Female and Male Sexually Transmitted Infections (STIs)

Welcome! Today we’ll be talking about Sexually Transmitted Infections. This is a very wide topic, and I will only be able to give you a very general overview. I will not have time to go into great detail, but I will be giving you some resources where you can find more information, and I will be trying to cover all the important facts that you need to know.

Many people are embarrassed or even ashamed when they have a Sexually Transmitted Infection, but I do encourage you to go and see your health provider when this happens, because your sexual health is just as important as your overall health. And there are several things that we can do have safer sex. Those are all methods that usually create a barrier between fluids such as semen, blood, and vaginal secretions. And also you do want to avoid getting in contact with genital sores. Some of things that you can use are condoms – lots of condoms available. I’m not going to demonstrate how to use condoms today, that will be in a different video on contraception. But condoms are easy to buy, I always recommend having your condoms with you, whether you are a man or a woman. And I do want to show you the female condoms, because a lot of people are not familiar with how they look, so I want to demonstrate that. It comes with instructions, so let me just show you how the female condom looks. It’s basically two rings – and this bigger ring stays on the outside, and the woman takes the smaller ring and then inserts it into her vagina, so then the condom really lines her vagina, and this is where the penis goes, right here. And it protects from Sexually Transmitted Infections, unless it ruptures or is displaced. This is a very good thing to have if you don’t want to use men’s condoms. There’s a lot of lubrication on there which makes it easier to insert, which is good. Another thing is latex gloves, if you want to protect your hands, cuts or whatever you might have – use latex gloves. They’re easy to get. And then finally, for oral sex we have dental dams, which are also made out of latex – they come in all kinds of colors, but it’s basically latex that you put on top of the vulva and the clitoral area when you want to have oral sex and you want to have safer sex. Use dental dams. So those are the safer sex methods, and again, if you want more information on all of this, go to the Planned Parenthood website – it’s www.plannedparenthood.org. We will have the link on the website, and the phone number is 1-800-669-0156. From Planned Parenthood you can get more detailed information on all these things I’m going to talk about today.

So, who should get tested for Sexually Transmitted Infections? If you have any symptoms – and I will be going over 12 of the most common Sexually Transmitted Infections in a little bit – so if you have symptoms or if you think you may have been infected, you should get tested. If you have had unprotected sex – meaning if you haven’t used any of these safer sex methods, and you’re not sure about the history, the sexual history of your partner, it’s a good idea to get tested. Also, if you’ve had several sexual partners, and you may not be sure about their sexual history, again get tested. If you’re using drugs and you share needles – this is a way that you can get many of the infections, through sharing needles – so DO NOT share needles. If you are pregnant or planning to be pregnant, it can be important to make sure that you don’t have any Sexually Transmitted Infections, both for your own health and also for the risk to and the health of your child. So again, in all of these cases, ask your health provider for more information and for a test, or go to one of the clinics to get tested.

Now what are the symptoms, what are the signs of having a Sexually Transmitted Infection – I will list several signs that are possible, starting with genital symptoms. First of all, discharge. Either any kind of abnormal or smelly discharge from the vagina or from the penis; bleeding; burning sensations; itching; genital pain; a rash; sores; swelling; urine changes, either more frequent urination or a burning sensation when you urinate, when you pee; warts – and I’ll be talking a little bit more about that as we go along. But there can also be symptoms that are not related to the genitals, that are more general. Those are abdominal pain; bellyaches; appetite loss; chills or fever; diarrhea; fatigue; vomiting; and unexplained weight loss. And very important to say that some of the infections, sometimes men and women have no symptoms. It’s not uncommon not to have any symptoms at all. So if you think that you might have been exposed or if you think that you might have an infection, do go to your health provider and get tested for the STIs.

Now next I’m going to cover 12 of the most common Sexually Transmitted Infections, and I will be going fairly quickly, and just really only give you the most important facts. But again, do go to the Planned Parenthood website if you want more information, or call them for a brochure. Or ask your health provider, of course.

The first one is bacterial vaginosis. It’s an imbalance of the normal bacteria in the vagina, and it’s not always transmitted sexually. But if a woman is sexually active, she’s usually at a higher risk for getting this. She’s usually not in doubt, because the vagina is very irritated, there’s a strong unpleasant odor, a smell, and there’s vaginal discharge. But again, some women have no symptoms. And if you are pregnant and have bacterial vaginosis there’s a higher risk of miscarriage or early delivery or the baby can be born with low birth weight. There is treatment – we have different types of cream that can treat this.

