra.

cellular stage to fetus

The fertilization of an egg cell by sperm in the uterine tube promotes the development of sexual division and the completion of a cell containing chromosomes of both parents. Human prenatal development is initiated with the fertilization of an ovum (egg) from a female by a sperm cell from the male. The chromosomes within the nucleus of a zygote (fertilized egg) contain all the genetic information necessary for the development and differentiation of body structures. For the first eight weeks of its life, the fertilized egg is called the embryo. The embryo develops from an egg fertilized by the sperm. It begins as one cell, which divides into two cells by the times it descends from the fallopian tube into the uterus. These cells divide further until they form two groups - one making up the wall lining of the embryo to become the placenta and the second becoming the embryo itself.

male reproductive system

The male reproductive system includes the scrotum, testes, spermatic ducts, sex glands, and penis. These organs work together to produce sperm, the male gamete, and the other components of semen. These reproductive organs also work together to deliver semen out of the body and into the vagina where it can fertilize egg cells to produce offspring

mammary gland lobules

The mammary gland lobules, or mammary gland lobes, are located within the female breast. There are fifteen to twenty irregularly shaped lobes, each of which includes alveolar glands, and a duct (lactiferous duct) that leads to the nipple and opens to the outside. The lobes are separated by dense connective tissues that support the glands and attach them to the tissues on the underlying pectoral muscles.

prostrate

The prostate is a walnut-sized exocrine gland that borders the inferior end of the urinary bladder and surrounds the urethra. The prostate produces a large portion of the fluid that makes up semen. This fluid is milky white in color and contains enzymes, proteins, and other chemicals to support and protect sperm during ejaculation. The prostate also contains smooth muscle tissue that can constrict to prevent the flow of urine or semen. Unfortunately the prostate is also particularly susceptible to cancer. Thankfully, DNA health testing can tell you whether you're at higher genetic risk of developing prostate cancer due to your BRCA1 and BRCA2 genes.

scrotum

The scrotum is a sac-like organ made of skin and muscles that houses the testes. It is located inferior to the penis in the pubic region. The scrotum is made up of 2 side-by-side pouches with a testis located in each pouch. The smooth muscles that make up the scrotum allow it to regulate the distance between the testes and the rest of the body. When the testes become too warm to support spermatogenesis, the scrotum relaxes to move the testes away from the body's heat. Conversely, the scrotum contracts to move the testes closer to the body's core heat when temperatures drop below the ideal range for spermatogenesis.

Seminal Vesicles

The seminal vesicles are a pair of lumpy exocrine glands that store and produce some of the liquid portion of semen. The seminal vesicles are about 2 inches in length and located posterior to the urinary bladder and anterior to the rectum. The liquid produced by the seminal vesicles contains proteins and mucus and has an alkaline pH to help sperm survive in the acidic environment of the vagina. The liquid also contains fructose to feed sperm cells so that they survive long enough to fertilize the oocyte.

seminal vesicle

The seminal vesicles are small sacs in which seminal fluid is stored.

Crash course female reproductive system

not concerned about you but your alleles and future population primary internal sex organs: gonads like testes and ovaries sex hormones gametes: sperm and eggs glands ducts external genitalia vulva: external female genital organs that include -the mons pubis over pubic bone -labia majora and labia minora which are skin folds around the vestibule -vestibule which contains the urethral orfice and vaginal orifice vagina: how menstrual blood and babies leave the body and how sperm gets in ovaries produce and release female gametes and sex hormones like estrogen and progesterone gametes: haploid cells formed by miosis when a sperm fuses with an egg they make a diploid cell which has all the genetic information needed to make a baby tunica albuginea: connective tissue surrounding ovary germinal epithelium: cuboidal epithelial cells, part of the peritoneum ovary contains: -cortex: houses developing eggs -medulla: contains most of the ovary's blood vessels and nerves a follicles structure varies depending on how mature it is-for example, youn primordial follicles are surrounded by a just single layer of follicle cells, while more matures ones ripen to include several extra layers of granulosa cell padding ovarian follicles: tiny, sac like structures that each hold a single primary oocyte -oocyte: incomplete proto-egg -follicle cells: the supporting cells are granula and theca cells, derived from germinal epithelium females are born with essentially all of these early versions of eggs in all of the primordial follicles they will ever have (1 million at birth) -get stuck at the first stage of miosis and stay that way for years or forever -oogenesis delayed until puberty oogenesis: egg development menstrual cycle: happens in the uterus to prepare for a fertilized egg ovarian cycle: the maturation of the follicle and egg -drives menstrual cycle -primordial follicle to late tertiary follicles -375 days -out of 20 follicles about one will end up supporting a single mature egg. the rest don't get the hormonal boost needed -atresia: kind of programmed self-destruction around puberty the hypothalamus and pituitary gland set up two cycles -ovarian cycle -menstrual cycle hypothalamus: starts ovarian cycle with gonadotropic hormones about once a month; stimulates the anterior pituitary gland to release FSH (Follicle stimulating hormone) and LH (leutenizing hormone) FSH stimulates dominate follicle to secrete its own estrogen hormone. Lots of follicles may start this ripening process, but only a single dominant one will make it to ovulation. The process by which the other ones die off along the way called astresia estrogen stimulates pituitary to release another batch of LH. the pituitary is actually inhibited by low levels of estrogen, but stimulated by high levels while this final rapid maturation only takes about 14 days, that follicle growth from primordial stage to full maturity ultimately takes about a year-- which means a follicle that actually ovulates actually started it's growth to maturity 10-12 ovarian cycles earlier. In other words, if you were to look inside an ovary, you'd see follicles at different stages of maturity any day of the year mature oocyte corpus luceum: progesterone estrogen and inhibine work to stop FSh and LH releasing fallopian tube: 10 cm long made of sheets of smooth muscle and highly folded mucosa layer; not connected to ovary uterus: is supported by various ligaments; laterally by the mesometrium, inferiorly by the cardinal ligaments, and posteriorly by the uterosacral ligaments, and anteriorly by fibrous round ligaments three layers -perimetrium- outside -myometrium: bulky, smooth muscle, contracts during labor -edometrium: inner mucosal lining consisting of stratum functionalis, stratum basalis an estimated 70% of fertilized eggs don't take hold in the endometrium. this could be because women's bodies may be able to detect if something might be wrong with the growing embryo, in which case, she'll shed the egg with the rest of the uterine lining and menstruate as usual

menstruation

While the ovum matures and travels through the fallopian tube, the endometrium grows and develops in preparation for the embryo. If the ovum is not fertilized in time or if it fails to implant into the endometrium, the arteries of the uterus constrict to cut off blood flow to the endometrium. The lack of blood flow causes cell death in the endometrium and the eventual shedding of tissue in a process known as menstruation. In a normal menstrual cycle, this shedding begins around day 28 and continues into the first few days of the new reproductive cycle.

Spermatic Cords and Ductus Deferens

Within the scrotum, a pair of spermatic cords connects the testes to the abdominal cavity. The spermatic cords contain the ductus deferens along with nerves, veins, arteries, and lymphatic vessels that support the function of the testes. The ductus deferens, also known as the vas deferens, is a muscular tube that carries sperm superiorly from the epididymis into the abdominal cavity to the ejaculatory duct. The ductus deferens is wider in diameter than the epididymis and uses its internal space to store mature sperm. The smooth muscles of the walls of the ductus deferens are used to move sperm towards the ejaculatory duct through peristalsis.

trichomoniasis

common and easy to cure Most people who have trichomoniasis do not have any symptoms. Print Versionpdf icon The content here can be syndicated (added to your web site). What is trichomoniasis? Trichomoniasis (or "trich") is a very common sexually transmitted disease (STD). It is caused by infection with a protozoan parasite called Trichomonas vaginalis. Although symptoms of the disease vary, most people who have the parasite cannot tell they are infected. How common is trichomoniasis? Trichomoniasis is the most common curable STD. In the United States, an estimated 3.7 million people have the infection. However, only about 30% develop any symptoms of trichomoniasis. Infection is more common in women than in men. Older women are more likely than younger women to have been infected with trichomoniasis. Two Trichomonas vaginalis parasites, magnified (seen under a microscope) How do people get trichomoniasis? The parasite passes from an infected person to an uninfected person during sex. In women, the most commonly infected part of the body is the lower genital tract (vulva, vagina, cervix, or urethra). In men, the most commonly infected body part is the inside of the penis (urethra). During sex, the parasite usually spreads from a penis to a vagina, or from a vagina to a penis. It can also spread from a vagina to another vagina. It is not common for the parasite to infect other body parts, like the hands, mouth, or anus. It is unclear why some people with the infection get symptoms while others do not. It probably depends on factors like a person's age and overall health. Infected people without symptoms can still pass the infection on to others. What are the signs and symptoms of trichomoniasis? About 70% of infected people do not have any signs or symptoms. When trichomoniasis does cause symptoms, they can range from mild irritation to severe inflammation. Some people with symptoms get them within 5 to 28 days after being infected. Others do not develop symptoms until much later. Symptoms can come and go. Men with trichomoniasis may notice: Itching or irritation inside the penis; Burning after urination or ejaculation; Discharge from the penis. Women with trichomoniasis may notice: Itching, burning, redness or soreness of the genitals; Discomfort with urination; A change in their vaginal discharge (i.e., thin discharge or increased volume) that can be clear, white, yellowish, or greenish with an unusual fishy smell. Having trichomoniasis can make it feel unpleasant to have sex. Without treatment, the infection can last for months or even years. What are the complications of trichomoniasis? Trichomoniasis can increase the risk of getting or spreading other sexually transmitted infections. For example, trichomoniasis can cause genital inflammation that makes it easier to get infected with HIV, or to pass the HIV virus on to a sex partner. How does trichomoniasis affect a pregnant woman and her baby? Pregnant women with trichomoniasis are more likely to have their babies too early (preterm delivery). Also, babies born to infected mothers are more likely to have a low birth weight (less than 5.5 pounds). How is trichomoniasis diagnosed? It is not possible to diagnose trichomoniasis based on symptoms alone. For both men and women, your health care provider can examine you and get a laboratory test to diagnose trichomoniasis. What is the treatment for trichomoniasis? Trichomoniasis can be treated with medication (either metronidazole or tinidazole). These pills are taken by mouth. It is safe for pregnant women to take this medication. It is not recommended to drink alcohol within 24 hours after taking this medication. People who have been treated for trichomoniasis can get it again. About 1 in 5 people get infected again within 3 months after receiving treatment. To avoid getting reinfected, all sex partners should get treated with antibiotics at the same time. Wait to have sex again until everyone has been treated and any symptoms go away (usually about a week). Get checked at 3 months to make sure you have not been infected again, or sooner if your symptoms come back before then. How can trichomoniasis be prevented? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting trichomoniasis: Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results; Use latex condoms the right way every time you have sex. This can lower your chances of getting trichomoniasis. Another approach is to talk about the potential risk of STDs before you have sex with a new partner. That way you can make informed choices about the level of risk you are comfortable taking with your sex life. If you or someone you know has questions about trichomoniasis or any other STD, talk to a health care provider.

Syphillis image

e images below depict symptoms of STDs and are intended for educational use only. Click images to view full size. Darkfield micrograph of Treponema pallidum. Primary stage syphilis sore (chancre) on the surface of a tongue. Lesions of secondary syphilis. Secondary stage syphilis sores (lesions) on the palms of the hands. Referred to as "palmar lesions." Secondary stage syphilis sores (lesions) on the bottoms of the feet. Referred to as "plantar lesions." Secondary syphilis rash on the back. Primary stage syphilis sore (chancre) on glans (head) of the penis. Primary stage syphilis sore (chancre) inside the vaginal opening.

crash course male reproductive system

female gamete is a big bet male penny slots human sperm are only about one-hundred-thousandth the mass of an egg The mass of a sperm is roughly 2x10^-14 kg and the mass for an ovum is about 3x10^-9 kg. A sperm is about 50 micorgmeters long. An ovum's diameter is about 120 micrometers sperm: nucleus, tail, extra mitochondria testicles: male gonads, responsible for making male gametes, sperm, and the androgen hormone testosterone, dangle outside for cool temp for sperm sperm production isn't so 'cool' at core body temperature of 37 degrees Celsius. Luckily, the average scrotal temp is about 3 degrees cooler, and thus more sperm freindly the testes have to be outside the body cavity to reach the lower temp necessary for proper spermatogenesis or sperm production Not only that, but the scrotum contains two muscles, the dartos and cremaster muscles, that help regulate testicular temp even more by relaxing a little to move the testes farther from the body if they are too warm or contracting and "shrinking" to pull them closer to the body if they're a bit chilly sperm surrounded by two tunics- the outer tunica vaginalis, and the fibrous inner tunica albuginea lobules loaded with semiferous tubules tubles make sperm surrounded by stratifed epithelium and a liquid filled lumen sertoli cells: sustentocytes, nourish developing sperm cells leydig cells: secrete testosterone hormonal cascade hypothalamus makes GnRH to tell pituitary gland to make FSH AND LH -LH makes leydig produce testosterone -FSH makes seroli cells release androgen binding protein which binds to testosterone sermatagonia type a stays up to dived type b primary spermatocytes go through mitosis spermiogenisis 5 weeks grow tale mature male can crank out 1500 sperm a second myoid cells peristalsis rete testis epididymis duct 6 meters -stereocilia takes sperm 20 days to work through sperm maturation isn't fully complete until it encounters the alkaline environment of the vaginal canal gain mitochondria vas deferens: the vas deferens is part of the spermatic cord, which also includes testicular artery, vein, and a number of nerve fibers ejaculation: if several months pass without any ejaculations all that sperm waiting in the wings will eventually get phagocytized, or destroyed and recycled ejacualtory gland prostate gland urethra seman: sperm, testicular fluid, and gland secretions provide sperm with 1. transportation 2. nutritional energy 3 chemical protection 4. activates their motility seminal vesicles: small hollow glands; this fluid makes up about 70 % of semen. Its slightly alkaline to help counteract the slightly acid environement both in the male urethra and female vagina prostate gland: the enzyme PSA makes the fluid more fluid (easier to move through) and antioxidant amine spermine ( which is present in all eukaryotic cells to protect DNA) also somehow increases motility by acting withing the sperm. Incidentally, it also inhibits motility at high doses, gives semen a characteristic odor, and is why some people claim semen is good for skin penis- 3 layers pubis glans penis foreskin

HPV

human papillomavirus vaccine can prevent some health effects caused by the virus like genital warts and some cancers There are many different types of HPV. All boys and girls ages 11 or 12 years should get vaccinated. Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Some health effects caused by HPV can be prevented by the HPV vaccines. The content here can be syndicated (added to your web site). Print Versionpdf icon What is HPV? HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). 79 million Americans, most in their late teens and early 20s, are infected with HPV. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening. How is HPV spread? You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms. Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected. Does HPV cause health problems? In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer. Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area. Does HPV cause cancer? HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers. There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV. How can I avoid HPV and the health problems it can cause? You can do several things to lower your chances of getting HPV. Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See "Who should get vaccinated?" below) CDC recommends HPV vaccination at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. For more information on the recommendations, please see: https://www.cdc.gov/vaccines/vpd/hpv/public/index.html Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer. If you are sexually active Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom - so condoms may not fully protect against getting HPV; Be in a mutually monogamous relationship - or have sex only with someone who only has sex with you. Who should get vaccinated? HPV vaccination is recommended at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination. At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection. How do I know if I have HPV? There is no test to find out a person's "HPV status." Also, there is no approved HPV test to find HPV in the mouth or throat. There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years. Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they've developed more serious problems from HPV, such as cancers. How common is HPV and the health problems caused by HPV? HPV (the virus): About 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that almost every person who is sexually-active will get HPV at some time in their life if they don't get the HPV vaccine. Health problems related to HPV include genital warts and cervical cancer. Genital warts: Before HPV vaccines were introduced, roughly 340,000 to 360,000 women and men were affected by genital warts caused by HPV every year.* Also, about one in 100 sexually active adults in the U.S. has genital warts at any given time. Cervical cancer: Every year, nearly 12,000 women living in the U.S. will be diagnosed with cervical cancer, and more than 4,000 women die from cervical cancer—even with screening and treatment. There are other conditions and cancers caused by HPV that occur in people living in the United States. Every year, approximately 19,400 women and 12,100 men are affected by cancers caused by HPV. *These figures only look at the number of people who sought care for genital warts. This could be an underestimate of the actual number of people who get genital warts. I'm pregnant. Will having HPV affect my pregnancy? If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Abnormal cell changes can be found with routine cervical cancer screening. You should get routine cervical cancer screening even when you are pregnant. Can I be treated for HPV or health problems caused by HPV? There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause: Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment. For more information visit www.cancer.orgexternal icon. Other HPV-related cancers are also more treatable when diagnosed and treated early. For more information visit www.cancer.orgexternal icon

