Health Education

Sexually Transmitted Diseases

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As a teen, you've probably heard about sexually transmitted diseases (STDs) in some form or another. Information about STDs is now everywhere and for a good reason - It is estimated that one in five people in the United States has an STD – teens having the most of any other age group.

Sexually transmitted diseases are types of infections that are spread from person to person through any sexual contact, which includes sexual intercourse and/or vaginal, anal, or oral (mouth) contact.

There are two things that make STDs dangerous:

  1. they are easily spread
  2. it is often impossible to tell if someone has an STD just by looking at him or her

What do I do if I think I have an STD?

An STD needs to be accurately diagnosed and fully treated. Some STDs can lead to long-term problems such as infertility (the inability to have a baby) and permanent disability or even death if they are left untreated. This means that if a person becomes sexually active (starts having sex – either vaginal or oral) or is considering becoming sexually active, he or she must have regular physical exams, including the genitals. If you think you may have an STD or if you have had a partner who may have an STD, you should see a provider right away.

How do I prevent STDs?

Just as with many other diseases, prevention of STDs is key - it's much easier to prevent STDs than cure them. The only way to completely prevent STDs is to abstain from all types of sexual contact. If you have sex, you must use a latex condom every time. This is the only birth control method that will help prevent most STDs - birth control pills and Depo-Provera don't offer protection against STDs (just pregnancy but we recommend to use them both together for extra pregnancy protection).

What is Chlamydia?

Chlamydia is an STD that is caused by bacteria called chlamydia trachomatis. Chlamydia is the most common sexually transmitted disease. It can be difficult for a male or female to know whether he or she has chlamydia- most people don't have any symptoms. That means you can have chlamydia and not know it! If females experience symptoms, chlamydia can cause an unusual vaginal discharge, pain during urination or during sexual intercourse, lower abdominal pain, or bleeding between menstrual periods. Males with chlamydia may have a discharge from the tip of the penis or experience itching or burning sensations around the penis. Chlamydia can be diagnosed with a urine test or vaginal swab. Chlamydia can be treated with antibiotics (such as a single dose of Azithromycin) and individuals should refrain some sexually activity for at least 1 to 2 weeks. You must notify anyone with whom you've had sex with as they will also need to be tested.

If untreated, Chlamydia can cause an infection of the urethra (where urine comes out) and inflammation of the cervix. It can also lead to pelvic inflammatory disease (PID), which can cause infertility (the inability to have a baby). If left untreated in guys, chlamydia can cause inflammation of the urethra and epididymis (the structure attached to the testicle that helps transport sperm) and this can be very painful.

What is Gonorrhea?

Gonorrhea is caused by bacteria called Neisseria gonorrhoeae. The bacteria can be passed from one person to another through vaginal, oral, or anal sex, even when the person who is infected has no symptoms. Symptoms usually appear 2 to 7 days after a person has been exposed to gonorrhea. A female who has gonorrhea may have no symptoms at all or her symptoms may be so mild that she doesn't notice them until they become more severe. A male who has gonorrhea is much more likely to notice symptoms, although he can have gonorrhea and not know it. A burning sensation is common with urination or yellow-green discharge from the vagina or penis. Females may also experience vaginal bleeding between menstrual periods.

Gonorrhea can be very dangerous if it is left untreated, even in someone who has mild or no symptoms. In females, the infection can move into the uterus, fallopian tubes, and ovaries causing PID and can lead to scarring and infertility. Gonorrhea infection during pregnancy can cause problems for the newborn baby, including meningitis and an eye infection that can result in blindness if it is not treated. In males, gonorrhea can spread to the epididymis, causing pain and swelling in the testicular area. This can create scar tissue that might make a male infertile. Gonorrhea can also affect other organs and parts of the body including the throat, eyes, heart, brain, skin and joints. Gonorrhea is diagnosed with a urine test or vaginal swab. Antibiotics are used to treat the infection; ideally patients need to return to the office for a Rocephin (generic ceftriaxone) injection which is the recommended treatment. Individuals should refrain from sexually activity for at least 1 to 2 weeks. You must notify anyone with whom you've had sex with as they will also need to be tested.

What is Trichomoniasis?

Trichomoniasis, commonly called "trich," is caused by a parasite (a tiny, one-celled organism). The parasite can cause vaginitis, the term for inflammation of the vagina. The parasite that causes trichomoniasis can be passed from one person to another during sexual intercourse. Although not as well known as Chlamydia and Gonorrhea, Trichomoniasis is one of the most common STDs and occurs very commonly along with the other infections. Females can have a thick vaginal discharge, foul odor, vaginal itching and/or painful urination. Males typically do not have symptoms.

Diagnosis is made with a vaginal swab. It is usually treated with an antibiotic called Flagyl (generic metronidazole). This medication has a significant interaction with alcohol that can cause nausea, vomiting, flushing of the skin, increased heart rate and even shortness of breath. It is extremely important to refrain from drinking any alcohol for at least 48 hours after finishing the medication. Individuals should refrain from sexually activity for at least 1 to 2 weeks. You must notify anyone with whom you've had sex with as they will also need to be tested.

What is Genital Herpes?

Genital Herpes is caused by a virus called herpes simplex (HSV). There are two different types of herpes virus, which are called HSV-1 and HSV-2. HSV-1 causes the cold sores or fever blisters that appear on or around the mouth, lips, or nose of many people. Many people have a cold sore at one time or another. It can be transmitted from person to person by sharing utensils, towels, and razors - or from kissing someone with a cold sore. HSV-1 is not a sexually transmitted disease. The other type of herpes, HSV-2, is a sexually transmitted disease. It causes herpes sores in the genital area, and it is transmitted through sexual contact (vaginal, oral, or anal sex).

