2. Sexually Transmitted Infections Page 1
GONORRHEA
is a highly contagious sexually transmitted STD bacterial infection, sometimes referred to as the clap.
The nickname of the clap refers to a treatment that used to clear the blockage in the urethra
from gonorrhea pus, where the penis would be 'clapped' on both sides simultaneously. This gonorrhea
treatment is rarely used today, however the nomenclature remains. Gonorrhea is characterized by thick
discharge from the penis or vagina. In addition to male reproductive organs & female genital tract,
gonorrhea may infect the rectum, throat, eyes, blood, skin, & joints.
Contraction
Gonorrhea spreads through semen or vaginal fluids during unprotected sexual contact, heterosexual or
homosexual, with an infected partner:
๏ vaginal or anal sex with an infected partner
๏ oral sex, although this is less common
๏ sharing sex toys
๏ touching parts of the body with fingers (for example, touching the private parts and
then the eyes)
๏ any very close physical contact
๏ the bacteria can be passed from hand to hand (very rare isolated cases)
๏ from a mother to her baby at birth
You can NOT catch it from simple kissing, sharing baths, towels, cups, or from toilet seats.
Incubation Period 1-14 days
I. Symptoms of Gonorrhea
1/2 of women & 1/10 of men who have gonorrhea have no symptoms at all. Women's symptoms can
include discharge from the vagina, frequent urination, pain or burning when urinating, & pain between
periods. Men are most likely to experience pain during urination & discharge from the penis. The throat
infection rarely shows symptoms.
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Gonorrhea Symptoms in Women
๏ strong smelling vaginal discharge that may be thin & watery or thick & yellow/green
๏ irritation or discharge from the anus
๏ abnormal vaginal bleeding
๏ possibly some low abdominal or pelvic tenderness
๏ pain or a burning sensation when passing urine
๏ low abdominal pain sometimes with nausea
Gonorrhea Symptoms in Men
๏ white, yellow or green thick discharge from the tip of the penis
๏ inflammation of the testicles & prostate gland
๏ irritation or discharge from the anus
๏ urethral itch & pain or burning sensation when passing urine
Gonorrhea Testing
A urine test & a swab test - collecting fluid from the penis or vagina by placing a swab in the opening of
the urethra; this causes brief discomfort.
๏ giving a sample of urine
๏ a genital examination by a doctor or nurse
๏ taking swabs from the cervix (entrance to the womb), urethra (tube where the urine
comes out), throat or rectum
๏ women may have an internal examination
Gonorrhea Treatment
Early treatment is simple & effective, & involves a single dose of antibiotics. In addition, the treatment
of chlamydia is also advocated. (It is common to have these two STD infections together โ 50% have
both)
Once it has been successfully treated, it won't come back unless a new infection is picked up.
If Gonorrhea Not Treated
Gonorrhea infection can spread through the bloodstream to other parts of the body, causing damage &
serious problems.
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In women, it can cause:
๏ life-threatening complications such as ectopic pregnancy (outside the womb)
๏ blocked fallopian tubes (the tubes which carry the egg from the ovaries to the womb),
which can result in reduced fertility or infertility
๏ long-term pelvic pain
In men, it can lead to:
Painful inflammation of the testicles, which may result in reduced fertility or sterility
CHLAMYDIA (NGU)
Is a sexually transmitted disease (STD). Chlamydia trachomatis, or simply chlamydia, is a bacterial
infection caused by pathogen (germ) Chlamydia trachomatis that usually infects the genitals of both
men and women, but can also infect the throat, rectum and eyes. Chlamydia is one of the most common
STD's - and because more than 50% who have chlamydia have no symptoms at all - chlamydia
infection usually goes untreated.
Contraction is mainly passed through sexual activity:
๏ vaginal or anal sex with an infected partner
๏ oral sex, although this is less common
๏ sharing sex toys
๏ touching parts of the body with fingers (for example, chlamydia often occurs in the
eyes)
You can NOT catch chlamydia from simple kissing, sharing baths, towels, cups, or from toilet seats.
