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“I feel like as long as if I don’t know what I have, I won’t feel sick.  People always start to get sick when they find out they’re positive.”

“I’m in a monogamous relationship, so there’s no need to get tested.”

“I don’t do pap smears.  They hurt.”

These are just some of the excuses you’d think I’d hear from my high school students, but they are all from the mouths of grown sexually active people who refuse to get tested for sexually transmitted infections.  Most of this faulty decision-making is based on myths they’ve heard from friends about getting tested or self-diagnosis from WebMD or some other website that has led them to be in denial about their situation or allowed their imagination to get the best of them.

April is Get Yourself Tested Month. As much as I’m happy to celebrate that teen and unplanned pregnancy is on the decline, the fact still remains that 19 million new STD cases are reported in the U.S. each year and millions more go undetected and unreported. Don’t allow faulty, second-hand information be the reason to not get tested.  Here are 14 things that you may not not know about STIs and getting tested:

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Q: Lately it seems as though the understanding about HPV is that everyone is going to eventually get it so why worry about it.  Is that true? And why aren’t men getting vaccinated for the virus as well?

As of 2008, the total number of HPV infections that occurred in the US was about 110 million.  However, according to the latest census, there are about 313 million people living in the US. What is the point I am making?  Although HPV is the most common sexually transmitted disease, not everyone gets it.

Even if it is very common, it can be deadly if it stays in the body and does not get treated. HPV can cause cervical cancer, analcancer, and oral cancer. Bottom line: it is not something you want to dismiss.

Boys and men are recommended for vaccination!  The HPV vaccine is currently recommended for all 11-12 year olds.  All teen girls and women should be vaccinated by age 26, while teen boys/men should be vaccinated by age 21 (gay, bisexual, and other men who have sex with men should be vaccinated by 26).

For more info about HPV, check out my previous article here.

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Q: Hello doctor, I have the worst cramps in the history of cramps when I’m on my period. Over the counter medicine doesn’t cut it anymore. What do you recommend?

A: About 50 to 90 percent of women who still have menstrual cycles experiences this type of pain, so a lot of us can relate to your pain!  Great news, though, as you increase in age, some of you may stop experiencing cramps all together.  Until then, here is the 411 on painful menstrual cramps.

What causes this? Well, hormones in your body, the same ones that happen during labor, are the major culprits. In fact, during the time you are experiencing this pain, you are actually having contractions! The same kind of contractions you would have when giving birth to a child, in fact, so this is a normal thing.

Menstrual cramps usually go away with over-the-counter medications like ibuprofen (Advil is its brand name), naproxen (Aleve, Naprosyn) or ketoprofen (Orudis).  It is best to start using these medications before the start of your menstrual cycle and continue as needed. If one kind of medication does not relieve the pain, then try another because these medications don’t work the same in everyone. Placing a heating pad on your lower belly or massaging the back and lower belly can also help.  Exercising on a regular basis has also been found to help in reducing menstrual cramps. Yoga, acupuncture, and even having orgasms (you heard right) may also help.

What happens if I have tried all that and it still does not go away?  Well, this may not be simple cramps then. Other conditions can be causing this extreme pain, like an infection, fibroids, or even the use of intrauterine devices (IUDs). Symptoms like pain with sex or abnormal bleeding usually are signs that this is not simple cramps. In this case, you should talk with your doctor about this. Your doctor can examine you and conduct tests to look for reasons why you are experiencing such pain; he or she can also prescribe medications like contraceptives or other pain medications to stop and/or relieve the cramps.

Disclaimer: The information contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion between you and your physician. Please consult your physician for further information in regards to your own general care.  Knowledge is power! Be informed.

By Mercy Edionwe, MD

So the doctor calls you into the office because she has something to tell you. Just a few weeks ago, you decided to get a pap smear.  At that time, the doctor told you that if the test was fine, you wouldn’t hear from her office. Now, as you sit anxiously awaiting the results, your mind starts to wonder, “Could I have AIDS, syphilis, or gonorrhea?” A chill runs down your spine as the door opens and in walks the doctor. She sits down and she tells you, “Ma’am, the results of your pap smear show that you have HPV?” Your mind starts to wonder, “What is HPV?”

Well, let me break it down for you.

HPV? What is that?

HPV stands for Human Papillomavirus. It is a family of viruses that look similar to each other but can cause different conditions in the body. Scientists associate the individual viruses as types. In general, there are a total of 40 types.  One type of HPV can cause warts while another type can cause cancer. The type of the virus someone has dictates what kind of disease the person will get.

HPV can be contracted from skin-to-skin contact.  It does not matter if you are into oral, anal, or plain old regular sex. If your partner is infected, you will have a high chance of being infected too.

