Sexually
Transmitted Diseases (or S.T.Ds)
Also known as sexually
transmitted infections (or S.T.I.s)
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The
following text is for information only. We
are
not medically qualified and no information
presented here should be construed as
medical advice. We cannot accept liability
for the accuracy or correctness of any
information presented here. Please consult a
qualified medical practitioner if you think
you have contracted an STD. At the least STDs are no fun
at all, at the worst they are life
threatening, and they need to be treated for your own
sake and your lover's!
A sexually
transmitted disease or STD is a disease
which is transmitted through genital contact
during sex from one partner to the other.
STDs are common and as a sexually active
adult you may be at risk of contracting a
disease during sex.
STDs are
caused by a wide range of pathogens (i.e.
organisms which cause illness). STDs include
many different
diseases: some may not cause you any
physical discomfort at all, whereas others
are deadly if not treated.
They can be
caused by bacteria (e.g. Gonorrhea), fungi
(e.g. Candida or thrush) or viruses (e.g. herpes or
HIV). Treatment for diseases other than the viral
infections is often easy and rapid with
antibiotics or anti-fungal medication. Some
conditions, including yeast infections like Candida, may respond to dietary regimes.
Some STDs are
localized in the genital region and do not
affect other parts of the body. However, the
opposite can also be true: the first
infection of the body happens via the genitals, but the disease
then spreads to the rest of the body as a
systemic infection - as in HIV or syphilis. If
infections stay localized they can cause
pelvic infections and lesions in the genital
area.
Most of them will be uncomfortable and
interfere with normal sexual activity. Most
localized STDs have the potential to affect
other membranes in the body such as
the oral and anal cavity as well as the
genital region.
Some STDs may
only be apparent in one sex. For example men
and women can contract gonorrhea, but the
illness does not show any early symptoms in
women, whereas it does in men.
If you contract an STD your sexual partner
must be screened too as he or she may be
carrying the infection without knowing it!
If you think you may have contracted an STD
you must get yourself screened by a doctor.
Quite often treatment is easy: however STDs
can be dangerous if untreated.
STDs have
always carried a strong stigma implying that
somebody is not faithful. This could be
indeed the case, however, one can catch
an STD whilst being 100% faithful! This
is the case if the initial infection is
caused by an organism which naturally lives
in the bowel or skin area of the body. These natural organisms
can be
displaced during sexual activity, or when a
person's immune system changes, e.g.
when a woman
gets pregnant, and the organism can then invade
the genital area. Such an infection, once
acquired, can be passed between two people
through genital contact, making it an STD.
The stigma
involved in STDs must not stop you from
seeking medical help if you have contracted
one!
In the Western world medical
services must keep your information
confidential. G.U.M clinics (Genito-Urinary
Medicine clinics) will be very aware of how hard it
is for patients to turn up and will make
every effort to make the service more
accessible.
You can also simply go to your
GP, who will then refer you on to a
specialist clinic. Additionally, you may
also have the option of attending a private
clinic.
This may be more costly, but could
shorten your waiting time. In some parts of
the world it will be the only way to get
medical attention.
STDs must
be treated! If you are concerned about
having contracted an STD please seek medical
assistance.
STDs are
not confined to the genitals.
Oral-genital contact can mean that a genital
infections spreads to the mouth and larynx
of another person and vice versa. This can
happen for example with herpes simplex. The
same type of cross infection can occur
through anal sex.
In the past
STDs increased during wartime as people
found more sexual outlets and a high
number of people were displaced and on the
move. Rates of STDs fell in the 1950s and
60s, but have been on the increase since
then.
Most STDs were treatable and rates
started to climb again in the 1970s and 80s
as people took less precautions. Since the
advent of HIV rates were falling for a
while, but are now on the rise again.
STDs
do not need to take away from your enjoyment
of sex. To keep yourself and your partner as
safe as possible
practice "safer sex".
