CONDITIONS

STD

What Is STD

Sexually transmitted infections and diseases are bacterial or viral conditions that are transmitted via sexual contact with an infected person or through contact with infected bodily fluids.

Common STDs include:

HPV (human papillomavirus). Some types can cause health problems including genital warts and cervical cancer.

  • Cervical cancera cancer arising from the cervix due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body.
  • Genital warts, which are small growths that can occur in the anal or genital areas, caused by a virus that is spread especially by sexual contact.

HIV/AIDS. Acquired immunodeficiency syndrome (AIDS), a chronic condition caused by the human immunodeficiency virus (HIV), damages the immune system and may lead to life-threatening diseases including cancer.

Herpes. The herpes simplex virus (HSV) is a common cause of infections of the skin and mucous membranes, manifesting as tiny, clear, fluid-filled blisters usually around the mouth or genitals.

Chlamydia. This is a common sexually transmitted bacterial infection that is often asymptomatic for years but that  can lead to other health problems if left untreated, including pelvic inflammatory disease (PID), infection near the testicles (epididymitis), prostate gland infection, infertility, infections in newborns, and reactive arthritis, known as Reiter’s syndrome.  

Trichomoniasis. A common, treatable sexually transmitted infection (STI), this disease is caused by a parasitic protozoa called Trichomonas vaginalis.

Syphilis. This is a chronic bacterial disease that is contracted chiefly by infection during sexual intercourse.

Hepatitis B. This is a severe form of viral hepatitis transmitted in infected blood or during sexual intercourse.

 

What Causes STD

STIs and STDs are spread through contact with infected bodily fluids. Transmission can occur during intercourse, skin-to-skin contact, sex toy use, or any other exchange of bodily fluids.

Risk Factors For STD

Having unprotected sex is the main risk factor for sexually transmitted infections and diseases. Women who began having sexual relations at a younger age, and/or have had multiple sexual partners, are more at risk for developing HPV.

Many older women, especially those who married young and stayed with the same partner or used the pill may never have had had sex using a condom. Yet no matter how old you are, or whether or not you can get still pregnant, you should use protection if you are going to have sex with a new partner.  According to the Centers for Disease Control (CDC), consistent and correct use of male latex condoms can reduce (though not eliminate) the risk of STD transmission. To achieve the maximum protective effect, condoms must be used both consistently and correctly.

Non-latex condoms. According to the results of several studies, non-latex condoms have higher rates of clinical breakage and slippage compared with latex condoms. Most people who use non-latex condoms have allergies to latex. There are also couples who simply prefer non-latex condoms because of the physical sensation during sex.

Latex condoms. Although latex condoms are safer in terms of STD protection because they are less likely to slip or break, the use of latex condoms by people with an allergy to latex can cause symptoms such as skin irritation and difficulty breathing. In people with severe latex allergies, using a latex condom can potentially be life-threatening. Repeated use of latex condoms can also cause some people to develop an allergy to latex. 

Diagnosing STD

Diseases and conditions that affect sexual health are usually diagnosed by a primary care physician (PCP) or gynecologist.

Your doctor’s work-up will include the following:

  • Medical history, most likely including questions about your previous sexual partners and sexual habits.
  • Physical exam, checking for physical signs of STDs such as warts, rashes, and abnormal discharge.
  • Blood tests, to check for disease-specific antibodies.

Depending on the results of your examination, your doctor may order further testing or send you to an infectious disease specialist who is knowledgeable about sexually transmitted diseases or an endocrinologist who works with hormonal issues.

Symptoms of STD

If you believe you have any of these STD symptoms (or that you may have been exposed to one), see your doctor for testing. Timely diagnosis and treatment are important to avoid or delay severe, potentially life-threatening health problems and to avoid infecting others. The most common symptoms of STD’s include:

