SEXUALLLY TRANSMITTED DISEASES( STDs)

Sexually transmitted diseases(STDs) are infections that are passed from one person to another through sexual contact(vagina, anal, oral sex), intravenous drug use or through nonsexual contact such as childbirth or breastfeeding.

STDs are really common, and lots of infected people who have them don’t always have symptoms. STDs can be dangerous, and some fatal but there are many that are treatable if testing is done regularly.

According to regions or countries, some diseases are more common than others. STDs prevalence can largely vary according to the economical growth of a region or country, level of literacy, access to information, access to healthcare, and access to vaccination.

Most common:

Human Papillomavirus(HPV) and Genital Warts: HPV is the most common STD and at least 50% of sexually active people will get it at some time in their lives. More than 40 types of HPV can be spread sexually. Most types have no symptoms and cause no harm, and your body gets rid of them on its own.

There are two categories of sexually- transmitted HPV. Low-risk HPV can cause genital warts, which are small, skin colored or gray bumps that develop in or near the genitals. They normally appear near the vagina, vulva, urethra, cervix, penis, larynx, or anus. They may clump together or look like cauliflower. They can feel itchy, burning, or painful; but often take months or years for genital warts to show.

High-risk HPV can cause various cancers, oral and throat cancers, cancer of the cervix, cancer of the penis, cancer of the anus, cancer of the vulva and cancer of the vagina.

 

HPV vaccination can reduce the risk of infection by the HPV types targeted by the vaccine. Three types of vaccination are available to prevent HPV infection: Gardasil, Gardasil 9, and Cervarix. These vaccines provide strong protection but they are not effective at treating established HPV infections or disease caused by HPV.

In mainland China, there have been an increasing HPV infection in the past years due to a lack of vaccination in the national health plan with an estimated two million visited Hong Kong from Chinese mainland to receive HPV vaccine each year. However, it has been reported last year that the Chinese mainland government has approved the use of Cervarix. The first vaccine against HPV, in girls and women between 9 and 25 years old with three doses in total.   

Although there is no treatment for the virus itself, there are treatments for the health problems that HPV cause:

.genital warts can be treated by your healthcare provider using freezing with liquid nitrogen, burning with trichloroacetic acid or bichloroacetic acid, applying tincture or ointment, cutting them with scalpel, scissors, curette or electo-surgery. The patient can use prescription medication such as creams, gels, and solutions .

.cervical precancer can be treated. Women who get routine pap smear tests can identify problems before cancer develops.

.other HPV-related cancers are also more treatable when diagnosed and treated early.

 

Chlamydia: it is a common STD caused by a bacteria( Chlamydia trachomatis). it infects both men and women, the infection in women is located in the cervix, rectum or throat. As for men, the infection is commonly located in the urethra, rectum and throat.

Chlamydia can be transmitted during childbirth. A reinfection can occur if you were treated for Chlamydia and have unprotected intercourse with someone who has it. The symptoms of Chlamydia don’t usually appear or can appear several weeks after you get infected.

Symptoms in women include an abnormal vagina discharge with or without a strong smell, a burning sensation when urinating, and pain during intercourse. If the infection spreads, you may experience a lower abdominal pain, nausea and fever.

Symptoms in men include a discharge from your penis, a burning sensation when urinating, burning or itching around the opening of your penis, pain and swelling in or both testicles.

When and if the infection affect the rectum(in men and women), it can cause rectal pain, discharge, and/or bleeding.

 

In women, an untreated infection can spread and result in a pelvic inflammatory disease(PID), which can cause permanent damage to your reproductive system. This can lead to long-term pelvic pain, infertility, and ectopic pregnancy. Women who have had chlamydia infections more than once are at higher risk or serious reproductive health complications.

Baby born infected from mothers can get eye infections and pneumonia, and are at risk of prematurity.

 

In men, an untreated infection doesn’t usually result in health problems but sometimes can infect the epididymis and cause pain, fever and, rarely, infertility.

Both men and women can develop reactive arthritis because of a chlamydia infection.  

Your chances of getting or giving HIV/AIDS might increase with an untreated chlamydia infection.

 

Antibiotics can cure the chlamydia infection, with a one-time dose or 7 days daily dose. The antibiotics cannot repair the permanent damage the infection has caused. In order to prevent the spread of the disease, one should wait at least 7 days after taking the one-time dose antibiotic and wait to finish the 7 days treatment before having intercourse again.

