Sexually Transmitted Diseases
Sexually transmitted diseases (STD), once called venereal diseases, are among the most common infections in the USA today.
- STD affect men and women of all backgrounds
- Most prevalent among teenagers and young adults
- Caused by bacteria and viruses that thrive in warm, moist environments within the body cavities
- Spread by transfer of body fluids during sexual activity – vaginal, anal or oral
- STD cannot be transmitted through casual contact (hand shake, clothing, toilet seats)
- Often there are no symptoms, particularly in women
Usual symptoms are
- Vaginal discharge
- Vaginal bleeding
- Pain in the vagina
- Frequent urination
- Burning during urination
- Genital burning and itching
- Pelvic pain
- Penile drip/discharge
- Sores, bumps or blisters near the genitalia, rectum or mouth
What are the most common types of STDs?
- Genital warts (HPV)
- Genital herpes
- Hepatitis B
How to prevent STDs?
- Monogamous relationship
- Use of condom correctly and consistently
- Do not share needles
Health problems caused by STDs?
- Ectopic pregnancy
- Cervical cancer
- HIV is incurable and deadly
- Liver damage
- Infecting a new born baby
- Caused by Chlamydia Trachomatis – bacteria
- Transmitted by vagina, anal or oral sex
- Usually there are no symptoms
- Oral herpes – incidence 50-80%
- Genital herpes – incidence 20%
- Does not affect the immune system
- Spread from genital to genital, oral to genital and oral to oral contact
- Herpes is caused by a virus: Herpes Simplex – there are two types
- Herpes Simplex Virus Type 1 (HSV-1)
- Herpes Simplex Virus Type 2 (HSV-2)
- Majority of oral herpes is caused by HSV-1
- Majority of genital herpes is caused by HSV-2
- It is not possible to get genital herpes from toilet seat, bathtub or towel
- Once you are infected by HSV, the virus begins making copies of itself and spreading leading to either no symptoms or very subtle symptoms. Virus will persist in the body for ever. They hide in the nerve roots and from time to time they become active again and can cause symptoms.
- Classic symptoms are sores, vesicles, ulcers, pimples or blisters, itching, tingling, or painful swelling. These lesions eventually crust over and finally scab like a small cut.
- Outbreaks – four to five time per year – more during the first year
- Viral culture – a swab taken from the lesion, high rate of false negative, but if the test is positive – you have the virus.
- Blood tests
- Do not actually defect the virus
- They look for antibodies
- Herpes Select HSV-1 and HSV-2 tests
- Biokit HSV-2 rapid test
- Herpes western blot
- Captia HSV IgG Type Specific Elisas
- When an individual contracts Herpes, the immune system responds by developing antibodies to fight the virus: IgG and IgM. There are blood tests to detect these antibodies. IgG appears soon after infection and stays in the blood for life. IgM is not very specific.
There is no treatment to cure Herpes. There are 3 antiviral medications to treat symptoms and control outbreaks
Over the counter creams or ointments are not recommended for genital herpes
Herpes and pregnancy
It is rare for infants to contract herpes – incidence is less than 0.1 percent. If a woman has symptoms of active genital herpes at the time of delivery, a Cesarean section is recommended.
- Genital warts are caused by the Human Papilloma Virus (HPV)
- There are more than 70 different types of these viruses
- Warts on hands and feet are caused by different types of HPV
- Genital warts spread through skin-to-skin contact, not through an exchange of body fluids.
- Warts can not be prevented by condom use for sure
- HPV is sexually transmitted disease
- The most common way to get HPV is by having oral, vaginal or anal sex with someone who has HPV.
- The only sure way to prevent genital warts (HPV) is to not have sex
- Just because you can’t see warts on you or your partner, does not mean you or your partner does not have HPV.
- HPV infection has a long incubation period
- HPV can be contracted from one partner, remain dormant, and then later be unknowingly transmitted to another sexual partner
- In USA about 20 million men and women are thought to have an active HPV at any given time
- HPV can lead to cancer of cervix in women or cancer of the penis in men
- Genital warts appear as growths or bumps, may be raised or flat, single or multiple, small or large.
- Cause no itching, burning or pain
- Genital warts can grow on the penis, near the anus, on the scrotum, on the vulva, perineal area, in the vagina and on the cervix
- When warts are present, the virus is active and you are contagious
- When warts are gone, the virus is inactive and you may not be contagious
- Diagnosis is made by physical examination of genital area
- Application of acetic acid to the lesions makes them easier to see.
- There are no blood tests available to diagnose HPV
- No medical cure for HPV
- Cutting off warts surgically
- Burning off warts with an electrical current
- Laser therapy
- Freezing – cryotherapy
- Podophyllin (condylox) cream – not very effective
- Aldara cream – very expensive
- Over the counter medications should not be used on genital warts
Pregnancy and Genital Warts
Most children are born healthy to women with a history of genital warts and there is no need to have Cesarean section.
Women and HPV
PAP tests – not specific screening for HPV – they are designed to detect abnormal cell changes of the cervix.
HPV test can find any of the 13 types of HPV that are most commonly found in cervical cancer. The presence of any of these HPV types in a woman for many years can lead to cell changes that may need to be treated so that cervical cancer does not occur.
Cervical cancer, the most serious problem associated with HPV, is rare and almost always can be prevented by regular testing for cervical cell changes that could lead to cancer.
Non Specific or Non Gonococcal Urethritis
Most common sexually transmitted disease (STD)
- Scanty urethral discharge, painful urination
- Gram – stain of discharge:
- Polymorphonuclear leukocytes (white cells)
- Abseence of gonococci
- Chlamydia trachomatis – most common
- Trichomonas vaginalis
Urethral swab for culture and chlamydiazyme assay
- Azithromycin 1 gm single dose