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Your Reproductive Health - Sexually Transmitted Infections (STIs)

 

Sexually Transmitted Infections (STIs)

What are sexually transmitted infections (STIs)?

Sexually transmitted infections

• Include chlamydia, gonorrhea, syphilis, genital herpes, genital warts (HPV), molluscum, hepatitis B, human immunodeficiency virus (HIV), and more than 25 other infections.
• Are the most commonly reported infectious diseases in North Dakota and the United States.
• Are one of the leading causes of infertility.

Common STIs

• Chlamydia
• Genital warts (HPV)
• Genital Herpes
• Molluscum
• Pelvic Inflammatory Disease (PID)
• HIV - Human Immunodeficiency Virus
• Gonorrhea
• Syphilis
• Hepatitis B

How are STIs spread?

People become infected by STIs when they have sexual contact with an infected person. Any type of sexual contact poses some risk, including genital-to-genital, oral-to-genital, anal-to-genital, and oral-to-anal contact.

What are the symptoms of STIs?

Symptoms vary depending upon the infection. Many people, especially women, may not have any symptoms. In general, symptoms of STIs may include:

• Sores, lesions, or bumps in the genital or anal area
• Painful urination
• Discharge from the penis
• Discharge from the vagina
• Bleeding between menstrual periods
• Abdominal or pelvic pain in females
• Rashes on the body (especially on the palms of the hands or soles of the feet)
• Painful sex

What are some of the complications of STIs?

Chlamydia and gonorrhea can cause pelvic inflammatory disease (PID) in females. Women who have had PID may not be able to have children. Syphilis can cause problems with the brain, spinal cord, eyes, skin, bones, and heart. Genital warts (HPV) is associated with cervical cancer.

Babies born to mothers with STIs are at high risk for infection. Chlamydia and gonorrhea can cause severe eye infections in infants. Herpes can cause severe brain infections often leading to death. Syphilis can cause stillbirth, brain damage, or other problems in babies.

Am I at risk of having an STI?

You may be at increased risk of having an STI if:

• You have multiple sexual partners
• You have a new sexual partner
• Your sexual partner now has or has previously had other sexual partners
• You do not consistently use condoms correctly
• You have any of the symptoms described in the STI Table below

If you have an STI, you can infect your sexual partner even if you do not have symptoms or know that you have an infection.

What about HIV and AIDS?

If you have an STI, you are more likely to become infected with HIV if you are exposed. If you are infected with HIV and also with another STI, you are more likely to pass HIV to your sexual partner.

Is there a cure for STIs?

STIs caused by viruses cannot be cured. These infections include genital warts, genital herpes, hepatitis B, and HIV. Treatment may help with symptoms.

STIs caused by bacteria can be treated with antibiotics. These include syphilis, gonorrhea, and chlamydia. The earlier these infections are diagnosed, the easier they are to treat.