And for all you virgins out there, even if you are not sexually active, you can still be affected. Why?  HPV can be found within the skin of your private parts. So, if your genitals or mouth have direct skin contact with an infected person’s genitals, you are at risk of getting it as well. The learning lesson is that with HPV, you are not safe with just 4-play.

Why is it important?

HPV can cause cervical cancer, which is the third most common cancer in the world. Cervical cancer is also the leading cause of cancer-related deaths in women living in developing countries. In other words, HPV can be deadly.

What signs or symptoms will someone have with HPV? Why would you call it the silent killer?

The problem is that you can’t always tell, hence being called the silent killer. Someone with HPV can walk around without any signs or symptoms.  On the other hand, HPV can be so sneaky and show up in different  forms.  It can cause genital or oral warts in both men and women. It can also cause cancer of the penis, cervix, vagina, anus, and even oral cancer. When it attacks these parts of the body, the person may not notice anything until it is too late.

There is another twist to the story. Not everyone who gets the virus gets the disease. According to the CDC, 90% of people who are infected with HPV do not have the virus after two years. The reason for this is that the body is designed to naturally clear it from its system, which would be great news if it stopped there.  However, the problem is there is no way to know which person will be able to clear the virus from their system and which person will not.

What can I do to find out if I have it?

You should report to your doctor if you see any suspicious warts or skin conditions in your genitals, mouth, or anywhere in your body. In HPV, the warts can resemble cauliflowers.

You should also report abnormal vaginal or rectal bleeding to your doctor.

Ladies, it is important to get a well women exam done yearly, especially if you are sexually active. A well women exam is an exam that your doctor does to check on the health of your vagina, ovaries, cervix, and other girl parts.  When they do the well women exam, they perform a test called a pap smear. Because HPV tends to change the way the cells look on the cervix microscopically, a pap smear checks for abnormal cells on your cervix (the opening hole to your uterus).  Your doctor will use a tool to gently scrape some of the cells off the cervix to send them to the lab. This process is similar to the common paternity test where someone scrapes the inside of the cheek for cells.  At the lab, the cells will be examined more closely with the use of a microscope.  Different tests can also be done on the cells to detect either HPV or cervical cancer. Well women exams are extremely important because early detection of HPV can prevent cervical cancer or stop a cancerous cells from growing to the point that they could potentially kill.

Unfortunately, at this time, there is no screening test for men.

The standing recommendation for HPV vaccination is that three shots should be given to 11- and 12-year-old girls within a six-month window, with catch-up shots advised up to age 26, but a new study found most young women aren’t getting that.

Scientists studied insurance records of 271,976 girls and women in the United States who received an initial vaccination from 2006 to 2009 and found that the rate at which the young women completed the series within a year dropped to less than 22 percent in 2009 from more than 50 percent in 2006. The only area where an increase in completion was seen was among the 2 percent of women older than 27 who received the shots off-label. That rate rose from 15 percent in 2006 to 24 percent in 2009.

Girls who received the vaccination from a clinic as opposed to a pediatrician were less likely to complete the series. On the other hand, women who received their vaccinations from a gynecologist were most likely to get all three shots. Dr. Abbey B. Berenson, a professor at the University of Texas Medical Branch, says something must be done to increase the rates of completion.

Getting one shot is not enough, she said. “All the data is based on three injections. Getting one shot does not protect, based on the data we have now.”

From the findings, it seems as though the onus is on clinics to stress the importance of receiving all three shots and encourage young girls to complete follow-up or else they want be protected.

Brande Victorian is a blogger and culture writer in New York City. Follower her on Twitter at @be_vic.

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The Human Papillomavirus (HPV) is an infection that typically shows up on one pap smear and is gone by the next without any threat to a woman’s health, but researchers are finding that the infection tends to last longer in college-aged black women and this lingering could lead to a higher risk of cervical cancer.

“African American women are more likely to have persistent high-risk HPV infection,” said study author Kim Creek, vice-chair and professor of pharmaceutical and biomedical sciences at South Carolina College of Pharmacy, in Charleston.

“If you are infected [with HPV], your body recognizes it as a viral infection and usually clears the virus within one or two years,” he said. “It is those women who have difficulty clearing it that are at higher risk of cervical disease and cervical cancer.”

The researchers assessed HPV infection and persistence in college-age women enrolled at the University of South Carolina beginning in 2004, and followed the women throughout their college years. HPV status was evaluated every six months in Pap test samples from 326 white women and 113 black women.

The rate of new high-risk HPV infection was similar between the two groups of women, but at any visit, black women were 1.5 times more likely to test positive for high-risk HPV infection. About 56 percent of black women were also still infected with the virus two years after they were first diagnosed, compared with 24 percent of white women.

