STD's and how to avoid?


[00:00:00] Good morning. It's Tuesday. It is horribly rainy and it's dreary, but we're gonna talk about STDs today cuz that's fun, right on a Tuesday. Okay, this is gonna be my STD talk. This is what I tell the young girls in my office, ideally before they have had intercourse sex. So STDs to me, I divide into three buckets.

I like things that are compartmentalized. You might have noticed from watching. the first bucket. I hate to call it the big and bad because um, it's not bad necessarily cuz people nowadays really do survive these, right? But hiv, hepatitis, syphilis, I consider in one bucket, like the ones you really don't wanna get.

Second bucket, gonorrhea and chlamydia. Not that anyone wants it. I'll explain why it's in the second. Don't wanna get but not horrible bucket. And then third is, , um, hiv, sorry, it's herpes and HPV. V. Okay, so [00:01:00] H, hiv, hepatitis, syphilis, gonorrhea, chlamydia, hpv, V, and herpes. Okay. Here's my reasons behind these buckets.

What I say to the young girls is, of course you're going to use condoms, right? And I say it like that nine times outta 10, they're like, um, yeah, I use condoms. And I'm like, really? Cuz it sounds like you're not using 'em all the time. A hundred percent of the time you use condoms so that you'll avoid h i v, hepatitis and syphilis.

You'll avoid them if you use condoms a hundred percent of the time. The likelihood of any of those. Being transmitted is incredibly small. I will never say zero doctors like to cover ourselves, but incredibly small because those are transmitted through semen and blood now. Yes. If you had a cut in your mouth and you were like really heavily making out with someone with hepatitis and they had blood pouring outta their mouth and a poured into your cut in your mouth, could you get it?

In theory, maybe yes. But that is so unlikely and the answer really is probably. Okay, so semen and [00:02:00] blood, hiv, hepatitis and syphilis, condoms, you won't get them. Let's put aside that bucket because those are things are, I can't say rare, but pretty rare. Gonorrhea and chlamydia, not so rare. I had three cases this past week.

Two chlamydia, one gonorrhea. That is like anecdotally from my practice on the rise. Um, and by the way, these were like wonderful, lovely, educated people. They weren't women who were like sleeping with 20 guys in a, in a night. I mean, they were not like paid prostitutes. They were women, women and girls, people who probably shouldn't be having sex so young.

But that's a whole nother story. How can you avoid gonorrhea and chlamydia? Guess what? Condoms. Condoms. Condoms. So when you use a condom, you will. Hiv, hepatitis, syphilis, gonorrhea, chlamydia. We've just dinged off five STDs, five. The ones that you really don't want. Why do we care about gonorrhea and chlamydia?

Well, it could cause a little bit of a discharge that's frustrating and annoying. Much more important than that. It can [00:03:00] cause silently scarring of your tubes because you might not always know you have an infection. So scarring of the fallopian tubes, which can lead to problems with getting pregnant. And it can lead to something that is obvious, which is pelvic inflammatory disease, where you have a lot of very horrible pussy discharge and a fever and pain, and it can be dangerous and it needs to be treated with IV antibiotics.

And while it's not so common, In at least many of our practices nowadays, it is something that people can get. Most of the time when we have patients with gonorrhea and chlamydia, they were just coming in for the routine screening. They were not coming in because like, oh my God, this one time I didn't use a condom.

Or, oh my God, the condom broke. They're just there for their pap smear. Um, they're just there for their birth control visit, and we talk about STDs and they're like, well, I guess if you wanna test me, you. I wish, I always joke like, I don't care. It's not my vagina, it's your vagina. Do you want me to test you?

Here's what you could have gotten. Unless you're telling me to use a condom a hundred percent of the time. And even then we know a hundred percent is not a hundred percent. So it's found incidentally. So when [00:04:00] people come in and go, well I don't have any symptoms, that's great. Glad you don't have any symptoms, cuz symptoms at this point would be something bad.

