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SEXUALLY TRANSMITTED INFECTIONS

WHAT ARE SEXUALLY TRANSMITTED INFECTIONS (STIs)?

A sexually transmitted infection is an infection that is spread through sexual contact (i.e. vaginal, anal or oral sex) with a person who has the infection. Sometimes people with STIs have symptoms and sometimes they do not.

WHAT CAUSES SEXUALLY TRANSMITTED INFECTIONS?

A wide variety of bacteria and viruses can cause STIs. Bacterial STIs are typically treated with antibiotics. STIs caused by virus may or may not cause symptoms and are more difficult to eliminate, although many treatments to control and prevent symptoms are available.

WHAT ARE THE RISK FACTORS FOR CONTRACTION OF STIs?

  • Prior history of STI
  • Having sex with someone who has STI
  • Unprotected sex (not using condoms)
  • Multiple sexual partners
  • Using IV drugs (injecting drugs in vein) or having a partner who uses IV drugs

WHAT ARE THE BEST WAYS TO PREVENT STIs?

  • Get immunized- Vaccines are available for Hepatitis B and HPV
  • Use a latex condom every time during vaginal, oral or anal sex. This can decrease chances of infection
  • Limit number of sexual partners
  • Know your partner’s sexual history
  • Avoid risky sex

CAN SEXUALLY TRANSMITTED INFECTIONS AFFECT MY PREGNANCY?

Yes. An STI during pregnancy can be passed to the baby. This can lead to many health problems in the baby. Gonorrhea and chlamydia can lead to eye infections and pneumonia, syphilis can cause miscarriage, still birth or congenital defects. HIV can also be passed from the mother to the baby.

WHAT ARE THE MOST COMMON STIs?

  • Genital Herpes : Caused by the herpes simplex virus types 1 and 2
    • Signs and symptoms of genital herpes
      • Many infected people have no symptoms at all.
      • Generally, genital herpes presents a few weeks after the infection.
      • Symptoms may include multiple blisters that become painful ulcers on the vagina, vulva, buttocks, anus and thighs.
      • Symptoms usually resolve in 2-3 weeks.
      • Some people may also develop flu-like symptoms (painful lymph nodes, joint pain, fever, headache, vomiting) and pain during urination.
      • Because the virus stays in the body, many people get recurrent episodes of ulcers. Some may experience pain, tingling or itching in the buttocks, leg or thigh before ulcers develop.
    • Prevention
      • Use latex condom with every sexual partner (even if no ulcers or blisters are present)
      • Avoid sex when genital ulcers are present
    • Diagnosis
      • Culture test
      • Blood test
      • PCR Test
    • Treatment
      • There is no cure for genital herpes.
      • The symptoms of the infection can be treated with antiviral medication and self-care measures.
      • Please speak to your healthcare provider about antiviral medications if you think you have genital herpes.
      • Self-care measures include: Keeping the genital area clean and dry, Tylenol (acetaminophen) or advil (ibuprofen) for pain.
      • Avoid soap and bubble baths, and tight or irritating underwear
      • Antiviral medications (acyclovir and valacyclovir) can be used to prevent herpes outbreaks for patients with recurrent flares of genital herpes

 

  • Genital Warts : Caused by the human papilloma virus (HPV)
    • Signs and symptoms
      • Genital warts are small, pink or skin colored growth that commonly present on the labia, opening of the vagina or around the anus.
      • Some women may experience itching, burning or tenderness in the area with warts but most women have no symptoms at all.
    • Prevention
      • Get the HPV vaccine (See section on HPV)--however, the vaccine only prevents infection with certain types of HPV that are also associated with cervical cancer and does not prevent all type of HPV
      • Avoid sexual contact with someone with genital warts or HPV
      • Use latex condom with every sexual partner
    • Treatment
      • There are many ways to treat genital warts including medications and procedures. Even after treatment however, warts may return because the virus (HPV) is difficult to completely clear from your body.  The best treatment for you depends on the number of warts, their location on your body and personal preferences. Please talk to your doctor for more information about treatments for genital warts. Options include topical medications, laser therapy, cryotherapy (freezing) and surgical removal.

 

  • Chlamydia : Caused by the bacteria Chlamydia trachomatis
    • Signs and symptoms
      • Nearly 90% of women have no symptoms at all
      • Common symptoms include: vaginal discharge, burn/pain when urinating, pain during sex, abdominal pain, abnormal bleeding
    • Prevention
      • Use latex condom with every sexual partner
      • Avoid sex if or your partner have a genital rash or sore, pain with urination and abnormal discharge from the vagina or penis.
      • See your doctor if you have any of these symptoms
    • Diagnosis
      • All sexually active women younger than 25 years should get a once-yearly testing for chlamydia.
      • Testing for chlamydia is done using a sample of urine or swab of fluid from vagina or cervix.
    • Treatment
      • Chlamydia is treated with antibiotics. Many times chlamydia infections occur with along with gonorrhea so antibiotics to treat both are recommended. Your sexual partner may also need treatment.  Talk to your doctor about treatments for you and your partner. You should avoid sex for 1 week after you and your partner have been treated, because it is possible to become re-infected.
    • Complications of Chlamydia
      • Untreated Chlamydia may lead to pelvic inflammatory disease (PID), which may cause scarring in the fallopian tubes and lead to infertility.  This may also increase the risk of ectopic pregnancy (pregnancy that occurs outside of the main portion of the uterus).

