Genital warts? Cervical cancer? We’ve got an HPV vaccine for that!

In fact there are three vaccines all of which target the Human Papillomavirus (HPV) which can cause health problems such as genital warts and cancer. So which is the best?

The three vaccines were developed at different times and target different strains of the HPV virus.

  • Cervarix – protects against types 16 and 18
  • Gardasil – protects against types 6, 11, 16, and 18
  • Gardasil 9 – protects against types 6, 11, 16, 18, 31, 33, 45, 52, and 58

Here’s the breakdown on the HPV types:

  • 6 and 11 – not cancer causing, but are responsible for 90% of genital warts
  • 16 and 18 – cancer causing responsible for 70% or cervical cancel, 50-60% of mouth/throat cancer, and 80% of anal cancer in the US
  • 31, 33, 45, 52, and 58 – cancer causing responsible for 15% or cervical cancer, 4-9% of oro-pharyngeal cancer and 4-11% of anal cancer in the UA

Gardasil 9 was approved by the FDA in December 2014 and is licensed for use in females age 9-25 and males 9-15.  It is also licensed for immunocompromised persons and for men who have sex with men through age 26.

Current recommendations by the Advisory Committee on Immunization Practices) ACIP include:

  • Females:
    • Vaccination for those aged 9-26
    • All three types of the vaccine can be used
  • Males:
    • Vaccination for those aged 9-21, but new data is suggesting it should be available for those aged 16-26
    • Recommended for those who have sex with men and immunocompromised men through age 26
    • Gardasil and Gardasil 9 can be used
  • All:
    • Dosage schedule includes 3 doses, with the second dose 1-2 months after the first and the third dose 4 months after the 2nd and 6 months after the first
    • If the dosage schedule is interrupted, the series does not have to be restarted
    • If you do restart and are unsure which vaccine you received, you can use the new vaccine safely

Ryo Choi-Pearson, M. D.

What are some symptoms of Chlamydia?

My friend was recently treated for Chlamydia which got me to wondering.  What are some symptoms of Chlamydia?

Good question.  Chlamydia is the most common bacterial sexually transmitted infection (STI) in the US with more than 1.44 million cases reported to the CDC in 2014.  More than half of these occurred in women aged 15-25 years.

The symptoms of Chlamydia may include abnormal vaginal discharge, vaginal irritation, pelvic pain, abnormal vaginal bleeding, dysuria, painful sex, and/or contact bleeding.  OR there may be no symptoms at all.  In fact, it is very common not to have any symptoms.  That is why routine screening tests are important for sexually active women.

Annual screening is recommended for all sexually active women who are:

  • less than 25 years of age
  • 25 year or older and have a new sex partner, more than 1 sex partner, a sex partner with concurrent partners, a sex partner who has an STI, or if you have had a previous history of Chlamydia

Early detection of Chlamydia is important as serious consequences can result.  These may include:

  • pelvic inflammatory disease (PID)
  • chronic pelvic pain
  • ectopic pregnancy
  • infertility

The treatment of uncomplicated Chlamydia is easy enough with a single dose of antibiotics.  However, this easy enough treatment will only be effective if your partner is Chlamydia free, so, and  I CANNOT STRESS THIS ENOUGH, sexual partners must be evaluated and treated as soon as possible to prevent re-infection.  Both partners must abstain from sexual activity (NO SEX OF ANY KIND) until 7 days after they have been treated.

The Ohio State University has various resources available for STI testing.

  • An appointment can be scheduled with a provider at Student Health Services.
  • An Order-it-Yourself (OIY) lab for detected Chlamydia can be completed at the Student Health Services Laboratory.
  •  Free STI testing is offered by the Student Wellness Center.

Ryo Choi-Pearson, M.D.

 

Is prolonged bleeding normal after starting birth control?

knol.google.com

Q: Is it natural to have prolonged periods after just starting birth control? I started taking the pill when I started my period and it still persists.

A: Irregular bleeding is the most common side effect of birth control pills.  It is especially common during the first three months as your body adjusts to the hormones in the medication.  However, other things (like sexually transmitted infections) can cause prolonged bleeding too.  If the bleeding is especially heavy (more than a normal period), persists throughout the whole month or occurs only with intercourse – especially if you’ve stopped using condoms – you should see your women’s health care provider to make sure nothing more serious is going on.

The most common cause of irregular bleeding is missed pills, so make sure you are taking the pill every day, and at the same time every day.

Birth control pills can cause a lot of other side effects, especially bloating, nausea and breast tenderness.  Most side effects resolve after a few months, but the clinicians in our Women’s Services Department usually recommend that you check in with your health care provider after your first 3 months on the pill to make sure everything is going OK.  If you have any questions or concerns about birth control, they’re happy to answer them for you.

