Sexually Transmitted Diseases
A sexually transmitted disease (STD) also termed as sexually transmitted infection (STI) or venereal disease (VD) has considerable possibilities of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex. Centers for Disease Control and Prevention estimates that there are over 15 million cases of sexually transmitted disease cases reported annually in the United States. There are more than 25 diseases that are transmitted through sexual interactions. Although most STDs affect both men and women, but in maximum cases the health problems can be more severe for women. If a pregnant woman has an STD, it can cause serious complications for the baby. Many STDs can be passed from a mother to her baby before, during, or instantaneously after birth.
STDs have become more frequent in nowadays, partially because people are becoming sexually active at a younger age, are having numerous partners, and do not use preventive methods to lower their chance of having a STD.
There are over 20 types of STDs some of which are caused by bacteria. STIs caused by viruses include hepatitis B, herpes, HIV and the human papilloma virus (HPV). The major types are:
- Chlamydia(Haemophilus ducreyi)
- Gonorrhea(Chlamydia trachomatis)
- Herpes Simplex(Neisseria gonorrhea)
- Syphilis(Treponema pallidum)
What are the symptoms of STDs?
The symptoms differ among the different kinds of STDs. Some examples of familiar symptoms include:
- Unusual discharge from the penis or vagina
- Sores or warts on the genital area
- Burning sensation while urinating
- Itching and redness in the genital area
- Anal itching, soreness, or bleeding
How can STDs be prevented?
The only possible way to ensure that you won’t get infected with any kind of STDs is to not have sex. This indicates avoiding all types of intimate sexual contact.
If you are sexually active, you can lessen your risk of infecting STDs by practicing “safe sex.” This signifies:
- Using a condom for vaginal, oral, and anal intercourse—always
- Knowing your partner and his/her STD status and health—before having sex.
- Having regular health check-ups, particularly if you have more than one sexual partner
Among all sexually transmitted diseases (STDs) Chlamydia is reported as most commonly bacterial infection. Global chlamydia statistics validate that an estimated 92 million new chlamydia infections crop up every year, infecting more women (50 million) than men (42 million).
The bacterium, chlamydia trachomatis is responsible for causing Chlamydia. This bacterium can infect the cervix in women and the urethra and rectum in both men and women. Infrequently chlamydia can also spread out other parts of the body, including the throat and eyes.
Chlamydia habitually has no symptoms, particularly among women. If left untreated, chlamydia can invite serious problems in later phase of life.
Symptoms and signs
Chlamydia symptoms generally emerge between 1 and 3 weeks after exposure but may not appear until much later. Chlamydia is called as the ‘silent’ disease as in many people it generates no symptoms. It is estimated that 70-75% of women affected with chlamydia are asymptomatic (have no symptoms) and a considerable proportion of men too have no signs. Those who do have symptoms of chlamydia may suffer from:
- An increase in vaginal discharge caused by an inflamed cervix
- The need to urinate more repeatedly, or pain at the same time as passing urine
- Pain during sexual intercourse or bleeding after sex
- Lower abdominal pains
- Irregular menstrual bleeding
- A white/cloudy and watery discharge from the penis that may tarnish underwear
- A burning sensation and/or pain when passing urine
- Pain and swelling in the testicles.
- Men are more likely to observe chlamydia symptoms than women, though they too may be asymptomatic.
Chlamydia can be transmitted:
- Chlamydia is an infection caused by the bacterium Chlamydia trachomatis. This bacterial infection is transmitted in 2 ways:
- From one human being to another by close personal contact such as through sexual intercourse (not by casual contact such as a handshake).
- From mother to child with passage of the child through the birth canal.
Chlamydia can cause pneumonia or severe eye infections in a newborn, especially among children born to infected mothers in developing countries.
Chlamydia testing is the only way to find out for certain whether a person is infected.
A urine sample is taken from the affected women and it is sent to a laboratory for testing. On the other hand a swab can be obtained from the vagina (either by a doctor or nurse, or by the woman herself) that is sent to a laboratory. Results for the chlamydia test are generally on hand within one week, though this may vary depending on location.
