WHAT ARE THE DIFFERENT KINDS OF SEXUALLY

TRANSMITTED DISEASES (STDs)? DISCUSS BRIEFLY.

Sexually transmitted diseases (STDs) are infections that pass from one person to
another through sexual contact. They are also known as sexually transmitted
infections (STIs) or venereal diseases (VD). Some STDs can spread through the
use of unsterilized drug needles, from mother to infant during childbirth or breast-
feeding, and blood transfusions. The genital areas are generally moist and warm
environments, ideal for the growth of yeasts, viruses, and bacteria.

People can transmit microorganisms that inhabit the skin or mucous membranes
of the genitals. Infectious organisms can also move between people in semen,
vaginal secretions, or blood during sexual intercourse. Individuals pass on STDs
more easily when they are not using contraceptive devices, such as condoms,
dams, and sanitizing sex toys.

The most common types of STDs include chlamydia, genital warts, genital
herpes, gonorrhoea, (among the treatable ones), but also hepatitis B&C, syphilis
and HIV(among the incurable and/or very severe ones).There are also various
other STD infections of the urinary tract and the genitals which can cause
annoying symptoms but are easy to cure. The sooner your infection is diagnosed,
the better are your chances of getting it treated and cured.

Common Types of Sexually Transmitted Diseases

1. Chlamydia

Chlamydia is an STD caused by Chlamydia trachomatis (C. trachomatis). This

bacterium only infects humans. Chlamydia is the most common infectious
cause of genital and eye diseases globally. It is also the most common
bacterial STD. It’s spread through oral, anal, and vaginal sex. Both men and
women can develop this common type of infection.

Symptoms of Chlamydia in women and men

Women with chlamydia do not usually show symptoms. Chlamydia microbes

can infect the urethra and cause a urinary tract infection (UTI), which can
noticeable itself in pain during urination (most commonly a 'burning'
sensation), as well as sudden, desperate urges to urinate. If a chlamydia
infection is left untreated, it may spread from the cervix to the fallopian tubes.

Any symptoms are usually non-specific and may include: bladder infection, a
change in vaginal discharge, and mild lower abdominal pain. If a person does
not receive treatment for chlamydia, it may lead to the following symptoms:
pelvic pain, painful sexual intercourse, either intermittently or every time, and
bleeding between periods.

Men with chlamydial urethritis may not show symptoms at all, or they may only
start to show symptoms several weeks after exposure to the bacteria.
Symptoms of chlamydia and the related inflammation of the urethra usually
occur between one and three weeks after exposure to the bacteria.

The signs of infection include: pain or burning during urination, itching,

redness, or swelling of the head of the penis or urethral opening, discharge
from the penis, which is usually yellowish or beige, and painful, swollen
testicles. The urethra becomes inflamed during infection, making urinating
more difficult. Discomfort in the penis is generally limited to the tip, where the
urethra ends.

Causes

Unprotected sex with an infected person is the cause of chlamydia. Chlamydia

may be transmitted by unprotected oral, anal, or vaginal sex with a person.
Genital contact can also pass on chlamydia. As chlamydial infection presents
no symptoms in at least 70 percent of carriers, an infected person may pass it
on to their sexual partner without knowing.Chlamydia cannot be transmitted
through:

 contact with a toilet seat that has been used by an infected person

 sharing a sauna with infected people

 sharing a swimming pool with infected people

 touching a surface that an infected person had previously touched

or coughed/sneezed on

 standing close to an infected person, inhaling the air after they have
coughed or sneezed

 sharing an office with an infected colleague

 an infected mother can pass the infection on to her baby during

childbirth. Sometimes, the infection leads to complications for the
infant, such as pneumonia. If a mother has a chlamydia infection
during pregnancy, she will require a test 3 to 4 weeks after
treatment to ensure the infection has not returned.

Diagnosis
 Diagnosing chlamydia may include a physical exam to look for the presence of
physical symptoms such as discharge, and will also include either a swab
sample from the penis, cervix, urethra, throat, or rectum, or a urine sample.
Women can go through the procedure at home or in the lab, either with a urine
sample or by taking a swab from the lower vagina. The swab is placed in a
container and sent to a laboratory. For men, a urine test is most commonly
used.

Treatment

Treatment of chlamydia is very important because, if left untreated, it can

cause long-term health consequences, including infertility and ectopic
pregnancy.

Antibiotics are effective in treating chlamydia if the patient follows the doctor's
instructions. In most cases, they will be in pill form. Repeat testing 3 to 4
months after treatment may be recommended, depending on risk factors.
Treatments for chlamydia may include:

 Azithromycin: The patient receives just one dose.

 Doxycycline: The patient usually takes the pills for 1 week. It is important
that the course is completed to ensure the infection does not return.

Some patients, such as pregnant women, may be given alternative antibiotics.

Doxycycline or tetracycline may affect the development of the baby's bones
and teeth. Azithromycin has been shown to be safe and effective. The
following antibiotics are alternatives recommended by the CDC are
erythromycin, levofloxacin, and ofloxacin.

Some people might experience side effects after taking antibiotics, including
diarrhea, stomach pain, gastrointestinal issues, and nausea.In most cases,
the side effects will be mild. Patients taking doxycycline might have a skin
rash if they are exposed to sunlight. If the chlamydia is not treated,
approximately 10 to 15 percent of women will develop pelvic inflammatory
disease (PID). Treatment of men is equally as important. If it is left untreated,
chlamydia can lead to epididymitis and reactive arthritis.

2. Gonorrhea

Gonorrhea is a very common sexually transmitted infection, especially for

teens and people in their 20s. Gonorrhea is sometimes called “the clap” or
“the drip.” bacterial infection that is transmitted by sexual contact. Gonorrhea
is one of the oldest known sexually transmitted diseases (STDs), and it is
caused by the Neisseria gonorrhoeae bacteria.

Gonorrhea is spread through vaginal, anal, and oral sex. The infection is
carried in semen (cum), pre-cum, and vaginal fluids. Gonorrhea can infect
your penis, vagina, cervix, anus, urethra, throat, and eyes (but that’s rare).
Most people with gonorrhea don’t have any symptoms and feel totally fine, so
they might not even know they’re infected.

Gonorrhea symptoms in women and men

In women, gonorrhea symptoms are usually undetectable, extremely mild or

often confused for other conditions. If left untreated, gonorrhea can spread
into the uterus or Fallopian tubes, causing pelvic inflammatory disease (PID).
PID might lead to infertility and an increased risk of ectopic (or tubal)
pregnancy. Consider gonorrhea testing as part of your routine STD testing,
especially if you are pregnant or at risk of contracting an STD.

About 50 percent of men with gonorrhea do not experience any symptoms at

all. If symptoms do present themselves, it is often in the form of painful
urination or a yellow or green tinted white discharge from the penis. Less
common symptoms include itching or burning around the urethra. Other
symptoms are often mild and unnoticeable. An untreated gonorrhea infection
can lead to serious complications like intense testicular or scrotal pain
(epididymitis).