Incubation Period of Chlamydia 7-21 days
Signs and Symptoms of Chlamydia
2/3 of women and 1/2 of men who have chlamydia have no symptoms at all; others have symptoms so
mild they aren't noticeable.
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Chlamydia Symptoms in Women:
๏ an unusual vaginal discharge
๏ pain or a burning sensation when passing urine
๏ bleeding between periods
๏ pain during sex or bleeding after sex
๏ low abdominal pain sometimes with nausea
Chlamydia Symptoms in Men:
๏ white/cloudy, watery discharge from the tip of the penis
๏ pain or a burning sensation when passing urine
๏ testicular pain and/or swelling
Testing of Chlamydia
A urine test and a swab test collecting fluid from the penis or vagina. (Swab test is obtained by briefly
placing a swab in the opening of the urethra at the tip of the penis; this causes brief discomfort and a
burning sensation)
Treatment of Chlamydia
Chlamydia is simple to treat with antibiotics, either a single dose or a course lasting up to two weeks:
To avoid re-infection, any sexual partners should be treated too. Treating gonorrhea is advocated for
patients being treated for chlamydia, and vice versa (50% have both infections together)
If Chlamydia is Not Treated
Without treatment, chlamydia infection can spread to other parts of the body causing damage and
serious long-term health problems.
In women, chlamydia can cause pelvic inflammatory disease, which can lead to:
๏ ectopic pregnancy (a pregnancy outside the womb)
๏ blocked fallopian tubes (the tubes which carry the egg from the ovaries to the womb), which
can result in reduced fertility or infertility
๏ long-term pelvic pain
๏ early miscarriage or premature birth
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In men, chlamydia can lead to:
๏ painful inflammation of the testicles, which may result in reduced fertility or sterility
๏ occasionally, Reiter's syndrome (inflammation of the joints, urethra and eyes)
SYPHILIS
A bacterial infection caused by an organism called a spirochete. is contracted through oral, anal, or
vaginal sex, or via intimate touching or kissing. Mothers can pass it to their babies by touching syphilis
sores (chancres) and then touching the baby.
Incubation Period: One week to three months
Symptoms:
First stage of a syphilis infection, painless sores or open ulcers may appear on the anus, vagina, penis, or
inside the mouth, and occasionally on other parts of the body.
Second stage (roughly three weeks to three months after the first symptoms appear), an infected person
may experience flu-like symptoms and possibly hair loss or a rash on the soles and palms -- and in
some cases all over the body. There are also latent phases of syphilis infection during which symptoms
are absent.
Testing: Diagnosis of syphilis is done through a blood test and/or examination of secretions from
chancres.
If not treated:
Untreated syphilis can lead to serious damage to the brain and the nervous system; mental
deterioration; a loss of balance, vision, and sensation; leg pain; and heart disease. A fetus is at particular
risk if the mother doesn't seek treatment; the chances for stillbirth and serious birth defects, including
blindness, are very high.
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TRICHOMONIASIS
Trichomoniasis, (also called "trich") is a common sexually transmitted disease (STD) that affects both
men and women. Trichomoniasis is caused by a protozoan parasite called Trichomonas vaginalis and is
a cause of vaginal infections in women and urethral infections in men, is one of the most common,
curable causes of vaginal infections in women.
Trichomoniasis is spread through sexual contact, as all other STD's. Transmission can occur even if a
person does not have symptoms of infection. Women contract trichomoniasis from infected male or
female partners while men usually contract it only from female partners. Using condoms and/or dental
dams provide some protection. Their use is strongly encouraged, but is not 100% safe. Trichomoniasis
can also survive on infected objects like sheets, towels, and underwear and could be transmitted by
sharing them.
Incubation Period If symptoms appear, it usually takes from 3 to 28 days for them to develop.