hepatitis

inflammation of the liver

genital herpes symptoms and treatment

FAST FACTS Genital herpes is a sexually transmitted infection (STI) that causes infected sores or blisters. It's caused by the herpes simplex virus (HSV) which can be passed on through close genital contact. You can reduce your chances of getting genital herpes by using condoms or dental dams during sex. If you think you have symptoms of genital herpes you should see a healthcare worker, they can take a swab from a blister and test to confirm if it's caused by the herpes simplex virus. Treatment can help with herpes outbreaks, but the virus cannot be cured and will remain in the body. This means that blisters normally come back once in a while. What is herpes? Genital herpes is a sexually transmitted infection (STI) that causes blisters and ulcers. Herpes is caused by the herpes simplex virus (HSV), which is transmitted through skin-to-skin contact. Herpes can affect various areas of the body but is most commonly found on the genitals, anus or mouth. The blisters heal with time (usually within 2-3 weeks), but the virus that causes them cannot be cured, and herpes outbreaks will often reoccur. How do you get genital herpes? Herpes is most infectious when you have blisters, but the virus can be passed on even when someone has no symptoms (normally immediately straight before or after an outbreak). Herpes is passed on through skin-to-skin contact, including vaginal, anal or oral sex without a condom or dental dam. This means the virus can be passed on even if you don't have penetrative sex, orgasm or ejaculate (cum). Herpes can be passed on by sharing sex toys that aren't washed or covered with a new condom each time they are used. If you have genital herpes while pregnant you can pass the virus on to your unborn baby. Speak to your healthcare provider if you're pregnant and worried you might have herpes. How do you avoid getting or passing on genital herpes? If either you or your partner has a herpes outbreak (or if you feel like you might be about to get one), it's best to wait until the symptoms have cleared up before having sex. Using a new male or female condom or dental dam every time you have vaginal, anal or oral sex will reduce the risk of herpes being passed on. Herpes can also be transmitted by sharing sex toys. To reduce your risk, either avoid sharing your sex toys or make sure that they are washed and covered with a new condom between each use. Use a new dental dam or latex gloves for rimming and fingering (exploring your partner's anus with your fingers, mouth or tongue) or use latex gloves for fisting, especially if you get herpes on your hands. Talking about your sexual health with your partners, and letting each other know about any infections that you have, can help you make decisions about safer sex together. Reducing your number of sexual partners can help you reduce your risk of getting sexually transmitted infections, like genital herpes. If you are having sex with multiple partners, it's even more important to use condoms and to have regular STI checks. Condoms are the best form of protection against STIs and pregnancy. Other contraceptives including the contraceptive pill will not prevent herpes, and neither will PrEP. What do genital herpes symptoms look like? The most common symptoms of herpes are small blisters that burst to leave red, open sores. You can get herpes blisters on your penis, vagina, anus, throat, on the top of your thighs and buttocks or around your mouth (where they're called cold sores). Other symptoms can include: pain when urinating (peeing) tingling or burning around the genitals feeling unwell, with aches, pains and flu-like symptoms unusual vaginal discharge in women. Many people with genital herpes won't get any symptoms, or may get symptoms for the first time months or even years after they were infected. For most people, the blisters go away within one to two weeks. Although the outbreaks clear-up by themselves, the virus stays in the body. This means that people usually get blisters again - which is called having a 'recurrent outbreak'. Outbreaks usually become shorter and less severe over time. Can I get tested for genital herpes? Yes, if you think you have symptoms of genital herpes or have been at risk of infection, you should speak to a healthcare worker. There are different tests available. If you have symptoms, the most common test is to take a swab from a blister. The fluid can be tested for the herpes simplex virus.Some places may also offer blood tests to check for antibodies to the virus, but these are often not routinely available, so ask a healthcare worker if you're unsure. If you have genital herpes you should be tested for other STIs. It's also advised that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have genital herpes do not notice anything wrong, and by telling them you can help to stop the virus being passed on. How is genital herpes treated? There is no cure for the herpes simplex virus. The blisters usually heal and go by themselves, so you may not always need treatment. There is antiviral medicines for herpes, which can: shorten outbreaks, relieve discomfort and stop symptoms from getting worse. The antiviral treatment is most effective when you take it within the first five days of symptoms appearing. Avoid touching the blisters as this can also increase the risk of spreading the infection. If your herpes treatment requires you to apply cream to a sore, just gently pat the cream on, being careful not to rub around the surrounding area. You can ease your symptoms by: keeping the affected area clean using plain or salt water to prevent blisters or ulcers from becoming infected applying petroleum jelly, such as Vaseline, to any blisters or ulcers to reduce the pain when passing urine asking a healthcare provider to recommend painkilling creams avoiding tight clothing because it may irritate the blisters and ulcers. Don't have sex until you or your partner have finished your treatment, and the blisters or ulcers have gone. If it's your first outbreak, it's sometimes advised that you check back with a healthcare provider before having sex again, to ensure that your symptoms have gone. Genital herpes and pregnancy It's really important to speak to a healthcare worker if you have herpes during pregnancy, especially if it's your first outbreak. There's a risk that your baby can develop 'neonatal herpes' which can be very dangerous or even fatal for the baby. If you have herpes, your healthcare provider will be able to prescribe antiviral treatment to keep your baby safe and help you have a healthy pregnancy. Speak to a healthcare worker for more information or if you have any concerns. Genital herpes, HIV and sexual health Genital herpes is one of the most common co-infections for people living with HIV and can be a more serious condition if you're HIV positive - meaning that outbreaks may last longer and blisters can be more severe. If you're having recurrent outbreaks of genital herpes, you should have an HIV test, as this may be a sign of a weakened immune system caused by HIV. Having an STI such as genital herpes can increase your risk of getting and passing on HIV, as the blisters and sores provide an easy way for HIV to get into your body and cause an infection. People living with HIV who aren't on treatment or who have a lower CD4 count are especially vulnerable to other infections, like herpes. If you're taking antiretroviral treatment for HIV, it's important to discuss with your doctor how treatment for herpes may interact with your HIV drugs.

genital warts symptoms and treatment

FAST FACTS Genital warts are caused by a virus that can be passed on through close genital contact, including sex without a condom. They look like small lumps or growths and are usually found around the penis, vagina, anus or upper thighs. If you think you might have genital warts, it's important to have them checked by a healthcare professional. The warts themselves can be treated and removed, but the virus that causes them can't be cured. The best way to prevent genital warts is to use condoms and dental dams for sex. What are genital warts? Genital warts are small, raised, usually painless growths. They are caused by the human papilloma virus (HPV) which can be passed on through sex without a condom. There are over 100 different strains of HPV. The strain of HPV that causes genital warts is different from the strain that causes genital cancers, such as cervical cancer. The HPV that causes warts isn't linked to cancer and doesn't cause any more serious health problems. The warts themselves can be treated and will clear. What are the symptoms of genital warts? Genital warts can appear as a single wart or as multiple warts in a cluster. Symptoms include: one or more small, flesh-coloured or grey painless growths or lumps around your vagina, penis, anus or upper thighs itching or bleeding from your genitals or anus a change to your normal flow of pee (for example, sideways), that doesn't go away. Be aware that the warts may be difficult to notice if they are internal (inside the vagina or anus) and that many people with the strain of HPV that causes genital warts will not develop any symptoms or know that they have it. Symptoms of genital warts can appear weeks, months or years after you were in contact with the virus that causes them. If you have symptoms of genital warts it's important to visit a health clinic to have them checked. How do you get genital warts? Genital warts can be passed on through vaginal or anal sex without a condom and by sharing sex toys. The virus is transmitted through close genital contact, which means that you can get and pass on warts if you touch genitals with someone, even if you don't have penetrative sex or ejaculate (cum). Although it's rare, genital warts can also be passed on through oral sex and affect the mouth and throat. You can only get genital warts from someone else who has the virus, but be aware that not everyone will know if they have it. If the warts are internal someone may not notice them and people can pass on the virus even if they don't have any symptoms. You can't get genital warts from kissing, hugging, swimming pools, sharing towels or cutlery. If a woman has genital warts while pregnant, there is a risk that she could pass them on to her baby at birth. This isn't very common, but it's important that pregnant women seek advice from a healthcare worker if they notice any symptoms. How do you prevent genital warts? The best way to prevent genital warts is to use a condom for vaginal, anal and oral sex. If you're sharing sex toys these should be covered with a new condom for each partner and washed between use. If you have symptoms that could be genital warts you should go to a health clinic to have these checked. If you have genital warts, you may be advised to avoid sex while they're being treated. If you do have sex, make sure that the warts are covered with a condom. This area of skin should be covered with a condom even after the warts have gone. You can still pass the virus on for up to three months after the warts have disappeared. Avoid rubbing or touching your warts, in case you spread the infection to the surrounding area. If you find out that you have genital warts your partner should also get checked. Talking about your sexual health with your partners, and letting each other know about any symptoms or infections, will help you decide how to have safer sex together. Reducing your number of sexual partners can also help you reduce your risk of getting sexually transmitted infections, like genital warts. If you are having sex with multiple partners, it's even more important to use condoms and to have regular STI tests. Condoms are the best form of protection against STIs and pregnancy. Other contraceptives including the contraceptive pill will not prevent genital warts, neither will PrEP. Get vaccinated The HPV vaccine, developed to protect against more serious forms of HPV, can also prevent genital warts. The vaccine does not guarantee that you will not develop genital warts in the future, but it will reduce your risk. It's best to have the vaccine before you start having sex. Ask a healthcare worker to find out if you can get the HPV vaccine where you are. Can I get tested for genital warts? Yes - a healthcare professional will usually diagnose warts by looking at them. They may check for hidden warts, by looking inside the vagina and or anus. If you have a problem urinating, a specialist may look at the urethra (the tube that carries pee from your bladder). This examination shouldn't be painful and you are welcome to have someone with you for the appointment if it would make you feel more comfortable. It's not something that you should feel embarrassed about, remember that the healthcare professional will do this all the time. How are genital warts treated? The sooner genital warts are treated, the easier they are to get rid of. There are two main types of treatment for genital warts. The type of treatment you receive will depend on the type of warts you have and where the warts are. Treatments include: applying a cream, lotion or chemicals to the warts destroying the warts by freezing, heating or removing them. It may take several weeks for the treatment to work. During this time, you may be advised to avoid soaps, or creams and lotions that could irritate the skin. You might also be advised not to have sex until you or your partner have finished your treatment, and the warts have gone. Although these treatments can remove the warts themselves, there's no cure for the virus that causes the warts. Some people's bodies, however, are able to clear the virus over time. You should always check with a healthcare worker before using treatments for genital warts. Many wart treatments are designed to be used on hands and feet and should not be used on your genitals. Genital warts and pregnancy It's possible for pregnant women to pass genital warts on to their babies during childbirth, but this is rare. Talk to your healthcare worker if you are pregnant and think you might have genital warts. They will be able to advise you which treatment to use, as not all of the treatments available are suitable for pregnant women. Genital warts, HIV and sexual health If you have genital warts you should also test for HIV and other STIs. Having an STI, including genital warts, can increase your risk of getting HIV. This is because having an STI makes it easier for HIV to get into your body and cause an infection. People living with HIV can also be more likely to get genital warts or have more severe cases of genital warts. This is especially the case for people who aren't on treatment or who have a lower CD4 count. You're more vulnerable to infections, like genital warts, if your immune system is weaker. Speak to your healthcare provider if you are living with HIV and taking treatment for genital warts, to make sure that the medication won't affect your antiretroviral treatment (ART).

gonorrhea symptoms and treatment

FAST FACTS Gonorrhoea is a sexually transmitted infection (STI) that is normally passed on through sex without a condom or sharing sex toys with someone who has the infection. Using male or female condoms and dental dams during sex will help to protect you from getting gonorrhoea. Many people with gonorrhoea don't have any symptoms, so it's important to get tested if you have had unprotected sex and think you might have it. Gonorrhoea is curable, but if left untreated it can cause other health problems. What is gonorrhoea? Gonorrhoea is a sexually transmitted infection (STI). It used to be known as 'the clap'. Gonorrhoea can be easily treated and cured with antibiotics. However if it isn't treated, gonorrhoea can cause infertility (inability to have children) and other health conditions. How do you get gonorrhoea? Gonorrhoea is usually passed on through unprotected vaginal, anal or oral sex. You can also get gonorrhoea through close genital contact. This means you can get gonorrhoea from someone if your genitals touch, even if you don't have sex or ejaculate (cum). It's also possible to have a gonorrhoea infection in your eye, if it comes into contact with semen (cum) or vaginal fluids from someone with the infection - but this is rare. Pregnant women can pass the infection onto their babies at birth. If you're pregnant and think you may have gonorrhoea, it's important to get tested as soon as possible so you can be treated before the baby is born. Gonorrhoea can't be passed on through kissing, hugging, sharing towels or using the same toilet as someone with the infection. How can you prevent gonorrhoea? Using a new male or female condom or dental dam every time you have vaginal, anal or oral sex is the best way to protect yourself from getting gonorrhoea. Gonorrhoea can be passed on by sharing sex toys. Always cover sex toys with a new condom and wash them after use to reduce your risk of getting gonorrhoea and other STIs. Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, it's even more important to use condoms and get tested regularly. The contraceptive pill and other forms of contraception (apart from condoms) won't protect you from gonorrhoea, neither will PrEP. What are the symptoms of gonorrhoea? Many people with gonorrhoea don't have any symptoms. If you do get symptoms, you will normally notice them within 10 days of infection, but they can occur many months later. Gonorrhoea symptoms in women include: unusual thick and green or yellow discharge from the vagina pain or burning when urinating (peeing) pain in the lower abdomen bleeding between periods and/or heavier periods bleeding after sex - this is rare. Gonorrhoea symptoms in men include: unusual discharge from the penis that may be white, yellow or green in colour pain or burning when urinating (peeing) inflammation or swelling of the foreskin pain in the testicles - this is rare. You can also get gonorrhoea in your anus (bottom), eyes or throat. Both women and men can experience pain, swelling or discharge in the anus, or inflammation (redness) of the eye (called conjunctivitis). Gonorrhoea in the throat doesn't normally have any symptoms. How do I test for gonorrhoea? You can get tested for gonorrhoea even if you don't have any symptoms. For women, a healthcare professional will usually take a swab from either the lower part of the womb (cervix) or the vagina. Men usually need to provide a urine (pee) sample and/or a swab taken from the tip of the penis (urethra). If you have had anal or oral sex, you may have a swab taken from the anus (bottom) or throat. If you test positive for gonorrhoea, it is important to tell your recent sexual partner/s so they can also get tested and treated. Your healthcare professional can advise you on this. You should also be tested for other STIs. When should I get tested for gonorrhoea? You can get tested for gonorrhoea within a few days of having sex, although sometimes you may have to wait up to a week. If you have had sex without a condom, or you are worried about gonorrhoea or other STIs, speak to your healthcare professional about getting tested as soon as possible. How is gonorrhoea treated? Gonorrhoea is usually treated with a short course of antibiotics. It's important to not have sex again until you and your current sexual partner/s have finished treatment and a healthcare professional says you can. Even if you've been treated for gonorrhoea, you are not immune and can get it again. Long-term effects of untreated gonorrhoea If left untreated, gonorrhoea can lead to other health problems. In women it can cause pelvic inflammatory disease (PID). PID is an infection that can cause pelvic pain, infertility (inability to get pregnant), and ectopic pregnancy (pregnancy outside the uterus) which can be life-threatening. PID can be treated with antibiotics. In pregnant woman, gonorrhoea can cause miscarriage and premature labour. The mother can pass it on to her unborn baby. Gonorrhoea can be more dangerous in babies, as it can cause eye infections such as conjunctivitis, which in serious cases can lead to blindness. In men untreated gonorrhoea can cause an infection in the testicles called epididymitis. This can result in fever, scrotal pain and swelling and, in rare cases, infertility. In rare cases, for both women and men, untreated gonorrhoea can spread to other parts of the body. This can cause inflammation and swelling of joints and tendons, skin irritation and redness, and inflammation around the brain and spinal cord (meningitis) or the heart. Gonorrhoea and HIV Having an STI, including gonorrhoea, increases your risk of getting HIV. If you are living with HIV and also have gonorrhoea, your viral load is likely to increase. This will make you more likely to pass on HIV if you have sex without a condom, even if you are on treatment. However, if you have an undetectable viral load (because you're taking antiretrovirals) there is no evidence that gonorrhoea makes you more likely to pass on HIV. If you are taking antiretrovirals it is important to discuss with your doctor how treatment for gonorrhoea may interact with your HIV drugs. If you are worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section.