Causes

People usually get gonorrhea from having unprotected sex with someone who
has the infection. Gonorrhea is spread when semen (cum), pre-cum, and
vaginal fluids get on or inside your genitals, anus, or mouth. Gonorrhea can be
passed even if the penis doesn’t go all the way in the vagina or anus.

The main ways people get gonorrhea are from having vaginal sex, anal sex,
or oral sex. You can also get gonorrhea by touching your eye if you have
infected fluids on your hand. Gonorrhea can also be spread to a baby during
birth if the mother has it.

Gonorrhea isn’t spread through casual contact, so you can’t get it from sharing
food or drinks, kissing, hugging, holding hands, coughing, sneezing, or sitting
on toilet seats. Many people with gonorrhea don’t have any symptoms, but
they can still spread the infection to others. So using condoms and/or dental
dams every time you have sex is the best way to help prevent gonorrhea —
even if you and your partner seem totally healthy.
 Diagnosis

To determine whether the gonorrhea bacterium is present in your body, your

doctor will analyze a sample of cells. Samples can be collected by:

 Urine test. This may help identify bacteria in your urethra.

 Swab of affected area. A swab of your throat, urethra, vagina or
rectum may collect bacteria that can be identified in a laboratory.
For women, home test kits are available for gonorrhea. Home test kits
include vaginal swabs for self-testing that are sent to a specified lab for
testing.

Treatment

One dose of azithromycin or doxycycline may be enough. If the infection is

severe, you might need to take antibiotics for a week or more. Your doctor will
likely closely monitor your health during this time. Combining oral azithromycin
with either oral gemifloxacin (Factive) or injectable gentamicin may be helpful
if you’re allergic to ceftriaxone. That medication is in a class of drugs known
as cephalosporin antibiotics.

Never share your medication. Also, be sure to tell your doctor about any drug
allergies you have, especially to antibiotics. Ask him about possible side
effects and what to do if you experience any negative ones.

After treatment, You and your partner should wait at least 7 days after you
both finish treatment to resume sexual activity. Your doctor may advise you to
follow up for testing to make sure the infection is completely gone.

3. Genital Warts

Genital warts are soft growths that appear on the genitals. They’re a sexually
transmitted infection (STI) caused by certain strains of the human
papillomavirus (HPV). Genital warts can cause pain, discomfort, and itching.

HPV can be a tricky STD to understand. It’s the most common STD, but most
of the time it goes away on its own. Sometimes certain types of “high-risk”
HPV can develop into cancer if left untreated. Other “low-risk” types of HPV
can cause warts on your vulva, vagina, cervix, rectum, anus, penis or
scrotum.
Genital Warts symptoms in women and men

In women, genital warts can grow on the vulva, the walls of the vagina, the
area between the external genitals and the anus, the anal canal, and the
cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or
the anus. Genital warts can also develop in the mouth or throat of a person
who has had oral sexual contact with an infected person. The signs and
symptoms of genital warts include:

 Small, flesh-colored or gray swellings in your genital area

 Several warts close together that take on a cauliflower-like shape
 Itching or discomfort in your genital area
 Bleeding with intercourse
Genital warts may be so small and flat that they can't be seen with the naked
eye. Sometimes, however, genital warts may multiply into large clusters.

Causes

You get genital warts from having skin-to-skin contact with someone who’s
infected, often during vaginal, anal, and oral sex. Genital warts can be spread
even if no one cums, and a penis doesn’t have to go inside a vagina or anus
to get them. You can spread them even when you don’t have any visible warts
or other symptoms, though that’s less common. You can also pass genital
warts to a baby during vaginal childbirth, but that’s pretty rare.

Diagnosis

To diagnose this condition, your doctor will ask questions about your health
and sexual history. This includes symptoms you’ve experienced and any times
you’ve engaged in unprotected sex, including oral sex. The doctor will also
perform a physical examination of any areas where you suspect warts may be
occurring. Since warts can occur deep inside a woman’s body, your doctor
may need to do a pelvic examination. They may apply a mild acidic solution,
which helps to make the warts more visible.

The doctor may also do a Pap smear, which involves taking a swab of the
area to obtain cells from your cervix. These cells can then be tested for the
presence of HPV. Certain types of HPV may cause abnormal results on a Pap
smear, which may indicate precancerous changes. If your doctor detects
these abnormalities, you may need more frequent screenings to monitor any
changes.
 If you’re a woman and concerned that you may have contracted a form of
HPV known to cause cervical cancer, your doctor can perform a DNA test.
This determines what strain of HPV you have in your system. An HPV test for
men is not yet available.

Treatment

While visible genital warts often go away with time, HPV itself can linger in
your bloodstream. This means you may have several outbreaks over the
course of your life. This makes managing symptoms important because you
want to avoid transmitting the virus to others. That said, genital warts can be
passed on to others even when there are no visible warts or other symptoms.

You may wish to treat genital warts to relieve painful symptoms or to minimize
their appearance. However, you cannot treat genital warts with over-the-
counter (OTC) wart removers or treatments. Your doctor may prescribe topical
wart treatments that might include: imiquimod (Aldara), podophyllin and
podofilox (Condylox), and trichloroacetic acid (TCA)

If visible warts don’t go away with time, you may need minor surgery to
remove them. Your doctor can also remove the warts through electrocautery, or
burning warts with electric currents, cryosurgery, or freezing warts, laser
treatments, excision, or cutting off warts, and injections of the drug interferon

4. Genital Herpes

Herpes is the most common sexually transmitted virus.It's highly contagious and
incurable, but with education and medical treatment, you can reduce or prevent
outbreaks and transmission to your sexual partner.
Genital herpes can cause serious or fatal infections in newborns if the mother is
shedding the virus at the time of vaginal delivery. The virus also makes it easier
for a person to transmit and get HIV and other sexually transmitted diseases.

Genital Herpes symptoms in women and men

Early symptoms and signs of genital herpes tend to develop within 3 to 7 days
of skin-to-skin contact with an infected person. This 3 to 7 day period is known
as the incubation period. Genital herpes infections look like a rash composed
of small blisters or ulcers (round areas of broken skin) on the genitals. Each
blister or ulcer is typically only 1 to 3 millimeters (1/32 inch to 1/8th inch) in
size, and the blisters or ulcers tend to be grouped into "crops." Usually the
blisters form first, then soon open to form ulcers. Herpes infections may be
painless or slightly tender. In some people, however, the blisters or ulcers can
be very tender and painful.

In men, genital herpes sores (lesions) usually appear on or around the penis.
In women, the lesions may be visible outside the vagina, but they commonly
occur inside the vagina where they can cause discomfort or vaginal discharge
and may not be seen except during a doctor's examination. The ulcers or
blisters may also be found anywhere around the genitals (the perineum) and
in and around the anus.