Creek is unsure why black women have difficulty clearing the virus from their bodies but he said, “We think that it likely has something to do with the immune system.” He added that black women are 40 percent more likely to develop cervical cancer and two times more likely to die from the disease than European or American white women. This study suggest that the difference may not just be a result of lack of access to medical care but that there may be a biological basis behind the varying rates. Considering how much is at stake for black women who become infected with HPV, Creek said the HPV vaccine may be even more beneficial in this population.

While this study certainly warrants further investigation, Dr. Diana Contreras, director of gynecologic oncology at Long Island Jewish Medical Center in New Hyde Park, said it’s too soon to determine how to to effectively handle HPV in black women:

“We are beginning to understand that HPV may behave differently in different ethnic groups,” she said. “This study is very provocative, but the jury is still out on screening and treatment, and we have to be careful about drawing too many conclusions.”

Until researchers come up with a more definitive approach, it seems skipping an annual pap smear may not be as applicable to black women. If anything, we might need to be even more diligent about gynecologic testing.

Brande Victorian is a blogger and culture writer in New York City. Follower her on Twitter at @be_vic.

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For a lot of women, going to the gynecologist for a pap smear is one of the worst days of the year, but new recommendations from the U.S. Preventive Services Task Force may allow you to cut down on trips.

The Task Force says women between the ages of 21 and 30 should now get a pap smear no more than every three years as long as they are screened for cervical cancer and tested for HPV during the exam. Women between 30 and 65 can stretch that frequency as far as five years, with women younger than 21 being told to skip the screening altogether.

The last time the Task Force put forth recommendations was in 2003, when they recommended women be tested at least every three years, which led many gynecologists to require annual screenings. Now, in a move to cut down on the number of women being treated for lesions that may heal on their own, the panel set this new standard. A potential downside, though, is that the increased length in between screenings could lead to a slight increase in the number of women who die from cervical cancer.

Dr. Michael LeFevre, co-vice chair of the task force and a professor of family and community medicine at the University of Missouri at Columbia, calls the risk a trade-off. He says more frequent screenings may turn up more cancers and pre-cancerous lesions, but it also leads to more painful therapies for conditions that often disappear on their own.

Colposcopic examinations are often recommended for women who are dealing with lesions, and according to Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico, “It’s like a Pap test on steroids.”

In addition to the pain, excision of these lesions can also affect one’s fertility down the line. By screening less often, these lesions will have time to heal on their own without their detection being a cause for alarm, the panel says.

Despite these recommendations, Cosmo Radio health expert Dr. Jennifer Wider, says women should still see their gyno once a year. “The Pap smear is only part of your annual exam,” she said, noting women still need clinical breast exams annually and regular STD testing.

Dr. Thomas Randall, director of gynecologic oncology at Pennsylvania Hospital, isn’t sold on the panel’s recommendation either, saying more effort should be placed on finding less invasive treatments for lesions, rather than limiting their ability to be detected.

What do you think of this new recommendation? Would you be comfortable waiting three-five years for a pap smear or would you rather have an annual exam just to be safe?

Brande Victorian is a blogger and culture writer in New York City. Follower her on Twitter at @be_vic.

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The human papillomavirus (HPV) sometimes seems harmless because there are rarely any symptoms associated with it, but researchers believe the virus is responsible for the increased rates of mouth and throat cancer during the past 25 years, and new research says 7% of Americans now have HPV in their mouths.

The study, published online in the Journal of the American Medical Association is the first to assess the prevalence of oral HPV in the U.S. population, and from the ages of 14 to 69, across men and women, the incidence was found to be 6.9%.

The findings also indicate that oral sex, rather than kissing, is the main cause for the spread of the virus—most likely because people still don’t understand that the practice can lead to disease.

“I don’t think people think of oral sex in the same way they do with traditional intercourse,” said Fred Wyand, director of the HPV Resource Center at the American Social Health Association in Research Triangle Park, NC. “Sometimes younger people engage in oral sex so they don’t have to worry about pregnancy. They may not even make the link between oral sex and STDs.”

Since most oral HPV infections are harmless and oral cancers are still somewhat rare, there isn’t a total cause for alarm, but there could be down the line. This is why the researchers say doctors, parents, and sexual partners need to talk about the use of protection upfront.

“It’s something people are not comfortable talking about, but it is protective,” Dr. Hans Schlecht, assistant professor of medicine at Drexel University College of Medicine in Philadelphia who wrote an editorial accompanying the study said in an interview. “If you are going to be intimate with someone, there are some adult conversations you need to have.”

Brande Victorian is a blogger and culture writer in New York City. Follower her on Twitter at @be_vic.

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