What Women Should Know To Stay Healthy

HIV Awareness

The CDC estimates that more than 1.2 million people in the United States are living with HIV infection, and almost 1 in 7 (14%) are unaware of their infection.

Getting an HIV test is the only way to know if you have HIV. The CDC recommends that health care providers test everyone between the ages of 13 and 64 at least once as part of routine health care. You should get tested for HIV at least every year if you share needles/syringes or other equipment for injecting drugs, have a history of sexually transmitted diseases, or have had unprotected sex with multiple or anonymous partners. Some healthcare providers may recommend testing every 3-6 months if you have certain risk factors, including injection drug use and/or unprotected sex with others who engage in high-risk behaviors.

You should consult your healthcare provider to see how often you should be tested.

There are several types of HIV tests used in the United States:

• Antibody Tests
The most common HIV tests look for HIV antibodies in your body, rather than looking for HIV itself. Enzyme immunoassay (EIA) tests use blood, oral fluid, or urine to detect HIV antibodies. Results for these tests can take up to two weeks. Rapid HIV antibody tests also use blood, oral fluid, or urine to detect HIV antibodies. Results for these tests can take 10–20 minutes. If you get a positive result from either of these tests, you will need to take another test, called a Western blot test, to confirm that result. It can take up to two weeks to confirm a positive result.

• Antigen Tests
These tests are not as common as antibody tests, but they can be used to diagnose HIV infection earlier—from 1-3 weeks after you are first infected with HIV. Antigen tests require a blood sample.

• PCR Test (Polymerase chain reaction test)
This test detects the genetic material of HIV itself, and can identify HIV in the blood within 2-3 weeks of infection.

Sexually Transmitted Diseases (STDs)

STDs are infections passed from person to person through sexual contact. Sometimes the term Sexual Transmitted Infection (STI) may also be used.  There are many types of STDs and many of them do not cause symptoms.  Becoming infected with an STD is common, therefore protection and testing are very important.  You can help protect yourself from many STDs by practicing safer sex, such as using a condom.  If you think you may have been exposed to an STD or are experiencing symptoms of an STD it is important to get tested.  Early diagnosis will allow you to begin treatment sooner.  If left untreated, some STDs can increase your risk of contracting HIV or lead to infertility.

Human Immunodeficiency Virus (HIV):

HIV can be transmitted through anal, oral or vaginal sex.  It can be transmitted to a child during childbirth and through breast milk.  Contact with blood infected by HIV can also transmit the disease.  It cannot be transmitted through casual contact such as hugging or sharing utensils.  If left untreated, HIV can lead to AIDs.  It is possible to go for years without showing any symptoms of HIV.

You should get tested if:  You have had unprotected sex, you have injected drugs with a needle or shared drug equipment with others, or you have a new sexual partner.  A blood or urine test is used to detect HIV.  If you have recently been exposed to HIV and your test result is negative, you may need to be tested again in 3 months to get a more accurate result.  HIV is treated with medicine called anti-retroviral, this medicine can prevent the virus from worsening and extend the life of a person with HIV for decades.  It is important to start treatment for HIV as early as possible.  There is no cure for this virus.

Pelvic Inflammatory disease (PID):

PID is a condition that only effects women.  It is an infection in the womb, ovaries and fallopian tubes.  STDs such as Chlamydia and Gonorrhea, if left untreated can cause PID.  Symptoms of PID include: pain during intercourse, pain in the lower abdomen, fever, vaginal discharge with odor, or irregular bleeding.  Some women may not experience any symptoms.  PID is diagnosed with a vaginal exam, pap test, and pelvic ultrasound.  The infections that cause PID are treated with antibiotics. PID is curable, however damage done by PID may not be reversible.

Human Papilloma Virus (HPV)

HPV is transmitted through anal, oral or vaginal sex with an infected person.  Some types of HPV cause cancer.  The vaccines Gardasil and Cervarix can protect against genital warts and from certain types of HPV.  The vaccine is recommended for males and females from age 9 to 26 years.  Symptoms of HPV can include genital warts which are bumps in the genital area that could be small or large, raised or flat, or they may be shaped like cauliflower.  Some individuals with HPV may not show any symptoms.  HPV is detected using a pap test which allows the physician to determine if you have abnormal cervical cells that might indicate HPV.  HPV is not curable.  The genital warts that accompany the virus can be treated or removed.  Abnormal cervical cells may be treated to help prevent cancer from developing.

Gonorrhea:

Gonorrhea is transmitted through anal, oral and vaginal sex.  Gonorrhea is a bacterial infection that can affect the genital tract, mouth, and anus.  Symptoms include painful urination, a pus-like discharge from the vagina or penis, anal irritation or painful bowel movements.  Some individual may have no symptoms.  Testing for Gonorrhea is done through a urine sample or a sample from the infected body part.  This condition is treated and cured with antibiotics.

