How to Detect and Treat STDs
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How to Detect and Treat STDs

Most people have only one thought when it comes to sexually transmitted diseases: It won't happen to me. But according to Planned Parenthood, one out of every four Americans will contract a sexually transmitted disease (STD) during his or her lifetime.

An STD (also called an STI or sexually transmitted infection) is an infection contracted through sexual activity. Both heterosexuals and homosexuals can get STDs. Some STDs are caused by viruses, and others by bacteria. You can contract an STD by engaging in intimate sexual contact such as vaginal or anal intercourse or oral sex with a person who is infected. A baby can also contract an STD from its mother either in utero or during the birth process, with potentially severe consequences.

Many STDs are easily treated, but a few have no cure. Since the consequences can range from emotional and physical discomfort to severe illness and even death, anyone who is sexually active should learn how to practice safe sex. You must be able to recognize the signs of infection and seek medical care. If you think you might have an STD, or have any of the symptoms associated with the STDs listed below, see your doctor immediately for diagnosis and treatment. If you are diagnosed with an STD, your sexual partner(s) must be treated, too.

Chlamydia

In America, the fastest spreading and most common STD is chlamydia. The culprit is a bacteria called Chlamydia trachomatis and affects both men and women. This microscopic bacteria can take up residence in the genitals, urinary tract, and rectum. It doesn't always produce symptoms, especially in women, and can be difficult to detect.

Chlamydia can lead to pelvic inflammatory disease and sterility in women. A woman with a chlamydial infection may experience painful urination, vaginal discharge, or lower abdominal pain. A man may experience burning during urination and/or a discharge from the tip of the penis. However, many women and men experience no symptoms at all. For this reason you should be evaluated by your doctor and always use condoms.

If left untreated, chlamydia can cause permanent damage to a woman's reproductive tract, resulting in infertility. In men it infrequently causes inflammation of the epidydymis (portion of the male genital tract next to the testis where sperm maturation is partially accomplished), rectum, or prostate. Also, in approximately 1% of men, chlamydial infection in the urinary tract can be a part of of a list of conditions called Reiter’s syndrome (arthritis, uveitis, and urethritis).

Gonorrhea

According to The Mayo Clinic Family Health Book, almost 500,000 cases of gonorrhea are reported in the United States each year. Both men and women contract it. This is one STD that is more readily apparent in men than woman. A woman may not know she's been infected until her partner is diagnosed.

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae, which can infect the urinary tract, reproductive organs, rectum, and when oral sex is practiced, the throat. Symptoms of gonorrhea in men include a thick, pus-like discharge from the penis, and burning during urination or symptoms of sore throat (pharyngitis). Women may have a cloudy vaginal discharge, lower abdominal discomfort, or burning while urinating. In both men and women, the symptoms may be mild enough to go unnoticed until complications develop.

Gonorrhea may appear mild at first, but if the condition goes untreated it can become chronic and cause damage to both the male and female reproductive organs. It can also spread throughout the bloodstream and infect other parts of the body, inflicting potentially permanent damage.

HIV/AIDS

Human immunodeficiency virus (HIV) is a virus with no known cure that is often transmitted through sexual contact. Most people who contract it will eventually die, not from the virus itself but from acquired immune deficiency syndrome (AIDS), the failure of the immune system caused by the HIV virus.

People can carry the HIV virus and show no symptoms for ten years or more. Even without causing visible symptoms, the virus is still transmissible and others can be unknowingly infected through unprotected sexual activity. According to Planned Parenthood, AIDS-related symptoms usually develop in 70-80% of adults who have tested positive for HIV, and 55-62% get fully-developed AIDS.

Although there is no known cure for AIDS yet, recently developed drug "cocktails" have been very effective in slowing the progress of the disease in many people.

Syphilis

Syphilis is a potentially serious STD that, fortunately, isn't very common in the United States and other developed countries. Initial symptoms may include painless ulcers on the genitals, rectum, tongue, or lips, and enlarged lymph nodes in the groin. Two to six weeks later, a rash may appear over any area of the body, but especially on the palms and soles. Mouth ulcers, fever, headache, soreness and aching in bones and joints, loss of appetite, and general malaise may also develop. When syphilis is left untreated, it can eventually attack the brain and other organs, resulting in paralysis, senility, insanity, blindness, and/or heart damage.

Treatment with penicillin or other antibiotics usually cures syphilis.

Genital Herpes

The first sign of a genital herpes attack is often pain or itching in the genital area. Then, small, tender red bumps appear on and around the genitals, buttocks, and sometimes the thighs. The bumps progress to blisters and then to painful ulcer-like sores. The sores then crust over and heal without scarring. The initial or primary episode lasts about three weeks. Attacks are often recurrent but become less severe and less frequent over time.

Genital herpes is mostly contagious during a flare-up, however viral shedding has been observed during the times when there are no signs of active infection, making the transmission of the infection to a sexual partner possible at any time after the initial infection.

Genital herpes is caused by the herpes simplex virus and is transmitted through any type of sexual contact, including anal, oral, and genital. The only prevention for herpes are using condoms (although condoms do not assure absolute protection) and abstaining from sexual contact with an infected partner.

It is important to remember that the virus is shed irregularly and unpredictably even when there are no lesions present. In fact, most new infections are believed to be the result of asyptomatic (no symptoms) viral shedding. There is no cure, but there are medications available (eg, acyclovir) to treat acute symptoms and also to decrease the frequency and severity of recurrent episodes.

Venereal Warts

Both men and women can get venereal warts. They are caused by the human papillomavirus (HPV), and occur on the genital and/or anal areas. They look a lot like any other wart, and are one of the less serious STDs. Nonetheless, they are contagious, and in cases where a woman's cervix is affected, certain strains of HPV can cause abnormal changes called dysplasia which may progress to cervical cancer. As with other STDs, both partners should be treated.

The best defense against sexually transmitted diseases is sexual abstinence. Barring that, following safe sex practices, including the use of latex condoms, will dramatically reduce your risk. If you suspect you may have contracted an STD, see your doctor immediately, and make certain your partner(s) receives treatment as well. Don't let embarrassment or ignorance keep you from seeking care.

RESOURCES:

American Social Health Association
http://www.ashastd.org/

Centers for Disease Control and Prevention
http://www.cdc.gov/

Planned Parenthood Federation of America, Inc.
http://www.plannedparenthood.org/

CANADIAN RESOURCES:

Sex Information and Education Council of Canada
http://www.sieccan.org/

Sexualityandu.ca
http://www.sexualityandu.ca/home_e.aspx

References:

Allison, DM. Sexually transmitted diseases. Nurse Practitioner Forum. 1996;7:9-50.

Hook EW, Sondheimer S, Zenilman J. Today's treatment for STDs. Patient Care. 1995;29:40-56.

Lemardo C, Chrisler JC. Women and STDs. Women and Health. 1992;18:1-15.

McHugh DR. Syphilis: an old disease with modern health concerns. Nurse Practitioner Forum. 1996;7:34-9.

Woods MC. Sexually transmitted diseases: highlights of the revised CDC management guidelines. Consultant. 1995;35:1298-1302.

Workowski, KA, Berman, SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep 2006; 55:1.



Last reviewed May 2008 by Marcin Chwistek, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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