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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!

 

What is an STD?

 

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.

 

Safer 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.

 

Common sexually transmitted infections in women

 

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.

 

1 Recurrent urethritis and cystitis

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.

 

2 Trichomonas vaginitis

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.

 

3 Monilial vulvovaginitis, also called thrush or Candida

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's 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, where the principles of Yeast Infection No More are explained in detail - click here for facts about yeast infection home remedies.

 

Common sexually transmitted infections in men

 

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.

 

Common sexually transmitted infections in men and women

 

1 Genital herpes

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.

 

3 Gonorrhea

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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