Sexually Transmitted Disease

Sexually transmitted disease (STD), more recently referred to as sexually transmitted infections (STIs), are sexually transmitted infections that are spread by sexual contact.

Sexually transmitted infections can cause severe damage to the body and can even cause death. Other than colds and flu, STIs are the most common and easily spread infections in the United States. Some Sexually transmitted diseases can be cured, others cannot.

SPREADING THE INFECTION

A person infected with an STI can pass it to others by contact with their mouth, genital, rectum, skin, intravenous drug use, or body fluids, such as semen and blood. Anyone who has sexual contact whether it is by vaginal, anal, or oral sex may get an STI.  STIs do not always cause symptoms.

Even if no symptoms are apparent, a person’s health can be still be affected. STIs caused by viral infection cannot be cured. However, symptoms can be treated.  Bacterial STIs are treated using antibiotics.

RISK FACTORS

Risk factors that increase the danger of getting a sexually transmitted infection are:

• Having more than one sexual partner
• Having a partner who has or has had more than one sexual partner
• Having sex with someone who currently has a sexually transmitted infection
• Having sex with someone who has a personal history of an STI
• The use of intravenous drugs
• Having sex with a partner who uses intravenous drugs

COMMON SEXUALLY TRANSMITTED INFECTIONS

Common Sexually Transmitted Infections include:

• Gonorrhea
• Chlamydia
• Syphilis
• Genital Herpes
• HIV
• AIDS
• Human Papilloma virus (HPV)
• Trichomonas
• Hepatitis B
• Molluscum Contagiosum

Gonorrhea & Chlamydia

Gonorrhea and Chlamydia are both caused by bacteria and can be treated with antibiotics.  These infections are passed from one person to another through vaginal, anal, or oral sex. Gonorrhea and chlamydia will occur together and can both be treated.

Women with gonorrhea or chlamydia typically show symptoms that manifest from 2 days to 3 weeks after being infected.  Symptoms may be mistaken for a vaginal infection or a urinary tract infection.  Symptoms may include:

• Yellow vaginal discharge
• Vaginal bleeding between periods
• Painful or frequent urination
• Rectal bleeding
• Rectal discharge and pain

Syphilis

Syphilis also is caused by bacteria.  Syphilis occurs in stages unlike gonorrhea and chlamydia. It is spread more easily in some stages than in others. The bacteria enters the body through a cut in the skin or through contact with a syphilis sore known as a chancre.  Because this sore commonly occurs on the penis, vulva, vagina, or anus, syphilis is generally spread through sexual contact. Other contagious sources it can be spread through can include infected blood during the second stage of the infection, or by touching the rash or warts.

Symptoms of Syphilis by Stages

Stage 1: Syphilis first appears as a painless chancre.  The sore goes away without treatment in 3 to 6 weeks.

Stage 2: The second stage begins as the chancre is healing and may last for several weeks after the chancre has been gone.  In Stage 2, a rash may appear and is mainly visible on the soles of the feet and palms of the hands.  There may be flat warts visible on the vulva and flu-like symptoms may be experienced.  In Stage 2, the infection is highly contagious and the sores caused by syphilis make it easier to become infected or transmit HIV.

Stage 3 (Latent or Late Stage): In this stage, the rash and other symptoms eventually go away within a few weeks or months.  However, even after the rash and other symptoms resolve the disease is still present in the body.

If untreated, the disease may return in a very serious form years later. It is a very serious illness and may lead to brain damage. Other possible conditions that can develop include:

• Brain Tumors
• Neurologic problems
• Heart problems
• Blindness
• Paralysis
• Death

Syphilis is treated with antibiotics and early treatment can prevent long term problems.  The sooner treatment begins, the sooner the patient can discontinue taking the medication.

GENITAL HERPES

Genital herpes is a virus which has no cure.  The infection causes sores and blisters around the lips, genitals or anus.  The virus may also effect the tongue, mouth, eyes, gums, fingers, and various other body parts.  The sores appear at the site where the virus entered the body.

Genital herpes is spread by direct contact with sores, and generally during sexual activity, whether it is vaginal, oral or anal sex.  The infection enters the body through the moist membranes of the penis, vagina, urethra (urinary opening), cervix or anus.  Exposure to genital herpes can also happen through a break in the skin.  Genital herpes may be spread even if there are no visible sores!

During oral sex, herpes can be passed from a cold sore around the mouth to a partner’s genitals or to the mouth from the genitals.  Infection can also happen when a person touches an infected sore and then rubs or scratches another part of their body, especially the eyes.

Symptoms of Genital Herpes

Symptoms of genital herpes usually appear about 2 – 10 days after the herpes virus enters the body. Some people never have symptoms, however, others may, and they include:

• Swollen glands
• Fever & chills
• Muscle aches & fatigue
• Nausea & flu-like symptoms
• Sores (fluid filled blisters grouped in clusters)
• Stinging or burning during urination

When symptoms reoccur, prodromal (early or precursor) symptoms may be experienced at the entry point which include:

• Burning
• Itching
• Tingling

Pain may also be experienced in the lower back, buttocks, thighs, or knees. After a few hours of these symptoms, a new bout of sores or lesions recur.

