"Doctor's orders"

I have been seeing more cases of STDs such as Chlamydia diagnosed in clinic these days.
It is probably because we have a new test to diagnose this illness and we are able to diagnose it before it causes a problem. 
Believe it or not, 50-75 percent of people who have STDs often have absolutely no signs or symptoms! That means that this disease festers in the body without the patient feeling anything abnormal.
Over a period of time, it causes problems in the reproductive system as the body tries to fight the foreign organisms. These organisms can scar women’s fallopian tubes, which are the little tubes that connect the ovaries to the uterus. Any scars on these tubes can prevent the egg from reaching the uterus and can cause problems with infertility in women.
Unfortunately, women will often find out that they have problems when it is too late and the damage is already done. Sometimes, the infection can spread upwards and can cause severe abdominal pain and is called Pelvic Inflammatory Disease or PID. When it gets this bad, the patient has to admitted to the hospital to get intravenous antibiotics.
There are some new tests that can help in early diagnosis and treatment.  These new tests are DNA tests and help to identify the genetic material of these organisms. Therefore, they are much more sensitive and can detect the disease even when there are no clinical signs or symptoms.
STDs are so common amongst teenagers that it is recommended that all women who are sexually active before twenty years of age get this test yearly. However, since this is a relatively new test, not all doctors order it, and not all insurance companies pay for it.
If there is any possibility of having been exposed to STDs, it is important for women to talk to their physicians and get checked for Chlamydia and Gonorrhea. Even men can get tested for these diseases now.
It used to be very difficult to test men for sexually transmitted diseases. A physician generally had to try and express any discharge from the penis and send it for culture. Now we can simply take a urine sample and the DNA looks for small traces of genetic material belonging to the foreign organisms.
Men should request a DNA test for Gonorrhea and Chlamydia if they suspect they might have been exposed to any sexually transmitted diseases.  Many older physicians might not do this test routinely so patients might need to ask for this test by name.
Besides being able to test for Gonorrhea and Chlamydia, there is also a new test for Human Pappiloma Virus, the most common sexually transmitted disease. This is the virus that often causes cervical cancer.
Any woman who has an abnormal pap smear should always be tested for HPV. Since this is also a new test, all physicians probably do not check for this. Therefore, when getting a pap smear, women should ask about getting checked for HPV.
There is a new vaccine, Gardasil, to help prevent infection with HPV. All women around 12 years old should get this vaccine, but at present not all insurance companies cover this. Therefore, it is important to talk to your physician about getting Gardasil as it might not be routinely offered.
Dr. Nitin Bawa is a board certified internal medicine physician. He can be reached at (850) 534-4170.