For men, either a urine sample is taken, or a swab is taken from the opening of the urethra at the tip of the penis. Many laboratories now just take a urine sample. This is an easier and less painful process, but is slightly less reliable than a swab.
A modern ‘rapid’ urine test for men has also been developed, which delivers the results within the hour and reduces the necessity for laboratory testing.
The doctor may recommend a single-dose antibiotic, such as azithromycin, taken as a pill. Alternatively, the doctor can prefer an antibiotic, such as doxycycline (Atridox, Bio-Tab), to be taken as a pill twice a day for a week. Approximately 95% of people with Chlamydia will be cured after one course of antibiotics.
- Use latex condoms at time of sexual intercourse.
- Avoid sexual contact with high-risk partners.
- Infected sexual partners should be treated or you should be aware of the test-report of your partner before having sexual relations. Up to one-fourth of sexual partners will be re-infected because the partner wasn’t treated.
Complications of Chlamydia
If Chlamydia is left undiagnosed and untreated it can cause severe health complications. Early diagnosis and treatment means that Chlamydia infection can be easily cured, but if left unchecked it can lead to:
Pelvic inflammatory disease (PID) – It is an infection of the uterus, ovaries and fallopian tubes. PID enhances the future risk of ectopic pregnancy (a pregnancy outside the womb) or premature birth. If the fallopian tubes are scarred, it can also bring about crisis with fertility.
Cervicitis – causes an inflammation of the cervix. Symptoms include a yellowish vaginal discharge and pain during sex. In long-term cervicitis the cervix turns into extremely inflamed and cysts can develop and become infected. This can cause deep pelvic pain and backache.
Epididymitis – painful inflammation of the tube system that is part of the testicles, which can lead to infertility.
Urethritis – inflammation of the urine tube (urethra), causing a yellow or clear pus-like discharge to collect at the tip of the penis. If it is left untreated it can lead to a narrowing of the urethra, which can affect the ability to urinate easily and can potentially cause kidney problems.
Gonorrhea is a sexually transmitted infection. It is caused by the bacterium Neisseria gonorrheoae. Gonorrhea affects both men and women and can infect the cervix, urethra, rectum, anus and throat. Gonorrhea is one of the most common sexually transmitted diseases (STDs) and according to global gonorrhea statistics that an estimated 62 million cases of gonorrhea occur each year, affecting more women than men.
Symptoms of gonorrhea infection may come out 1 to 14 days after exposure, although it is likely to be infected with gonorrhea and have no symptoms. Men are far more likely to notice symptoms as they are more apparent. It is estimated that almost half of the women who are infected with gonorrhea experience no symptoms, or have non-specific symptoms such as a bladder infection.
- A change in vaginal discharge; it may come out in loads, change to a yellow or greenish color, and develop a strong smell.
- A burning sensation or pain whilst passing urine.
- Irritation and/or discharge from the anus.
- No symptoms 30-40% of the time.
- A white or yellow secretion from the penis
- A burning sensation or pain whilst passing urine.
- Irritation and/or discharge from the anus.
Irritation of the mucous membranes in the eyes (if not treated, can cause blindness).
Gonococcal throat infection should be considered in people who complain of sore throat and have other signs of gonococcal infection. Throat infections from gonorrhea are transmitted through oral sex but occur without any other indications in less than 5% of people infected with gonorrhea.
Rectal pain or discharge can be a sign of infection of the prostate and is passed on through anal intercourse.
Gonorrhea is transmitted through penetrative sex, including:
- Vaginal sex
- Anal sex
- Oral sex – oral sex can either spread gonorrhea from the genitals to the throat of the person giving the stimulation, or it can pass an infection from the throat to the genitals of the person receiving stimulation.
Health care providers generally employ three laboratory tests to detect gonorrhea.
