Women's health involves many issues that are unique. We learn about these unique issues through research studies.  For example, recent research has taught us about early detection of cervical cancer, concerns about hormone replacement therapy, urinary incontinence, risk factors for preterm labor, the importance of mammograms and prevention of osteoporosis. These sorts of studies help all women. In fact, every one of us has benefited in some way from research.

It is important that your physician and nurses know about the latest research. When your physician is also a researcher, she or he has access to the most current information and treatments. Often, they will know about the research results before they are announced to the public. This translates into improved health care for women.

For more information about Women's Health research check out our Research page.  For more information about all research at MUSC check out our MUSC HERO website.

Today is World AIDS Day.  Here are a couple things that you can do today and this week to join in on the fight against AIDS:

Drink coffee:  Starbucks will make a five-cent U.S. contribution to the Global Fund for every beverage sold at participating locations in the U.S. and Canada on World AIDS Day.

Walk:  At 5:30p.m. everyone is invited to a candle light vigil walk from Marion Square to the College of Charleston Rivers Green (behind Addlestone Library) and ending with a speaking and entertainment program.

Shop:  Shop at any of the 100+ RED RIBBON RETAILERS on Saturday, December 5th and 10% of every dollar you spend will go to Lowcountry AIDS Services (LAS).

Buy lipstick:  Trish McEvoy has developed a stunning red lip color, “Gorgeous Red.” Three dollars and fifty cents will be donated to LAS from each tube sold.  The public can purchase the lipstick at Saks Fifth Ave. on King Street or Gwynns in Mt. Pleasant.

Get tested:  Women concerned that they have been infected with HIV can be tested at their physician’s office, the state health department or a non-profit clinic such as Planned Parenthood of America. 

The Lowdown on STD’s: Chlamydia
Chlamydia is the third most common sexually transmitted infection (STI) in the United States.  It is the most common bacteria causing an STI.  According to a 2007 Center for Disease Control report, South Carolina ranks 3rd out of the 50 states in chlamydial infections.  Those at most risk of infection are single, minority women between ages 15-21 with new or multiple sexual partners.  However, Chlamydia affects women and men of all backgrounds. 

Like all sexually transmitted infections, Chlamydia enters a woman’s body during intercourse.  Chlamydia trachomatis is different from most bacteria in that it must live inside cells, making it difficult to grow in a culture. In this way, it is more similar to a virus.  Chlamydia prefers to live inside the cells of the cervix (the opening of the uterus) and the cells that line the bladder. 

Symptoms
Most women infected with Chlamydia are asymptomatic. Cervical infection may present with pain or bleeding during intercourse or a change in vaginal discharge.  Symptoms of chlamydial infection of the bladder and urethra can mimic a urinary tract infection.  Similar to women, men do not usually have symptoms.  If symptomatic, they may present with a discharge from the penis or pain during urination or ejaculation.

Diagnosis
Prenatal diagnosis and treatment of Chlamydia is extremely important. Women with untreated Chlamydia can develop postpartum fever and uterine infection.  Forty percent of babies born to mothers with untreated Chlamydia will develop eye infections.  Worldwide, Chlamydia conjunctivitis is a leading cause of preventable blindness.

The majority of cases are diagnosed during routine gynecologic exams and pregnancy screening.  At the time, physicians may note a discharge from the cervix.  Because Chlamydia does not grow in routine culture, standard diagnostic tests use nucleic acid amplification to detect the proteins that make up the bacteria.

Treatment
The CDC recommends immediate treatment of Chlamydia and encourages expedited treatment of known partners.  The most commonly prescribed antibiotics are macrolides, tetracyclines, and fluoroquinolones.  Because Chlamydia often accompanies a gonorrheal infection, patients diagnosed with gonorrhea are often treated for both.  For those in a relationship, both partners should complete treatment and wait approximately 1-2 weeks after their last dose to have sex to avoid re-infection.  Couples can also use condoms to prevent re-infection.  Condoms are the only reliable method for prevention of Chlamydia transmission.

Effects of Untreated Chlamydia
Due to the absence of symptoms, many women are unaware of current or past chlamydial infection.  Untreated Chlamydia can have devastating effects on the reproductive organs.  Although it initially infects the cervix, Chlamydia can migrate upward into the uterus and fallopian tubes. Upper genital tract infection can lead to infertility, pelvic inflammatory disease, and chronic pelvic pain. 

