Herpes and Hepatitis B

Herpes and Hepatitis B are two sexually transmitted diseases that are often confused with one another because of their similar names.   The similarities end there.  What are the differences between the two?  And what are the symptoms, the causes, and the treatments?

The technical name for herpes is herpes simplex and it is caused by one of two viruses:  herpes simplex virus 1 (HSV-1) or herpes simplex virus 2 (HSV-2).  (Pretty obvious names, right?)  HSV-1 causes oral sores commonly called cold sores (pictured below).  HSV-2 causes genital herpes, the dreaded sexually transmitted disease that about 1 in 7 adults in the United States currently have.  Herpes goes through cycles of being active and inactive (when sores are present or not present).  Genital herpes can be spread during both the active and inactive cycles, even when being treated.  Herpes has no cure and will last a lifetime if contracted.


Herpes is not a fatal disease (though it can be if passed between a mother and baby during childbirth) but it can be quite annoying and embarrassing.  There are treatments to help moderate the disease, but it is important to remember that herpes can always be spread even when it is in an inactive stage.  The treatments for herpes are anti-viral and the best choice for you can be determined by your physician.  There is currently no vaccination to prevent herpes, but there may be in the future.

Herpes is a disease that is quite easy to detect visually, unlike that other H-disease hepatitis B.  Hepatitis B (often shortened to hep-b) is also caused by a virus, called hepatitis B virus (HBV; pictured below).  Hep-b is a disease that affects a staggering number of people.  Over 2 billion people are believed to have the disease.  It is spread by the transmission of bodily fluids (notably through blood transfusions and sexual acts, as well as other ways).

Hepatitis B affects the liver by causing acute (short-term) and chronic (long-term) inflammation.  This can result in jaundice, cirrhosis, and sometimes liver cancer.  The earliest symptoms, preceding these maladies, can include nausea, vomiting, body aches, mild fever, and darker than usual urine.  These can be mistaken for other illnesses if testing is not carried out.  These early symptoms often go away on their own but the disease may still be present allowing for more damage to the liver and for it to be spread to others.

So, it is crucial to visit a physician in order to have a test (usually a blood test) performed to determine the exact nature of your illness.  Hep-b very often clears on its own in those who suffer from the acute version.  However, the acute version may develop into a longer course of chronic hep-b.  If this occurs, it can cause serious damage to the liver and may even result in death.  Young adults, children, and infants are much more likely to develop chronic hepatitis B from the acute disease.  Though a virus cannot be totally cured through medication, it can be slowed and inhibited from causing more damage.

Hep-b is a disease that can be protected against.  The best means of protection is by receiving the vaccination against it.  This offers long-term protection.  As in any sexual situation, it is always best to be as careful as possible and in this case a condom will greatly lower the risk of spreading the disease.

So, to sum up, herpes is associated with genital sores, is generally not fatal, and can never be cured.  Hepatitis B has few outward symptoms, can be fatal if not monitored, and can only be cured by the body’s natural virus-fighting processes.  So, if you’re worried at all about either of these diseases, please visit a doctor who can make sure that your issues are carefully dealt with.  Your and your sexual partner’s health rely on it.

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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.

Linea Nigra and the “Mask of Pregnancy”: Skin Discoloration during Pregnancy

During pregnancy, a woman’s skin can undergo any number of changes.  This article will exam two of the most common of these dermatological changes:  “linea nigra” and the “mask of pregnancy.”

Linea nigra, which is Greek for “black line,” is a dark line that develops on a pregnant woman’s abdomen and can stretch from the pubic mound up to the navel or beyond.  (The length of the linea nigra can have great variation.)  Approximately three-quarters of all pregnancies exhibit linea nigra.  Scientists have not determined what exactly causes linea nigra, and its causes my vary from person to person.  The linea nigra can be more than just a colored line beneath the skin–it can include a new growth of dark hairs along the same axis.  This is all quite normal and no reason to worry

Linea nigra is more common among women with darker skin, hair, and eye pigmentation.  These lines usually appear approximately half-way through a pregnancy and can last well beyond the time of birth.  In some women, the line may persist throughout one’s life.  In others, the lines may disappear but recur due to increased sun exposure.  In most women, though, the linea nigra will eventually completely fade.  If you develop a linea nigra and you really don’t like it, the absolute worst thing you can do is to try to tan your skin to match.  Tanning will only make the line darker and darker and less likely to go away.  In general, it is good to avoid too much UV radiation (sunlight, tanning bed, etc.).  It is especially good to avoid UV radiation during pregnancy so as to prevent problems.  If you are worried about your linea nigra (the color, size, direction, etc.), make sure to consult a physician.  Overall, though, a wide range of different linea nigra is totally normal.