The first genital herpes outbreak is usually the most painful, and the initial
episode may last longer than later outbreaks. Symptoms may last for 2 to 4
weeks. Some people develop other signs of genital herpes infection,
particularly with the first episode, including: fever, muscle aches,
headaches (may be severe), vaginal discharge or painful urination, and
swollen and tender lymph nodes in the groin (these swell as the body tries to
fight the infection).

If the disease returns, later outbreaks generally have much less severe
symptoms. Many people with recurrent disease develop pain or a tingling
sensation in the area of the infection even before any blisters or ulcers can be
seen. This is due to irritation and inflammation of the nerves leading to the
infected area of skin. These are early signs that an outbreak is about to begin.
The condition is particularly contagious during this period, even though the
skin still appears normal.

Causes

A virus called herpes simplex virus (HSV) causes herpes. There are two strains
of the virus. HSV-2 is the most common cause of genital herpes. HSV-1, which
causes the cold sores or fever blisters many people get on their lips, can
also cause genital herpes.
The virus can be spread through both vaginal and anal intercourse as well as by
oral sex. The virus is spread most easily by coming into contact with a herpes
ulcer. However, the virus can also be spread from an infected person who does
not have any signs or symptoms of infection; this is referred to as asymptomatic
shedding.

Diagnosis

Genital herpes frequently has no symptoms, so you can be infected and

contagious without knowing it. When symptoms do occur, they can easily be
mistaken for something else. Without adequate testing you may be told you
are infected with genital herpes and not be, or the other way around. If you
 have sores on your genitals, your health care provider can perform tests to
determine if you have genital herpes. Tests are also used to diagnose or
screen for genital herpes include:

 PCR blood test: The PCR blood test can tell if you have genital herpes
even if you don't have symptoms. The PCR test looks for pieces of the
virus's DNA. This is the most common test used to diagnose genital
herpes and is very accurate.
 Cell culture: During the exam, your health care provider can take a
sample of cells from a sore and look for the herpes simplex virus (HSV)
under a microscope.

Treatment

There's no cure for genital herpes, but antiviral treatment can help. Your doctor
might prescribe: Zovirax, Famvir, and Valtrex.
All of these antivirals can be used to shorten or prevent outbreaks. Daily
suppressive therapy can reduce the number of outbreaks and potential spread to
partners when ulcers are not apparent (called asymptomatic shedding). The
newer drugs, Famvir and Valtrex, can be taken less frequently and may be better
absorbed and better tolerated in some. During an active herpes episode, you
should take steps to speed healing and to keep from infecting others:

 Keep the affected area clean and dry. This helps keep other infections
away.
 Don't touch herpes sores. If you do, wash hands thoroughly.

Avoid sexual contact from the first sign of symptoms until the sores are
completely gone. This is when the scab has fallen off and new skincovers the
place where there were blisters. But remember that you can still infect someone
even if you don't have any symptoms or sores.
5. Syphillis

Syphilis is a highly contagious disease spread primarily by sexual activity,

including oral and anal sex. Occasionally, the disease can be passed to another
person through prolonged kissing or close bodily contact. Although this disease is
spread from sores, the vast majority of those sores go unrecognized. The
infected person is often unaware of the disease and unknowingly passes it on to
his or her sexual partner. Syphilis causes sores on your genitals (called
chancres). The sores are usually painless, but they can easily spread the
infection to other people. Syphilis cannot be spread by toilet seats, door
knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils.
Syphillis stages in women and men

There are four stages of syphilis. The stages of syphilis are called “primary,”
“secondary,” “latent,” and “tertiary (late).”

Primary Syphilis
Symptoms for the first stage normally appear 10 days to 3 months
after you’re exposed to syphilis. You might notice that the lymph
nodes near your groin are enlarged. Typically, the first visible sign of
syphilis is a small, painless sore (doctors call it a “chancre”) on the skin
(you may develop several sores). It normally appears at the spot where
the bacteria entered your body. The sore won’t hurt, and it may be
hidden inside your rectum or vagina. You might not even know you
have it.
The sore will heal on its own in about 3 to 6 weeks. But this doesn’t
mean the infection is gone. It means you’re about to enter the second
stage of syphilis.

Secondary Syphilis
About 2 to 10 weeks after the first sore appears, you may develop
the following: A skin rash that causes small, reddish-brown sores, sores
in your mouth, vagina, or anus, fever, swollen glands, weight loss, hair
loss, headache, extreme tiredness (fatigue), and muscle ache.
If you don’t get treatment right away, your symptoms will go away
only to come back. This could happen for up to a year. Even if your
symptoms don’t return, the infection is still alive in your body. Syphilis
will get worse, and you can still infect your sexual partner.

Latent Syphilis
If you’re not treated for secondary syphilis, the disease may
progress to the latent (hidden) phase. Not everyone who has syphilis
will go through this stage. If you do, you won’t have any symptoms,
maybe for years. In some cases, symptoms will never return. But the
infection isn’t gone, it’s simply progressing to the tertiary stage.

Tertiary Syphilis
This is the final, most severe stage of syphilis. It can appear 10 to 30
years after the initial infection. You might experience permanent organ
damage and death. Complications may include: neurological problems,
stroke, infection and inflammation of membranes around the brain and
spinal cord, numbness, deafness, visual problems or blindness,
 personality changes, dementia, heart valve disease, aneurysm, and
inflammation of blood vessels.

Causes

The cause of syphilis is a bacterium called Treponema pallidum. The most

common route of transmission is through contact with an infected person's
sore during sexual activity. The bacteria enter your body through minor cuts
or abrasions in your skin or mucous membranes. Syphilis is contagious
during its primary and secondary stages, and sometimes in the early latent
period.

Less commonly, syphilis may spread through direct unprotected close contact
with an active lesion (such as during kissing) or through an infected mother to
her baby during pregnancy or childbirth (congenital syphilis). Once cured,
syphilis doesn't recur on its own. However, you can become reinfected if you
have contact with someone's syphilis sore.

Diagnosis

Only your doctor can know for sure whether you have syphilis. He’ll give you
a physical exam, check your genitals, and look for skin rashes or sores called
chancres. You’ll also have a blood test. Results typically come back within a few
days. Syphilis can be diagnosed by testing samples of:

 Blood. Blood tests can confirm the presence of antibodies that the
body produces to fight infection. The antibodies to the bacteria that
cause syphilis remain in your body for years, so the test can be
used to determine a current or past infection.

 Cerebral spinal fluid. If it's suspected that you have nervous

system complications of syphilis, your doctor may also suggest
collecting a sample of cerebrospinal fluid through a procedure
called a lumbar puncture (spinal tap).

Treatment

Primary and secondary syphilis are easy to treat with a penicillin

injection. Penicillin is one of the most widely used antibiotics and is usually
effective in treating syphilis. People who are allergic to penicillin will likely be
treated with a different antibiotic, such as: doxycycline, azithromycin, and
ceftriaxone.
 If you have neurosyphilis, you’ll get daily doses of penicillin intravenously.
This will often require a brief hospital stay. Unfortunately, the damage caused
by late syphilis can’t be reversed. The bacteria can be killed, but treatment
will most likely focus on easing pain and discomfort.

