"Hm. That doesn't smell right..."

Got a health question? Don’t trust those “Doctors” at the University Health Center? Are you scared of Web M.D. because it always tells you you’re gonna die? Ask a real doctor, our friend Dr. Lissa Rankin. She’s here every Thursday to answer whatever you throw at her – like the ultimate cure for a hangover! – so ask away. Leave your question in the comments or send it over to us. Don’t be shy; she’s waiting for ya!

Q: After unprotected sex I noticed my urine becoming really smelly on a consistent basis, which is a new thing for me. There are no other symptoms-no burning or itching or anything, just the smelliness when I pee. Could this be an STD??

A: Usually, healthy urine has almost no odor (unless you’ve been feasting on asparagus or other foods or vitamins that are known offenders).  If you are dehydrated, your urine will be more concentrated and may have a stronger smell. Also, if bacteria have contaminated the normally sterile urinary system, which happens when you have a urinary tract infection, you may notice an odor.

Most of the time, when women approach me complaining of foul-smelling urine, they’re actually smelling their vagina. If you have a vaginal infection, such as bacterial vaginosis or trichomonas vaginalis, you may notice that your vaginal discharge, when it mixes with your urine, smells icky.

While it could be a sexually transmitted disease, such as trichomonas infection, which causes a vaginal infection characterized by a foul-smelling odor, most STD’s do not cause your urine to smell. Sex however, can trigger urinary tract infections, and infected urine may smell icky.

I would suggest a visit to the gynecologist. Make sure they check out your vagina, as well as your urine, to make sure there are no infections either place. And if you’ve had unprotected sex, go ahead and get tested for everything while you’re there. You can set a good example for your partner and feel more secure about next time.

–Dr. Lissa Rankin’s book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend, will be published by St. Martin’s Press in Fall 2010. She invites you to join her Pink online community (www.owningpink.com/forum) or read more of her writing at Owning Pink (www.owningpink.com).

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We took the embarrassment (and speculum!) factor out of the equation and asked you, the CollegeCandy readers, to submit the questions you had regarding STDs and sexual health to our new pal, OB/GYN Dr. Lissa Rankin. Check out the first batch of questions she answered and get the rest of the info below:

1. If you have a high risk strain of HPV and so does your current partner, will my chances of it progressing to cervical cancer increase if we do not use a condom, and just use birth control? I am positive he is also monogamous.

Bummer about the HPV, but rest assured, you’re so not alone. As many as 80% of sexually active young people will test positive for HPV, even in the absence of symptoms.  If you and your partner already have a high risk strain of HPV and you’re both completely monogamous, using a condom probably won’t help you unless there are other strains of HPV or other STDs that the two of you have not already transmitted to each other.  Whether or not your high risk HPV leads to precancerous changes of the cervix, or worse, cervical cancer, has much more to do with how well your immune system functions.  The best thing you can do to avoid cervical cancer once you have high risk HPV is to eat a whole foods, healthy diet, exercise regularly, get enough sleep, take a multivitamin, manage your stress in healthy ways, and generally take good care of your body – all things that strengthen your immune system.  If you have access to an integrative medicine physician or a naturopathic doctor, there are herbal formulas that can help your body naturally fight the HPV.  Read More »

[The following post is courtesy of Vanessa Cullins, M.D., Vice President of Medical Affairs at Planned Parenthood. If anyone knows anything about the importance of testing and sexual health, it is Dr. Cullins.]

Here’s a disturbing tidbit:  A U.S. government study found that an average of 14 percent of college women become infected with a human papilloma virus (HPV) each year. At the end of a three-year study, 43 percent of college women were infected.  Why should you care?  Because in some cases HPV can lead to cancer. To avoid HPV infection, girls and women should be vaccinated with Gardasil, which prevents infection of the types of HPV that cause 70 percent of the cases of cervical cancer in the U.S.

Here’s another: An estimated 19 million Americans are infected with a new sexually transmitted disease (STD) each year and, by the age of 25, half of all sexually active young people will contract an STD. In fact, at least one in four teenage girls already has an STD.

Read More »

[The following post is courtesy of Vanessa Cullins, M.D., Vice President of Medical Affairs at Planned Parenthood. Upon speaking with Vanessa and asking for information on STDs we began discussing HIV/AIDS. Naively, I mentioned that college kids are safe and know to protect themselves against this deadly disease. Turns out, I was wrong, and thinking that way is incredibly dangerous.]

Once in a while, we get a variation of this question via e-mail: “I’m a woman in college, and I’m wondering if I still need to be worried about getting HIV. Isn’t it pretty much under control by now?”

HIV/AIDS is definitely still a threat — especially among young people and women. Today, women account for more than one-quarter of all new HIV/AIDS diagnoses, and women of color are especially affected by HIV infection and AIDS. The growing complacency about this deadly disease is alarming.  You cannot tell from looking at someone whether that person is infected with HIV or any other sexually transmitted disease (STD). That is why all sexually active people need to protect themselves against HIV. Read More »

Talking sex with your doctor isn’t always easy. Whether you are afraid she or he will judge you,  you just don’t feel comfortable sharing the intimate details of your life between the sheets, or you can’t think straight with a speculum between your legs, many people get tight lipped in the doctor’s office. But that doesn’t mean you don’t have questions.

We took the embarrassment (and speculum!) factor out of the equation and asked you, the CollegeCandy readers, to submit the questions you had regarding STDs and sexual health to our new pal, OB/GYN Dr. Lissa Rankin. She shares her experience and knowledge below. There were so many questions that we had to break it into two parts, so come back later to read the rest!