So again, hiv, hepatitis, syphilis, condoms, gonorrhea and chlamydia condom. got acclimated. Just to be clear. You get from sex and it means someone else had sex with someone else. Probably recently, like at least within the last, we think like six months, maybe six to 12 months is a stretch. So if you've just started dating a guy who had a previous girlfriend five months ago, okay, maybe he didn't cheat.

But if you've been dating someone for two straight years and he tells you he hasn't been with anyone else, chances are he was, or you were, just to be clear. And then the third bucket, , um, HPV and herpes, and I put those into the third bucket. Why? If you've listened to any of my previous videos, because how common are they?

Super common. 90% of us carry hpv, 50% of us carry herpes. And some people would say that's an underestimate because not everyone is tested for these. Please remember, if you don't already [00:05:00] remem know. Men cannot be tested for hpv. There is no blood test for it. There is no pap smear equivalent. Men can be tested as women can for herpes.

We test indirectly by checking the antibodies in your blood. But many men and many women don't get tested for herpes cuz when they go in for. STD test is just not always tested. I'm gonna talk about when you test in a second, so HPV v herpes. Why are they so prevalent? Why are we not able to predict, protect ourselves against those?

Because they are viruses that live outside of the shaft of the penis and all around the vagina and vulva. So even if you're wearing a condom, You can still transmit them. Could you wear a dental dam, which is a larger film, kind of made of condom material that covers the entire vagina and vva? Yes. I think realistically people just don't do it.

So I view this as when I speak to my young patients, ideally again before they've had sex, Please use a condom every single time. And again, I joke like I shouldn't say please cuz it's [00:06:00] not my vagina. But use a condom every single time to protect yourself against h, hiv, hepatitis, syphilis, gonorrhea, and chlamydia.

Use a condom every single time to protect against those and decrease the chance of HPV V and herpes. But please know, HPV and herpes are very common. There is a decent chance that at some point in your life you are gonna hear . My little faux fur thing is falling away that you have those and don't freak out because they're really common.

Do you want them? No. But are they somewhat unavoidable unless you actually abstain from oral, vaginal, anal sex a hundred. Yeah, they're unavoidable. So you have to kind of accept that they might happen and you have to, like I keep talking about not be fearful, but be cognizant. Go into it with eyes wide open, understand and know what your risks are.

So what I say to my young patients is, I don't wanna be the scary doctor. And it's like, oh my god. Hepatitis, I mean, um, herpes and hpv. I wanna be the doctor who makes you understand and know it so that if or when you find out that you were [00:07:00] exposed to it, , you've at least made every effort to decrease transmission by being judicious about who and how often you have sex.

Because obviously if you decrease the numbers of partners, you might decrease your chance. Um, that doesn't mean that there's any number that is the right number. I don't know the right number. Everyone has a different number in their life of who they think the right number of sexual partners is. But be your dishes.

I mean, go into a relationship knowing that it should. Something that you're willfully doing because you either want to, like to love to, whatever your values and ethics are about it, wear a condom every single time and accept that you still might get these things and that's okay. So that's my Diddy on the buckets.

How do you test for it in a nutshell is H, hiv, hepatitis, syphilis, and herpes are blood tests. Sometimes you can do a little swab in your cheek, but that's not for all of those. So most of our practices, we do hiv, hepatitis, syphilis, herpes blood tests, gonorrhea and chlamydia. Can be a vaginal culture, a urine culture, or off of your [00:08:00] pap.

Okay, so when you go to your doctor, I often will write it down for my little, for my young patients and say, take a screenshot of this. Show this to your friends every six to 12 months. Get tested. Even if you're in a relationship, just get used to it so that you don't have to be like, should I, should I not get tested?

No. Just get tested every six to 12 months. Just get tested. Just get tested so that you know your status at any given point. The world would be a better place if we all did this because there would be no shame, there would be no stigma. We would all know that millions of people have these things and we would understand it.

Okay. And rant. Can you tell I'm like passionate about this. All right, bye. Happy Tuesday..