• Common STIs
  Chlamydia - Chlamydia trachomatis (an unusual intracellular bacteria)
  Transmission	Contact of mucus membranes (cervix, urethra) with infected person's fluids (semen and mucus). Transmission most common with exposure through vaginal or anal sex. Casual contact considered to be safe.
  Symptoms	Most patients with chlamydia have no symptoms. If present, they may be: Women - pain or dull aching from cervix, heavy feeling in pelvic area, pain with urination or intercourse, heavier menstrual flow, breakthrough bleeding, heavy cervical discharge. Men - urethral discharge, pain with urination, epididymitis.
  Potential Complications	In women, serious complications can occur if spread to tubes. May result in tubal scarring, infertility, and risk of tubal (ectopic) pregnancy. If other organisms become involved, pelvic inflammatory disease (PID) can occur.
  Treatment	A number of commonly used antibiotics are effective. Partners must be treated at the same time.
  Prevention	Intact condoms (latex or polyurethane) should provide protection.
  Genital Warts - Human Papilloma Virus
  Transmission	Caused by the human papilloma virus (HPV). HPV is acquired through genital-to genital, anal-to-genital, or rarely, hand-to-genital, or oral-to-genital sexual contact. Babies born to infected mothers also can be affected.
  Symptoms	Symptoms can occur weeks to months after infection. Many people will have few or no symptoms. Warts inside the vagina or on the cervix may not be noticeable. Men may have flat warts on the penis that look like normal skin. HPV can be transmitted to sexual partners even if the infected person has no symptoms or visible warts.
  Potential Complications	Warts may grow so large as to block the vagina, making sexual intercourse painful or impossible and hindering giving birth. Babies born to moms infected with HPV may develop warts in the throat. Several HPV types have been associated with cervical and anal cancer. Tests can detect the HPV types that are high risk for cancer.
  Treatment	HPV infections cannot be cured; the goal of treatment is to remove visible warts by freezing, using chemicals, or through surgery. HPV infections may lead to cervical cancer and need to be treated by an expert. Regular Pap tests can help prevent cervical cancer associated with HPV infections.
  Prevention	Barrier methods are only partially protective. With condoms, for example, lesions may be present in areas not covered. Only total absence of any touching of infected tissue will avoid transmission; partners probably do not continue to transmit.
  Genital Herpes - Herpes Simplex Virus
  Transmission	A virus called herpes simplex virus II (HSV II) is the usual cause of genital herpes. A closely related virus called herpes simplex I (HSV I) can also cause herpes. HSV I usually causes "cold sores" around the mouth. These viruses are acquired through genital-to-genital, oral-to-genital, anal-to-genital, or oral-to-anal sexual contact.
  Symptoms	Symptoms usually occur two to 20 days after infection, but may occur later. Symptoms include sores or lesions that usually develop into fluid- filled, blister-like sores. The sores, which are often painful, will heal in two to three weeks. For most people, the sores will return periodically. How often they come back varies from person to person.
  Potential Complications	Herpes lesions can be very painful. People who have weak immune systems can develop herpes anywhere on the body or in the nervous system. Babies born to mothers who have herpes may be infected during birth. Babies infected with herpes may suffer brain damage or death. Genital herpes infections can increase the risk for HIV transmission.
  Treatment	Herpes cannot be cured. Once a person is infected, they remain infected. There are anti-viral medications that may help sores heal more quickly or reduce the recurrence of sores. These medications may also reduce the amount of herpes virus being shed from the skin.
  Prevention	Barrier methods are only partially protective. With condoms, for example, lesions may be present in areas not covered. Only total absence of any touching of infected tissue will avoid transmission.
  Molluscum - Molluscum Contagiosum Virus
  Transmission	Touching (hand-to-genital or genital-to-genital) an infected person's lesions can transmit cells containing the virus. Penetrative sex is not necessary for transmission.
  Symptoms	Small, round, raised lesions with a shiny surface and white material inside, located on genital skin and also thighs, abdomen, and even the chest. Usually no symptoms, but may itch. May become infected with bacteria.
  Potential Complications	Secondary bacterial infection.
  Treatment	Cryo (freezing), scraping, or chemicals to remove lesions.
  Prevention	Barrier methods are only partially protective. With condoms, for example, lesions may be present in areas not covered. Only total absence of any touching of infected tissue will avoid transmission.
  PID - Pelvic Inflammatory Disease
  Transmission	Chlamydia and gonorrhea are common causes of PID. PID occurs when these infections spread to the uterus, fallopian tubes, and abdominal cavity. Repeated chlamydia and gonorrhea infections increase a woman's risk for developing PID.
  Symptoms	It may take weeks or months for females to develop symptoms. Some women have very mild symptoms. Symptoms can include vaginal discharge, pelvic pain, lower back pain, bleeding between periods, heavier than usual periods, fever, nausea and vomiting.