Syphilis:

Syphilis is transmitted through anal, oral, and vaginal sex with an infected person.  The bacteria is passed to another person through syphilis sores.  Symptoms of Syphilis are categorized into 3 stages: primary, secondary, late or latent stage.  The primary stage is characterized by a single sore, the second stage involves a skin rash and lesions on the palm of the hands and both feet, the late stage begins when the other symptoms disappear but the disease is still present.  Untreated Syphilis can lead to blindness and death.  The test for Syphilis includes a blood test and microscopic exam of a syphilis sore.  The disease is treated with a single antibiotic injection for persons infected for less than 1 year.  Additional doses may be needed for those infected for more than 1 year.

Trichomoniasis:

Trichomoniasis or Trich is transmitted through vaginal sex or genital to genital contact with an infected person.  This condition is caused by a tiny parasite.  Trich can be dangerous in pregnant women potentially causing premature birth or low birth weight.  Symptoms of Trich include unusual discharge, strong odor, and pain when urinating or having sex.  Many people don’t experience any symptoms. Trichomoniasis is detected by testing a sample of the discharge from the vagina or penis.  It may also be tested using a urine sample.  Trich can be cured with antibiotics.

Chlamydia:

Chlamydia is a bacterial infection that is transmitted through anal, oral or vaginal sex.  The symptoms of Chlamydia are pain during intercourse, abdominal and lower back pain, burning during urination, and abnormal discharge.  Some people infected with Chlamydia do not experience any symptoms.  A urine test or specimen from the penis or cervix is used to test for Chlamydia.  Antibiotics are used to treat and cure Chlamydia.

Herpes:

Herpes is a viral infection caused by herpes simplex.  The virus is transmitted through anal, oral, and vaginal sex with an infected person even if no symptoms are present.  Symptoms of herpes include cold sores around the mouth; sores or blisters around genitals, buttocks, or anal area; flu-like symptoms such as fever and swollen glands.  Some infected individuals have no symptoms.  Herpes is detected with a blood test.  There is no cure for this infection but antiviral medications are used to treat outbreaks.

Contraception

Contraception, also known as birth control and fertility control, are methods or devices used to prevent pregnancy. There are many safe and effective contraception options available. Talk to your OB/GYN about which contraception is best for you based on your lifestyle, personal preferences and health status.

Barrier Methods
Designed to prevent sperm from entering the uterus, barrier methods are removable and may be an option for women who cannot use hormonal methods of contraception. Types of barrier methods include:

Male condoms. This condom is a thin sheath that covers the penis to collect sperm and prevent it from entering the woman's body. Male condoms are generally made of latex or polyurethane, but a natural alternative is lambskin. Latex or polyurethane condoms also reduce the risk of spreading sexually transmitted diseases (STDs), but lambskin condoms do not. Male condoms should be disposed of after a single use.

Female condoms. These are thin, flexible plastic pouches. A portion of the condom is inserted into a woman's vagina before intercourse to prevent sperm from entering the uterus. The female condom also reduces the risk of STDs. Female condoms are disposed of after a single use.

Diaphragms. Each diaphragm is a shallow, flexible cup made of latex or soft rubber that is inserted into the vagina before intercourse, blocking sperm from entering the uterus. Spermicidal cream or jelly should be used with a diaphragm. The diaphragm should remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but it should be removed within 24 hours. A diaphragm should be replaced after 1 or 2 years. Women also need to be measured again for a diaphragm after giving birth, having pelvic surgery, or gaining or losing more than 15 pounds.

Cervical caps. These are similar to diaphragms, but smaller, more rigid, and less noticeable. The cervical cap is a thin silicone cup that is inserted into the vagina before intercourse to block sperm from entering the uterus. As with a diaphragm, the cervical cap should be used with spermicidal cream or jelly. The cap must remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but it should be removed within 48 hours. With proper care, a cervical cap can be used for 2 years before replacement.

Contraceptive sponges. These are soft, disposable, spermicide-filled foam sponges. One is inserted into the vagina before intercourse. The sponge blocks sperm from entering the uterus, and the spermicide also kills the sperm cells. The sponge should be left in place for at least 6 hours after intercourse and then removed within 30 hours after intercourse.

Spermicides. A spermicide destroys sperm. A spermicide can be used alone or in combination with a diaphragm or cervical cap. The most common spermicidal agent is a chemical called nonoxynol-9 (N-9). It is available in several concentrations and forms, including foam, jelly, cream, suppository, and film. A spermicide should be inserted into the vagina close to the uterus no more than 30 minutes prior to intercourse and left in place 6 to 8 hours after intercourse to prevent pregnancy. Spermicides do not prevent the transmission of STDs and may cause allergic reactions or vaginitis.