It is advised to get tested again about three months after treatment because it is common to get a repeat infection.

 

Gonorrhea: it is most common in young adults. The bacteria that causes it can infect the genital tract, mouth or anus. Gonorrhea can be contracted during vaginal, oral, or anal sex with an infected partner. It can be passed during childbirth.

Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles.

In women, the early symptoms of gonorrhea are usually mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. Left untreated, it can lead to pelvic inflammatory disease, which causes problems with the pregnancy and infertility.

Gonorrhea can also cause infections in the throat and eyes.

 

The diagnosis is done by a lab tests and treatment is with antibiotics but treating has become more difficult because drug-resistant strains are increasing. It strongly recommended to wait until you finish treatment and until symptoms disappear(If you have them) before engaging in sexual activities. This is to make sure the infection is not spread.

 

 

Syphilis: It is a common bacterial infection spread through sex. Although it can be easily cure with antibiotics, it can cause permanent damage such as brain and nervous system damage, blood infection and even death, if not treated.

Syphilis infects the genital area, lips, mouth, or anus of both men and women. It can be pass during pregnancy or during childbirth from mother to child.

Syphilis is a complex disease with four stages.

The primary stage and its early signs may include a small, painless, firm sores(called chancres) in or around the vagina, penis, mouth or anus. The sore can look like a cut, an ingrown hair, or a harmless bump, and they sometimes are open and wet. The sores can usually appear between 3 weeks and 3 months and can last about 3 to 6 weeks before they go away on their own.

 

In the secondary stage, this can be associated with a rash on the body and particularly the hands and feet; the sores can be then found is the mouth, vagina , or anus. Other less common signs and symptoms may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue.

These symptoms can last 2 to 6 weeks at a time, and may come and go for up to 2 years.

 

In between the secondary stage and the late stage, symptoms usually disappear; sometimes this period is referred as the third or latent stage. This stage can last for years or even the rest of your life.

Only about 15% of people with untreated syphilis will develop the final stage.

 

In the late stage, syphilis causes organs and nerves damage, blindness, paralysis or even affects your brain. The complications from late stage syphilis can happen 10-20 years after you first get infected.

Syphilis is spread from sexual skin-to-skin contact with someone who has it, you get infected when your vulva, vagina, penis, anus, or mouth come in contact with someone’s syphilis sores.

Syphilis is serious but it can be cured, when in primary and secondary stage, with antibiotics when treated early. It does leave a positive mark, called the treponema pallidum particule agglutination (TPPA) which is an indirect agglutination assay used for detection and titration of antibodies against the Treponema pallidum which causes syphilis. There is another similar specific test called Treponema pallidum hemagglutination assay or TPHA.

 

 

Trichomoniasis- also called “trich” is the most common curable STI. Infecting millions of people every year, it is caused by a parasite that is easily spread during sex. The parasite is transmitted through sexual fluids, like semen, pre-ejaculate, and vaginal fluids.

Like many other STDs, those infected are not aware because they have no symptoms and feel totally fine, so they might not even know they have it. If you do get symptoms, they usually happen within 5 to 28 days after being infected.

In women trichomoniasis causes vaginitis and the symptoms include excessive, frothy, yellowish or greenish vaginal discharge, discomfort during sex, vaginal foul odor, painful urination,swelling around the genitals, itching in or near the vagina.

In men,the symptoms are so mild that they hard to identify. There may be a whitish discharge from the penis and painful or difficult urination and ejaculation.

The only way to rule out or to be sure, is to get tested.

It is important to treat partners of anyone with trichomoniasis because reinfection is very common.

Avoiding drinking alcohol until 24-48hours after finishing treatment(depending on the type of antibiotic prescribed).

Trichomoniasis has been linked to an increased risk of HIV acquisition.

 

Herpes: it is a common virus that causes sores on your genitals and/or mouth. Herpes can be annoying and painful but does not usually lead to serious health problems.

Once infected with the virus, the infection stays in your body for life. It is caused by two different but similar viruses: herpes simplex virus type 1(HSV-1) and herpes simplex virus type 2(HSV-2). Both strains can cause sores to appear on or around your vulva, vagina, cervix, anus, penis, scrotum, butt, inner thighs, lips, mouth, throat, and rarely, your eyes.

According to whether the sores are located on or around your genitals, it is called genital herpes and when located in or around your lips and mouth, it is called oral herpes. Oral herpes sores are sometimes called cold sores or fever blisters.