 

 

  • Syphilis : Cause by the bacteria Treponema pallidum. Syphilis infection that has multiple stages and each has different symptoms. The 4 stages are Primary, Secondary, Latent and Tertiary symptoms.
    • Stages
      • Primary syphilis
        • Symptoms start 2-3 weeks after become infected
        • Painless raised red bump which may turn into a sore or ulcer, usually on the vagina, anus or penis
        • These symptoms spontaneously resolve after a few weeks
      • Secondary syphilis
        • Usually occurs in individuals who don’t get primary syphilis treatment
        • Starts weeks to months after primary syphilis.
        • Possible signs/symptoms include: a widespread rash, large raised gray/white patches on body, flu-like symptoms (sore throat, muscle ache, fever, headache, swollen lymph nodes)
        • Weight loss
      • Latent syphilis
        • Defined as having a positive blood test for syphilis, but without any symptoms of disease.
      • Tertiary syphilis
        • Usually occurs in individuals who don’t get primary syphilis treatment, and several years after the initial infection.
        • Also called late stage syphilis.
        • Can lead to serious problems of the heart, brain,  eyes and other organs.
    • Prevention
      • Use latex condoms when having sex
      • Avoid sex if or your partner have a genital sore or ulcer
      • See your doctor if you have any of these symptoms
    • Diagnosis
      • Typically made with a blood test or a swab from an ulcer if one is present
    • Treatment
      • The anitibiotic penicillin is usually used to treat syphilis infections with a single intramuscular injection. Alternatively, ceftriaxone, azithromycin, doxycycline, or tetracycline may be used.

 

  • Trichomoniasis : Caused by the parasite Trichomonas vaginalis
    • Signs and symptoms
      • Vaginal discharge with a bad (foul) smell
      • Foamy and greenish/yellow vaginal discharge
      • Itching of vagina
      • Burning/pain when urinating
      • Pain with having sex
    • Prevention
      • Always use a latex condom when you have sex
      • Avoid sex if your partner has any of the above signs or symptoms.
    • Diagnosis
      • If you have any of the above signs and symptoms, you should see a doctor. If your partner was infected with trichomoniasis, you should also see a doctor. Trichomoniasis is tested by doing a vaginal exam and taking a sample of the vaginal discharge. You may also need testing for other sexually transmitted diseases.
    • Treatment
      • The most common treatment is the antibiotic metronidazole, also called Flagyl. If you are diagnosed with Trichomoniasis, your partner should also get tested and treated.

 

  • HIV: The human immunodeficiency virus (HIV) is the virus that causes the acquired immunodeficiency syndrome (AIDS). HIV can be transmitted by sexual contact, sharing needles for intravenous drug use, and, rarely, blood transfusion. If you have had unprotected sexual contact or have used IV drugs, you should consider being tested for HIV. A blood test is typically used to detect the virus. If positive, you would typically be referred to your primary physician or infectious disease specialist for further treatment.
  • Gonorrhea : Caused by the bacteria Neisseria gonorrhoeae
    • Signs and symptoms
      • Vaginal itching
      • Abnormal vaginal discharge
      • Vaginal bleeding or spotting
      • Pain or burning with urination
      • Anal itching or anal discharge
      • Men with gonorrhea may have milky discharge from penis and pain and swelling of one or both testicles
    • Prevention
      • Use latex condoms when having sex
      • Avoid sex if or your partner have a genital rash or sore, pain with urination and abnormal discharge from the vagina or penis.
      • See your doctor if you have any of these symptoms
    • Diagnosis
      • Gonorrhea testing is done at the doctor’s office with a sample of your urine or swab of your cervix. Results usually take 24 hours.
    • Treatment
      • Gonorrhea is treated with antibiotics, and because there is often co-infection with Chlamydia, treatment for Chlamydia is recommended if you test positive for Gonorrhea. Your partner should also be tested and treated. You may also need further testing for other STIs.
    • Complications of Gonorrhea
      • If gonorrhea is untreated, it can lead to serious complications including joint infections, arthritis, pelvic inflammatory disease (PID), which can lead to infertility or ectopic pregnancy, and increased risk of HIV infection

 

|    © 2014-2018 copyright Taraneh Shirazian, MD

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Joan H. Tisch Center for Women's Health

207 E 84th Street

New York, NY 10028

Phone: 646-754-3300

 

Email: info@wwcofny.com