Sexually Transmitted Diseases (STDs)

Published by Dr Gigi on May 29, 2020

Sexually transmitted diseases or infections (STDs/STIs) are a variety of highly contagious diseases caused by different organisms that are transmitted from one individual to another through sex; oral, anal or vaginal intercourse.

Abstinence is the only way to prevent STDs. The risk of acquiring it increases when an individual or their partner has sex of any kind with multiple partners. Couples committed only to each other and those who practice safe sex have lower risk of STDs.

Condoms when properly used can be effective in offering protection from some STDs. However, condoms are not 100% effective in preventing transmission.

If you have a sexually transmitted disease, it is important to speak with your partner to encourage them to seek treatment to prevent complications and long term damage that may result from not receiving treatment.

Not everyone with STD will have signs or symptoms, for some STDs, the symptoms may appear after a few days or weeks of incubation. These individuals are more likely to pass it to others inadvertently. This means you can not tell if someone you are about to have sex with, has STD, so it becomes important to use protection, a condom at the least.

Anyone with one STD is likely to have another given the mode of transmission. Having sores or bumps around the genitalia also increases an individual’s risk  of some STDs like HIV.

For treatment to be effective, both partners must be treated at the same time, even if only one was tested. If one partner is untreated, then the other will be reinfected till both are treated.

How Common Are Sexually Transmitted Diseases

According to the World Health Organization, greater than a million people acquire STDs, everyday. Every year there is a record of 376 million new infections with the most common STDs; chlamydia, gonorrhea, trichomoniasis and syphilis.

Types Of STDs

1. Chlamydia

This is an infection caused by the bacteria Chlamydia trachomatis. It affects both males and females. Any one, as long as they are sexually active is at risk of the infection. It is transmitted through sexual contact with the penis, vagina, mouth, throat, anus of someone with the infection, even without ejaculation.

An infected pregnant woman can transmit the infection to their unborn child, especially if untreated. In newborns, chlamydia infection can cause irreversible blindness, making it important that every pregnant woman with chlamydia be treated.

Successful treatment following previous chlamydia infection does not prevent reinfection if an individual is re-exposed. Untreated chlamydia infections leads to pelvic inflammatory disease, infertility, ectopic pregnancy among others.

Signs and symptoms

Most people with Chlamydia usually show no symptoms. In some, it may take a few weeks for symptoms to appear. If symptoms present at all, they may include:

• Yellowish, pus-like, vaginal discharge with strong smell
• Pain or burning sensation while urinating
• Pus or watery/milky discharge from the penis
• Pain during sex
• Pain in the lower abdomen
• Bleeding between periods
• Swollen or tender testicles
• Pain, discharge and/or bleeding around the anus

2. Gonorrhea

This is caused by a highly common and contagious bacteria; Neisseria gonorrhea.  It is transmitted through sexual contact with the penis, vagina, mouth, throat, anus of someone with the infection, even without ejaculation. It causes infection in both men and women and can be transmitted from a pregnant mother to their unborn child during delivery.

Young people between the ages of 15-24 are at higher risk. Gonorrhea and chlamydia often occur together. This means that if an individual has one, they are likely to have the other. So a positive test for one is enough indication to treat the other.

Men who have sex with men are highly at risk of gonorrhea.

Signs and symptoms

It is often asymptomatic and as such may go untreated resulting in chronic, silent infection with serious health complications. In women, it may progress to pelvic inflammatory disease affecting the cervix, fallopian tubes and in men, epididymitis (inflammation of the tubes that store and carry sperm) resulting in infertility.

Women often do not show any of the symptoms while men are likely to. Symptoms in those who may experience them include:

Males

• Milky-white, yellow, or green discharge from the penis
• Swelling and pain in the testicles
• Swelling or redness at the opening of the penis

Females

• Watery, creamy, or greenish discharge from the vagina
• Pain or burning sensation while urinating
• Fever
• Frequent urination
• Heavier periods or bleeding between menstruation
• Pain during sex
• Sharp pain in the lower abdomen

3. Trichomoniasis

This infection is caused by the parasite Trichomonas vaginalis. It is highly contagious and can be transmitted through sex; vaginal, oral or anal. Not everyone will show symptoms, however, females are more likely to experience symptoms. Risk is higher in people with multiple sex partners and have unprotected sex.

In women, it affects the vulva, vagina, cervix, or the urethra and in men, it affects the urethra and testes.

If untreated, it may lead to infertility and premature delivery in pregnant women. It increases one’s risk of acquiring HIV.

Symptoms:

70% of infected individuals will not show symptoms. The symptoms may be seen after 5 or 28 days after exposure and may include:

• Irritation and itching of the vagina
• Frothy, thin, green, gray or yellow foul smelling vaginal discharge. Sometimes characterized as fishy smell
• Burning or painful sensation during urination
• Discharge from the penis
• Increased urination and urgency

4. Genital Herpes 

This is an infection caused by Herpes simplex virus types 1 and 2. Type 1 usually affects the mouth and is commonly associated with cold sore and can be transmitted through mouth to mouth, or mouth to genital contact during oral sex. Type 2 affects the genitals mostly, but can also affect the mouth through oral sex.

