Syphilis

Syphilis–we have all heard of it and are probably all vaguely afraid of it.  But what is it?  What does it do?  How does it spread and can it be cured?  Let’s find out.

The word “syphilis” comes from the 1530 poem titled Syphilis sive morbus gallicus (“Syphilis or the French Disease”).  In the poem, the supposed first sufferer of syphilis was named Syphilus.  Both “syphilis” and the “French disease” were names given to the illness when it first showed up in Europe at the very end of the fifteenth century.  The ultimate biological origins of the disease are debated.  Throughout the middle ages, syphilis was treated with applications of mercury.  By the start of the twentieth century, somewhat more effective treatments were being used.  It was not until the mid-twentieth century with the rise of penicillin and other antibiotics that syphilis could be cured.

Syphilis is caused by a spiral-shaped bacteria called Treponema pallidum. There are two main types of syphilis:  transmitted (that which is passed sexually) and congenital (that which is passed from a pregnant woman to her fetus).  Congenital is the most dangerous and is a leading cause of infant mortality in much of the world.  Transmitted is the most common type of syphilis and goes through four phases.

Phase one:  Primary.  This is the phase immediately after the syphilis as been communicated.  The first phase of syphilis is when it is most likely to be spread because there are open chancres (said like ‘shank-er’), but it can be spread any time.  These are responsible for spreading the disease, though simply covering the chancre(s), with a condom for instance, is not enough to stop transmission totally.  Chancres may appear in the newly infected person within anywhere from a week to several months after the transmission.  There is usually just one sore in the area of the genitals (or mouth, if sex was oral), though there are sometimes more and they usually remain for 1-2 months.  The spot may appear in a normally unviewed location.  In this case, syphilis may continue to the second phase before it is detected and treated.  Generally, the sooner it is detected, the more easily it can be treated.

Phase two:  Secondary.  This phase occurs about 2-3 months after the initial infection.  The range of symptoms during this stage is wide, but the most common include a widespread reddish, non-itching rash that covers various body parts (often including the back, chest, arms, legs, hands, and/or feet).  Also common are flu-like symptoms such as fever, fatigue, sore throat, and headache.  Many other types of symptoms may occur and it is best to consult a physician in order to have tests run.  This phase usually lasts 1-2 months before the symptoms disappear–but the disease is still there!

Phase three:  Latent.  During this phase, the disease’s symptoms go into hiding.  Those who have not yet sought out medical help may assume the disease has cleared up on its own.  This is virtually unheard of.  A blood test will quickly reveal the presence of syphilis.  This phase may last 1-15 (or more!) years.  Syphilis can be quite deceptive.

Phase four:  Tertiary.  This phase announces the roaring return of syphilis symptoms.  By the time this occurs, it is too late to effectively treat syphilis.  This is why it is of the utmost importance to investigate syphilis early by undergoing testing.  Various symptoms may occur, including a type of chronic inflammation resulting in large, tumor-like growths called gummas.  Tertiary syphilis sufferers may also develop massive swelling of the aorta of the heart called aortic aneurysm; if this ruptures, it will quickly cause death.  A third, main type of tertiary symptom is neurological in which the brain and central nervous system are eroded causing dementia and other problems.  Treatment can still be administered at this point, but it will not be able to reverse the damage already done.  Left untreated, syphilis can be fatal–a very unpleasant way to die.

So, the bad news is that syphilis is easily transmitted between individuals and is, for the first time in more than 50 years, increasing in prevalence.  The good news is that syphilis is very curable.  The earlier it is found, the less damage it can do and the easier it is to treat.  So, if you have any suspicions, please see your doctor right away and you’ll soon be on the path to good health again.

The Uterus

Pound for pound, the uterus is the strongest muscle in the human body. The uterus weighs about 40 ounces (2.5 pounds; 1.1 kg) and is about the size of a pear when not pregnant. Yet, in the process of giving birth, the uterus can exert over 100 pounds of force (440 newtons). The uterus is responsible for protecting and nursing a growing fetus during a pregnancy, and also for pushing that fetus out when it’s time to give birth. Let’s further explore this great muscular feat of nature–the human uterus.

The word uterus comes from Latin meaning “womb” or “stomach.”  It is an organ particular to mammals.  The human uterus consists of two parts:  the main body, generally just called the uterus, and the narrow “neck” called the cervix (Latin for “neck”).  In humans, the uterus is labeled as simplex because it is generally a single (simple) compartment, but sometimes the uterus does not end up like this.  When a female fetus is developing in the womb, it starts out initially as an organ shaped like a V–as though the cervix has two horn-shaped compartments.  As the fetus develops, the horns will generally fused into one, “simplex” uterus.  About 6.7% of the time, though, this does not happen resulting in a malformed uterus.

The most common type of malformation is the bicornuate (or “two-horned”) uterus.   Other malformations include unicornuate (“one-horned”) uterus, double uterus (two whole, functioning uteruses), and absent uterus (where the uterus fails to develop at all).  Each of these malformations has its own set of issues, and a medical professional can help counsel a person with a malformed uterus.

The uterus consists of three main “layers,” much like the different layers of skin.  The innermost layer on the inside of the uterus is called the endometrium.  It is a temporary layer that builds up and jettisons away over the course of a menstrual cycle.  The middle layer is called the myometrium.  This is the main, muscular layer of the uterus and consists of smooth muscle mass.  The outermost layer is referred to as the perimetrium.  It is a thin membrane that secretes serous fluid.

Uterus IllustrationIn the reproductive cycle, the uterus receives the egg after it has been fertilized while traveling down the Fallopian tube (labeled here as the uterine tube).  Once the fertilized egg is in the uterus, it will usually implant in the endometrial lining of the uterus (that is normally shed when a woman has her period).  From this implantation, the uterus and the embryo form a network of blood vessels that exist only during the pregnancy.  This is called the placenta and is what the umbilical cord is attached to.

The uterus, besides being key to the reproductive cycle, is also important in the sexual response cycle.  It directs blood flow toward the pelvis and outer genitalia during sex. This directed flow of blood happens during arousal and allows for sex to be pleasurable to the woman.  The uterus is also involved in a somewhat rare type of orgasm called, of course, the uterine orgasm.

The uterus is, arguably, the most central organ to not only reproduction but also sexual response.  Take good care of your uterus and go to the gynecologist for your regular check-up!  Have questions or comments?  Let’s hear ’em.