Introduction to STD Doctors.com

What are STD's?

An "STD" is a Sexually Transmitted Disease - these are infectious diseases which spread from person to person during intimate sexual contact. Approximately 30% of men and 70% of women who have an STD have no symptoms at all. If not diagnosed and treated early, STD's can cause serious illness or lifelong disability. Common STD's include gonorrhea, chlamydia, trichomoniasis, genital herpes, urethritis, genital warts, syphilis, hepatitis B, hepatitis C, and HIV.

Gonorrhea
Gonorrhea is an infection caused by bacteria called Niesseria gonorrhea. It is easily treated soon after infection with antibiotics. If not diagnosed and treated early, it may cause lifelong complications such as blindness, arthritis and infertility. Gonorrhea is sexually transmitted by oral, anal and genital sex. Gonorrhea can be passed from a woman to her baby during birth.
Both men and women may have gonorrhea without symptoms, so you can be infected without knowing that anything is wrong. In men, a yellow discharge from the penis and pain when passing urine may occur. In women, there may be a vaginal discharge, lower abdominal pain and irregular menstrual bleeding.
Diagnosis requires laboratory tests to look for bacteria. Swab specimens may be taken from the urethra, throat, cervix or rectum. Gonorrhea can be simply and effectively treated with antibiotics if it is diagnosed early.

Chlamydia
Chlamydia is a common infection of the reproductive organs caused by the bacterium Chlamydia trachomatis. Chlamydia is sexually transmitted, often through vaginal intercourse. Occasionally, it is transmitted by oral or anal sex. Chlamydia can be also passed from mother to child during birth, causing eye infections or pneumonia.
Most people with chlamydia do not have any symptoms and are unaware they have the infection. In men, chlamydia may cause urethritis, which can produce a discharge from the penis or pain when urinating. If not treated, it can lead to inflammation near the testes, which can cause pain and infertility. In women, infection often starts in the cervix and symptoms such as vaginal discharge, burning when passing urine, lower abdominal pain, or pain during sexual intercourse may occur. If chlamydia is not treated in women, the infection can spread through the uterus to the fallopian tubes causing pelvic inflammatory disease (PID), resulting in infertility or ectopic (tubal) pregnancy.
Chlamydia is best diagnosed from swab tests collected from the cervix in women or the urethra in men, or from the throat or rectum. Chlamydia can be treated with antibiotics. As with other STD's, it is very important to treat chlamydia as soon as possible after a person is infected.

Trichomoniasis
Trichomoniasis ("trich") is a genital infection caused by the organism Trichomonas vaginalis. The symptoms of trich vary widely. In women, infection may produce a vaginal discharge which may be yellow-green in color and foul-smelling. Itching and burning may also be present. Many women are infected without symptoms. Men may not have symptoms and may act as carriers of the infection. In some cases, men may experience a discharge from the penis and discomfort when passing urine.
The infection is spread through sexual contact with an infected person. To diagnose trichomoniasis, a specimen swab can be obtained from the vagina in women and from the urethra in men. A specimen of urine can also be submitted to the lab. Trich is treated with antibiotics.

Genital Herpes
Genital herpes is caused by the herpes simplex virus, type 1 or type 2. Both types can infect the mouth (producing cold sores) or the genital area (genital herpes).
When a person is infected with the herpes virus, it may pass unnoticed into their body and they may be unaware that they contracted the infection. This is called "subclinical infection." In fact, many people with genital herpes are not aware that they carry the infection and can pass on the virus to others even when there is no visible evidence of blisters or sores.
When symptoms occur, they appear from time to time in episodes called outbreaks. After contracting the herpes virus, a person may experience an episode within a few days, but it may take much longer, sometimes years, before symptoms are noticed. Often, the person never develops recognizable herpes symptoms.
Most genital herpes outbreaks cause symptoms similar to the cold sores that many people experience on or around their lips or nostrils. With genital herpes, the "cold sores" usually appear on or near the genitals or anus. Sometimes they appear on the buttocks or thighs.
Outbreaks may produce small fluid-filled blisters which break open to form shallow, painful sores. These develop a scab after 1-2 weeks and then heal. Sometimes the first outbreak causes considerable pain and distress, fever or chills; future episodes are usually less severe.
Although herpes sores heal, the virus remains in the body and may produce more sores later. There are called recurrent outbreaks. Recurrent outbreaks usually occur on or near the same part of the body as the first attack, but are often shorter in duration and not as painful. The may be triggered by general illness, stress, menstruation or sexual activity. Often, no trigger is identified. In most cases, recurrent outbreaks become less frequent with time and may eventually stop altogether. Recurrent outbreaks are caused by reactivation of the dormant herpes virus already present in the body - not by being re-infected.
The virus is spread by skin-to-skin contact. Cold sores on the mouth are a potential source of genital infection during mouth-to-genital contact (oral sex). Because recurrent herpes may cause few symptoms or pass unnoticed, it is possible to pass on the virus even when there are no visible blisters or sores.
In pregnant women, herpes infection may be transmitted to the baby at delivery, causing serious illness. The obstetrician should be told of past genital herpes infections so the risk of this complication can be minimized.
Herpes is diagnosed by taking a sample from an infected area during an outbreak. The herpes virus will usually grow from a swab taken from a ruptured blister. The test can identify the strain (type 1 or type 2) of the herpes virus. Type 1 genital herpes tends to cause fewer recurrences than type 2. Blood tests also assist in herpes diagnosis, especially if no blisters are present to swab.
Genital herpes is caused by a virus, so it cannot be cured. Herpes can be treated, however. Anti-viral medications prescribed by the doctor may reduce the severity and duration of the outbreak. If outbreaks are frequent, anti-viral medications may be taken continuously to try to decrease the number of outbreaks. Anti-viral medications do not eliminate the herpes virus from the body.

