Ep#225: Everyone Has Herpes with Nurse Amber

Today I'm chatting with Nurse Amber, a board-certified women's health nurse practitioner, to discuss sexual health and STIs. We cover the prevalence and stigma of herpes, common STIs like chlamydia and gonorrhea, testing frequency, and prevention methods including PrEP and DoxyPEP.

Our conversation also addresses female health concerns such as UTIs, bacterial vaginosis, and pelvic floor health, as well as men's sexual health topics.

Nurse Amber emphasizes open communication, regular testing, and finding a sex-positive healthcare provider.

Understanding Herpes Transmission (00:02:11)

Discussion on HSV-1 and HSV-2, how both can be transmitted genitally or orally, and why blood testing has limited utility.

Most Common STIs (00:08:18)

Chlamydia, gonorrhea, and trichomonas are identified as the most common STIs seen in clinical practice, with chlamydia being most frequent.

Symptoms of Common STIs (00:08:50)

A description of potential STI symptoms in people with vaginas and penises, noting that 50% of cases are asymptomatic.

What is Trichomonas? (00:10:02)

An explanation of trichomonas, a common parasitic STI that often causes no symptoms but can cause severe inflammation.

Long-Term Risks of Untreated STIs (00:11:50)

Untreated bacterial STIs can lead to serious complications like Pelvic Inflammatory Disease (PID), chronic pain, and impaired fertility.

STI Incubation Periods (00:14:39)

Genital STIs are detectable 1-2 weeks post-exposure, while blood-borne infections like HIV and syphilis can take 1-3 months.

How to Disclose an STI to a Partner (00:15:53)

Advice on having a direct conversation with partners about a positive STI test and the need for mutual treatment.

STI Testing Frequency (00:17:19)

Recommendations for testing frequency based on sexual activity, ranging from every 6-12 months to every 2-3 months for active individuals.

PrEP and DoxyPEP Explained (00:21:49)

An overview of PrEP for HIV prevention and DoxyPEP, a post-exposure prophylaxis to reduce the risk of bacterial STIs.

Syphilis is Not Gone (00:26:47)

Syphilis, known as "the great pretender," is still prevalent and can have sneaky symptoms, making regular screening important.

The Current State of HIV (00:29:00)

HIV is now a highly treatable chronic condition, and transmission rates are much lower than for other STIs like Hepatitis C.

What to Ask For at the Gynecologist (00:31:59)

Clarifying that a pelvic exam is not always a Pap smear and what specific STI tests patients should request.

The Importance of Triple Testing (00:37:23)

Why testing genital, oral, and rectal sites is crucial for a comprehensive screening, as infections can exist in one area.

Myth-Busting: Partner Testing (00:42:04)

Debunking the myth that if one partner tests negative, the other is also clear. Each person needs individual testing.

Vaginal Health and Hygiene (00:44:01)

Advice on maintaining vaginal health, emphasizing that vaginas are self-cleaning and harsh soaps or douching should be avoided.

Squirting and Prolapse (00:50:31)Explaining that squirting is largely urine and discussing bladder prolapse, a common condition that can cause stress incontinence.

Pelvic Floor Health (00:54:39)

How to maintain pelvic floor health through exercises like Pilates and yoga, which can improve sex and prevent incontinence.

Hormone Replacement Therapy (HRT) (00:58:16)

A discussion on the benefits and considerations of HRT for perimenopausal symptoms, cautioning against unproven testing methods.

When Men Should See a Doctor (01:02:54)

An overview of symptoms like itching, discharge, pain, or sores that should prompt a person with a penis to seek medical care.

Finding a Sex-Positive Provider (01:17:29)

The importance of finding a healthcare provider you can be open with about your sexual health for accurate testing and treatment.

Follow The Open Bedroom:

https://www.instagram.com/theopenbedroompodcast/