Miscarriage

Feb 5, 2022

Miscarriage

Miscarriage or spontaneous abortion is the loss of pregnancy (unplanned or death o the fetus) naturally before twenty weeks of pregnancy and is referred to as a miscarriage.

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What is it?

 Miscarriage or spontaneous abortion is the loss of pregnancy (unplanned or death o the fetus) naturally before twenty weeks of pregnancy and is referred to as a miscarriage. When you have a miscarriage, it can increase the risk of another spontaneous abortion in a future pregnancy. A key indicator for spontaneous abortion is a dilated cervix.

Risks:
Risk factors due to the mother include being older than 35, having a history of spontaneous abortion, being overweight, smoking cigarettes, using cocaine, alcohol, high doses of caffeine, having infections, and poorly controlled chronic disorders such as diabetes, hypertension, & thyroid disorders.

Risk factors due to the father include being older than 35, structural abnormalities in sperm chromosomes, abnormal sperm shape, damage in the sperms’ DNA, excessive stress, smoking cigarettes, using cocaine, alcohol, high doses of caffeine, and infection,

Causes:
Problems with the placenta (the organ that joins the mother’s blood supply to the baby’s), abnormal womb structure, weakened or injured cervix, problems with the immune system, chromosome abnormalities, molar pregnancy (abnormal tissue in the uterus in place of a fetus), ectopic pregnancy (embryo attaches outside the womb and is fatal to the fetus) and hormonal problems such as Polycystic ovary syndrome (PCOS) (when the ovaries are overly large causing a hormonal imbalance).

Caused by the baby: Genetic/chromosome problems (A fetus may receive the incorrect number of chromosomes, resulting in improper development)

Complications include:

  • Infection
  • Pelvic abscess (life-threatening collection of infected fluid in the fallopian tube or ovary)
  • Septic shock (a widespread infection that causes organ failure and dangerously low blood pressure)
  • Pain
  • Hemorrhage (severe bleeding)
  • Uterine perforation (accidental piercing of the uterus during a procedure
  • Difficulty conceiving or recurrent miscarriages
    Symptoms
    • Pelvic pain
    • Bleeding or brownish-colored discharge 
    • Burst of liquid (after the fetal membrane breaks)
    • Passing clots (a thick mass of liquid stuck together, usually blood)
    • Abdominal cramps 
    • Lower back pain
    • Weight loss
    Treatment

    Your doctor will perform examinations that typically include checking the vagina, uterus, cervix for abnormalities, assessing the fetal viability, getting an ultrasound check, and blood tests. Surgical procedures like D&E and Vacuum aspirations can be recommended to remove all fetal tissue. You might be prescribed medications to help ease pain, increase hormone levels, stop bleeding, and keep you healthy. You might be recommended to avoid strenuous activity, sexual intercourse, and best rest.

     

    Prevention

    A miscarriage often can’t be prevented, but in some cases, you can reduce your chances by:
    Exercise and eat healthy
    Keep your body weight within healthy limits
    Manage stress
    Do not smoke (avoid secondhand smoke as well)
    Do not drink alcohol or take other drugs
    Limit or eliminate caffeine
    Check with your doctor before taking any over-the-counter medicine
    Avoid environmental risks such as radiation, infectious diseases, and X-rays
    Protect your stomach
    Avoid contact sports or activities that are at risk of injury

    Classifications of Spontaneous abortion

    1. Threatened: is characterized by symptomatic or ‘threatened’ expulsion of the fetus. However, the cervix isn’t dilated, and the embryo or fetus remains viable. There is vaginal bleeding and slight abdominal cramping, and miscarriage is possible, but pregnancy can be saved sometimes.
    2. Inevitable : is characterized by an ‘inevitable’ expulsion of the fetus when the cervix is dilated, whether the embryo or fetus is viable or not. There is heavy vaginal bleeding, lower back pain, & cramping. Due to cervical dilation, a miscarriage will almost always occur. This typically occurs before the 16th week of pregnancy.
    3. Incomplete: is characterized when all of the pregnancy tissue isn’t removed from the uterus (some of the baby’s or placenta’s tissue leaves your body, while some remains in your uterus). There is constant and heavy vaginal bleeding, abdominal cramps, and the passing of blood clots or pieces of tissue. This typically occurs before the 16th week of pregnancy.
    4. Complete: is characterized by ‘complete’ removal of the fetus from the uterus. There is intense abdominal pain, vaginal bleeding until all the tissue is removed and the cervix is not dilated. This typically occurs before the 12th week of pregnancy.
    5. Missed: is characterized when the embryo dies, but the fetal tissues remain in the uterus for several weeks until it gets dispelled naturally or with induced abortion. Sometimes, there is a brownish vaginal discharge, and the cervix isn’t dilated. This typically occurs before the 12th week of pregnancy.
    6. Septic: is characterized when there is fetal tissue remaining after induced abortion and causes a miscarriage due to an infection in the uterus. It is often due to the procedure performed by an untrained person and using nonsterile equipment. There is fever, chills, vaginal discharge that smells bad, continuous vaginal bleeding, abdominal cramping, and pelvic pain.
    7. Recurrent or Habitual: is when there are three or more consecutive miscarriages during the first trimester. Repeated miscarriages need to be medically evaluated for chronic problems such as hormonal dysregulation and infection. Recurrent miscarriage is when a woman has two or more consecutive pregnancy losses. 1% of women who have one miscarriage experience a second one. However, increases to 20% for the second, 25% for the third, and 30% after the third consecutive miscarriage.
        Causes
        • Hormonal / Endocrine disorders
        • Anatomical (abnormal uterus or weakened cervix)
        • Infection
        • Inherited thrombophilia (predisposition to develop blood clots)
        • Immunological 
        • Genetic (chromosome abnormalities)
        • Lifestyle (alcohol, smoking, drugs)
        • Unknown
        Symptoms
        • Vaginal bleeding
        • Pelvic pain
        • Loss of morning sickness
        • More frequent urination
        Diagnosis

        Tests are usually done after a woman has experienced 2 or 3 abortions. Some tests to determine the cause include ultrasonography (using ultrasound to produce diagnostic images of the internal organs of the body or fetus) and blood tests.

        Treatment

        Treatment for recurrent abortion may help a woman’s womb hold the fetus. Treatment depends on medical conditions, chromosomal abnormalities, uterine abnormalities, immune system issues, and more. Recurrent miscarriages can cause psychological stress, so it is essential to have a strong support system. For chromosomal causes, treatment can be in vitro fertilization (IVF). For anatomical causes, treatment can be minor surgery. For immunological and blood clotting causes, treatment can be blood-thinning medications. For hormonal abnormalities, treatment to balance hormones is recommended.

        Postabortion Care (PAC)

        It is a care service that treats women with complications of abortion following spontaneous abortion and unsafe abortion. PAC reduces maternal mortality & morbidity and includes both medical and preventive care. Essential elements of PAC include emergency treatment of incomplete abortion & potentially life-threatening complications and post-abortion family planning counseling & services.

        After your procedure, your doctor will provide you with specific after-care instructions, but sometimes it isn’t enough to reduce undesirable side effects. Some methods to increase comfort include:

        • Use heating pads to relieve cramps
        • Stay hydrated, particularly if you’re vomiting or diarrhea
        • Have a support system to help with emotional changes due to the hormone shift
        • Rest for a day or two to recover at home
        • Take medication to decrease cramps and pain
        • Massage the area where you have cramps
        • Wear a tight-fitting bra to reduce breast soreness

        Every woman seeking PAC care should receive physical and emotional support. The woman must be aware of precisely what will happen before, during, and after the procedure, including pain relief, immediate & future side effects, and possible complications. If the patient is an adolescent, additional care and attention are required to prepare her for the whole process.

        A diagnosis should assess injury or permanent damage to internal and external organs, permanent damage to the bladder or bowel that cause chronic problems, permanent infertility, possible death due to complications like infection and hemorrhage.

        Healthcare providers need to be prepared to manage unsafe procedures including providing treatment for signs of inevitable, incomplete, and septic abortions. Manual Vacuum Aspiration (MVA) is a procedure that can safely and effectively treat women with incomplete abortion, either spontaneous or induced.

        Multiple Pregnancies & Genetic Testing

        Jan 29, 2022

        Multiple Pregnancies 

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        Multiple pregnancies

        Multiple pregnancies occur when more than one egg is released and fertilized casual fraternal twins/more. With multiple pregnancies, you will usually go through the same symptoms as a single pregnancy but more intensely, more painful, and harder to manage. There are two types called identical (monozygotic), non-identical (dizygotic), or fraternal. 

        • Identical: occurs when a single fertilized egg splits into two or more embryos creating same-sex babies (2+ boys or 2+ girls) with the same genes. 
        • Non-identical: occurs when 2+ separate eggs are fertilized with 2+ sperms. They can have the same or different sex. These siblings only share 50% of the chromosomes like any other siblings born at different times. They are more common than identical. 

        Causes; There aren’t any concrete explanations for multiple pregnancies. Everyone has a chance, and therefore it doesn’t have to run in the family. However, some studies show non-identical pregnancies are more common in certain ethnic groups (such as more twins for Africans and the lowest chances for Asians) if the mother is 35 years old or above and if it runs on the mother’s side of the family. 

        Risk factors: Most multiple pregnancies are healthy with healthy babies, but more risks are associated with them. You have a higher chance of anemia (limited healthy red blood cells to carry enough oxygen to your body’s tissues), pre-eclampsia (high blood pressure (hypertension) and high levels of protein in the urine (proteinuria)), gestational diabetes (elevated levels of glucose in the blood during pregnancy), and having a premature birth where more than half of all twins and almost all triplets & more are born prematurely. 

        Pregnancy care: Because these pregnancies have a higher likelihood of growth problems, you will need to visit the doctor more frequently and have more ultrasound exams than a single pregnancy would need. In some cases, one fetus is bigger than the other, called discordant caused by an infection or a problem with the umbilical cord or placenta. However, this doesn’t mean a problem with the babies. With twin pregnancies, there can be vaginal pregnancies that depend on the position, weight, & health of each baby, your health & how the labor is going, and the experience of your doctor. If these conditions aren’t met, then you are more likely to have a cesarean pregnancy for twins or more. 

        • Pregnancy genetic testing (before and after birth)

        It aids in identifying if the fetus has a genetic abnormality that can cause health conditions or birth defects. It is available before you give birth (prenatal genetic testing) and after (postnatal genetic testing). All women need to get genetic testing, especially if you or your partner have a family history of a genetic disorder, are above 35 years old, have a child with a genetic abnormality, previous stillborn, more than two miscarriages, or genital infections. There are two types of testing called screening tests performed to identify the women’s chance of having a baby with chromosome abnormalities and diagnostic tests to determine if the fetus has birth defects. 

        Prenatal genetic testing: can determine certain genetic conditions. You will give a blood or saliva test (to identify your Rh factor, if you have iron deficiency, diseases such as STD, gestational diabetes, thyroid, etc.), urine test (to measure your glucose, protein, ketones (formed when there is not enough sugar or glucose), and bacteria), and other tests by swabbing your vagina or rectum (to check for signs of infection).

        There are different types, but the common ones include carrier screening done on parents to identify certain inherited disorders, prenatal genetic screening done on pregnant women to detect the baby’s defects in the abdomen, heart, & facial features, cell-free DNA/ Non-invasive prenatal screening done on women with an increased risk of health conditions. Carrier screening can be done before or during pregnancy, prenatal genetic screening can be done in the first or second trimester, and cell-free DNA can either be done before or after the first-trimester screening. 

        Postnatal genetic testing: is performed on newborns and can determine inherited anomalies, diseases, and developmental delays in children. Newborns undergo genetic screening called a newborn screening to check for specific genetic abnormalities using blood samples. 

        Screening is recommended for the different types of a genetic disorders (at least 30). These screening tests differ from country to country. Some tests can be those for hypothyroidism (under activity of the thyroid gland), galactosemia (how your body metabolizes galactose), and sickle cell disease (a severe hereditary form of anemia).

          Pregnancy and risks

          Jan 29, 2022

          Pregnancy & risks

          Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals).

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          What is it?

          • Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals). As your pregnancy progresses, a lot of the uncomfortable changes will stop. But some women might not feel any discomfort at all. Being pregnant before could make it easier/different when you get pregnant again. Every pregnancy is different. Pregnancy is split into three stages called trimesters. The significant events in each trimester are:

          First trimester (Week 1- 12)

          This stage starts when the sperm penetrates an egg and fertilizes it. The fertilized egg (a zygote) then goes through the fallopian tube to the uterus, where it implants itself in the uterine wall. The zygote comprises a cluster of cells that later form the fetus and the placenta. The placenta connects the mother to the fetus and provides nutrients and oxygen.

          Your body goes through several changes, and hormonal changes affect most of your organ systems. The clear sign of pregnancy is when your period stops. Additional changes can include:

          • Extreme exhaustion
          • Tender, swollen breasts (nipples might stick out)
          • Morning sickness (Upset stomach with or without vomiting)
          • Cravings or disgust for some foods
          • Mood swings
          • Constipation (difficult bowel movements)
          • Frequent urination (more than usual)
          • Headache
          • Heartburn
          • Weight gain or loss
          Second trimester (Week 13 - 28)

          • This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.

            Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience: 

            • Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
            • Stretch marks (stomach, breasts, thighs, or buttocks)
            • Skin around the nipples darken
            • Noticeable line on the skin from the belly button to the pubic hairline
            • Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
            • Carpal tunnel syndrome (hands numb or tingle)
            • Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
            • Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)
          Third trimester (Week 29 - 40)

          • This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.

            Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience: 

            • Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
            • Stretch marks (stomach, breasts, thighs, or buttocks)
            • Skin around the nipples darken
            • Noticeable line on the skin from the belly button to the pubic hairline
            • Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
            • Carpal tunnel syndrome (hands numb or tingle)
            • Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
            • Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)

          Antenatal Care

          It is a care you receive when you are pregnant to check on your baby. Your doctor or midwife will check both you and your baby’s health, give you helpful information for a healthy pregnancy (healthy eating and exercise), discuss choices for your care during pregnancy, labor, and birth.

          You will go through several tests like urine tests, blood pressure checks, pregnancy scans every time you go to the hospital, and screening for sickle cell and thalassemia at 10 weeks of pregnancy. It is normal to have 10 antenatal appointments during your first pregnancy. If you’ve previously given birth, you’ll have about 7 appointments that can be more if you develop a medical condition. 

          Your doctor or midwife will give you a schedule (after discussing with you) for your appointments. These appointments should be in an environment where you can easily talk about difficult issues such as mental health issues, drugs, domestic or sexual abuse. You will be asked about your family’s health or any support you might need to get the best of your pregnancy care. You must go to every appointment since it may influence your choice later in pregnancy.

          Postnatal care

          The riskiest time for the death of an infant or mother is the first few hours or days after giving birth. This is why postnatal care is necessary to help ensure the survival of mother and baby. Both infant and mother are kept in the hospital for the first 24 hours during postnatal care. Your baby needs constant care and attention. Your nurse or doctor will prioritize giving you information on exclusive breastfeeding, cleaning your baby’s skin, umbilical cord care, and keeping your baby warm. You will be getting counseling and education before leaving the hospital on signs of any danger to your baby and the steps you can take immediately.

          This care is even more important for infants who are born too early, too small, suffer from different kinds of infections, or suffocate during delivery to keep you and your infant healthy. Counseling is given to the mother, partner, and available family. Postnatal exams allow doctors to look for anything odd with the mother or baby.

          Danger signs of pregnancy and what to do when she gets these signs

          Almost all women feel pain or discomfort throughout their pregnancy, but some are worse than others and may require them to get immediate medical care. Signs to look out for that are dangerous to your pregnancy are;

          • Unusual discharge or bleeding from your vagina
          • Your water breaking before labor starts or the liquid is greenish or brown color (doesn’t look healthy or clean)
          • Your baby moves less than usual or not at all
          • Cramps or pain in your stomach during the first few weeks of pregnancy
          • Sudden swelling of your hands, feet, or face
          • Pain or burning while urinating combined with a sore back and fever is terrible
          • Painful area behind your calf or knee which is reddened and too warm to the touch
          • Intense headaches that last more than a few hours
          • Blurry or double vision or seeing white flashes or spots
          • Fever above 38° C that lasts more than a day
          • Injury to your stomach
          • 5 or more uterine contractions in one hour before 36 weeks
          • Unable to pee but get very thirsty
          • During late pregnancy, frequent throwing up and getting sick even more so if you have pain and fever
          • Diarrhea nausea, or vomiting for more than a day

          If you get any of these signs, you have to immediately call or visit your doctor to make sure everything is alright and to take the necessary steps for treatment if needed.

          Abnormal pregnancies

          There are several causes for abnormal pregnancies, terrible like issues with the placenta that can be deadly for the fetus. The different types of abnormal pregnancies include pregnancy failure (miscarriage), ectopic pregnancy, and molar pregnancy.

          Pregnancy failure (miscarriage)

          • also known as early pregnancy loss or spontaneous abortion and occurs in the 1st trimester (20th weeks) of pregnancy. Several factors contribute to this, but fetal abnormalities are the most common. Other causes can be a woman who has already experienced miscarriage and older women. The most common symptoms are bleeding from the vagina and uterine cramping. 

          Causes:

          There are different causes for miscarriages, such as genetic issues and a mother’s health conditions. Genetic problems include intrauterine fetus death (embryo formation stops), blighted ovum (embryo doesn’t form at all), problems with the placenta (the organ that joins the mother’s blood supply to the baby’s), molar pregnancy (no development of the fetus but there’s an abnormal growth of placenta), & partial molar pregnancy (abnormal placenta and abnormal fetus growth). The mother’s long-term health conditions include uncontrolled diabetes, infections, uterus and cervix problems, thyroid disease, health disease, immune system disorders, kidney disease, antiphospholipid syndrome (the immune system wrongly produces antibodies that attack the embryo/fetus), Polycystic ovary syndrome (PCOS) (ovaries are larger than usual that can lower egg production and is the leading cause for infertility), and more. 

          Risk factors:

          Multiple risk factors raise the chances of miscarriage, such as a woman who is 35 or above, being overweight, smoking, alcohol, drugs, excess caffeine, food poisoning, physical trauma, and certain medications. 

          Prevention:

          Since many causes of miscarriage are unknown, you wouldn’t be able to prevent it, but you can lower your chances by:

          • Quitting smoking, alcohol, drugs

          • Limit caffeine intake (less than 200 mg per day) and herbal teas (maximum 4 cups)

          • Eating a balanced healthy diet and being a healthy weight before getting pregnant

          • Clean fruits and vegetables thoroughly

          • Avoid infections

          • Avoid certain foods like unpasteurized milk/cheese, raw or undercooked meat or eggs, liver,

          Ectopic pregnancy

          occurs when the embryo attaches outside the womb and is fatal to the fetus. This abnormality in pregnancy mainly occurs in the fallopian tube but can also happen in the abdomen, cervix, or ovary. It may cause bleeding and pain in your pelvis. Some women may not have any symptoms unless the site the egg attaches itself to breaks. A ruptured ectopic pregnancy has symptoms such as hemorrhaging (excessive release of blood from blood vessels) and extreme pain, which can cause maternal death; however, if treatment is provided before the rupture, maternal death can be avoided. 

          Treatment:

          • Medical treatment: is used to treat an early ectopic pregnancy without heavy bleeding. It is injected into your body, prevents growth cells, and breaks down existing cells. After being injected, your doctor will examine you to check if the treatment has been effective. 
          • Laparoscopic surgery: a small cut is made in the stomach (around or in the belly button) for a thin camera tube to view the area and remove the ectopic pregnancy. There are two types of laparoscopic surgery, and the amount of bleeding and damage will determine the type of procedure. 

          Emergency surgery: this is necessary if you have heavy bleeding where you will get an abdominal cut to remove the torn tube, but in some cases, the fallopian tube is saved.

            Molar pregnancy

            occurs when an undeveloped egg gets fertilized, causing the tissue that was supposed to become a fetus turns into a large mole that can grow and fill the uterus. Another way is when two sperms fertilize one egg causing the placenta (organ providing nourishment to the fetus) to turn into a mole. Fetal tissue that is available will have serious defects. Symptoms can be the same as a normal pregnancy but can also have unusual ones like discomfort in the pelvis and vaginal discharge that look like grapes. To treat this pregnancy, the abnormal tissue needs to be removed.

            Treatment:
            Surgical treatment is effective for most women called dilatation and auction evacuation (D&E), where a thin tube is used to suck the molar tissue. Another method called dilation and curettage (D&C) is when a sharp object cuts the tissue from the womb’s lining.
            Medical treatment: this is effective for women with partial molar pregnancy and is referred to as medical management or medical evacuation. The drug will make the womb shrink to remove the abnormal cells.

            Placental abruption

            occurs when the placenta separates from the uterus before the baby is born, causing a reduction or prevention of oxygen and nutrient supply to the baby and can cause heavy bleeding in the mother. It happens without warning and is dangerous to the mother and baby. In the worst-case scenario, a placental break might cause fetal death.

            Treatment:
            Mild: if you are less than 37 weeks into your pregnancy and your baby’s heart rate is normal, you will be hospitalized to be monitored closely. If your bleeding stops and your baby’s condition is stable, then you could be able to go home.
            Moderate or Severe: if you are after 37 weeks of your pregnancy and the placenta abruption seems very little, you can have a vagina delivery with close observation. However, an immediate C-section will be performed if the abruption gets worse or endangers you or your baby.

            Suppose you get any symptoms, you need to visit your doctor immediately for proper diagnosis and treatment. If you had any of these abnormalities in your previous pregnancy, you should talk to your doctor when you think of conceiving again. This will reduce your chances of going through this painful experience again. In addition to this, you might suffer from negative thoughts about the loss of your baby. Please talk to trusted friends, family, or mental health experts if you have difficulty copying.

            Postpartum Depression

            A new mother suffers severe depression (feels empty and sad) after giving birth that lasts longer than 2 weeks. It is a serious condition that affects your brain, behavior, physical health, and overall day-to-day life. Hormonal changes might trigger these symptoms where some mothers go through anxiety disorders. Some mothers might not feel connected to their baby, feel like they aren’t the baby’s mother, or might not love their baby.

            Symptoms

            • Depression gets more and more intense
            • Difficult to work or get things done at home
            • Pulling back from family and friends
            • Lack of care for yourself or your baby (eating, sleeping, washing)
            • Thoughts about hurting yourself or your baby
            • Intense crying, irritability, anger
            • Insomnia or sleeping too much
            • Overwhelming fatigue
            • Feeling shame, guilt, worthlessness, or inadequacy

            Treatment
            Therapy: you talk to your therapist to help you figure out ways to cope with your depression and change your thoughts.
            Medicine: If your therapist believes your depression is severe, she/he will refer you to a doctor to prescribe you antidepressants (the most common medication for depression) to help relieve symptoms of depression. However, it will take several weeks to work.
            Electroconvulsive therapy (ECT): is used for extreme cases of postpartum depression.

            Your doctor might recommend you to take the treatments together or alone after discussing the benefits and concerns of treatment. Treatment is essential for you and your baby. Getting help is necessary for your overall health. 

            Contraceptives

            Jan 22, 2022

            Contraceptives

            A contraceptive is a device, drug, or method to prevent pregnancy. It can be swallowed, injected, attached, or inserted into the body. Contraceptives may be temporary (taken daily, weekly, monthly, yearly, bi-yearly, or more) or permanent. 

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            WHAT IS IT?

            A contraceptive is a device, drug, or method to prevent pregnancy. It can be swallowed, injected, attached, or inserted into the body. Contraceptives may be temporary (taken daily, weekly, monthly, yearly, bi-yearly, or more) or permanent. There are several ways to prevent pregnancy, such as: 

            Long-Acting Reversible Contraceptive (LARC)

            Intrauterine Methods (Device / Systems) - IUD

            • What is it?

            An IUD is a small, soft, T-shaped device made of plastic or metal with a string attached. A healthcare professional put the IUD in the uterus (womb) to prevent pregnancy by stopping the egg and sperm from meeting. There are two types of IUD (copper and hormonal). They work in different ways to help prevent pregnancy.

            • Hormonal IUD or IUS

            The IUS thickens the mucus in the cervix, making it harder for the sperm to get to the egg and thins the uterus lining. This makes it less likely that a fertilized egg will attach to it. It also may stop the ovaries from releasing an egg. The IUD can help prevent pregnancy for 3 to 5 years.

            • Copper IUD

            This IUD has a copper wire wrapped around it. It changes the lining of the uterus so that if an egg is fertilized, it’s less likely to attach to it and slows the sperm movement, so it is harder to get to the egg. Depending on the type of copper IUD, it can help prevent pregnancy for up to 10 years.