Symptoms in Women
๏ Genital itching and/or burning
๏ Vaginal or vulval redness
๏ Frothy yellow-green vaginal discharge with a strong odor
๏ Blood spotting
๏ Frequent and/or painful urination
๏ Discomfort during intercourse
๏ Abdominal pain
A woman might also find that the above symptoms worsen after menstruation and that the symptoms
may be confused with an yeast infection. This fact emphasizes the importance of always having an yeast
infection diagnosed properly, because it might not be an yeast infection.
Symptoms in Men
Men are usually asymptomatic, but if a man has symptoms, they can include:
๏ Unusual penile discharge
๏ Painful urination
๏ Burning sensation after ejaculation
๏ Tingling inside the penis.
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Treatment
Antibiotics - Metronidazole 500mg 2-3 times a day for 7-10 days. It is especially important that both
partners are treated at the same time because an infected man, even a man who has never had
symptoms or whose symptoms have stopped, can continue to infect a female partner until he has been
treated. Anyone being treated for trichomoniasis should avoid sex until they and their sex partners have
completed the treatment.
If not treated
Trichomoniasis is one of the most common and most curable STD's. The symptoms are more annoying
than they are threatening to your health. The genital inflammation caused by trichomoniasis might
however, increase a person's risk of acquiring HIV infection if s/he is exposed to HIV or might also
increase the chances of transmitting HIV infection to a sex partner. In rare case, trichomoniasis in
pregnant women may cause a premature rupture of the membranes and early delivery.
HERPES (Herpes Simplex)
Two types of a viral infection characterized by periodic outbreaks of painful sores, Stress, sunburn, and
certain foods are the primary causes of a herpes outbreak.
Contraction Both herpes simplex virus-1 and virus-2 may be transmitted through sex, or by kissing or
touching any affected area. A condom can prevent herpes transmission during vaginal or anal sex, but
oral contact with genitals or open sores anywhere can spread the disease. Washing hands can also
minimize transmission.
Incubation Period: Anywhere from five to twenty days
Symptoms: Herpes simplex virus-1 usually shows up as cold sores or blisters. For those who have herpes
simplex virus-2, some have no symptoms, while others may show signs of an infection from five to
twenty days after having sex with an infected partner. Early symptoms can include a burning sensation
in the genitals, low back pain, pain when urinating, and flu-like symptoms. A short while later, small
red bumps may appear around the genitals or on the mouth; later these bumps become painful blisters
which then crust over, form a scab, and heal.
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HPV / GENITAL WARTS
Human Papilloma Virus (HPV) - a group of more than 70 viruses, some of which can lead to cervical
cancer., Several strains of HPV cause external genital warts. .
Contraction, Through oral, anal, and vaginal sex and through skin-to-skin contact, To help prevent
infection, use a condom. It's not clear exactly how effective condoms are at protecting against HPV and
genital warts, but they will protect you against other STDs, including HIV.
Incubation Period: Anywhere from one month to several years
Symptoms: Many types of HPV have no symptoms, though some cause visible genital warts that may be
found in the vagina or urethra or on the cervix, vulva, penis, or anus. Rarely, they are found in the
mouth or throat. Warts are often flesh-colored, soft to the touch, and may look like miniature
cauliflower florets. They usually grow in more than one area and are often painless, although they may
itch.
SCABIES
A mite that burrows under the skin and lays eggs
Contraction, Through close contact or through sleeping in bedding or wearing clothes that are infested.
Rarely, holding or shaking hands can transmit scabies.
Incubation Period::As long as a week if it's the first time you've been infested; a day if it's a recurrence.
Symptoms: Signs of a scabies infestation include intense itching, or small bumps or a rash on the penis,
between the fingers, on buttocks, breasts, wrists, thighs, or around the navel.
Testing: A dermatologist will perform several different tests on the surface of the skin.
Treatment: Creams and lotions containing permethrin such as Rid and Nix must be applied to the whole
body from the neck down. (As with pubic lice, products containing lindane may be harmful to the fetus
if used by a pregnant woman; check with your doctor.) Change clothing and sleep on freshly laundered
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sheets after you've applied the lotion. Any bedding or clothing that may have been infested should be
washed with very hot water or dry-cleaned.