HSV-1 usually causes oral herpes, and HSV-2 causes genital herpes, but it is totally possible for both strains to infect either area.

Herpes is spread with skin-to-skin contact with infected area, usually vaginal, oral, anal sex, and kissing. Mothers can also infect their babies during childbirth.

Symptoms of herpes are called outbreaks, the sores are blisters which break and become painful, and then heal. Many people don’t notice the sores or mistake them for something else and you can still spread herpes in the absence of sores.

There is no cure for herpes, but certain antiviral drugs can shorten and prevent outbreaks, when taken regularly they can lower the risk of infecting others. Outbreaks usually become less frequent over time.

 

 

HIV/AIDS: the human immunodeficiency virus(HIV) is the virus that causes Acquired Immune Deficiency Syndrome(AIDS). it is transmitted by blood and other body fluids such as semen, vaginal fluids, and breast milk.

HIV damages your immune system by breaking down certain cells (CD4 or T cells) in charge of your immunity, making it easier to get sick by not allowing your body to fight off infection normally.

Most people with HIV carry it for many years without being aware of it due to an absence of symptoms.

The virus can get in your body through cuts or sores in your skin, through mucous membrane( vagina and rectal walls, opening of the penis) when having sex, by sharing infected syringes or needles( drugs, piercings, tattoos,…). it can also be passed during pregnancy, birth, or breastfeeding.

 

HIV is the virus that causes AIDS which is the actual disease, so the two are not to be confused. Some people with HIV do not always have AIDS.

Early HIV symptoms can take up to 10 years or much longer for people taking medications to show.

About 2-4 weeks after being infected with HIV, you may experience flu-like symptoms, as your body reaction to the infection. These symptoms usually last a few weeks and they don’t show again for years.

 

Later HIV/AIDS symptoms: As your cells immunity system levels decrease your body has hard time fighting off disease. Overtime, the damage HIV does to your immune system leads to AIDS.

You have AIDS when you get rare infections, called opportunistic infections, or types of cancer, or if you’ve lost a certain number of CD4.

The signs of AIDS include: thrush( a thick, white coating on your tongue or mouth), sore throat, bad yeast infections, chronic pelvic inflammatory disease, fast weight loss, just to name a few.

Unfortunately, there’s no cure for HIV or AIDS, but medication can slow down the damage it causes. Antiretroviral therapy(ART) is a combination of medicines that lower the amount of HIV in your blood- sometimes to the point where you HIV isn’t a threat. The therapy helps you keep your cells immune system high to keep you healthy and it lowers the risk of giving HIV to others. Paying attention to your lifestyle can help you stay healthy too.   

 

Hepatitis: there are three kinds of hepatitis some of which are spread more easily than others. However Hepatitis B is the one most likely to be transmitted sexually. Hepatitis B is an infection that can cause liver disease, it caused by a virus (hepatitis B virus, or HBV).

Hepatitis B is really contagious and is transmitted through semen, vaginal fluids, blood, and urine. You can get infected by having vaginal, anal, or oral sex; sharing toothbrushes, razors, or needles. It can also be passed to babes during childbirth from the mother.

Hepatitis B often doesn’t show symptoms. When people do show signs of hepatitis B, the first ones usually show up between 6 weeks and 6 months after they got the virus. The symptoms typically last for a few weeks, but can sometimes be present over a longer period.

If symptoms are present, they may include joint pain, skin eruptions, a hive-like rash, fatigue, loss of appetite, nausea, vomiting, headache, fever, dark urine, jaundice, liver enlargement and tenderness.

Hepatitis B can go away on its own but it can also become chronic. Chronic Hepatitis B requires the right medical care to help you stay healthy. Taking good care of your liver is very important.

Hepatitis B can’t be cured but there are medications that can help treat long-lasting hepatitis infections. One in 20 people who get hepatitis B as adult become “carriers”, which means they have a chronic hepatitis B infection. Carriers are more likely to pass hepatitis B to other people because they are contagious for the rest of their lives. Hepatitis B infections that last a long time may lead to serious liver diseases like cirrhosis and liver cancer.

There are medications and treatments that can help less the symptoms but be sure to talk to your doctor before taking anything. There are also vaccines available and post-exposure prophylaxis can help prevent infection.