            • How to use it?

            Your gynecologist inserts an IUD. The best time to have an IUD inserted is during your period, as this is when your cervix is most open. The whole procedure takes less than five minutes. Some women usually choose to take over-the-counter pain medication (ibuprofen) before the procedure since the insertion may cause some mild cramping.

             

            You must check to see if the string is in the right place every month. Your healthcare provider will teach you how to feel for the strings when inserted.

             

            The copper IUD protects you from pregnancy as soon as it is inserted. If your hormonal IUD is inserted on days 1 to 7 of your period, it works right away to prevent pregnancy, but if it is on any other day, you need an extra form of birth control (e.g., condoms, abstinence) for seven days.

             

            Once inserted, an IUD can be removed on request or at the time of expiration, approximately 3 to 10 years later. Removal takes about two to three minutes by your gynecologist. You may experience some normal cramping and bleeding as a result, but this should go away quickly.

            • Advantages
            • They’re predominantly hassle-free. You do not have to remember to do anything or take any birth control medicines regularly. It can help prevent pregnancy for 3 to 10 years (depending on the type).
            • IUDs do not contain estrogen, a hormone that some women can’t take
            • If you decide to get pregnant, you can have the IUD taken out.
            • If you use an IUD for several years, it costs less overall than many other types of birth control. That’s because there are no costs after you have it inserted.
            • They’re safe to use if you’re breastfeeding
            • The copper IUD can be used as emergency contraception (EC) for seven days after unprotected sex or contraceptive failure.
            • The copper IUD may lower your risk of cancer of the uterus.

            • What it doesn’t protect you from
            • An IUD doesn’t protect you from sexually transmitted infections (STIs) and HIV.


            • Common Side Effects
            • Irregular periods (spotting, heavier or longer periods) 
            • Pain when your IUD is put in and cramping, or backaches for a few days after
            • More cramping during your periods (Copper IUD)

             

            • Effective level (used properly and not) / Failure rate

            • IUDs are so effective because there’s no chance of making a mistake.  The copper IUD is 99.2% effective in preventing pregnancy. The hormonal IUD is more than 99% effective in preventing pregnancy.

            • Who can’t use it?
            • You can’t use a copper IUD if you have an allergy to copper
            • You can’t use a hormonal IUD if you have liver disease or breast cancer
            • You can’t use an IUD if you have an STD, have a recent pelvic infection, are pregnant, have a cervix or uterus cancer, or have unexplained vaginal bleeding.

            • What to do if it falls out?

            The IUD rarely falls out. It usually happens when a woman is on her period during the first three months after getting the IUD or if her flow is heavy. Another reason could be because of a small uterus. This typically includes women who are under 20 or have never been pregnant. 

             

            An IUD can come out partially without falling out completely. If this happens, it will need to be removed since it can not prevent pregnancy in this state. Another possibility is a perforation (stabbing) through the uterus (womb), which must be surgically removed. If this happens, you need to see your doctor and not have sex without utilizing another form of birth control.

            • Where to find it?

             

            Implants

            What is it?

            Contraceptive implants are a long-term birth control option: a flexible plastic rod about the size of a matchstick placed under the skin of the upper arm. The implant releases a low, steady hormone dose to prevent the sperm from reaching the egg and typically suppress ovulation.

            How to use it?

            You must see your doctor to get an implant. After conducting a physical exam, the implant will be inserted under the skin of your upper arm and can stay in place for up to three years. Implant insertions take just a few minutes. They’re done with a local anesthetic, which makes the procedure painless.

            After insertion, you will have a small bandage covering the insertion site. Some bruising, scarring, pain, or bleeding at the insertion site may occur after the procedure.

            If you get the implant during the first five days of your period, it’s immediately effective, but if the implant is inserted at any other point, you should use a backup form of birth control for seven days.

            Advantages

            You do not need to worry about birth control for three years

            If you want to get pregnant, you can be fertile as soon as it is removed 

            It is appropriate for women who can’t use birth control containing estrogen

            Almost anyone, at any age, can have an implant

            What it doesn’t protect you from

            no protection against sexually transmitted infections (STIs)

            Common side effects

            Abdominal or back pain

            Changes in vaginal bleeding patterns, including the absence of menstruation

            Decreased sex drive

            Headaches

            Mood swings and depression

            Nausea or upset stomach

            Potential interaction with other medications

            Sore breasts

            Vaginal inflammation or dryness

            Weight gain

            Effective level (used properly and not) / Failure rate

            It is one of the highest levels of effectiveness of all contraceptives and has a more than 99% effectiveness rate

             Who can’t use it?

            If you are:

            allergic to any components of the implant

            have had severe blood clots, a heart attack, or a stroke

            have liver tumors or liver disease

            have known or suspected breast cancer or a history of breast cancer

            have undiagnosed abnormal genital bleeding

            taking some medications that might counteract the implant (talk to your healthcare provider)

            What if I’m late?

            If you have forgotten to replace the implant after three years, use condoms until it is replaced.

            Where to find it?

            Hormonal Methods

            Short-Acting Hormonal Methods

            Injectable Birth control

            Injectable Birth control

            What is it?

            Injectable contraceptives are long-term hormonal birth control available in a progestin-only form and hormones combined with progestin and estrogen hormones. 

            Combined injectable contraceptives (CICs) are a form of hormonal birth control consisting of monthly injections of combined formulations containing estrogen and progestin to stop the release of an egg each month and prevent pregnancy. It also makes it difficult for sperm to move through the cervix.

             

            How to use it?

            Injectables are prescribed by a doctor and administered only four times a year. The first shot should be given during the first five days of a regular menstrual cycle and should be administered differently after labor and during the period of breastfeeding. The drug is given in the buttocks or the upper arm. You have to remember to get a new shot every three months to get its full effects.

             

            If you get your first injection during the first 5 days of your period, it takes 24 hours to become effective, but if it is at any other time, you need to use an extra form of birth control for 7 days. 

             

            Advantages

            it doesn’t interrupt sex

            it’s an option if you can’t use estrogen-based contraception

            you don’t have to remember to take it every day

            it’s safe to use while you’re breastfeeding

            it’s not affected by other medicines

            it may reduce heavy, painful periods and help with premenstrual symptoms for some women

            many of the symptoms  usually go away after 2 or 3 months

             

            Though the return of fertility is a bit delayed and that too more with DMPA but more than 80% of women conceive within 1 year after stopping the contraceptive measures.

             

            What it doesn’t protect you from

            Injectable contraception does not protect against sexually transmitted diseases and HIV.

             

            Common side effects

            Mild Headaches

            Acne

            Mood Swings

            Irregular Periods

            Depression

            Tender Breasts

            Less Interest In Sex

            Upset Stomach (Nausea)

            Weight Gain

            Brittle Bones

            Bloating

             

            Effective level (used properly and not) / Failure rate

            With perfect use (this means you follow the exact directions all the time), the injection is 99.8% effective, and with typical use (this means not following the exact directions), the injection is 94% effective

             

            Who can’t use it?

            It is less effective on women who are obese. 

            It is not recommended for women with unexplained vaginal bleeding, liver disease, breast cancer, and blood clots.

             

            What if I miss or I’m late for my injection?

            If your last injection was 13 to 14 weeks ago, you should still be protected from pregnancy. You need to have your injection right away before 14 weeks have passed.

             

            If your last injection was over 14 weeks ago, use a backup form of birth control and see your healthcare provider right away for your next injection. If you’ve had unprotected sex, you need to get emergency contraception.

             

            Where to find it?

            Progestin-only Pills (POPs)

            Progestin-only Pills (POPs)

            What is it?

            The progestin-only pill (POP) is a type of birth control pill often called the “Mini-Pill” because it doesn’t contain estrogen and comes in a pack of 28 pills. Progestin is a female hormone that works by preventing the release of eggs from the ovaries and changing the cervical mucus and the lining of the uterus.

            Young and adult women who can’t take estrogen due to an underlying medical condition, sensitivity, or an unwanted side effect are prescribed this pill. They are also used for treating menstrual period problems, cramps, and other conditions.

            How to use it?

            It is beneficial to take the pill when you start your period or the first Sunday after your period begins. You have to take one pill every day at the same time. Every pill is an “active” pill, meaning that all the pills contain progestin, unlike combination pill packs with inactive pills or “placebo” pills in the last row of the pack.  If you’re sexually active, be sure to use a backup barrier method of birth control (condom) for the first 7 days after starting to prevent pregnancy.

            There are 2 different types of POP:

            3-hour progestogen-only pill (traditional progestogen-only pill) – take within 3 hours of the same time each day

            12-hour progestogen-only pill (desogestrel- a synthetic progestogen- progestogen-only pill) – taken within 12 hours of the same time each day

            There’s no break between packs of pills – when you finish a pack, you start the next one the next day. Follow the instructions that come with your pill packet – missing pills or taking the pill alongside other medicines can reduce its effectiveness.

            Advantages

            Can help clear up acne

            Doesn’t require surgery

            No interruption of foreplay or intercourse

            Can be used by women who cannot take estrogen

            Can be used by women who are over 35 and smoke

            What it doesn’t protect you from

            sexually transmitted infections (STIs).

            Common side effects

            Spotting can last a few days until your body gets used to it or for as long as you are taking it

            Not having a period is also common

            Acne

            Bloating

            Weight gain

            Headaches

            Dizziness

            Mood changes

            Breast tenderness

            Abdominal pain

            Nausea

            Effective level (used properly and not) / Failure rate

            If taken correctly, it’s more than 99% effective.

            Who can’t use it?

            Pregnant women

            If you do not want your periods to change

            If you take other medicines that may affect the pill. Talk to your doctor for more information.

            Get unexplained bleeding in between periods or after sex

            Have developed arterial disease or heart disease or have had a stroke

            Have liver disease, severe cirrhosis, or liver tumors

            Have breast cancer or have had it in the past

            What if I miss or I’m late?

            If you’re less than 3 hours (traditional progestogen-only pill) or less than 12 hours (desogestrel progestogen-only pill) late taking the pill, then take the late pill as soon as you remember. Take the pill remaining pills as usual. This might mean that you will have to take 2 pills on the same day. 

            The pill will still work, and you’ll be protected against pregnancy – you do not need to use additional contraception. If you are confused about the pills you have missed, keep taking it but don’t have sex or use a backup method of birth control (condom) until you can talk with your health care provider.

            If you become sick with vomiting or severe diarrhea within three hours after taking it, keep taking the Pill every day. Do not have sex or use a backup method (condom) until 2 days after the vomiting has stopped. If you have very severe diarrhea (6 to 8 watery poos in 24 hours), then this might also mean that the pill does not work correctly.

            If you missed your pill for 2 days and had unprotected sex, you may need emergency contraception. 

            Where to find it?

            Combined Hormonal Methods

            Combined oral contraceptives (COCs, "the pill")

            • What is it?

            The pill is a type of birth control, also known as the combined pill or oral contraceptive pill, containing estrogen and progestogen designed to be taken orally every day by women. The pill works by stopping the ovaries from releasing an egg each month and thickens the fluid around the cervix (opening to the uterus or womb) to prevent the sperm from entering. 

            • How to use it?

            When you start the pill for the first time or after a break from the pill, it can take up to 12 days to start working to prevent pregnancy. This depends on whether you start with the hormone or sugar /placebo pills. You have to take one pill around the same time every day. 

            You will usually have your period while taking the sugar pills. You can skip your period by missing the sugar pills and continuing to take the hormone pills each day. 

            • Advantages
            • Can be used to skip your period
            • Make your periods lighter, more regular, and less painful 
            • improve acne
            • Reduce your chance of getting cancer of the uterus (womb), ovaries, and bowel 
            • Help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.

            • What it doesn’t protect you from

            STI protection: No. Use external condoms or internal condoms to help protect yourself from STIs.

            • Common side effects
            • irregular vaginal bleeding
            • nausea 
            • sore or tender breasts
            • headaches
            • bloating 
            • acne
            • mood changes

            • Effective level (used properly and not) / Failure rate

            It’s 99% effective at preventing pregnancy with perfect use and 91% effective with typical use

            • Who can’t use it?
            • If you are a 35-year-old or over smoker or stopped smoking less than a year ago
            • you take certain medicines
            • you’re breastfeeding a baby less than 6 weeks old
            • If you have had heart disease or stroke
            • Get regular migraines
            • Have breast cancer or have a family history of breast cancer
            • you’re immobile for an extended time or use a wheelchair
            • you’re at a high altitude (more than 4,500m) for more than a week.
            • active disease of the liver or gallbladder
            • diabetes with complications

            If you’re healthy, don’t smoke, and there are no medical reasons for you not to take the pill, you can use it until you’re 50 years old. You’ll then need to change to another method of contraception.