The second skin change I mentioned earlier is usually referred to as the “mask of pregnancy,” though its technical name is melasma.  Melasma is a discoloration of the face in a mask like pattern (think of masquerade masks).  The discoloration is a darkening of the skin and usually appears to be brown (light or dark).  The change in color primarily affects the nose, upper cheeks, and forehead.  In some cases, the melasma can affect other parts of the face.  Melasma can actually occur in both men and women, but it is most common in women who are pregnant.  Melasma also occurs frequently in women taking oral contraceptives (“the pill”).

Melasma, like linea nigra, usually fades with time and intensifies with exposure to sun (as well as tanning beds).  Melasma is totally normal but is more common among women who have naturally dark skin and who are often exposed to high amounts of sun.  There are several treatments to speed the fading of melasma, though they should not be used until after the pregnancy has finished because the chemicals involved may be harmful to the fetus.

Also note that moles, freckles, and areola (the area around the nipples) can also darken during pregnancy.  Like the above-mentioned skin changes, they are perfectly normal, can last for various amounts of time, and usually fade away after pregnancy.  The body goes through so many changes during pregnancy but these changes are among some of the most visible.  If you are ever worried about any of these changes, seek the advice of a medical professional.  Any questions or comments?  Please feel free to leave them here.

Vaginal Rejuvenation

While there are a myriad of possible gynecological surgeries, which ones do women elect to have performed?  In the past tubal ligation and varying degrees of hysterectomy have been the most popular elective gynecological surgeries.  In the 1990s, though, elective c-sections began to boom.  Recently, however, a growing movement has developed in backlash to the increased number of unnecessary c-sections in the United States–both voluntary and involuntary.  Now, there is a new trend towards cosmetic gynecological surgeries such as “vaginal rejuvenation” procedures.

What are currently the most popular “vaginal rejuvenation” surgeries?  Labiaplasties are rising in popularity.  A labiaplasty is a plastic surgery that involves tightening of loose labial folds or removal of extra tissue of the vulva.  After childbirth, with age, because of disease, or because of genetics women may have labia that they feel is large or perhaps too loose.  Surgeons can perform reductions of this tissue to make it smaller and/or tighter feeling.  These surgeries can now be done with the assistance of laser, which are meant to help the healing process.  The American College of Obstetricians and Gynecologists (ACOG) issued a statement in 2007 stating that there is no documentation of the efficacy and safety of such a procedure.  The risks include those inherent with any surgical procedure (clots, bad reaction to anesthesia, etc), botched outcome leading to further complications or surgeries, and the ring of scar tissue created causing issues with childbirth.  A woman with such scar tissue would be less likely to be able to deliver vaginally, and would face enormous complications if she did.  Young women have labiaplasties more often than older women, thus the concern for childbirth.

Other “vaginal rejuvenation” surgeries include hymenorrhaphy and vaginoplasty.  Hymenorrhaphy is rarer than labiaplasty and bears fewer risks.  It is a simpler surgery in which an already ruptured hymen is recreated in order for the woman to prove (or feign) virginity.  Vaginoplasties are much more invasive and dangerous.  A vaginoplasty is performed in order to tighten or reconstruct vaginal muscles.  Reasons for vaginoplasty can include disease, childbirth, or other trauma to the vagina.  However, many women now seek vaginoplasties because they feel it will increase their pleasure and sensitivity during sex.  As the ACOG points out, though, there is no evidence to support this assumption.  Vaginoplasties are also very common among males seeking gender reassignment surgeries, as a vagina can be created out of penile or scrotal tissue.  Most associations and societies of plastic and cosmetic surgeons do not yet count or keep track of the abovementioned plastic surgeries, or have only recently begun tracking them.  So it is difficult to say how many such surgeries are performed every year.  However, it is clear even from the basic figures that the numbers of these elective surgeries are increasing exponentially every year.  (One figure shows that about 600 were performed in 2005, 1,000 in 2006, and over 4,000 in 2007.)  It is a whole other topic to discuss the socio-psychological reasons why women choose such surgeries, but what do you think?  Would you ever be willing to go under the knife for such a procedure?  Other comments or questions?  Shoot!