Wednesday, August 27, 2014

Sexually Transmitted Diseases (STDs)

Definition

Sexually transmitted diseases (STDs) are transmitted sexually by someone who is infected. These infections are usually passed by intercourse, but can also be passed through other types of sex, such as oral sex.

STDs can be caused by viruses or bacteria. If you have ever had sex, you may be at risk for having an STD. You are at higher risk if you have had many sex partners, have had sex with someone who has had many partners, or have had sex without using condoms (rubbers).

Description

Sexually transmitted diseases (also called venereal diseases) are among the most common infectious diseases in the U.S. today. At least 20 STDs have now been identified. They affect more than 10 million men and women in this country each year.

It is important to understand at least five key points about all STDs in this country today:

  • STDs affect men and women of all backgrounds and economic levels. They are most prevalent among teenagers and young adults. Nearly one-third of all cases involves teenagers.
  • The incidence of STDs is rising, in part because in the last few decades, young people have become sexually active earlier. Sexually active people today are also more likely to have more than one sex partner or to change partners frequently. Anyone who has sexual relations is potentially at risk for developing STDs.
  • Many STDs initially cause no symptoms. When symptoms develop, they may be confused with those of other diseases not transmitted through sexual contact. However, even when an STD causes no symptoms, a person who is infected may be able to pass the disease on to a sex partner. That is why many doctors recommend periodic testing for people who have more than one sex partner.
  • Health problems caused by STDs tend to be more severe and more frequent for women than men.
  • Some STDs can cause pelvic inflammatory disease (PID), a major cause of both infertility and ectopic (tubal) pregnancy. The latter can be fatal to a pregnant woman.
  • STD infections in women may also be associated with cervical cancer. One STD, genital warts, is caused by a virus associated with cervical and other cancers. The relationship between other STDs and cervical cancer is not yet known.
  • STDs can be passed from a mother to her baby before or during birth; some of these congenital infections can be cured easily, but others may cause permanent disability or even death of the infant.

When diagnosed and treated early, almost all STDs can be treated effectively. Some organisms, such as certain forms of gonococci, have become resistant to the drugs used to treat them and now require higher doses or newer types of antibiotics. The most serious STD for which no effective treatment or cure now exists is acquired immunodeficiency syndrome (AIDS), a fatal viral infection of the immune system.

Major Types

Diseases that can be transmitted sexually are:

Papillomavirus (condylomas)

Papillomavirus is a virus that causes growths (called condylomas or genital warts) and it is the most common STD in the U.S. Condylomas commonly accompany other STDs, such as gonorrhea. The virus is usually spread by direct contact with a wart from an infected person.

Condylomas are fleshy growths that appear alone or in clusters. They usually break out in moist areas on or around the genitals (sex organs) and anus. Growths inside the genital organs are soft and red or pink. Outside growths are firm and dark. They are often no larger than the tip of a pencil, but they may combine to form large, cauliflower-like growths.

Genital warts usually appear one to three months after contact, but some go undetected until they cause discomfort. Lesions can become infected and cause mild irritation or itching. Small condylomas may cause rectal pain or pain during intercourse. Papillomavirus may have a serious complication – the presence of condylomas has been linked to cervical cancer. Women with histories of genital warts should have a Pap test at least once a year.

Questions

What tests are needed to determine if there is an STD?

Does each condition have its own test, or is there one test for several STDs?

Can any of these tests have a false reading?

Do doctors automatically test for STD with complaint of a discharge (or other symptoms), or does an additional STD test need to be requested?

How long can a STD stay dormant with no symptoms?

Could a yeast infection be mistaken for a STD?

What is the percentage of protection is there with condoms?

Should the sexual partners be notified?

How can you tell if the sex partner has STDs?

How do you ask your partner if he/she has been infected?

Prevention

Each year, hundreds of thousands of people in the U.S. contract a sexually transmitted disease. Thus, it is important to understand what behaviors put you, your family and friends at risk. All of us must take responsibility for protecting ourselves and our partners. Simply addressing these issues does not imply approval of the sexual practices discussed.

Most STDs are treatable, but AIDS has no cure and death is virtually certain. Therefore, education about this disease is vital. Although AIDS can be spread through shared use of contaminated needles among drug abusers, or rarely, through a blood transfusion, it is usually transmitted by sexual contact. The virus is present in semen and vaginal secretions and enters a person's body through the small tears in the vaginal or rectal tissues that can develop during sexual activity. AIDS is not considered a highly contagious disease; transmission of the virus occurs only after very intimate contact with infected blood or semen.

On the other hand, STDs (such as chlamydia, gonorrhea, herpes, venereal warts and syphilis) are highly contagious and many can be spread through even brief sexual contact. However, none of these infections are spread through casual contact, such as handshaking, talking, sitting on toilet seats, or living in the same house with an infected person. The microorganisms that cause STDs (including AIDS) all die quickly once outside the body.

