Rubbing her eyes the following morning, she was greeted by a lightly snoring Derek at her side. Crap, she thought, Colin is going to be so pissed.

Disheveled, Sarah grabbed her scattered clothes and headed to the bathroom to put herself together before enduring the never pleasant walk of shame.

“Ohmigodd!” she practically shouted. Her neck was as thick as her head and her eyelids so swollen she might as well have just lost in the ring against Mike Tyson. Splashing some cold water on her face, Sarah ignored the absolute atrocity that was her appearance and briskly walked back to her house.

Loading up on DayQuill, NyQuill, and hot tea galore, she spent the day nursing her moral and physical hangover — as well as her cold. Hours later, still feeling lousy, Sarah went to the student health center and got a strep and a blood test. The result: She had mono.

Rather than worrying about the state of her body, or (more importantly) her liver, she immediately worried about her hookups. She had both Colin and Derek on a cycle, wasn’t serious with either of them, but had swapped enough saliva with both to infect their bodies with the pesky virus she now endured.

Do I tell them? she pondered, Or just risk it and hope they both get lucky?

This scenario is all too common in college. I think it’s more uncommon to not get mono during your four years at university than to get it. However, what happens when your condition is even more serious? What if you find out you have HPV, Herpes, Chlamydia, or some other STD? Do you tell your current partner (and previous ones), or do you keep the secret to yourself and hope no one finds out?

This ethical dilemma is a scary but extremely realistic issue. According to a 2007 Stanford research study, 1 in 4 college students has an STD. A lot of the young adults are completely unaware they are even spreading a disease because they have never gotten tested. In order protect your partner, you need to actually know you’re infected. If you’re worried about your current state of cleanliness, head to your student health center, campus hospital, or STD testing site.

This conversation, however, is focused on those who have peed in that cup, gotten pricked with that needle (no pun intended), and received extremely undesirable results.

Morally, it’s important to tell your partner about any contagious little packages you may be carrying, from mono to HIV. In order to make sure your partner is protected, you need to wise up and take responsibility for your condition. Doing this is mortifying and difficult, but necessary. If you are in the know and can prevent the spread of a virus or bacterial infection, you should. You would want your partner to tell you, right?

So, we all know there’s a right way to handle the situation. If you’re infected, man up, tell your partner(s), and grab the nearest box of condoms. Ethically, if you know, you tell. If you don’t want to tell future partners, then you probably shouldn’t be in bed with them to begin with. But, as evidenced by the statistics, a lot of people are keeping their dirty little secrets to themselves mentally… and spreading them all around physically.

Even though Sarah only had mono, she proceeded to text each of the boys letting them know about her illness. They each went and got tested, came out of the entire situation mono-free, and were extremely grateful she told them about her virus. Yes, it was not the most pleasant experience for any of the parties involved. Rather, it was awkward and uncomfortable. But, it was a necessary precaution they all needed to take in order to ensure their well-being.

So, how would you handle this situation: Do you have a “don’t ask, don’t tell” policy, or do you share all of your down-below info before getting serious with a special friend? And if you have had to tell previous partners (including old flames, casual hook ups and – eep! – bitter ex-boyfriends), how did you do it?

No matter how you slice it, visiting the gyno is awkward. Not only do you have to expose yourself in the most unflattering way to your doctor (and the nurse who is required to be in there), but you gotta do it while he or she makes small talk from between your legs.

“How’s your day?”
“How are classes going?”
“How many sexual partners have you had?”

[Cue the look of disappointment and the lecture on safe sex.]

I don’t know about you, but whenever I walk into my gyno’s office I always feel the need to prepare her for what she’s about to see. “Uh, just so you know, it’s winter so, uhhhh, yeah, I haven’t really done much, uhhhh, maintenance down there in, erm, a few months.” She promises me she’s not looking and that she’s seen it all before and then she comes at me with some metal tools, one of which looks eerily similar to that thing you use to clean the toilet. And then it’s done. You put on your pants, she bids you adieu and you’re on your way….with a little less pep in your step than on your way in.

But sometimes things get even weirder (how could they not when you’re spread eagle with your junk in someone’s face?), like my most recent appointment involving a doctor who left me to grab a phone call mid-exam. (Let’s just say it was windy down there.) It was traumatizing, but upon telling my friends the story (who all thought it was just HILARIOUS), I learned that everyone’s had a particularly uncomfortable trip to the gyno. And I wanted to hear them. So this week I asked the CollegeCandy writers to share their most awkward and traumatizing gyno experiences. Hard to believe, but reading these hurts me more than an actual appointment.

