Tuesday, January 18, 2011

A good thing to avoid

Just file this under "things I didn't know" (or perhaps more likely, "something I had once read but forgotten"):
Women who have had chlamydia are at greater risk of an ectopic pregnancy because of a lasting effect of the infection. A new study provides evidence for the first time of how chlamydia can increase the risk of an ectopic pregnancy .
And just how "popular" is this disease? According to a report just a few days ago, quite:

Sexual health experts are demanding the Federal Government urgently fund a national screening program for chlamydia after figures showing infection rates have more than tripled in 10 years.
More than 61,000 people were diagnosed last year, up from about 17,000 in 2000. About 14,500 were diagnosed in NSW alone, the second highest rate in Australia.
More than half those infected were aged 20 to 29 and a quarter were aged under 19.

11 comments:

Geoff said...

I have no doubt the incidence is once again on the rise and tubal infections certainly lead to infertility and ectopics.

To put things in perspective though, diagnosis is now much easier than it was because frequently it only needs a urine test rather than swabs.

Chlamydia was rampant in the early 80s with the commonest cause of abdominal pain in young women being pelvic inflammatory disease caused by what turned out to be chlamydia, which couldn't be tested for easily in those days.

My personal observation is that it became far less common after AIDS and the recent increase is minor compared to that caused by the dreadful sexual etiquette of the late 70s and early 80s.

Steve said...

All very interesting. The recent increase would certainly indicate that young people are not very concerned about HIV anymore, though.

In my previous career, I remember hearing a young woman talking to a male doctor in the mid 1980's (she was talking openly in the bar about it) about whether she should get tested, just as a precaution. As I recall, his advice was "no", and I thought he said it wasn't even clear if she had it that treatment would work. But maybe I am misremembering that part of it.

Caz said...

Nothing new about this, and the rise has never fallen.

The infertility problem is real enough, as many woman now, and in the future, will find.

There is usually an annual news story, but for reasons unknown, nothing happens ... the cost in IVF alone is already massive (well, there is that whole "right" to breed crowd) ... always thought it very odd that this continues under the radar, and continues as if it's only a problem for women (why it's so under funded too, is my thought). So much for the bargain basement cost of preventative medicine.

Easily treated Steve, it's not complex stuff ... not like herpes or even syphilis.

The problem is that most people don't notice, don't know, and their doctors don't test or treat. So on it goes.

Steve said...

Actually, now that I think of it, the doctor may have said it was not worth worrying about (as a simple precaution) because the testing was unreliable.

Caz said...

Geoff - for MEN (who will not potentially lose their fertility) a blood test is fine, but never for women - cervical swab is the only reliable test.

Steve - I think you've been subject to poor information, as have others from GPs ... this has never been difficult or unreliable to test, nor to treat.

Getting people to recognize they might need the test is the issue! All too often the symptoms are mild, or there are none. Anyone having unprotected sex should have regular testing for VDs, and doctors have a moral obligation to support and encourage that testing. Appalled that any GP would discourage a test.

Steve said...

Geoff's a doctor, Caz. You seem to have an unusually detailed interest in the topic yourself.

Remember, the conversation I am trying to remember was in about 1985, so my memory of it is fading. The only reason I remember it at all is because I thought it showed how much the world has changed that a young woman, mid 20's, would just start a conversation amongst a group of work acquaintances about how she was worried maybe she had an STD and didn't know it.

Caz said...

Then Geoff should know that current (Australian sites, published 2010) state unequivocally that women require cervical swab ... that's the advice; no ifs or buts.

I've never had fertility problems, nor had chlamydia Steve. Anyone who has any sense should take an active interest in their own and other's sexual health. Being informed doesn't mean that someone has a history of catching VDs ... more likely to have kept themselves healthy, BECAUSE they are informed. Your pointed comment suggests that only someone who has this or other VDs would have a clue. Perhaps that's why so many people remain ignorant, and therefore at risk ... and then, of course, are oh so surprise that "little old me" got some nasty sexual disease?

HIV is again increasing in Australia as well, particularly amongst young gay men. I know this, yet I'm neither gay nor a man!

It's a worry.

There's a strong case for more health campaigns about all sexually transmitted diseases.

I note that a recently run telly ad about herpes (I think?!) offers the incredibly and self evidently stupid statement that "if you've had more than one sexual partner ..." you might be at risk, or something like that; would need to look up the verbatim quote. Of course, you don't need to have had more than ONE partner to catch herpes or anything else. I was pretty disgusted at such stupid advice!

Steve said...

Yes, sorry about the "pointed" sound of my comment; it was actually more alluding to the fact that maybe your work was associated with public health. I thought you might even be a nurse, 'cos I know there can be friction between nurses and doctors over how well doctors do their job.

Caz said...

Noooo, not at all Steve, although some might suggest that writing outsourced IT solutions and contracts (and various other things) is of a medicinal nature.

By training: sociology, political science, economics, media and communications and the odd bit of psychology. All the soft "sciences".

It's not difficult to be reasonable well, if superficially, read in relation to anything, and especially health matters ... goodness knows that "breakthroughs" are reported every three minutes.

I read the NYTs weekly health reporting supplement, which is excellent, no equivalent here, and that's a bit surprising given how gung-ho our media are when it comes to medical miracles and the next ('though highly improbable) new thing.

I also enjoy keeping across developments in law, but have never studied or worked in law.

It's really more a sociological interest I suspect. Society at the macro and micro level is forever of interest, as are the abysmal and sloppy *scientific* methods that are used to present evidence and *proof* of things.

Geoff said...

Sorry for my late reply, Caz.

I'm certainly happy to agree that cervical swabs are superior to urine tests, and I suppose I was thinking mainly of males, in whom swabs are unreliable, but also of screening reluctant asymptomatic subjects.

I would take issue with your suggestion that chlamydia has always been easy to detect and treat. It was known as non-gonococcal urethritis because we knew it wasn't normal clap but we had no definitive tests for it.

We also had hospital wards full of young women on IV tetracycline because their tubes were full of pus from it and it was the devil to get rid of with just oral antibiotics.

This was back in the eighties, of course, but nowadays,as a cause of presentation with abdominal pain, PID from chlamydia is now rare.

Caz said...

Geoff - I didn't know the history of it, thought it was always fairly straight forward, particularly in the 80s (sheesh, doesn't seem that long ago, but is!!). I'd always thought the main problem was that people didn't realise that something was wrong, and, of course, doctors don't go looking unless the patient raises a problem.

Not sure if you're suggesting when you say that PID is now rare ... interesting, but don't understand why that symptom would not be rare, even though numbers of chlamydia cases in Oz have tripled over last decade, mostly people in their 20s. That's only the diagnosed cases, of course. More than half of sexually active people have never been tested for any sexually transmitted disease!

(61,000 in 2009; 17,000 in 2000; with up to 75% showing no symptoms ... so yes, that would mean not presenting with PID.)