            • What if I miss or I’m late?
            • If you missed 1 active (hormonal) pill or started a pack 1 day late, take an active (hormonal) pill as soon as possible and then continue taking pills daily. If you missed the pills during the first week and had unprotected sex, you should use emergency contraception for maximum protection, in addition to taking today’s active birth control pill.

            • If you missed 2 or more active (hormonal) pills or started a pack 2 or more days late, take 2 active (hormonal) pills as soon as possible and then continue taking pills daily. You may take one at the moment of remembering, and the other at the regular time, or both at the same time. Use condoms or abstain from sex until you have taken active (hormonal) pills for 7 days in a row.

            • If you missed the pills in the third week of the pack, you should continue taking the active (hormonal) pills in your current pack daily. After taking all the active pills, discard the pack without taking the 7 inactive pills and begin a new pack the next day.

            • If you missed any inactive (non-hormonal) pills, discard the missed inactive (non-hormonal) pill(s) and continue as scheduled. 

            • Where to find it?

            Contraceptive patch

              • What is it?

              The contraceptive patch is a very thin and smooth adhesive tape securely attached to your skin. It is attached to an easily reachable area of your body, such as the lower abdomen, buttock, shoulder blade, or the outer part of the shoulder.

              The patch contains a combination of hormones, which stops ovulation and thickens the cervical mucus, making it less permeable for the sperm.  Hormones are absorbed into the blood through the skin, bypassing the stomach, so this method is suitable for people suffering from gastrointestinal diseases. It doesn’t interfere with daily activities, and it doesn’t come off upon contact with water.

              • How to use it?

              The patch needs to be removed and changed every week for 3 weeks. After three patches, you will have a patch-free week which allows you to have your period.

              The contraceptive patch should be applied to clean, dry, non-hairy skin. Do not use any lotions, make-up, creams, powders, or anything else on the area of the skin before you apply the patch. These can interfere with the patch’s stickiness and make it more likely to fall off. Do not use on areas of skin that are irritated or broken. 

              Each time you change your patch, you should use a different place to avoid skin irritation. You should check each day to ensure that the patch has not fallen off.

              Patches come in a protective pouch and should be kept in the pouch until use. It should be stored at room temperature (not in the fridge or freezer). The used patches should be folded, sticky-side together, before discarding. They should not be flushed down the toilet. 

              You have to keep the patches away from them if you have children since they still contain hormones. Patches should be stored in a child-proof container before being thrown away.

              • Advantages
              • Needs to be applied only once a week
              • Its presence can be verified by sight
              • Does not detach with exposure to water or sweat
              • May improve acne in many cases
              • May improve bone strength due to the estrogen content
              • May reduce the risk of benign breast disease, as well as uterine endometrial and ovarian cancers

              • What it doesn’t protect you from
              • It does not protect against sexually transmitted infections (STIs), including HIV.

              • Common side effects
              • Nausea
              • Breast pain
              • Headache
              • Skin irritation at the patch site
              • Mood changes
              • Changes in menstrual bleeding
              • Weight gain

              • Effective level (used properly and not) / Failure rate

              Despite seeming like nothing more than a piece of bandaid, it is 99.4% effective.

              • Who can’t use it?

              Birth control patches are not recommended for people who weigh more than 90 kg or have a body mass index (BMI) higher than 30 kg/m2. This is because the dosage of medication delivered by the patch can not be adjusted, and therefore there will be the risk of blood clots.

              • What if it falls off?
              • It is unlikely that your contraceptive patch will fall off, as it has been carefully designed to minimize this. If it should become partially detached or fall off, what you should do depends on how long ago it came off.

              • If it was less than 24 hours ago, reattach the same patch in the same location (as long as it is still sticky) or replace it with a new patch.
              • If it was more than 24 hours ago, you must apply a new patch and use a backup birth control method for the first seven days afterward.

              • If it was less than 48 hours, reapply it as quickly as possible if it is still sticky, but if it is not, replace it with a new patch. Do not use anything (such as tape) to try to hold a patch in place that is no longer sticky.
              • If it has been off for 48 hours or longer, or if the time that it has been detached is uncertain: start a whole new patch cycle by applying a new patch as soon as possible. This is now week 1 of the patch cycle. 

              • If you have sex within the following seven days, you need to use additional contraception such as condoms. If you have had sex within the previous five days, you may need to take additional emergency contraception. 

              • If you forget to take the patch off at the end of week 3, take the patch off as soon as possible and apply the next patch on the usual start day of the next patch cycle. This may mean that you do not have a seven-day patch-free break.

              • If you replace the patch with a new one, the day you replace the patch will become the new day of the week you change your patch.

              • Where to find it?

            Contraceptive / Vaginal ring

              • What is it?

                The vaginal ring is a soft, flexible piece of plastic that contains synthetic hormones to be absorbed inside the vagina. It is a hormonal method of contraception obtained by prescription. These hormones help regulate your fertility similarly to how natural hormones work.

                How to use it?

                You need a prescription from your healthcare provider and be sure to tell your healthcare provider if you are allergic to any medicine. 

                The device is inserted into your vagina, which remains for three weeks. It is removed during the fourth week to allow your menstrual period to occur. At the end of the fourth week, the process is repeated. The vaginal ring begins to work immediately, but a second form of birth control should be used during the first seven days of your first month’s use of the vaginal ring.

                To insert a vaginal ring: IMAGE

                Find a comfortable position, such as standing with one leg up, squatting, or lying down. Separate your labia with one hand. Squeeze together the opposite sides of the vaginal ring between your thumb and index finger with your other hand.

                Gently push the vaginal ring deep inside your vagina. An applicator, similar to a tampon, can help with insertion. The exact placement of the ring doesn’t change its effectiveness.

                Try pushing the vaginal ring deeper inside your vagina if you feel discomfort.

                Keep the ring in place for three weeks.

                You don’t need to remove the vaginal ring during sex. But if you prefer, you can remove the ring for up to three hours and then reinsert it.

                To remove a vaginal ring: IMAGE

                Hook your index finger under the rim of the ring or grasp the ring between your index finger and middle finger and gently pull it out.

                Discard the used vaginal ring. Don’t flush it down the toilet.

                Wait one week to insert a new ring. Withdrawal bleeding usually begins two to three days after removing the ring. You may still be bleeding when you insert the new ring.

                Advantages

                It only requires the user to change it once a month

                It is a good alternative to contraceptive implants or intrauterine devices

                What it doesn’t protect you from

                The vaginal ring does NOT protect against the transmission of sexually transmitted diseases.

                Common side effects

                Headaches

                Dizziness

                Nausea

                Breast tenderness

                Fatigue

                Moderate weight gain

                Change of appetite

                Breakthrough bleeding or spotting

                Vaginal infection or irritation and increased discharge

                Depression

                Decreased sex drive

                Abdominal pain

                Diarrhea

                An increased risk of blood-clotting problems, heart attack, stroke, liver cancer, gallbladder disease, and toxic shock syndrome

                Effective level (used properly and not) / Failure rate

                If used ideally, the ring is a highly effective form of birth control, but it has a 91% effectiveness rate since humans are prone to errors.

                Who can’t use it?

                Smokers 

                Are older than age 35 and smoke

                Have high blood pressure, diabetes, liver disease, unexplained vaginal bleeding

                Have a history of breast or uterine cancer, blood clots, heart attack, or stroke

                Allergic to hormones or sensitive to any components of the vaginal ring

                Taking certain medications for hepatitis C

                Migraines with aura or, if you’re over age 35, any migraines

                What if it falls out?

                If the vaginal ring accidentally falls out, rinse it with cool or warm — not hot — water and reinsert it within two hours. 

                If the vaginal ring remains outside of your vagina for longer than two hours, reinsert the vaginal ring as soon as possible and use backup contraception for a week if the expulsion occurs during the first or second week of vaginal ring use. 

                Discard the ring if the expulsion occurs during the third week of using the vaginal ring and start using a new ring right away, which might cause breakthrough spotting or bleeding. Use a backup method of contraception until you have used the new ring continuously for seven days.

                Where to find it?

            Barrier Methods

            Female Condoms

            Do NOT use male and female condoms at the same time.

            • What is it?

            The female condom, also called an internal condom, is a birth control device that acts as a barrier to keep sperm from entering the uterus to prevent pregnancy. It also protects against sexually transmitted infections (STIs).

             

            The female condom is a soft, loose-fitting pouch with a ring on each end. One ring is inserted into the vagina to hold the female condom. The ring at the open end of the condom remains outside the vagina. The outer ring helps keep the condom in place and is also used for removal. The female condom can be used during anal sex, too.

             

            • How to use it? IMAGE

             

            You insert a female condom is similar to putting in a tampon. It may seem a little tricky at first, but all you need is a little practice. Here’s how you do it:

             

            • Be careful not to tear it when you open the package.
            • Put the condom in before contact between the penis and vagina or anus.
            • Put lubricant on the closed end of the condom.
            • Find the most comfortable position to put it in. You may prefer to lie down, squat, or stand with one leg on a chair.
            • Squeeze the ring on the closed end of the condom together and insert it in your vagina as far as it will go, just like a tampon. For anal sex, put it as far as it will go.
            • Let go of the ring so that it opens and stays in place.
            • Let the ring on the other end hang about an inch outside your vagina or bottom.
            • Use a new condom every time you have sex.

             

            • Advantages
            • Protection from STIs
            • Your partner doesn’t need to remove their penis as soon as they ejaculate
            • Suitable for people who are allergic to latex
            • An erect penis isn’t required to keep it in place
            • Can be used or anal sex
            • Female condoms also make life easier by allowing you to prepare for sex. You can put one in up to 8 hours in advance. Your partner may also have a more comfortable experience since female condoms can fit various penis sizes. You may also enjoy extra stimulation to your clitoris from the outer ring.

             

            • Common side effects
            • If you are allergic to human-made latex, nitrile, or polyurethane
            • Discomfort during insertion, a burning sensation, itching, or a rash

             

            • Effective level (used properly and not) / Failure rate

            Female condoms work almost as well as male condoms as long as you use them correctly, they are about 95% effective,

             

            • Who can’t use it?
            • Are allergic to polyurethane or synthetic latex
            • Are at high risk of pregnancy — younger than age 30, have sex three or more times a week, had a previous contraceptive failure with vaginal barrier methods, or not likely to consistently use the female condom
            • Aren’t comfortable with the insertion technique
            • Have vaginal abnormalities that interfere with the fit, placement, or retention of the female condom

             

            • What if?
            • The condom breaks
            • The condom slips out of the vagina
            • The penis slips between the vagina and the outer surface of the condom
            • The outer ring of the condom gets pushed into the vagina during sex

             

            Change it as soon as you realize and take emergency contraception.

             

                • Where to find it?

            Contraceptive Sponge

            What is it?

            The contraceptive sponge is a type of birth control that contains spermicide which kills sperm. It is a soft circular disposable device inserted deep into the vagina and placed over the cervical opening to kill sperm before entering the uterus and fertilizing an egg.  The sponge prevents pregnancy by blocking the entrance to your uterus and slowing the sperm down with the spermicide.

             

            The sponge can be used alone or with condoms. To best prevent pregnancy, you should use both. Not only that, but condoms can help avoid contracting STIs.

             

            How to use it?

            You first moisten the sponge with water and then insert it into the vagina. This blocks sperm from entering the uterus. Next, a spermicide that is absorbed in the sponge is continually released. This will decompose the sperm and prevent them from reaching the egg.

             

            Inserting the Sponge IMAGE

             

            Wash your hands before inserting the sponge to prevent germs from entering your vagina.

            To activate the spermicide, you have to wet the sponge with at least two tablespoons of water. You can not use saliva.

            You will know the spermicide is active when you gently squeeze the sponge, which gets foamy.

            Fold the sides away from the removal loop to make the sponge narrow. Then, insert the sponge in your vagina with the dented side going in first.

            Once you release it, the sponge will unfold and cover the cervix. The string loop side should be facing out to cover the cervix tightly. Check the position and fit by sliding your fingers around the edges of the sponge. The sponge will be held in place by the walls of your upper vagina.

