Sexually Transmitted Infections (STIs)

Bacterial vaginosis (BV) is a condition of having too much of the gardnerella vaginalis bacterium present. This bacterium is already in the vagina, but the overgrowth creates a pH imbalance between “good” and “harmful” bacteria. It is the most common vaginal condition in women ages 15-44 years. The known cause of BV is not fully understood since many factors can upset the pH balance of the vagina. But the condition typically occurs in sexually active women. Having a new sex partner or multiple sex partners, as well as douching, can lead to a BV infection.

Serious health risks of BV:

• Being more susceptible to other STDs such as

  • Chlamydia and gonorrhea (can cause pelvic inflammatory disease (PID, see tab))

  • HIV (from having vaginal or anal sex with someone who is HIV-positive)

• Increased chance of passing HIV to your sex partner if you are HIV-positive

• Being more likely to have a premature delivery (if you have BV while pregnant)

Many women do not display symptoms initially but if or when they do, they may notice:

• Itching around the outside of the vagina

• Thin, white or gray vaginal discharge

• Pain, itching, or burning in the vagina

• A strong fish-like odor, especially after sex

• Burning when urinating

PREVENTION

1. Limiting your number of sex partners

2. Avoid vaginal douching and douche products

3. Using latex condoms CORRECTLY every time you have sex

TREATMENT

BV will sometimes go away without treatment. But if you are on antibiotics, you must take ALL of the pills as prescribed, even if your symptoms go away. A health care provider can treat the infection, but taking all the pills reduces the chance of it returning. Treatment may also reduce the risk of contracting other bacterial STIs. Male sex partners of women diagnosed with BV generally do not need to be treated. BV may be transferred between female sex partners.

Chlamydia is one of the most common STIs. Caused by an overgrowth of the chlamydia trachomatis bacterium, most people who have chlamydia have no symptoms or their symptoms may not appear until several weeks after you have sex with an infected partner. Still, the infection can damage your reproductive system with mild to no symptoms. Though it can be contracted by men and women, it is more dangerous for women. If left untreated, the disease can cause severe or permanent damage to the female reproductive system making it difficult or impossible for the women to conceive.

For women, untreated chlamydia can spread to the uterus and fallopian tubes and cause pelvic inflammatory disease (PID, see tab). PID can cause permanent damage to your reproductive system leading to long-term pelvic pain, inability to get pregnant, and potentially deadly ectopic pregnancy (pregnancy that occurs outside the womb). Symptoms in women include:

• Abnormal vaginal discharge (usually yellow with a strong odor)
• Burning sensation when urinating
• Bleeding between periods

For men, the infection sometimes spreads to the tube that carries sperm from the testicles, causing pain and fever. Rarely do they experience health problems linked to chlamydia, but on a rare occasion the disease could prevent a man from being able to have children. Symptoms in men include:

• Discharge from the penis
• Burning sensation when urinating
• Pain and swelling in one or both testicles (less common)

Other Facts:

• Without protection, you are susceptible to the infection even if
  • The male does not ejaculate during sex. There are bodily fluids besides sperm that can transmit the infection.
  • You or your sex partner have had chlamydia before. The infection can be contracted and transmitted multiple times.
• The infection typically grows inside the reproductive genitals (penis and vagina), but it can grow inside the rectum as well! Via receptive anal sex or from another infected site (such as the vagina), anal chlamydia is usually asymptomatic. But, it may cause:
  • Rectal pain
  • Anal discharge
  • Bleeding from the rectum

PREVENTION

1. Limiting your number of sex partners or make sure you partner is negative for STIs
2. Using latex condoms CORRECTLY every time you have sex

TREATMENT

You must take ALL of the medication your doctor prescribed to effectively cure the infection. Even if the symptoms seem to have gone away before the medication runs out, continuing to take them could decrease your chances of repeating the infection (which happens often). You should not have sex again until you and your sex partner(s) have completed treatment and get tested again around three months after you are treated.

Gonorrhea is caused by the Neisseria gonorrhoeae bacterium. Infections are most common among 15 to 24 year old adults and occurs in the genitals, rectum, and throat. Most men and women with gonorrhea have few to no symptoms and can be mistaken for a bladder infection or, for females, vaginal infection. Untreated gonorrhea may increase your chances of having HIV and can cause serious health problems in both women and men. In women, untreated gonorrhea can cause pelvic inflammatory disease (PID). In men, gonorrhea can cause a painful condition in the epididymis tubes (tubes attached to the testicles). In rare cases, this may cause a man to be sterile, or prevent him from being able to father a child. Even more rare, untreated gonorrhea could spread to the blood or joints and endanger your life.

