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Sexually Transmitted Diseases (STDs) - Overview

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Introduction

STDs which are sometimes called sexually transmitted infections (STIs) are contracted via sexual activity as the organisms be it viruses, bacteria, or parasites carrying the disease pass from one person to the other. These organisms are found in the semen, vaginal fluid, blood, and other bodily fluids.

In other cases, STDs can be transferred in non-sexual ways. For instance, from an infected mother to her child via shared needles, blood transfusion, during pregnancy or delivery.People may have STDs without knowing as they can be asymptomatic (have no symptoms) and pass it onto other persons.

STD symptoms

There is a plethora of symptoms and signs of STIs. Sometimes there are no signs until diagnosis or complications happen. Some obvious signs and symptoms of STDs are:

  • Pain or burning sensation when urinating
  • Bad smelling or abnormal vaginal discharge
  • Painful sex
  • Sores or bumps on the genitals, mouth, or anus
  • Penile discharge
  • Abnormal vaginal bleeding
  • Fever
  • Pain in the lower abdomen
  • Rash over the hands, feet, and trunk
  • Sore and swollen lymph nodes especially in the groin, but often everywhere

After exposure to STDs, symptoms may be detected as early as few days or several years later depending on the organism in play.

When to consult a doctor

You should contact your gynaecologist in London:

  • If you've got signs and symptoms of STDs
  • If you're sexually active and have been exposed to an STD

Schedule an appointment with your doctor:

  • Before having sex with a new partner
  • When you're 21 or becoming sexually active

Causes of STDs

  • Viruses, like in the case of HIV, genital herpes, and human papillomavirus
  • Bacteria, in the case of Chlamydia, syphilis, and gonorrhoea
  • Parasites, in the case of trichomoniasis

Other kinds of infections can be contracted via sex, but it's possible to get infected non-sexually—for instance, hepatitis A, B, and C viruses, Giardia intestinalis, and shigella.

Risk factors

Sexually active persons are under the risk of contracting STIs. The following factors may increase the risk:

  • Unsafe sex - Having anal or vaginal sex with an infected person without using condom heightens the risk of contracting an STD. Not using condoms the right way increases risk too. Without a dental dam, oral sex, which is less risky can cause infection.
  • Multiple sex partners - When you have sex with more partners, you increase your risk of having an STI.
  • Forceful sexual activity - People who have been forced into sex should see a doctor at once for diagnosis and treatment
  • Having a history of STI - It's easier to contract another STI when one already exists
  • Substance misuse - You become prone to engaging in risky sexual acts when you misuse drugs or alcohol
  • Intravenous activities - Sharing needles can spread STIs including hepatitis B and C and HIV
  • Age - People between 15 to 24 years are likely to be infected with an STI
  • Men treating erectile dysfunction with prescription drugs - Higher rates of infection are found in men requesting drugs like vardenafil (Levitra), tadalafil(Adcirca, Cialis), and sildenafil (Viagra, Revatio). Ensure you're updated on protected sex should you be asking for any of these drugs from your doctor.

Mother to baby transmission

Common STIs like Chlamydia, syphilis, gonorrhoea, and HIV can get to a baby from its infected mother during pregnancy or childbirth. STI-infected babies can face serious problems or even die. Pregnant mothers should go for STI screening and treatment.

Complications

Since most people may be asymptomatic, especially in the early phase of infection, complications can be avoided with STI screening.

Some complications are:

  • Infertility
  • Pelvic inflammatory disease, PID
  • Pelvic pain
  • Heart disease
  • Eye inflammation
  • Arthritis
  • Pregnancy complications
  • Some cancer types like HPV-related cervical and rectal cancers

STD prevention

You can lower your risk of STD by:

  • Abstinence - This remains the best way to avoid STI. Stay away from sex
  • Maintain a monogamous relationship - Seeing only one partner who is not infected and don't have other partners can help avoid STD
  • Wait and test - Don't have vaginal or anal sex with new partners until you've both been tested. In case of oral sex, use a dental dam and latex condom to keep skin contact between the mouth and genital at zero level
  • Vaccine - There are vaccines that can prevent STDs before sexual exposure, like a vaccine for HPV and hepatitis A and B. It's recommended by the Centres for Disease Control and Prevention (CDC) that girls and boys between 11 to 12 years be vaccinated. Should they miss it at this age, they can get it again at the age of 26. Newborns usually get the hepatitis B vaccine while one-year-olds get the hepatitis A vaccine. People who have not beenimmunised should get both of these vaccines, including men sleeping with men and IV drug users, as they have higher chances of getting infected.
  • Correct use of condoms and dental dams - For every sexual act, use a fresh latex condom and dental dam. Don't use oil-based lubes with a dental dam or latex condom. While condoms may lower your exposure to STIs, they offer less protection from STIs involving genital sores like HPV or herpes. Again, contraceptive without barriers like IUDs don't protect against infection
    Avoid excessive consumption or use of alcohol and drugs - Too much drug and alcohol use can motivate you to undertake risky sexual encounters
  • Talk with your partner - You and your partner should communicate. Talk about safe sex practices and set rules
  • Consider male circumcision - Report shows a 60% reduction of contracting HIV for circumcised men. It also prevents the spread of genital herpes and HPV
  • Consider pre-exposure prophylaxis (PrEP) - People who are at a very high risk of HIV infection have been allowed to use the combination drugs emtricitabine plus tenofovirdisoproxilfumarate (Truvada) and emtricitabine plus tenofoviralafenamide (Descovy). This was approved by the Food and Drug Administration (FDA). You'll get this doctor-prescribed only if you're HIV-free. Before taking PrEP, you'll take an HIV test. Every 3 months, you'll get tested for HIV as you continue to take the drugs. Your kidney condition will also be examined by your doctor before they prescribe Truvada, and it will be checked every 6 months. Should you have hepatitis B, get examined by an infectious disease or liver specialist before starting therapy. Follow your doctor's prescription and take these drugs daily. Should you take Truvada every day, you can reduce your risk of having HIV by above 90%. When you add extra protection like condoms, the risk becomes much lesser. Keep with safe sex practice to avoid other STIs.

Diagnosis of STD

Tests

Should your sexual history plus existing symptoms show that your STI status is positive, lab tests can highlight the cause and identify related infections you may also have.

Blood tests

With blood tests, HIV and advanced stages of syphilis can be confirmed

Urine samples

Using a urine sample, certain STIs can be confirmed

Fluid samples

Samples and fluid from genital sores if you've got any can be tested by your doctor to identify the infection type

Screening

This is when someone without symptoms is tested for a disease. STI screening, formost of the time, isn't a part of routine healthcare. However, there are exceptions:

  • Everyone - For everybody aged 13 to 64 years, the single STI screening test recommended for them is a saliva or blood test for HIV, the virus responsible for AIDS. Yearly HIV test is recommended for persons at high risk
  • Everyone born between 1945 and 1965 - People born between these years record a high rate of hepatitis C. Because this disease is asymptomatic until it gets to the late phase, hepatitis C screening is recommended for persons born during this time frame.
  • Pregnant women - During their initial prenatal visit, every pregnant woman will undergo screening for Chlamydia, syphilis, hepatitis B, and HIV. Women at greater risk of these infections are recommended for hepatitis C and gonorrhoea screening test.
  • Females from 21 years and above - A Pap test screen which checks abnormalities including cancer, precancerous alterations, and inflammation, sometimes caused by certain strains of HPV. It's recommended that women, starting from the age of 21, have a Pap test every 3 years. Beyond 30 years, women are recommended for a Pap test and HPV DNA test every 5 years. Also valid is a Pap test every 3 years.
  • Sexually active women below 25 years - A chlamydia test is recommended for females below this age. Samples of your vaginal fluid or urine which you can take yourself is needed for this test. Should you test positive and get treated, it's recommended you repeat this test 3 months later. This is because you can get reinfected by a chlamydia-infected partner; testing again is a confirmation that you're completely chlamydia-free. Where you have a new partner, get retested since you can get Chlamydia several times. Gonorrhoea screening is also recommended for this age group of women.
  • Men sleeping with other men - Gays are at a greater risk of contracting STIs. A yearly or regular STI screening is recommended for these men. Most important are regular testing for Chlamydia, syphilis, gonorrhoea, and HIV. Checking for hepatitis B is also great.
  • HIV-infected persons - Having HIV already increases your chance of contracting other infections. After an HIV check, it's recommended you get tested immediately for herpes, gonorrhoea, syphilis, and Chlamydia. HIV-infected women are advised to get a Pap test within one year of testing positive to HIV as they may develop chronic cervical cancer. This test should be repeated after 6 months.
  • Persons having a new partner - You and your new partner should get STI screening before having vaginal or anal sex. It's not recommended you get a routine test for genital herpes except you're showing symptoms. There's a possibility that you can test negative yet infected with an STI, especially in the early phase of the infection.