Urethritis
Urethritis is inflammation of the urethra (the passage in the penis that urine and semen go through). Common causes of urethritis are chlamydia, gonorrhea and genital herpes, but other bacteria or viruses may be involved. Often the cause is not identified.
There may be no symptoms of urethritis, but when symptoms are present they may include discharge from the penis, stinging or burning during urination, or itching, tingling, burning or irritation inside the penis.
Urethritis may be diagnosed with a urine sample and a swab specimen. The doctor inserts a small swab into the urethra and the sample is then examined in the laboratory for signs of infection.
Urethritis not caused by an identifiable microbe is called non-specific urethritis (NSU). The cause of NSU frequently is not known, but antibiotic treatment is usually effective. Sexual partners of men with NSU need to be examined and treated.

Genital Warts
Genital warts, or condyloma, are sexually transmitted infections caused by a virus known as the human papilloma virus (HPV). There are over 70 different strains of HPV.
HPV is spread by direct skin-to-skin contact with a partner, or during sexual intercourse. It may spread even without intercourse, however. Infection may occur by contact with a visible wart, and possibly also from an area of skin with no visible wart (subclinical infection). After sex with an infected person, warts may take a few weeks to many months (or even years) to appear. Condoms help to prevent spreading of warts, but they only protect the area they cover. Warts can spread even when a condom is used, because any areas that the condom does not cover can transmit the virus. Since HPV may be present anywhere in the genital and anal area, condoms may not provide full protection.
Genital warts or condyloma are HPV-associated growths that appear around the genitals and anus, and sometimes in the vagina, rectum or urethra. They may be raised or flat, single or multiple, small or large, and may cluster together with a cauliflower-like appearance. They are painless and rarely cause discomfort. A subclinical HPV infection occurs when there are no warts visible, but microscopic changes in cells show evidence of the virus.
Genital warts are diagnosed by looking for them. Subclinical HPV infection is difficult to diagnose. However, if present on the cervix, it may show up on a Pap smear or swab of the cervix. Being infected with certain high-risk HPV strains may increase the risk of developing cancer of the penis or cancer of the cervix in the future.
Treatment removes visible warts, but does not eradicate the wart virus. Treatment involves removing the wart with applications of chemicals, freezing, or burning them off with electrocautery or laser. Each method may cause mild irritation and scarring.
Because the HPV virus may persist in normal-appearing cells, it is possible for warts to return after treatment. If the warts reappear, it does not necessarily mean that you have been reinfected. In most people, warts eventually resolve and do not reappear. This is thought to be due to the body's natural defenses modulating the HPV.
The Human Papilloma Virus (HPV) vaccine has been released and made available to the public. The HPV virus causes Genital Warts, but it has also been found to cause the majority of Cerivcal Cancer in women. This vaccine may help prevent millions of cases of dangerous HPV virus from spreading. We have the vaccine available at our medical center for immediate use. To view more information from the manufacturer, click here.