Rachael – University of Miami: The first time I went to the gyno, she asked if I was sexually active. I looked at my mom, who I’d said could stay in the room, and the two of us burst out laughing. Obviously, the answer was no.

Brittany – University of Saint Thomas: I suppose my most awkward experience isn’t too brutal. But when the lady held up her metal instrument and said, “OK, I’m goin in” my soul shrunk a size.

Nina – Michigan State University: It was my first time, and she’s like “Are you sexually active?” And for a second, in the process of freaking out, I forgot what that meant. So I said no. It was the shortest gyno visit ever…

Sarabeth – University of Texas: My worst/most awkward gyno experience was my first one. I went to my mom’s doctor, so she felt the need to tag along and go into the room with me, and then when it came time to ask for a prescription of birth control I got lectured about how an unmarried girl such as myself shouldn’t need birth control… FROM THE DOCTOR.

Lauren – University of Michigan: I had extreme stomach pains one day so I went to the health center. The doctor there told me she had to rule out pregnancy and STDs (for a stomachache!?), so she did a pelvic exam on me and gave me an STD test. As I opened the door (which led into the waiting area), she handed me the lab work and said, “OK Lauren, take this gonorrhea test upstairs to the lab and they’ll get back to you.” I looked over and my T.A. was sitting in the waiting room. He waved. I waved. Then I ran away as fast as I could.

Alex – University of South Carolina:  I went for the first time when I was sixteen and she asked me if I was sexually active.  When I said no, she looked up at me from the exam and said, “Honey, maybe you can fool your mother, but I don’t believe that for a second.”  Sad part was, I was telling the truth.

Jessica – Delaware: When I was getting a pelvic exam at Student Health, the gyno decided I would be a good guinea pig for a brand new intern to practice on.  An intern with a shaky hand who had not had much (read: any) experience with a speculum or a vagina before. Needless to say, I walked funny for a couple of days, and not for a good reason.

Leah – Ryerson University: My boyfriend at the time left some marks on my chest after a weekend away and I got very disapproving looks from my doctor when I went in.

Alex – Lakehead University: I find the fact that my doctor delivered me and also does my gyno exams awkward. He’s seen me naked more than I care to think about!

Emmy-Loyola University Chicago: Male gynos just shouldn’t be allowed. Enough said.

Norah – Drake University: Mid-exam, my gyno tells me she hopes her daughter grows up to be a lot like me. It was sweet, but not exactly the best timing…

Sara C – Fordham: I was once told by a gyno that my “vagina doesn’t look pregnant.” Great to know, because (a) vaginas can’t get pregnant, and (b) I could better evaluate the thoroughness of the exam, which is to say not very.

Charlsie – Hollins University: Last time I had a pap smear, the nurse practitioner at my school told me I had herpes. She grabbed a mirror to show me, while I was all up in the stirrups and on the table, and then failed to point out exactly what she was talking about. Her reply was “Well, it was there a minute ago. Now it’s not — but I know you have it.” This was before she tested me or asked me any questions about my sexual history and background. Of course, I was hysterical even though I was about 99.9% sure there was no possible way I would have it. Sure enough, when the test came back — I didn’t have it. However, she called me to tell me about the results and said “Unfortunately, you don’t have herpes.” What kind of doctor wants a patient to have an STD?

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 getting over your fear of sex– 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: I recently started hooking up with a boy who has, well, gotten around. I asked him if he’d been tested recently and he said he did (and he was “all good!”), but I don’t know if I trust him. Maybe he’s just saying that to get in my pants? I obviously plan on using a condom when I sleep with him, but are there any things I can look for before I go down that path?  Any visible signs I should pay attention to so I know if he’s telling me the truth or not?

A: Honey, if you can’t trust the guy, do you really want to sleep with him? I mean- yeah, there are some things you can do to check him out, but it’s not necessarily enough to protect you.  Make sure you care enough about this guy that, if you do get a sexually transmitted infection, it’s not the end of your world. Because the truth is- even if he got tested for “everything,” you may still be at risk.

Why? Because condoms don’t protect you against all STI’s, and testing doesn’t always test for everything. Most testing will not reveal whether a guy carries HPV, and often, it will not represent whether he might be infectious for herpes.

So what’s a girl to do? Here are a few tips:

1. Ask your partner to be honest about whether he has really been tested. Explain that you value the health of both of you, and that if he cares about you, he needs to demonstrate this. Ask for a copy of his test results if you can’t trust him but want to sleep with him anyway. Offer him a copy of yours first. Then inspect him.
2. Look for cauliflowery warts on and around his penis.
3. Inspect the tip of the penis for funky discharge (anything greenish or yellowish) that may represent gonorrhea or chlamydia. (Wetness in this region should always be clear).
4. Hunt for reddish ulcerations that might represent genital herpes.
5. Check for little round bumps that can represent molluscum contagiosum.
6. Take a gander at his pubic hair to make sure there are no pubic lice or little white eggs.

