Health (A weekly column prepared by Dr Balwant Singh’s Hospital Inc.

By Dr Soumyaroop Dash  MD,  DNB
(Consultant Obstetrician and Gynaecologist)

What is a sexually transmitted disease (STD)?
It is an infection or disease passed from person to person through sexual contact.

How do you get an STD?
You can get and pass STDs through vaginal, anal, or oral sex. Trichomoniasis (a type  of STD) can also be picked up from contact with damp or moist objects such as towels, wet clothing, or a toilet seat, if the genital area gets in contact with these damp objects. Some STDs cause no symptoms. But STDs can still be passed from person to person even if there are no symptoms.

What are the symptoms of STDs?
STDs have a wide variety of symptoms and sequelae in women. In men, the manifestations of an STD are limited. Men usually manifest with an ulcer on the penis, which can be painful, and pain when urinating. The manifestations of STDs are more in men who are gay. It is also important to know the fact that men tend to give an STD much more easily to the female partner than vice versa.  So, it is imperative for women to take precautions.
Here are some STDs and their symptoms:
STD    Symptoms
 

BV (Bacterial      Most women have no symptoms. Women with
     vaginosis)     symptoms may have:
   ■ vaginal itching  ■pain when urinating
   ■ discharge with a fishy odour 
Chlamydia  Most women have no symptoms.
   Women with symptoms may have:
   ■ abnormal vaginal discharge  ■ burning when urinating
   ■ bleeding between menstrual periods

   Infections that are not treated, even if there are no
   symptoms, can lead to:
   ■ lower abdominal pain ■ low back pain  ■ nausea     ■ fever ■ pain during sex ■ bleeding between periods 
Genital Herpes  Some people may have no symptoms. During an
   ‘outbreak,’ the symptoms are clear:

   ■ small red bumps, blisters, or open sores on the penis,          vagina, or on areas close by
   ■ vaginal discharge ■ fever ■ headache
   ■ muscle aches  ■ pain when urinating      ■ itching, burning, or swollen glands in genital area
   ■ pain in legs, buttocks, or genital area
   
   Symptoms may go away and then come back. Sores heal after
                                     two to four weeks.

 
Gonorrhea  Symptoms are often mild, but most women have no symptoms.
   This is an STD where men are usually more symptomatic than      women. Even when women have symptoms, they can sometimes be    mistaken for a bladder or another vaginal infection. Symptoms are:
   ■ pain or burning when urinating in men.
   ■ yellowish and sometimes bloody vaginal discharge
   ■ bleeding between menstrual periods
Hepatitis B  Patients with symptoms may have:
   ■ mild fever ■ headache and muscle aches     ■ tiredness
   ■ loss of appetite ■ nausea or vomiting ■ diarrhoea
   ■ dark-coloured urine and pale bowel movements
   ■ stomach pain ■ skin and whites of eyes turning yellow
 
 
HIV/AIDS  Some people may have no symptoms for 10 years or more.
   Patients with symptoms may have:
   ■ extreme fatigue  ■ rapid weight loss
   ■ frequent low-grade fevers and night sweats
   ■ frequent yeast infections (in the mouth)
   ■ vaginal yeast infections and other STDs
   ■ pelvic inflammatory disease (PID)
   ■ menstrual cycle changes
   ■ red, brown, or purplish blotches on or under the skin or inside
      the mouth, nose, or eyelids 

Human Papillomavirus  Visible warts in the genital area, including the thighs. Warts can
(HPV)   be raised or flat, alone or in groups, small or large, and sometimes     they are cauliflower-shaped.
   ■ lesions on the penis, anus or the vagina 
   ■ Pubic Lice  ■  Itching ■ finding lice 

Syphilis  Symptoms in the first, or primary stage:
   ■ a single, painless sore appears, usually in the genital areas but
     may appear in the mouth
   ■ if infection is not treated, it moves to the next stage
   Symptoms in the next, or secondary stage are:
   ■ skin rash on the hands and feet that usually does not itch and
      clears on its own ■ fever ■ swollen lymph glands
   ■ sore throat ■ patchy hair loss  ■headaches
   ■ weight loss ■ muscle aches  ■ tiredness

   In the latent, or hidden, stage, the symptoms listed above
   disappear, but the symptoms from the second stage can come
   back. In the late stage, infection remains in the body and can
   damage the brain, nerves, eyes, heart, blood vessels, liver,
   bones, and joints. 

Trichomoniasis  Symptoms usually appear 5 to 28 days after exposure
   and can include:
   ■ yellow, green, or grey vaginal discharge (often foamy)
      with a strong odour
   ■ discomfort during sex and when urinating
   ■ irritation and itching of the genital area
   ■ lower abdominal pain in rare cases 
 
How do you get tested for STDs?
Talk with your doctor or nurse about getting tested for STDs. She or he can tell you how to test for each STD.

Can STDs cause health problems?
Yes. While each STD causes different health problems, overall, they can cause cervical cancer and other cancers, liver disease, pelvic inflammatory disease, infertility, pregnancy problems, and other complications. Some STDs increase your risk of getting HIV/AIDS. HIV/AIDS can cause a number of health problems and raise the risk of getting life-threatening diseases and certain forms of cancer.

How are STDs treated?
The treatment depends on the type of STD. For some STDs, treatment may involve taking medicine or getting a shot. For other STDs that can’t be cured, like herpes, there is treatment to relieve the symptoms.

What can I do to avoid getting an STD?
There are steps you can take to keep from getting an STD:

Don’t have sex. The best way to prevent any STD is to practise abstinence, or not having vaginal, oral, or anal sex.

Be faithful. Have a sexual relationship with one partner who has been tested for STDs and is not infected is another way to reduce your chances of getting infected. Be faithful to each other, meaning that you only have sex with each other and no one else.

Use condoms. Protect yourself with a condom EVERY time you have vaginal, anal, or oral sex. Condoms should be used for any type of sex with every partner. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a dental dam. A dental dam is a rubbery material that can be placed over the anus or the vagina before sexual contact.

Know that some methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STDs. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sex.

Talk with your sex partner(s) about STDs and using condoms. It’s up to you to make sure you are protected. Remember, it’s YOUR body!

Talk frankly with your doctor or nurse and your sex partner(s) about any STDs you or your partner have or had. Try not to be embarrassed.

Have regular pelvic exams. Talk with your doctor about how often you need them. Many tests for STDs can be done during an exam. Ask your doctor to test you for STDs. The sooner an STD is found, the easier it is to treat.