If not treated: Continued scratching can cause an infection, and if it left untreated, scabies can be
transmitted to anyone you come in close contact with.
VAGINAL YEAST INFECTION
A naturally occurring fungus called Candida albicans (C. albicans) usually causes this type of vaginitis.
An estimated three out of four women will have a yeast infection in their lifetime.
Contraction. Yeast infections occur when certain internal or external factors change the normal
environment of your vagina and trigger an overgrowth of a microscopic fungus โ the most common
being a fungus called Candida albicans (C. albicans). Besides causing most vaginal yeast infections, C.
albicans also causes infections in other moist areas of your body, such as your mouth (thrush), skin folds
and fingernail beds. The fungi can also cause diaper rash.
Factors that increase your risk of yeast infections include:
๏ Medications such as antibiotics and steroids
๏ Uncontrolled diabetes
๏ Hormonal changes, such as those associated with pregnancy and birth control pills
๏ Bubble baths, vaginal contraceptives, damp or tightfitting clothing and feminine
hygiene products such as sprays and deodorants don't cause yeast infections, but they
may increase your susceptibility to infection.
Incubation Period: Anywhere from 12 hours to five days
Symptoms: The main symptom is itching, but you may have a white, thick discharge that resembles
cottage cheese.
Testing: Your doctor may take a sample of a cervical or vaginal discharge for laboratory analysis.
Treatment: Antibiotics - Diflucan 150 mg one single dose.
If not treated: Generally, vaginal yeast infections don't cause serious complications. If it is not treated
the itch may persist.
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YEAST INFECTION IN MEN (Balanitis)
Men can get yeast infection of the genitals. Yeast organisms are a common cause of infection of the tip
of the penis, a condition called balanitis.
Contraction, Almost from anywhere; nevertheless, one is more likely to get balanitis if you:
๏ Are uncircumcised
๏ Have diabetes
Incubation Period: Anywhere from 12 hours to five days
Symptoms: Itching or burning of the tip of the penis or the foreskin. A red rash on the affected areas
Testing: Physical examination of the red rash in the affected area.
Treatment:
If you're uncircumcised, you can help prevent balanitis by practicing good hygiene. Each day, gently
pull back (retract) the foreskin on your penis and clean the skin with soap and water. Then dry the skin
carefully. You may also apply an antifungal cream periodically to prevent recurrence.
Treatment of balanitis includes:
๏ Cleaning under the foreskin of the penis
๏ Applying antifungal creams at least twice a day
๏ Recurrent balanitis: Diflucan 150 mg one single dose
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BACTERIAL VAGINOSIS (BV)
Bacterial vaginosis (BV) results from overgrowth of one of several organisms that are normally present
in the vagina, upsetting the natural balance of vaginal bacteria. More than one in six women has
bacterial vaginosis, though many aren't aware of having it.
Contraction,
results from an overgrowth of organisms that are normally present in the vagina. Usually, "good"
bacteria outnumber "bad" bacteria in your vagina. But if bad bacteria become too numerous, they upset
the balance and bacterial vaginosis results. This type of vaginitis (bacterial vaginosis) can spread during
sexual intercourse, but it also occurs in people who aren't sexually active. Women with new or multiple
sex partners, as well as women who douche or use an intrauterine device (IUD) for birth control, have a
higher risk of bacterial vaginosis.
Incubation period: Anywhere from 12 hours to five days
Symptoms: You may develop a grayish-white, foul-smelling discharge. The odor, often described as
fish-like, may be more obvious after sexual intercourse.
Testing: Your doctor may take a sample of a cervical or vaginal discharge for laboratory analysis
Treatment: Antibiotics - Metronidazole 500mg 2-3 times a day for 7-10 days.