Remember, a clean inspection doesn’t mean you’re good to go. Most sexually transmitted infections have absolutely no signs on a clinical exam. Which is why it all comes down to trust. At the end of the day, do you really want to hook up with someone you can’t believe?

Hope that helps!

- 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).

"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).

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. 

2. I would like to get a general STD test. However, I’m on a budget. I don’t want to spend money on a test because my mom will probably find out, and if I use my insurance my mom will probably find out! What can I do?
You can call your local public health clinic. Most offer free, anonymous STD testing, so your mother never needs to know (although, as a Mom myself, I highly encourage you to talk to your mom if you have a good relationship. You might be surprised how much we moms want to help, if we can get over our own embarrassment. Sometimes we need a good kick in the pants from our kids.)  Also, if you don’t have access to a public health clinic, donate blood. They won’t test for everything (like gonorrhea, chlamydia, or HPV), but it’s free, and you will be screened automatically for all blood-borne STD’s, such as HIV, hepatitis B & C, and syphilis.  If anything comes back abnormal, they will contact you to let you know.

3. What are the options for testing and the costs? Can you get anonymously tested?
There are many STDs, such as gonorrhea, chlamydia, syphilis, hepatitis B and C, HIV, herpes, HPV, trichomonas, and pubic lice (crabs).  For most of them, you can be tested, through blood tests, urine or cervical testing, or visual inspection, depending on the type of STD.  Costs vary depending on the facility and your insurance coverage.  If you have health insurance, testing is covered much of the time.  If not, you can usually get free, anonymous testing at your local public health clinic.  But remember that peace of mind (and good health) is money well spent.

4. Is it okay to lie to your doctor with the famous “How many partners have you had” question?
As one of those doctors, I’m reluctant to say, “Sure, go ahead!  Lie to your doctors!”  After all, we’re here to be your friend, confidante, health-partner, and advisor – not a judge or the morality police.  That said, let me try to answer your question very honestly.  What we’re really looking for is a sense of how much risk you’ve assumed in your sexual life.  If you tell me you’ve had 101 partners by the time you’re 19, I’m gonna assume you haven’t been uber-careful, and I’m going to look very carefully for the kinds of health issues that accompany high risk behaviors.  (Not to mention, I’m going to worry about your self-esteem and wonder why you might be needing so much external validation, when the only place you can really find it is within).

On the other hand, if you tell me that you’ve only had one or two partners, it changes how I will care for you.  And if you’re nineteen and you’ve never had intercourse, it makes a big difference. I probably won’t even subject you to a pap smear yet, since, unless you’re having problems, you really don’t need one until you’re either 21 or sexually-active, whichever comes first.

But whether you’ve had 6 or 8 partners?  Whether you’ve had 23 or 31 partners?  To be honest, it really isn’t that important.  So if you’ve only told your boyfriend about 4 of your partners and there’s this one other you don’t want to admit to your doctor in front of him, go ahead and lie.  (Yikes, I can’t believe I just said that!)  But keep it in the ballpark.  That way we can optimize the kind of health care we provide for you.  But don’t bother wracking your brain to make sure you get the number exactly right.

[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.

STDs continue to pose a serious public health threat in this country, particularly to young women, who are more vulnerable to infection than men, due to biological factors.

Because many STDs do not cause any symptoms — and most doctors do not automatically test for STDs — many women and men may not even realize that they are infected and at risk of spreading the infection to their partners.

Yet, without treatment, STDs can lead to serious short- and long-term health consequences, including infertility. Some untreated STDs, such as chlamydia and gonorrhea, can cause pelvic inflammatory disease, with the potential for other serious health problems. Others, like HIV, permanently jeopardize a person’s health and can kill.

STDs are preventable, treatable, and in some instances, curable. Women and men should minimize their STD risk by practicing safer sex. The use of condoms significantly reduces the risk of contracting an STD during vaginal, oral, and anal sex. Monogamy is better than latex but it only works if both partners are uninfected and both remain committed to monogamy — the problem with relying on monogamy is that one can only be sure of one’s own behavior.

Regular STD testing is critical. Health care authorities suggest that young, sexually active women and men be screened annually for the most dangerous and common sexually transmitted infections: HIV, chlamydia, and gonorrhea, if rates of gonorrhea are high in your community. Your local Planned Parenthood health care provider can talk with you about STDs and help you get the testing or treatment you may need. Visit www.plannedparenthood.org to locate your nearest health center. Or visit http://gyt09.org to learn about the “Get Yourself Tested” campaign, a partnership between Planned Parenthood, MTV, and the Kaiser Family Foundation.

