SEXUALLY TRANSMITTED DISEASES
Sexually Transmitted Diseases (STD), also known as Sexually Transmitted Infections (STI) and in the past as Venereal Diseases (VD), are infections that are spread through intimate sexual contact. They can spread from a man to a woman, from a woman to a man, and between same sex couples. The stigma of having an STD can be significant in a large part due to lack of accurate information. The information below is meant to give clear, concise information about some common STDs.
Chlamydia
Cause: A bacterium called Chlamydia trachomatis.
Symptoms: About 70% of those with Chlamydia have no symptoms. Women may experience unusual vaginal discharge, pain or bleeding with intercourse, or pelvic pain. Men may notice burning with urination.
Transmission: Because most people do not experience symptoms, Chlamydia is unknowingly passed from partner to partner with ease and remains the most common STD caused by a bacterium. Condoms help decrease the likelihood of transmission.
Complications: In women: pelvic inflammatory disease, infertility, and pre-term delivery.
In men: epididymitis (inflammation of the tube leading from the testicles to the urethra).
Treatment: Antibiotics, usually Azithromycin or Doxycycline. Medications must be taken in their entirety even after symptoms have resolved.All sexual partners must be treated.
For more information:
Gonorrhea
Cause: A bacterium called Neisseria Gonorrheae. It is the second most common STD caused by bacteria, and very common in youth and young adults.
Symptoms: Men often experience burning with urination and/or a white/yellow discharge from the urethra. Women may experience unusual vaginal discharge, pain or bleeding with intercourse, or pelvic pain. Some individuals have mild symptoms that go unnoticed.
Transmission: Though more often symptomatic than Chlamydia, gonorrhea is passed with ease from partner to partner. Condoms help decrease the likelihood of transmission.
Complications: In men: Pain and swelling in the testicles and penis.
In women: Pelvic Inflammatory Disease (PID), infertility, and pre-term delivery.
In both: Increased susceptibility to HIV infection.Treatment: Antibiotics: Antibiotics called Cephalosporins (Rocephin) administered intramuscularly (IM) in the doctor’s office or clinic. Until April of 2007, antibiotics called fluoroquinolones (Ciprofloxacin, ofloxacin, levofloxacin) were also used to treat gonorrhea. Due to increasing resistance to fluoroquinolones, these medications should no longer be used to treat gonorrhea.
http://www.cdc.gov/STD/Media/GonTreatmentPressRelease4-11-07.pdf
All sexual partners must be treated.
For More Information:
http://www.health.state.ny.us/diseases/communicable/gonorrhea/fact_sheet.htm
Pelvic Inflammatory Disease
Cause: Pelvic Inflammatory Disease (PID) is an infection of the female reproductive organs (uterus, fallopian tubes, and ovaries). Though not an STD, per se, PID is usually caused by an STD: chlamydia or gonorrhea most commonly.
Symptoms: In some cases there are no symptoms. In fact, PID caused by chlamydia is sometimes referred to as “silent PID”. When symptoms do develop they may include pelvic pain, abnormal vaginal discharge and/or irritation, irregular vaginal bleeding, pain with urination, fever, and painful intercourse.
Complications: PID can cause permanent damage to a woman’s reproductive organs, resulting in chronic pain and infertility. Because infection may cause scarring around a woman’s fallopian tubes, the risk of ectopic pregnancy (a pregnancy outside of the uterus) increases. A fertilized egg, unable to “fit” through a scarred fallopian tube may become lodged. As the pregnancy grows, the tube may rupture and bleed, causing hemorrhage and death. Ectopic pregnancy is an obstetrical emergency and usually requires surgery. Any woman who experiences progressively worsening pelvic pain in very early pregnancy (5-7 weeks after her last menstrual period) should see her physician immediately.
Treatment: Antibiotics are required to treat PID and are often given Intravenously (IV). Some women require hospitalization and pain medications. In severe cases surgery is needed to drain abscesses (collections of pus) in the pelvis.
For More Information:
http://www.niaid.nih.gov/factsheets/stdpid.htm
http://www.nlm.nih.gov/medlineplus/pelvicinflammatorydisease.html
Syphilis
Causes: A bacterium called Treponema Pallidum. It is transmitted sexually and from mother to infant during the birth process.
Symptoms: Syphilis is often called the “great imitator” because it has three different stages with three different sets of symptoms, and symptoms vary dramatically from person to person.
In its first stage, Syphilis is characterized by a painless sore called a chancre at the site of exposure. In a woman, this may be inside her vagina or on the cervix, and she may never even know it is there. Sometimes, nearby lymph nodes become swollen. Even without treatment this chancre will heal.