Safer sex techniques minimize the
risk of catching an STD. Although these
techniques can help reduce the risk of
catching an STD, only complete abstinence
would be 100% safe. As life itself carries
all sorts of risks, there is no need to go
over the top though! However, do your best
to keep yourself safe.
To
keep yourself as safe as possible, follow these
guidelines:
-
Reduce the number of sexual partners
-
Use a condom and lubricants
-
Avoid anal sex
-
Do not have oral sex with somebody with
cold sores
The following
list of common STDs is divided into a list
of common infections in women and men and a
list of STDs which affect both sexes
equally. Of course, STDs always affect both
sexes, however they may show up more in one
sex than the other, in which case they are
listed in that category.
Women's
sexual anatomy makes infections of the
genital region common. Normally, women's
bacterial flora and the slightly acidic
environment in the vagina prevents
infections.
However, often pathogens are
already present in the vagina, skin or
bowels and may get a hold on the
membranes when outside conditions change.
This could happen through being run down or
stressed, taking a broad-band antibiotic for
something else or when becoming pregnant.
Often STDs will show up in women through an
abnormal vaginal discharge or small lesions.
If you are experiencing an unpleasant and
unusual discharge or pain, please get
medical assistance! Localized genital
infections can ascend into the pelvic cavity
and may cause long term conditions such as
deep
dyspareunia or infertility. If you are
pregnant, an untreated STD can be extremely
serious or even fatal for the fetus.
Urethritis
describes an infection of the urethra, which
is the canal which passes urine from the
bladder to the outside of the body. Due to the position
of the urethra in women it is prone to
infections.
Urethritis can be divided into gonococcal (see below) and non-gonococcal or
non-specific urethritis (also known as NSU) depending on which
organism causes the infection. Cystitis
describes an inflammation of the bladder.
Therefore, the organism which causes
urethritis can grow and also infect the
bladder resulting in cystitis.
However,
cystitis can also be caused through other
means such as a stone or an injury.
The symptoms
of urethritis and cystitis include a
frequent urge to urinate even though little
water is passed and a burning sensation on
urinating. It may also include slightly
white or yellow discharge from the vagina.
Non-gonococcal urethritis can be caused by
the following organisms:
a) Faecal
organisms such as Escherichia coli.
This infection may occur after first time
sex for women (which got it the old name of
"honeymoon cystitis").
It is
normal for bacteria to be displaced during
sexual activity and they may then be able to
infect the urethra. Post-menopausal women
are also prone to this type of infection.
b)
Chlamydia trachomatis is the primary
cause of non-specific urethritis. Chlamydia
infections are serious as they can cause, if
untreated, inflammation of the cervix and
pelvic area and subsequent infertility.
c) Other
organisms, which can cause non-specific
urethritis are Ureaplasma urealyticum
and Mycoplasma hominis.
Treatment is
often simple and may involve tetracycline
treatment or antibiotics depending on which
organism is implicated. Both sexual
partners must be treated even if one does
not experience any symptoms.
This
condition is caused by a protozoan organism
called Trichomonas vaginalis. It
causes a vaginal infection with itching,
burning and thin yellowish-green or grey,
badly smelling, discharge. In men the
infection may not cause any symptoms or only
a light infection of the urethra.
Therefore
a man may carry the infection and pass it on
to his partner without knowing. Treatment is
recommended with metronidazole and both
partners need to be treated.
Monilia
is a fungi, which is normally present in the
vagina without causing problems.
However, if
the vaginal flora is disturbed, for example
through the use of antibiotics, this
organism can take over. Some women are prone
to Candida, a tendency which can be
exacerbated by obesity, diabetes or during
pregnancy.
Monilial infections cause intense
burning or itching of the vagina and a thick
white discharge with a yeast-like odor.
Infections in
males can be symptomless. It is suggested
that at least 10% of cases are sexually
transmitted and that partners need to be
treated too.
Fungicides such as oral or
vaginal nystatin can be used to cure Candida.
It is also recommended that patients
restrict their sugar and carbohydrate intake
to help re-establish the normal vaginal
flora.