During treatment, make sure to avoid sexual contact until all sores on your
body are healed and your doctor tells you it’s safe to resume sex. If you’re
sexually active, your partner should be treated as well. Don’t resume sexual
activity until you and your partner have completed treatment.

6. Hepatitis B

As for hepatitis B, it is a virus that attacks the liver (like hepatitis C) and is
passed through sexual contact and blood (e.g. via needles). The symptoms of
hepatitis B start with a short acute infection to which everyone responds
differently: a few will develop chronic hepatitis B and others will develop liver
severe dysfunction.

Note that hepatitis A and C can also be passed on through sexual activity but
it remains quite rare, so we won’t include them in this list of STDs. If you have
had unprotected sex you may need to go to a clinic and get tested for
hepatitis.

Hepatitis B symptoms in women and men

Signs and symptoms of hepatitis B range from mild to severe. They usually
appear about one to four months after you've been infected, although you
could see them as early as two weeks post-infection. Some people, usually
young children, may not have any symptoms. Hepatitis B signs and symptoms
may include: abdominal pain, dark urine, fever, joint pain, loss of appetite,
nausea and vomiting, weakness and fatigue, yellowing of your skin and the
whites of your eyes.

Causes

Hepatitis B infection is caused by the hepatitis B virus (HBV). The virus is

passed from person to person through blood, semen or other body fluids. It
does not spread by sneezing or coughing. Common ways that HBV can
spread are:

 Sexual contact. You may get hepatitis B if you have unprotected sex
with someone who is infected. The virus can pass to you if the person's
blood, saliva, semen or vaginal secretions enter your body.
  Sharing of needles. HBV easily spreads through needles and syringes
contaminated with infected blood. Sharing IV drug paraphernalia puts
you at high risk of hepatitis B.
 Accidental needle sticks. Hepatitis B is a concern for health care
workers and anyone else who comes in contact with human blood.
 Mother to child. Pregnant women infected with HBV can pass the virus
to their babies during childbirth. However, the newborn can be
vaccinated to avoid getting infected in almost all cases. Talk to your
doctor about being tested for hepatitis B if you are pregnant or want to
become pregnant.
Diagnosis

The doctor will examine you and look for signs of liver damage, such as
yellowing skin or belly pain. Tests that can help diagnose hepatitis B or its
complications are:

 Blood tests. Blood tests can detect signs of the hepatitis B virus in
your body and tell your doctor whether it's acute or chronic. A simple
blood test can also determine if you're immune to the condition.

 Liver ultrasound. A special ultrasound called transient elastography

can show the amount of liver damage.

 Liver biopsy. Your doctor might remove a small sample of your liver
for testing (liver biopsy) to check for liver damage. During this test, your
doctor inserts a thin needle through your skin and into your liver and
removes a tissue sample for laboratory analysis.

Treatment

Treatment to prevent hepatitis B infection after exposure

If you know you've been exposed to the hepatitis B virus and aren't sure if
you've been vaccinated, call your doctor immediately. An injection of
immunoglobulin (an antibody) given within 12 hours of exposure to the virus
may help protect you from getting sick with hepatitis B. Because this
treatment only provides short-term protection, you also should get the
hepatitis B vaccine at the same time, if you never received it.

Treatment for acute hepatitis B infection

 If your doctor determines your hepatitis B infection is acute — meaning it is
short-lived and will go away on its own — you may not need treatment.
Instead, your doctor might recommend rest, proper nutrition and plenty of
fluids while your body fights the infection. In severe cases, antiviral drugs or a
hospital stay is needed to prevent complications.

Treatment for chronic hepatitis B infection

Most people diagnosed with chronic hepatitis B infection need treatment for
the rest of their lives. Treatment helps reduce the risk of liver disease and
prevents you from passing the infection to others. Treatment for chronic
hepatitis B may include:

 Antiviral medications. Several antiviral medications — including

entecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir
(Hepsera) and telbivudine (Tyzeka) — can help fight the virus and slow
its ability to damage your liver. These drugs are taken by mouth. Talk to
your doctor about which medication might be right for you.
 Interferon injections. Interferon alfa-2b (Intron A) is a man-made
version of a substance produced by the body to fight infection. It's used
mainly for young people with hepatitis B who wish to avoid long-term
treatment or women who might want to get pregnant within a few years,
after completing a finite course of therapy.
 Liver transplant. If your liver has been severely damaged, a liver
transplant may be an option. During a liver transplant, the surgeon
removes your damaged liver and replaces it with a healthy liver.

7. HIV (Human Immunodeficiency Virus)

It’s a virus that breaks down certain cells in your immune system (your body’s
defense against diseases that helps you stay healthy). When HIV damages
your immune system, it’s easier to get really sick and even die from infections
that your body could normally fight off.

Once you have HIV, the virus stays in your body for life. There’s no cure for
HIV, but medication can help you stay healthy longer and lower your chances
of spreading the virus to other people. People who have HIV and don’t get
treatment almost always die from the virus. But with medication, people with
HIV can be healthy and live a long time.
HIV and AIDS

HIV is the virus that causes AIDS. AIDS stands for Acquired Immune
Deficiency Syndrome. HIV and AIDS are not the same thing. And people with
HIV do not always have AIDS.

HIV is the virus that’s passed from person to person. Over time, HIV destroys
an important kind of the cell in your immune system (called CD4 cells or T
cells) that helps protect you from infections. When you don’t have enough of
these CD4 cells, your body can’t fight off infections the way it normally can.

AIDS is the disease caused by the damage that HIV does to your immune
system. You have AIDS when you get dangerous infections or have a super
low number of CD4 cells. AIDS is the most serious stage of HIV, and it leads
to death over time.

Without treatment, it usually takes about 10 years for someone with HIV to
develop AIDS. Treatment slows down the damage the virus causes and can
help people stay healthy for several decades.

HIV symptoms for women and men

The symptoms of HIV are mostly the same for men and women. But they can
vary from person to person.

In the early stages, about 2 to 4 weeks after you’re infected, you may feel like
you have the flu. It’s a sign that your body is responding to the virus. These
symptoms may last for a few weeks. Symptoms of a new HIV infection
include: chills, fatigue, fever, genital sores, mouth sores, muscle aches, night
sweats, rash, sore throat, and swollen lymph nodes.

Some people have no symptoms of early HIV infection. Either way, if you feel
you might have been infected with HIV, you should get tested. Another
reason to get tested for HIV early is that you may be contagious to others
during this time. Knowing that you are infected with HIV will be important for
your own health and will also enable you to inform your partner(s) that they
should get tested for HIV.