Diagnosis & Treatment

Genital herpes is diagnosed by a blood test or a sample taken from the sore.  Oral medications may help control the length of the outbreak and give some relief from the discomfort.  If repeat outbreaks have happened, daily medication may be prescribed to reduce symptoms prevent outbreaks.  Medication can also reduce the chance of transmitting the herpes infection to someone else.

Preventing Genital Herpes Transmission

Using a condom reduces the risk of passing or getting genital herpes but does not protect against all cases.  The virus does not pass through the condom but sores that are not covered can cause transmission.  Remember, the transmission of the herpes virus to another person is possible even if sores are not present.

Avoid sex when prodromal symptoms occur and continue to refrain from sex until the scabs have gone away.  Be diligent about hand washing with soap and water after any possible contact with a sore.  Be cautious that secretions do not touch another’s skin.

Herpes during Pregnancy

During pregnancy, there are increased risks to the baby, especially if it is the mother’s first outbreak.  Women who are infected for the first time in late pregnancy have a high risk (30 – 60%) of infecting the baby because they have not yet made antibodies against the virus.  Although rare, when a newborn is infected, it most often occurs when he or she passes through the mother’s infected birth canal.  An herpes infection can cause serious problems in newborns, such as brain damage or eye problems.

Women infected with the herpes virus for the first time during pregnancy have medications available to reduce the length and severity of the symptoms.  If it is not the first infection, the Rosmark obgyn doctor may provide a prescription to reduce the likelihood of a herpes outbreak near the baby’s birth.

If prodromal symptoms or sores are evident at the time of delivery, a cesarean delivery will be necessary.  A cesarean delivery may reduce the risk of the baby becoming infected.  However, a baby can still be infected without a vaginal birth if the water breaks (rupture of the amniotic fluid) a few hours before birth.

Herpes and Breastfeeding

Women infected with genital herpes virus can usually breastfeed as the herpes virus does not pass through the breast milk.  If the mother has sores on the breast or nipples from an outbreak she may pump or express her milk by hand until the sore is gone.  In this case, the mother should make sure the parts of the breast pump that touch the milk does not touch the sore while pumping.  If this happens, the milk should be thrown away.

HIV:  HUMAN IMMUNODEFICIENCY VIRUS

HIV is an abbreviation for human immunodeficiency virus. The virus causes a weakening in a person’s immune system by destroying the important cells (T-cells) that fight infection and disease. Left untreated, HIV can destroy so many T-cells that the body can no longer fight off infections and disease. When the T-cells are destroyed, the condition progresses to acquired immunodeficiency syndrome (AIDS).  There is no effective cure for HIV and the body cannot get rid of it.

With proper medical care HIV can be controlled.  The medication used to treat human immunodeficiency is called antiretroviral therapy.  If taken early it can greatly increase a person life expectancy, keep them healthy and lower their chance of infecting others.  The antiretroviral medication can help people in all stages of the disease.

If treatment is not received, HIV progresses through three stages of disease.

Stages of HIV

Stage 1:  Within 2 to 4 weeks, a person may experience flu-like symptoms, which can last for a few weeks. These symptoms are the body’s natural response to an infection.  This stage is called Acute HIV infection.  At this stage, a person is highly contagious due to the large amount of the virus in their blood.

Stage 2:  Sometimes there is a period called asymptomatic HIV or chronic HIV infection.  The virus is active but reproduces at low levels.  Left untreated, this stage can last a decade or longer but some people may progress through this phase faster.  At the end of this stage, the viral load starts to go up and the T-cell count goes down.

Stage 3:  Acquired Immunodeficiency Syndrome (AIDS) is evident and this is the most severe stage of an HIV infection.  AIDS symptoms include:

• Fever
• Chills
• Sweats
• Weakness
• Weight loss
• Swollen lymph glands

At this stage, a person’s immune system is badly damaged, which causes vulnerability to an increasing number of severe illness.  Normally a person at this stage, left untreated, will survive about 3 years.

HPV: HUMAN PAPILLOMAVIRUS INFECTION

HPV is the most common sexually transmitted infection and there are many different types of the infection.  HPV is transmitted by having vaginal, oral or anal sex with someone with the virus.  It can be passed to a partner even if there are no signs or symptoms.  Different types of HPV can cause genital warts and cancer.

Genital HPV infection often has no signs or symptoms.  The infected person usually is not aware that they have been infected and can inadvertently spread the infection to others.