Treatment for STDs

Bacteria-related STIs are easier to treat. Viral infections are not always cured but can be managed. Lower the chances of mother to child STI transmission if you're pregnant and infected.

Depending on the infection type, STI treatment typically consists of any of the underlisted:

  • Antibiotics - Sometimes, a single dose of antibiotics can cure bacterial and parasitic infections like Chlamydia, syphilis, gonorrhoea, and trichomoniasis. You'll get treated simultaneously for gonorrhoea and Chlamydia since they're sometimes present together. Complete your antibiotic treatment once you start. Not able to take prescribed medications? Inform your doctor; a simpler form of treatment can be arranged. Don't have sex for the next 7 days after finishing your antibiotic treatment, and the sores have healed. Since women have an increased risk of getting reinfected, a retest is recommended after 3 months.
  • Antiviral drugs - Herpes or HIV-infected persons will take a prescribed antiviral drug. Combining suppressive therapy with a prescribed antiviral drug everyday will reduce herpes recurrences. But, you can still spread herpes to your partner. HIV can be controlled by antiviral drugs for years, however, the virus will still be in your body and can be spread though the chances are low. Early treatment is very effective. Following your doctor's prescription to take your drugs can possibly reduce the virus count such that it's hardly noticed.

Consult your doctor on when you should get retested after treating a contracted STI. This is key as it ensures you're not reinfected and free of infection.

Telling your partner(s) and preventive treatment

Should you test positive to an STI, kindly let your current partners know and any other partner you've had over the last 3 months to a year, so they can get screened and treated if infected.Although state requirements differ, so many states recommend reporting a case of certain STIs to the state or local health department. Sometimes, there are available trained disease intervention specialists at Public health departments whose job is to inform partners and get them referred for treatment.

Confidential and official partner notification can lower STI transmission, especially for HIV and syphilis. This approach directs those at risk to counselling and proper treatment. Because you can get reinfected again, informing partners can lower your chances of getting infected again.

Clinical trials

At the Sexual Health Clinic London, all the necessary tests, treatment, and intervention are available for disease management, prevention, diagnosis, and treatment.

Support and coping with STDs

It's not easy to handle an STI psychologically and physically. To help you, we recommend having an open conversation with your doctor, stop the blame game, and contact your health department for confidential testing, partner help, and treatment.

Getting an appointment

Many people may not freely talk about their sexual encounters, but an honest talk with your doctor can actually be of great help. While preparing for your appointment, find out if there's anything you should do before the appointment, note down all your symptoms and medications you're currently taking, and write down all the questions you'll love your doctor to answer.

Questions about the STI, mode of transmission, the possibility of recurrences, other health conditions you might have if the STI will cause sterility, whether you can pass it to your baby during pregnancy, if you can pass to someone during a one-time sex, and other relevant questions can be of great benefits.

What to expect from your doctor

While providing a full report on your sexual history and symptoms, your doctor may ask you some questions to determine how best to care for you.

Questions like how long you've been with your sexual partner, how long you've had symptoms, your prevention method for STIs, how many sex partners you've had in the past two months to one year, among others.

What to do in the interim?

It's always best to discuss any STI you have contracted with your doctor before engaging in sexual practices. Should you have had an STI and still having sex before seeing your doctor, kindly do well to adhere to protected sexual practices like the use of condoms, dental dams, and others.

Getting tested is the only sure way to know your status and begin treatment in the case of an STD. Contact 020 7183 0435 to book an appointment today if you are in London.

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