hepatitis A symptoms

FAST FACTS Hepatitis A is a virus found in human faeces (poo). It's usually passed on through contaminated food and water, but it's also a sexually transmitted infection (STI) passed on by having sex without a condom or dental dam (particularly anal sex), fingering and rimming, or sharing sex toys with someone who has the virus. You can also get it if you share contaminated needles and syringes. Hepatitis A can be prevented by being careful where you eat and drink; practising safer sex, including using male and female condoms, dental dams and latex gloves; never sharing needles and syringes; and/or having a hepatitis A vaccination. A simple blood test carried out by a healthcare professional will show whether you have hepatitis A. There is no treatment for hepatitis A - it usually clears up on its own. If you've had unprotected sex, or you're worried about hepatitis A or other STIs, get tested as soon as possible - even if you haven't got any symptoms. What is hepatitis A? Hepatitis A (also known as hep A or HAV) is part of a group of hepatitis viruses that causes inflammation of the liver - which is when your liver becomes swollen and painful. Usually hepatitis A isn't serious and it only lasts around 10 to 14 days. However, it's important to get tested to make sure you haven't got a more serious condition with similar symptoms, such as hepatitis B or C, or cirrhosis (scarring) of the liver. How do you get hepatitis A? The virus needs to get from human faeces (poo) into the mouth to infect someone. You only need to be in contact with small amounts of poo to become infected. Hepatitis A can be passed on very easily and you can get it if you: eat food prepared by someone with the virus who hasn't washed their hands properly in clean water. drink dirty water (including ice cubes). eat raw or undercooked shellfish from dirty water. are in close contact with someone who has hepatitis A. less commonly - have sex without a condom or dental dam with someone who has the virus (even if they don't have symptoms), particularly if you have anal sex, are fingering, rimming or fisting - exploring their anus (bottom) with your fingers, mouth or tongue; or touching used condoms and sex toys that have been in someone else's anus (bottom). share contaminated needles and syringes during recreational drug use (also less common). Hepatitis A, HIV and sexual health Having an STI, including hepatitis A increases your risk of getting HIV. This is because most STIs cause sores or lesions that make it easier for HIV to enter the body. Some people will have both hepatitis A and HIV, which is known as co-infection. If you're living with HIV and also have hepatitis A, your viral load is likely to increase because your immune system is weaker. This will make you more likely to pass on HIV if you have sex without a condom. People living with HIV may stay sick with hepatitis A for longer than people who haven't got the virus. Many HIV drugs (antiretrovirals), as well as medicines used to treat other conditions, are processed in the liver. If you have hepatitis A it's likely that your liver will be swollen, so it may not be able to process other medicines properly, which could lead to side effects or worse side effects than usual. Some people need to stop taking their HIV drugs or other medicines when they have hepatitis A, but these decisions need to be taken with your doctor. If you're living with HIV or at risk of HIV, for example, if you're a man who has sex with men, sell sex or use drugs, ask your healthcare professional if you should have a hepatitis A vaccination. If you're worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section How do I protect myself against hepatitis A? Wash your hands each time you go to the toilet, before you prepare or eat food, after coughing or sneezing, or handling rubbish or other dirty items. Peel and wash all your fresh fruit and vegetables; don't eat raw or undercooked meat and fish; avoid all drinks if you're not sure if they're safe - with or without ice. If tap water isn't safe and bottled water isn't available, boil tap water before drinking it. Practise safer sex:Know the status of your sexual partners.Use a new male (or external) or female (or internal) condom or dental dam every time you have vaginal, anal or oral sex.Use a new dental dam or latex gloves for rimming and fingering (exploring your partner's anus with your fingers, mouth or tongue) or use latex gloves for fisting.Cover sex toys with a new condom and wash them after use.Avoid sex that involves contact with faeces (poo).Wash your hands after touching someone's anus (bottom) or handling used condoms and sex toys.Never share needles and syringes or other items that may be contaminated with the virus.Limit the number of sexual partners you have, remember to use a new condom for each partner, and have regular STI tests.Have the hepatitis A vaccine (where available) if you're in close contact with someone with hepatitis A or if you're in a high-risk group. High-risk groups include men who have sex with men and people who inject drugs. You may also be exposed to hepatitis A through your work, for example, sewage workers, staff in institutions where levels of personal hygiene may be poor (such as a homeless shelter) and people working with animals that may be infected with hepatitis A. Remember - apart from condoms, other types of contraception such as the contraceptive pill don't protect you from sexually transmitted infections. Ask your doctor or healthcare professional if you need further advice on how to protect yourself and your partner's from HIV and STIs. What do hepatitis A symptoms look like? Many people with hepatitis A don't have any symptoms. If symptoms do develop, you'll usually notice them around four weeks after infection. These symptoms will usually pass within two months. Symptoms for women and men include: flu-like symptoms, including tiredness, a fever and aches and pains loss of appetite feeling and/or being sick diarrhoea pain in the upper right part of your tummy (abdomen) dark urine and pale faeces (poo) yellowing of the skin and eyes (jaundice) itchy skin. Can I get tested for hepatitis A? Yes - a simple blood test carried out by a healthcare professional will show whether you have the virus. If you've got hepatitis A you should be tested for other STIs. It's important that you tell people you live with or have close contact with, and your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis A don't notice anything wrong, and by telling those you're in close contact with you can help to stop the virus being passed on. It can also stop you from getting the infection again. How is hepatitis A treated? There isn't a specific treatment for hepatitis A, and most people will recover fully within a one to two months. Usually symptoms are managed at home with plenty of rest; and painkillers and/or medication to help with itchiness, nausea or vomiting may be prescribed. Whether you've got symptoms or not, don't prepare food for others or have sex until you're told by a healthcare professional that you're no longer infectious. Once you've recovered from hepatitis A you're immune - this means you can't get it again, but you can get other types of hepatitis such as hepatitis B and hepatitis C, which are more serious. Complications of hepatitis A As with most STIs, hepatitis A puts you at risk of other STIs, including HIV. Unlike other types of viral hepatitis, hepatitis A does not normally cause long-term liver damage and doesn't become a long-term (chronic) illness. Occasionally hepatitis A can last longer and, in rare cases, it can be life-threatening if it causes the liver to stop working properly (liver failure).

pubic lice symptoms and treatment

FAST FACTS Pubic lice are tiny insects found on coarse human body hair, such as the hair around your genitals. They are passed on through close bodily contact with someone who has pubic lice and are usually sexually transmitted - which is when they move from one person to another during sex. Pubic lice cannot be prevented from spreading during sex - even by using condoms. A simple examination by a healthcare provider can easily tell if you have pubic lice. Pubic lice can be treated at home with insecticide cream, lotion or shampoo. If you've had unprotected sex, or you're worried about pubic lice or other STIs, get tested as soon as possible - even if you don't have symptoms. What are pubic lice? Pubic lice, also known as crabs - are tiny parasitic insects that live on coarse human body hair, such as pubic hair (the hair around your genitals). They can also sometimes be found in other body hair such as underarm hair and beards, but don't live in the hair on your head. They are also called crabs because they have two large front legs that look like the claws of a crab. Adult pubic lice and lice eggs are very small (2mm long) and can be seen in coarse hair. They are a yellow-grey or dusky red colour and have six legs. The lice lay their eggs (nits) in sacs that stick to hair and are a pale brownish colour. When the eggs hatch, the empty egg sacs are white. Pubic lice need human blood to survive, so will only leave the body to move from one person to another. They crawl from hair to hair, they can't fly or jump. Are pubic lice serious? Infestation is not usually serious, but it's important to get treatment to avoid minor complications such as an infection from scratching or eye irritation. How do you get pubic lice? Pubic lice can be passed on easily and you can get them if you: are in close contact with the body of someone who has pubic lice - most commonly sexual contact, including vaginal, anal or oral sex. hug and kiss someone who has lice. share clothes, towels and bedding - although this is much less common. Pubic lice, HIV and sexual health Pubic lice don't carry other diseases, and although they feed on blood, pubic lice cannot pass on HIV or other STIs. If you are taking antiretrovirals, it is important to discuss with your doctor how treatment for pubic lice may interact with your HIV drugs. If you're worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section How do I protect myself against pubic lice? To prevent infestation, avoid having sexual or other close contact or sharing bedding or clothing with anyone who has lice. Using condoms and other methods of barrier contraception don't protect you. Ask your doctor or healthcare worker for advice. What do pubic lice symptoms look like? It can be several weeks before any symptoms appear. Symptoms for women and men include: itching - the most common symptom - and usually worse at night inflammation and irritation caused by scratching black powder in your underwear blue spots or small spots of blood on your skin, such as on your thighs or lower abdomen (caused by lice bites). Can I get tested for pubic lice? Yes - pubic lice are usually easy to diagnose. A healthcare professional will examine you and may use a magnifying glass to look for signs of the lice or their eggs. If you have pubic lice, you should be tested for other STIs . The lice don't transmit HIV or other STIs, but a check-up is a good idea as a precaution. It's also important that you tell the people you live with, other people you have been in close bodily contact with and your recent sexual partner/s so that they can be checked and treated. This is important to stop the lice being passed on, and can stop you from getting them again. How are pubic lice treated? Pubic lice can be treated at home with insecticide cream, lotion or shampoo without a prescription. A pharmacist can provide advice. Some treatments only need to be applied to the affected area, but sometimes the whole body must be treated, and treatment usually needs to be repeated after three to seven days. Certain groups, such as young people under 18 years of age and pregnant or breastfeeding women, may require a specific type of treatment. Your healthcare provider can advise on this. Wash all clothes, towels and bedding in hot water (50°C or higher) when you start treatment. If there are some things that you can't wash, put them in an airtight bag for three days. Whether you can see the lice and their eggs or not, don't have sex or close body contact with other people until you and your current sexual partner/s have finished your treatment and have been checked to make sure the lice have gone. Complications of pubic lice Occasionally, a pubic lice infestation can lead to minor complications, such as skin or eye problems. Scratching can lead to an infection such as impetigo (a bacterial skin infection) or furunculosis (boils on the skin). Eye infections, such as conjunctivitis, and eye inflammation, such as blepharitis, can sometimes develop if your eyelashes have been infested with pubic lice. Untreated, long-standing infestations can cause you to feel generally unwell.

syphilis symptoms and treatment

FAST FACTS Syphilis is a sexually transmitted infection (STI) that causes infected sores, blisters or ulcers on your genitals, anus (bottom) or mouth. It's normally passed on through sex without a condom or by sharing sex toys with someone who has the infection. Using condoms and dental dams during vaginal, anal and oral sex can protect you from getting syphilis. To be effective any sores or rashes must be covered. If you think there's a chance you might have syphilis, it's important to get tested and treated early on. Syphilis can be cured, but without treatment it can cause lasting health problems. Syphilis can also be passed on from mother to child, so it's important that women test for syphilis during pregnancy. What is syphilis? Syphilis is a sexually transmitted infection (STI). Syphilis can be passed on through sex without a condom, sharing needles and injecting equipment and from mother-to-child during pregnancy. Syphilis is not passed on through sharing food, hugging or using the same toilet as a person with syphilis. Syphilis can be cured with antibiotics, but it's important to get tested and treated early on, as without treatment, it can cause lasting health problems. How do you get and prevent syphilis? Sex and syphilis Syphilis is most commonly passed on through vaginal, anal or oral sex without a condom or dental dam, with someone who has syphilis. A person can pass on syphilis even if they don't have any symptoms. Syphilis causes infectious sores or rashes. Contact with these sores and rashes is the main way that syphilis is passed on. This means the infection can be passed on through genital contact or sex, even if you don't ejaculate (or cum). How do I prevent syphilis being passed on through sex? Using condoms and dental dams correctly and consistently for sex is the best way to prevent syphilis being passed on. Make sure that you use a new condom each time and remember that the condom or dental dam must cover sores or rashes or you won't be protected. Syphilis can also be passed on by sharing sex toys. To reduce your risk of syphilis, avoid sharing your sex toys or make sure that they are washed and covered with a new condom between each use. Testing regularly for syphilis and other STIs is important, especially if you have multiple sexual partners. Talking to your partners about your sexual health and knowing each others' statuses helps you protect both of your sexual health. PrEP doesn't prevent you from getting syphilis, neither does the contraceptive pill or other forms of contraception (apart from condoms). Sharing needles and blood transfusions Syphilis can be passed on by sharing needles and injecting equipment. To reduce your risk, avoid sharing needles or injecting equipment. Read more information on getting new needles and injecting safely. It's possible for syphilis to be passed on through blood transfusions, but this is very rare as most places test blood for infections including syphilis before transfusions. If you're worried about a blood transfusion, speak to your healthcare provider. Syphilis and pregnancy Syphilis can be passed from mother to child during pregnancy (this is called congenital syphilis). To avoid passing syphilis on, it's important that women test for syphilis during pregnancy. Pregnant mothers are advised to test at their first antenatal appointment, as well as after any time that they think they were at risk of getting syphilis. If you test positive for syphilis, your healthcare worker will offer you antibiotics to cure the infection for you and your baby. It's important that you take the treatment, because without it syphilis can be very dangerous for your baby, and increase your risk of miscarriage and stillbirth. Speak to your doctor or healthcare worker for more information and advice. What are the symptoms of syphilis? Many people with syphilis won't notice any symptoms for years, so, if you think there's chance you could have syphilis, don't wait for symptoms to develop, just go for a test. Without treatment a syphilis infection develops through different stages and can become a more serious, spreading to other parts of the body. Early symptoms The first thing a person may notice is a painless sore (called a chancre) - usually around their anus or genitals. A person would usually get this around 2-3 weeks after infection, but not everyone experiences this symptom. Chancres normally heal by themselves, but without treatment the infection will progress and more symptoms and health problems will develop. Later symptoms A few weeks after the early symptoms have passed, you might start to feel ill, with a fever or headache and notice weight loss or skin growths around your anus or genitals. Some people get rashes on their body, often on the palms of their hands or soles of their feet. Latent stage After this, a person may live with syphilis for years without any signs of infection. This is known as the 'latent stage' of infection. However, if syphilis is still left undiagnosed and untreated, the infection will go on to cause serious health problems. Problems if left untreated (late stage syphilis) If left untreated, syphilis will eventually cause serious health problems. It can cause irreversible damage your heart, brain and nervous system and lead to loss of sight, hearing, and other problems. Getting tested and treated early means that you can prevent this from happening, allowing you a full-recovery. How do you test for syphilis? Testing regularly for STIs, including syphilis is one of the best ways to look after your health. To test for syphilis a healthcare professional will do a blood test. The test doesn't hurt and will only take a small amount of blood. A healthcare professional may also examine your genital area, mouth and throat, to check for rashes or growths. If you have sores, a swab will be taken from these. You shouldn't feel embarrassed going for these tests, they're a normal part of looking after your health and the healthcare worker will do them all the time. If you test-positive for syphilis, it's important that you let any current or recent sexual partners know, as they will need to test too. Your healthcare worker can give you advice on how to tell them or may offer to tell them anonymously for you. You should also test for other STIs. How is syphilis treated? Syphilis can be cured with antibiotics. However, it's important that you get tested and treated early on, as some health problems caused by late-stage syphilis can't be resolved. The specific antibiotics used to treat syphilis may vary depending on where you are. Ask your healthcare professional any questions you have about your treatment. Your healthcare worker will be able to tell you when your infection has cleared. They may advise you to avoid having sex until you have finished your treatment, the sores have healed and they say it's ok. Remember, having been treated for syphilis previously does not make you immune. You can still get syphilis again. Syphilis and HIV If you have been diagnosed with syphilis you should also test for HIV. Having an STI, including syphilis, can increase your risk of getting HIV. This is because having an STI, especially one that causes sores, makes it easier for HIV to get into your body and cause an infection. People living with HIV can also be more likely to get syphilis. This is especially the case for people who aren't on treatment or who have a lower CD4 count. You're more vulnerable to infections, like syphilis, if your immune system is weaker. Syphilis may also progress more quickly in people living with HIV, so if you're living with HIV and think there's a chance you might have syphilis it's important to get tested and treated early on. Speak to your healthcare provider if you are living with HIV and taking treatment for syphilis, to make sure that the syphilis medication won't affect your antiretroviral treatment (ART).

trichomoniasis treatment and symptoms

FAST FACTS Trichomoniasis is a sexually transmitted infection (STI) caused by a tiny parasite. It can be passed on through having sex without a condom with someone who has the infection. Using male and female condoms during sex will help to protect you from trichomoniasis. It is easy to test for trichomoniasis, and the infection can be treated with antibiotics. What is trichomoniasis? Trichomoniasis, or trich (pronounced 'trick'), is a sexually transmitted infection (STI) caused by a tiny parasite called trichomonas vaginalis. It is easy to treat but most people don't have any symptoms. If you've had unprotected sex, or you are worried about trichomoniasis or other STIs, it's important to get tested as soon as possible. Getting the infection while pregnant can make women more likely to give birth prematurely and have a baby with a low birth weight. How do you get trichomoniasis? Trichomoniasis is easily passed on through unprotected vaginal sex (when the penis goes into the vagina) with someone who has the infection - even if they don't have any symptoms. Trichomoniasis can't be passed on through oral or anal sex, kissing or hugging. How do you prevent trichomoniasis? Using a new male or female condom every time you have sex will help prevent you getting trichomoniasis. However, some people have the infection in the area around the penis or vagina that is not covered by a condom. This means sometimes the infection can still spread even if you use a condom. Regularly testing for trichomoniasis and other STIs will help you to look after your sexual health, especially if you are having sex with multiple partners. It's really important to talk to your partner/s about your status and decide how to have safer sex together. Trichomoniasis can also be passed on through sharing sex toys, although this is less common. Always cover sex toys with a new condom and wash them after use. Remember that taking PrEP or using the contraceptive pill or other forms of contraception (apart from condoms) won't prevent you from getting trichomoniasis. What are the symptoms of trichomoniasis? Many people with trichomoniasis don't have any symptoms. If you do get symptoms, they normally appear within a month of infection. Trich symptoms in women include: yellow-green vaginal discharge which may have an unpleasant fishy smell soreness, swelling and itching in and around the vagina pain when urinating (peeing) or having sex pain in the lower stomach. Trich symptoms in men include: thin, white discharge from the tip of the penis pain or a burning sensation when urinating (peeing) soreness, swelling and redness around the head of the penis and foreskin. How do you test for trichomoniasis? Getting tested for trichomoniasis is easy and doesn't hurt. A healthcare professional will examine you and take a swab from the vagina or the penis. Sometimes men will also be asked to give a urine sample. If you find out that you have trichomoniasis you should test for other STIs. You will need to tell any recent sexual partners so they can also get tested and treated. You can ask your healthcare professional for advice about this. How is trichomoniasis treated? Trichomoniasis is easily treated with antibiotics. This can either be taken in one day as a single dose or over the course of a week. Wait until you have finished your treatment before having sex again, even if you don't have any symptoms. If you have taken the one-day treatment, you will need to avoid having sex for seven days afterwards. Ask your healthcare professional before having sex again. Remember that if you have been treated for trichomoniasis you are not immune and you can get infected again. Without treatment, the infection can last for months or even years. Trichomoniasis and HIV Having an STI, including trichomoniasis, increases your risk of getting HIV. If you are living with HIV and also have trichomoniasis, your viral load will likely increase. This will make you more likely to pass on HIV if you have sex without a condom, even if you are taking HIV drugs (antiretrovirals). However, if someone has an undetectable viral load, there's no evidence that trichomoniasis makes them more likely to pass on HIV. If you're taking antiretroviral treatment, it's important to discuss with your doctor how treatment for trichomoniasis may interact with your HIV drugs. If you're worried about HIV, find out everything you need to know in our HIV Transmission and Prevention section.

