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Can You Catch Genital Herpes When There Are No Lesions?

The answer might seem obvious, but I get this question often in clinic. In particular, patients want to know if genital herpes is contagious even if they or their partner is not having an outbreak.

The answer is yes. Genital herpes is a common sexually transmitted disease and is highly contagious. Although the risk of infecting someone else is much higher if you’re having an outbreak, it is still possible to transmit the virus, called HSV, even if you have no symptoms. About 1 in every 6 adults has genital herpes.

Once you have herpes, there is way to cure it. It is common to have recurring outbreaks especially in the first year, but in most people these lessen over time.

The only way to ensure you won’t get herpes is to abstain from sexual contact or to be in a monogamous relationship with a partner who is not infected. Wearing a condom can reduce the chances of infection, but it’s still possible to be transmitted. Taking anti-herpes medication such as acyclovir can reduce the amount of virus and minimize the risk of transmitting it.

April is STD awareness month. If you’re thinking you might need to get tested, then you need to get tested.

*This blog post was originally published at The Dermatology Blog*

Questioning The Annual Pelvic Exam

A new article in the Journal of Women’s Health by Westhoff, Jones, and Guiahi asks “Do New Guidelines and Technology Make the Routine Pelvic Examination Obsolete?”

The pelvic exam consists of two main components: The insertion of a speculum to visualize the cervix and the bimanual exam where the practitioner inserts two fingers into the vagina and puts the other hand on the abdomen to palpate the uterus and ovaries. The rationales for a pelvic exam in asymptomatic women boil down to these:

  • Screening for chlamydia and gonorrhea
  • Evaluation before prescribing hormonal contraceptives
  • Screening for cervical cancer
  • Early detection of ovarian cancer

None of these are supported by the evidence. Eliminating bimanual exams and limiting speculum exams in asymptomatic patients would reduce costs without reducing health benefits, allowing for better use of resources for services of proven benefit. Pelvic exams are necessary only for symptomatic patients and for follow-up of known abnormalities. Read more »

*This blog post was originally published at Science-Based Medicine*

Why Don’t More People Use Female Condoms?

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I first heard about the female condom in 2006. I was in Seattle to see what was happening at the Bill and Melinda Gates Foundation. One of the many impressive projects it was supporting was at PATH, a non-profit organization that was developing and promoting a new female condom. The sad, age-old reason: the health of millions of women around the world is threatened by irresponsible men. Read more »

Half Of Teens Contract A Sexually Transmitted Disease Within 2 Years Of First Having Sex

This is a very scary reality. A recent study from the Indiana University School of Medicine suggests that half of young urban women will get a sexually transmitted infection (STI) shortly after sexual debut, while screening typically begins years later.

Researchers conducting the eight -year study found that by age 15, 25 percent of the adolescents in the study had acquired an STI, half within two years, and most often Chlamydia. The results also reflect a high repeat infection rate, with 25 percent of the teens getting at least one reinfection or other STI within 4 to 6 months.

The results, published in the Archives of Pediatrics & Adolescent Medicine call for health practitioners to inquire about sexual activity and screen teens, preferably every 3 to 4 months.

This post, Half Of Teens Contract A Sexually Transmitted Disease Within 2 Years Of First Having Sex, was originally published on by Nancy Brown, Ph.D..

Sexually Transmitted Infections Still On The Rise

The CDC announced last week that the latest statistics on Chlamydia, gonorrhea and syphilis are still unacceptably high in the United States. The U.S. has some of the highest rates of sexually transmitted infections of any developed country in the world including 1.2 cases of Chlamydia in 2008 and syphilis cases, up 18 percent, are at 13,500. Men who have sex with men accounted for 63 percent of the syphilis cases, but the rate among women also increased 36 percent between 2007 and 2008.

Almost half of the 19 million new sexually transmitted infection cases reported each year are among 15- to 24-year-olds. Clearly marking the shift away from abstinence-only policies, the CDC called for better, more honest and open, sex education including how to use a condom, limiting the number of sexual partners, and avoiding people who have had multiple sex partners. Read more »

This post, Sexually Transmitted Infections Still On The Rise, was originally published on by Nancy Brown, Ph.D..

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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