• You can get gonorrhea by having vaginal, anal, or oral sex with someone who has gonorrhea.
• A pregnant woman with gonorrhea can give the infection to their baby during childbirth.

Symptoms in women:

• Painful or burning sensation when urinating
• Increased vaginal discharge
• Vaginal bleeding between periods

Symptoms in men:

• A burning sensation when urinating
• A white, yellow, or green discharge from the penis
• Painful or swollen testicles (less common)

Rectal infections may cause:

• Discharge
• Anal itching
• Soreness
• Bleeding
• Painful bowel movements

PREVENTION

1. Limiting your number of sex partners or make sure you partner is negative for STIs
2. Using latex condoms CORRECTLY every time you have sex

TREATMENT

You must take ALL of the medication your doctor prescribed to effectively cure the infection. Completing treatment prevents getting or giving gonorrhea again. Avoid sex until you or your partner has completed treatment and the symptoms are gone OR wait seven days after finishing treatment. Some drug-resistant strains of gonorrhea are more difficult to treat, so consult with your doctor if your prescribed medication is not working. When you are cured, have you and your sex partner(s) have get tested again about three months after treatment.

Herpes is caused by one of two viruses: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Though most people with the virus don’t have symptoms, the disease is still transmittable. It is spread by having vaginal, anal, or oral sex with someone who has the disease. Oral herpes is caused by HSV-1 and genital herpes is usually causes HSV-2. In some cases, HSV-1 can cause genital herpes - oral herpes can spread from the mouth to the genitals - but most cases were caused by HSV-2. If you contract herpes, you could have outbreaks for the rest of your life.

Outbreaks after the initial one can repeat, but the repeated outbreaks are usually shorter, less severe than the first, and may decrease in number over time.

Cold sores or fever blisters on or near the mouth is a symptom of oral herpes. But most people get it in childhood or young adulthood through non-sexual contact with saliva. Genital sores can appear from HSV-2 and be painful. 

If you come into contact with the herpes virus, it can be spread by:

• A herpes or cold sore (click here to learn the similarities and differences)
  • Touching the sores or fluids from them can transfer to another body part
  • Quickly and thoroughly washing your hands helps avoid spreading
• Body fluids from a partner with a herpes infection including...
  • Saliva from a partner with an oral herpes infection
  • Genital fluids from a partner with a genital herpes infection
• Skin-to-skin contact in the...
  • Oral area of a partner with oral herpes
  • Genital area of a partner with genital herpes

PREVENTION

1. Limiting your number of sex partners or make sure you partner is negative for STIs
2. Using latex condoms CORRECTLY every time you have sex

Skin can shed and release the virus to and from areas that would not show a visible herpes sore. Thus, condoms may not provide full protection. Lower your risk by:

• Taking or having your partner take anti-herpes medicine. it is a daily medication and should be discussed with a health care provider
• You avoid having vaginal, anal, or oral sex when your partner displays herpes symptoms

TREATMENT

There is no cure for genital herpes. But there are some medicines that can prevent or shorten outbreaks. A daily anti-herpes medicine can make it less likely to transmit the infection.

HPV is the most common STI and there are many different types of HPV. In most cases, HPV goes away on its own and does not cause any health problems. But health problems such as genital warts and cancer can occur if it does not. It is most commonly spread through vaginal or anal sex, but you can get HPV by having vaginal, anal, or oral sex with someone who has the virus. The infection can be passed to and from those who are asymptomatic. And, symptoms can develop years after you have contact with the virus.

HPV there is no approved test to find the virus in the mouth or throat. But there are HPV tests that screen for cervical cancer (Pap test). These tests are NOT recommended to screen men, adolescents, or women under the age of 30 years.

PREVENTION

The HPV Vaccine lowers the risk of infection and can be taken by boys and girls as early as preteen years (age 11 or 12 years). It is safe, effective, and can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. Vaccination is not recommended for those older than 26, but they can if it is discussed and approved by a health care provider

If you are not vaccinated, getting screened for cervical cancer is the next best option. Routine screening for women starts at age aged 21 to 65 years old and doubles as a way to prevent cervical cancer.

If you are sexually active, use condoms the right way during sex (while keeping in mind that HPV can infect areas not covered by a condom)  and try to keep your number of sex partners low.

TREATMENT

The virus cannot be treated, but the side effects (genital warts, cervical precancer, and HPV-related cancers) can. Genital warts can go away with treatment and the cancers can be counteracted when found early or before they develop.