hepatitis B symptoms and treatment

FAST FACTS • Hepatitis B is found in infected blood, semen and vaginal fluids. • It's a sexually transmitted infection (STI) that can be passed on through having sex without a condom or sharing sex toys with someone who has hepatitis B (even if they don't have symptoms); using contaminated needles and syringes or other items with infected blood on them; or from a pregnant woman to her unborn baby. • Hepatitis B can be prevented by practising safer sex including using male and female condoms, dental dams and latex gloves; never sharing needles and syringes; and avoiding unlicensed tattoo parlours and acupuncturists; and/or having a hepatitis B vaccination (high risk groups and infants). • A simple blood test carried out by a healthcare professional will show whether you have hepatitis B. • Most people don't need treatment for acute hepatitis B. If it develops into chronic hepatitis B, treatment is available to reduce the risk of further complications, such as liver damage. If you've had unprotected sex, or you're worried about hepatitis B or other STIs, get tested as soon as possible - even if you don't have any symptoms. What is hepatitis B? Hepatitis B - hep B or HBV - is part of a group of hepatitis viruses that causes inflammation of the liver - which is when your liver becomes swollen and painful. Is hepatitis B serious? Hepatitis B can be serious and, without appropriate treatment and care, can cause liver disease and liver cancer leading to death. How do you get hepatitis B? Hepatitis B can be passed on very easily and you can get it if you: have unprotected sex (sex without a condom or dental dam), including vaginal, anal and oral sex with someone who has hepatitis B (even if they don't have symptoms). share sex toys that aren't washed or covered with a new condom each time they are used. are fingering, rimming or fisting - exploring your partner's anus (bottom) with your fingers, mouth or tongue; touching used condoms and sex toys that have been in someone else's anus (bottom). share contaminated needles and syringes during recreational drug use. are exposed to unsterilised tattoo, body-piercing or medical/dental equipment (occasionally you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them). are a pregnant woman with hepatitis B you can pass the virus on to your unborn baby. Hepatitis B, HIV and sexual health Having an STI, including hepatitis B, increases your risk of getting HIV. This is because most STIs cause sores or lesions that make it easier for HIV to enter the body. Because they are passed on in similar ways, some people have both viruses, which is known as co-infection. People with both viruses are more likely to develop chronic hepatitis B, and their liver can get damaged more quickly. If you're living with HIV and also have hepatitis B, your viral load is likely to increase because your immune system is weaker. This will make you more likely to pass on HIV if you have sex without a condom. If you're living with HIV, your healthcare professional should give you regular hepatitis B tests and regularly check your liver. If you're taking antiretrovirals, it's important to discuss with your doctor how treatment for hepatitis B may interact with your HIV drugs. If you're living with HIV or at risk of HIV, for example, if you're a man who has sex with men, sell sex or use drugs, ask your healthcare professional if you should have a hepatitis B vaccination. If you're worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section How do I protect myself against hepatitis B? Practise safer sex:Know the status of any sexual partner.Use a new male or female condom or dental dam every time you have vaginal, anal or oral sex.Use a new dental dam or latex gloves for rimming and fingering (exploring your partner's anus with your fingers, mouth or tongue) or use latex gloves for fisting.Cover sex toys with a new condom and wash them after use.Never share needles and syringes or other items that may be contaminated with blood, such as razors, toothbrushes and manicure tools (even old or dried blood can contain the virus).Only have tattoos, body piercings or acupuncture in a professional setting, and ensure that new, sterile needles are used.Have the hepatitis B vaccine (where available) if you are in a high-risk group (for example, you inject drugs, are a sex worker, are a man who has sex with men, change partners frequently, are in close contact with someone who has chronic hepatitis B, or your occupation exposes you to the virus, for example, a nurse). This immunisation is also recommended for infants born to mothers who have the virus and people living with HIV. Note - apart from condoms, other types of contraception - such as the contraceptive pill offer no protection against sexually transmitted infections. Ask your healthcare professional if you need further advice on how to protect yourself and your partner(s) from HIV and other STIs. What do hepatitis B symptoms look like? Many people with hepatitis B don't have any symptoms. If you do get symptoms you may not notice them until two or three months after infection and they will last up to three months. There can be two stages of infection: acute and chronic. For women and men acute (or short-term) symptoms include: flu-like symptoms, including tiredness, fever and aches and pains feeling and/or being sick loss of weight/appetite diarrhoea tummy (abdominal) pain jaundice, meaning your skin and the whites of your eyes turn yellow dark urine (pee) pale faeces (poo). For people who can't fight off the infection (for example, babies, young children and people with a weakened immune system because of HIV) the virus can move to the chronic stage. This is when people are at higher risk of liver failure, liver disease and cancer of the liver, but may be unaware of the dangers as symptoms can take years to develop. Can I get tested for hepatitis B? Yes - a simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given extra tests to see if your liver is damaged. If you've got hepatitis B you should be tested for other STIs. It's important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis B don't notice anything wrong, and by telling them you can help to stop the virus being passed on; and it can also stop you from getting the infection again. How is hepatitis B treated? There is no specific treatment for acute hepatitis B, and most people recover within one to two months. Usually, you can manage symptoms at home with painkillers if necessary. Your healthcare professional should advise you to have regular blood tests and physical check-ups. Most people make a full recovery from acute hepatitis B. If you develop chronic hepatitis B you'll be given treatment to reduce the risk of permanent liver damage and liver cancer. Treatment does not cure chronic hepatitis B and most people who start treatment need to continue on it for life. Whether you have symptoms or not, don't have sex until your heathcare professional says you can. Once you've had acute hepatitis B, you're immune - which means you can't get it again - but you can get other types such as hepatitis A and C. Complications of hepatitis B As with most STIs, hepatitis B puts you at risk of other STIs, including HIV. Without treatment a pregnant woman with hepatitis B can pass it on to her unborn baby. Without treatment, chronic hepatitis B can cause scarring of the liver (cirrhosis), which can cause the liver to stop working properly; a small number of people with cirrhosis develop liver cancer; and these complications can lead to death. Other than a liver transplant, there is no cure for cirrhosis. However, treatments can help relieve some of the symptoms.

Chlamydia symptoms and treatment

FAST FACTSChlamydia is a sexually transmitted infection (STI) that is normally passed on through sex without a condom or sharing sex toys with someone who has the infection.Using male or female condoms and dental dams during sex will help to protect you from getting chlamydia.Chlamydia is often symptomless however if left untreated it can lead to long-term health problems.Chlamydia is easily treated with antibiotics.Chlamydia can be passed on from mother to child during pregnancy, so it's important for pregnant women to get tested. What is chlamydia? Chlamydia is a sexually transmitted infection (STI) caused by a bacteria called chlamydia trachomatis. Usually it doesn't cause any symptoms and can be easily treated with antibiotics. However, if it isn't treated early it can spread to other parts of your body and lead to long-term health problems. How do you get chlamydia? Chlamydia is usually passed on through unprotected vaginal, anal or oral sex. Chlamydia can be passed on through genital contact. This means you can get chlamydia from someone who has the infection if your genitals touch, even if you don't have sex or ejaculate (cum). You can also get chlamydia if you come into contact with infected semen (cum) or vaginal fluid, or get them in your eye. Chlamydia can't be passed on through kissing, hugging, sharing towels or using the same toilet as someone with the infection. How do you prevent chlamydia? Using a new male or female condom or dental dam every time you have sex is the best way to protect against chlamydia. Chlamydia can be passed on by sharing sex toys. Always cover sex toys with a new condom and wash them after use to reduce your risk of getting chlamydia and other STIs. It's important to regularly test for chlamydia, even if you don't have any symptoms, especially if you've had multiple sexual partners. The contraceptive pill and other types of contraception (apart from condoms) won't prevent you getting chlamydia, and neither will PrEP. What are the symptoms of chlamydia? Many people with chlamydia don't have any symptoms. If you do get symptoms, you may not notice them until several weeks after infection. Other people might not have any symptoms for several months. Signs of chlamydia in women include: increase in vaginal discharge pain or burning when urinating (peeing) pain during sex and/or bleeding after sex pain in the lower stomach - especially when having sex bleeding between periods and/or heavier periods. Signs of chlamydia in men include: white, cloudy or watery discharge from the penis pain or burning when urinating pain and/or swelling in the testicles. You can also get chlamydia infection in your anus, eyes and throat. For both men and women, this can cause pain, discharge or bleeding in the anus, or inflammation (redness) of the eye (called conjunctivitis). Chlamydia in the throat does not usually have any symptoms. How do I test for chlamydia? You can get tested for chlamydia even if you don't have any symptoms. Getting tested for chlamydia is easy and doesn't hurt. A healthcare professional will ask for a urine (pee) sample and/or take a swab from the area that might be infected. This is usually the lower part of the womb (cervix) or the vagina for women, and the tip of the penis (urethra) for men. If you've had anal or oral sex, you may have a swab taken from your anus or throat. In some countries you can get a self-testing kit to do at home. If you test positive for chlamydia, it's important to tell any recent sexual partner/s so they can also get tested, and treated if necessary. If you need advice about how to do this, speak to your healthcare professional. You should also test for other STIs. When should I get tested for chlamydia? If you have had sex without a condom, or you are worried about chlamydia or other STIs, get tested as soon as possible. However if you test within two weeks of having sex, you may need to repeat the test later as the infection may not always be detectable in the early stages. How is chlamydia treated? Chlamydia can be easily treated with a short course of antibiotics. You may be able to take all the antibiotics in one day, or over a week, depending on the type of treatment you are prescribed. It's important to not have sex until you and your current sexual partner/s have finished treatment. If you've had the one-day course of treatment, you should avoid having sex for seven days afterwards. Ask your healthcare professional when it's safe to have sex again. Remember that if you've been treated for chlamydia you are not immune and you can get infected again. Long-term effects of untreated chlamydia If left untreated, chlamydia can lead to other, sometimes serious, health problems. In women, untreated chlamydia cause pelvic inflammatory disease (PID). PID can cause pelvic pain, infertility (inability to get pregnant), and ectopic pregnancy (pregnancy outside the uterus) which can be life-threatening. PID can be treated with antibiotics. In men untreated chlamydia can cause swelling and pain in the testicles, and pain when urinating or during sex. Rarely, it can cause infertility in men. Chlamydia can also cause reactive arthritis in both women and men - inflammation of the joints, and in some people, the urethra and the eyes (conjunctivitis). Chlamydia and HIV If you have been diagnosed with chlamydia you should also test for HIV. Having chlamydia increases your risk of getting HIV, as it causes inflammation and sores that make it easier for HIV to enter the body. If you are living with HIV and not on treatment, having chlamydia can make you more likely to pass HIV on if you have sex without a condom. However, if you are on effective treatment and have an undetectable viral load, you will not be able to pass HIV on - having chlamydia will not affect this. If you're taking antiretrovirals, it's important to discuss with your doctor how the chlamydia treatment may interact with your HIV drugs. If you're worried about HIV infection, find out everything you need to know in our HIV Transmission and Prevention section.

STD risk and oral sex

Fast Facts Many sexually transmitted diseases (STDs) can be spread through oral sex. Using a condom, dental dam or other barrier method every time you have oral sex can reduce the risk of giving or getting an STD. There is little to no risk of getting or transmitting HIV from oral sex. What is Oral Sex? Oral sex involves using the mouth, lips, or tongue to stimulate the penis (fellatio), vagina (cunnilingus), or anus (anilingus) of a sex partner. The penis and testicles and the vagina and area around the vagina are also called the genitals or genital area. How Common is Oral Sex? Oral sex is commonly practiced by sexually-active adults. More than 85% of sexually-active adults aged 18-44 years reported having had oral sex at least once with a partner of the opposite sex. A separate survey conducted during 2011 to 2015 found that 41% of teenagers aged 15-19 years reported having had oral sex with a partner of the opposite sex. Can STDs Be Spread During Oral Sex? Many STDs, as well as other infections, can be spread through oral sex. Anyone exposed to an infected partner can get an STD in the mouth, throat, genitals, or rectum. The risk of getting an STD from oral sex, or spreading an STD to others through oral sex, depends on several things, including The particular STD. The sex acts practiced. How common the STD is in the population to which the sex partners belong. The number of specific sex acts performed. In general: It may be possible to get some STDs in the mouth or throat from giving oral sex to a partner with a genital or anal/rectal infection, particularly from giving oral sex to a partner with an infected penis. It also may be possible to get certain STDs on the penis (and possibly the vagina, anus or rectum) from getting oral sex from a partner with a mouth or throat infection. It's possible to have an STD in more than one area at the same time, for example in the throat and the genitals. Several STDs that may be transmitted by oral sex can then spread throughout the body (i.e., syphilis, gonorrhea, and intestinal infections). Anilingus (or oral sex involving the anus) can transmit hepatitis A and B, intestinal parasites like Giardia, and bacteria like E. coli and Shigella. STDs can be spread to a sex partner even when the infected partner has no signs or symptoms. If you are infected with an STD, you might not know it because many STDs may have no symptoms. Which STDs Can Be Passed On from Oral Sex? Chlamydia Chlamydia(Chlamydia trachomatis) Risk of infection from oral sex: Giving oral sex to a partner with an infected penis can result in getting chlamydia in the throat. Giving oral sex to a partner with an infected vagina or urinary tract may result in getting chlamydia in the throat.* Giving oral sex to a partner with an infected rectum might result in getting chlamydia in the throat.* Getting oral sex on the penis from a partner with chlamydia in the throat can result in getting chlamydia of the penis. Getting oral sex on the vagina from a partner with chlamydia in the throat might result in getting chlamydia of the vagina or urinary tract.* Getting oral sex on the anus from a partner with chlamydia in the throat might result in getting chlamydia in the rectum.* * Statements followed by an asterisk (*) have not been well studied. Areas of initial infection: Throat Genitals Urinary tract Rectum Initial signs and symptoms of infection: Most chlamydia infections in the throat have no symptoms. When symptoms are present, they can include a sore throat. Many genital, urinary tract, or rectal chlamydia infections have no symptoms. When symptoms are present, they can include:Discharge from vagina or penis (discharge from the vagina may be bloody).Burning feeling when urinating.Painful or swollen testicles.Rectal pain or discharge Treatment: Chlamydia can be cured with the right medicine. The sex partners of a person with chlamydia should also be tested for infection. Those who are diagnosed with chlamydia should not have sex until 7 days after they and their sex partners have completed treatment. If left untreated, throat infections: Can be spread to uninfected sex partners, particularly by performing oral sex on a male partner's penis. If left untreated, genital, urinary and/or rectal infections: Can be spread to uninfected sex partners. In women:Can cause pelvic inflammatory disease (PID), which can lead to chronic pelvic pain, infertility, and ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb). In pregnant women:Might result in premature birth or low birth weight in babies.Can be spread to the baby during delivery, and it can cause chlamydia infection in the eyes or infection of the respiratory tract that can develop into pneumonia. In men:Can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to ductal scarring. In everyone:May increase risk of getting HIV infection.Might increase risk of spreading HIV to sex partners.May cause a reaction (reactive arthritis) throughout the body that can lead to arthritis (joint pain), conjunctivitis (pink eye), and/or a rash on the soles of the feet or elsewhere. Gonorrhea Syphilis Herpes HPV (human papillomavirus) HIV Trichomoniasis Is Oral Sex Safer than Vaginal or Anal Sex? Many STDs can be spread through oral sex. However, it is difficult to compare the exact risks of getting specific STDs from specific types of sexual activity. This is partly because most people who have oral sex also have vaginal or anal sex. Also, few studies have looked at the risks of getting STDs other than HIV from giving oral sex on the vagina or anus, compared to giving oral sex on the penis. Studies have shown that the risk of getting HIV from having oral sex with an infected partner (either giving or getting oral sex) is much lower than the risk of getting HIV from anal or vaginal sex with an infected partner. This may not be true for other STDs - in one study of gay men with syphilis, 1 out of 5 reported having only oral sex.Getting HIV from oral sex may be extremely low, but it is hard to know the exact risk. If you are having oral sex you should still protect yourself. Repeated unprotected oral sex exposure to HIV may represent a considerable risk for spread of other STDs for which the risk of spread through oral sex has not been as well studied. It is possible that getting certain STDs, such as chlamydia or gonorrhea, in the throat may not pose as great a threat to an infected person's health as getting an STD in the genital area or rectum. Having these infections in the throat might increase the risk of getting HIV. Having gonorrhea in the throat also may lead to spread of the disease throughout the body. In addition:Having infections of chlamydia and gonorrhea in the throat may make it easier to spread these infections to others through oral sex. This is especially important for gonorrhea, since throat infections can be harder to treat than urinary, genital or rectal infections.Infections from certain STDs, such as syphilis and HIV, spread throughout the body. Therefore, infections that are acquired in the throat may lead to the same health problems as infections acquired in the genitals or rectum.Mouth and throat infections by certain types of HPV may develop into oral or neck cancer. What May Increase the Chances of Giving or Getting an STD through Oral Sex? It is possible that certain factors may increase a person's chances of getting HIV or other STDs during oral sex if exposed to an infected partner, such as: Having poor oral health which can include tooth decay, gum disease or bleeding gums, and oral cancer. Having sores in the mouth or on the genitals. Being exposed to the "pre-cum" or "cum" (also known as pre-ejaculate or ejaculate) of an infected partner. However, no scientific studies have been done to show whether or not these factors actually do increase the risk of getting HIV or STDs from oral sex. What Can You Do to Prevent STD Transmission During Oral Sex? You can lower your chances of giving or getting STDs during oral sex by using a condom, dental dam or other barrier method every time you have oral sex. For oral sex on the penis:Cover the penis with a non-lubricated latex condom.Use plastic (polyurethane) condoms if you or your partner is allergic to latex. For oral sex on the vagina or anus:Use a dental dam.Cut open a condom to make a square, and put it between the mouth and the partner's vagina or anus. The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting an STD: Being in a long-term mutually monogamous relationship with a partner who is not infected with an STD (e.g., a partner who has been tested and has negative STD test results). Using latex condoms the right way every time you have sex. It's important to remember that many infected individuals may be unaware of their infection because STDs often have no symptoms and are unrecognized. If you are sexually active, you should get tested regularly for STDs and HIV and talk to your partner(s) about STDs. If you think you might have an STD, stop having sex and visit your doctor or clinic to get tested. There are free and low-cost options for testing in your area.external icon It is important that you talk openly with your health care provider about any activities that might put you at risk for an STD, including oral sex.