Syphilis
Syphilis is a sexually transmitted disease caused by the spirochete bacteria Treponema pallidum. Syphilis is treatable with antibiotics, but can have serious complications if not treated soon after infection. Both men and women can have syphilis, and it can be passed on from an infected pregnant woman to her unborn infant.
Syphilis occurs in 3 stages. In stages 1 and 2 a person is infectious during sexual contact. The condition is transmitted by skin-to-skin contact with an infected area. Sores develop on the site that has touched the infectious area. Depending on the type of sexual contact, sores may therefore appear on or near the genitals, lips, fingers or anus. The hard, usually painless sores can appear any time between 10 days to 3 months after acquiring the infection. Two to four months after infection there may be symptoms including a skin rash, patchy hair loss, fever, lumps around the genitals and anus, or general tiredness. If not treated, these symptoms may disappear and then recur over the next two years. The rash can be all over the body and is very contagious. An infected, but untreated, person may remain infectious through sexual contact for 2 years. The third stage occurs in about one third of untreated individuals, and some people develop severe complications involving the brain, heart, or spinal cord.
Blood tests are used to detect syphilis infection. After treatment with antibiotics, further blood tests are done to check that the infection has been cured. Do not have sex until the follow-up test is clear. Recent sex partners need to be tested and treated.

Hepatitis B
Hepatitis B is a virus which infects the liver. It is present in both the blood and body fluids of infected people. Hepatitis B is spread by blood-to-blood contact or by having sex (vaginal, oral or anal) with an infected person. A high risk for blood contact is the sharing of needles or equipment with infected IV drug users. Sharing razors or toothbrushes with an infected person may spread the disease. Health workers may be at risk by accidental needlestick injuries. Women who are hepatitis B carriers may infect their babies around the time of birth.
People who are infected may have no symptoms at all or they may become ill with fever, nausea, dark urine, or jaundice (yellow skin and eyes). After infection, most adults recover and become immune to the virus. A few people do not clear the virus, but become carriers and may continue to infect other people. Hepatitis B carriers may experience no health problems or, over a period of years, may develop liver disease such as cirrhosis (scarring of the liver) or liver cancer.
Hepatitis B can be diagnosed with blood tests.
A vaccine to protect against hepatitis B is available, but it is not effective for hepatitis B carriers. Vaccination requires 3 injections over 6 months, and you need to complete the course for full protection. The hepatitis B vaccine will not protect you against hepatitis C, hepatitis A, HIV, or any other sexually transmitted disease.

Hepatitis C
Hepatitis C infection is caused by a virus which is carried in the blood and infects the liver. About 80% of people infected with the hepatitis C virus remain carriers, with the virus staying in their liver and bloodstream. Long-term carriers may develop liver problems years after infection.
Hepatitis C is spread by contact with infected blood. A high risk of blood contact is the sharing of needles or equipment with infected IV drug users. Sharing razors or toothbrushes with an infected person may spread the disease. Other common methods of transmission are tattoos, body piercing and acupuncture. Some people with hepatitis C werhttps://p3slhsccweb.secureserver.net/filemanager/f6dae054-a7f4-4c8e-a722-acbd9b5a8845e infected through blood transfusions before testing began in the mid-1980's. Hepatitis C can spread through sexual contact, and hepatitis C may be transmitted from mother to baby.
Most hepatitis C infections do not cause symptoms. Some people may experience abdominal discomfort, fatigue, or jaundice. Long-term hepatitis C virus carriers may go on to develop scarring (cirrhosis) of the liver or liver cancer.
Hepatitis C can be diagnosed with a blood test.
Treatment is available for some people with chronic hepatitis C. There are side effects and the treatment may not be effective in all cases.
There is no vaccine to prevent hepatitis C infection.

HIV
Human immunodeficiency virus (HIV) is a virus which affects the immune system. HIV is present in the blood, semen and vaginal fluids of people who are infected. Any person who has the virus can pass it on through these fluids. A person who does not have the virus can become infected by contact with any of these fluids from an infected person.
Once infected, a person remains infected - and infectious - for life. People with HIV infection may have no symptoms for many years. The virus, however, slowly damages the person's immune system. Ultimately, the immune system becomes ineffective and serious infections and/or cancers develop. This disease is known as Acquired Immune Deficiency Syndrome (AIDS).
HIV is diagnosed with a blood test. It can take up to 6 months after being infected with the HIV virus before the blood tests becomes positive. If the test is positive, it means you have acquired the HIV infection and are infectious to others. HIV is now a treatable long-term condition, and there are many support services for people living with HIV.

Other STD's, "Non Specific Urethritis" and others
Many patients complain of persistant urinary discomfort despite being "tested for everything" at medical clinics. Upon further investigation, it is often discovered that most of these patients have only been tested for HIV, hepatitis, herpes, syphilis, chlamydia, gonorrhea and sometimes trichomonas. Unfortunately, this is not a complete STD profile. There are quite a few atypical STD's that require very special testing in order to detect. If you believe that you have been "tested for everything" and found to have been negative, but you continue to have symptoms, please contact us for a more complete consultation and evaluation. We will be happy to perform a more comprehensive evaluation of your symptoms, including more sophisticated and rarely performed STD screening tests.

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