            The maximum time to insert the sponge before sexual intercourse is 24 hours. It must be left in place for at least 6 hours after intercourse to allow the spermicide to kill the sperm. 

            You are protected from pregnancy even if you have intercourse more than once. It should not be left in place for more than 30 consecutive hours. You will no longer be protected against pregnancy upon removal of the sponge.

             

            Removing the Sponge

             

            Wash your hands.

            Use the string loop to pull the sponge out of your vagina. 

            If the sponge turns upside down, find the loop by sliding your finger around the edge of the sponge, or grab the edge with two fingers and carefully pull it out. 

            If the sponge sticks to the cervix, use your finger to lift it away from one side.

            After taking out the sponge, you should check to ensure that the entire sponge has been removed and then throw it away.

            Contact your doctor if you couldn’t remove the sponge or only remove part of it.

            The sponge is for single use only. Do not flush a used sponge in the toilet but instead throw it away in a waste container.

             

            Advantages

            Does not hinder the sexual experience

            Effective immediately if used correctly

            Small and inexpensive

            You don’t have to see a doctor before using the sponge

            Can be inserted up to an hour before sex, effective for 24 hours

            Can have intercourse an unlimited number of times with each wear

             

            What it doesn’t protect you from

            The sponge does not protect against STDs and may increase your risk of getting HIV and other STDs. That’s because the spermicide in sponges contains a chemical that can irritate your vagina, making it easier for STD germs to enter.

             

            Common side effects

            The sponge and the spermicide it releases may cause:

             

            Vaginal irritation or dryness

            Urinary tract or vaginal infection

            An increased risk of contracting STIs, including HIV

             

            Effective level (used properly and not) / Failure rate

            For women who have never given birth and use the sponge ideally every time, it’s about 91% effective and 88% with typical use (not perfect).

             

            For women who have given birth and use the sponge ideally every time, it’s about 80% effective and 76% with typical use.

             

            Who can’t use it?

            Sensitive or allergic to spermicide or polyurethane

            Have a vaginal abnormality that does affect the way the contraceptive sponge fits

            Have frequent urinary tract infections

            Have a history of toxic shock syndrome

            Recently has given birth, had a miscarriage, or had an abortion

            Are at high risk of contracting HIV, or one has HIV or AIDS

            Younger women (less than age 30) who have sex three or more times a week

             

            Where to find it?

            Spermicides

            What is it?

            Spermicide is a contraceptive containing chemicals that kill sperm or stop it from moving. Spermicide isn’t a very effective birth control method when used alone. You can improve its effectiveness by using a barrier method form of birth control like a condom, diaphragm, or cervical cap.

             

            It stops pregnancy two ways, by blocking the entrance to the cervix and preventing the sperm from moving well enough to swim to your egg. 

             

            It’s available in many forms, including cream, gel, foam, film, suppository ( a small, solid pill), and tablet.

             

            Types

            Gels, jellies, and creams

            These come in different consistencies and textures, but all contain about 1 to 5% of the spermicide chemical. They are inserted into the vagina using a syringe-like applicator.

             

            Foam 

            It contains a high level of spermicidal chemical, about 12.5 percent, and can irritate the genitals. This is also placed using a syringe-like applicator.

             

            Film

            A spermicidal film is a thin translucent layer of spermicide placed on the vagina and absorbed. You insert it by folding it in half twice, then putting it on your finger and sliding it deep into the vagina. It contains about 28% of the spermicide chemical.

             

            You have to apply it 30 minutes before sex, or the vagina will not fully absorb it. It needs to be stored in a cool, dry place, and make sure your hands are completely dry while applying it. Otherwise, the film might dissolve before you get a chance to use it. 

             

            Other types

            Spermicides are also available as tablets or suppositories. Tablets and suppositories should be inserted high into the vagina near the cervix approximately 30 minutes before intercourse so that they fully dissolve. 

             

            How to use it?

            Since there are different types of spermicide, check the directions that come in the package. If you don’t use spermicide correctly, it won’t work as well.

             

            Inserting spermicide into your vagina is usually pretty straightforward — it’s similar to putting in a tampon. First, check the expiration date. Then, into a comfortable position — you can stand with one foot on a chair, lie down, or squat — then gently insert the cream, film, foam, gel, or suppository deep into your vagina using your fingers or the applicator that came in the package.

             

            Timing is essential when it comes to spermicide. Some spermicide must be put in your vagina at least 10-15 minutes before sex. And many others are only effective for 1 hour after you apply them. 

             

            You’ll need to add more spermicide if you want to have sex more than once. However, using spermicide several times a day can irritate and increase your risk for STDs.

             

            Advantages

            Doesn’t interrupt sex

            Doesn’t have hormones

            They have no lasting effect on a woman’s hormones

            They can be conveniently tucked into your pocket or purse.

             

            What it doesn’t protect you from

            Spermicide doesn’t protect against sexually transmitted infections. Using it several times a day may increase your risk for HIV and other STIs. That’s because the chemical in spermicide can irritate your vagina and make it easier for STD germs to enter your body. Adding condoms to the mix helps protect you from STDs and gives you an extra boost in pregnancy prevention. 

             

            Common side effects

            Recurring urinary tract infections due to irritation 

            Irritation increases your risk for HIV and other STDs 

            Allergic to spermicide (soreness or irritation)

            Allergic reaction may lead to itching, burning, or redness

             

            Effective level (used properly and not) / Failure rate

            72% effective at preventing pregnancy

             

            Who can’t use it?

            All women can safely use spermicides except those at high risk for HIV infection or already have HIV infection.

             

            Where to find it?

            Diaphragm

            What is it?

            A diaphragm is a form of reusable birth control that is a small, dome-shaped cup you insert into your vagina to block sperm from entering your uterus. For added protection, diaphragms are meant to be used with spermicide. The diaphragm can be put in right before you have sex or up to six hours before you have sex.

            There are two kinds of diaphragms:

            Flat Ring Diaphragm: Can be folded into an oval and easily inserted with an applicator provided with it.

             

            Arcing or Coil Spring Diaphragm: Is a little hard to fold and forms an irregular circle but can be inserted using only your fingers.

             

            How to use it? IMAGE

            First, you need a prescription to get one.

             

            Before you put it in

            A diaphragm is most effective when it’s used with spermicide. Apply a teaspoon of spermicide into the dome, spread it around the rim, and then insert. 

             

            Don’t use petroleum jelly or other oil-based creams in your diaphragm. These products may create tiny holes in the silicone. Be sure to check the expiration date because it may not be as effective if it expires.

             

            How to put it in

            Find the best position to insert your diaphragm by lying down, squatting, or standing with one leg propped up. Whatever position you choose, the idea is that your legs should be wide open and your knees bent.

             

            To use the diaphragm, follow these steps:

             

            Wash your hands well

            Apply spermicide to the diaphragm.

            Fold the diaphragm in half and hold it in one hand, with the dome pointing down. Use your other hand to keep your vagina open.

            Place the diaphragm into your vagina and use your fingers to push the diaphragm as far into the vagina as you can.

            Use your finger to wrap the front rim up. It’s helpful to aim for your belly button.

            After placing the diaphragm, check to see if it’s placed correctly. Try inserting your finger into your vagina again to see if you can feel any part of your cervix through the diaphragm. If the device doesn’t cover your cervix, remove the diaphragm and try reinserting.

             

            You shouldn’t be able to feel the diaphragm once it is in place. If placed correctly, it will stay put even if you cough, squat, sit, walk, or run.

             

            When to take it out

            Leave your diaphragm in for at least six hours after having sex. If you plan to have sex again that same day, leave it in and apply more spermicide into your vagina beforehand.

             

            You shouldn’t leave the device in for longer than 24 hours. Doing so may lead to a severe bacterial infection called toxic shock syndrome.

             

            How to take it out

            Wait at least six hours after having sex to remove your diaphragm. 

             

            Then, follow these steps:

             

            Wash your hands well

            Find a comfortable position — lying down, squatting, or standing with one leg propped.

            Place your index finger into your vagina. Hook it over the rim of the diaphragm.

            Gently pull the diaphragm down and out of your vagina. Be careful not to tear the device with your fingernails.

             

            Diaphragm aftercare

            After you take your diaphragm out, take care to prevent bacteria from settling into the diaphragm. This will preserve the product’s continuous use. With proper care, a diaphragm can last from 2 to 10 years.

             

            You should:

             

            Check for holes or other damage. Try filling the dome with water to see if it has leaks. You shouldn’t use a damaged diaphragm. Any holes will allow sperm to enter the cervix and into the uterus.

            Rinse it off and let it air dry.

            Store in a cool, dry container.

             

            Advantages

            Effective as soon as you start using it, it’s easy to stop using it, too.

            Doesn’t interrupt sex. You can put your diaphragm in up to 2 hours before you have sex (that’s how long the chemicals in spermicide work). 

            Don’t have hormones

            Can use them over and over

            Can have sex during menstruation

            Either partner cannot feel the device

            Portable and can be carried in your purse with ease

            Can be used while breastfeeding

            Can be used if you have medical problems or smoke.

             

            What it doesn’t protect you from

            The diaphragm does not protect from sexually transmitted infections.

             

            Common side effects

            Genital irritation, red or swollen vulva/vagina due to silicone sensitivity or by the chemicals in the spermicide 

            Latex allergies

            Irregularities of the vagina or cervix could create additional risks

            Some people get urinary tract infections (UTIs)

            Irregular spotting or bleeding, 

             

            Effective level (used properly and not) / Failure rate

            If you use your diaphragm ideally every time you have sex, it’s 94% effective. But with typical use, it is  88% effective.

             

            Who can’t use it?

            If either partner is allergic to latex or spermicide

            If inherited problems and surgery change the elasticity or shape of the vagina, the diaphragm is not the best form of birth control

            Get frequent urinary tract infections 

            Have a history of toxic shock syndrome 

             

            Where to find it?

            Cervical Caps

            What is it?

            A cervical cap is a silicone cup you insert in your vagina to cover your cervix and keep sperm out of your uterus. Your vaginal muscles hold the cup in place and stop it from being moved during intercourse. The cervical cap is best effective when used with spermicide, which kills any sperm that come into contact with the cap. 

             

            Cervical caps are smaller than diaphragms and shaped slightly differently. Diaphragms are shaped like a dish, and cervical caps look like hats.

             

            You can leave the cervical cap in longer than a diaphragm (up to 2 days), but diaphragms are slightly more effective at preventing pregnancy. Consult your doctor to help you decide which one is better for you.

             

            How to use it? IMAGE

            The cervical cap should be inserted before intercourse. You will need to apply a small amount of spermicide to the hole and the edge of the cap. Pinch the cap so it folds in half, bowl side up to insert. Push the cap into your vagina and down towards your rectum. Then push the cervical cap as far back as you can so that it covers your cervix.

             

            You can leave the cervical cap in place for up to 48 hours. There is no need to reapply spermicide every time you have sex but remember to leave the cap in place for at least eight hours after intercourse.

             

            To remove the cap, insert your finger into your vagina and gently push on the dome of the cap. This will release the suction that is holding the cap on your cervix. Pull the strap located on the front of the cap and remove the device.

             

            Wash the cervical cap in warm water and mild, antibacterial hand soap. Let it air dry or pat with a towel, and store it in its protective case.

             

            Advantages

            Can be inserted in advance without interrupting intimacy

            Can be used multiple times

            No side effects from hormones

            Small and easy to carry

            Requires less spermicide than a diaphragm

            Rarely hinders the sexual experience

            May be used for repeated intercourse within 48 hours

             

            What it doesn’t protect you from

            The cervical cup does not prevent STDs.

             

            Common side effects

            Can cause vaginal irritation

            Some women wind up getting frequent urinary tract infections

            If you’re allergic to spermicide or silicone, you shouldn’t use a cervical cap

             

            Effective level (used properly and not) / Failure rate

            The cervical cap is fairly effective—better with spermicide. The cervical cap is 86% effective if you have never given birth and is 71% effective if you have.

             

            Who can’t use it?

            Currently, have a vaginal or cervical infection 

            Have an abnormal Pap smear, and the cause is not known. 

            An abnormally shaped cervix

            A history of pelvic inflammatory disease (PID)

            Are at high risk of or have HIV/AIDS

            If you are younger than age 30 and have sex three or more times a week; 

            Have vaginal bleeding or have a vaginal or cervical infection

            Recently gave birth or had a miscarriage or an abortion

            Recently had cervical surgery

             

            Where to find it?