Hormonal Methods
Hormonal methods of birth control use hormones to regulate or stop ovulation and prevent pregnancy. Hormones can be introduced into the body through various methods. Health care providers prescribe, monitor, and administer hormonal contraceptives.

Combined oral contraceptives ("the pill"). Combined oral contraceptive pills (COCs) contain different combinations of the synthetic estrogens and progestins, and are given to interfere with ovulation. A woman takes one pill at the same time each day. Use of COC pills is not recommended for women who smoke tobacco and are more than 35 years old or for any woman who has high blood pressure, a history of blood clots, or a history of breast, liver, or endometrial cancer.

Progestin-only pills (POPs). A woman takes one pill at the same time each day. Progestin-only pills may interfere with ovulation or with sperm function. POPs thicken cervical mucus, making it difficult for sperm to swim into the uterus or to enter the fallopian tube. POPs alter the normal cyclical changes in the uterine lining and may result in unscheduled or breakthrough bleeding.

Contraceptive patch. This is a thin, plastic patch that sticks to the skin and releases hormones through the skin into the bloodstream. The patch is placed on the lower abdomen, buttocks, outer arm, or upper body. A new patch is applied once a week for 3 weeks, and no patch is used on the fourth week to enable menstruation.

Injectable birth control. This method involves injection of a progestin given in the arm or buttocks once every 3 months. Most patients using injectable birth control should eat a diet rich in calcium and vitamin D or take vitamin supplements as this method of birth control can cause a temporary loss of bone density.

Vaginal rings. The ring is thin, flexible, and approximately 2 inches in diameter. It delivers a combination of a synthetic estrogen and a progestin. The ring is inserted into the vagina, where it continually releases hormones for 3 weeks. The woman removes it for the fourth week and reinserts a new ring 7 days later.

Implantable rods. Each rod is matchstick-sized, flexible, and plastic. A physician surgically inserts the rod under the skin of the woman's upper arm. The rods release a progestin and can remain implanted for up to 5 years.

Emergency Contraceptive Pills (ECPs). ECPs are hormonal pills, taken either as a single dose or two doses 12 hours apart, that are intended for use in the event of unprotected intercourse. If taken prior to ovulation, the pills can delay or inhibit ovulation for at least 5 days to allow the sperm to become inactive. They also cause thickening of cervical mucus and may interfere with sperm function. ECPs should be taken as soon as possible after semen exposure and should not be used as a regular contraceptive method.  Pregnancy can occur if the pills are taken after ovulation or if there is subsequent semen exposure in the same cycle.

Intrauterine Methods
An IUD is a small, T-shaped device that is inserted into the uterus to prevent pregnancy. A health care provider inserts the device. An IUD can remain and function effectively for many years at a time. After the recommended length of time, or when the woman no longer needs or desires contraception, a health care provider removes or replaces the device.

Copper IUD. Releases a small amount of copper into the uterus, causing an inflammatory reaction that generally prevents sperm from reaching and fertilizing the egg. If fertilization of the egg does occur, the physical presence of the device prevents the fertilized egg from implanting into the lining of the uterus. Copper IUDs may remain in the body for 12 years.

Hormonal IUD. Releases a progestin hormone into the uterus. The released hormone causes thickening of the cervical mucus, inhibits sperm from reaching or fertilizing the egg, thins the uterine lining, and also may prevent the ovaries from releasing eggs. Hormonal IUDs can be used for up to 5 years.

Sterilization
Sterilization is a permanent form of birth control that either prevents a woman from getting pregnant or prevents a man from releasing sperm. A health care provider must perform the sterilization procedure, which usually involves surgery. These procedures usually are not reversible.

A sterilization implant is a nonsurgical method for permanently blocking the tubes. A health care provider threads a thin tube through the vagina and into the uterus to place a soft, flexible insert into each fallopian tube. No incisions are necessary. During the next 3 months, scar tissue forms around the inserts and blocks the fallopian tubes so that sperm cannot reach an egg. After 3 months, a health care provider conducts tests to ensure that scar tissue has fully blocked the fallopian tubes. A backup method of contraception is used until the tests show that the tubes are fully blocked.

Tubal ligation is a surgical procedure in which a doctor cuts, ties, or seals the fallopian tubes. This procedure blocks the path between the ovaries and the uterus. The sperm cannot reach the egg to fertilize it, and the egg cannot reach the uterus.

Vasectomy is a surgical procedure that cuts, closes, or blocks the vas deferens. This procedure blocks the path between the man’s testes and urethra. The sperm cannot leave the testes and cannot reach the egg. It can take as long as 3 months for the procedure to be fully effective. A backup method of contraception is used until tests confirm that there is no sperm in the semen.