Syphilis

Syphilis can have very serious complications when left untreated. Syphilis is a sexually transmitted disease (STD) that can have very serious complications when left untreated, but it is simple to cure with the right treatment. Basic Fact Sheet | Detailed Version | View Images of Symptoms Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated (added to your web site). Print Versionpdf icon What is syphilis? Syphilis is a sexually transmitted infection that can cause serious health problems if it is not treated. Syphilis is divided into stages (primary, secondary, latent, and tertiary). There are different signs and symptoms associated with each stage. How is syphilis spread? You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth. Syphilis can spread from an infected mother to her unborn baby. Example of a primary syphilis sore. What does syphilis look like? Syphilis is divided into stages (primary, secondary, latent, and tertiary), with different signs and symptoms associated with each stage. A person with primary syphilis generally has a sore or sores at the original site of infection. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually (but not always) firm, round, and painless. Symptoms of secondary syphilis include skin rash, swollen lymph nodes, and fever. The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed. During the latent stage, there are no signs or symptoms. Tertiary syphilis is associated with severe medical problems. A doctor can usually diagnose tertiary syphilis with the help of multiple tests. It can affect the heart, brain, and other organs of the body. How can I reduce my risk of getting syphilis? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting syphilis: Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis; Using latex condoms the right way every time you have sex. Condoms prevent transmission of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis. Am I at risk for syphilis? Any sexually active person can get syphilis through unprotected vaginal, anal, or oral sex. Have an honest and open talk with your health care provider and ask whether you should be tested for syphilis or other STDs. All pregnant women should be tested for syphilis at their first prenatal visit. You should get tested regularly for syphilis if you are sexually active andare a man who has sex with men;are living with HIV; orhave partner(s) who have tested positive for syphilis. I'm pregnant. How does syphilis affect my baby? If you are pregnant and have syphilis, you can give the infection to your unborn baby. Having syphilis can lead to a low birth weight baby. It can also make it more likely you will deliver your baby too early or stillborn (a baby born dead). To protect your baby, you should be tested for syphilis at least once during your pregnancy. Receive immediate treatment if you test positive. An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies can have health problems such as cataracts, deafness, or seizures, and can die. Secondary rash from syphilis on palms of hands. What are the signs and symptoms of syphilis? Symptoms of syphilis in adults vary by stage: Primary Stage During the first (primary) stage of syphilis, you may notice a single sore or multiple sores. The sore is the location where syphilis entered your body. Sores are usually (but not always) firm, round, and painless. Because the sore is painless, it can easily go unnoticed. The sore usually lasts 3 to 6 weeks and heals regardless of whether or not you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage. Secondary Stage During the secondary stage, you may have skin rashes and/or mucous membrane lesions. Mucous membrane lesions are sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can look like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet. The rash usually won't itch and it is sometimes so faint that you won't notice it. Other symptoms you may have can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired). The symptoms from this stage will go away whether or not you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis. Secondary rash from syphilis on torso. Latent Stage The latent stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. If you do not receive treatment, you can continue to have syphilis in your body for years without any signs or symptoms. Tertiary Stage Most people with untreated syphilis do not develop tertiary syphilis. However, when it does happen it can affect many different organ systems. These include the heart and blood vessels, and the brain and nervous system. Tertiary syphilis is very serious and would occur 10-30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death. Neurosyphilis and Ocular Syphilis Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis) or to the eye (ocular syphilis). This can happen during any of the stages described above. Symptoms of neurosyphilis include severe headache; difficulty coordinating muscle movements; paralysis (not able to move certain parts of your body); numbness; and dementia (mental disorder). Symptoms of ocular syphilis include changes in your vision and even blindness. Darkfield micrograph of Treponema pallidum. How will I or my doctor know if I have syphilis? Most of the time, a blood test is used to test for syphilis. Some health care providers will diagnose syphilis by testing fluid from a syphilis sore. Can syphilis be cured? Yes, syphilis can be cured with the right antibiotics from your health care provider. However, treatment might not undo any damage that the infection has already done. I've been treated. Can I get syphilis again? Having syphilis once does not protect you from getting it again. Even after you've been successfully treated, you can still be re-infected. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your health care provider is recommended to make sure that your treatment was successful. It may not be obvious that a sex partner has syphilis. This is because syphilis sores can be hidden in the vagina, anus, under the foreskin of the penis, or in the mouth. Unless you know that your sex partner(s) has been tested and treated, you may be at risk of getting syphilis again from an infected sex partner. What is syphilis? Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. Syphilis can cause serious health sequelae if not adequately treated. How common is syphilis? During 2018, there were 115,045 reported new diagnoses of syphilis (all stages), compared to 38,739 estimated new diagnoses of HIV infection in 2017 and 583,405 cases of gonorrhea in 2018.1, 2 Of syphilis cases, 35,063 were primary and secondary (P&S) syphilis, the earliest and most transmissible stages of syphilis. In 2018, the majority of P&S syphilis cases occurred among gay, bisexual, and other men who have sex with men (MSM). In 2018, MSM accounted for 77.6% of all P&S syphilis cases among males in which sex of sex partner was known and 64.3% of P&S syphilis cases among men or women with information about sex of sex partner. However, in recent years, the rate of P&S syphilis has been increasing among MSM as well as heterosexual men and women. Congenital syphilis (syphilis passed from pregnant women to their babies) continues to be a concern in the United States. During 2018, 1,306 cases of congenital syphilis were reported, compared to an estimated 73 cases of perinatal HIV infection during 2017. 1 In 2018, congenital syphilis rates were 6.4 times and 3.3 times higher among infants born to black and Hispanic mothers (86.6 and 44.7 cases per 100,000 live births, respectively) compared to white mothers (13.5 cases per 100,000 live births). How do people get syphilis? Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres can occur on or around the external genitals, in the vagina, around the anus , or in the rectum, or in or around the mouth. Transmission of syphilis can occur during vaginal, anal, or oral sex. In addition, pregnant women with syphilis can transmit the infection to their unborn child. How quickly do symptoms appear after infection? The average time between acquisition of syphilis and the start of the first symptom is 21 days, but can range from 10 to 90 days. What are the signs and symptoms in adults? Syphilis has been called "The Great Pretender", as its symptoms can look like many other diseases. However, syphilis typically follows a progression of stages that can last for weeks, months, or even years: Primary Stage The appearance of a single chancre marks the primary (first) stage of syphilis symptoms, but there may be multiple sores. The chancre is usually (but not always) firm, round, and painless. It appears at the location where syphilis entered the body. These painless chancres can occur in locations that make them difficult to notice (e.g., the vagina or anus). The chancre lasts 3 to 6 weeks and heals regardless of whether a person is treated or not. However, if the infected person does not receive adequate treatment, the infection progresses to the secondary stage. Secondary Stage Skin rashes and/or mucous membrane lesions (sores in the mouth, vagina, or anus) mark the second stage of symptoms. This stage typically starts with the development of a rash on one or more areas of the body. Rashes associated with secondary syphilis can appear when the primary chancre is healing or several weeks after the chancre has healed. The rash usually does not cause itching. The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. However, rashes with a different appearance may occur on other parts of the body, sometimes resembling rashes caused by other diseases. Sometimes rashes associated with secondary syphilis are so faint that they are not noticed. Large, raised, gray or white lesions, known as condyloma lata, may develop in warm, moist areas such as the mouth, underarm or groin region. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The symptoms of secondary syphilis will go away with or without treatment. However, without treatment, the infection will progress to the latent and possibly tertiary stage of disease. Latent Stage The latent (hidden) stage of syphilis is a period of time when there are no visible signs or symptoms of syphilis. Without treatment, the infected person will continue to have syphilis in their body even though there are no signs or symptoms. Early latent syphilis is latent syphilis where infection occurred within the past 12 months. Late latent syphilis is latent syphilis where infection occurred more than 12 months ago. Latent syphilis can last for years. Tertiary Syphilis Tertiary syphilis is rare and develops in a subset of untreated syphilis infections;, it can appear 10-30 years after infection was first acquired, and it can be fatal. Tertiary syphilis can affect multiple organ systems, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Symptoms of tertiary syphilis vary depending on the organ system affected. Neurosyphilis and Ocular Syphilis Syphilis can invade the nervous system at any stage of infection, and causes a wide range of symptoms, including headache, altered behavior, difficulty coordinating muscle movements, paralysis, sensory deficits, and dementia.3 This invasion of the nervous system is called "neurosyphilis. Like neurosyphilis, ocular syphilis can occur at any stage of infection. Ocular syphilis can involve almost any eye structure, but posterior uveitis and panuveitis are the most common. Symptoms include vision changes, decreased visual acuity, and permanent blindness. Clinicians should be aware of ocular syphilis and screen for visual complaints in any patient at risk for syphilis (e.g., MSM, persons living with HIV, others with risk factors and persons with multiple or anonymous partners). A 2015 Clinical Advisory and a MMWR: Notes from the Field discuss recent reported cases and provide information for clinicians on the diagnosis and management of ocular syphilis. How does syphilis affect a pregnant woman and her baby? When a pregnant woman has syphilis, the infection can be transmitted to her unborn baby. All pregnant women should be tested for syphilis at the first prenatal visit. For women who are at high risk for syphilis, live in areas of high syphilis morbidity, are previously untested, or had a positive screening test in the first trimester, the syphilis screening test should be repeated during the third trimester (28 to 32 weeks gestation) and again at delivery.3 Any woman who delivers a stillborn infant after 20 week's gestation should also be tested for syphilis. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth or of giving birth to a baby who dies shortly after birth. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases. An infected baby born alive may not have any signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures, or die. All babies born to mothers who test positive for syphilis during pregnancy should be screened for syphilis and examined thoroughly for evidence of congenital syphilis. 3 For pregnant women only penicillin therapy can be used to treat syphilis and prevent passing the disease to her baby; treatment with penicillin is extremely effective (success rate of 98%) in preventing mother-to-child transmission. 4 Pregnant women who are allergic to penicillin should be referred to a specialist for desensitization to penicillin. How is syphilis diagnosed? The definitive method for diagnosing syphilis is visualizing the Treponema pallidum bacterium via darkfield microscopy. This technique is rarely performed today. Diagnoses are thus more commonly made using blood tests.pdf iconexternal icon There are two types of blood tests available for syphilis: 1) nontreponemal tests and 2) treponemal tests. Both types of tests are needed to confirm a diagnosis of syphilis. Nontreponemal tests (e.g., VDRL and RPR) are simple, inexpensive, and are often used for screening. However, they are not specific for syphilis, can produce false-positive results, and, by themselves, are insufficient for diagnosis. VDRL and RPR should each have their antibody titer results reported quantitatively. Persons with a reactive nontreponemal test should always receive a treponemal test to confirm a syphilis diagnosis. This sequence of testing (nontreponemal, then treponemal test) is considered the "classical" testing algorithm. Treponemal tests (e.g., FTA-ABS, TP-PA, various EIAs, chemiluminescence immunoassays, immunoblots, and rapid treponemal assays) detect antibodies that are specific for syphilis. Treponemal antibodies appear earlier than nontreponemal antibodies and usually remain detectable for life, even after successful treatment. If a treponemal test is used for screening and the results are positive, a nontreponemal test with titer should be performed to confirm diagnosis and guide patient management decisions. Based on the results, further treponemal testing may be indicated. For further guidance, please refer to the 2015 STD Treatment Guidelines. 3 This sequence of testing (treponemal, then nontreponemal, test) is considered the "reverse" sequence testing algorithm.Reverse sequence testing can be more convenient for laboratories, but its clinical interpretation is problematic, as this testing sequence can identify persons previously treated for syphilis, those with untreated or incompletely treated syphilis, and persons with false-positive results that can occur with a low likelihood of infection.5 Special note: Because untreated syphilis in a pregnant woman can infect and possibly kill her developing baby, every pregnant woman should have a blood test for syphilis. All women should be screened at their first prenatal visit. For patients who belong to communities and populations with high prevalence of syphilis and for patients at high risk, blood tests should also be performed during the third trimester (at 28-32 weeks) and at delivery. For further information on screening guidelines, please refer to the 2015 STD Treatment Guidelines. 3 All infants born to mothers who have reactive nontreponemal and treponemal test results should be evaluated for congenital syphilis. A quantitative nontreponemal test should be performed on infant serum and, if reactive, the infant should be examined thoroughly for evidence of congenital syphilis. Suspicious lesions, body fluids, or tissues (e.g., umbilical cord, placenta) should be examined by darkfield microscopy, PCR testing, and/or special stains. Other recommended evaluations may include analysis of cerebrospinal fluid by VDRL, cell count and protein, CBC with differential and platelet count, and long-bone radiographs. For further guidance on evaluation of infants for congenital syphilis, please refer to the 2015 STD Treatment Guidelines. 3 What is the link between syphilis and HIV? In the United States, approximately half of men who have sex with men (MSM) with primary and secondary (P&S) syphilis were also living with HIV.2 In addition, MSM who are HIV-negative and diagnosed with P&S syphilis are more likely to be infected with HIV in the future. 6 Genital sores caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present. 7 Furthermore, syphilis and certain other STDs might be indicators of ongoing behaviors and exposures that place a person at greater risk for acquiring HIV. What is the treatment for syphilis? For detailed treatment recommendations, please refer to the 2015 CDC STD Treatment Guidelines. The recommended treatment for adults and adolescents with primary, secondary, or early latent syphilis is Benzathine penicillin G 2.4 million units administered intramuscularly in a single dose. The recommended treatment for adults and adolescents with late latent syphilis or latent syphilis of unknown duration is Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units administered intramuscularly each at weekly intervals. The recommended treatment for neurosyphilis and ocular syphilis is Acqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units intravenously every 4 hours or continuous infusion, for 10-14 days. Treatment will prevent disease progression, but it might not repair damage already done. Selection of the appropriate penicillin preparation is important to properly treat and cure syphilis. Combinations of some penicillin preparations (e.g., Bicillin C-R, a combination of benzathine penicillin and procaine penicillin) are not appropriate replacements for benzathine penicillin, as these combinations provide inadequate doses of penicillin. 8 Although data to support the use of alternatives to penicillin is limited, options for non-pregnant patients who are allergic to penicillin may include doxycycline, tetracycline, and for neurosyphilis, potentially ceftriaxone. These therapies should be used only in conjunction with close clinical and laboratory follow-up to ensure appropriate serological response and cure. 3 Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary. Who should be tested for syphilis? Any person with signs or symptoms suggestive of syphilis should be tested for syphilis. Also, anyone with an oral, anal, or vaginal sex partner who has been recently diagnosed with syphilis should be tested for syphilis. Some people should be tested (screened) for syphilis even if they do not have symptoms or know of a sex partner who has syphilis. Anyone who is sexually active should discuss his or her risk factors with a health care provider and ask whether he or she should be tested for syphilis or other STDs. In addition, providers should routinely test for syphilis in persons who are pregnant; are sexually active men who have sex with men (MSM); are living with HIV and are sexually active; are taking PrEP for HIV prevention. Will syphilis recur? After appropriate treatment, syphilis does not recur. However, having syphilis once does not protect a person from becoming infected again. Even following successful treatment, people can be reinfected. Patients with signs or symptoms that persist or recur or who have a sustained fourfold increase in nontreponemal test titer probably failed treatment or were reinfected. These patients should be retreated. Because chancres can be hidden in the vagina, rectum, or mouth, it may not be obvious that a sex partner has syphilis. Unless a person knows that their sex partners have been tested and treated, they may be at risk of being reinfected by an untreated partner. For further details on the management of sex partners, refer to the 2015 STD Treatment Guidelines. 3 How can syphilis be prevented? Correct and consistent use of latex condoms can reduce the risk of syphilis when the infected area or site of potential exposure is protected. However, a syphilis sore outside of the area covered by a latex condom can still allow transmission, so caution should be exercised even when using a condom. The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Partner-based interventions include partner notification - a critical component in preventing the spread of syphilis. Sexual partners of infected patients should be considered at risk and provided treatment per the 2015 STD Treatment Guidelines. 3

testes

The 2 testes, also known as testicles, are the male gonads responsible for the production of sperm and testosterone. The testes are ellipsoid glandular organs around 1.5 to 2 inches long and an inch in diameter. Each testis is found inside its own pouch on one side of the scrotum and is connected to the abdomen by a spermatic cord and cremaster muscle. The cremaster muscles contract and relax along with the scrotum to regulate the temperature of the testes. The inside of the testes is divided into small compartments known as lobules. Each lobule contains a section of seminiferous tubule lined with epithelial cells. These epithelial cells contain many stem cells that divide and form sperm cells through the process of spermatogenesis. The testes (singular: testis), commonly known as the testicles, are a pair of ovoid glandular organs that are central to the function of the male reproductive system. The testes are responsible for the production of sperm cells and the male sex hormone testosterone. The testes produce as many as 12 trillion sperm in a male's lifetime, about 400 million of which are released in a single ejaculation. Located in the hollow sac of the scrotum, each testis is about 1.5 to 2 inches long along its long axis and around 1 inch in diameter.The testes are connected to the vital organs of the ventral body cavity via the spermatic cords. Nerves, blood vessels, and lymphatic vessels travel through the spermatic cords to support the testes. The vas deferens also passes through the spermatic cord carrying sperm out of the testes toward the prostate and urethra. The cremaster muscle wraps around the exterior of the spermatic cord to lift the testes closer to the body or permit them to descend. The testes are wrapped by the tunica vaginalis, an extension of the peritoneum of the abdomen, and the tunica albuginea, a tough, protective sheath of dense irregular connective tissue. Each testis is divided by invaginations of the tunica albuginea that divide it into several hundred small segments called lobules. Each lobule contains several tightly coiled tubes called seminiferous tubules. The walls of the seminiferous tubules contain the germ cells, Sertoli cells, and Leydig cells that give the testes their function. Millions of germ cell in the walls of the seminiferous tubules multiply and differentiate to produce spermatocytes from the onset of puberty until death. The spermatocytes develop into spermatids and eventually spermatozoa, or sperm cells. The immature sperm cells are supported and protected by Sertoli cells as they travel the length of the seminiferous tubules and slowly mature. Leydig cells at the ends of the seminiferous tubules produce the male hormone testosterone that produces the secondary sex characteristics associated with males. Each sperm produced by the testes takes about seventy-two days to mature and its maturity is overseen by a complex interaction of hormones. The scrotum has a built-in thermostat that keeps the testes and sperm at the correct temperature. It may be surprising that the testes should lie in such a vulnerable place outside the body, but it is too hot for them inside. Spermatogenesis requires a temperature that is three to five degrees Fahrenheit below body temperature. If it becomes too cool on the outside, the cremaster muscle will contract to bring the testes closer the body for warmth.

