The Guide to Getting It On (112 page)

When a woman has bacterial vaginosis, the pH of her vagina is usually higher or more alkaline than normal, although some women’s vaginas are more alkaline than others and this should not be automatically be associated with bacterial vaginosis. With bacterial vaginosis there may be several more types of bacteria in the vagina than is normal, however, it is normal for many women to have more types of bacteria than was originally thought.

BV increases a woman’s chances of getting pelvic inflammatory disease. It can also endanger pregnancies, cause premature birth, premature rupture of membranes and inflammation of fetal membranes, pelvic inflammatory disease, and it can increase your chances of getting HIV and other STIs.

While antibiotics are the treatment of choice, they are not effective in 15% to 20% of women. Recurrence rates are as high as 75% in only a year’s time.

Risk factors for getting BV include recently douching, having a new sex partner, sex with multiple partners (either male or female), having sex with another woman, sharing insertive sex toys, recently using sex lube, and not using condoms. It is important to carefully clean sex toys and not share them. Anything that’s been in a woman’s anus should stay far away from her vagina. It is recommended women abstain from vaginal sex during treatment for bacterial vaginosis. Using condoms during the first month after treatment will possibly help.

Currently, treatment of the male partner has not improved BV-related outcomes in women. Douching is not recommended in any way, shape or form, and various “yogurt cures” and probiotics have not proven effective. Most preparations that are intended to help acidify the vagina have not been shown to be helpful in clinical trials for the treatment of bacterial vaginosis.

There is a great deal of research being done on BV. These recommendations might have changed by the time you are reading this, so be sure to check with your healthcare provider. The hope is that with time and research, we will understand how to manage the vaginal environment in ways that promote health rather than often having to use antibiotics.

If you are interested in learning more about the normal bacterial cultures in the vagina, see the Chapter 50:
A Trip Inside Amber’s Vagina
.

Yeast Infections or Candida Albicans (Thrush)

Candida is a fungus that normally occurs in the body. Symptoms of candida can include itchy genitals and a heavy, whitish, clumpy discharge that can smell like yeast. The discharge almost always looks like cottage cheese.

Candida is not really a sexually transmitted infection because most healthy people have at least some of it. Also, people who have never had sex can get a candida or thrush infection. Something needs to disturb the body’s natural balance for a candida or thrush infection to occur.

Up to 75% of women get candida or thrush in their genitals at least once in their life, although you can also get it in the mouth and on the skin. 40% to 50% of women have a reoccurrence of candida.

Most women have no identifiable precipitating factors that lead to candida. It would probably be easier to list the things that candida is not associated with than the things it is associated with. Recurrent candida has been associated with spermicide use, douching and using feminine hygiene products (especially panty liners). Candida can be caused by wearing anything that’s tight enough to cause a camel toe, including tight jeans, leotards, swimwear and panty hose, but not the crotchless kind (thank goodness!). Candida has also been associated with vaginal intercourse and possibly receiving a healthy amount of oral sex, taking antibiotics, using birth control pills (especially those with higher amounts of estrogen), with being pregnant, having diabetes, and with yogurt consumption or a diet heavy in carbs.

Women are often misdiagnosed as having candidas when they actually have genital herpes, linchen planus, recurrent bacterial vaginosis, contact dermatitis, atrophic vaginitis or a urinary tract infection. Women who are self-treating for candidas are often treating themselves for the wrong thing.

As of presstime, treating a partner was not recommended unless a woman is getting recurrent infections or a man has a form of candida called balantitis or a yeast infection of the foreskin.

— Mites, Lice and Things That Crawl —

Condoms Are of No Help in Preventing the Spread of These!

The Louse Family (aka Lice)

There are three different kinds of louses or lice that can take residence on the human body. One is the head louse that gets onto your head. The other is the body louse that gets on your body minus your head and pubic area. The third is the pubic or crab louse, which is the perv of the group because it lurks in the bush around your genitals. While all three louses can be spread by intimate contact, the pubic louse is the one that’s consider to be sexually transmitted.

Each of the louses has adapted to the part of the body where it lives, so it’s unusual for a louse to be living outside of its normal hood. You generally won’t find a head louse living where body or pubic lice live. It’s unusual for a body louse to be living above your shoulders or below your belt. And if there’s a pubic lice on your eyebrows, eyelashes or beard, you may have gotten it while you were giving head because pubic lice normally prefer to be in your pubes.

The reason lice cause a person to itch is because they inject saliva into the skin before they suck the blood out. This is to keep the blood from clotting as they draw it up. It’s probably your body’s reaction to the lice’s saliva rather than the actual blood sucking that can make you itch to the point of near insanity.

In the next three sections, you’ll discover much about the three different kinds of lice. This will give you interesting things to talk about the next time you have dinner with your partner’s family.

Pubic Lice (aka Crab Lice)

Pubic lice are called crab lice because they look like crabs when under a microscope. They are broader and flatter than their cousins, the head and body lice, which look more like tiny beetles.

You will know you have pubic lice when you find yourself needing to scratch so badly that you’ll even do it in front of friends or co-workers. However, you can have crab lice for two to six weeks without experiencing any symptoms or itching. That’s probably because your body’s immune system hasn’t yet learned to pitch a itchy fit when the crab lice injects its saliva into your skin. This means you can infect others without knowing you have crab lice. Fortunately, crab lice do not transmit disease, although you can get a bacterial infection from scratching yourself too much.

Lice related discomfort might be worse at night because lice are apparently nocturnal, or at least head lice are. The day-night cycle might be less of an issue for crab lice, given they live where the sun don’t shine.

