Dr. Sandeepa

While the term STD clearly explains that it is transmitted only through penetrative intimacy, is it always the case? Quite often, there is paranoia about using a public rest room, which brings up an image of a place highly populated with germs. Is it possible to get an STD from there?

These places are, of course, full of germs, and there are multiple instances of developing a urinary tract infection from these areas. However, the chances of developing an STD from these areas are quite low. Read on to get a little more clarity on the same.

1. The organisms causing STD are like any other germs, except that they grow and flourish in the mucosa (oral/genital/rectal), which is conducive for their growth. These germs cannot flourish under any other circumstances. So even if an infected person uses the toilet seat before you, the chances that those germs remain active enough to cause an infection are quite low. These germs cannot survive in the outside environment and die very quickly. Also note that the public restrooms are drier and hotter compared to the mucous membranes that these germs thrive on.
2. The mucous membranes (genital/oral/anal) can get infected only, if they come in contact with someone’s infected fluids (vaginal secretions or ejaculate).
3. Moreover, STDs spread through contact from one point to another. Given this fact, the chances that the sexual organs come into contact with the public restroom are very low. The body parts are vulnerable to sexual contact and therefore infection do not come in direct contact with the toilet seat. If there was a cut or a bruise that could get exposed to the fluid, there is a slim chance of catching an STI, but this situation is extremely rare.
4. Our body has a natural immune system which fights most germs and infections effectively. So in people with good immunity, the chances of developing an infection are highly unlikely.

Preventative measures 

While the chances of actually getting an infection are quite low, there are still some precautions that can be taken to improve the safety levels. Always think of hygiene while in a public bathroom.

1. After using the bathroom, wash and dry your hands, which helps in preventing the spread of different viruses.
2. Do not touch your face until after the hands are washed, especially after a visit to the bathroom.
3. Wash hands with soap and dry them thoroughly. Touching surfaces like doorknobs without drying your hands helps create a moist environment in which these germs can thrive.

If you follow these precautionary measures, rest assured, you are not going to catch an STI by using any public toilet or shower. If you wish to discuss about any specific problem, you can consult a Sexologist.

The body has multiple chemicals called hormones, which regulate many of its functions. Increased or decreased levels of these hormones affect various functions including metabolism, growth and sexual functions. Thyroxin produced by the thyroid (situated in the front of the neck) is one such hormone, which has a significant role to play in metabolism.

Graves’ disease is one of the main causes of hyperthyroidism, where there is excessive production of thyroid hormones. Graves’ disease is an autoimmune disorder, wherein the body reacts against its own tissues. It is very common in women than men, especially after 20 years of age. Family history also has a strong correlation in developing Graves’ disease. The high levels of thyroid hormone increase the rate of metabolism, thereby altering weight, mental energy levels, physical stamina, and also mood.

Thyroid hormone is related to metabolism and more amount of it lead to higher metabolism. This causes the following symptoms.

1. Intolerance to heat
2. Excessive sweating
3. Nervousness and anxiety
4. Inability sleep, as the mind is always excited
5. Increased appetite (sometimes despite weight loss) due to higher metabolism
6. Irregular menstrual cycles
7. Palpitations (rapid, loud heartbeat)
8. Irregular heartbeats (tachyarrhythmia)
9. Fine tremors of the extended arms
10. Breast enlargement in men, known as gynecomastia
11. Extreme moodiness, causing irritability and anger
12. Inability to focus and concentrate
13. General fatigue and shortness of breath with any exertion
14. Increased frequency of bowel movements

In addition, the eye symptoms are quite diagnostic including:

1. Protrusion of the eyes (exophthalmos), giving an impression that they are going to fall out
2. Double vision
3. Excessive tearing
4. Increased irritation in the eyes

Diagnosis: The first symptom would be the presence of an enlarged thyroid gland (front of the neck above the collarbone), and the some of the above symptoms would be present.
In addition, tests to check for thyroid gland functioning including T3 and T4 levels would reveal increased amounts of hormone in the blood stream.
As a confirmatory test, the radioactive iodine uptake test also is done, which will indicate increased uptake by the thyroid gland. This indicates that the gland is functioning at an increased pace and requires additional iodine for the production of thyroid hormones.

Treatment: There are two approaches to it, one to control the symptoms and the other to control the thyroid gland per se.

1. Beta blockers are very useful in controlling rapid heart rate and anxiety.
2. Prednisone may be used to control eye irritation and swelling
3. Antithyroid drugs are used to control the production of thyroid
4. Radioactive iodine is given orally to control excessive thyroid production
5. In severe cases, thyroid gland may be surgically removed partially or completely

Graves’ disease is not life-threatening and once symptoms are controlled, the patient’s quality of life improves drastically. If you wish to discuss about any specific problem, you can consult a endocrinologist.