1. How does someone get tested for STDs?
If you wish to be screened for STD’s, screening is simple.  Readily available blood tests exist for HIV, hepatitis B and C, syphilis, and herpes.  Chlamydia, gonorrhea, and trichomonas can all be tested from swabbing the vagina or cervix, as well as from a urine test, and it’s important to get tested, since the presence of these infections may make you more susceptible to contracting HIV.  HPV testing can be performed at the time of a pap smear, although this test is usually only done if your pap smear is abnormal.  Genital warts, pubic lice and molluscum contagiosum are usually diagnosed by a doctor’s visual inspection or, sometimes, a biopsy.  Most STD tests are readily available at any OB/GYN or primary care medical office.

2. How often should I get tested?
I recommend being tested any time you change sexual partners (or any time your partner does). So if you break up with your boyfriend and he hooks up with someone else, then wants to get back together, it’s time to get tested again.  If you’ve been tested once and everything was negative, it’s a good idea to get retested in 6 months, just to make sure.  After that, as long as you’re with the same partner and you know for sure your partner is faithful, you’re probably safe to just get your annual pap smear. Read More »

About a month and a half ago, I wrote about testing positive for Chlamydia. It’s been hard on me ever since then to really come to terms with it. Sure, it was easy to get rid of (just a few pills) and I don’t have to relive it by telling every past or future partner that I have an STD, but the worst part for me is the stigma. It is a sad but true fact that I chose not to tell anyone close to me. Not even my friends. I was afraid of being judged. No matter what kind of STD you get, curable or not, there is a stigma that comes along with being a person who has one.

I know, I’ve been one to judge before. Read More »

Jill Grimes, MD, is a board-certified family practice physician in Austin, TX. She is an associate editor for the 5-Minute Clinical Consult textbook, and clinical instructor at UMASS Medical School.  Her book, Seductive Delusions: How Everyday People Catch STDs, proves how serious STDs are for all of us – yes, even you! We had a chance to speak with Jill and she had this to share with everyone at CollegeCandy:

Okay, ladies, it’s time for a sneak peak behind closed exam-room doors. Outside, we are bombarded with the constant message that sex is all about fun, excitement, and personal empowerment – our bodies, our choice. Inside, however, we see a disconnect between these choices and unexpected consequences. People like “us”- whether that’s preppy Greeks, computer geeks, scholarship athletes, nurturing elementary ed majors, intense pre-law or pre-med majors, or any other student – these aren’t the kind of people who would be at risk of carrying a sexually transmitted disease, right?

WRONG!

As a private practice family physician located near a major university, I’m here to give you the REAL scoop about the STDs we diagnose every day, in women just like you.

The majority of my patients have had fewer sexual partners than they can count on one hand, and yet my colleagues and I diagnose genital herpes, chlamydia, and HPV (either obvious genital warts or abnormal Pap smears) like crazy! To be honest, one of the most common things we hear when we diagnose someone with genital herpes is “but there’s NO WAY I can have herpes, because I haven’t even had sex yet!” Of course, they’ve had oral sex, but they didn’t realize that cold sores = Herpes and cold sores in the mouth + genitals = Herpes down low. Read More »

When I found out that 25% of college students have a Sexually Transmitted Disease, I laughed. Surely that statistic referred to the more promiscuous students, or those who were dumb enough not to use a condom during sex.

Then I found out that two of the eight girls living in my house (25%) had contracted an STD. These two girls weren’t promscuous – one was a virgin! – and the other was always safe. And that was when I realized just how serious STDs were for all women on college campuses.

The problem with STDs is that people don’t talk about them. We all think that by practicing safe sex – using a condom – we are safe from everything and because we have this false sense of safety, many of us never get tested. And that is why 1 in 4 college students currently have an STD.

April is STD Awareness Month and in conjuction with that, we at CollegeCandy decided to stop regular posting and turn today into STD Awareness Day. We have teamed with with many experts in the field – doctors, nurses, STD specialists, etc. – to bring you the information you need to protect yourself and start a necessary dialogue on a serious issue.

We urge you to learn a little bit and make an appointment to get tested!

Below are some pretty serious and scary facts about STDs that we never knew. Chances are, you don’t know about them either and that is dangerous. Knowledge is power and when it comes to STDs, it is the power to protect youself: Read More »

Q: I gave head to a guy I met when I was studying abroad, and now I’m worried about STDs. We didn’t use a condom, but he didn’t orgasm. Should I still get tested?

A: Don’t get yourself too worked up over it, but yes, you should get tested. Really, you should get tested after every new sexual partner (yes, oral sex counts). I’ll preface this by saying that I’m not a doctor–which is especially why you should see one–but I do strongly urge you to go get tested, for your health and more so, your peace of mind.

The greater the quantity of infected semen you’re exposed to, the greater the chances are that you may have something–of course, that’s assuming in the first place that the guy even has an STD. Since he didn’t ejaculate, you were at most, only exposed to pre-cum–so yes, it’s technically possible you caught something if he was infected, but the risk is low.

For something like HIV or hepatitis B, which is passed through the bloodstream, you would have to have had abrasions or cuts in your mouth (from a dental visit or biting your tongue, for example.) The same isn’t true for genital warts or herpes, which can spread through contact with the lesion. Even if you inspected his package with a microscope before going downtown, and you’re sure you didn’t see anything suspicious, remember that it’s still possible (but not super likely) to catch something even if there is no active, visible outbreak. Read More »