            Emergency Contraception

            • Emergency contraception is a birth control measure taken to reduce the risk of pregnancy after having unprotected sexual intercourse or when other regular contraceptive measures have not been used correctly. It is intended to be used occasionally and is not the same as medical abortion. 
            • There are different forms of EC, Emergency contraceptive pills (ECPs), the morning-after pill, and the Copper IUD.

            Copper IUD

            What is it?

            An IUD with a small, soft, T-shaped device made of plastic or metal has a string and a copper wire wrapped around it. It changes the uterus lining so that a fertilized egg is less likely to attach to it and slows the sperm movement to make it harder to get to the egg. 

             

            How to use it?

            For a copper IUD to work as emergency contraception, a doctor or nurse must put it in within 5 days after you have unprotected sex. The copper prevents pregnancy by interfering with the way sperm moves, making it hard for sperm to swim well enough to get to an egg.

             

            Effective level (used properly and not) / Failure rate

            The Copper IUD reduces your chances of getting pregnant by more than 99.9 percent if you get it put in within 5 days of unprotected sex. It’s the most effective kind of emergency contraception there is. Unlike morning-after pills, it works the same no matter how much you weigh. 

             

            One of the most convenient things about getting an IUD as emergency contraception is that it keeps giving you super-effective birth control for up to 12 years. You won’t have to think about emergency contraception again until you stop using the IUD.

            Emergency Contraceptive Pills (ECPs) / Morning After Pill / Post pill

            What is it?

            The emergency contraceptive pill or the ‘Morning After Pill’ is a safe and effective way to prevent pregnancy after unprotected sex, contraceptive failure, or a sexual assault. Emergency contraceptive pills work by delaying ovulation (the release of an egg during the monthly cycle). If fertilization and implantation have already happened, ECPs will not interrupt the pregnancy.

             

            How to use it?

            Despite its name, women do not have to wait until the morning after sex to take it. It is more effective the sooner you take it. ECPs are pills that can be taken up to 120 hours (5 days) after having unprotected sex. Some types work best when taken within 72 hours (3 days) after intercourse.

             

            Advantages

            You can buy the morning-after pill in advance to always have it on hand 

            No serious side effects 

            Requires you only to take one pill

             

            What it doesn’t protect you from

            Emergency contraception does not protect against STDs. 

             

            Common side effects

            Irregular bleeding, spotting, or heavier bleeding

            Headache

            Dizziness

            Breast tenderness

            Fatigue

            Stomach pain

             

            Effective level (used properly and not) / Failure rate

            The effectiveness rate varies from 87% to 90% for the 3-day pill and from 72% to 87% for the 5-day pill. 

             

            Who can’t use it?

            Females who are pregnant

             

            Where to find it?

            Sterilization

            Sterilization is a permanent form of birth control that prevents a woman from getting pregnant or prevents a man from releasing sperm. It usually involves surgery and usually is not reversible.

            Female sterilization is a permanent procedure to prevent pregnancy and works by blocking the fallopian tubes (tubes that carry the egg from the ovary to the uterus ). When your fallopian tubes are blocked or removed after a sterilization procedure, sperm can’t get to an egg and cause pregnancy. But you still get your period after sterilization. It’s a slightly more complex and expensive procedure than male sterilization (vasectomy)

             

            Sterilization Details

            There are a few different types of tubal sterilization procedures: 

            1. Tubal ligation: is a surgical procedure that permanently closes, cuts, or removes pieces of the fallopian tubes.
            2. Bilateral salpingectomy: is a surgical procedure that removes the fallopian tubes entirely.
            3. Essure sterilization: is a tiny coil put in the fallopian tubes to block them.

            Advantages

            • Never worrying about getting pregnant
            • Do it once, and never have to think about it again
            • It’s safe for almost all women and has an extremely low failure rate
            • The procedure does not affect your hormones, menstruation, or sexual desire.

            What it doesn’t protect you from

            Sterilization does not protect you from STDs.

            • Common side effects
            • A very rare risk that your tubes may reconnect themselves, leading to a pregnancy
            • Possible complications with surgery, like bleeding, infection, or a reaction to anesthesia
            • For the Essure method, the coils may move out of place and damage the uterus during insertion.

            Effective level (used properly and not) / Failure rate

            It’s permanent and more than 99% effective at preventing pregnancy.

            Who can’t use it?

            • Having undergone prior abdominal surgery
            • Have pelvic inflammatory disease, diabetes, or lung disease
            • If you are overweight

            Breastfeeding as a Contraceptive

            In the first few months after childbirth, breastfeeding reduces the chances of pregnancy by preventing ovulation and delaying the return of menstruation. This is called Lactational Amenorrhea, meaning the lack of periods due to breastfeeding. This is because breastfeeding round the clock releases high levels of prolactin (the milk-producing hormone) in the mother’s body. This can be seen as the body’s natural method of spacing out pregnancies to ensure the health and safety of the mother.

            Breastfeeding as a Contraceptive Details

            How to use it?

            These three necessary conditions must be all met for it to be successful. If they are not met, it is time to start using other forms of contraception.

             

            You breastfeed around the clock. This means that your baby is fed only from your breast, and no other food, water, or liquids are given to the baby.

            Your baby must be six months of age or less.

            Your periods (including spotting) haven’t returned since childbirth.

             

            Advantages

            Prevents pregnancy right away.

            It’s free and safe.

            It doesn’t interrupt sex.

            It reduces bleeding after you deliver your baby.

            Breastfeeding may reduce your chance of getting breast cancer.

            What it doesn’t protect you from

            It does not protect you from STDs.

            Common side effects

            Breastfeeding can lower vaginal lubrication (getting wet when aroused), making sex uncomfortable. 

            And some people find that nursing makes their breasts feel less sexual.

             

            Effective level (used properly and not) / Failure rate

            If all the conditions are met, it is 99% effective. During the first 3 months, the chance of pregnancy is practically zero. When it is between 3 and 6 months, the chance of pregnancy is less than 2%, and about 6% after 6 months (assuming mom’s menstrual periods have not yet returned).

              Sexually Transmitted Infections

              Jan 15, 2022

              Sexually Transmitted Infections

              An STI is an infection spread predominantly by sexual contact, including kissing, vaginal, anal and oral sex.

              Talk With a Sexual Health Expert

              Quick Links

              STI Screening

              Bacterial STI

              Vaginitis 

              Chlamydia

              Gonorrhea 

              Syphilis

              Pelvic Inflammatory Disease

                Viral STI

                Herpes

                Human Papillomavirus

                Hepatitis

                HIV

                Parasitic STI

                Trichomoniasis

                Pubic Lice

                  Fungal STI

                   Yeast Infection(Vaginal)

                  Yeast Infection(Penile)

                   

                  What is it?

                  • An STI is an infection spread predominantly by sexual contact, including kissing, vaginal, anal and oral sex. Some STIs can also be transmitted from mother-to-child during pregnancy, childbirth and breastfeeding. An infection is when a bacteria, virus, or parasite enters and grows in or on your body. STIs are also called sexually transmitted diseases, or STDs.
                  • More than 30 different bacteria, viruses and parasites are known to be transmitted through sexual contact. Eight of these pathogens are linked to the greatest incidence of sexually transmitted disease. Of these, 4 are currently curable: syphilis, gonorrhea, chlamydia and trichomoniasis. The other 4 are viral infections which are incurable: hepatitis B, herpes simplex virus (HSV or herpes), HIV and human papillomavirus (HPV).
                  • A person can have an STI without showing symptoms of disease. Common symptoms of STIs include vaginal discharge, urethral discharge or burning in men, genital ulcers and abdominal pain. 
                  • Common STDs in women include Chlamydia, genital herpes, human papillomavirus (HPV) infection, syphilis, gonorrhea, pubic lice, chancroid, and HIV/AIDS.

                  STI Screening 
                  STI tests are relatively easy and depending on the type of STI test, could range from 20 minutes to a week for results.

                  Based on Common Types of Tests

                  For both

                  • Check your genitals visually
                  • Take a swab from a wound or sore
                  • Ask for a urine sample
                  • Take a blood test

                  For women

                  • Inspect vaginal walls and cervix 
                  • Swab from your vagina and/or cervix 

                  For men

                  • Touch your penis and testicles to check for discharge, pain or sores Take a swab from your urethra (opening of the penis)

                   

                  Based on the type of STI
                  • Vaginitis: Pelvic exam (look inside your vagina for inflammation and abnormal discharge) and pH testing 
                  • Chlamydia & Gonorrhea : Swab of genital area, urine sample
                  • Syphilis: Blood test, sample from a sore
                  • Pelvic Inflammatory Disease: Pelvic exam, blood, test, urine test, ultrasound, laparoscopy (inserts a thin device through a small cut in your abdomen to view pelvic organs), endometrial biopsy (inserts a thin tube into the uterus to sample endometrial tissue for signs of infection & inflammation)
                  • Genital Herpes
                    • No symptoms: Blood test 
                    • With symptoms: Swab of infected area and blood test 
                    • Human Papillomavirus (HPV): HPV test (women), visual exam. There is currently no approved test for HPV in men however, visit your doctor immediately if you notice any abnormal skin growths or changes in your penile, scrotal, anal, or throat areas. 
                    • Hepatitis B & C: Blood tests 
                    • Human Immunodeficiency Virus (HIV): Blood, oral fluid and urine test 
                    • Trichomoniasis: Swab of infected area, visual exam or a sample of discharge
                    • Pubic Lice: skin exam
                  • Yeast Infection (Vaginal): Pelvic exam, sample of vaginal fluid

                  Yeast Infection (Penile): swab of infected area, blood and urine test

                  Get vaccinated – There are vaccines to protect against HPV and hepatitis B.

                  Use condoms – Condoms are the best way to prevent STIs when you have sex. Condoms can protect against some, but not all, STDs and are never 100% effective in protecting against STDs. Other birth control methods, like birth control pills, shots, implants, or diaphragms, will not protect you from STIs. 

                  Do not douche –Vaginal douching is washing the vagina with a mixture of fluids such as vinegar, baking soda or iodine. A few also contain antiseptics and fragrances. It can cause side effects like burning and irritation. Douching removes some of the normal bacteria in the vagina that protects you from infection. This may increase your risk of getting STIs.

                   

                  • Bacterial STDs such as chlamydia, syphilis, and gonorrhea can be cured by antibiotic treatment. 
                  • No cure is available for some STDs like HIV or chronic hepatitis B infection, but medications are available to manage these chronic conditions.
                  • The pelvic inflammatory disease (PID) and infertility are complications of some STDs. Other complications depend upon the specific type of illness.

                  Bacterial STIs

                  Bacterial STIs/STDs are caused by bacteria, tiny single-celled microorganisms. Bacteria are highly resistant and are able to survive in various environments. Our body is home to many microorganisms and not all of them are dangerous.

                   Since bacterial STIs/STDs often give no warning signs, you can contract and transmit it without your knowledge. This means that before you realize the problem, serious complications which can cause irreversible damage can progress silently.

                  They are curable through treatment with antibiotics as long as you get tested and treated, follow through on all the medication, avoid sexual contact until cured, and make sure your sexual partner(s) get tested and treated as well.

                  Complications can include pelvic inflammatory disease, urethritis, infertility, and ectopic pregnancy (a pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube). The longer it is left untreated, the more damage it can do. Medication will stop the infection, but it will not repair any permanent damage done before treatment begins.

                  Vaginitis

                  Vaginitis, also called vulvovaginitis, is an inflammation or infection of the vagina and can also affect the vulva, which is the external part of a woman’s genitals. Vaginitis can cause itching, pain, discharge, and odor.

                  Common Cause

                  Bacterial vaginosis (BV) is the most common vaginal infection in women ages 15-44. It occurs when there is an imbalance between the “helpful” and “harmful” bacteria typicallyouter found in a woman’s vagina. 

                  Several things can change the balance of bacteria, such as taking antibiotics, douching, using an intrauterine device (IUD), having unprotected sex with a new partner, or having many sexual partners.

                  Another cause for vaginitis is yeast infections (candidiasis), typically outer when too much candida grows in the vagina. Candida is the scientific name for yeast that lives naturally in your mouth, gut, and vagina. 

                  You may have too much growing in the vagina because of antibiotics, pregnancy, diabetes, especially if it is not well-controlled, corticosteroid medicines.