 

Chancroid: is a bacterial STI that causes painful ulcers or sores in the genital region, it also know as soft chancre and ulcus molle. It is know to be transmitted from one person to another solely through sexual contact. It enters the skin through microabrasions incurred during sexual intercourse. Tissue reaction leads to development of erythomatous papule, which later progesses into becoming pustules in about 4-7 days. It then undergoes central necrosis to ulcerate.

The symptoms are only local in manifestations and no systemic symptoms are present. The ulcer can ranges in size from 3 to 50mm across, they are painful, has sharply defined, undermined borders or irregular, ragged borders. Covered by a gray or yellowish-gray material at its base, it bleeds easily when traumatized or scraped. Pain while urinating and pain during intercourse in female. Half of infected man have only a single ulcer. Women frequently have four or more ulcers, with fewer symptoms.

 

 

Scabies: it is an itchy skin condition caused by tiny parasites called scabies mites. They can be passed just through skin-to-skin contact of any kind, sexual or not.

Scabies causes rashes, irritation, and excessive itching. The itching will often be worse at night than during the day. Itching and rash most often show up on the penis, buttocks, wrist, nipples, waist, shoulder blades, armpits, elbows and between fingers. Sometimes scabies might also result in tiny burrows in the skin caused by the female mites tunneling beneath the skin and lay eggs. The eggs lead to more mites, but most people with scabies only have about 10-15 mites on their body at a time.

If a person has scabies for the first time, it will usually take 2-6 weeks for the symptoms to start appearing. For those who have scabies before, symptoms can occur as little as 24 hours. It important to know that even when symptoms are not present, scabies can still be spread.

Scabies is treated with prescription medication that kills scabies mites and eggs- called “scabicide”. scabicides usually come in the form of a cream or lotion. There is also an antibiotic that can be taken orally in a single dose, followed by another single dose two weeks later.

 

Pubic lice: pubic lice- also known as crabs- are small parasites that attach to the skin and hair near your genitals causing itching, blue spots and sores in the infected area. Pubic lice is quite common with millions of people getting infected every year and it is spread easily during sexual contact.

The main symptom of pubic lice is a pretty intense itching. You may also see crabs or eggs in your pubic hair. They symptoms usually appear 5 days after you get the lice. The itching and irritation is caused by your body’s reaction to the crabs’ bites. You can feel feverish, run-down, or irritable.

 

But even though pubic lice can be uncomfortable, they do not cause any serious health problems. It is usually easy to get rid of them with prescription or over-the-counter shampoos and solutions. In addition to treating the lice, clothing and bedding should be washed in hot water and dried in a dryer or dry cleaned because the lice can be spread through sharing clothing or bedding.

 

Get tested

Most of the time, STDs don’t immediately show symptoms as most have a long incubation period. Testing is the only way to know for sure if you have an STD. So if you have had unprotected vaginal, anal, or oral sex, talk with a doctor or nurse about getting tested. Many of the symptoms associated with STDs can be caused by other diseases or conditions other than STDs.

It’s really important to get tested if you think you have an STD. The idea of getting tested may seem scary, but you should know that most STDs can be treated and some can be cured. So the sooner you find out, the faster you can start taking care of yourself and your partners.

STD testing can be quick, painless, and sometimes even free. STD testing isn’t usually included in regular medical exams- you have to ask for it. Your doctor will help you figure out which tests you need. STD testing may include:

. A urine test

. A cheek swab

. A blood test

. A physical exam

. Testing your sores

Prevention

As with all STIs, the most effective protection is to abstain from sexual activity or be monogamous with one long-term partner who has tested negative for STDs.

There are many ways you can reduce your risk of getting an STD:

. Know your sexual partners and limit their number- your partner’s sexual history is as important as your own. The more partners you or your partners have, the higher your risk of getting an STI and consequently and STD.

. Use of latex condom- using a latex condom every time you have vaginal, oral, or anal sex decreases the chances of infection. Condoms lubricated with spermicides do not offer extra protection. Frequent use of some spermicides can increase the risk of HIV.

. Avoid risky sex practices- sexual acts that tear or break the skin carry a higher risk of STDs. Even small cuts that do not bleed let germs pass back and forth.

. Get immunized- vaccinations are available that will help prevent hepatitis B ans some types of HPV.

 

 

The above article serves only as reference. Kindly refer to your primary care provider for complete consultation and treatment.

For more details please send email to: generalenquiry@shanghaiskyclinic.com

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