  • Chlamydia
    • Painful urination
    • Lower abdominal pain
    • Vaginal discharge in women
    • Discharge from the penis in men
    • Pain during sexual intercourse in women
    • testicular pain in men
  • Trichomoniasis
    • Clear, white,greenish or yellowish vaginal discharge
    • discharge from the penis
    • Strong vaginal odor
    • Vaginal itching or irritation
    • Itching or irritation inside the penis
    • Pain during sexual intercourse
    • Painful urination
  • Genital herpes: The signs and symptoms of HSV can be mild that they go unnoticed. When signs and symptoms are noticeable, the first episode is generally the worst. Some people never experience a second episode. Other people, however, can experience reecurrent episodes over a period of decades. When present, genital herpes signs and symptoms may include;
    • Small red bumps, blisters (vesicles) or open sores (ulcers) in the genital, anal, and nearby areas.
    • Pain or itching around the genital area, buttocks, and inner thighs
  • Genital warts (HPV infection) Some genital warts cause no symptoms. Genital warts may be a small as 1 millimeter in diameter or may multiply into large clusters. IN women genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, and the cervix. IN men they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sex with an infected person.
    • Small, flesh-colored or gray swellings in your genital area
    • Several warts close together that take on a cauliflower shape
    • Itching or discomfort in your genital area
    • Bleeding with intercourse
  • Syphillis.  These signs may occur 10 days to three months after exposure:
    • A small, painless sore (chancre) on the part of your body where the infection was transmitted, usually your genitals, rectum, tongue or lips. A single chancre is typical, but there may be multiple sores.
    • enlarged lymph nodes

Prognosis

There’s a wide range of treatments for STDs but without treatment, STDs can lead to serious and even life-threatening ailments:

  • HPV or Human Papillomavirus. The outlook varies. Many common warts disappear without treatment over six to 12 months. Others dissolve when an over-the-counter remedy is used for several weeks or months. Of the office-based therapies, surgical removal of a wart gives the best immediate results, because the wart is cut away in one doctor’s visit. Other forms of therapy require several office visits
  • Herpes Simplex Virus. Genital herpes cannot be cured. Antiviral medicines may be prescribed to help relieve pain and discomfort during an outbreak by healing the sores more quickly. The medications seem to work better during a first attack than in later outbreaks. For repeat outbreaks, the medicine should be taken as soon as tingling, burning, or itching begins, or as soon as blisters appear. Persons who have many outbreaks may take these medicines daily over a period of time. This helps prevent outbreaks.
  • Chlamydia. Treated with antibiotics, chlamydial infections can be cured most of the time. Complications of untreated chlamydia include the development of pelvic inflammatory disease and becoming sterile due to blockage of the fallopian tubes. Some people (more common in men) develop reactive arthritis or Reiter Syndrome. Men may experience painful swelling of the testicles.
  • Trichomoniasis. Oral metronidazole cures trichomoniasis in 90% to 95% of cases. If the condition is not cured, this is often because the infected person’s sex partner has not been treated and continues to transmit the disease.
  • Syphilis. With antibiotic treatment (penicillin unless the patient is allergic to the medication), early syphilis infection can be cured before the disease causes permanent damage. Although later stages of syphilis also respond to antibiotics, treatment will not repair any organ damage caused by the disease. Without treatment, about one-third of patients with latent syphilis develop tertiary syphilis, and these patients risk severe organ damage and death.

Living With STD

Sex can be a powerful expression of intimacy, a lot of fun and a great tool for protecting or improving health. Here are some suggestions on how to boost your sex life:

  • Engage in protected sex, especially with new partners. Prevention of further STDs through condom use is crucial, even if you can no longer have children
  • Ask potential new partners to be tested for STDs, including HIV/AIDS, before you agree to have sexual contact.
  • Be open with your sexual partners about your STD, and be prepared to answer their questions. Respect their concerns and reservations
  • Get tested regularly for sexually transmitted diseases at a doctor’s office or local clinic.
  • Seek prompt treatment. Most STDs are easily treatable if discovered early enough. Get regular STD testing and don’t be afraid to report any potential STD symptoms to your doctor.