  Potential Complications	Complications include sterility or pregnancy outside the uterus which can lead to rupture of the fallopian tubes. This condition can be fatal. Removal of the reproductive organs may be necessary.
  Treatment	PID can be treated with antibiotics. Permanent damage to the fallopian tubes cannot be corrected. Treatment often requires hospitilization.
  Prevention	Intact condoms (latex or polyurethane) should provide some protection. Hormonal contraceptive methods (birth control pills, patch, or injection) should prevent recurrent attacks by suppressing ovulatory menstrual cycle.
  HIV - Human Immunodeficiency Virus
  Transmission	HIV is the virus that causes AIDS. This virus usually is acquired through anal-to-genital or genital-to-genital sexual contact. Activities involving the exchange of blood, semen, vaginal fluids and breast milk also can result in transmission. HIV can also be acquired by sharing needles to inject drugs or steroids. Babies can be infected before or during birth or from breast milk of infected mothers.
  Symptoms	People who are infected may notice flu-like symptoms 2 to 6 weeks after being infected. These symtoms may include fever, muscle or joint pain, tiredness, diarrhea, weight loss, and night sweats. Many people will not have any, or will have only mild symptoms until they develop AIDS.
  Gonorrhea
  Transmission	A bacteria called Neisseria gonorrhoeae is the cause of gonorrhea. Acquired through genital-to-genital, oral-to-genital, anal-to-genital, or oral-to-anal sexual contact. Babies born to infected mothers also can be infected.
  Symptoms	About 90 percent of men will develop symptoms within 10 days of exposure. About 50 percent of women have no symptoms. Symptoms include painful urination and discharge from the penis or vagina.
  Potential Complications	Women may develop PID. Both men and women may develop heart problems or arthritis. Infection of the blood also can occur. Babies can develop eye infections. Gonorrhea infections can increase the risk for HIV transmission.
  Treatment	Gonorrhea can be treated with antibiotics. Partners must be treated at the same time.
  Prevention	Intact condoms (latex or polyurethane) should provide some protection.
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  Syphilis - (Treponema pallidum)
  Transmission	Syphilis is a bacterial infection acquired through genital-to-genital, anal-to-genital, oral-to-genital, or oral-to-anal contact or other contact with syphilis lesions or rashes. Babies born to infected mothers also can be infected. People are most infectious during the first two stages of syphilis.
  Symptoms	Symptoms can occur 10 to 90 days after exposure, usually at about 21 days. The first stage of syphilis is called primary syphilis and consists of a sore called a chancre. This sore develops where the bacteria entered the body. It is usually painless. The second state of syphilis is called secondary syphilis. Skin rashes are the usual symptoms.
  Potential Complications	Syphilis can affect almost any part of the body. The skin, brain, and spinal cord are common areas of complications. Babies can become infected in the uterus and suffer brain damage and skin and bone problems. Many babies are stillborn. Syphilis infections can increase the risk for HIV transmission.
  Treatment	Syphilis can be treated with antibiotics. Later stages may require hospitalization.
  Prevention	Correct and consistent use of condoms (latex and polyurethane) and spermicides provide some protection.
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  Hepatitis B
  Transmission	Hepatitis B is caused by the hepatitis B virus. It is acquired through genital-to-genital, oral-to-genital, or anal-to-genital sexual contact. It can also be acquired by sharing needles to inject drugs or steroids or by other exposure to infected blood, semen, vaginal secretions, and breast milk. Babies born to infected mothers also can be infected.
  Symptoms	Symptoms usually occur two to three months after infection, but may take as long as six months. Symptoms may include abdominal pain and tenderness, nausea, vomiting, loss of appetitie, rash and jaundice. Many adults have mild or no symptoms.
  Potential Complications	About 10 percent of infected people will develop chronic hepatitis B. These people usually have the infection for the rest of their lives. A smaller percentage will develop chronic active hepatitis. Chronic hepatitis is associated with liver cancer and other serious liver conditions. Babies born to mothers with hepatitis B are at risk for infection. Hepatitis B is very serious in infants.
  Treatment	There is no cure and most people will recover. A vaccine effective in preventing hepatitis B infections is available. People with multiple sexual partners or who share needles should get the vaccine. Vaccinating babies at birth reduces their risk of acquiring hepatitis B from their mothers.
  Prevention	Vaccination. Avoid contact with blood, semen, vaginal secretions, and other body fluids and needles used to inject IV drugs. Condoms (latex and polyurethane) provide some protection.
  Potential Complications	The major complication with HIV is AIDS (acquired immunodeficiency syndrome). AIDS occurs when HIV has made the immune system weak. People with AIDS develop many different infections that healthy people do not get. It may take 10 years or longer for someone with HIV to develop AIDS.