Denial and embarrassment are the two most dangerous risks to your sexual health. Both can keep you from getting tests and treatment.  This is the real deal:  All sexually active people are at risk for getting STDs — no matter how faithful, how clean, or how cool you may be.  So don’t let denial or shame jeopardize your health.  Practice safer sex, and get checked out every year to make sure you can enjoy your sex life for many more years to come, in addition to ensuring that you and your partner can experience pregnancy when the time is right.

[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.

The U.S. Centers for Disease Control and Prevention report that more than 56,000 women and men are infected with HIV every year. And the American College Health Association has found that the rate of HIV infection among college students is about the same as it is for the general public. It seems that a lot of people — especially women — aren’t getting the message.

So what’s a girl to do?

First, get tested regularly. Know your status and the status of your partners. Planned Parenthood Federation of America has partnered with MTV and the Kaiser Family Foundation to launch the GYT — Get Yourself Tested — campaign. Visit http://gyt09.org to get information you can rely on about STDs, including HIV, and find your nearest testing location.

Second, plan your safer-sex strategy. Condoms used correctly and consistently are the best protection against HIV and other STDs, including HPV, gonorrhea, and chlamydia. Condoms reduce the risk of HIV infection substantially.  In fact, aside from abstinence and other forms of intimacy that result in no contact with another person’s genitals, condoms are the best protection against HIV.  Some studies show that about one out of two college students used a condom the last time they had sex. That’s good. But it also means that one of two didn’t.  And that’s not good — that’s a whole lot of people playing Russian roulette with contracting HIV/AIDS.

Having a good safer-sex strategy means knowing your risks and deciding which ones you are willing to take.  Here’s a step-by-step walk-through of some of your options:

•    Use a latex or female condom during vaginal, oral, and anal sex.
•    If you are not using a condom, it’s safer to have oral sex than vaginal or anal sex.
•    Rubbing against your partner, whether clothed or naked, is safer than sexual intercourse. Rubbing against your partner clothed is even safer.
•    If you and your partner are engaged in mutual fondling, it is safer to wash your hands before touching your own genitals.
•    Masturbating alone or together — or having phone sex or cybersex — is the safest sex option.

But the most important safer-sex strategy of all is to assume that all potential partners may be infected — and then take precautions.  The reality is that people will lie in order to have sex.  Another reality is that many people with HIV don’t know it!  Given these odds, you can’t rely on anyone else to protect you.

Remember: all sexually active people are at risk, and we need to protect ourselves.

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.

If you’re changing partners, you need to be tested before every new partner.  If you’re changing partners daily- or even weekly, you’re putting yourself at high risk, even with frequent testing. Always use condoms in this situation, but understand that even condoms can’t protect you from all the cooties that are out there.  Be safe!

3. How do you broach the subject with your partner?
You DON’T wait until things are hot and heavy before you bring it up.  I recommend that women initiate the discussion by getting tested themselves.  When you show your partner that you care about the health of both of you by getting tested, it will motivate him to do the same.  So go ahead and draw the line in the sand.  Tell him you don’t feel comfortable being sexual with him until you know you’re safe.  Then use condoms anyway, just to be safe.  But keep in mind that some STDs like herpes and HPV can still be transmitted, even if you use condoms, since the virus can still be shed from genital skin that isn’t covered by the condom.

If you already have an STD and need to tell your partner, bring him with you to the gynecologist. Having a doctor present to alleviate concerns and answer questions is a good way to break the news.  Or write a letter if that’s easier for you, and include website links that can help answer his questions.

4. What are the odds of catching an STD through oral sex with ejaculation? And does the likelihood increase if you spit (it’s already in your mouth) or swallow?

Many young people enjoy oral sex over intercourse specifically because you can’t get pregnant and you’re less likely to get sexually transmitted diseases, but that doesn’t make it risk-free.  As you can imagine, this is a hard thing to study. Few couples engage only in oral sex, so it’s hard to get a clean study.  It’s not like you can take two groups of people and say, “You guys have intercourse and you guys have oral sex and we’ll study the risk of STD transmission!”  No, that doesn’t work.  So all we have is theoretical data, really.

So what do we know? You can get STDs from oral sex with ejaculation, but it’s pretty rare. Several factors increase your risk of contracting a STD from oral sex.  If you have poor oral hygiene, such as oral ulcers, gum disease, or oral thrush, this makes you more susceptible to someone’s body fluids.  If you hold semen in your mouth, this also increases the risk of transmission. It’s better to spit or swallow immediately, since stomach acids inactivate most infections.