Screening

Screening for STDs should take place at least once a year if you are sexually active, these are the main screening tests for STDs:

  • Chlamydia and gonorrhea. Chlamydia and gonorrhea screening is done either through a urine test or through a swab inside the penis in men or from the cervix in women. The sample is then analyzed in a laboratory. Screening is important, because if you don’t have signs or symptoms, you can be unaware that you have either infection.
  • HIV, syphilis and hepatitis. The Centers for Disease Control and Prevention (CDC) encourages HIV testing, at least once, as a routine part of medical care if you’re an adolescent or adult between the ages of 13 and 64. The CDC advises yearly HIV testing if you are at high risk of infection.  Your doctor tests you for syphilis by taking either a blood sample or a swab from any genital sores you might have. The sample is examined in a laboratory. A blood sample is taken to test for HIV and hepatitis.
  • Genital herpes (HSV). No good screening test exists for herpes, a viral infection that can be transmitted even when an infected person doesn’t have symptoms. Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, for examination in a laboratory. But a negative test doesn’t rule out herpes as a cause for genital ulcerations. A blood test also may help detect a herpes infection, but results aren’t always conclusive. Some blood tests can help differentiate between the two main types of the herpes virus. Type 1 is the virus that more typically causes cold sores, although it can also cause genital sores. Type 2 is the virus that more typically causes genital sores. Still, the results may not be totally clear, depending on the sensitivity of the test and the stage of the infection. False-positive and false-negative results are possible.
  • HPV. No HPV screening test is available for men, in whom the infection is diagnosed only by visual inspection or biopsy of genital warts. In women, HPV testing involves:
    • Pap test, which check the cervix for abnormal cells, are recommended every two years for women between ages 21 and 30. Women age 30 and older can wait three years between Pap tests if their past three tests have been normal.
    • HPV test. Samples for the HPV test are collected from the cervical canal. This test usually isn’t offered to women younger than 30 because HPV infections that will ultimately clear up on their own are so common in this age group.  

Prevention

To prevent getting a sexually transmitted disease, or STD, always avoid sex with anyone who has genital sores, a rash, discharge, or other symptoms. The only time unprotected sex is safe is if you and your partner have sex only with each other, and if it’s been at least six months since you each tested negative for STDs. Otherwise you should:

  • Use latex condoms every time you have sex. If you use a lubricant, make sure it’s water-based. Oil-based lubricants can break down condoms.
  • Use condoms for the entire sex act. Condoms are not 100% effective at preventing disease or pregnancy. However, they are extremely effective if used properly. Learn how to use condoms correctly.
  • Avoid sharing towels or underclothing
  • Wash before and after intercourse
  • Get a vaccination for hepatitis B. This is a series of three shots.
  • Get tested for HIV
  • If you have a problem with drug or alcohol abuse, get help. People who are drunk or on drugs often fail to have safe sex.
  • Clean sex toys after use

Medication And Treatment

There are prescription medications available that can control or cure most STDs.


HPV

While over-the-counter remedies for genital warts can be effective, these other remedies are generally recommended:

  • Cryotherapy. The freezing off of the wart with liquid nitrogen
  • Trichloracetic acid. A chemical applied to the surface of the wart that burns it off
  • Surgical removal of a wart. The doctor excises the wart with a scalpel.
  • Electrocautery. The burning off warts using an electric current
  • Laser vaporization or excision of the warts

When treatment is indicated, patients can get a prescription cream from their doctor to apply at home. There are two options:

  • Podofilox, or Condylox: generally used for 1 month and works by selectively destroying wart tissue. Research shows that 45-90% of warts are cleared, yet in 30-60% of cases, warts can return.
  • Imiquimod, or Aldara: improves the immune system. Clearance of the warts vary from 70-85%, but may return up to 20% of the time.

HSV

Genital herpes may be managed, but not cured. Antiviral medicines may be prescribed to help relieve pain and discomfort during an outbreak by healing the sores more quickly.

Acyclovir, famciclovir, and valacyclovir (brand name Valtrex) are antiviral medicines used to treat genital herpes.. While all are effective valacyclovir and famciclovir are absorbed more easily by the stomach, and can be taken less often than acyclovir. Antiviral medicines are usually taken by mouth (orally). But they are sometimes given intravenously (IV) in severe genital herpes outbreaks or herpes in newborns.

There is a topical form of acyclovir (Zovirax ointment), but it offers little benefit in the treatment of genital herpes, and is not usually recommended. For repeat outbreaks, the medicine should be taken as soon as tingling, burning, or itching begins, or as soon as blisters appear. Persons who have many outbreaks may take these medicines daily over a period of time. This helps prevent outbreaks


Chlamydia

As Chlamydia is caused by a bacteria, it is best treated with antibiotics. As a result, chlamydial infections can often be cured..

