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Sexually Transmitted Infections (STIs)

While it can be an embarrassing subject to bring up, it is important to know as much as possible about sexually transmitted infections, including how to protect yourself whenever possible, how to recognize symptoms, and how to treat the various kinds of STIs. If you suspect that you may have been exposed to a sexually transmitted infection, talk with you AOA healthcare provider immediately. Your AOA provider is an important resource in helping you protect your sexual health.

Sexually Transmitted Infections (STIs) are infections that you can get from having sex with someone who has the infection. The three causes of STIs are bacteria, parasites, and viruses. There are more than twenty types of STIs. Among the most common are:

  • Chlamydia
  • Gonorrhea
  • HPV
  • Genital herpes 

 

Sexually Transmitted Infections (STIs)

Chlamydia

Chlamydia is a common STI caused by bacteria. You get it by having sex or sexual contact with someone who is infected. Both men and women can get it. Chlamydia can infect the urinary tract and can lead to pelvic inflammatory disease, which can cause infertility or serious problems with pregnancy. Babies born to infected mothers can get eye infections and pneumonia from chlamydia.

Symptoms

Chlamydia usually doesn't cause symptoms. If it does, you might notice a burning feeling when you urinate or abnormal discharge from your vagina.

Treatment

You can cure chlamydia with antibiotics. If you are sexually active, you can decrease your risk of getting it by using condoms. Experts recommend that women 25 and younger get a chlamydia test every year.

Gonorrhea

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Anyone who has any type of sex can catch gonorrhea. The infection can be spread by contact with the mouth, vagina, penis, or anus.

The bacteria grow in warm, moist areas of the body, including the tube that carries urine out of the body (urethra). In women, the bacteria may be found in the reproductive tract (which includes the fallopian tubes, uterus, and cervix). The bacteria can even grow in the eyes.

Symptoms

Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the infection, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. They include:

  • Vaginal discharge
  • Burning and pain while urinating
  • Increased urination
  • Sore throat
  • Painful sexual intercourse
  • Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
  • Fever (if the infection spreads to the fallopian tubes and stomach area)

If the infection spreads to the bloodstream, fever, rash, and arthritis-like symptoms may occur.

Signs and tests

Gonorrhea can be quickly identified by staining a sample of tissue or discharge and then looking at it under a microscope. This is called a gram stain. Although this method is fast, it is not the most certain.

Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours.

If you have gonorrhea, your AOA physician will want you to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV. If you are 21 or older, you should be sure you have had a recent pap smear.

Treatment

There are two goals in treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infection in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the disease. It is extremely important that you see your AOA physician, who will be able to determine the best and most up-to-date treatment.

About half of the women with gonorrhea are also infected with chlamydia, another very common sexually transmitted infection. Chlamydia is treated at the same time as a gonorrhea infection.

You should receive the hepatitis B vaccine. If you are younger than 26, you also need the HPV vaccine.

A follow-up visit 7 days after treatment is important if joint pain, skin rash, or more severe pelvic or belly pain is present. Tests will be done to make sure the infection is gone.

All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the disease. In some places you may be able to take counseling information and medicines to your sexual partner yourself. In other places, the health department will contact your partner.

A gonorrhea infection that has not spread to the bloodstream or other areas almost always can be cured with antibiotics. Gonorrhea that has spread is a more serious infection but almost always gets better with treatment.

If you have symptoms suggestive of gonorrhea, or have no symptoms, but suspect you may have been exposed to the infection, you should call your AOA health care provider immediately.

HPV

Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it.

HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.

A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.

Symptoms

Most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body’s immune system clears HPV naturally within two years. But, sometimes, HPV infections are not cleared and can cause:

  • Genital warts
  • Rarely, warts in the throat.
  • Cervical cancer and other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils).

Preventing HPV

Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers. One of these vaccines (Gardasil) also protects against most genital warts. Gardasil has also been shown to protect against anal, vaginal and vulvar cancers. Either vaccine is recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the shots when they were younger. These vaccines can also be given to girls beginning at 9 years of age. It is recommended to get the same vaccine brand for all three doses, whenever possible.

For those who choose to be sexually active, condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV.

People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently

Genital Herpes

Genital herpes is an STI caused by a herpes simplex virus (HSV). It can cause sores on your genital or rectal area, buttocks, and thighs. You can get it from having sex, even oral sex. The virus can spread even when sores are not present. Mothers can also infect their babies during childbirth.

Symptoms

Symptoms of herpes are called outbreaks. You usually get sores near the area where the virus has entered the body. They turn into blisters, become itchy and painful, and then heal. Sometimes people do not know they have herpes because they have no symptoms or very mild symptoms. The virus can be more serious in newborn babies or in people with weak immune systems.

Most people have outbreaks several times a year. Over time, you get them less often and the symptoms become milder. The virus stays in your body for life.

Treatment

Medicines do not cure genital herpes, but they can to help your body fight the virus. This can help lessen symptoms, decrease outbreaks, and lower the risk of passing the virus to others. Correct usage of latex condoms can reduce, but not eliminate, the risk of catching or spreading herpes.

We will cover other common STI’s in our next AOA newsletter.

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