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Sexually Transmitted Infections

Sexually transmitted infections are a serious health problem in the United States. These infections may have both short and long-term consequences for the female patient. Acute infection may lead to the need for emergent treatment and potentially even hospital admission with surgery. The impact of these diseases can be severe and life altering. A brief sexual encounter may be all that is necessary for complete loss of fertility or even a life-threatening illness.

There are many diseases that can spread by way of sexual contact. Chlamydia and Gonorrhea are just a few of the potentially sexually transmitted infections. Herpes Simplex and Human Pappiloma Virus account for significant visits to the Gynecologist every year, but they will be excluded from this article. There is a divergence in the clinical features associated with each infection. Some diseases are found to be quite indolent and others may present with early symptoms. Because the prevalence of these two STI’s is much higher than others not listed, such as HIV, we will focus this article on these alone.

Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman's reproductive organs. Chlamydia can be transmitted during vaginal, anal, or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth. Symptoms of Chlamydia are commonly mild or absent, yet serious complications can arise that cause irreversible damage, including infertility. Chlamydia can occur "silently" or asymptomatically before a woman ever recognizes a problem. Chlamydia in men usually presents as a painful penile discharge.

There are laboratory test to diagnose Chlamydia. Some can be performed on urine, other test require that a specimen be collected from a site such as the penis or cervix. In 2008, 1,210,523 Chlamydia infections were reported to the CDC from 50 states and the District of Columbia. Under-reporting is substantial because most people with Chlamydia are not aware of their infections and do not seek testing.

Chlamydia can be treated easily based on the severity of the illness. It is also recommended, and in some states required, to report and treat sexual partners. Oral and intravenous (IV) antibiotics can be used to treat Chlamydia infections. Reference to treatment will be made at the bottom of this article for all diseases discussed.

Women who have symptoms might have an abnormal vaginal discharge or a burning sensation when urinating. If the infection spreads from the cervix to the fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), some women still have no signs or symptoms; others have lower abdominal pain, low back pain, nausea, fever, pain during intercourse, or bleeding between menstrual periods. It is this spread, which may lead to damage in the upper reproductive tract causing infertility.

Gonorrhea is another sexually acquired disease which is having significant impact on women in the United States. CDC estimates that more than 700,000 persons in the U.S. get new gonorrheal infections each year. Gonorrhea is spread through sexual contact with the penis, vagina, mouth, or anus. Gonorrhea can also be spread from mother to baby during delivery.

In women, the symptoms of Gonorrhea are often mild, but most women who are infected have no symptoms. Even when a woman has symptoms, they can be so non-specific as to be mistaken for a bladder or vaginal infection. The initial symptoms and signs in women include a painful or burning sensation when urinating, increased vaginal discharge, or vaginal bleeding between periods. Women with Gonorrhea are at risk of developing serious complications from the infection, regardless of the presence or severity of symptoms. In men, the symptoms can vary from no symptoms at all to penile discharge.

According to the CDC, several antibiotics can successfully cure Gonorrhea in adolescents and adults. However, drug-resistant strains of Gonorrhea are increasing in many areas of the world, including the United States, and successful treatment of Gonorrhea is becoming more difficult. Floroquinilone resistance is a new development in the treatment of this disease. Because many people with Gonorrhea also have Chlamydia, another STD, antibiotics for both infections are usually given together. Persons with Gonorrhea should be tested for other STDs.

It is important to take all of the medication prescribed to cure Gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease. People who have had Gonorrhea and have been treated can get the disease again if they have sexual contact with persons infected with Gonorrhea. If a person's symptoms continue even after receiving treatment, he or she should return to a doctor to be reevaluated. "

Now that we know the impact STI’s may have on a women's sexual health, "What can I do to protect myself?" The surest way to avoid transmission of STDs is to abstain from sexual intercourse, or be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.

Latex condoms, when used consistently and correctly, can reduce the risk of transmission of Gonorrhea or Chlamydia.

Overall, ST'Is are a serious problem in the United States and worldwide. There is significant financial cost to the patient and health care system. The social and health impact of these diseases contribute to the need to prevent and treat early.

 

 

 

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