If you are diagnosed with chlamydia, your doctor will prescribe oral antibiotics. A single dose of azithromycin or taking doxycycline twice daily for 7 to 14 days are the most common treatments


Trichomonniasis

Oral metronidazole cures trichomoniasis in 90% to 95% of cases—this medication is typically prescribed as a vaginal suppository.


Syphilis

With proper antibiotic treatment, which is traditionally penicillin, early syphilis infection can be cured without causing permanent damage. Those with penicillin allergies may be treated with other antibiotics, such as tetracycline. Although later stages of syphilis also respond to antibiotics, such as cephalosporins, like ceftriaxone, treatment will not repair any organ damage caused by the disease, which may be irreversible depending on the organ affected and severity of damage.


HIV

HIV cannot be cured, but treatment has come a long way, and is primarily focused on supporting white blood cell count (specifically CD4 fighter cells—which are a type of white blood cell that fights infection. Another name for them is T-helper cells.), which provide immunity. CD4 cells move throughout your body, helping to identify and destroy germs such as bacteria and viruses. The most effective treatment for HIV is antiretroviral therapy (ART), a combination of several medicines that aims to control the amount of virus in your body. Among the most commonly prescribed medications are:

  • Nucleoside/nucleotide reverse transcriptase inhibitors, such asabacavir, emtricitabine, and tenofovir.
  • Nonnucleoside reverse transcriptase inhibitors (NNRTIs), such asefavirenz, etravirine, and nevirapine.
  • Protease inhibitors (PIs), such as atazanavir, darunavir, and ritonavir.
  • Entry inhibitors, such as enfuvirtide and maraviroc.
  • Integrase inhibitors, such as dolutegravir and raltegravir.

Care Guide

  • Visit a doctor or clinic annually for STD testing, or after having unprotected sex with someone with an unknown sexual history.
  • Follow your treatment plan. Don’t take more or less medication than prescribed, and always carry out taking medication until the last dose. Stopping too soon or altering dosage may interfere with the effectiveness of the treatment.
  • Engage in protected sex, especially with new partners. Prevention of further STDs through condom use is crucial, even if you can no longer have children.
  • Ask potential new partners to be tested for STDs, including HIV/AIDS, before you agree to have sexual contact.
  • Be open with your sexual partners about your STD, and be prepared to answer their questions. Respect their concerns and reservations.

When To Contact A Doctor

Make an appointment with your doctor:

  • If you’re a man who is experiencing erectile dysfunction as a result of injury to the back, legs, buttocks, groin, penis, or testicles; or who has with enlargement of the breasts (gynecomastia), or backache.
  • If you’re a woman who is experiencing pain or dryness (atrophic vaginitis) during sexual intercourse
  • If you’ve lost interest in sex
  • If you have any symptoms of Sexually Transmitted Diseases including, rash, pain, warts, or blisters. Or if you have had unprotected sex with a partner who may be infected with STDs.

Contact your doctor immediately if:

  • You are a woman who is experiencing sudden, severe pelvic pain.
  • You are a man who has an erection that lasts longer than three hours (priapism) and, have taken sildenafil (for example, Viagra) or vardenafil (for example, Levitra) in the past 24 hours or tadalafil (for example, Cialis) in the past 48 hours, and you have chest pain
  • You are a man who has erection problems that occur along with pain or difficulty with urination, fever, or pain in the lower belly

Questions For Your Doctor

The first stop with any sexual health concern should be with your primary care physician. Women may be referred to gynecologist and men to an urologist. An infectious disease specialist is a doctor who works with patients who have STDs. An endocrinologist is a specialist who diagnoses and treats hormonal issues. Depending on underlying conditions your doctor might also refer you to a neurologist, cardiologist, or therapist.

Questions For A Doctor

If you’re not enjoying sex or have lost your desire, these are the questions you might want to ask your doctor. Try not to be embarrassed. Your physician has most likely heard everything:

  • Should I have my hormones tested?
  • Are there medications to boost my sex drive? What are the side effects?
  • Have any natural aphrodisiacs been proven to boost sexual drive?
  • If you’re a man with ED, you might want to ask what your options are.
  • If you’re a woman with low sex drive, you might want to ask what your options are.
  • Is it “normal” to feel this way?
  • Should I be tested for sexually transmitted diseases?
  • How frequently should I be having sex?

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