If not treated:
Bacterial vaginosis is usually not serious. In some cases, however, it can cause infections in the uterus
and fallopian tubes. It is important to treat bacterial vaginosis, especially before having an IUD inserted,
an abortion, or tests done on the uterine lining.
Both trichomoniasis and bacterial vaginosis have been linked to an increased risk of transmission of
human immunodeficiency virus (HIV) and other sexually transmitted diseases.
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HEPATITIS
There are five types of hepatitis -- A through E -- all of which cause inflammation of the liver. Type D
affects only those who also have hepatitis B, and hepatitis E is extremely rare in the United States.
Contractions
๏ Type A hepatitis is contracted through anal-oral contact, by coming in contact with the feces of
someone with hepatitis A, or by eating or drinking hepatitis A contaminated food or water.
๏ Type B hepatitis can be contracted from infected blood, seminal fluid, vaginal secretions, or
contaminated drug needles, including tattoo or body-piercing equipment. It can also be spread
from a mother to her newborn.
๏ Type C hepatitis is not easily spread through sex. You're more likely to get it through contact
with infected blood, contaminated razors, needles, tattoo and body-piercing equipment, or
manicure or pedicure tools that haven't been properly sanitized, and a mother can pass it to her
baby during delivery.
๏ Type D hepatitis can be passed through contact with infected blood, contaminated needles, or
by sexual contact with an HIV-infected person.
๏ Type E hepatitis is most likely to be transmitted in feces, through oral contact, or in water that's
been contaminated.
CHANCROID (SHANG-kroid)
A bacterial infection that results in sores on the mouth, throat, lips, anus, tongue, vagina, or penis.
Contraction, You can get chancroid sores or spread them through skin-to-skin contact with open sores,
from hands that have touched a sore, or from sex toys such as a vibrator or dildo that have touched a
sore.
Incubation Period: 12 hours to 5 days
Symptoms:Painful open sores on the genitals, and, in some cases, swollen and tender lymph nodes in the
groin. Women may be less likely to get the sores; instead, their symptoms may include painful urination
or defecation, painful intercourse, rectal bleeding, or vaginal discharge.
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Testing: Chancroid lesions can look like syphilis or genital herpes, so a doctor needs to analyze the
discharge from the sores to get an accurate diagnosis.
Treatment: Antibiotics are usually effective - Zithromax 1.0 gm (250mg x 4 tablets) or Cipro 500 mg
twice a day for 3 days or Cipro XR 500 mg once a day for 3 days.
If not treated: The sores that remain from an untreated chancroid infection may put you at risk for other
STDs, as well as other types of infections.
CRABS (Pubic Lice)
Tiny insects that live off human blood. Although they're often found around the genitals, they can live in
any part of the body with hair.
Contraction Through sexual transmission, skin-to-skin contact, or in clothing, bedding, or on a toilet
seat harboring the insects.
Incubation Period: As long as a week if it's the first time you've had pubic lice; as little as a day if this is a
recurrence.
Symptoms: Itching in the genital area or any other part of the body with hair.
Testing: Pubic lice are very small, whitish-gray parasites that look like crabs. You'll be able to see the
insects or their eggs (which are pearl-colored and oval-shaped) in your hair. You may notice that the
skin under your hair is red and scaly, or there may be small blue spots -- signs of lice bites. If you're
unsure whether or not you have lice, see your doctor.
Treatment: Over-the-counter lotions that contain the chemical permethrin such as Rid and Nix will get
rid of the lice. (Talk to your doctor before using any product that contains the chemical lindane, which
can be toxic, especially for unborn children.) After washing with the lotion, use a fine-toothed comb to
comb out the crabs and their eggs (called nits). Your sexual partner(s) must be treated as well, and all
clothing or bedding that may be infested must be washed in very hot water or dry-cleaned. In some
cases, clothing, towels, or bedding may need to be washed a few times before they're completely lice-
free.
If not treated: If you don't seek treatment you're likely to pass pubic lice on to any sexual partners, or
anyone else you're in close contact with.