- Staining samples directly for the bacteria
- Detecting bacterial genes or DNA in urine
- Growing the bacteria in laboratory cultures
Treatment is trouble-free and vital. The patient will be recommended an antibiotic in tablet, liquid or injection form.
Doctors normally prescribe a single dose of one of the following antibiotics to treat gonorrhea.
- Single-dose cephalosporin regimens
These types of antibiotics are not suitable for one who is pregnant, or are younger than 18 years old. Your health care provider can advise the best and safest antibiotic or shot instead of a pill for them.
- Use latex condoms when having sexual intercourse.
- Avoid sexual contact with high-risk partners.
- Treat infected sexual partners or have them tested before having sexual relations.
Gonorrhea can cause Pelvic Inflammatory Disease (PID), an inflammation of the fallopian tubes (the tubes along which an egg passes to get to the womb), which amplifies the future threat of ectopic pregnancy (a pregnancy outside the womb) or premature birth.
If a pregnant woman has gonorrhea when giving birth, the infection may be transmitted to her child. The baby could be born with a gonoccocal eye infection, which must be treated with antibiotics as it can cause blindness. It is better for the woman with this bacterial disease to acquire proper treatment prior to giving birth.
Gonorrhea can bring about painful inflammation of the testicles and the prostate gland, potentially leading to epididymitus, which can cause infertility. Without treatment, a narrowing of the urethra or abscesses can grow after time. This causes significant pain and troubles at the time of urinating.
Syphilis is caused by the bacterium Treponema pallidium. The sexually transmitted infection is known as venereal syphilis. Congenital syphilis occurs when the infection may pass from an infected mother to her unborn child.
Syphilis has been rare since penicillin become widely accessible in the 1950s, although global syphilis statistics points out that an estimated 12 million new infections still happen every year.
The initial phase of syphilis is frequently marked by the symptom of a particular sore (called a chancre), but there can be several sores. The time between infection with syphilis and the beginning of the first sign can range from 10 to 90 days (average 21 days). The chancre is generally firm, round, small, and painless. It appears at the spot where syphilis penetrated into the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if proper treatment is not controlled, the infection progresses to the secondary stage.
Skin rash and mucous membrane lesions are the symptoms of the secondary stage. This stage normally begins with the growth of a rash on one or more areas of the body. The rash usually does not cause itching. Rashes associated with secondary syphilis can appear as the chancre is healing or several weeks after the chancre has healed. The characteristic rash of secondary syphilis may appear as rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet. On the other hand, rashes with an unusual appearance may arise on other parts of the body, at times resembling rashes caused by other diseases. Sometimes rashes related with secondary syphilis are so pale that they are not noticed. Besides rashes, signs of secondary syphilis may comprise of fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will develop to the dormant and perhaps late stages of disease.
Late and Latent Stages
The latent (hidden) stage of syphilis starts when primary and secondary symptoms fade away. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection lingers in the body. This hidden phase can last for years. The late stages of syphilis can increase in about 15% of people who have not been treated for syphilis, and can appear 10 – 20 years after infection was first acquired. In the late stages of syphilis, the disease may consequently injure the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis consist of difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be adequately grave to cause death.
Syphilis is a contagious, regularly sexually transmitted; disease caused by the bacteria Treponema pallidum.
The bacteria go into chafed skin or the mucous membranes.
Transmission most frequently happens when one person comes into contact with lesions on an infected person through sexual activity.
Men are more susceptible to contracting syphilis than women.
The active disease is found most often among men and women aged 15-39 years.
Syphilis cannot be spread over by sharing baths, toilets, towels or eating utensils.
The doctor will usually perform the following examinations and tests to diagnose the diseases:
- A blood sample is taken and sent to an STD testing laboratory.
- A sample of fluid is received from all sores using a cotton swab and observed under a microscope.
- The genital area is examined for any primary signs of syphilis. The rest of the body is also checked.
- Women are given an internal examination to check for sores.
- A sample of urine is taken.