The only sure way of preventing STDs and AIDS is through sexual abstinence or a relationship with only one uninfected person (straight or gay). If you have several partners, either heterosexual or homosexual, you place yourself at a high risk of contracting disease. At present, no vaccine is available to prevent any of the STDs.

To help prevent the spread of STDs:

  • Know your sexual partner. Tell your sexual partner if you have an STD and ask your partner if they may have an STD.
  • Look for signs of an STD in your sexual partner. For example, look for sores around the penis or vagina. If your partner has:

Chlamydia - Look for signs of itching around the vagina, a yellow and odorless discharge, pain during sex and pain and frequency during urination for women. Men may have pain or burning when urinating, and a watery, milky-colored discharge from the penis.

Gonorrhea - Women may have a white, green or yellow discharge, painful urination, spotting between periods and sometimes fever and abdominal pain. Men may have a thick yellow discharge, painful urination and the opening of the penis may be sore.

Syphilis - A painless red sore will appear where you were touched during intercourse. A few months later, you may have a fever, sore throat, headaches and joint pain.

Herpes - A tingling and itching around the genitals. Small painful blisters may form in the area

  • Limit the amount of sexual partners.
  • Always use a condom when having sex.
  • Don't douche. Douching may spread infections higher into the womb.

Use Of Condoms

While condoms do not eliminate risk, the correct use of a condom and avoidance of certain sexual practices can decrease the risk of contracting AIDS, as well as other STDs. The condom (also known as a prophylactic, a rubber or safe) is a thin sheath, usually made of latex rubber, that covers the erect penis.

When used correctly, a latex condom is effective, both for preventing pregnancy and for decreasing the chances of contracting most STDs (including AIDS). Condoms can be purchased over the counter at any drugstore and are available in various thicknesses, colors and shapes. They may be lubricated or unlubricated, have a plain end or a reservoir end, and have a smooth (the most common), ribbed or corrugated texture.

Condoms can cost as little as three for a dollar, but usually the cost ranges from 50 cents to a dollar each. Condoms sometimes are made of animal membrane; however, some experts believe that the pores in such natural "skin" condoms may allow the virus to pass through. To be effective, the condom must be undamaged, applied to the erect penis before genital contact, and must remain intact and snugly in place until completion of the sexual activity.

About a third of all condoms now sold in the U.S. are purchased by women. They can be kept in a pocket or purse until needed, and they provide protection against STDs. The condom can be placed on the erect penis of a male partner as a part of the initial foreplay; a man who objects to a condom may be less opposed to wearing one if his partner puts it on for him.

Sexual Practices and STDs

Different sexual practices carry different degrees of risk of contracting the AIDS virus. Receptive (passive) anal intercourse is the riskiest, because this may damage the anal and rectal membranes and allow the AIDS virus to enter the bloodstream. The passive partner is at a much higher risk of contracting the AIDS virus than the active partner, although gonorrhea and syphilis can be transmitted from the passive partner's rectum. Most studies have focused on male homosexuals, but heterosexual anal sex probably carries the same risk.

Heterosexual vaginal intercourse, particularly with multiple partners, also carries a risk of contracting AIDS. The virus is believed to be transmitted more easily from the man to the woman than vice versa. This type of sex is how most other STDs are transmitted.

Oral/genital sex is a possible (though probably uncommon) means of transmission of the AIDS virus. However, inserting the penis in the mouth (fellatio) with ejaculation and swallowing of semen is the most common cause of throat gonorrhea, and oral contact with the clitoris and vaginal opening (cunnilingus) is a frequent method of transmission of the herpes virus.

Herpes is probably the only disease that can be contracted by light (dry) kissing, but deep (French) kissing may transmit other STDs. Activities that involve only skin-to-skin contact, (such as hugging, massage and mutual masturbation) with little or no exposure to body fluids, do not spread disease.

Other Prevention Methods

Spermicides are creams, foams, suppositories, jellies or film that a woman puts in her vagina to kill sperm. Lab studies show that spermicides also kill many of the germs that cause STDs. However, they offer less protection than condoms. For STD prevention, spermicides are best used with condoms, not in place of them.

Diaphragm, Sponge and Cap These types of birth control are inserted into the vagina to hold spermicide up to the cervix (entrance to the uterus - womb). The spermicide used with these methods can help protect the cervix from STDs.

Pill, Norplant, Depo-Provera and the IUD. The birth control pill, the Norplant implant and Depo-Provera injection, use man-made hormones to stop pregnancy. These devices give no protection against STDs. The IUD is a small device put inside the uterus to prevent pregnancy. It also gives no protection against STDs.

Withdrawal, Washing or Urinating Withdrawing the penis before ejaculation is not a reliable way to prevent STDs. Washing or urinating after intercourse may help remove some of the germs that cause certain STDs, but they cannot prevent STDs.