                  Trichomoniasis can also cause vaginitis. It is a common sexually transmitted disease caused by a parasite.

                  You can also have vaginitis if you are allergic or sensitive to certain products that you use. Some products that can cause burning, itching, and discharge are vaginal sprays, douches, spermicides, soaps, detergents, or fabric softeners.

                  You can have more than one cause of vaginitis at the same time. Therefore, it is essential to treat BV and trichomoniasis because having either can increase your risk of getting HIV or another sexually transmitted disease. BV or trichomoniasis can increase your risk for preterm labor and preterm birth if you are pregnant.

                  Symptoms

                  Bacterial vaginosis: have a thin white or gray vaginal discharge with an odor, such as a strong fish-like odor, especially after sex.

                  Yeast infections: produce a thick, white discharge from the vagina that can look like cottage cheese. It can be watery, often has no smell, and usually causes the vagina and vulva to become itchy and red.

                  Trichomoniasis: you may not have symptoms, but if you do, you could have gray-green discharge, which may smell bad. You can also have itching, burning, and soreness of the vagina and vulva.

                  Treatment

                  Bacterial vaginosis: is treatable with antibiotics. You may get pills to swallow or cream/gel to apply in your vagina. You should use a condom or not have sex until you are cured.

                  Yeast infections: are usually treated with a cream or medicine that you put inside your vagina. You can buy over-the-counter treatments for yeast infections, but you need to be sure that you do have a yeast infection, so you must see your doctor for a diagnosis. Even if you have had yeast infections before, double-checking is a good idea.

                  Trichomoniasis: treatment is usually a single-dose antibiotic that you and your partner(s) take to prevent spreading to others and avoid getting it again.

                  Allergy or sensitivity to a product: find out which product is causing the problem and stop using the product.

                  Hormonal change: consult your doctor, who may give you estrogen cream to help with your symptoms.

                  Prevention
                  • Do not douche or use vaginal sprays.
                  • Use a latex condom when having sex. If your partner is allergic to latex, you can use polyurethane (type of plastic) condoms.
                  • Avoid clothes that hold in heat and moisture
                  • Wear cotton underwear

                  Chlamydia

                  Chlamydia is a common STD that can cause serious, permanent damage to a woman’s reproductive system. This can make it difficult or impossible to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb). It can be easily cleared up with antibiotics. But if you don’t treat chlamydia, it may lead to major health problems in the future.

                  Common Cause

                  The bacterium Chlamydia trachomatis causes chlamydia. It commonly affects 14-24-year-old and be contracted during oral, vaginal, or anal sex with someone who has the infection. A woman can also pass chlamydia to her baby during childbirth or by carrying the infected liquid on hands to the eyes, which is rare. If you’ve had chlamydia and were treated in the past, you can get re-infected if you have unprotected sex with someone who has it.

                  Chlamydia can’t be spread through casual contact, so you are safe from infection even if you share food or drinks, kiss, hug, hold hands, cough, or sneeze. The best way to prevent infection is by using condoms orher  dental dams (a thin, flexible piece of latex that protects against oral sex) every time you have sex.

                  Symptoms

                  Chlamydia often runs without symptoms, making it potentially dangerous, especially for women’s fertility. 

                  Sometimes this disease shows up through: 

                  • unusual discharge from the genitals
                  • sometimes yellowish and smelly painful urination 
                  • bleeding during or after the intercourse
                  • bleeding between periods or heavy periods 
                  • pain in the lower abdominal sometimes with nausea and low-grade fever 
                  • swollen skin inside the vagina or around the anus
                  • If chlamydia infects your eyes, you may have redness, skin discoloration around your eye, itching, or discharge. Sometimes chlamydia infections in the throat cause soreness, but it’s rare.
                  Treatment

                  Chlamydia is effectively treated with antibiotics if diagnosed early, but it cannot repair any permanent damage that the disease has caused. Your doctor will help you figure out which treatment is best for you. Depending on the severity, you may only have to take one dose or several that last seven days. 

                  To prevent spreading the disease, you should wait seven days after taking the single dose or until you finish taking all the doses for seven days. Your partner(s) should also get treated to prevent infecting others or re-infecting each other. It is common to get a repeat infection, so you should get tested again about three months after treatment.

                  If left untreated for a long time, it can spread to your uterus and fallopian tubes, causing pelvic inflammatory disease (PID). This can cause permanent damage that leads to pain, infertility, or ectopic pregnancy. Therefore, regular checkups are necessary to lower your chances.

                  Prevention
                  • Abstain from sex contacts or limit the number of sex partners 
                  • Use condoms during every intercourse
                  • Make sure your new sexual partner is uninfected (encourage them to get tested) o
                  • Avoid using water-based spermicides.
                  • Get tested regularly if you have active sexual life and often change partners.

                  Gonorrhea

                  Gonorrhea is an STI most common in young adults. Gonorrhea is an STI very similar to chlamydia in the way it is transmitted and the way it is treated. Gonorrhea mostly attacks the urethra, cervix, and fallopian tubes. 

                  It has a nickname called the clap because it refers to a treatment that is used to clear the blockage in the urethra from gonorrhea pus, where the penis would be ‘clapped’ on both sides simultaneously.

                  The bacteria grow in warm, moist areas of the body and can include the urethra (the tube that carries urine out of the body) and grow in the eyes. It is an especially serious problem for women because it can damage the female reproductive organs (the fallopian tubes, uterus, and cervix).

                  Common Cause

                  Gonorrhea is caused by Neisseria gonorrhoeae and can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea most often affects women ages 15 to 24 but is becoming more common in older women.

                  Symptoms

                  This disease can show no symptoms in most women, but sometimes signs are noticeable. 

                  • bleeding between periods
                  • pain when urinating
                  • increased discharge from the vagina. 
                  • If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility.
                  • Rectal infections may either cause no symptoms or cause symptoms that may include discharge, anal itching, soreness, bleeding, and painful bowel movements.
                  Treatment

                  The patients with chlamydia are almost always prescribed to take medications against gonorrhea and vice versa.  The antibiotics are usually a pill you swallow. Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is essential to get tested and take antibiotics immediately.

                  To be cured, you must finish all antibiotics even if the symptoms go away and do not share your antibiotics with anyone. See your doctor if symptoms do not go away after treatment. It is possible to get reinfected if you have sex with someone who has gonorrhea. You should inform your recent sex partner(s), so they can be tested and treated as well.

                  Gonorrhea that is not treated can cause serious health problems in women, such as pelvic inflammatory disease (PID), leading to chronic pelvic pain, pregnancy problems, and infertility. It can also put you at a higher risk of getting HIV or spreading HIV. Although it is not common, gonorrhea can cause widespread infection in other parts of the body (blood, joints, heart, or brain) and can lead to death.

                  Prevention

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                  Syphilis

                  Syphilis is one of the most common sexually transmitted diseases (STDs). It is a bacterial infection spread through vaginal, oral, or anal sex with an infected person. Syphilis develops in stages that can last for weeks, months, or even years. The stages may be separated by long periods of apparent good health. It usually starts with a small, painless sore, called a chancre, on the genitals, anus, or mouth. In the next stage, you may have flu-like symptoms and/or a rash. Later stages of syphilis can damage the brain, heart, spinal cord, and other organs.

                  Common Cause

                  Syphilis is a disease caused by the bacterium Treponema pallidum. Young adults ages 20 to 35 are usually the highest at risk of getting this disease. This bacterium causes infection during sexual activity but can also get into your body through cuts on your skin or through your mucous membranes. Syphilis is most often transmitted through sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.

                  It can’t be spread by toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.

                  Symptoms

                  Sometimes syphilis is difficult to distinguish as it can imitate the course of other diseases, but generally, it starts with the sore in the area of the penis or vagina. If you do not treat it, syphilis usually causes a non-itchy skin rash, often on your hands and feet. Many people do not notice symptoms for years. Symptoms can go away and come back.

                  The sores caused by syphilis make it easier to get or give someone HIV during sex. If you are pregnant, syphilis can cause complications, or you could lose your baby. In rare cases, syphilis causes serious health problems and even death.

                  Syphilis is divided into stages (primary, secondary, latent, and tertiary), with different signs and symptoms associated with each stage. 

                  Primary syphilis: occurs between 10 and 90 days (3 weeks on average) after you’re exposed to the disease. It causes one or more sores called chancres on or around the genitals, around the anus or in the rectum, or in or around the mouth. These sores are usually firm, round, and painless. Even if you don’t treat them, they heal without a scar within six weeks. But treatment will keep your disease from moving to the next stage.

                  Secondary syphilis: begins six weeks to 6 months after you’re exposed and can last 2 to 6 weeks at a time and may come and go for up to 2 years. Symptoms include a pinkish rash on the palms, soles of the feet, and on other parts of their body. The inflammation is sometimes hard to see, and it usually doesn’t itch.

                  People may have moist, wart-like lesions in their groin, white patches on the inside of their mouth, swollen lymph glands, fever, hair loss, and weight loss.

                  The signs and symptoms of primary and secondary syphilis can be mild, and they might not be noticed. As with primary syphilis, symptoms of secondary syphilis will get better without treatment.

                  Latent stage: there are no signs or symptoms for months or even years, but you still need treatment to get rid of it.

                  Tertiary syphilis: isn’t contagious at this point, but the infection has started to affect your organs. It can cause tumors, blindness, and paralysis, damage your nervous system, brain, and other organs, and even kill you.

                  The damage that late-stage syphilis has already caused can’t be changed or healed.  The complications from late-stage syphilis can happen 10-20 years after you first get infected.

                  Treatment

                  Syphilis is easy to cure with antibiotics if you catch it early. A blood test is a reliable way to detect this disease, and the preferred treatment at all stages is the antibiotic penicillin. To get cured, you might only need one injection of penicillin if you’ve been infected for less than a year and more doses if it’s more than a year. 

                  After getting a penicillin injection or taking other antibiotics, you may experience fever, headaches, joint or muscle pain, all of these in addition to nausea and chills. These usually only last about a day. There are no over-the-counter medications or home remedies that will cure syphilis — only antibiotics can do that.

                  Your sexual partner(s) needs to get treated to prevent transferring to other people and back to each other. You should abstain from sex until you finish your treatment and all the sores are have healed.

                  Prevention
                  • Not have vaginal, anal, or oral sex.
                  • Have a mutually monogamous relationship with a partner who has been tested and is clean
                  • Correct usage of latex condoms significantly reduces (but does not eliminate) the risk of catching or spreading. If you or your partner is allergic to latex, you can use polyurethane (type of plastic) condoms. 

                  Pelvic Inflammatory Disease

                  Pelvic Inflammatory Disease (PID) affects only women and comes as a result of bacteria moving from vagina or cervix to the uterus, fallopian tubes, ovaries, or pelvis. It causes scarring in these organs and can lead to infertility, ectopic pregnancy (a complication of pregnancy in which the embryo attaches outside the uterus), pelvic pain, abscesses, and other serious problems.

                  Common Cause

                  Gonorrhea and chlamydia are two STDs that commonly cause PID. It can develop as the complication of these two STDs, which damage the fallopian tubes and tissues in and around the uterus and ovaries and might also lead to infertility in severe untreated cases. Other causes include abortion, childbirth, pelvic procedures, and an intrauterine device (IUD), either copper or hormonal.  You are more likely to get infected if you are younger than 25 and sexually active (one or more partners) and if you douche.

                  Symptoms

                  Some women have no symptoms. Others have:

                  • Pain in the lower abdomen
                  • Fever
                  • Smelly vaginal discharge
                  • Irregular bleeding
                  • Pain during intercourse or urination
                  Treatment

                  PID is easily cured with antibiotics taken orally if caught early on. However, late detection can have harmful consequences to the reproductive system that can be irreversible and increase the risk of infertility.

                  To fully treat PID, you may need to take one or more antibiotics to clear the infection in about two weeks. You should take it simultaneously every day and finish all of it even if you feel better. The infection can come back if you do not quit. Your doctor will inform you what types of foods, alcohol, or other medicines you should avoid until you finish the treatment.

                  You and your sexual partner(s) must be treated to prevent PID from coming back. Use condoms until you both(all) have finished taking antibiotics.