It is easy to treat the contagious disease in its initial stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Further doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are prescribed to treat syphilis. There are hardly any home remedies or over-the-counter drugs that will cure syphilis. Treatment will eradicate the syphilis bacterium and prevent further damage, but it will not restore damage already done.
Even after the completion of the treatment the patient will be asked to visit the clinic at regular intervals for blood tests to verify that the syphilis has gone.
Once a person has been treated and confirmed cleared of syphilis, any future blood tests (e.g. for immigration reasons) will still be positive, because the body maintains antibodies against the bacteria. Doctors can give the person a certificate explicating that they have been treated and no longer have syphilis.
Although using a condom decreases the possibilities of becoming infected with syphilis, it is not completely effective. A condom may not envelop all of the sores or rashes in the affected areas, and direct skin contact can cause transmission.
If a person has sex frequently with numerous partners, then it is advisable for them to get frequent STD check-ups.
A person can be re-infected with syphilis even if they have had proper treatment for an earlier infection: past infection with syphilis and the treatment of it does not make a person protected.
The herpes simplex virus (HSV) causes blisters and sores around the mouth, nose, genitals, and buttocks, but they can happen about anywhere on the skin.
It is extremely irritating because HSV infections may recur periodically. The sores may be painful and hideous. The viral infection can be severe, but hardly ever critical for chronically ill people and newborn babies. HSV is categorized into two types- Type 1 and Type 2.
Herpes Simplex Virus Type 1
HSV Type 1 infection are tiny, clear, fluid-filled blisters like fever blisters or cold sores that most frequently arise on the face. Less commonly, Type 1 infections can happen in the genital area. Type 1 can also expand in wounds on the skin.
There are two types of infections – primary and recurrent. Although nearly everyone get infected when exposed to the virus, only 10 percent will actually develop sores. The sores of an initial infection emerge two to twenty days after contact with an infected person and can last from seven to ten days.
The number of blisters varies from one to a cluster of blisters. Before the blisters appear, the skin may itch, sting, burn, or tingle. The blisters can break as an effect of minor injury, allowing the fluid inside the blisters to ooze and crust. Ultimately, crusts fall off, leaving slightly red healing skin.
The sores from the primary infection heal entirely and seldom leave a scar. However, the virus that caused the infection remains in the body. It moves to nerve cells where it remains in a latent state.
People possibly will then have a recurrence either in the similar location as the first infection or in a nearby site. The infection may reappear every few weeks or not at all.
Frequent infections tend to be mild. They can be set off by a diversity of factors including fever, sun exposure, a menstrual period, trauma (including surgery), or nothing at all.
Herpes simplex virus 2 (HSV-2)
It is generally, but not always, sexually transmitted. Symptoms consist of genital ulcers or sores. Nevertheless, some people with HSV-2 experience no warning signs. Approximately 30% of adults in the U.S. take antibodies to heal the infections of HSV-2. Cross-infection of type 1 and 2 viruses may take place from oral-genital contact. That is, sometimes you can unexpectedly get genital herpes on your mouth and oral herpes on your genital area.
Herpetic whitlow, a finger infection is a different form of HSV infection. It mainly affects health care providers who are exposed to saliva during course of actions. Sometimes, young children also can get the infection.
HSV can transmit the infection to a fetus and cause abnormalities. A mother who is infected with HSV may pass on the virus to her newborn during vaginal delivery, especially if the mother has an active infection at the time of delivery. The women who do have hardly any symptoms of HSV infection or a history of genital HSV infection may deliver newborns among them 60 – 80% are with HSV infections.
The symptoms can differ. Many infected individuals have few, if any, noticeable symptoms. In people who do have indications, the symptoms start 2 to 20 days after the person was exposed to someone with HSV infection. Symptoms may last for several weeks.
The first occurrence of herpes is generally worse than outbreaks that come later. The major symptom of herpes is the eruption of painful, itching blisters filled with fluid on and around the external sexual organs or, for oral herpes, on or very near the lip. Females may have a vaginal discharge. Symptoms vaguely alike to those of flu may come with these outbreaks, such as fever, headache, muscle aches and fatigue. There may be painful urination, and swollen and tender lymph glands in the groin.
