What are sexually transmitted infections?
Sexually transmitted infections (STIs) are infections that are primarily or solely transmitted by sexual contact with an infected person. Many STI infectious organisms enter the body through mucosal membranes of the genitals, through oral contact with the mucosal membranes of the genitals or anus, and through open sores on, or in the region of, the genitalia. Some sexually transmitted diseases can be transmitted by body secretions as well.
- Herpes simplex I and II
- HIV and AIDS
- Hepatitis B & C (not exclusively sexual in transmission)
- HPV–human papilloma virus causing cervical cancer and genital warts
- Trichomoniasis vaginal protozoan infection.
- Bacterial vaginosis (not exclusively sexual in transmission)
- Molluscum contagiosum.
- and others (tuberculosis, lymphogranuloma venereum, etc.)
Complications from STIs:
- Abdominal pain
- Severe febrile states
- Infertility and permanent sterility
- Ectopic pregnancy
- Perinatal and neonatal transmission
- Malignancy (from hepatitis cirrhosis: hepatic cancer; and HPV: cervical and throat cancer)
- Psychological impact: guilt, shame, depression
- Sociological impact: separation, divorce, and crimes of passion
- Pelvic adhesive disease with abdominal pain and obstruction
- Sepsis intra-abdominal abscess, and death
Herpes simplex virus (HSV) is very communicable. Although the skin lesions come and go, the virus continues to reside in the dorsal root ganglion of the nerves at the spine. Whatever area of the skin is innervated by this nerve will be the area where eruptions of very painful blisters will occur. It cannot be cured, but episodes of eruptions can be made less frequent and the severity lessened by treatment with antivirals such as acyclovir and valcyclovir. HSV can be passed on to an infant at delivery, which can be life-threatening to the newborn.
Different Human Papilloma Virus (HPV) strains cause cervical and throat cancer and/or genital warts, depending on which type one contracts–usually by direct skin-to-skin contact, oral relations, and vaginal or anal intercourse.
Bacterial vaginosis, which can develop without sexual contact, can also be acquired by intercourse. The majority of cases have no symptoms, diagnosed incidentally at the time of a routine GYN visit. Treatment is with antibiotics or antibiotic vaginal cream. When symptomatic, a vaginal discharge is noted.
Trichomonas: infection with a protozoan, which can lead to preterm labor in pregnancy, and vaginal discharge, spotting, and pain in non-pregnant women. Treatment is with antibiotics.
Chlamydia: this is a bacterium that infects men and women, often without symptoms, causing infertility years later in women. Symptoms of it can include pain, burning with urination, painful intercourse, and fever. It is diagnoses with a culture and treated with antibiotics. Untreated, it can cause adhesions in the female reproductive tract that can cause ectopic pregnancy or infertility.
Gonorrhea: this is almost always symptomatic with a purulent discharge from the vagina or penis and severe dysuria (pain with urination). In the woman, it can rise into the pelvis to involve the uterus (endometritis), Fallopian tubes (salpingitis), and ovaries–tubo-ovarian abscess. Untreated, it can lead to life-threatening sepsis or it can even burn itself out, leaving adhesions that cause ectopic pregnancy or infertility.
Syphilis comes in three waves of presentation:
- Painless ulceration at the site of contact with an infected person, usually on the vulva in the woman or the penis or scrotum of a man. This is called Primary Syphilis and the ulcer goes away spontaneously.
- A rash on the palms of the hands and soles of the feet, although it can occur elsewhere as well. This is called Secondary Syphilis and its rash goes away spontaneously.
- Tertiary Syphilis is central nervous system involvement, leading eventually to ataxia (uncoordinated movements), delirium, and death.
HIV/AIDS: The Human Immunodeficiency Virus is the cause of Acquired Immune Deficiency Syndrome. The previous 100% mortality has been significantly reduced. Currently the virus is treated and often kept in check at the HIV stage, followed by a count called the “viral load.” Patients infected have an impaired immune system that can make other infections and malignancy more likely.
Hepatitis: Hepatitis B and C can manifest as mild involvement of the liver all the way to hepatic failure and death. Also, hepatitis can lead to liver cancer. Jaundice in the absence of alcoholism can occur.
The most common cause of ectopic (tubal) pregnancy is an STD, with both gonorrhea and chlamydia being the most frequent offenders.
Pelvic Inflammatory Disease, or “PID,” is a general term for infected pelvic organs from any STD, such as gonorrhea or chlamydia. It is associated with generalized pelvic pain and tenderness and a purulent vaginal discharge.