A person who has been exposed to genital herpes will notice genital itching and/or pain about 2 to 20 days later. The sores usually appear within days afterward. The sores, which may appear on the vagina, head or shaft of the penis, scrotum, thighs, buttocks, and anus, start out as red bumps that soon turn into red, watery blisters. They may make it very painful to urinate. The sores then open up, ooze fluid or bleed, and then scab over and clear up during the next 3 to 4 days. The entire genital area may feel very tender or painful.

After the herpes blisters disappear, a person may think the virus has gone away - but it is actually hiding in the body. Both HSV-1 and HSV-2 have the ability to stay hidden away in the body until the next herpes outbreak, when the virus reactivates itself and painful sores return. Over time, the herpes virus will reactivate itself again and again, causing discomfort and episodes of sores each time. Usually a person has about four to five herpes outbreaks each year - but in some people, the number of outbreaks will lessen over time.

There is no cure for herpes; it will always remain in the body and can always be passed to another person with any form of unprotected sex. This is the case even if blisters aren't present on the genitals. Most cases of genital herpes are transmitted when symptoms are not present. Genital herpes also increases the risk of HIV infection. This is because the HIV virus can enter the body more easily whenever there's a break in the skin, such as a sore, during unprotected sexual contact. In addition, if a pregnant woman with genital herpes has an active infection during childbirth, the newborn baby is at risk for getting herpes infection. Herpes infection in a newborn can cause meningitis, seizures, and brain damage.

A latex condom must be used with any form of sexual intercourse (vaginal, oral, or anal sex). Remember that herpes is passed sexually even if no signs and symptoms of an outbreak, such as sores, are present. There is no cure for genital herpes, however antiviral medications can help control recurring herpes and clear up the painful sores.

What is HPV and Genital Warts?

HPV is short for the Human Papillomavirus, a sexual transmitted disease that causes most genital warts. HPV is a STD that hasn’t been talked about a lot because until just recently, we didn’t know much about it. It is thought that 80% of sexually active people have some strain of HPV. Certain strains are largely responsible for cancer of the cervix or vagina in females. HPV can also cause cancer of the penis in males and has now been linked to other cancers as well such as oropharyngeal and anal cancer. Cancer often takes years or decades to develop once a person is infected with HPV.

Genital warts are caused by different strains of HPV. They look like regular warts that some people get on their hands or feet; they are small, hard, skin-colored, and don't hurt, but may be itchy. Many times, the warts look like tiny cauliflowers as they start to grow bigger. A person who has been exposed to genital warts may have warts appear anytime from 3 weeks to 3 months later. Sometimes they can take even longer to appear; the virus can live in the body for a very long time without causing any symptoms.

If genital warts are left untreated, they may grow bigger and multiply. Some genital warts can be dissolved by using a special medication. If warts are large, a specialist may need to carefully "freeze" them off by using a chemical or laser treatment to remove them. Genital warts may recur and re-treatment is necessary.

What about HIV?

AIDS, or acquired immunodeficiency syndrome, is caused by HIV, or human immunodeficiency virus. HIV destroys a type of defense cell in the body called a CD4 helper lymphocyte. Normally these lymphocytes are part of the body's immune system, the defense that fights infectious diseases. But as HIV destroys the lymphocytes, people with the virus begin to get serious infections that they normally wouldn't - that is, they become immune deficient. Half of all new HIV infections in the United States occur in people under 25 years of age, and thousands of U.S. teens become infected with HIV each year.

HIV can be transmitted from an infected person to another person through blood, semen, vaginal fluids, and breast milk. The virus is spread through high-risk behaviors including unprotected oral, vaginal, or anal sexual intercourse and sharing needles, such as needles used to inject drugs and those used for tattooing. People who have another sexually transmitted disease, such as genital herpes, Chlamydia or Gonorrhea infection are at greater risk for contracting HIV during sex with infected partners.

Severe symptoms of HIV infection and AIDS may not appear for 10 years, and for years leading up to that, a person may not have symptoms of AIDS. The amount of time it takes for symptoms of AIDS to become evident vary from person to person. Some people may feel and look healthy for years while they are infected with HIV. It is still possible to infect others with HIV, even if the person with the virus has absolutely no symptoms. You cannot tell simply by looking at someone whether he or she is infected. When a person's immune system is overwhelmed by AIDS, the symptoms can include extreme weakness or fatigue, rapid weight loss, frequent fevers that last for several weeks with no explanation, heavy sweating at night, swollen lymph glands, minor infections that cause skin rashes and mouth, genital, and anal sores, white spots in the mouth or throat, chronic diarrhea, a cough that won't go away, or even short-term memory loss. Females may also experience severe vaginal yeast infections that don't respond to usual treatment, as well as pelvic inflammatory disease.

AIDS is one of the most serious, deadly diseases in human history. There are an estimated 42 million people living with HIV or AIDS worldwide, and more than 3 million die every year from AIDS-related illnesses. Because their immune systems are compromised, people who have AIDS are unable to fight off many infections, particularly tuberculosis and other kinds of otherwise rare infections of the lung, meningitis, or encephalitis. People who have AIDS tend to become progressively sicker especially if they are not taking antiviral medications properly.

AIDS can affect every body system. The immune defect caused by the absence of CD4 cells also permits some cancers that are stimulated by viral illness to occur - some people with AIDS get forms of lymphoma and rare tumors of blood vessels in the skin called Kaposi's sarcoma. Because AIDS is fatal, it's important that providers detect HIV infection as early as possible so a person can take medication to delay the onset of AIDS.

HIV or AIDS can be detected by a simple blood test. It is recommended that teens and young adults who are sexually active be routinely tested at least once per year. There are drugs that slow down the progress of the disease, and people with the disease now live much longer. But there is still no cure for HIV and AIDS.