While men and women generally have similar warning signs, there are a few
that affect only women:

 Changes in your period. You may have lighter or heavier bleeding,

skip periods, or have really bad PMS. Stress or other STDs, which are
common with HIV, can cause these issues. But they may also happen
because of the virus's effects on your immune system, which may
affect your hormones.
  Lower belly pain. It’s one of the signs of an infection of the uterus,
ovaries, and fallopian tubes, called pelvic inflammatory disease (PID).
For some women, it’s one of the first red flags they have HIV. Along
with lower belly pain, PID can cause: unusual vaginal discharge , fever,
irregular periods, pain during sex, and pain in the upper belly
 Vaginal yeast infections. Many women with HIV get these often --
several times a year. Sometimes they're the first sign you have the
virus. When you get a yeast infection, you can have: thick, white
discharge from your vagina, pain during sex, pain when you pee, and
vaginal burning or soreness

Both men and women with HIV can get a yeast infection of the mouth,
called thrush or oral candidiasis. It causes swelling and a thick, white coating
in your mouth, tongue, and throat.

Timeline of HIV

HIV typically progresses through three stages. Each stage has particular
characteristics and symptoms.

Stage 1: Acute phase

Flu-like symptoms, such as a fever, are common in the acute phase of

HIV.This stage usually occurs 2 to 4 weeks after transmission, and not
every person will notice it.

Typical symptoms are similar to flu and may include fever, sickness, and
chills. Some people do not realize they have the virus because their
symptoms are mild and they do not feel sick.

At this stage, people usually have a significant amount of virus in their

bloodstream, which means that it is easy to pass it on. If someone thinks
that they might have the virus, they should seek medical care and get
tested as soon as possible.

Stage 2: Clinical latency

This stage can last for 10 years or more if the person does not receive
treatment. It is marked by an absence of symptoms, which is why this is
phase is also known as the asymptomatic phase.
At this stage, a medication known as antiretroviral therapy (ART) can
control the virus, meaning that HIV does not progress further. It also
means that people are less likely to transmit the virus to others.

While the virus is still reproducing in the bloodstream, it may do so at

levels that are undetectable by testing. If someone has undetectable levels
of the virus for at least 6 months, they cannot pass the virus on to others
through sex. During this phase, HIV is still multiplying inside the body but
at lower levels than in the acute phase.

Stage 3: AIDS

This is the most severe stage when the amount of virus in the body has
devastated the body's population of immune cells. At this stage, the
immune system is very weakened, which allows opportunistic infections to
invade the body.

Causes

HIV is caused by a virus. It can spread through sexual contact or blood, or

from mother to child during pregnancy, childbirth or breast-feeding. To
become infected with HIV, infected blood, semen or vaginal secretions
must enter your body. This can happen in several ways:

 By having sex. You may become infected if you have vaginal, anal
or oral sex with an infected partner whose blood, semen or vaginal
secretions enter your body. The virus can enter your body through
mouth sores or small tears that sometimes develop in the rectum or
vagina during sexual activity.
 From blood transfusions. In some cases, the virus may be
transmitted through blood transfusions. American hospitals and blood
banks now screen the blood supply for HIV antibodies, so this risk is
very small.
 By sharing needles. Sharing contaminated intravenous drug
paraphernalia (needles and syringes) puts you at high risk of HIV and
other infectious diseases, such as hepatitis.
 During pregnancy or delivery or through breast-feeding. Infected
mothers can pass the virus on to their babies. HIV-positive mothers
who get treatment for the infection during pregnancy can significantly
lower the risk to their babie
Diagnosis

HIV is most commonly diagnosed by testing your blood or saliva for

antibodies to the virus. Unfortunately, it takes time for your body to develop
these antibodies — usually up to 12 weeks.

A quicker test checks for HIV antigen, a protein produced by the virus
immediately after infection. It can confirm a diagnosis soon after infection
and allow the person to take swifter steps to prevent the spread of the
virus to others.

Home testing is allowed to check HIV, at least two Food and Drug
Administration-approved home test kits for HIV are available. Depending
on which you choose, you'll need a drop of dried blood or sample of saliva.
If the test is positive, you'll need to see your doctor to confirm the
diagnosis and discuss your treatment options. If the test is negative, it
needs to be repeated in a few months to confirm the results.

Tests to stage disease and treatment

If you receive a diagnosis of HIV/AIDS, several tests can help your doctor
determine the stage of your disease and the best treatment. These tests
include:

 CD4 T cell count. CD4 T cells are white blood cells that are
specifically targeted and destroyed by HIV. Even if you have no
symptoms, HIV infection progresses to AIDS when your CD4 T cell
count dips below 200.
 Viral load (HIV RNA). This test measures the amount of virus in your
blood. A higher viral load has been linked to a worse outcome.
 Drug resistance. Some strains of HIV are resistant to medications.
This test helps your doctor determine if your specific form of the virus
has resistance and guides treatment decisions.
Tests for complications

Your doctor might also order lab tests to check for other infections or
complications, including: tuberculosis, hepatitis, toxoplasmosis, sexually
transmitted infections, liver or kidney damage, and urinary tract infection
Treatment

There's no cure for HIV/AIDS, but many different drugs are available to
control the virus. Such treatment is called antiretroviral therapy, or ART.
Each class of drug blocks the virus in different ways. ART is now
recommended for everyone, regardless of CD4 T cell counts. It's
recommended to combine three drugs from two classes to avoid creating
drug-resistant strains of HIV. The classes of anti-HIV drugs include:

 Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off

a protein needed by HIV to make copies of itself. Examples include
efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
 Nucleoside or nucleotide reverse transcriptase inhibitors
(NRTIs) are faulty versions of the building blocks that HIV needs to
make copies of itself. Examples include Abacavir (Ziagen), and the
combination drugs emtricitabine/tenofovir (Truvada), Descovy
(tenofovir alafenamide/emtricitabine), and lamivudine-zidovudine
(Combivir).
 Protease inhibitors (PIs) inactivate HIV protease, another protein
that HIV needs to make copies of itself. Examples include atazanavir
(Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and indinavir
(Crixivan).
 Entry or fusion inhibitors Tblock HIV's entry into CD4 T cells.
Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
 Integrase inhibitors work by disabling a protein called integrase,
which HIV uses to insert its genetic material into CD4 T cells.
Examples include raltegravir (Isentress) and dolutegravir (Tivicay).
When to start treatment

Everyone with HIV infection, regardless of CD4 T cell count, should be

offered antiviral medication. HIV therapy is particularly important for the
following situations:

 You have severe symptoms.

 You have an opportunistic infection.
 Your CD4 T cell count is under 350.
 You're pregnant.
 You have HIV-related kidney disease.
 You're being treated for hepatitis B or C.
 Treatment can be difficult
HIV treatment plans may involve taking several pills at specific times every
day for the rest of your life. Each medication comes with its own unique set
of side effects. It's critical to have regular follow-up appointments with your
doctor to monitor your health and treatment. Some of the treatment side
effects are: nausea, vomiting or diarrhea, heart disease, weakened bones
or bone loss, breakdown of muscle tissue (rhabdomyolysis), abnormal
cholesterol levels, higher blood sugar.