Usually the blisters will disappear without treatment in two to 10 days, but the virus will remain in the body, lying dormant among clusters of nerve cells until another outbreak is triggered. Cold, fever, fatigue, sunburn, menstruation or sexual intercourse and stress are the responsible factors for the emergence of HSV-2.
Most people with genital herpes have five to eight outbreaks per year, but not everyone has regular symptoms. As time goes on, the number of outbreaks generally decreases. Oral herpes can return as often as monthly or only one or two times each year.
Sores typically reappear near the spot of the first infection. Usually, as the outbreaks recur, there are fewer sores and they cure faster and are less painful.
How it is transmitted
It can be transmitted by kissing, sharing eating utensils, or by sharing towels. The sores most commonly affect the lips, mouth, nose, chin, or cheeks and occur shortly after exposure. Patients may scarcely notice any symptoms or find these sores irritating and ask for medical attention.
Sexual contact with an infected person can often cause genital sores that is the result of Type 2 infections. The virus infects anywhere between five and twenty million people, up to 20% of all sexually active adults in the United States.
Both types of lesions of herpes simplex can be spread by touching an unaffected part of the body immediately after touching a herpes lesion.
Exams and Tests
Many times, doctors can comprehend whether you have an HSV infection simply by looking at the sores. However, certain tests may be recommended to be sure of the diagnosis. These tests include:
- Blood test for antibodies of HSV (serology)
- Direct fluorescent antibody (DFA) test of cells taken from a lesion
- Viral culture of the lesion.
There are hardly any known cures for herpes, there are a number of safe medications to diminish outbreaks .Some cases are mild and may not require treatment.
Antiviral medications like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex) are useful to the people who have severe or prolonged outbreaks (particularly if it is the first episode), people with immune system problems, or those with frequent recurrences.
People who have frequent or severe recurrences of oral or genital herpes may prefer to continue taking antiviral medications to lower the episode and severity of recurrences.
During an outbreak of genital herpes, a number of steps of self-care can be taken to ease the irritation of the patient:
- Wear loose clothing
- Avoid too much heat or sunlight
- Keep the sore locale clean and dry
- Put cool or lukewarm cloths on the sore area for short periods of time
- Avoid perfumed soaps, sprays, feminine deodorants, or douches
- Take aspirin, acetaminophen or ibuprofen for the pain
- Avoid touching sores
- Wash hands immediately if you do touch the sores
Because the possibilities of contracting this disease increase with the number of sexual partners a person has, limiting the number of partners is the first step toward prevention.
To keep herpes from spreading, intimate contact should be avoided when sores are on the body. Itching, burning or tingling may arise just prior to the sores develop. Sexual intercourse should be avoided during this time. People with mouth herpes should avoid kissing, sharing cups, or lip balms. Latex condoms should be used during all sexual contact. It can lower the risk of spreading of diseases. Spermicidal foams and jellies may offer added protection although the evidence on this is controversial.
The herpes virus can also be spread by touching the sores and then touching another part of the body. If you touch the sores, wash your hands with soap and water as soon as possible. Also, do not share towels or clothing with anyone.
People with active HSV lesions should also avoid contact with newborns, children with eczema, or people with suppressed immune systems, because these groups are at higher risk for more severe disease.
To reduce the risk of infecting newborns, a cesarean delivery (C-section) is recommended for pregnant women who have an active HSV infection at the time of delivery.
Eye Infections – Herpes keratitis, an eye infection is caused by the HSV infection. It leads to pain, light sensitivity, a discharge, and a gritty sensation in the eye. Prompt treatment is required, unless scarring of the eye may occur. Fortunately, there are drugs available to get rid of the infection and prevent severe scarring in the cornea.
