Sexually Transmitted Diseases: Herpes, PID, BV, and HPV Dr. Nicholas Viyuoh, MD Board Certified OB/GYN Lock Haven Hospital Haven Health Care for Women

Herpes  What is it? Herpes is a viral infection caused by Herpes Simplex Virus. There are 2 types of Herpes:  HSV 1 (oral), and HSV 2 (genital)  Signs/Symptoms Burning/itching/tingling before an outbreak, then painful ulcers will break out.  The first outbreak will typically occur 2 weeks after infection, and last from 2-4 weeks. Outbreaks can vary in severity and amount, but they typically decline as people age.

Herpes  How common is it? Herpes is one of the most common STDs.  1 in 4 women have genital herpes  1 in 5 men have genital herpes *statistics from the CDC*  How is it transmitted? Sexual contact, whether a sexual partner is having an outbreak or not!  Complications: HSV infection in pregnancy can result in transmission to fetus, which can be fatal (particularly if first outbreak during pregnancy) An infection with HSV can make you more susceptible to contracting HIV if exposed.

Herpes  Can herpes be treated? Unlike other STDs, Herpes cannot be cured, once infected, a person will never be free of the virus. Treatment is to limit the number and severity of outbreaks. Herpes outbreaks can be limited with antiviral drugs (Valtrex). Antiviral drugs can also help to prevent transmission to sexual partners  Prevention: Abstinence is the only absolute prevention Condoms can help to reduce transmission, but are not 100% effective

PID- Pelvic Inflammatory Disease  What is it? Pelvic Inflammatory Disease is an infection and inflammation of the uterus and/or fallopian tubes.  What causes it? Infection (untreated/undiagnosed) of Gonorrhea and/or Chlamydia, or other types of infection  Signs/Symptoms Lower abdominal pain Painful intercourse Fever Discharge Burning with urination

PID  Complications? Infertility due to damage/scarring of reproductive tracts Ectopic pregnancy: “tubal pregnancy” any pregnancy which implants outside the uterus, a life threatening condition for the mother!  How many women get it? 1 million women/year 100,000 women become infertile each year from PID 150 women die each year from PID or complications of PID  Treatment: Treat underlying cause (Gonorrhea/Chlamydia/BV)  Prevention: Do not douche Limit sexual partners Get annual STD screening, or screenings with new partners

BV- Bacterial Vaginosis  What is it? Overgrowth of bacteria in the vagina  Signs/Symptoms Vaginal discharge with odor (usually fishy) Burning with urination, vaginal itching, pain Some women are asymptomatic  What causes it? Multiple sexual partners, douching, etc  How many women are affected? Up to 16% of women Most common in women of childbearing age

BV- Bacterial Vaginosis  How do you test for it? Vaginal culture during a pelvic exam  Treatment: BV can be treated effectively with antibiotics (orally or intravaginally)  Complications: Bacterial Vaginosis can make women more susceptible to other STDs as well as AIDS. It can also make women more susceptible to Pelvic Inflammatory Disease (PID).  Prevention: Limit number of sexual partners Do not douche

STDs and Pregnancy Center for Disease Control Estimates: STDNumber of Women BV800,000 Herpes800,000 Chlamydia200,000 Trichomoniasis 80,000 Gonorrhea 40,000 Hepatitis B 40,000 HIV 8,000 Syphilis 8,000

HPV-Human Papillomavirus  What is it? A group of viruses that cause genital warts and cervical cancer. Numbers that cause cervical cancer include:  16, 18, 31, 33, 35, 39, 45, 51, 52, 58  HPV 16 is responsible for about 54% of cervical cancer cases  HPV 18 is responsible for about 13% of cervical cancer cases Numbers that do not cause cervical cancer include:  6, 11, 40, 42, 43, 44, 54  Anogenital warts are associated with 6 and 11

HPV  How common is it? 80% of people will have an HPV infection by age 50 In individuals that are sexually active: 9.2 million people are affected

1 million new cases of genital warts million new cases of low-grade cervical dysplasia (CIN 1) 2 330,000 new cases of high-grade cervical dysplasia (CIN 2/3) 2 9,710 new cases of cervical cancer 1 1. American Cancer Society. Cancer Facts and Figures Atlanta, Ga: American Cancer Society; 2006:4. 2. Schiffman M, Solomon D. Findings to date from the ASCUS-LSIL Triage Study (ALTS). Arch Pathol Lab Med. 2003;127:946– Fleischer AB, Parrish CA, Glenn R, Feldman SR. Condylomata acuminata (genital warts):Patient demographics and treating physicians. Sex Transm Dis. 2001;28:643–647. 3,700 deaths estimated in CIN = cervical intraepithelial neoplasia. HPV in the US-from American Cancer Society