8. Pubic “Crabs” Lice

Pubic lice, also known as crabs, are very small insects that infest your
genital area. There are three types of licethat infest humans:

 pediculus humanus capitis: head lice

 pediculus humanus corporis: body lice
 phthirus pubis: pubic lice

Lice feed on human blood and cause intense itching in affected areas.
Pubic lice usually live on pubic hair and are spread through sexual contact.
In rare cases, they can be found in eyelashes, armpit hair, and facial hair.
Pubic lice are often smaller than body and head lice.

Pubic lice infestations are more common among people who have sexually
transmitted infections.

Crabs symptoms in women and men

People with pubic lice often experience itching in their genital region or
anus about five days after the initial infestation. At night, the itching will
become more intense. Other common symptoms of pubic lice include low-
grade fever, irritability, lack of energy, and pale bluish spots near the bites

Causes

Pubic lice are typically transmitted through intimate contact, including

sexual intercourse. It’s also possible to catch pubic lice by using the
blankets, towels, sheets, or clothing of people who have pubic lice.

Adult lice lay their eggs on the hair shaft, near the skin. These eggs are
called nits. Seven to 10 days later, the nits hatch into nymphs and start
feeding on your blood. The lice can live without their food supply for one to
two days.

Contrary to common belief, you’re highly unlikely to get pubic lice from a
toilet seat or furniture. Pubic lice usually don’t fall off of their host unless
they’re dead. They also can’t jump from one person to another like fleas.

Diagnosis

You can usually diagnose yourself by thoroughly examining your pubic

area. You can use a magnifying glass to look for pubic lice if you suspect
an infestation but can’t see well enough to be sure.

Lice are usually pale gray, but they can darken in color after drinking your
blood. You’re probably infested with lice if you see small, crab-shaped
insects moving in your pubic hair. Lice eggs are another indicator of
infestation. The eggs are tiny and white, and are usually found around the
roots of pubic hair or other body hair. Call your doctor if you’re showing
signs of a pubic lice infestation.

Treatment

Treatment for pubic lice consists of decontaminating yourself, your clothes,

and your bedding. Topical, over-the-counter lotions and shampoos can be
used to remove pubic lice from your body. These treatments
include permethrin lotions: RID, Nix, and A-200. Ask your doctor which
products are safe to use if you are pregnant or breastfeeding, or are
treating an infant for pubic lice.

You may only need to wash your pubic hair if your lice infestation is mild.
Read the instructions to find out exactly how much product you should use
and how long you’ll need to leave the product on your skin. Prescription
medication might also be necessary if the topical solutions don’t work.

Even after successful treatment, a few stubborn lice eggs might cling to
your hairs. Remove any leftover nits with tweezers. Home remedies, such
as shaving and hot baths, aren’t effective for treating pubic lice. Lice can
easily survive ordinary soap and water.

You might need stronger medicine if the lice survive these efforts. These
products include:
  Malathion (Ovide), a topical lotion that you leave on the affected
areas for 8 to 12 hours.
 Ivermectin (Stromectol), a two-pill dose that you take orally. You
might need a follow-up dose 10 days later.
 Lindane, the strongest and most toxic product among the
commonly prescribed pubic lice medications. You only leave it on
for four minutes before washing it off. Don’t use this product on
infants or on yourself if you’re breastfeeding or pregnant.

DIFFERENT METHODS OF CONTRACEPTIONS (BOTH NATURAL

AND ARTIFICIAL)

Women, men, or couples can choose from many contraceptive methods to help
them plan their family and prevent an unplanned pregnancy. They need to know
that if they are having sex regularly and do not use a contraceptive method, about
8 of every 10 women will become pregnant during the next 12 months.

Different people want different things from a contraceptive method. Some want a
method that guarantees there is no chance of pregnancy. Some want a quick
return to fertility so they can get pregnant soon after stopping a contraceptive
method. Some do not want to think about contraceptives every time they have
sex. Some do not want to depend on their partner for the success of the method.
Some women do not want to remember to take a daily pill, while others find that is
easy.

There are still other factors that influence method choice. Some may need
protection from STIs and will choose condoms to be used alone or in addition to
another contraceptive method. Some people want a method they can always get
easily whenever they need more. Some people prefer fertility awareness methods
because of religious beliefs, because they are worried about side effects, or do
not like other methods. Some women want a method that their partner will not
know they are using. A few may have a medical condition that could affect the
safe use of a particular method.

Before using and utilizing these methods of contraceptions, there are other
aspects that should be remembered and studied. Natural Family Planning (NFP)
is a fertility awareness that allows a couple to read and understand the body’s
signs. It’s a scientific approach that can be tailored to an individual and can be
used to both achieve and avoid pregnancy.

Natural family planning works by observing and recording your body’s different
natural signs or fertility indicators on each day of your menstrual cycle. The main
fertility indicators are:
  Mucus: monthly you can feel a wet sensation that usually lasts a few days.
A yellowish or clear discharge will appear when you wipe yourself with
toilet paper. This discharge is a sign that ovulation is near. The texture and
appearance of the mucus will change as ovulation approaches.
 Temperature: If you take your temperature every morning for a month,
you will see an abrupt elevation of your body’s temperature after a certain
point. That’s one sign that ovulation just happened.
 Cervix position: the cervix is positioned high, open and soft around the
time of ovulation and low, closed and firm otherwise. With a bit of guidance
you can learn to tell the difference on your own.
 Hormonal production: right around the time of ovulation, two key
hormones are produced: luteinizing hormone and estrogen. These can be
detected in your urine with a simple at-home test.

Natural family planning is more effective when taught by a specialist natural

family planning teacher, and when more than one fertility indicator is used. Some
people choose to combine their fertility awareness knowledge with male or female
condoms – this is sometimes known as fertility awareness combined methods.
The effectiveness of this depends on how well you use male or female condoms.

What are the advantages of natural family planning?

 Using fertility awareness makes you more aware of your fertility and can
help to plan a pregnancy or avoid a pregnancy.
 It does not involve using any chemicals or physical devices.
 There are no physical side effects.
 It can help you recognise normal and abnormal vaginal secretions.
 It can help you to communicate about your fertility and sexuality.
 It is acceptable to all faiths and cultures.

What are the disadvantages of natural family planning?

 It takes 3–6 menstrual cycles to learn effectively.
 You have to keep daily records.
 Some events, such as illness, lifestyle, stress or travel, may make fertility
indicators harder to interpret.
 You need to avoid sex or use male or female condoms during the fertile
time.
 Natural methods don’t protect you against sexually transmitted infections
(STIs).

These next methods listed below are recommended for women who have pretty
consistent cycles and are generally healthy.
Calendar-based Methods
Calendar-based methods estimate the likelihood of fertility based on the length of
past menstrual cycles. This method doesn’t rely on physical symptoms of fertility.
In this practice, it’s recommended that you chart your menstrual cycle for at least
6 months, if not 12, to become very familiar with its “rhythm” before you
implement these forms of natural birth control.