Pelvic inflammatory disease (PID) infects the female reproductive system. Caused by STDs, like chlamydia and gonorrhea, and some non-sexually transmitted diseases, this condition leads to severe pain and damage to the organs such as uterus, fallopian tubes, and ovaries. This disease can be diagnosed early, treated, and prevent permanent damage. If left untreated, the risks are:

• Long-term pelvic or abdominal pain
• Infertility (inability to get pregnant)
• Ectopic pregnancy (pregnancy outside the womb)
• Formation of scar tissue both outside and inside the fallopian tubes that can lead to tubal blockage

Factors that increase your risk:

• Being sexually active at age 25 or younger
• Having multiple sex partners
• Having a sex partner with a sex partner besides you
• Not seeking treatment for an STI/STD
• Having PID more than once
• Douching or using vaginal douche products
• Using an intrauterine device (IUD) for birth control (usually limited to the first three weeks after the IUD is placed)

You can lower your chances of getting PID by:

• Limiting your sex partners
• Having a partner who has tested negative for STIs
• Using latex condoms the right way every time you have sex

Though you may be symptomatic or have mild symptoms, schedule an appointment right away if you notice these symptoms:

• Pain in your lower abdomen
• Fever
• Pain and/or bleeding when you have sex
• Burning sensation when you urinate
• Bleeding between periods
• Unusual genital symptoms (ex. an unusual sore or off-color, smelly discharge)

Also see a doctor if you think you or your sex partner(s) have or were exposed to an STD.

PREVENTION

• Follow the advice for lowering your risks
• Get a test for chlamydia or gonorrhea every year
• Have an honest and open talk with your health care provider if you are sexually active and ask whether you should be tested for other STIs

TREATMENT

Treatment of PID (antibiotics) cannot reverse any damage the disease may have caused, but the longer you wait to get treated, the more likely it is that you will have complications from PID. Even if symptoms go away, you should finish taking all of your medicine since the infection could still be present with no symptoms. Avoid sex until advised by a health care provider to prevent re-infection.

Syphilis is a sexually transmitted infection that is caused by the Treponema pallidum bacterium. You can get it through direct contact with a syphilis sore during vaginal, anal, or oral sex. This infection is divided into four stages (primary, secondary, latent, and tertiary), and each stage has different signs and symptoms:

• Primary syphilis is generally presented as a sore or sores at the original site of infection. Usually, the sore is firm, round, and painless. These sores usually occur on or around the genitals, around the anus or in the rectum, or in or around the mouth.
• Secondary syphilis infection displays a skin rash, swollen lymph nodes, and fever.
  • The signs and symptoms of primary and secondary syphilis can be mild and unnoticeable. 
• The Latent (dormant) stage shows no signs or symptoms. Syphillis can remain in the boy for years.
• Tertiary syphilis is associated with severe medical problems affecting the heart, brain, and other organs of the body. A doctor can usually diagnose tertiary syphilis with the help of multiple tests.

If you are sexually active, you can do the following things to lower your chances of getting syphilis:

• Being in a long-term mutually monogamous relationship with a partner who has been tested for syphilis and does not have syphilis;
• Using latex condoms the right way every time you have sex.
  • Condoms prevent transmission of syphilis by preventing contact with a sore.

Any sexually active person can get syphilis through unprotected vaginal, anal, or oral sex.  You should get tested regularly for syphilis if you are sexually active and:

• are a man who has sex with men (MSM)
• are living with HIV
• have a partner or partners who have tested positive for syphilis

PREVENTION

1. Limiting your sex partners
2. Having a partner who has tested negative for STIs
3. Using latex condoms the right way every time you have sex

TREATMENT

Though it cannot undo damage that the infection has already done, syphilis can be cured with antibiotics from your health care provider..

Trichomoniasis is caused by infection with a protozoan parasite called Trichomonas vaginalis and is the most common yet curable STD, specifically among women. Although symptoms of the disease vary, most people who have the parasite cannot tell they are infected. Although an estimated 3.7 million people in the U.S. had the infection, only about 30% develop any symptoms of the disease.

Symptoms of trichomoniasis come and go. They can develop within 5 to 28 days after being infected and can range from mild to severe irritation and inflammation. Others do not develop symptoms until much later. 

Men may notice:

• Itching or irritation inside the penis
• Burning after urination or ejaculation
• Discharge from the penis

Women may notice:

• Itching, burning, redness or soreness of the genitals
• Discomfort with urination
• A change in their vaginal discharge in color, consistency or volume

PREVENTION

1. Limiting your sex partners
2. Having a partner who has tested negative for STIs
3. Using latex condoms the right way every time you have sex

TREATMENT

Trichomoniasis can be treated with pills that are taken by mouth. The infection heals in about a week. Taking antibiotics at the same time can prevent re-infection. Avoid sex until treatment is complete and all symptoms have gone. Get checked three months after treatment to be sure you are free of infection or if symptoms are still present.