Cowper's Glands

The Cowper's glands, also known as the bulbourethral glands, are a pair of pea-sized exocrine glands located inferior to the prostate and anterior to the anus. The Cowper's glands secrete a thin alkaline fluid into the urethra that lubricates the urethra and neutralizes acid from urine remaining in the urethra after urination. This fluid enters the urethra during sexual arousal prior to ejaculation to prepare the urethra for the flow of semen. The Cowper's glands (or bulbourethral glands) are a pair of exocrine glands in the male reproductive system. Roughly the size of peas, they are located inferior to the prostate gland and lateral to the urethra in the urogenital diaphragm. The Cowper's glands are only found in the male body and play an important role in the protection of sperm during ejaculation. Each Cowper's gland is made of several connected glandular lobules. Many tiny hollow tubules spread through each lobule and are surrounded by columnar glandular epithelium. A thin fibrous membrane surrounds the lobules to hold the gland together and give a firm structure to the gland. The many lobules meet at an inch-long (2.5 cm) duct that carries the secretions of the Cowper's gland to the urethra at the base of the penis. The secretions produced by the Cowper's glands help to protect sperm as it passes through the urethra during ejaculation. In response to sexual stimulation prior to ejaculation, the Cowper's glands begin producing an alkaline mucous secretion known as pre-ejaculate. Pre-ejaculate neutralizes acidic urine that may still be present in the urethra while also lubricating the urethra and external urethral orifice to protect sperm from mechanical damage during ejaculation. Innerbody Research is the largest home health and wellness guide online, helping over one million visitors each month learn about health products and services. Our mission is to provide objective, science-based advice to help you make more informed choices.

areola

The areola is a circular area of pigmented skin which surrounds each nipple.

ductus deferens

The ductus deferens, also known as the vas deferens, is a tiny muscular tube in the male reproductive system that carries sperm from the epididymis to the ejaculatory duct. There is a pair of these ducts in the male body, with one duct carrying sperm from each testis to the left and right ejaculatory ducts. Along the way they pass through the scrotum, spermatic cord, inguinal canal, and pelvic body cavity. The location and function of the ductus deferens makes it a prime area for male contraception surgery.The ductus deferens is a thin tubule less than a quarter of an inch (5 mm) in diameter, but more than one foot (30 cm) long. It begins as a continuation of the tail of the epididymis in the posterior region of the scrotum. Compared to the epididymis, the ductus deferens is much wider and less convoluted, with most of its folds at the transition between the two structures. From the epididymis, the ductus deferens ascends posterior to the testes and enters the spermatic cord that connects the testes to the rest of the body. It continues with the spermatic cord, exiting the scrotum and entering the pelvic body cavity at the inguinal canal. Inside the pelvic cavity, the ductus deferens passes anterior to the pelvic bone before turning about 90 degrees toward the posterior and passing over the pelvic brim toward the urinary bladder. It continues around the side of the bladder and passes superior to the ureters before turning 90 degrees toward the inferior direction and descending along the posterior end of the bladder to the prostate gland. Between the ureters and the prostate, the ductus deferens expands its diameter considerably in a region known as the ampulla before narrowing and joining with the seminal vesicles at the ejaculatory duct inside the prostate. The tissue structure of the ductus deferens includes an inner lining of epithelial tissue; a middle layer of connective tissue and visceral muscle; and an outer layer of adventitia. Pseudostratified columnar epithelium makes up the inner lining of the ductus deferens and contains many absorptive stereocilia. This layer absorbs excess liquid and dead sperm while secreting nutrients to support sperm during their storage and transportation. The middle layer of the ductus deferens is by far the thickest layer and contains many elastin fibers and visceral muscle cells arranged in longitudinal and circular bundles. Contraction of visceral muscle propels sperm along the length of the ductus deferens, while elastin fibers allow the wall of the tubule to expand and contract along with the muscle cells. Finally, the outer adventitia consists of areolar connective tissue that anchors the ductus deferens to the surrounding tissues so that it remains stationary throughout a person's lifetime and through countless waves of peristalsis. The ductus deferens serves dual functions in the male reproductive system: Transporting sperm from the testes to the ejaculatory duct and urethra Storing sperm until it is ready to be ejaculated.Sperm passing through the ductus deferens is not yet motile, or able to swim, and thus must be transported via peristalsis. Smooth muscle tissue in the walls of the ductus deferens contracts in waves of peristalsis to slowly move sperm along its length. After sperm has reached the far end of the ductus deferens, it can be stored in the widened ampulla for several months as it awaits ejaculation. Older and damaged sperm that are non-viable are absorbed by the epithelial lining of the ampulla and broken down by the body and their parts reused in other cells.

epididymis

The epididymis (plural, epididymides) is a tightly coiled mass of thin tubes that carries sperm from the testes to the ductus deferens in the male reproductive system. Sperm matures as it passes through the epididymis so that it is ready to fertilize ova by the time it enters the ductus deferens. The epididymis is a crescent-shaped coil of thin tubules located inside the scrotum and posterior to the testis. The entire mass of the epididymis is actually a single, 20-foot-long (six-meter) tubule that has been coiled upon itself so tightly that the entire mass of the epididymis is only around 1.5 inches (4 cm) long.Starting at the efferent tubules of the testis, the tubule of the epididymis winds over the top of the testis and then down the posterior side. Then, near the bottom of the testis, it turns 180 degrees and continues superiorly before joining the ductus deferens. The epididymis can be divided into three major regions: the head, body, and tail. The head is the widest and most superior region, which receives sperm from the efferent ducts of the testis. Inferior to the head is the body, which is slightly narrower in diameter than the head and descends along the posterior edge of the testis. Finally, the tail is the narrow inferior portion of the epididymis; it joins with the ductus deferens. The tubule of the epididymis is made of a pseudostratified columnar epithelium lining surrounded by a layer of connective tissue and smooth muscle. A special feature of the lining of the epididymis is the presence of stereocilia — long, branching microvilli that increase the surface area of the lining cells. Stereocilia help the lining of the epididymis to absorb excess fluids from the hollow lumen of the epididymis, along with dead or defective sperm. The smooth muscle tissue contracts in waves of peristalsis to slowly push the sperm along the length of the epididymis toward the ductus deferens. When sperm first enters the epididymis from the testis, it is very immature and diluted by a relatively large volume of liquid. The smooth muscle of the epididymis pushes the sperm along tubule with slow waves of peristalsis, so that the sperm traverse its entire 20-foot length in about two weeks. During this time the sperm is supplied with nutrients secreted from the lining of the epididymis and incubated while it matures. All defective and dead sperm, along with most of the liquid medium, are slowly absorbed by the body to concentrate the sperm, which can be stored in the epididymis for up to a month. After a month in the epididymis, sperm begin to expire and are absorbed by stereocilia and replaced by younger sperm. As sperm is needed for ejaculation, it moves from the epididymis to the ductus deferens and onward into the male reproductive tract.

Epididymis

The epididymis is a sperm storage area that wraps around the superior and posterior edge of the testes. The epididymis is made up of several feet of long, thin tubules that are tightly coiled into a small mass. Sperm produced in the testes moves into the epididymis to mature before being passed on through the male reproductive organs. The length of the epididymis delays the release of the sperm and allows them time to mature.

penis according to barclay

The penis is the male external excretory and sex organ. The penis contains the external opening of the urethra, which is used for urination and to deliver semen into the vagina of a female sexual partner. Erectile tissue inside the penis allows the penis to increase in size and become rigid during sexual stimulation. A penis' erection helps to deliver semen deeper into the female reproductive tract during sexual intercourse. The penis is located in the pubic region superior to the scrotum and inferior to the umbilicus along the body's midline. It is made up of 3 major regions: the root, body, and glans. The root of the penis connects the penis to the bones of the pelvis via several tough ligaments. Roughly cylindrical in shape, the body of the penis is the largest region. Large masses of erectile tissue in the body allow this region to harden and expand greatly during sexual stimulation. The glans is the enlarged tip of the penis that contains the urethral orifice where semen and urine exit the body. Erectile tissue in the glans causes this region to harden and expand in width during sexual stimulation. Histology The penis is an organ made of several distinct tissue layers. The outside of the penis is covered with skin that is continuous with the skin of the surrounding pubic region. Many sensory receptors in the penis' skin allow it to receive sensory stimulation during sexual intercourse. Deep to the skin of the penis is a layer of subcutaneous tissue containing blood vessels and protein fibers that loosely anchor the skin to the underlying tissue. Under the subcutaneous tissue is a tough and elastic layer of fibrous connective tissue known as the tunica albuginea. The tunica albuginea plays an important role by providing strength and support to the penis when it becomes erect. Inside the tunica albuginea are three masses of erectile tissue: the two corpora cavernosa and corpus spongiosum. The corpora cavernosa (singular: corpus cavernosum) fill the left and right dorsal regions of the penile body, while the corpus spongiosum surrounds the urethra on the ventral side of the body and in the glans. These regions of erectile tissue fill with blood to harden and enlarge the penis during times of sexual excitement. Functions The penis functions as both a reproductive organ and an excretory organ. As a reproductive organ, the penis becomes erect during sexual intercourse in order to deliver semen more effectively into the vagina. Semen travels through the urethra to the tip of the penis where it is ejaculated out of the body. Erectile dysfunction is a much more common reproductive issue than some people realize. Did you know that it affects 20% of men in their twenties? The percentage of men with moderate symptoms of ED rises by about 10% each decade of men's lives, so that by age 60, roughly 60% of men will experience ED. Subsequently the medical community has responded with increasingly effective and convenient treatment options. Check out our unbiased Hims ED review to learn more. As an excretory organ, the penis delivers urine out of the body through the urethra.

penis

The penis is the male external sexual organ located superior to the scrotum and inferior to the umbilicus. The penis is roughly cylindrical in shape and contains the urethra and the external opening of the urethra. Large pockets of erectile tissue in the penis allow it to fill with blood and become erect. The erection of the penis causes it to increase in size and become turgid. The function of the penis is to deliver semen into the vagina during sexual intercourse. In addition to its reproductive function, the penis also allows for the excretion of urine through the urethra to the exterior of the body. Erectile dysfunction is a common reproductive issue; in each decade of men's lives, it affects about an equivalent percentage of peers. For instance, roughly 20% of men in their 20s experience a degree of erectile dysfunction. The rate rises to 30% of men experiencing ED symptoms in their 30s, and 50% of men in their 50s (and so on). Because it's so common, the medical community has responded with increasingly convenient ways to treat ED. Read our Hims ED review for more information.

Sperm Production in the Testicle

The testes (singular: testis), commonly known as the testicles, are a pair of ovoid glandular organs that are central to the function of the male reproductive system. The testes are responsible for the production of sperm cells and the male sex hormone testosterone. The testes produce as many as 12 trillion sperm in a male's lifetime, about 400 million of which are released in a single ejaculation. Located in the hollow sac of the scrotum, each testis is about 1.5 to 2 inches long along its long axis and around 1 inch in diameter.The testes are connected to the vital organs of the ventral body cavity via the spermatic cords. Nerves, blood vessels, and lymphatic vessels travel through the spermatic cords to support the testes. The vas deferens also passes through the spermatic cord carrying sperm out of the testes toward the prostate and urethra. The cremaster muscle wraps around the exterior of the spermatic cord to lift the testes closer to the body or permit them to descend. The testes are wrapped by the tunica vaginalis, an extension of the peritoneum of the abdomen, and the tunica albuginea, a tough, protective sheath of dense irregular connective tissue. Each testis is divided by invaginations of the tunica albuginea that divide it into several hundred small segments called lobules. Each lobule contains several tightly coiled tubes called seminiferous tubules. The walls of the seminiferous tubules contain the germ cells, Sertoli cells, and Leydig cells that give the testes their function. Millions of germ cell in the walls of the seminiferous tubules multiply and differentiate to produce spermatocytes from the onset of puberty until death. The spermatocytes develop into spermatids and eventually spermatozoa, or sperm cells. The immature sperm cells are supported and protected by Sertoli cells as they travel the length of the seminiferous tubules and slowly mature. Leydig cells at the ends of the seminiferous tubules produce the male hormone testosterone that produces the secondary sex characteristics associated with males. Each sperm produced by the testes takes about seventy-two days to mature and its maturity is overseen by a complex interaction of hormones. The scrotum has a built-in thermostat that keeps the testes and sperm at the correct temperature. It may be surprising that the testes should lie in such a vulnerable place outside the body, but it is too hot for them inside. Spermatogenesis requires a temperature that is three to five degrees Fahrenheit below body temperature. If it becomes too cool on the outside, the cremaster muscle will contract to bring the testes closer the body for warmth.

urethra according to barclay

The urethra is a tube that conveys urine from the urinary bladder to the outside of the body. Its wall is lined with mucous membranes and contains a relatively thick layer of smooth muscle tissue. It also contains numerous mucous glands, called urethral glands that secrete mucus into the urethral canal. In females the urethra is about 4 cm long. It passes forward from the bladder, descends below the symphysis pubis, and empties into the labia minor. Its opening is located above the vaginal opening and about 2.5 cm below the clitoris. In males, the urethra functions both as a urinary canal and a passageway for cells and secretions from various reproductive organs. It can be divided into three sections: the prostatic urethra, the membranous urethra, and the penile urethra.

what pregnant women can do about syphilis

As a soon-to-be mom, you are constantly being reminded of the things you should or shouldn't do and what you should and shouldn't worry about when it comes to protecting the health of your developing baby. While pregnancy fears are normal, the best way to handle them is by being informed and prepared. If you've already had your first prenatal visit, your doctor likely discussed syphilis testing with you. If not, read on to find out the most important facts about this disease, how it can affect your baby, and actions you can take to improve your chances of a healthy pregnancy and baby. WHAT IS IT? Syphilis is a sexually transmitted disease that can cause very serious health problems if not treated. However, it is simple to prevent and can be cured with the antibiotic penicillin. When syphilis is not treated, it can eventually spread to the brain and nervous system or to the eye. This can cause problems like hearing loss, stroke, and blindness. Having syphilis can also increase a person's risk for getting HIV or giving it to others. Syphilis can also be passed on to an unborn baby during pregnancy. Congenital syphilis is the disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. How Congenital Syphilis Can Affect Your Baby's Health Up to 40% of babies born to women with untreated syphilis may be stillborn (a baby born dead) or die from the infection as a newborn. Infants born with congenital syphilis might have health problems like skin rashes, yellowing of the skin or whites of the eyes (jaundice), enlarged liver and spleen, or severe anemia (low blood count). Untreated babies that survive the newborn period can develop problems later on. They may be developmentally delayed or have seizures. HOW CONCERNED DO I TRULY NEED TO BE? Congenital syphilis should be on your radar because there has been a sharp increase in the number of babies born with the disease in the United States. In fact, cases of congenital syphilis increased by 185% between 2014 and 2018. Public health professionals across the country are very concerned about this growing number of congenital syphilis cases. WHAT CAN I DO TO MAKE SURE MY BABY DOESN'T GET CONGENITAL SYPHILIS? If you are pregnant, here's what you can do: Go to Your Doctor. If you think you may be pregnant, see a health care provider as soon as possible to be sure that you and your baby are healthy during your pregnancy. Prenatal care is important for every pregnancy. Even if you've been pregnant before, it's important to ensure that THIS pregnancy is healthy. All pregnant women should be tested for syphilis, ideally at their first doctor visit. Make sure to ask your doctor about getting tested at your first visit. Ask for the Results of Your Syphilis Test. And if you test positive for syphilis during pregnancy, be sure to get treatment right away. Your doctor can treat you with medicine that is safe for both you and your unborn baby. Complete Follow-Up Visits with Your Doctor. Continue to visit your doctor regularly during your pregnancy to be sure that you and your baby stay healthy. If you learn that one of your sexual partners has or may have syphilis, tell your doctor right away so you and your partner can be treated, and your baby can be protected. Your doctor may need to retest you for syphilis at the beginning of your third trimester and at delivery, depending on how common syphilis infections are in the area that you live in. Ask your doctor if you should be retested during your pregnancy and at delivery. To learn more about CS, visit CDC's Congenital Syphilis Fact Sheet. CDC is working with other federal agencies and national partners to reduce the number of women and their babies who are infected with syphilis. What CDC Will Do CDC is committed to protecting the health of the nation's babies. Here is what CDC will do to reduce the numbers of women and their babies who are infected with syphilis: Work to improve CS data through an enhanced CS surveillance system to capture stillbirths, infant morbidity, and cases prevented. Investigate all CS cases in states to identify missed opportunities and improve services. Develop tools and evaluate high-impact prevention services, such as syphilis screening; timely treatment; partner services; and linkage to contraceptive counseling, behavioral health, and pregnancy case management programs. Develop CS prevention guidelines for health care providers and health departments. Identify and share best practices, such as infant morbidity review boards, assessment approaches to identify missed opportunities, and implementation of system level changes. Support health care providers to implement recommended syphilis screening and treatment of pregnant women and women of reproductive age through training, guidelines, tools, and resources.

birth (deliver)

Birth, or delivery, is the process in which muscular contractions force the fetus through the birth canal. Once labor starts, rhythmic contractions that begin at the top of the uterus and travel down its length force the contents of the uterus toward the cervix. Since the fetus is usually positioned with its head downward, labor contractions force the head against the cervix. This action causes the cervix to stretch, which is thought to elicit a reflex that will stimulate still stronger labor contractions until a maximum effort is achieved. At the same time, the cervix dilates and, as labor continues, abdominal wall muscles are stimulated to contract and aid in forcing the fetus through the cervix and vagina to the outside. During normal birth, the head appears first, the shoulders turn, and more contractions push the baby out. The baby's mouth and nasal passages are cleared of mucus, the baby breathes, cries, and is given to the mother. When the umbilical cord ceases to pulsate, it is clamped and cut. Following the birth of the fetus, the placenta, which remains inside the uterus, becomes separated from the uterine wall and is expelled by uterine contractions through the birth canal. This expulsion is called the afterbirth.