1. Rhythm Method: As a form of birth control, you apply the following formula:
To find the estimated length of the pre-ovulation infertile phase, nineteen days
(some say 18) are subtracted from the length of the woman’s shortest cycle.
To find the estimated start of the post-ovulation infertile phase, ten days
(some say 11) are subtracted from the length of the woman’s longest cycle.
As you can see, for some people this means a substantial time of abstaining
from sexual intercourse throughout a month.
Effectiveness: With perfect use and very consistent cycles, 91%. Real world
effectiveness rate: 76%.

2. Standard Days Method: In order to do The Standard Days method, you need
to have regular cycles that come every 26-32 days. You also cannot
have unprotected vaginal intercourse from day 8 through day 19 of each
cycle.
Effectiveness rate: 95%

3. Symptoms-based Method: The symptoms-based method of NFP tracks

biological signs of fertility. The three primary signs of a woman’s fertility are:
Cervical Mucus
Some systems use only cervical mucus to determine fertility. Commonly
called the Ovulation Method or Cervical Mucus Method (CMM), a woman
learns how to identify the thicker cervical mucus that accompanies
ovulation. The thicker mucus “catches” the sperm and increases the
chances of getting pregnant. While everyone’s different, the general
pattern of cervical fluid throughout a month’s time includes:

 dry or sticky
 to creamy, like lotion
 to wet and watery
 to a raw egg white consistency (most fertile time)
 back to dry and sticky
 Cervical Position
Outside of ovulation, our cervixes are relatively low and firm (think the
firmness of your nose). During ovulation and our fertility time, however, our
cervixes become higher and softer (think the softness of lips) than normal.
It’s best to practice feeling your cervix several times throughout a cycle so
you can feel how it changes.

Basal Body Temperature

In most women, our basal body temperature will go up at least four-tenths
of a degree (usually more like 1/2 a degree) for at least 3 consecutive days
after ovulation. For this marker to be effective, you need to take your
temperature at the same time,or with no more than a 30 minute difference,
each day.

Permanent Options
1. Vasectomy
A male surgical option, a vasectomy is when a doctor block the vas deferens
tubes to keep sperm out of the seminal fluid. Instead, the sperm are absorbed by
the body rather than being ejaculated. This is designed to be a permanent
solution to birth control, although there are successful attempts at reversing
effects.

However, the body continues to produce sperm after a vasectomy just as it did
before the procedure. The sperm is absorbed by the body, which may cause the
immune system to recognize the cells as foreign proteins. To fight the foreign
invaders, the body produces antibodies. This occurs in as many as 80% of men
who have a vasectomy. Immune reactions can also cause arteries to clog, which
in turn could cause a heart attack.

There are still other concerns:

 hypoglycemia
 diabetes mellitus
 skin eruptions
 itching, hives
 inflamed prostate gland, prostate cancer
 swelling
 bruising
 bleeding
 blood clot in the scrotum
 blood in the semen
 stones in the urinary tract
  thrombophlebitis
 lymph node enlargement
 inflammation
 intense sleepiness
 hormonal imbalance
 infection at the incision site or in deeper tissue
 pain
 depression, anxiety
 erectile dysfunction and/or decreased libido

2. Sterilization or Tubes Tied

A permanent birth control procedure for women is sterilization, often referred to
as “getting tubes tied” in which a healthcare provider will go in and tie and sever
the fallopian tubes. This is called tubal ligation. The fallopian tubes also can be
closed with clips, clamps, or rings. Many women who have planned c-sections
may opt for this procedure since they will be having an incision already.

Tubal ligation is the only surgical procedure that renders healthy organs
dysfunctional. It is a birth control method that requires tying, cutting, burning or
blocking the fallopian tubes to disrupt movement of the ovum to the uterus and
sperm from traveling to the ovum. While often passed off as completely safe,
tubal ligation has been associated with several significant problems:

 Tubal ligation requires the administration of anesthesia, which carries its

own set of risks.
 It is not 100% effective as pregnancy can still occur up to 5.4% of the time.
 In the long-term, there is a 5 - 25% increased risk of heavy menses.
 Increased risk of pelvic pain.
 Tubal ligation may cause depression and anxiety.
 Within 14 years of getting a tubal ligation, nearly 17% of women need a
hysterectomy.
 There can be a decrease in sexual desire.
 Women who undergo a tubal ligation may develop premature ovarian
failure, which can result in irregular or missed periods, hot flashes, night
sweats, vaginal dryness, irritability and/or difficulty concentrating.
 Post Tubal Ligation Syndrome
 Ectopic pregnancy
 Depression
Today there are many diverse methods of artificial birth control available on the
worldwide market.There are about 15 different types of contraceptives which
allow you to do sexual intercourse without the risk of getting pregnant. These birth
control methods include: condoms, the diaphragm, the contraceptive pill,
implants, IUDs (intrauterine devices), sterilization and the morning after pill.

Most types of contraceptives work by:

a) preventing an egg from being released every month (hormones)

b) preventing sperms from reaching the egg (barrier and some IUD
methods)

c) blocking the reproductive function – in men or women (sterilization)

d) preventing a fertilized egg from implanting in the uterus (hormones)

Many of these methods of contraception also lower your chance of getting an STI.
Condoms, spermicides and sponges aside, most types of contraception can only
be obtained with the help of a doctor.

In the last 50 years, the number of contraception methods has dramatically

increased. You can differentiate between different types of contraception based
on how they work: there are barrier methods (e.g. condoms or a cervical cap),
hormonal methods (e.g the pill), intrauterine devices (IUD) and sterilization.

Here are the artificial methods of contraception:

Pill

The contraceptive pill will prevent you from getting pregnant in 95% of cases and
it comes close to providing 99% protection if you take one pill every day as
prescribed.

The pill can come in two forms: the combined contraceptive pill (containing the
hormones estrogen and progestin) or the mini-pill (only progestin). In the case of
the mini-pill, it's important that you take your pill every day at the same time (you
should not be late by more than three hours).

Birth Control Pills

Success Rate with Typical Use: 91%

Pros Cons

 Very effective against pregnancy if  Doesn’t protect against STIs

used correctly  Depending on your insurance, your
 Makes menstrual periods more birth control may be free or there
regular and lighter may be a co-pay.
 Decreases menstrual cramps and  Need to remember to take every day
acne at the same time
 Makes you less likely to get ovarian  Can’t be used by women with certain
and uterine cancer, pelvic medical problems or by women
inflammatory disease, ovarian cysts, taking certain medications
and anemia  Can occasionally cause side effects
 Doesn’t interrupt sexual activity such as nausea, increased appetite,
headaches, and, very rarely, blood
clots
 Need a prescription
 Still need condoms to lower the risk
of STIs

Emergency Contraception

Emergency contraception exists to stop you getting pregnant if you have had
unprotected sex. This method is for one-off occasions and is not recommended
for daily use. It is particularly useful if a condom broke or if you missed one of
your contraceptive pills.

You should take it ideally within 24 hours after unprotected sex (this offers over
95% protection). The longer you wait, the less effective it will be. After 72 hours (3
days) the effectiveness drops to below 50%. If you vomit within three hours after
taking the pill, you must take another one.