There is lots
of information on dealing with yeast
infection available on this specialist site.
You can get more information here about
Candia.
1
Non-specific urethritis
Non-gonococcal urethritis can affect men as
well as women. The organisms most often
implicated are Chlamydia trachomatis
and Ureaplasma urealyticum. It can
result in painful or difficult urination and
a urethral discharge.
Recurrences after
intercourse can be common. The
non-gonococcal variety is harder to treat
and may respond to life style changes.
Although 9 in 10 men infected with Chlamydia
have some symptoms, many ignore the
discomfort. Urethritis can be passed as a
sexually transmitted disease between
partners and both partners need to be
treated. Please also read the paragraph on
recurrent urethritis in women.
2
Gonorrhea
See also the
paragraph on
gonorrhea in women. In men the
infection can result in painful urination
and a discharge from the urethra.
Gonorrhea
can progress to an inflammation of the
bladder and the prostate if not treated.
Long term consequences can involve arthritis
of the joints. Anal-rectal infections can
occur through anal intercourse. The
infection may be more obvious in men
especially in the early stages.
3 Trichomonas and Monilia infections
Trichomonas
and
Monilia infections do normally not cause
any symptoms in men. In men, Trichomonas can
occasionally result in urethritis and Monilia in itching and soreness of the
penis. However, men need to be treated for
both infections for treatment of their
female partners to be successful.
The human
Herpes simplex virus can take two forms,
Type 1 and Type 2. Type 1 results in cold
sores around the mouth, whereas Type 2 or
genital herpes causes clusters of sores on
the labia and cervix in women. In men
vesicles can arise on the genitals,
especially the glans penis.
The sores may be
extremely painful. Infection occurs through
contact with the lesions in an infected
person through kissing, vaginal, oral or
anal sex.
About one week after first
infection the skin on the site of infection
may start to tingle and itch. It will form a
small, sometimes very painful, fluid-filled
blister.
Once infected the herpes virus lies
dormant within skin cells and only
occasionally becomes active and causes an
attack of vesicles. Genital herpes
is one of the most common STDs.
The virus is
highly infectious and can be easily
transmitted through sexual contact. The
virus is at its most infectious during the
primary acute attack and less so during
subsequent attacks.
During times when the
virus lies dormant and no sores have broken
the skin the virus is not very infectious.
15% of "genital" herpes are actually caused
by the Type 1 virus, which usually affects
the mouth area. It can be transmitted
through oral sex to the genitals and vice
versa. This is also the case for the Type 2
strain, which can infect the mouth area.
Additionally, the herpes virus can affect
the anal region.
The Herpes
simplex virus is difficult to treat and at
present incurable. However, outbreaks can be
controlled with oral acyclovir. It can help
to keep affected skin areas clean with the
use of mild soap and water and to keep areas
dry afterwards.
Loose, non-rubbing cotton
underwear may also help. The frequency of occurrence of
genital herpes is on the increase. For more
information see the
UK Herpes
Viruses Association.
2
Genital warts
Genital warts
are caused by the papilloma virus. They are
also known as condylomata. They most
commonly occur in women on the vulva, i.e.
the outside of women's genital area, less
often inside the vagina.
Genital warts can
affect other moist areas of the body such as
oral or vaginal cavity, and anal and
urethral openings. The warts themselves are
pink or red cauliflower-like growths. They
are often painless, or can itch.
There seems
to be a link between genital warts and
cervical cancer due to the presence of the papilloma virus. Women with warts need to
receive regular cervical screening.
Treatment
follows the same guidelines as with other
warts namely cryotherapy, laser therapy or
the drug podophyllin. Infection rates with
genital warts are on the increase.
Gonorrhea is
a bacterial infection (Neisseria
gonorrheae), which is typically
transmitted sexually.
In women, it initially
tends to infect the cervical canal and
urethra, resulting in gonococcal urethritis.
If untreated, the infection can spread to
the lower abdominal cavity causing
inflammatory disease, acute pelvic infection
and infertility.