John A. Vaughn, MD
Student Health Services
The Ohio State University

Mononucleosis

Mononucleosis is a viral infection. It is spread through direct contact with saliva from another person infected with the virus. The infected person can spread the infection by kissing, sharing food, coughing, or shaking hands. It is spread less often through contact with blood or semen.

Symptoms usually begin 4-6 weeks after exposure to the virus. Symptoms include fatigue, muscle aches, fever, sore throat, and swollen neck glands. Most people will improve within 2-4 weeks.

The doctor will diagnosis mononucleosis from your symptoms, exam and lab tests. Treatment includes rest, drinking plenty of fluids, and acetaminophen or ibuprofen for pain or fever. Antibiotics do not help.

Mononucleosis can cause your spleen to enlarge and possibly rupture with minimal injury. Therefore, it is wise to avoid contact sports until a month after your mono symptoms have resolved.

The best prevention is to avoid contact with the infected person’s saliva and other bodily fluids until their symptoms have completely resolved.

Submitted by Matthew Peters, MD

Veggie Vitals – Asparagus, A great weapon in your arsenal of healthy foods!

AsparagusThe asparagus spears – get it? Weapon – spears?  Anyway, these spears pack quite a punch when it comes to nutritional benefits and they have been doing so for over 4,000 years.  It was declared a food of the gods by Pharaoh Ikhnaton and his wife Nefertiti and was well liked by the Greeks, Persians, and Babylonians.

Asparagus does take a bit of time, however, to grow into maturity.  It is planted in the ground 3 years before it can be harvested for a full season.  But, once it does start growing, it does so with gusto.  A mature plant is harvested all season – approximately 90 days, and can sometimes grow 6 to 7 inches in one day.

Whenever I pick up some asparagus from the store, my husband always says, “I don’t like the green asparagus, I like white!”  Obviously he is not aware that green and white asparagus come from the same plant.  Sunlight is what causes the spears to turn green.  When the spears puncture through the ground, dirt is piled on top of them to shield them from sunlight.  They continue growing underground and when finally harvested the stalk is all white.  FYI – purple asparagus comes from a completely different plant and if cooked for a prolonged period of time will turn green.

Asparagus is considered by some to be an aphrodisiac.  Apparently there is an Arabian love manual from the 16th century that provided an asparagus recipe for the stimulation of erotic desires.  I did some Googling, but couldn’t find the recipe.  But I did find some scientific rational as to why it might have been considered as such.  Asparagus contains high levels of vitamin E and foliate which are necessary for histamine production and histamine is related to easy sexual orgasm, both in men and women.  Recommendations are that it be consumed over 3 consecutive days for the most powerful effects.

One cup of raw asparagus contains approximately 27 calories, 0 grams of fat, 5 grams of carbohydrate, 3 grams of sugar, 3 grams of fiber, and 3 grams of protein.  That same cup also provides 70% of your daily vitamin K needs, 20% of vitamin A, 17% of folate, 16% of iron, 13% of vitamin C, 13% of thiamin, and smaller amounts of vitamin E, niacin, vitamin B6, and potassium.

Here are some of the benefits indicated by the Juicing for health website.

Acidity, Blood:  The high alkalinity of this wonder juice is effective in reducing the acidity of the blood and helps cleanses the tissues and muscles of waste.

Arthritis and Rheumatism:   A unique phytochemical in asparagus that produces anti-inflammatory effect helps relieve arthritis and rheumatism.

Bowel movement:  Consume asparagus regularly for its mild laxative effect and dietary fiber that provides for regular bowel movement.

Cancer:   Asparagus is a prime source of anti-oxidant and glutathione that can help prevent the dreaded cancer.

Cataracts:  The anti-oxidant and glutathione in asparagus prevents the progression of cataracts and other eye problems.

Diabetes/Hypoglycemia:  The healthful minerals in asparagus juice make it an important diet for people who are controlling their blood sugar levels. However, it is not to be taken by people with advanced kidney diseases.

Diuretic:  Asparagus is a wonderfully diuretic vegetable and its efficacy is more pronounced when it is taken in juice form.

Heart disease:  Drink a small amount of asparagus juice mixed with raw honey three times a day daily to strengthen a weak or enlarged heart.

Kidney:  The diuretic and alkaline properties of asparagus help prevent or dissolve kidney stones. It helps break up oxalic acid crystals formed in the kidney.

