Sexually transmitted diseases (STDs) include chlamydia, gonorrhea, syphilis, trichomoniasis, pubic lice, genital herpes, and genital warts. Chlamydia is a bacterial infection that often has no symptoms but can cause reproductive health issues if left untreated. Gonorrhea is also a bacterial infection that may cause discharge and pain when urinating. Syphilis is a bacterial infection with stages including chancres, rashes, and potential long-term organ damage. Genital herpes and genital warts are caused by viruses that remain in the body indefinitely.

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Sexually Transmitted Diseases
(STD’s)

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Common STD’s
• Chlamydia
• Gonorrhea
• Syphillis
• Trichomoniasis
• Pubic Lice
• Genital Herpes (HSV-2)
• Genital Warts (HPV)

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Chlamydia
• Bacterial Infection (curable) - Chlamydia trachomatis.
• Affects the reproductive organs of both males and females.
• World wide occurrence is 3-4 million cases/year.
• Spread through unprotected oral, vaginal or anal sex.
• 70% of woman and 10% of men have no symptoms
• Symptoms generally appear within three weeks of infection.

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• Female symptoms:
- Vaginal discharge or burning with urination
- Lower abdominal pain
- Low-grade fever
• Male symptoms:
- Discharge from the penis or burning with urination
- Burning and itching around the opening of the penis
- Pain and swelling in the testicles
- Low –grade fever
• Treatment: Azithromycin (drug of choice) and other antibiotics - Cefixime,
Erythromycin, Amoxicillin, Doxycycline
• Prokarium (London, UK based company) is in the process of developing
Chlamydia trachomatis vaccine.

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Gonorrhea
• Bacterial Infection (Treatable) - Neisseria gonorrhoeae.
• Usually affects mucous membranes (mainly in urethra and
genital tract)
• Spread through unprotected oral, vaginal or anal sex.
• Also spread from mother to child (vaginal delivery).
• Male symptoms:
- Discharge from penis
- Painful urination

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• 50 % of females with gonorrhea have no symptoms while 50 % have
vaginal discharge and pain or burning when urinating
• Treatment:
- Initial therapy consists of a 3rd generation cephalosporin e.g.
Ceftriaxone.
- Also given in combination with Azithromycin or Doxycycline
• Prevention of neonatal disease is with the use of silver nitrate,
erythromycin, ciprofloxacin, gentamicin or erythromycin eye drops.
• Newer Approach - Interleukin-12 (IL-12) cytokine therapy.

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Images of Gonorrhea

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Syphilis
• Bacterial Infection (Curable) - Trepenoma pallidum.
• Attacks many parts of the body and is caused by a small bacterium –
spirochete.
• Transmits through unprotected oral, vaginal or anal sex.
• Sores mainly occur on the external genitalia, vagina, anus, or rectum.
• Sores can also occur on the lips and in the mouth.

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• Primary syphilis: Chancre
- Penetrate mucous membranes of genital tract, oral cavity, rectal mucosa
- Forms a chancre: small ulcer at site of inoculation
- Persists for 4-6 weeks and heals even without treatment
• Secondary syphilis: Systemic infection with skin rash & enlarged lymph nodes
- Begins several months after chancre has healed
- Persist for several weeks then subsides even without treatment
• Tertiary syphilis: Late destructive lesions in internal organs
- Late manifestations of the disease may appear 20 years after initial infection
- Organisms remain active, causing irreparable organ damage (scarring of aortic valve;
degeneration of fiber tracts in spinal cord; mental destruction; paralysis)

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• Congenital Syphilis
- Transmission of disease from mother to child
- May cause death of fetus
• Treatment:
- Penicillin (Drug of Choice)
- Other antibiotics Doxycycline, Tetracycline, Ceftriaxone, Azithromycin
• Prevention:
- Safe sex with condoms may help prevent transmission

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Images of Syphilis

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Genital Herpes (HSV-2)
• Virus Infection (Incurable) - Herpes Simplex Type 2 Virus
• “Outbreaks” of blisters and ulcers.
• Herpes infection is of two types:
- Type 1: infects oral mucous membrane (80% of infections).
- Type 2: infects genital tract (80% of infections).
• Transmission via vaginal, oral and anal sex.
• Transmission of virus can also occur through fingers.
• Herpes simplex remains in body for life.