Gonorrhea antibiotic resistance

Gonorrhea has progressively developed resistance to the antibiotic drugs prescribed to treat it. Following the spread of gonococcal fluoroquinolone resistance, the cephalosporin antibiotics have been the foundation of recommended treatment for gonorrhea. The emergence of cephalosporin-resistant gonorrhea would significantly complicate the ability of providers to treat gonorrhea successfully, since we have few antibiotic options left that are simple, well-studied, well-tolerated and highly effective. It is critical to continuously monitor antibiotic resistance in Neisseria gonorrhoeae and encourage research and development of new treatment regimens. Antibiotic-Resistant Gonorrhea Basic Information Antibiotic-Resistant Gonorrhea: An Overview Antibiotic resistance is the ability of bacteria to resist the effects of the drugs used to treat them. This means the bacteria are no longer killed by a drug that used to kill them before. The bacteria are then free to keep multiplying. Gonorrhea has developed resistance to nearly all of the antibiotics used for its treatment. We are currently down to one last recommended and effective class of antibiotics, cephalosporins, to treat this common infection. This is an urgent public health threat because gonorrhea control in the United States largely relies on our ability to successfully treat the infection. Gonorrhea is skilled at outsmarting the antibiotics that are used to kill it. For this reason, we must continuously monitor for antibiotic resistance and encourage the research and development of new drugs for gonorrhea treatment. Surveillance Surveillance for resistant gonorrhea in the United States is conducted through several projects: the Gonococcal Isolate Surveillance Project (GISP), the enhanced Gonococcal Isolate Surveillance Project (eGISP), and Strengthening the United States Response to Resistant Gonorrhea (SURRG). Antibiotic susceptibility testing is an activity common to each project. Gonorrhea has decreased susceptibility to a given antibiotic when laboratory results indicate that higher-than-expected levels of an antibiotic are needed to stop its growth. The Clinician's Role in Surveillance Clinicians are asked to report any gonorrhea specimen with decreased cephalosporin susceptibility and any gonorrhea cephalosporin treatment failure to CDC through their state or local public health authority. In the United States, reports of apparent failures of gonorrhea to respond to treatment with CDC-recommended therapies should be reported to Sancta St Cyr, MD, MPH ([email protected]; 404-718-5447). Surveillance and Data Management Branch, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop E02, Atlanta, GA 30333. CDC also recommends that isolates from certain infections be submitted to the Neisseria Reference Laboratory at CDC for confirmation: Cau Pham, PhD, [email protected], 404-718-5642, Neisseria Reference Laboratory, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop A12, Atlanta, GA 30333. These infections comprise those that do not respond to CDC-recommended therapy. See pg. 6, Recommended Testing and Confirmatory Testingpdf icon for a complete list. Timeline of Antibiotic Resistance and Changing Treatment Recommendations In 1993, ciprofloxacin, a fluoroquinolone, and two cephalosporins (ceftriaxone and cefixime) were the recommended treatments for gonorrhea. However, in the late 1990s and early 2000s, ciprofloxacin resistance was detected in Hawaii and the West Coast. By 2004, ciprofloxacin- resistant gonorrhea had significantly increased among men who have sex with men (MSM) leading to the discontinuation of the drug in this population. By 2006, nearly 14% of gonorrhea samples were resistant to ciprofloxacin. Ciprofloxacin resistance was present in all regions of the country and in the heterosexual population. On April 13, 2007, CDC stopped recommending fluoroquinolones as empiric treatment for gonorrhea altogether. The cephalosporins, either cefixime or ceftriaxone, were the only remaining recommended treatments. Similar to trends observed elsewhere in the world, CDC observed worrisome trends of decreasing cephalosporin susceptibility. To preserve cephalosporins for as long as possible, CDC has updated its STD Treatment Guidelines frequently since 2010. Currently, just one regimen is recommended as first-line treatment for gonorrhea: the injectable cephalosporin, ceftriaxone, alongside oral azithromycin. Gonorrhea's susceptibility to azithromycin has declined in recent years; however, CDC continues to monitor antibiotic resistance to it, cephalosporins, and other drugs. An animated video with a historical timeline of drug-resistant gonorrhea in the U.S. is also available. CDC has not received any reports of verified clinical treatment failures to any cephalosporin in the United States. See Gonorrhea Statistics. Laboratory Challenges Culture testing is when bacteria is first grown on a nutrient plate and is then exposed to known amounts of an antibiotic to determine the bacteria's susceptibility to the antibiotic. A major challenge to monitoring emerging resistant gonorrhea is the substantial decline in the use of gonorrhea culture testing by many clinicians, as well as the reduced capability of many laboratories to perform the gonorrhea culture techniques required for antibiotic susceptibility testing. The decline in culture testing results from an increased use of newer laboratory technology, such as a diagnostic test called the Nucleic Acid Amplification Test (NAAT). Currently, there is no well-studied, reliable technology that allows for antibiotic susceptibility testing from nonculture specimens. Increased laboratory culture capacity is needed. CDC recommends that all state and local health department labs maintain or develop the capacity to perform gonorrhea culture, or form partnerships with experienced laboratories that can perform this type of testing.

Trichomoniasis statistics

In the United States, an estimated 3.7 million people have trichomoniasis. Trichomoniasis can increase the risk of getting or spreading HIV, and pregnant women with the infection are more likely to have their babies too early (preterm delivery) and with a low birth weight. STD Surveillance 2018 - Other Sexually Transmitted Diseases - Trichomoniasis (October 8, 2019)Figure 54. Trichomonas vaginalis and Other Vaginal Infections Among Females — Initial Visits to Physicians' Offices, United States, 1966-2016Table 44. Selected STDs and Complications - Initial Visits to Physicians' Offices, National Disease and Therapeutic Index, United States, 1966-2017 Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United Statespdf icon (February 13, 2013) Prevalence The prevalence of Trichomonas vaginalis in the United States is 2.1% among women ages 14-59, and 0.5% among men based on a nationally representative sample of people who participated in NHANES 2013-2016. The following are other findings from this study: Prevalence was 9.6% for African American women, 1.4% for Hispanic women, and 0.8% for non-Hispanic white women. For men and women, increasing poverty level, lower educational level, unmarried status, and having been born in the U.S. are associated with T. vaginalis infection. For women, younger age at first sex, greater number of sex partners, and a history of chlamydia infection in the past 12 months are associated with T. vaginalis infection. Sources Satterwhite CL, Torrone E, Meites E, Dunne EF, Mahajan R, Ocfemia MC, Su J, Xu F, Weinstock H. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis. 2013 Mar;40(3):187-93. Flagg EW, Meites E, Phillips C, Papp J, Torrone EA. Prevalence of Trichomonas vaginalis Among Civilian, Noninstitutionalized Male and Female Population Aged 14 to 59 Years: United States, 2013 to 2016. Sex Transm Dis. 2019 Oct;46(10):e93-e96.

Chalamydia

Most people who have chlamydia don't know it since the disease often has no symptoms. women under 25 and older women with risk factors need testing every year Chlamydia is a common sexually transmitted disease (STD) that can be easily cured. If left untreated, chlamydia can make it difficult for a woman to get pregnant. Chlamydia is a common STD that can infect both men and women. It can cause serious, permanent damage to a woman's reproductive system. This can make it difficult or impossible for her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb). How is chlamydia spread? You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia. If your sex partner is male you can still get chlamydia even if he does not ejaculate (cum). If you've had chlamydia and were treated in the past, you can still get infected again. This can happen if you have unprotected sex with someone who has chlamydia. If you are pregnant, you can give chlamydia to your baby during childbirth. How can I reduce my risk of getting chlamydia? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting chlamydia: Be in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results; Use latex condoms the right way every time you have sex. Am I at risk for chlamydia? Anyone who has sex can get chlamydia through unprotected vaginal, anal, or oral sex. However, sexually active young people are at a higher risk of getting chlamydia. This is due to behaviors and biological factors common among young people. Gay, bisexual, and other men who have sex with men are also at risk since chlamydia can spread through oral and anal sex. Have an honest and open talk with your health care provider. Ask whether you should be tested for chlamydia or other STDs. If you are a sexually active woman younger than 25 years, you should get a test for chlamydia every year. If you are an older woman with risk factors such as new or multiple sex partners, or a sex partner who has an STD, you should get a test for chlamydia every year. Gay, bisexual, and other men who have sex with men; as well as pregnant women should also get tested for chlamydia. I'm pregnant. How does chlamydia affect my baby? If you are pregnant and have chlamydia, you can pass the infection to your baby during delivery. This could cause an eye infection or pneumonia in your newborn. Having chlamydia may also make it more likely to deliver your baby too early. If you are pregnant, you should get tested for chlamydia at your first prenatal visit. Testing and treatment are the best ways to prevent health problems. How do I know if I have chlamydia? Most people who have chlamydia have no symptoms. If you do have symptoms, they may not appear until several weeks after you have sex with an infected partner. Even when chlamydia causes no symptoms, it can damage your reproductive system. Women with symptoms may notice An abnormal vaginal discharge; A burning sensation when urinating. Symptoms in men can include A discharge from their penis; A burning sensation when urinating; Pain and swelling in one or both testicles (although this is less common). Men and women can also get infected with chlamydia in their rectum. This happens either by having receptive anal sex, or by spread from another infected site (such as the vagina). While these infections often cause no symptoms, they can cause Rectal pain; Discharge; Bleeding. You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD. STD symptoms can include an unusual sore, a smelly discharge, burning when urinating, or bleeding between periods. How will my doctor know if I have chlamydia? Laboratory tests can diagnose chlamydia. Your health care provider may ask you to provide a urine sample or may use (or ask you to use) a cotton swab to get a sample from your vagina to test for chlamydia. Can chlamydia be cured? Yes, chlamydia can be cured with the right treatment. It is important that you take all of the medication your doctor prescribes to cure your infection. When taken properly it will stop the infection and could decrease your chances of having complications later on. You should not share medication for chlamydia with anyone. Repeat infection with chlamydia is common. You should be tested again about three months after you are treated, even if your sex partner(s) was treated. I was treated for chlamydia. When can I have sex again? You should not have sex again until you and your sex partner(s) have completed treatment. If your doctor prescribes a single dose of medication, you should wait seven days after taking the medicine before having sex. If your doctor prescribes a medicine for you to take for seven days, you should wait until you have taken all of the doses before having sex. What happens if I don't get treated? The initial damage that chlamydia causes often goes unnoticed. However, chlamydia can lead to serious health problems. If you are a woman, untreated chlamydia can spread to your uterus and fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus). This can cause pelvic inflammatory disease (PID). PID often has no symptoms, however some women may have abdominal and pelvic pain. Even if it doesn't cause symptoms initially, PID can cause permanent damage to your reproductive system. PID can lead to long-term pelvic pain, inability to get pregnant, and potentially deadly ectopic pregnancy (pregnancy outside the uterus). Men rarely have health problems linked to chlamydia. Infection sometimes spreads to the tube that carries sperm from the testicles, causing pain and fever. Rarely, chlamydia can prevent a man from being able to have children. Untreated chlamydia may also increase your chances of getting or giving HIV - the virus that causes AIDS.

genital herpes

Most people with genital herpes do not know they have it. Genital herpes is a common sexually transmitted disease (STD) that any sexually active person can get. Most people with the virus don't have symptoms. Even without signs of the disease, herpes can still be spread to sex partners. Basic Fact Sheet | Detailed Version Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated (added to your web site). Print Versionpdf icon For desktop printing, choose "exact size" instead of "fit to page" to omit crop marks. What is genital herpes? Genital herpes is an STD caused by two types of viruses. The viruses are called herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). What is oral herpes? Oral herpes is usually caused by HSV-1 and can result in cold sores or fever blisters on or around the mouth. However, most people do not have any symptoms. Most people with oral herpes were infected during childhood or young adulthood from non-sexual contact with saliva. Is there a link between genital herpes and oral herpes? Oral herpes caused by HSV-1 can be spread from the mouth to the genitals through oral sex. This is why some cases of genital herpes are caused by HSV-1. How common is genital herpes? Genital herpes is common in the United States. More than one out of every six people aged 14 to 49 years have genital herpes. How is genital herpes spread? You can get genital herpes by having vaginal, anal, or oral sex with someone who has the disease. If you do not have herpes, you can get infected if you come into contact with the herpes virus in: A herpes sore; Saliva (if your partner has an oral herpes infection) or genital secretions (if your partner has a genital herpes infection); Skin in the oral area if your partner has an oral herpes infection, or skin in the genital area if your partner has a genital herpes infection. You can get herpes from a sex partner who does not have a visible sore or who may not know he or she is infected. It is also possible to get genital herpes if you receive oral sex from a sex partner who has oral herpes. You will not get herpes from toilet seats, bedding, or swimming pools, or from touching objects around you such as silverware, soap, or towels. If you have additional questions about how herpes is spread, consider discussing your concerns with a healthcare provider. How can I reduce my risk of getting genital herpes? The only way to avoid STDs is to not have vaginal, anal, or oral sex. If you are sexually active, you can do the following things to lower your chances of getting genital herpes: Be in a long-term mutually monogamous relationship with a partner who is not infected with an STD (e.g., a partner who has been tested and has negative STD test results); Using latex condoms the right way every time you have sex. Be aware that not all herpes sores occur in areas that are covered by a latex condom. Also, herpes virus can be released (shed) from areas of the skin that do not have a visible herpes sore. For these reasons, condoms may not fully protect you from getting herpes. If you are in a relationship with a person known to have genital herpes, you can lower your risk of getting genital herpes if: Your partner takes an anti-herpes medication every day. This is something your partner should discuss with his or her doctor. You avoid having vaginal, anal, or oral sex when your partner has herpes symptoms (i.e., when your partner is having an outbreak). I'm pregnant. How could genital herpes affect my baby? If you are pregnant and have genital herpes, it is very important for you to go to prenatal care visits. Tell your doctor if you have ever had symptoms of, or have been diagnosed with, genital herpes. Also tell your doctor if you have ever been exposed to genital herpes. There is some research that suggests that genital herpes infection may lead to miscarriage, or could make it more likely for you to deliver your baby too early. Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a 'C-section' is usually performed. How do I know if I have genital herpes? Most people who have genital herpes have no symptoms, or have very mild symptoms. You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it. Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called "having an outbreak." The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands. People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they are infected with HSV-2. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection stays in the body for the rest of your life, the number of outbreaks may decrease over time. You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD. STD symptoms can include an unusual sore, a smelly genital discharge, burning when urinating, or (for women) bleeding between periods. How will my doctor know if I have herpes? Your healthcare provider may diagnose genital herpes by simply looking at your symptoms. Providers can also take a sample from the sore(s) and test it. In certain situations, a blood test may be used to look for herpes antibodies. Have an honest and open talk with your health care provider and ask whether you should be tested for herpes or other STDs. Please note: A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or how long you have been infected. Can herpes be cured? There is no cure for herpes. However, there are medicines that can prevent or shorten outbreaks. One of these anti-herpes medicines can be taken daily, and makes it less likely that you will pass the infection on to your sex partner(s). What happens if I don't get treated? Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems. If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection. If you are pregnant, there can be problems for you and your developing fetus, or newborn baby. See "I'm pregnant. How could genital herpes affect my baby?" above for information about this. Can I still have sex if I have herpes? If you have herpes, you should talk to your sex partner(s) and let him or her know that you do and the risk involved. Using condoms may help lower this risk but it will not get rid of the risk completely. Having sores or other symptoms of herpes can increase your risk of spreading the disease. Even if you do not have any symptoms, you can still infect your sex partners. You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy (i.e., daily use of antiviral medication) for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDsexternal icon. What is the link between genital herpes and HIV? Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, having genital herpes increases the number of CD4 cells (the cells that HIV targets for entry into the body) found in the lining of the genitals. When a person has both HIV and genital herpes, the chances are higher that HIV will be spread to an HIV-uninfected sex partner during sexual contact with their partner's mouth, vagina, or rectum. etailed fact sheets are intended for physicians and individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more in depth. What is genital herpes? Genital herpes is a sexually transmitted disease (STD) caused by the herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2). How common is genital herpes? Genital herpes infection is common in the United States. CDC estimates that, annually, 776,000 people in the United States get new genital herpes infections.1 Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection (12.1% when adjusted for age).2 However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. 3 Oral HSV-1 infection is typically acquired in childhood; because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. 4 HSV-2 infection is more common among women than among men; the percentages of those infected during 2015-2016 were 15.9% versus 8.2% respectively, among 14 to 49 year olds. 2 This is possibly because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex. 5 HSV-2 infection is more common among non-Hispanic blacks (34.6%) than among non-Hispanic whites (8.1%). 2 A previous analysis found that these disparities, exist even among persons with similar numbers of lifetime sexual partners. Most infected persons may be unaware of their infection; in the United States, an estimated 87.4% of 14 to 49 year olds infected with HSV-2 have never received a clinical diagnosis. 6 The age-adjusted percentage of persons in the United States infected with HSV-2 decreased from 18.0% in 1999-2000 to 12.1% in 2015-2016. 2 How do people get genital herpes? Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8 What are the symptoms of genital herpes? Most individuals infected with HSV are asymptomatic or have very mild symptoms that go unnoticed or are mistaken for another skin condition. 9 When symptoms do occur, herpes lesions typically appear as one or more vesicles, or small blisters, on or around the genitals, rectum or mouth. The average incubation period for an initial herpes infection is 4 days (range, 2 to 12) after exposure. 10 The vesicles break and leave painful ulcers that may take two to four weeks to heal after the initial herpes infection. 5,10 Experiencing these symptoms is referred to as having a first herpes "outbreak" or episode. Clinical manifestations of genital herpes differ between the first and recurrent (i.e., subsequent) outbreaks. The first outbreak of herpes is often associated with a longer duration of herpetic lesions, increased viral shedding (making HSV transmission more likely) and systemic symptoms including fever, body aches, swollen lymph nodes, or headache. 5,10 Recurrent outbreaks of genital herpes are common, and many patients who recognize recurrences have prodromal symptoms, either localized genital pain, or tingling or shooting pains in the legs, hips or buttocks, which occur hours to days before the eruption of herpetic lesions. 5 Symptoms of recurrent outbreaks are typically shorter in duration and less severe than the first outbreak of genital herpes. 5 Long-term studies have indicated that the number of symptomatic recurrent outbreaks may decrease over time. 5 Recurrences and subclinical shedding are much less frequent for genital HSV-1 infection than for genital HSV-2 infection.5 What are the complications of genital herpes? Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis (inflammation of the linings of the brain). 5 Development of extragenital lesions (e.g. buttocks, groin, thigh, finger, or eye) may occur during the course of infection. 5 Some persons who contract genital herpes have concerns about how it will impact their overall health, sex life, and relationships. 5,11 There can also be considerable embarrassment, shame, and stigma associated with a herpes diagnosis that can substantially interfere with a patient's relationships. 10 Clinicians can address these concerns by encouraging patients to recognize that while herpes is not curable, it is a manageable condition. 5 Three important steps that providers can take for their newly-diagnosed patients are: giving information, providing support resources, and helping define treatment and prevention options. 12 Patients can be counseled that risk of genital herpes transmission can be reduced, but not eliminated, by disclosure of infection to sexual partners, 5 avoiding sex during a recurrent outbreak, 5 use of suppressive antiviral therapy, 5,10 and consistent condom use. 7 Since a diagnosis of genital herpes may affect perceptions about existing or future sexual relationships, it is important for patients to understand how to talk to sexual partners about STDs. One resource can be found here: www.gytnow.org/talking-to-your-partnerexternal icon There are also potential complications for a pregnant woman and her newborn child. See "How does herpes infection affect a pregnant woman and her baby?" below for information about this. HIV/AIDS & STDs What is the link between genital herpes and HIV? Genital ulcerative disease caused by herpes makes it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 4-fold increased risk of acquiring HIV, if individuals with genital herpes infection are genitally exposed to HIV. 13-15 Ulcers or breaks in the skin or mucous membranes (lining of the mouth, vagina, and rectum) from a herpes infection may compromise the protection normally provided by the skin and mucous membranes against infections, including HIV. 14 In addition, having genital herpes increases the number of CD4 cells (the target cell for HIV entry) in the genital mucosa. In persons with both HIV and genital herpes, local activation of HIV replication at the site of genital herpes infection can increase the risk that HIV will be transmitted during contact with the mouth, vagina, or rectum of an HIV-uninfected sex partner. 14 How does genital herpes affect a pregnant woman and her baby? Neonatal herpes is one of the most serious complications of genital herpes.5,16 Healthcare providers should ask all pregnant women if they have a history of genital herpes.11 Herpes infection can be passed from mother to child during pregnancy or childbirth, or babies may be infected shortly after birth, resulting in a potentially fatal neonatal herpes infection. 17 Infants born to women who acquire genital herpes close to the time of delivery and are shedding virus at delivery are at a much higher risk for developing neonatal herpes, compared with women who have recurrent genital herpes . 16,18-20 Thus, it is important that women avoid contracting herpes during pregnancy. Women should be counseled to abstain from intercourse during the third trimester with partners known to have or suspected of having genital herpes. 5,11 While women with genital herpes may be offered antiviral medication late in pregnancy through delivery to reduce the risk of a recurrent herpes outbreak, third trimester antiviral prophylaxis has not been shown to decrease the risk of herpes transmission to the neonate.11,21,22 Routine serologic HSV screening of pregnant women is not recommended. 11 However, at onset of labor, all women should undergo careful examination and questioning to evaluate for presence of prodromal symptoms or herpetic lesions. 11 If herpes symptoms are present a cesarean delivery is recommended to prevent HSV transmission to the infant.5,11,23 There are detailed guidelines for how to manage asymptomatic infants born to women with active genital herpes lesions.24 How is genital herpes diagnosed? The preferred HSV tests for patients with active genital ulcers are detection of HSV DNA by nucleic acid amplification tests such as polymerase chain reaction (PCR), or isolation by viral culture.11 HSV culture requires collection of a sample from the lesion and, once viral growth is seen, specific cell staining to differentiate between HSV-1 and HSV-2.11,25,26 However, culture sensitivity is low, especially for recurrent lesions, and declines as lesions heal. 11,26 PCR is more sensitive, allows for more rapid and accurate results, and is increasingly being used. 25 Because viral shedding is intermittent, failure to detect HSV by culture or PCR does not indicate an absence of HSV infection. 11 Tzanck preparations are insensitive and nonspecific and should not be used. 11 Herpes serologic tests are blood tests that detect antibodies to the herpes virus.11,26 Providers should only request type-specific glycoprotein G (gG)-based serologic assays when serology is performed for their patients.11 Several ELISA-based serologic tests are FDA approved and available commercially. While the presence of HSV-2 antibody can be presumed to reflect genital infection, patients should be counseled that the presence of HSV-1 antibody may represent either oral or genital infection. 26 The sensitivities of glycoprotein G type-specific serologic tests for HSV-2 vary from 80-98%; false-negative results might be more frequent at early stages of infection.11 The most commonly used test, HerpeSelect HSV-2 Elisa might be falsely positive at low index values (1.1-3.5).11 Such low values should be confirmed with another test such as Biokit or the Western Blot.11 Negative HSV-1 results should be interpreted with caution because some ELISA-based serologic tests are insensitive for detection of HSV-1 antibody.11 IgM testing for HSV-1 or HSV-2 is not useful, because IgM tests are not type-specific and might be positive during recurrent genital or oral episodes of herpes.27 For the symptomatic patient, testing with both virologic and serologic assays can determine whether it is a new infection or a newly-recognized old infection.26 A primary infection would be supported by a positive virologic test and a negative serologic test, while the diagnosis of recurrent disease would be supported by positive virologic and serologic test results.26 CDC does not recommend screening for HSV-1 or HSV-2 in the general population. 11 Several scenarios where type-specific serologic HSV tests may be useful include Patients with recurrent genital symptoms or atypical symptoms and negative HSV PCR or culture; Patients with a clinical diagnosis of genital herpes but no laboratory confirmation; Patients who report having a partner with genital herpes; Patients presenting for an STD evaluation (especially those with multiple sex partners); Persons with HIV infection; and MSM at increased risk for HIV acquisition.7 Please note that while type-specific herpes testing can determine if a person is infected with HSV-1 or HSV-2 (or both), there is no commercially available test to determine if a herpes infection in one individual was acquired from another specific person. CDC encourages patients to discuss any herpes questions and concerns with their health care provider or seek counsel at an STD clinic. Is there a cure or treatment for herpes? There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication.11 In addition, daily suppressive therapy (i.e., daily use of antiviral medication) for herpes can reduce the likelihood of transmission to partners.11 There is currently no commercially available vaccine that is protective against genital herpes infection. Candidate vaccines are in clinical trials. How can herpes be prevented? Correct and consistent use of latex condoms can reduce, but not eliminate, the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.28,29 The surest way to avoid transmission of STDs, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested for STDs and is known to be uninfected. Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV. Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection . 30 Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences

congenital syphilis fact sheet

Recently, there has been a sharp increase in the number of babies born with syphilis in the United States. Protect your baby from congenital syphilis by getting tested for syphilis during your pregnancy. Print Version pdf icon[PDF - 160 KB]The content here can be syndicated (added to your web site). CDC Expert Commentary A Devastating Surge in Congenital Syphilis: How Can We Stop It?external icon Dr. Laura H. Bachmann, MD, MPH, on the surge in congenital syphilis and what healthcare providers can do to stop it (January 23, 2019) What is congenital syphilis (CS)? Congenital syphilis (CS) is a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. Learn more about syphilis. How can CS affect my baby? CS can have major health impacts on your baby. How CS affects your baby's health depends on how long you had syphilis and if — or when — you got treatment for the infection. CS can cause: Miscarriage (losing the baby during pregnancy), Stillbirth (a baby born dead), Prematurity (a baby born early), Low birth weight, or Death shortly after birth. Up to 40% of babies born to women with untreated syphilis may be stillborn, or die from the infection as a newborn. For babies born with CS, CS can cause: Deformed bones, Severe anemia (low blood count), Enlarged liver and spleen, Jaundice (yellowing of the skin or eyes), Brain and nerve problems, like blindness or deafness, Meningitis, and Skin rashes. Do all babies born with CS have signs or symptoms? No. It is possible that a baby with CS won't have any symptoms at birth. But without treatment, the baby may develop serious problems. Usually, these health problems develop in the first few weeks after birth, but they can also happen years later. Babies who do not get treatment for CS and develop symptoms later on can die from the infection. They may also be developmentally delayed or have seizures. How common is CS? After a steady decline from 2008-2012, data show a sharp increase in CS rates. In 2018, the number of CS cases was the highest it's been since 1995. Public health professionals across the country are very concerned about the growing number of congenital syphilis cases in the United States. It is important to make sure you get tested for syphilis during your pregnancy. I'm pregnant. Do I need to get tested for syphilis? Yes. All pregnant women should be tested for syphilis at the first prenatal visit (the first time you see your doctor for health care during pregnancy). If you don't get tested at your first visit, make sure to ask your doctor about getting tested during a future checkup. Some women should be tested more than once during pregnancy. Talk with your doctor about the number of syphilis cases in your area and your risk for syphilis to determine if you should be tested again at the beginning of the third trimester, and again when your baby is born. Keep in mind that you can have syphilis and not know it. Many people with syphilis do not have any symptoms. Also, syphilis symptoms may be very mild, or be similar to signs of other health problems. The only way to know for sure if you have syphilis is to get tested. Is there treatment for syphilis? Yes. Syphilis can be treated and cured with antibiotics. If you test positive for syphilis during pregnancy, be sure to get treatment right away. If you are diagnosed with and treated for syphilis, your doctor should do follow-up testing for at least one year to make sure that your treatment is working. How will my doctor know if my baby has CS? Your doctor must consider several factors to determine if your baby has CS. These factors will include the results of your syphilis blood test and, if you were diagnosed with syphilis, whether you received treatment for syphilis during your pregnancy. Your doctor may also want to test your baby's blood, perform a physical exam of your baby, or do other tests, such as a spinal tap or an x-ray, to determine if your baby has CS. CDC has specific recommendations for your healthcare provider on how to evaluate babies born to women who have positive syphilis tests during pregnancy. My baby was born with CS. Is there a way to treat the infection? Yes. There is treatment for CS. Babies who have CS need to be treated right away — or they can develop serious health problems. Depending on the results of your baby's medical evaluation, he/she may need antibiotics in a hospital for 10 days. In some cases, only one injection of antibiotic is needed. It's also important that babies treated for CS get follow-up care to make sure that the treatment worked. How can I reduce the risk of my baby getting CS or having health problems associated with CS? Your baby will not get CS if you do not have syphilis. There are two important things you can do to protect your baby from getting CS and the health problems associated with the infection: Get a syphilis test at your first prenatal visit. Reduce your risk of getting syphilis before and during your pregnancy. Talk with your doctor about your risk for syphilis. Have an open and honest conversation about your sexual history and STD testing. Your doctor can give you the best advice on any testing and treatment that you may need. Get a syphilis test at your first prenatal visit If you are pregnant, and have syphilis, you can still reduce the risk of CS in your baby. Getting tested and treated for syphilis can prevent serious health complications in both mother and baby. Prenatal care is essential to the overall health and wellness of you and your unborn child. The sooner you begin receiving medical care during pregnancy, the better the health outcomes will be for you and your unborn baby. At your first prenatal visit, ask your doctor about getting tested for syphilis. It is important that you have an open and honest conversation with your doctor at this time. Discuss any new or unusual physical symptoms you may be experiencing, as well as any drugs/medicines you are using, and whether you have new or multiple sex partners. This information will allow your doctor to make the appropriate testing recommendations. Even if you have been tested for syphilis in the past, you should be tested again when you become pregnant. If you test positive for syphilis, you will need to be treated right away. Do not wait for your next prenatal visit. It is also important that your sex partner(s) receive treatment. Having syphilis once does not protect you from getting it again. Even after you've been successfully treated, you can still be reinfected. For this reason you must continue to take actions that will reduce your risk of getting a new infection. Reduce your risk of getting syphilis before and during your pregnancy Preventing syphilis in women and their sex partners is the best way to prevent CS. If you are sexually active, the following things can lower your chances of getting syphilis: Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis. Using latex condoms the right way every time you have sex. Although condoms can prevent transmission of syphilis by preventing contact with a sore, you should know that sometimes syphilis sores occur in areas not covered by a condom, and contact with these sores can still transmit syphilis. Also, talk with your doctor about your risk for syphilis. Have an open and honest conversation with your doctor about your sexual history and about STD testing. Your doctor can give you the best advice on any testing and treatment that you may need. Remember that it's possible to get syphilis and not know it, because sometimes the infection causes no symptoms, only very mild symptoms, or symptoms that mimic other illnesses.

STI

SEXUALLY TRANSMITTED INFECTIONS (STI) Sexually transmitted infections (STIs) can be passed on when you have unprotected sex or close sexual contact with someone who already has an STI. Using a male (external) or female (internal) condom or dental dam every time you have sex is the best way to prevent STIs. Getting tested regularly for STIs will also help you to look after your sexual health. Most STIs can be easily treated, however without treatment they can sometimes lead to more serious health problems. If you think you have an STI, it's important to see a healthcare professional rather than trying to diagnose it yourself, as symptoms can vary from person to person. Find out more here about the different types of STIs, their symptoms, testing and treatment options and how to protect yourself from them.

ovaries

The ovaries are a pair of small glands about the size and shape of almonds, located on the left and right sides of the pelvic body cavity lateral to the superior portion of the uterus. Ovaries produce female sex hormones such as estrogen and progesterone as well as ova (commonly called "eggs"), the female gametes. Ova are produced from oocyte cells that slowly develop throughout a woman's early life and reach maturity after puberty. Each month during ovulation, a mature ovum is released. The ovum travels from the ovary to the fallopian tube, where it may be fertilized before reaching the uterus.

what healthcare providers can do about syphilis

Syphilis Is Preventable and Treatable...And May Not Be On Your Radar 1 in 3 physicians have not received any post-medical school training in sexually transmitted diseases. And if knowing syphilis is knowing medicine, then too many providers now find themselves at a great disadvantage. If you have had limited, or no, experience with diagnosing and treating syphilis, do you know where to turn? Simply look to CDC's STD Treatment Guidelines for recommendations and strategies that you can use to help prevent and treat this ancient disease. The troubling reality is that when not adequately treated, syphilis can lead to visual impairment, hearing loss, stroke, and other neurological problems. Syphilis infection can also increase a person's risk for getting HIV or giving it to others. As a provider, you need to be aware that all 50 states require that syphilis cases be reported to the state or local public health agency so that it can take action to find and treat exposed persons. Syphilis Rates Are Increasing in Men, Women, and Some Newborns in the United States Knowledge about the prevention and treatment of syphilis is especially important nowadays. Why? Because recent data show that syphilis rates are on the rise. Rates of primary and secondary (P&S) syphilis—the most infectious stages of the disease—increased a troubling 14.4% between 2017 and 2018. While rates have increased among both men and women, men account for 86% of all P&S cases. Gay, bisexual, and other men who have sex with men (MSM) account for 78% of male cases with information on sex of sex partner. Likewise, increases in congenital syphilis (CS) have paralleled the national increase in P&S syphilis among women of reproductive age. CS can cause miscarriage, stillbirth, early infant death, or severe illness in those infants who survive. Cases of CS increased by a staggering 185% between 2014 and 2018. As a health care provider, you play an important role in reducing CS. Here's what you can do: Complete a Sexual History for Your Patients. Have an honest and open talk with your patients about their sexual history. STD counseling should be provided to those at risk for STDs, and contraceptive counseling should be provided to those at risk of unintended pregnancy. Test All Pregnant Women for Syphilis. This should occur at the first prenatal visit or at the time pregnancy is confirmed. Repeat screening for pregnant women at high risk and in areas of high prevalence at 28 weeks and at delivery. Treat Women Infected with Syphilis Immediately. If a woman has syphilis or suspected syphilis, treat her immediately with long-acting penicillin G, especially if she is pregnant, according to CDC's STD Treatment Guidelines. Test and treat the infected woman's sex partner(s) to avoid reinfection. If you have challenges obtaining penicillin G, contact your state or local health department. Confirm Syphilis Testing at Delivery. Before discharging the mother or infant from the hospital, make sure the mother has been tested for syphilis at least once during pregnancy or at delivery. If she tests positive, manage the infant appropriately. All women who deliver a stillborn infant should be tested for syphilis. Quickly Report All Cases of Syphilis and CS. Report cases of syphilis by stage to the local or state health department right away; CS cases should be reported within 24 hours. You also play an important role in reducing syphilis in MSM. Here are the actions you can take: Complete a Sexual History for Your Patients. Have an honest and open talk with your patients about their sexual history. Order CDC-recommended tests based on age, gender, sex or gender of sex partners, anatomic sites of exposure, and risk. Perform a syphilis test for sexually active MSM, including those with HIV infection, at least annually, and as frequently as every 3 to 6 months if there are multiple sex partners or substance use. Immediately Treat and Report Syphilis Cases. Stage and treat syphilis cases according to CDC's STD Treatment Guidelines. Presumptively treat all MSM with signs or symptoms suggestive of primary or secondary syphilis and all MSM who are sexual contacts to a case of syphilis at the initial visit. If you have challenges obtaining penicillin G, contact your state or local health department. Report all syphilis cases by stage to your state or local health department

breasts and mammary glands

The breasts are specialized organs of the female body that contain mammary glands, milk ducts, and adipose tissue. The two breasts are located on the left and right sides of the thoracic region of the body. In the center of each breast is a highly pigmented nipple that releases milk when stimulated. The areola, a thickened, highly pigmented band of skin that surrounds the nipple, protects the underlying tissues during breastfeeding. The mammary glands are a special type of sudoriferous glands that have been modified to produce milk to feed infants. Within each breast, 15 to 20 clusters of mammary glands become active during pregnancy and remain active until milk is no longer needed. The milk passes through milk ducts on its way to the nipple, where it exits the body.

fallopian tubes

The fallopian tubes are a pair of muscular tubes that extend from the left and right superior corners of the uterus to the edge of the ovaries. The fallopian tubes end in a funnel-shaped structure called the infundibulum, which is covered with small finger-like projections called fimbriae. The fimbriae swipe over the outside of the ovaries to pick up released ova and carry them into the infundibulum for transport to the uterus. The inside of each fallopian tube is covered in cilia that work with the smooth muscle of the tube to carry the ovum to the uterus.