PMS symptoms:  The diuretic effect of asparagus juice helps relieve premenstrual swelling and bloating. The magnesium in this wonder juice also help relieve irritability, fatigue, depression, etc.

Pregnant women:  The high content of folate, calcium and other minerals in asparagus are important in reducing the risk of birth defects and low birth weight. The diuretic effect of the juice is also a big help in reducing water retention in pregnant women.

June 11 is Asparagus Day!

#TBT Bigger Bust Belief Burst

SpencerTurner---BiggerBustBeliefBurstDr. Turner received a question on bust developing courses in 1975. The question asked if they are safe and do they cause any side effects in the future. While I personally have not received such questions, a quick search on Google shows that this is still a very popular topic.

It is possible, with exercise, to increase your bust measurement, but as Dr. Turner indicated this measurement does not actually measure the size of your breasts, but rather the circumference of the chest.  The breasts themselves do not contain any supportive muscle tissue. Therefore it is not possible, through exercise to increase your cup size.  What exercise can do, however, is develop the muscles behind your breasts to make them more attractive.

The original article can be read in the Lantern Archives.

Condom-minimums

Turner_Condom_Minimums

Dr. H. Spencer Turner, former director of Student Health Services, published the above article in the Lantern in 1975. (You can view this article and others in the Lantern Archives.)

What was true in 1975 regarding the use of condoms, is still true today. The Centers for Disease Control and Prevention (CDC) recommends the following:

  • Use a new condom for every act of vaginal/anal/oral sex, throughout the entire sex act. Make sure to put the condom on PRIOR to any genital contact.
  • After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Gently pull off the condom being careful not to spill any of the semen.
  • If you feel the condom break at any point during sexual activity, stop immediately, withdraw, remove the broken condom, and put on a new condom.
  • If using a lubricant, make sure it is water-based. Oil-based lubricants can weaken the latex and cause breakage.

FYI – the CDC did not have any comment on colored toilet paper.

Tina Comston, M.Ed.

Condoms are a beautiful thing!

Condoms are a beautiful thing!

Condoms are a beautiful thing.  They are effective at preventing both pregnancy and sexually transmitted diseases.  They are inexpensive and easily obtained.  They are small and compact and easily kept in a wallet or purse.

However, they are only beautiful when they are used correctly.

WebMD reports the most commonly reported condom use errors are:

  • Not using condoms throughout sexual intercourse
  • Not leaving space at the tip
  • Not squeezing air from the tip
  • Putting the condom on inside out
  • Not using only water-based lubricants
  • Incorrect withdrawal

These types of errors reduce the effectiveness of condoms to about 85%. To get the maximum protection from your condom, follow these guidelines:

  • Use a NEW condom every time you have sex, be it vaginal or oral and make sure the condom is in place before there is any genital contact.
  • Make sure there is at least a ½ inch space at the tip of the condom for semen collection.  Some condoms have a built in reservoir tip for this purpose.  If yours does not, then just pinch the end while placing the condom to allow for this extra space.
  • After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Then gently pull the condom off the penis, making sure that semen doesn’t spill out.
  • Wrap the condom in a tissue and throw it in the trash where others won’t handle it.
  • If you feel the condom break at any point during sexual activity, stop immediately, withdraw, remove the broken condom, and put on a new condom.
  • Ensure that adequate lubrication is used during vaginal and anal sex, which might require water-based lubricants. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) should not be used because they can weaken latex, causing breakage.

If you’re interesting in learning more about condoms or in obtaining a few of these beautiful things for your own protection, check out the Condom Club at the Student Wellness Center.

Submitted by Tina Comston, M.Ed.

Can a Toilet Give You Gonorrhea?

an aquarium you don't want to visit!

Clinical Correlations is a blog managed by the NYU Department of Internal Medicine.  I was perusing it this week and came across a great post about whether or not you can catch gonorrhea from sitting on a toilet seat.  The blog is written by medical students and physicians for medical students and physicians, so it’s a little heavy on the scientific details, but it’s actually pretty readable and since this is a topic that is always of interest around campus, it’s definitely worth a read. 

Check it out… and always remember to put the lid down when you’re done!   

John A. Vaughn, MD
Student Health Services
The Ohio State University

Enough with the manscaping, already!

blog.rivalus.net

Dr. Emily Gibson, Director of Student Health Services at Western Washington University, wrote a great story about the risks of frequent pubic hair removal in their student paper.  I agree with my esteemed colleague that the obsession with pubic hair removal on campuses nationwide has gotten out of hand – I encourage you to check out the article, and put the razor/wax/light saber away for a while.

John A. Vaughn, MD
Student Health Services
The Ohio State University