The same pattern of
infection affects men, namely infection of
the urethra with a potential to spread
deeper into the body.
Early
gonococcal infection in women may not result
in any symptoms and a woman may pass the
infection on without knowing it at this
stage. Later, female symptoms include
itching and a vaginal discharge. Gonorrhea
can also affect the oral and anal region.
Untreated gonorrhea can result in
gonorrheal arthritis affecting joints
throughout the body. Gonorrhea can easily
be treated with penicillin.
4
Syphilis
Syphilis is
the most feared STD, and has been
written about in both popular and medical
literature.
It
is caused by an organism called Treponema
pallidum (for the technically minded,
it's a spirochete). It is
usually transmitted sexually and the disease
progresses in three stages.
The initial
infection triggers off the primary stage,
which results in "chancres"' at the site
where the organism entered the body usually
on the genitals or the perianal region.
The
chancres are small craterlike sores, which
are painless. They are normally hard and
heal without extra treatment leaving no
scars within 1 to 5 weeks.
The disease
then progresses to the secondary stage
resulting in flu-like symptoms, mouth sores,
patchy balding or a rash within 6 to 8
weeks.
This infectious second stage may
continue for 2 or more years before
remission. Again, these symptoms naturally
disappear without treatment and the person
is then no longer infectious to others.
About one third of all infections would
progress to a tertiary stage if left
untreated resulting in an attack on internal
organs and the nervous system. This can lead
to blindness, paralysis, insanity and
eventually death. Really very unpleasant!
However,
syphilis can now be treated easily with the
help of penicillin or other antibiotics.
Blood tests need to be repeated every 3
months for 1 year to ascertain that the
organism has been eliminated.
5
Acquired immune deficiency syndrome (AIDS)
AIDS was
first identified in 1981. It is caused by a
retrovirus called HIV (human immune
deficiency virus).
The HIV virus infects a
certain type of immune cells in the body
called T helper cells. HIV therefore damages
the body's immune system and leaves it
vulnerable to other, so-called
"opportunistic" infections such as
pneumonia.
An initial infection with HIV can
result in fever; however this stage of the
disease can pass unnoticed - similar to the
primary stage in syphilis. The virus then
spreads throughout the body and can lie
dormant for many years.
The HIV virus
is transmitted through direct vaginal or
anal sexual contact or an exchange of blood,
for example through sharing syringes or
blood infusions. Infection with HIV can also
occur during birth or through breast
feeding.
The HIV virus in itself is not very
infectious and cannot survive outside the
human body for any length of time. Infection
seems to be aided through tissue
damage such as may occur, for example,
during anal sex.
Although HIV
has originally been seen as a disease of
minority groups such as the gay community
and intravenous drug users, the majority of
infections now occur through heterosexual
contact, especially in Africa.
The HIV virus
can be controlled to some extent through a
cocktail of anti-viral drugs, but a
cure has not been found yet. Survival rates
are at the moment high in the Western world
where drugs are available; however nobody
knows about the long term effects of the
drug regime used to control HIV.
HIV may
have lost its nightmarish reputation in the
Western world to some extent but
complacency is clearly not a useful
strategy in preventing the spread of this
disease!
As a global community we need to
fight HIV and make anti-viral drugs
available to all who are affected
especially in the Third World.
If you are
worried that you may have contracted the HIV
virus, please go for a screening test, which
you can access anonymously at your nearest
GUM clinic.
You will need to wait for 3
months from when you think you have been
infected to when a test would be able to
confirm a negative result (i.e. the absence
of the virus).
False positive
tests showing the presence of the virus are extremely rare; false
negatives can occur if you are tested too
early.
Other links
References:
Bancroft, J (1983,
reprinted 2002) Human Sexuality and Its
Problems. Second edition, Churchill
Livingstone
Francoeur, R. (ed.) (1995)
The Complete Dictionary of Sexology. New
expanded edition, Continuum New York
Written by Anna 04.08.07
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