Male Condom

Among the different types of contraceptives, the male condom is a strong

contender to the title of most common contraception method. It is easy to use,
affordable and offers the best protection against STIs (e.g. gonorrhoea,
chlamydia, HIV).

Condoms are usually made of latex, but if you are allergic to latex, some brands
also specialize in condoms made of polyurethane or lambskin. These two are
also compatible with lube (latex condoms are not, unless with water-based
lubricant); however lambskin condoms do not provide protection against STIs. For
safety reasons, make sure you use a new condom each time you have sex.

Male Condom

Success Rate with Typical Use: 82%

Pros Cons

 Lowers risk of STIs  Have to use a new one every

 Contraception that provides the most
protection against sexually transmitted
infections (latex condoms are best)
 Don’t cost much (50 cents each), can
buy at almost any drug store (don’t need
a prescription)
 Men feel they can “last longer” when
using a condom
 Allow men to have an active part in
preventing pregnancy
time you have sexual intercourse
(can only be used once)
 May disrupt/interrupt sexual
activity as it needs to be put on
just before penetration
 Can break
 Women may be allergic to latex

Female Condom

Just like the male condom, the female condom is one of the few types of
contraception that you can buy over-the-counter at pharmacies and grocery
stores without a prescription. Female condoms are generally more expensive
than the male ones but they are less likely to burst. They can be inserted up to
eight hours before sex.

Female Condom

Success Rate with Typical Use: 79%

Pros Cons
 Provide protection against STIs  May move, be noisy, or uncomfortable
(new product, so not clear how  Can only use for one act of sexual
much protection given) and intercourse
pregnancy
 Cost about $2.50 each
 Can be inserted well before
intercourse so less interruption of
sexual activity
 Male does not need to withdraw
right after ejaculation, as he does
with a male condom

Cervical Cap - Femcap

The cervical cap (sold as Femcap) is a thimble-shaped latex cup, basically like a
diaphragm but smaller. It also needs to be used with a spermicide. The cervical
cap must remain in the vagina at least 6 hours after sex, but it also has to be
taken out within 48 hours after sex.

Because some women get cystitis (bladder infection) from using a diaphragm, the
cervical cap is a useful replacement because it has less contact with the vagina (it
only covers the cervix).

The problem with types of contraceptives such as the Femcap or the diaphragm
is that their effectiveness - 92 to 95% protection in ideal use - is lower than other
types (98-99%) and that they offer only partial protection against STIs (e.g. no
HIV protection).

Cervical Cap

Success Rate with Typical Use: 92%

Pros Cons

 Can insert several hours before  Doesn’t protect against STIs

sexual intercourse  Cost $30-$50, plus the cost of
 Can leave in place 24-48 hours, spermicidal gel
will give protected sex for up to 48
 hours
 Use less spermicide with the cap
than with the diaphragm, no need
to apply more spermicide with
each act of intercourse
 Need to be fitted by a health care
provider and need a prescription
 Limited sizes available
 Can’t take out until 6-8 hours after
intercourse
 May get moved out of place
 Some women may be allergic to
material of cap or to spermicide
 Can’t be used by women with a history
of abnormal Pap tests
 Can cause increased urinary tract
infections

Intrauterine Device (IUD)

You have the choice between two types of IUDs: hormonal or copper-based
devices. Hormonal and copper IUDs are part of the few long-term solutions,
meaning that you can keep them inside the vagina for up to five or ten years
respectively.

The effectiveness rate for IUDs is above 99%, however they provide no protection
against STIs. Note that IUDs can be a form of emergency contraception if the
device is inserted within 5 days after unprotected sex. You will nonetheless need
to visit a doctor to have it properly inserted and follow the prescription (e.g. a few
follow-ups and check-ups for possible infection in the first weeks).

Intra-Uterine Device (IUD)

Success Rate with Typical Use: 99%

Pros Cons

 Very effective against pregnancy  Doesn’t protect against STIs and

 Provide protection against shouldn’t be selected if high risk of STI
pregnancy as long as in place in  Needs to be inserted by a health care
your uterus- protects as soon as provider
inserted (so don’t need to
 remember to use contraception if  Can fall out or can rarely puncture the
you have sexual intercourse) uterus
 Doesn’t need daily attention- just  The copper IUD can have side effects
need to check to make sure in such as menstrual cramping, longer
place at least once a month at and/or heavier menstrual periods, and
time of menstrual period spotting between menstrual periods
 Comfortable- you and your  Slightly higher risk for infection in the
partner cannot feel the IUD, first 20 days after insertion
although you partner may feel the
string
 The levonorgestrel IUD (Mirena,
Skyla) lessens menstrual flow and
can be used to treat heavy
periods
 Can be removed at any time and
you can get pregnant right after
removal

Spermicide

Spermicide is a recurrent "ingredient" in contraception because it proves very

effective when used in combination with other methods (e.g. diaphragm, sponge).
In itself spermicide doesn't always offer the best protection against pregnancy,
although this is also due to inconsistent use of the product.

You don't need a prescription to buy spermicide and it has very few associated
side-effects, but keep in mind that it does not protect against STIs.

Spermicide

Success Rate with Typical Use: 72%

Pros Cons

 Doesn’t cost much, available at  Doesn’t protect against STIs and may
many drug stores, don’t need a increase the risk of HIV infection in
prescription women who have sex multiple times
daily because of irritation from the
 spermicide
 Effectiveness usually lasts only one
hour (need to reapply each time have
sexual intercourse)
 Some women and men may be
allergic to spermicides
 May interrupt sexual activity (some
forms need to be inserted at 10-20
minutes before intercourse)
 Has a lower effectiveness against
pregnancy than many other types of
contraception- should use with another
form of contraception to increase
effectiveness
 Increases urinary tract infections

Contraceptive Injections

One shot of hormones lasts in the body for 8 to 12 weeks (3 months) and has the
same effect as the pill. Injectable contraceptives are about 99% effective, with
pregnancy occurring mostly with women who forgot to renew their contraceptive
shot in time (i.e. past weeks 11 to 12). Obviously, once the shot is given it cannot
be reversed, so you are effectively infertile for the next three months. Just like the
contraceptive pill, contraceptive injections do not protect from STIs.

Injection

Success Rate with Typical Use: 99%

Pros Cons

 Each injection provides 3 months  Doesn’t protect against STIs

of protection against pregnancy
 Very effective against pregnancy if
used correctly
 Many women stop getting their
menstrual period while getting
 Need to see your health care provider
every 3 months for an injection
 Depending on your insurance, your
birth control may be free or there may
 injections. (This is not a medical
problem and menstrual periods 
usually return 6-18 months after
you stop taking injections)
 Helps protect against uterine 
cancer
 Doesn’t interrupt sexual activity
Johann Red Rubite
be a co-pay
May have side effects such as weight
gain, tiredness, and possibly a
decrease in bone density
Many women have very irregular
menstrual bleeding or spotting for the
first 3 to 6 months and sometimes
longer