Crab lice are usually transmitted through acts of sexual congress. While it’s possible to get crab lice from sharing clothes, towels or bed linens, the lice don’t live for long when away from the warmth and blood of their human brethren. Plus, they can’t hop like fleas do, so it generally takes an actual groin grinding for crabs to move from person to person.

People with shaved pubic hair are probably less likely to get pubic lice because there’s less of what pubic lice need to hold onto. However, no studies have been done on this subject, so no one really knows. In other words, don’t go shaving your pubic hair for the sole purpose of avoiding crab lice.

Each of the lice’s six legs have claws for feet that are especially made to grab onto hair. This makes crab lice phenomenal at holding on to pubic hair. However, lice aren’t nearly as epic when it comes to staying on a glossy surface like a toilet seat. This is why you can’t get crab lice from toilet seats.

Dogs, cats, birds and livestock have their own unique families of lice that don’t like the taste of human flesh. So you can’t blame a case of crab lice on the family dog, even if you and the dog have an especially close relationship.

Crab lice organization is somewhat like that of a fraternal order. The female lice will lay 30 eggs or nits during their lifetime, which lasts about a month. If the eggs hatch, a mini-me version of the adult crab lice will emerge which is called the 1st nymph. After the 1st nymph sucks enough blood, it molts and becomes a bigger version of itself, which is called the 2nd nymph. The 2nd nymph will suck more blood until it molts and becomes the 3rd nymph, which will suck more blood until it molts and becomes a full-fledged adult or grand master louse, which will suck even more blood until it grows old and dies. As soon as the former female nymphs become mature enough, they will have sex and start laying eggs in your pubes.

Treatment for crab lice is available over-the-counter. Follow the instructions carefully and be sure that you and anyone who you’ve had sex with during the past month is treated. You might be instructed to use a special nit comb or a tight flea comb to get the nits or eggs out. Wash any clothes, towels and bed linens that you’ve used in the last two or three days in hot water and put them in a hot dryer. If you have clothes or bedding that you’ve made contact with that can’t be washed, you can save on dry cleaning costs by putting them in plastic bags for two weeks. The nits will hatch within 10 days, but they can’t live after hatching for more than two or three days without having a human groin to grab on to.

The louse literature from the CDC says it’s only “occasionally” that someone will get crab lice from clothing or linens, given how lice die in one or two days after falling off a person. Also keep in mind that a lice infection is not the end of the world. There’s no need to fly into an obsessive-compulsive panic and wash everything in the house. Lice are not a sign of having a dirty house. Lice don’t care if you are dirty or clean. They are much more interested that you have sex with different people so their species can keep marching on.

Be extra careful about the treatment if you have lice or nits on your eyebrows or eye lashes. The usual treatment is toxic to the eyes. You might be able to get the nits and lice with your fingernails or a nit comb. If not, you’ll need to use ophthalmic-grade petrolatum ointment to the eyelids to suffocate the crabs with.

There is a fairly high association of other STIs with crab lice. So if you were with a partner who gave you the crabs, it’s wise to get checked for other sexually transmitted infections.

Head Lice

Head lice are about the size of a sesame seed. They can live on your head, eyebrows and eyelashes. The females cement their eggs to the shaft of the hair follicles. It’s easy to confuse head lice with dandruff or flaky scalp.

Head lice will generally make your scalp itch. They tend to be night owls, so you are more likely to feel a tickling sensation on your head at night. The only disease that head lice can spread is social annoyance, so if the school calls and says your kid has head lice, there’s no reason to rush and pick him or her up. By the time a diagnosis has been made, the head lice have most likely been there for a few days or weeks. Simply pick up some over-the-counter head lice shampoo on your way home.

The little pincers of head lice are designed to hold onto the shaft of actual hair, so it’s unusual for them to be on hats or clothing. The way people usually get head lice is from making head-to-head contact. Not from borrowing someone’s cap, hat or helmet. So you are more likely to get head lice from sleeping together than from wearing your partner’s clothes.

The treatment for head lice is an over-the-counter medication that has pyrethrin in it. You usually need to retreat nine days later, because it’s hard to kill all of the eggs the first time. Be sure to follow the instructions and remember that partners of an infected person should also be treated. (Overnight treatments of olive oil, mayonnaise or Vaseline might do wonders for your hair, but they don’t kill head lice.)

If you get a reinfestation, it’s probably because you didn’t get all of the lice out of the person’s head to begin with. So don’t get all crazy about washing and fumigating every square inch of the house. Head lice don’t live for long once they exit your cabasa. One or two days with no blood and heat from a human head, and the louse is history.

Focus your washing and drying efforts on the clothing and bed linens that an infested person wore or used in the last two days prior to treatment. Using hot water and high heat in the dryer will do the job. Or you can seal the items in a plastic bag for two weeks or take them to the dry cleaner.

There’s no need to give the family dog or cat a bath. Lice that like human heads want nothing to do with dogs, cats and other pets. However, you do want to soak any of your family members’ combs and brushes in hot soapy water for at least fifteen minutes (130 to 140 degrees) or soak them in Lysol for an hour.

If you think it will help, vacuum the carpets and furniture in the area where the infected person sat or lay. However, the CDC says the risk of getting infested by lice that are in your carpet or on your furniture is very small. That’s because head lice don’t hop. So they can’t act like fleas and leap on you from the carpet or furniture. Your carpet and furniture will soon become a cemetery for any louse that falls on it.

Body Lice

Body lice live and lay eggs on your clothing. They only move to your skin a feeding. Treatment for body lice is simple. It revolves around removing the body lice from their immediate habitat, which is usually your clothes. So all that is generally needed is good personal hygiene, washing your clothes and wearing clean clothes on a regular basis.