Pap Smear

In most women, the immune system fights most high-risk and low-risk HPV infections and clears them from the body.  If the infections are not cleared from the body, however, they are labeled persistent infections.  A high risk type HPV and a persistent infection can cause cells of the cervix to be abnormal, which is why Rosemark providers encourage Pap smears as early detection is the key to preventing cancer.  Women can easily screen for the HPV virus with a Pap smear.  Without scheduled pap smears, women may find out they have an HPV infection only after they contract genital warts or after they develop cancers of the anus, vulva, vagina, tongue including the back of the throat and tonsils.

Treatment

The type of HPV that causes genital warts is not the same type that causes cancer.  There are more than 100 types of human papilloma, 40 types that affect the genitals.  Fortunately, vaccines are available to help prevent some types of HPV.  To receive the best protection, the patient will need to have three doses of the Gardasil vaccine over a 6-month period. It’s best if the vaccinations are received before they become sexually active.

Vaccination may be given as early as 9 up to 26 years of age.  All three vaccines protect against the two HPV types (16 and 18) that are the most common cause of cancer. Girls may receive of the Gardasil vaccines which are given as a shot in the upper arm.

TRICHOMONAS

Trichomonas is the most curable sexually transmitted disease.  Trichomonas is a parasite that is passed from an infected person to an uninfected person during sex.  It can be transmitted from a penis, vagina, hands, mouth or anus.

Approximately 30% of men and women develop symptoms of this disease.  Symptoms of this disease vary, from mild irritation to severe inflammation of the genitals.  Urination will often times be uncomfortable.  Women may experience vaginal discharge with an unusual smell that can be clear, white, yellowish or greenish in color.

Trichomonas is cured with a treatment of a single dose of an antibiotic medication.

HEPATITIS B

Hepatitis B is a serious liver infection caused by the hepatitis B virus.  The Hepatitis B infection may last a short time (acute) which means the body has cleared the virus in less than six months.

Chronic hepatitis B means it last a long time, more than six months.  When the immune system does not fight the acute infection, Hepatitis B may last a lifetime.  Chronic hepatitis increases the risk of developing liver failure, cancer or cirrhosis.

Most people infected with hepatitis B as adults recover fully, even if their signs and symptoms are severe.  Infants and children are more likely to develop a chronic hepatitis B infection.  A vaccine can prevent hepatitis B, but there’s no cure.  Those who are infected can take certain precautions to help prevent spreading HBV to others.

Causes

The hepatitis B infection is caused by the hepatitis B virus (HBV).  The virus is passed from person to person through blood, semen or other body fluids.  HBV can be transmitted through unprotected sex with an infected person whose semen, vaginal secretions, blood, or saliva enter the body.

Sharing needles and syringes infected by another person puts the individual at a high risk of contracting hepatitis B.  Health care workers are at risk if they come in contact with an infected person’s blood by an accidental needle stick or exposure to the person’s body fluids. Pregnant women infected with HBV can pass the virus to their babies.

Symptoms

Symptoms of Hepatitis B can include many different symptoms such as:

• Abdominal pain
• Joint pain
• Fever
• Dark urine
• Loss of appetite
• Weakness & fatigue
• Nausea & vomiting
• Skin turning yellow
• Whites of the eyes turning yellow

If a Rosemark provider suspects hepatitis B, they will examine the patient and order blood tests.  Blood tests can determine if the virus is in the cardiovascular system and whether it’s acute or chronic.  If the blood test returns a positive result, a liver biopsy may also be performed to determine if there is liver damage.

REDUCE YOUR RISKS WITH SAFE PRACTICES

The following practices will reduce the risk of STIs:

1. Limit the number of sexual partners.  The more partners you or your partners have, the higher your risk of getting an STI.
2. Know your partner’s sexual history, which is as important as your own.
3. When having sex use protection.  Sexual contact with an infected person poses a high risk of contracting an STI.
4. Use a latex condom every time you have vaginal, oral, or anal sex to decrease the chances of infection.  Note: Condoms lubricated with spermicides do not offer extra protection.  Frequent use of some spermicides can increase the risk of HIV.
5. Avoid risky sex practices or sexual acts that may tear or break the skin.  These types of practices carry a higher risk of STIs.  Even small cuts that do not bleed let germs pass back and forth.
6. Anal sex poses a high risk because tissues in the rectum tear easily.
7. Receive a vaccine that guards against some types of HPV and hepatitis B.

PREGNANCY HEALTH RISKS

Women who are pregnant and suspect they or their partner may have an STI should contact a Rosemark obgyn doctor right away.  They will test for Hepatitis B, Syphilis, HIV, Gonorrhea and Chlamydia.  It is best to treat the STI early to decrease the chance of it harming the baby.

The following items are a few risks to the baby:

1.  Gonorrhea and chlamydia during pregnancy can cause health problems to the baby, including eye infections and pneumonia.
2.  Syphilis may cause miscarriage or stillbirth.
3.  The human immunodeficiency virus (HIV) infection can infect the baby.

If you have questions about sexually transmitted infections, call your Rosemark provider right away.