Substance use disorder: contraceptive options counseling

What’s New in Contraception?

Contraceptive Technology Conference!

Biologic sexism of STIs

Excess breast cancer deaths after COVID-19

Contraception for patients with medical conditions

Pelvic Floor Dysfunction

Treating vulvodynia

Puzzling Over the Hurt Down-Under

Serious Mental Illness and Contraception

New 13-Cycle Vaginal Contraceptive System

The Future of Family Planning in Post-COVID America

New ASCCP Guidelines: Implications for FP

On the alert: mood disorders during 2020 stressors

Sex in the Time of COVID-19

Challenges old and new during the pandemic

Reproductive health in the time of Covid-19

Talking about toys

Missed Pills: The Problem That Hasn’t Gone Away

Find the “yes! . . . and” rather than “no” or “but”

Digital Family Planning: the Future is Now

Irregular Bleeding Due to Contraceptives

When she’s low on libido…

Ouch! Best approaches to menstrual pain

Contraceptive efficacy: understanding how user and method characteristics play their part

Strategizing treatment for chronic heavy menstrual bleeding


Untangling the literature on obesity and contraception

High tech apps for no-tech FABM

Menstrual exacerbation of other medical conditions

From Princeton University: Thomas James Trussell (1949-2018)

The Short and Long of IUD Use Duration

Selecting a Method When Guidance Isn’t Clear-cut

Healthcare in the Time of Digital Expansion

The Scoop on Two New FDA-Approved Contraceptive Methods

Pregnancy of unknown location—meeting the challenge

Big “yes” (with caveats) to CHCs during perimenopause

The role of IUDs (LNG IUDs, too!) in emergency contraception

Combined pills’ effect on mood disorders

Abortion in the U.S.: safe, declining, and under threat

Hope for ovarian cancer screening test

Breast cancer still a small risk with some hormonal contraceptives

New treatment modality for BV

Record rate of HPV-related throat cancer

Viruses in semen potentially transmissible

Don’t Abstain from Your Role in Abstinence

Teens births declining but geographic ‘hotspots’ defy trend

Online Medical Abortion Service Effective and Safe

Do Women Really Need to Wait That Long?

Reassuring news on depression and OC use

PMDD: Genetic clues may lead to improved treatment

Breast cancer risk when there is a family history

Body weight link to breast and endometrial cancers (and 11 others)

Family Planning in 2017 and Beyond

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm


Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use

Alcohol consumption when pregnancy is unwanted or unintended

Latest Data on Contraceptive Use in the United States

LateBreaker sampler from Contraceptive Technology conference

Emergency Contraceptive Pill Efficacy and BMI/Body Weight

Handout on Unintended Pregnancy and Contraceptive Choice

Ask About Withdrawal (Really!)

Rules to Practice By: Safety First and Cleanliness is Close to. . .

What’s Vanity Fair Got Against the NuvaRing?

Promising New Treatment for Hepatitis C

Numbers matter, so make them simple for patients

The Recession’s Effect on Unintended Pregnancies

Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative

Applying the “New” Cervical Cytology Guidelines in Your Practice

Acute Excessive Uterine Bleeding: New Management Strategies

Medical indications for IUD use in teens

Whatever happened to PID?

Update on Emergency Contraception New and Improved

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”
August 2015


RTIs, STIs, STDs, or even the old “VD”—do these terms mean the same thing, or does each refer to something a little different? In health care, science, and communication, we need to be on the same page, so to speak, in defining what it is we are talking about.

At most Contraceptive Technology conferences, I’m asked to differentiate among the terms reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases. Each of us has our own distinct preferences, some with a fervent advocacy. In our book Contraceptive Technology, we use the term “reproductive tract infections,” in part because we tackle the realm of issues related to women’s reproductive health.[1]

The field of sexually transmitted diseases is currently reevaluating its own semantics. A colleague, Hunter Handsfield, has recently described the history and current thinking on the topic.[2] The new editor of the journal Sexually Transmitted Diseases, Bill Miller, has requested readers to offer their own opinions about what they think their field should be called.[3] So the time is right for those of us in the reproductive health field to consider what we want to label the infections we see in our sexual and reproductive health clinics each day.

My own personal odyssey reflects the history of the changing terminology. When I moved in 1981 from the family planning to the sexually transmitted infection side of the Centers for Disease Control, the group I joined was still named the Venereal Disease Control Division. The two main VD we were concerned about were gonorrhea and syphilis. Together with the national family planning program, our VD group had initiated a highly successful gonorrhea control program in the 1970s. We produced key national treatment guidelines on both syphilis and gonorrhea. But by the 1980s, the field had expanded to include chlamydia, herpes, and the emerging human papilloma virus. Even worse, the term VD had become pejorative, symbolic of the inadequate clinical care sometimes offered to persons with these infections in public health facilities. So CDC changed the name of our group to the Division of Sexually Transmitted Diseases, and included the range of new infections in our 1982 STD treatment guidelines. We embraced chlamydia control programs, discussed ways to prevent herpes infections, and even tried to attack HPV as we had other sexually transmitted infections, with vinegar washes and lasers. This last approach failed miserably.

Although this STD nomenclature seemed broad enough to include most new possibilities identified as being transmitted sexually, a move began to rename the field with a more precise term—sexually transmitted infections. The debate between “diseases” and “infections” has raged for the last 3 decades. The traditionalists argue that we are primarily concerned about the consequences of the infections (pelvic inflammatory disease, infertility, general cancer, chronic ulcers, etc.), thus the term “diseases” is more appropriate. The purists argue that the organism—specific etiology takes precedence, and that the term “diseases” is itself pejorative, thus “infections” should predominate. Lines in the sand have been drawn. To further complicate things, as mentioned above, some of us have employed a distinctly different semantic, namely reproductive tract infections

So what are we to do right now? My own personal view is that “a rose by any other name is still a rose.” Namely, all of these terms are basically synonymous. Use them interchangeably, whatever best suits your preference and/or your clinical situation. We have no evidence about which one is preferable to our clients, but if any of you have the inclination to conduct a survey, we’d love to hear what your clients prefer.

Meanwhile, if you would like to let the editor of STD know your opinion, please submit any comments to the following link: Do you prefer any of the three terms over the other? Does it really matter? Dr. Handsfield has even suggested the field may evolve to use the term “disorders” rather than either diseases or infections. This would allow incorporation of the microbiome hypothesis of some of the syndromes such as bacterial vaginosis and even pelvic inflammatory disease. Note that this would still retain the “D” of STD, always preferable.

Stay tuned for any follow up, since I am sure that regardless of what people may feel, or journals may be renamed, or organizations may develop, the terminology will continue to be debated.

—Willard Cates, Jr., Distinguished Scientist and President Emeritus, FHI 360, Durham North Carolina

[1] Marrazzo J, Cates W, Reproductive tract infections, including HIV and other sexually transmitted infections. In: Hatcher RA, Trussell J, Nelson A, et al. Contraceptive Technology. 20th edition. New York: Ardent Media, Inc., 2011.

[2] Handsfield HH. Sexually transmitted diseases, infections, and disorders: what’s in a name? Sex Transm Dis 2015; 42: 169.

[3] Miller WC. Tell us what you think: Sexually transmitted disease, sexually transmitted infection, both, or neither. Sex Transm Dis 2015; 42: 170.