Infections in babies – a pregnant woman with genital herpes at the time of delivery can transmit the virus to her child as it passes through the birth canal and infects the affected area. The baby may die or suffer severe damage, generally mental retardation. Women who know that they have had genital herpes or think they might have it during pregnancy should inform their physician so protective steps can be taken.
With the exposure to the virus from non-genital lesions the newborn can also be affected. If the mother or a person working in the nursery has active blisters on the lips or hands, the baby can become infected. Family members and friends with active HSV should not touch a newborn child.
HSV can be life-threatening to a person who has cancer, AIDS, a person who has had an organ transplant, or anyone who has some other major illness like Eczema herpetiform (widespread herpes across the skin) Encephalitis, Infection of the trachea, Meningitis, Pneumonia- prolonged, severe infection in immunosuppressed individuals, because their immunity to infection has been decreased.
Trichomoniasis is a sexually transmitted infection (or STD) caused by a protozoan (a microscopic parasite), usually found in the vagina and urethral tissues. Although this condition is most frequently treated in women, men can also be infected.
- Vaginal discharge
- Vaginal itching
- Smelly, itchy, and usually frothy or foamy discharge
- Yellow or gray-green discharge
- Pain with urination
- Up to one-third of infected women have no symptoms
The majority of infected men have no signs
- Urethral discharge
- Pain with urination
- Pain and swelling in the scrotum (from epididymitis)
Trichomonas vaginalis, a flagellated motile protozoan is responsible for this disease.
Around 174 million people through out the world are contaminated with this parasite every year, making it the most regular curable sexually transmitted infection.
The average size of a trichomonad is 15 mm (they are not noticeable with the bare eye).
Reproduction of the parasites happens each 8-12 hours.
Trichomonas vaginalis was secluded in 14%-60% of male partners of infected women and in 67%-100% of female partners of infected men. It is unknown why women are infected mostly than men. One chance is that prostatic fluid contains zinc and other substances that may be damaging to trichomonads.
This infection can also be transmitted through shared towels. It is advised to wash cloths and bathing suits since the parasite is known to be able to survive in damp conditions for about an hour or so.
Exams and Tests
For both men and women, to diagnose trichomoniasis a physical examination and laboratory test should be performed by the health care provider. The parasite is problematic to detect in men than in women. In women, a pelvic examination can expose small red ulcerations (sores) on the vaginal wall or cervix.
The doctor will take the specimen during a pelvic examination.
The doctor inserts a speculum into the vagina and then uses a cotton-tipped applicator to collect a sample.
The sample is then put onto a microscope slide and sent to the laboratory to be examined.
Trichomonads are seen hardly ever during urine testing.
A diagnosis of trichomoniasis usually prompts a search for other sexually transmitted diseases, such as syphilis, HIV, gonorrhea, or chlamydia.
A large single dose is as useful as longer term treatment, but increases the risk of side effects such as nausea and vomiting.
Pills taken twice a day for 7 days are an alternative.
Clotrimazole (Gyne-Lotrimin, Mycelex-7) if pregnant and having symptoms
Medicine is placed into the vagina at night for 14 days.
This will minimize the symptoms, but the cure rate is merely 20%.
However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eradicate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms.
Research has revealed a connection between trichomoniasis and two serious sequelæ. Data shows that:
- Trichomoniasis is related with increased risk of transmission of HIV.
- Trichomoniasis may cause a woman to deliver a low-birth-weight or premature infant.
- Trichomoniasis is also associated with increased possibilities of cervical cancer.
- Evidence shows that infection in males potentially raises the risks of prostate cancer development and spread due to inflammation.
We know that Trichomoniasis is a sexually transmitted disease. That is why self-restraint is the ideal method to limit the spread of this disease. Safe sex and hygiene practices are the best preventive measures to restrict the trichomonas infection.
- During the sexual intercourse use condoms positively.
- Wash before and after intercourse.
- Don’t share swimsuits or towels with anybody. (Trichomonads stay alive for up to 45 minutes outside the body.)
- Take a shower immediately after swimming in a public pool.