Women concerned they have been infected with Chlamydia or another sexually transmitted disease can be tested at their physician’s office, the state health department or a non-profit clinic such as Planned Parenthood of America.  MUSC Women’s Health offers a specialty clinic for STI testing and treatment of women and their partners.

by:  Gweneth Lazenby, M.D.

Dr. Jennifer Young sounded off on the HPV vaccine in the November issue of skirt! magazine.  Read more. 

Watch The Savage Report on Comcast 2 today and tomorrow as they explore the flu shot controversy-- giving you both sides of the debate.  Dr. David Soper will be on to discuss swine flu and the risks to pregnant women, plus a discussion of vaccinating pregnant women, possible risks, what pregnant women should do, etc.

Dr. Gweneth Lazenby spoke with Live 5 News about H1N1 and what MUSC has done to get the word out to the medical community and general public:  http://www.live5news.com/global/story.asp?s=10821827

Reports of cases of swine flu have been noted in the United States since March, 2009.  Now the number of cases is increasing and sites include many states.  It is important for pregnant women to understand the signs and symptoms of swine flu and to present promptly to their health care provider if such symptoms begin.  In addition, pregnant women exposed to a person with swine flu may be candidates for a preventative prescription of an antiviral medicine active against swine flu.

Symptoms of swine flu are the same as symptoms of regular flu and include; fever, cough, sore throat, body aches, headache, chills and fatigue.  Some women may develop diarrhea and vomiting.  Early diagnosis and treatment can help prevent progression to a severe illness such as pneumonia.

Pregnant women are considered at high risk for complications resulting from flu.  For this reason, if you live in an area in which swine flu cases have been reported and you develop the above symptoms, you should contact your health care provider.  In addition, if you have come in contact with an individual who has been diagnosed with swine flu, you should also be evaluated even if you don’t have symptoms.

Antiviral medicines, both Tamiflu and Relenza, can be used in pregnancy.  They are clearly indicated for swine flu infections complicating pregnancy and in some cases may be prescribed to prevent an exposed pregnant woman from coming down with flu symptoms.  The medications are most effective if started within the first 48 hours of symptom onset.

Many pregnant women take care of children.  The flu is contagious for about 7 days after symptoms develop.  Transmission of the virus occurs from person to person.  Coughing and sneezing spreads the flu in respiratory droplets.  Touching a contaminated object or shaking hands with an individual with flu virus on his/her hands and then touching one’s nose, eyes or mouth can lead to infection.  Adults and children should be encouraged to cover their mouth when they cough and to refrain from touching their eyes, nose and mouth.   They should be kept home from daycare or school if they are sick.

Measures to prevent infection include frequent hand washing with soap and water or using a hand sanitizer.  Cough or sneeze into a tissue.  Stay at least six feet away from sick persons.

Stay aware of the current epidemic by following the reports on television and practice the simple preventative measures.  If you do develop flu-like symptoms, early treatment can shorten the length of time you are sick and make your symptoms less severe.

by:  David Soper, M.D.

To learn more about the swine flu, listen to a podcast and watch a video by Dr. Michael Schmidt, PhD, Professor of Infectious Diseases.

Request an appointment with a MUSC provider

FREE talk
April 1, 2009
9:15 a.m.
Citadel Mall
Dillard's common area

Margaret Villers, M.D., MUSC OB/GYN, will address what every woman should know about HPV and the HPV vaccine. 

For those interested in HPV and other women's health topics, this is a great opportunity to get information from a highly skilled physician.  These talks will be given on the first Wednesday of every month.  No registration required.

Beginning February 23rd, MUSC Women’s Health will offer a specialty clinic for sexually transmitted infections (STI’s). The goal of the clinic is to offer screening, treatment, and counseling regarding STI’s.  We welcome women to bring their partners.

In celebration of these new services, Women Speak will be introducing a blog series about sexually transmitted infections.  Each installment will discuss a common STI, symptoms, diagnosis, treatment, pregnancy complications, long-term consequences, and prevention.  In this inaugural installment of the “The Lowdown on STD’s,” I will discuss Trichomonas.

Trichomonas vaginalis is the second most common STI in the United States with 3-4 million cases diagnosed each year.  Unfortunately, women of color are disproportionately represented.  The rates of Trichomonas in African American women seeking STI screening have been recorded as high as 13%.  In comparison to other STI’s, which are more common among adolescents, Trichomonas is frequently diagnosed in older women. 