                   

                  These antibiotics can have side effects such as:

                  • Nausea
                  • Diarrhea
                  • Stomach pain
                  • Rash and itching
                  • Vaginal yeast infection
                  Prevention
                  • Practice abstinence
                  • Having a sexual relationship with only one person
                  • Using a condom every time you have sex
                  • Get regular checkups

                  Viral STIs

                  Viral STDs are caused by viruses that dwell inside a person. Viral infections spread by modifying human cells and producing more viral cells. Viral STDs usually have no symptoms. If they do, the symptoms like sores or blisters for genital herpes come and go making it easy to get infected and transmit unknowingly. 

                  You can get this disease even if you are not sexually active. It can be transmitted during blood transfusion, pregnancy, birth, breastfeeding, and sharing personal things such as towels or toothbrushes. 

                  There is no permanent cure for viral STDs, and many can persist for a long time. It could go on for your whole life and could bring irreversible damage to your health if left untreated. This is why early treatment can keep it managed for a continuous period, relieve symptoms, and minimize the impact on the patient’s day-to-day life. In addition to this, there are vaccines to help prevent HPV and hepatitis. Until the active treatment is finished, it is vital to abstain from sex.

                  Herpes

                  Herpes is a common infection that stays in your body for life. It causes sores on your genitals or mouth. Herpes can be annoying and painful, but it usually doesn’t lead to serious health problems.

                  Common Cause

                  Two different but similar viruses cause herpes: 

                  • Herpes simplex virus type 1 (HSV-1): causes oral herpes, which usually affects the mouth and surrounding skin.
                  • Herpes simplex virus type 2 (HSV-2): causes genital herpes, usually sexually transmitted. 

                  It is spread through contact with the infected parts of the skin, mainly during intercourse, but in some cases, it can be transmitted from mother to child while giving birth. It can also be spread by direct contact of the skin by blistered areas, but transmission can also happen even if there are no outbreaks.

                  Symptoms

                  The first symptoms to develop are tingling, itching, or burning, and then you might notice sores or blisters forming around the mouth or genitals. It takes 2–20 days to develop these symptoms after exposure to the virus.

                  Oral Herpes 

                  • Oral herpes usually is less painful than genital herpes and. Symptoms can fade away and pop up again in weeks, months, or years. They are typically harmless in kids and adults but can be dangerous to newborn babies.

                  Symptoms include:

                  • Sores in or around your mouth are referred to as cold sores or fever blisters that last a few weeks and fo away on their own

                  Genital herpes 

                  It’s called an outbreak when blisters and other genital herpes symptoms show up. The first outbreak usually starts about 2 to 20 days after you get infected, getting infected, getting but sometimes it takes years for the first outbreak to happen.

                  The first outbreak lasts about 2 to 4 weeks, getting infected, and even though the blisters go away, the virus stays in your body and can cause sores again. It’s really common to get repeat outbreaks, especially during the first year you have herpes.

                  Symptoms include:

                  • Several itchy or painful blisters (vagina, vulva, cervix, anus, butt, or the inside of your thighs). These blisters then break and turn into sores.
                  • Burning when you pee if your urine touches the herpes sores or if it is blocking your urethra (the tube that passes from the bladder to the outside of the body).
                  • Fever, chills
                  • Headache
                  • Feeling achy and tired
                    Treatment

                    Although herpes symptoms are easy to treat, there’s no cure against the virus, so that that infected people will have it for the rest of their lives. After the outbreak lasts 2–3 weeks, the disease goes into a dormant stage, with the infected person remaining a potential transmitter. However, some people never develop symptoms. 

                    No drug can get rid of the herpes virus. However, a doctor may prescribe an antiviral medication, such as acyclovir, to prevent the virus from multiplying. There are also over-the-counter herpes treatments, usually creams, to help manage tingling, itching, and pain.

                    If a person uses antiviral medication, symptoms may resolve 1–2 days more quickly than if they had used no treatment and may lessen the severity of symptoms. Depending on the frequency of recurrence, a doctor may recommend you to take medication for 6-12 months at a time. You can reduce the likelihood of transmitting by taking these medications every day for longer periods.

                      Prevention
                      • Using barrier protection, such as condoms and dental dams, when having sex
                      • Avoiding sex while symptoms are present
                      • Avoiding kissing and oral sex when there is a cold sore around the mouth
                      • Washing the hands thoroughly, especially after touching the affected area, during an outbreak

                      Human Papillomavirus

                      Human Papillomavirus (HPV), also known as “genital warts’ ‘ is a widespread disease with about 100 types detected. It passes from person to person through sexual contact, primarily through skin-to-skin contact with the infected areas. Warts are highly contagious, but even the dormant stage without warps can infect other people. 

                      Common Cause

                      HPV infection is caused by HPV, a type of the Papillomaviridae strain. HPV-6 or HPV-11 are usually the ones that cause genital warts. There are high-risk HPV that are even more serious and can cause cancer in the reproductive systems of both men and women.  

                      The virus that causes HPV infection is transmitted through skin-to-skin contact. You can get a genital HPV infection through direct sexual contact, including vaginal, anal, and oral sex.

                      Since many people don’t get symptoms, they contract and spread them, but it is possible to have multiple HPVs without being aware. A mother can transmit the virus during delivery which might cause the baby to develop a condition called recurrent respiratory papillomatosis (HPV-related warts inside the throat or airways).

                      Symptoms

                      Most people do not experience any symptoms of HPV, and the virus often goes away by itself. But in some people, HPV causes. 

                          • Genital warts
                          • Cancer
                          • Pain during sex
                          • Bleeding after sex
                          • Abnormal periods, unusual vaginal bleeding, or unusual discharge
                          • Itchiness
                          • Pain in the pelvis
                      Treatment

                      There is no treatment for HPV; however, the body usually gets rid of the virus by itself over the course of a year. To make sure it is gone, you need to be re-tested. Even if warts no longer occur, it is necessary to undergo regular checkups to prevent HPV from developing into cancer.

                      If you develop genital warts, your doctor may suggest:

                          • Cryotherapy: using liquid nitrogen to freeze off warts
                          • Electrocautery: an electrical current to burn away the warts
                          • Laser or light therapy: using a high-powered, targeted beam to remove the unwanted tissue
                          • Surgical removal: cut away the warts
                      Prevention
                      • Using condoms is necessary, but you can still catch HPV because the whole genital area isn’t covered.
                      • A vaccine is available that can protect against nine types of HPV known to be associated with either cancer or genital warts. 
                      • Get regular health checkups, screenings, and Pap smears.

                      Hepatitis

                      Hepatitis means inflammation of the liver, which affects the function of the liver. There are several causes for hepatitis, such as heavy alcohol use, toxins, medications, and certain medical conditions. Usually, hepatitis is caused by a virus. The most common hepatitis viruses are hepatitis A virus (not commonly sexually transmitted), hepatitis B virus, and hepatitis C virus (not commonly sexually transmitted).

                      Hepatitis B

                      Hepatitis B is the most common severe liver infection globally that attacks and injures the liver. Most people do not have symptoms when they are newly or chronically infected and can unknowingly spread the virus to others.

                      Common Cause

                      The hepatitis B virus causes hepatitis B. Some people with hepatitis B are sick for only a few weeks, known as acute hepatitis B. Still, for others, the disease progresses to a severe and lifelong illness known as chronic hepatitis B.

                      Hepatitis B is a sexually transmitted virus spread through the infected blood, semen, and vaginal fluids that cause the inflammation of the liver. It can also be applied by:

                      • An infected mother to her baby during birth
                      • Sharing needles, syringes, or drug preparation equipment
                      • Sharing items such as toothbrushes, razors, or medical equipment (like a glucose monitor) with an infected person

                      The chance of developing chronic infection is more significant when a  a person is (0-6 years old). Children older than six years old and adults recover completely and do not develop chronic infection.

                      Symptoms

                      Most people do not experience any symptoms when newly infected. However, some people have acute illness with symptoms that last several weeks, such as:

                      • Flu-like symptoms like nausea, tiredness, loss of appetite,  and muscle pain 
                      • Yellowing of the skin and eyes (jaundice)
                      • Dark urine
                      • Vomiting 
                      • Abdominal pain. 
                      • Can develop acute liver failure, which can lead to death
                        Treatment

                        There’s no cure for hepatitis B, but there’s an effective vaccine that can help prevent this dangerous disease. Therefore, you need to maintain comfort and adequate nutritional balance, such as substituting fluids lost from vomiting and diarrhea. You must avoid unnecessary medications such as acetaminophen, paracetamol, and medication against vomiting.

                        The infection can be treated with medicines, including oral antiviral agents, which can slow the advancing of complications and improve long-term survival. 

                        Prevention

                        • Getting vaccinated is the best way to prevent hepatitis B. Other methods include:

                          • Implementation of blood safety strategies 
                          • Safer sex practices (limit the number of partners and using barrier protective measures like condoms)

                        Hepatitis C

                        Hepatitis C is a virus that can infect the liver. If left untreated, it can sometimes cause severe and potentially life-threatening damage to the liver over many years. It invades liver cells, causing inflammation, swelling, dysfunction, and eventual organ damage.

                        Common Cause

                        Hepatitis C is caused by the hepatitis C virus and rarely spreads through sexual contact. Hepatitis C is not contracted through kissing, sneezing, coughing, and sharing objects. A person can transmit the virus to someone else through blood-to-blood contact. The virus can be described as acute or chronic.

                         

                        • Acute hepatitis C occurs within the first six months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but acute infection leads to chronic infection for most people.

                        Chronic hepatitis C can be a lifelong infection if left untreated. Chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis (liver scarring), liver cancer, and even death.

                        Symptoms

                        The symptoms of Hepatitis B and Hepatitis C are very much alike. The incubation period ranges from 2 weeks to 6 months. Most people do not exhibit symptoms, while some may exhibit:

                        • Fever
                        • Fatigue
                        • Reduced appetite
                        • Nausea
                        • Vomiting
                        • Abdominal pain
                        • Dark urine
                        • Pale feces
                        • Joint pain
                        • Jaundice (yellowing of the skin and the whites of the eyes)
                          Treatment

                          New infection with HCV does not always require treatment, as the immune response in some people will clear the infection. However, when HCV infection becomes chronic, treatment is necessary. It can be treated with medicines that stop the virus from multiplying inside the body. Current treatments usually involve just 8–12 weeks of pills or injections and cure most people with few side effects. In addition to this, regular checkups are essential to reduce the advancement of liver disease, including liver cancer.

                           

                          But it’s essential to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.

                          Prevention

                          • There is no vaccination to prevent hepatitis C. The best way to avoid it is to avoid exposure to blood that may contain hepatitis C.

                                • Never share needles, syringes, prevent and other injecting equipment
                                • Avoid contact with other people’s body fluids
                                • Always use condoms, gloves, or dental dams during sex if blood may be present.
                                • Never share personal items such as razors, toothbrushes, combs, and nail clippers.

                          Human Immunodeficiency Virus (HIV)

                          Human Immunodeficiency Virus (HIV) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. If left untreated, it may lead to Acquired Immunodeficiency Syndrome (AIDS). AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. 

                          There are three stages infected people go through if they don’t get treated early on Acute, Chronic, and AIDS. Symptoms range from flu to no signs to severe infections depending on the stage.

                          Common Cause

                          HIV infection in humans came from a type of chimpanzee in Central Africa. The virus was probably passed to humans when humans hunted these chimpanzees for meat and contracted their infected blood.

                          HIV can be transmitted through the infected human liquids, through unprotected sex of any type, through the infected needles for drugs injection, as well as the instruments for tattooing and from mother to child.

                           It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV) or through sharing injection drug equipment.

                          Symptoms

                          Some people get symptoms similar to the flu within 2 to 4 weeks after infection and may last for a few days to several weeks. Other possible symptoms include

                          • Fever
                          • Chills
                          • Rash
                          • Night sweats
                          • Muscle aches
                          • Sore throat
                          • Fatigue
                          • Swollen lymph nodes
                          • Mouth ulcers
                            Treatment

                            Once you get HIV, you have it for life. However, it can be controlled by a combination of medications to enable infected people to live long and healthy lives and prevent transmitting to their sexual partners.

                            It can be managed by treatment regimens composed of a combination of three or more antiretroviral (ARV) drugs. It does not cure HIV infection but highly suppresses viral replication within a person's body and allows an individual's immune system recovery to strengthen and regain the capacity to fight off opportunistic infections and some cancers.

                              Prevention

                              • You can limit your exposure by:

                                • Male and female condom use
                                • Testing and counseling for HIV and STIs
                                • Use of antiretroviral drugs (ARVs) for prevention
                                • Prevent transmission from mother to baby by following doctors orders

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