The lesions of herpes are in form of small, painful vesicles/blisters that may occur in clusters. It is incurable. Once a person is infected, it stays dormant in the area even when the blisters disappear, and will recur as flare ups from time to time.

The content of the vesicles are highly contagious and will spread from person to person on contact. It is usually more severe in people with HIV and low immunity. Condoms do not prevent herpes infection as it can still pass from skin around the genitals not covered by condom unto the partner’s skin upon contact.

Symptoms

People with the virus experience flare ups, episodes where painful blisters erupt over the genital region.

• Excruciating pain
• Fever
• Swollen lymph nodes; small nodule-like swellings in the groin area.
• Generalized body aches

5. HIV (Human Immune Virus)

This is a sexually transmitted viral infection, primarily through semen and blood. Transmission can also occur through breast milk, vaginal and rectal fluids.

The virus attacks and wreaks havoc on white blood cells in the body, consequently damaging the immune system. The immune system is the body’s defense against diseases.

HIV infection makes an individual susceptible to all sorts of infection that ordinarily would not have made them sick. Risk of contracting diseases caused by other viruses or bacteria and certain cancers increases.

Fortunately, there are medications that help in slowing the progress of the disease and help protect the immune system. Without these medications, HIV infection often progresses to AIDS (acquired immune deficiency syndrome).

The symptoms of HIV in the initial stage may resemble flu or malaria-like symptoms: fever, chills, body aches and pains, headache, nausea, rashes, sore throat, swollen lymph nodes. 

6. Hepatitis B Virus

This is a viral disease that affects the liver caused by the hepatitis B virus. It can be contracted through sexual intercourse, contact with blood and body fluids of an infected person. It can also be transmitted from mother to child during delivery.

Read more here Hepatitis B: Symptoms, Transmission,Treatment And Prevention

7. Crabs (Pubic lice)

These tiny parasites are similar to the lice that infests the head and body. They also feed on human blood and can be contracted through sexual contact with an infected person.

They are so small that you may not know your partner has them. Some of the symptoms of genital lice infestation include: incessant itching around the vagina or penis, skin irritation and redness over the pubic area.

Diagnosis Of STDs

Signs and symptoms or physical examination are not specific enough to help in establishing diagnosis of STDs.

There is no specific test capable of detecting all the STDs. Your doctor may recommend the appropriate test (culture, blood or urine tests) for the specific infection.

If you have many sexual partners you may already have an STD even if you do not have symptoms, you should go to your doctor to get tested.

Untreated STDs have long term complications including infertility and the risk of acquiring other infections.

Pap smear is not an STD test, it only detects the presence of precancerous cells on the cervix.

Treatment Of STDs

This will depend on the type of STD

Bacterial STDs are generally treated with antibiotics. All antibiotics are not the same, they are of different classes, with different mechanism of actions and potency against specific organisms. Each disease has specific antibiotics for its treatment. Check with your doctor who will carry out the necessary tests and recommend the appropriate medication, based on the organism’s sensitivity to the class of antibiotics. Taking antibiotics indiscriminately will result in resistance of the bacteria against the medication and prevent cure.

Viral STDs have no cure but some may be cleared by the body. Many medications may help relieve some symptoms and suppress flare ups (Herpes) or progression of the disease (HIV progressing to AIDS).

Antibiotics do not treat viruses so they should never be taken as treatment for viral infections.

Can STDs be cured?

Yes, certain STDs are curable.

Chlamydia, syphilis, gonorrhea, crabs, trichomoniasis can be cured with specific antibiotics.

On the other hand, viral STDs such as human papilloma virus (HPV), Human Immune Virus (HIV), and herpes can not be cured. Treatment options are available to help relieve some of the symptoms even though they can not be cured.

STD Prevention

The best preventive measure is complete abstinence. Another close second is being in a committed relationship with a faithful partner who has been tested and cleared from all STDs.

Condoms provide protection from STDs that may be contracted through body fluids such as semen or blood. They do not offer protection against other forms of STDs such as those passed via skin to skin contact.

Are Vaccines Available?

Safe and effective vaccines are currently available for only 2 STDs; Human Papilloma Virus and hepatitis B. The hepatitis B vaccine is part of the current infant immunization scheme implemented in 2004. People born prior to 2004 need to visit a healthcare provider to discuss their risks and available options. HPV vaccines could help prevent cervical cancer in women.

Sources

• https://pubmed.ncbi.nlm.nih.gov/1411843/
• https://journals.lww.com/jaids/Abstract/2000/05010/Effect_of_Intravaginal_Practices_on_the_Vaginal.9.aspx
• https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354567/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837252/
• https://journals.lww.com/greenjournal/Fulltext/2012/07000/Subclinical_Pelvic_Inflammatory_Disease_and.9.aspx
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524331/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475227/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5177552/