Trichomonas is unique among sexually transmitted infections because it is not a virus or bacteria.  T. vaginalis is a single-celled protozoa that swims using a flagellated tail.  It is large enough to be seen using a low-power microscope.  (See picture)
 
In women, Trichomonas is a common cause of vaginal discharge and vulvar symptoms.  Men infected with Trichomonas most commonly have painful urination. Like other sexually transmitted infections, Trichomonas enters a woman’s body during sexual contact with an infected partner. It can live in both the vagina and around the opening of the bladder or urethra. 

Not all women who are infected by Trichomonas have symptoms.  For those that do, the most common is a foul-smelling vaginal discharge.  Other symptoms include: painful urination, vaginal and vulvar itching, and spotting after intercourse or between periods. If you are concerned about infection or have any of these symptoms, you should consult your physician.

Trichomonas can be diagnosed by your doctor.  A pelvic exam is required in which specimens are collected for microscopic examination or culture.  Most results are available in 1-5 days. It is treated with antibiotics, which should be taken by both partners.  Patients cannot drink alcohol within 48 hours of taking these medications.  If your partner is unable to receive treatment, it is necessary to use condoms to avoid re-infection.

During pregnancy, infection with Trichomonas has been associated with preterm labor and low birth weight.  Treatment of symptomatic women during pregnancy is recommended.  Untreated infection can lead to long-term consequences.  Women infected with Trichomonas are at an increased risk of acquiring HIV, the virus that causes AIDS.  Trichomonas can also increase the risk of infection with other common STI’s.  If Trichomonas is present during or shortly after gynecologic surgery, women can develop abscesses that require a longer period of therapy.  Screening and treatment are imperative to avoid these complications.

Trichomonas infection can be avoided by consistent use of condoms.  Latex condoms are the only form of birth control that prevents STI’s.  If you have any questions regarding Trichomonas or STI’s, please feel free to send questions via the comment function or attend our specialty clinics at MUSC Women’s Health.

by:  Gweneth Lazenby, M.D.

Request an appointment with a MUSC provider.

Urinary tract infections are one the most common reasons for doctor visits.  The urinary tract consists of the urethra, bladder, and kidneys.  UTI’s are more common in women, because the urethra is short and close to the vagina and rectum.  During her lifetime, a woman has a 6/10 risk of developing at least one urinary tract infection.  Given that UTI’s are so common, it is important to know the signs and symptoms, associated risk factors, and prevention and treatment measures.   
 
The most common symptoms of a bladder infection include pain during urination and increased frequency.  Less often, you may experience increased urge to urinate but make less urine, bad smelling urine, abdominal pain, and bloody urine.  If neglected, bladder infections can spread to the kidneys, which is a more serious infection.  Signs of kidney infection include back pain, fever, chills, and nausea.  These infections need immediate attention, especially if you are pregnant. 

Urinary tract infections should be treated with antibiotics.  Over the counter medications, such as pyridium, are for pain relief only and do not treat the infection.  If you are experiencing symptoms of a urinary tract infection, call your physician’s office.  Because 90% of bladder infections are caused by E. coli, your physician may call in an antibiotic prescription without a visit.  However, to determine the bacteria causing the infection and it’s susceptibility to antibiotics, a urine specimen must be sent to a lab.  Bacteria can become resistant to antibiotics, so it is important to call your physician if the symptoms are not resolving.

Treatment is half the battle, but understanding your risks for infection is key to avoiding UTI’s.  Factors associated with bladder infections are frequent sexual activity, diaphragm and spermicide use, incomplete bladder emptying, and poor hygiene.  Some medical conditions associated with bladder infections include pregnancy, diabetes, sickle cell trait, and kidney stones.  Postmenopausal women may experience more frequent UTI’s due to low estrogen levels.

In order to prevent a urinary tract infection, consider the following tips:

- Drink at least eight 8oz glasses of water a day
- Drink cranberry juice when you suspect a UTI to increase the acidity of your urine
- Go to the bathroom frequently and don’t hold your urine for long periods
- Urinate before and after sex
- Wipe from front to back

by:  Gweneth Lazenby, M.D.

Request an appointment with a MUSC provider.