In the second stage of syphilis, many have a skin rash. It may be limited to the palms of the hands or the soles of the feet. It appears after several weeks after the chancre has healed. Other individuals suffer from headaches, sore throat, fatigue, weight loss and/or body aches. Eventually these symptoms also resolve without treatment.
After a period of latency (with no symptoms), the infected individual can develop tertiary syphilis. In this third stage, the bacteria can damage many different body organs including the brain, the heart, the eyes or the joints. Tertiary syphilis can result in death.
Treatment: In its early stages, syphilis can be treated with antibiotics. In later stages, treatment with antibiotics helps to control the bacteria, but it cannot reverse damage already done to body organs.
Complications: Pregnant women who have syphilis can pass the infection to their babies (congenital syphilis). The mother’s infection can result in stillbirth, miscarriage, premature birth, birth defects, developmental delays, and seizures in her offspring. Infants infected with syphilis may not have any obvious symptoms at first. Some babies develop tertiary syphilis and die. All pregnant women should be tested for syphilis early in pregnancy.
For More Information:
http://www.niaid.nih.gov/factsheets/stdsyph.htm
Genital Herpes
Cause: The Herpes Simplex Virus (HSV).
There are two types of herpes viruses that can be sexually transmitted. Herpes 1 (HSV 1) commonly causes “fever blisters” on the mouth or lips. The Herpes 2 (HSV 2) virus generally causes blisters or sores in the genital region.
Though each virus has a preferred infection site both can cause oral and genital lesions.
Symptoms: In the past it was thought that an initial outbreak of genital herpes was always very painful, but studies have shown that many primary cases go undiagnosed due to lack of symptoms. If symptoms do develop, they may be severe and include painful, blister-like lesions on the genitals accompanied by itching, painful urination, swollen lymph nodes, fever, chills, headache and malaise (weakness/fatigue). Symptoms generally start 2-12 days after exposure. Herpes sores heal in about 2 weeks but the virus remains in the body indefinitely and may cause additional outbreaks throughout a person’s lifetime. Thankfully, future outbreaks are usually less severe and may consist of tingling or mild irritation or sores at the site of initial exposure.
Transmission: Though the fluid from herpatic lesions (blisters) is extremely contagious, herpes is generally spread during or just prior to subsequent outbreaks when symptoms are less severe. Additionally, the virus can be spread by infected individuals when they are completely symptom-free. This is referred to as asymptomatic shedding of the virus.Condoms offer limited protection, as skin-to-skin contact cannot be completely prevented.
Complications: Individuals with damaged immune systems may experience severe symptoms or complications from the herpes virus, including viral meningitis/encephalitis (inflammation in the fluid surrounding the spinal cord and brain).
Because outbreaks cause open sores, infected individuals are at greater risk of contracting HIV infection it their partner is HIV positive.
Herpes can be spread from a mother to her infant during birth. It is extremely important for a pregnant woman to discuss her history of herpes with her obstetrician.
Treatment: Herpes infections usually remain life-long, but medications are now available that can decrease the severity and frequency of outbreaks, prevent asymptomatic shedding of the virus, and decrease the likelihood of newborn transmission. Discuss your options with your physician.
For more information:
Human Papillomavirus (HPV)
Cause: A very common virus with many subtypes (strains).
Symptoms: Usually there are no symptoms, though some strains of HPV cause visible warts on the genitalia of men and women.
Transmission: Transmission occurs easily between sexual partners due to the lack of symptoms. HPV is by far the most common of all STDs.
Condoms offer limited protection, as skin-to-skin contact cannot be completely prevented.
Complications:
- Cervical cancer: Two strains of HPV cause about 70% of all cervical cancers.
- Vaginal, vulvar, penile, anal and oral/pharyngeal cancers; less common than cervical cancer.
- External genital warts that can be disfiguring and can interfere with vaginal delivery, if severe.
Prevention: There is now a vaccine (Gardasil) that protects against four strains of HPV, two that cause cervical cancer and two that cause genital warts. It is licensed for women between the ages of 9and 26 years. Studies are under way to determine if it will also be effective in men. Some struggle with the idea of an “STD vaccine”. Gynecologists have known for years that HPV and cervical cancer are not just diseases of the promiscuous. In fact, it is estimated that 80% of all women will contract HPV by their fiftieth birthday. Let’s protect our daughters while they are young.
For more information about this vaccine:http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm
http://www.health.state.ny.us/prevention/immunization/human_papillomavirus/
For more information about Genital warts please see:
For more information about cervical cancer please see:
http://www.nlm.nih.gov/medlineplus/cervicalcancer.html
http://www.cancer.org/docroot/lrn/lrn_0.asp
http://www.cancer.gov/cancerinfo/pdq/treatment/cervical/patient/
Cancer Screening
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