By Gilda Morales, ANP, DC
This week’s column is being written in response to an increasing incidence of sexually transmitted diseases being seen in this area and as a matter of information for a topic that is commonly avoided.
Sexually transmitted diseases, or STDs, by definition, are caused by having unprotected sex, and if left untreated can cause serious complications. While there may be symptoms such as sores, itching or discharge, often there are no symptoms until late in the disease. STDs affect both partners and it is imperative that both be treated in order to be effective and to prevent reinfection or spread of the disease.
Chlamydia is the most common bacterial infection, and is usually asymptomatic, especially in females. In females that do have symptoms, there is a mucopurulent discharge, painful urination and pelvic cramping. If left untreated, it can lead to pelvic inflammatory disease, ectopic pregnancies and even infertility. If the female is infected during pregnancy, the baby may be born with pneumonia or conjunctivitis. Males may present with painful urination, discharge, scrotal pain, or rectal pain. The consequences of undiagnosed and untreated disease can result in epididymitis and urethritis, prostatitis, or even a serious arthritic condition called Reiter’s syndrome.
Gonorrhea can present as an infection affecting the eyes, throat, urogenital or anorectal areas, but can spread and cause other symptoms such as fevers, skin lesions, arthritis, tendon problems and can even affect the heart (endocarditis). Carriers of the infection will not always have symptoms and can be males or females, and babies born to infected mothers will be infected as they pass through the birth canal.
HPV, or the herpes papilloma virus, is also sexually transmitted, but unlike the other STDs, it will be a chronic and recurrent infection that presents on the lips or genitals. The incubation period ranges between 2 to 12 days after exposure, and in many cases, there are no symptoms. However, in those that do exhibit symptoms, there is a long list that can occur initially, including multiple genital ulcers, painful urination, itching, fever, enlarged lymph glands, headache, muscle pain and a general malaise. In recurrent episodes, the patient will usually experience a warning symptom of tingling, burning, or shooting pain approximately one day before the lesion as well as painful urination and itching, with the episodes lasting about 4 to 6 days. The HPV infection can also be passed on to infants if the mother is infected, and the disease is extremely contagious, especially during outbreaks.
Except for HPV, the STDs mentioned here can be cured by different antibiotics. HPV, on the other hand, cannot be cured, but outbreaks can be lessened or suppressed with antivirals such as Acyclovir. Testing for Chlamydia and Gonorrhea can be performed by a simple urine test, while HPV requires a culture of the live virus or PCR serum testing. The latter two STDs are also on the CDC (Center for Disease Control) “must report” list, which means that anyone testing positive, will be reported and the CDC will contact the patient to insure that all partners are notified in an effort to curb spreading of the diseases.