If you give a man with herpes oral sex, and he is shedding the virus from his genitals, you can get oral herpes or herpes pharyngitis, leading to ulcers in the mouth and throat. While genital herpes (HSV-2) tends to prefer infecting the genitals, there can be some crossover, so HSV-2 can still cause problems in the mouth, although this is much less common.  Transmission in the absence of genital ulcers in uncommon, although not impossible.  Similarly, oral infection with syphilis can cause syphilitic mouth ulcers, or chancres.

Certain strains of human papillomavirus (HPV) can cause warts in the throat, although this is extremely uncommon.  Some data suggests that HPV infection of the throat may also increase the risk of throat cancer, but again, this is an uncommon outcome.  Having oral sex with a man with gonorrhea can cause a gonococcal throat infection, although this is usually asymptomatic.  Chlamydia has also been isolated from the throats of men and women, although it doesn’t appear to cause symptoms.

Blood-borne STD’s or those carried in body fluids, such as HIV and hepatitis B and C, have a theoretical risk of transmission from oral sex.  Poor oral hygiene or blood in the semen may increase this risk.  Overall, a few reports of transmission from oral sex exist, but this appears to happen very rarely.

All in all, oral sex is much safer than either vaginal intercourse or anal intercourse, and transmission of STD’s is a rare but theoretical risk.  If you decide to take your chances with oral sex, the likelihood is that you’ll be just fine.  But if you wish to protect yourself, your partner can wear a condom. Flavored condoms exist specifically for the enjoyment of safe oral sex.

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.

But now that I’m here – someone who had an STD – I know that not everyone who gets infected by a sexually transmitted disease is promiscuous or slutty. Unfortunately, many STDs are results of bad decisions. I made one and trusted someone I should have known better than to trust.

I’m lucky that I don’t have to tell anyone about what I had, but in an effort to be honest with someone I was seeing, I told him. At first he seemed happy that I was honest with him, but things changed and I knew he saw me differently. He saw me for the mistake I made instead of the person he had spent so long getting to know and with that little piece of information, everything changed.

I learned a lot from this experience, and the thing I learned the most is not to judge someone. If someone trusts you enough to share something about their life like that, don’t let that change the way you look at them. It is more than likely that he or she made one bad decision – one that you may have made many times with no repercussions – and are now living with the unfortunate results.

The other big lesson I’m taking from this is, of course, to be safe. Trust no one. Most people don’t even know they have something, so think twice before you let your libido make your decisions for you. An hour of fun is not worth a lifetime of regret.

[Photo courtesy of Amvollmar on Flickr.]

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.

Today’s statistics show that 1 in 5 Americans over the age of 12 have genital herpes (as determined by blood antibody testing), but only 10% are aware that they have it! HPV (the virus that causes genital warts and cervical cancer) is so common that it’s estimated that 50-75% of sexually active 15-59 year olds will become infected. Look around your next class and do the math to realize how many of your peers might share these diseases.

Chlamydia is silent in 50% of guys, and 75% of women – no wonder it gets passed around so easily! If you catch chlamydia (or gonorrhea) and it gets diagnosed EARLY, it is treated very simply with a short course of antibiotics for you and your partner. If, however, you bury your head in the sand and pretend that because you have no symptoms and you haven’t slept with anyone “yucky” that you’re not at risk, (and therefore, conveniently choose not to be tested), both chlamydia and gonorrhea can sit around and silently scar your reproductive tract potentially leaving you infertile down the road. While I’m sure most of you have no desire to be pregnant now, I’d bet most of you would like to have that option in the future.

So, take a good look in the mirror and ask that wonderful woman staring back at you, “Have you had ANY sexual partners (including oral, anal, or vaginal) since you were last tested?” If the answer is YES, go schedule an appointment to get checked out. This is not about being “good” or “bad,” and no medical provider is there to judge you. Trust me, you’ve done nothing any experienced doctor hasn’t heard or seen before, and our goal is simply to maximize your health, both now and for the future.

Don’t lie to yourself or hide from the truth. The best way to protect your body and future health is to get up and find out the truth. Stop worrying about sitting on public toilet seats and start realizing where the real risks for STDs are lurking!

For more information and STD facts, check out JillGrimesMD.com. If you’ve had enough dry facts in your statistics class and are looking for a more engaging way to learn, grab Jill’s book, Seductive Delusions: How Everyday People Catch STDs, which reads like episodes of Grey’s Anatomy and highlights accurate facts throughout the dialogue.