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• Symptoms:
* Most common symptom is blister
- First (primary) outbreak occurs within a few weeks of contact
- May continue for a couple weeks
- May feel painful, itchy, burning
* Flu-like symptoms (headache, fever, swollen lymph glands, muscle
aches, etc)
* Burning during urination
• Treatment: Symptoms are treatable only
- Antiretroviral drugs e.g. aciclovir, famciclovir and valaciclovir.
- Keep affected area clean, Wash hands
- Refrain from sexual activity until outbreak is gone
- Condoms may help prevent herpes transmission

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Images of Genital Herpes

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Genital Warts (HPV)
• Virus Infection (Incurable) - Human Papilloma Virus (HPV)
• Human Papilloma Virus (HPV)
* A group of many viruses
* 200+ strains
* 40+ HPV forms can be sexually transmitted
• Characteristics of Warts:
- Pink or reddish warts.
- Cauliflower like tops that appear on the genitals, the vagina, or the
cervix one to three months after infection from HPV.

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• Transmission via vaginal, oral and anal sex.
• Warts may cause itching, burning and some pain.
• Approx. 30 of the HPV strains cause cervical cancer.
• HPV may also increase risk of vulvar, anal, penile and oral cancers.
• Genital warts may disappear on their own.
• Topical ointments/creams provided by physician.
• Freezing/burning/laser treatments for smaller warts

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• Treatment: Prescription medicines include:
- Podofilox for external warts (to stop the wart cells from growing).
- Imiquimod (boosts the body’s immune system so it can fight HPV).
- Green tea extract (sinecatechins) ointment for external warts.
- Interferon, an antiviral medicine, may be injected into genital warts
• Procedures: A dermatologist may perform one of these procedures:
- Cryosurgery (freeze off the warts with liquid nitrogen).
- Excision (cut out the warts).
- Electrocautery (destroy the warts with an electric current).
- Laser treatment (destroy the warts with laser light).
• Prevention:
* Refrain from sexual activity until warts are gone
* Condoms may help prevent HPV transmission
* HPV Vaccines
- Gardasil (FDA approved for males & females, age 9-26 yrs)
- Cervarix (FDA approved for females, aged 10-25)

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Images of Genital Warts

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Trichomoniasis
• Parasitic Infection (Curable) - Trichomonas vaginalis
• Sometimes called “trich” - a parasite that can be passed from person
to person during sexual intercourse.
• Occurs in vagina of women.
• Trichomoniasis is a common cause of Vaginitis.
• Transmitted to the baby during delivery.
• Also occur in the urethra in men with no symptoms usually.

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• Symptoms:
1. Female Symptoms:
- Itching and burning at the opening of the vagina and vulva.
- Painful and frequent urination
- Heavy, unpleasant smelling greenish, yellow discharge
2. Male symptoms:
Usually nothing, or discomfort in urethra, inflamed head of the penis.
• Treatment:
- Metronidazole (Oral antibiotic)
• Prevention:
- Safe and Protected sex with partner
- Using male/ female condoms

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Pubic Lice
• Parasitic Infection (Curable): Phthirus pubis
• Pubic lice are called “crabs” because they look like crabs.
• They are tiny insects that can crawl from the pubic hair of one person to
the pubic hair of another person.
• They usually attack the sexual (pubic) areas of the body.
• Also found in under arms, eyelashes, moustaches.
• Spread through direct physical contact or close body contact with an
infected person.
• Symptoms:
- Persisting itch in the genital, rectal area.

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• Treatment:
- Decontaminating yourself, your clothes, and your bedding.
- Medications include:
Malathion: topical lotion
Ivermectin: two-pill oral dose
Lindane: toxic to lice
• Prevention:
- Avoid sharing clothes, bedding, or towels with anyone having public lice.
- Sexual contact - avoided until treatment is complete and successful.

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Images of Pubic Lice

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