The next one I want to talk about is chlamydia. This is a very common Sexually Transmitted Infection, and it’s so important to diagnose because if it’s not treated, and it’s easily treated, but if it’s not treated, it can cause sterility, so you might be unable to have children, for both men and women. So it’s very, very important to diagnose. And 75% – 3 out of 4 women – and 50% – every other man – of men have no symptoms when they have chlamydia. Those who do have symptoms have either discharge from the penis or the vagina, they have pain or burning when urinating, and also you typically urinate more frequently. There can be excessive vaginal bleeding; pain during intercourse for women; spotting, which means a little bit of bleeding between periods and after intercourse; abdominal pain; nausea; fever; and swelling or pain in the testicles. So these are all symptoms – you may not have all of them, but these are all possible symptoms when someone has chlamydia. And remember, a lot of men and women do not have any symptoms. If it turns out that you have chlamydia, both you and your sexual partner(s) need to be treated with antibiotics, but it’s very easy – we have good medication available. So you need – both of you need – treatment.

The next one is Cytomegalovirus, which is CMV. And this is a virus that is spread through many different types of body fluids – saliva or spit, so it’s actually transmitted through kissing, blood – you can get it through blood transfusions, but nowadays the blood for transfusions is always screened for Sexually Transmitted Infections. But we all have heard stories about people getting different types of diseases from blood transfusions. Also, because it’s spread through the blood, sharing of drugs – it’s not a good idea to share the needles because this is definitely one of the infections you can catch by sharing drugs and sharing needles. Condoms and what I just showed you of the safer sex methods work very well to protect from CMV. And if someone is pregnant and has CMV, she can spread the virus on to her fetus, and this can cause permanent disability, hearing loss, and even mental retardation in those babies. So it’s important to know whether you have that or not. Symptoms are swollen glands; fatigue; fever; weakness; nausea; diarrhea; and sometimes loss of vision. And again you need a blood test to be diagnosed, and since it’s a virus we don’t have any cure – but there’s medication available to treat some of the symptoms, and reduce some of the symptoms.

Gonorrhea – it spreads through vaginal, anal, and oral intercourse. And very important – 80% of women and 10% of men show no symptoms. Those who do have symptoms have, for the women, frequent and burning urination, so they have to go to the bathroom and pee a lot, and it burns; irregular periods; pelvic or lower abdominal pain; painful sex again; and then there’s something very typical – it’s a yellowish or yellowish-green discharge, it’s also typical for gonorrhea. And also they can have arthritic pains, in their joints. Men have a pus-like discharge from the tip of the penis, from the urethra, and they also usually have pain during urination. But again, 10% of men have no symptoms. And both partners, of course, need to be treated with antibiotics – it’s easily treatable. Also, if someone is pregnant, it can cause premature labor and even stillbirth. Nowadays routinely, babies after they are born routinely get eyedrops to prevent infection with gonorrhea.

Next I will talk about hepatitis. And there are three types of virus that can cause hepatitis – it really means virus infection of the liver. And there’s the virus hepatitis A, B and C. And the hepatitis B virus, that is the one that is most commonly transmitted through sexual transmission. And it can be prevented with vaccination – very important. And then the sexual transmission of types A and C is less common. So usually we talk about hepatitis B. And 90-95% of adults with hepatitis B recover completely, but it can cause severe liver disease, and it can even cause death. Pregnant women who have been exposed to hepatitis B should consider having their babies vaccinated – remember I said there is a vaccine for hepatitis B. Symptoms are extreme fatigue; headache; fever; hives; lack of appetite; nausea; vomiting; and tender lower abdomen. And then usually a little bit later – this is when the liver is affected – the urine turns dark, and the stool turns clay colored. And the skin, you’ll notice, gets yellow and the whites of the eyes turn yellow. This is called jaundice, and this is a sign of liver infection. Hepatitis B spreads through semen, saliva, and blood. Again, DON’T share needles if you are a drug user – hepatitis B is easily transmitted this way. And it also spreads through urine. Since it’s a virus, again there’s no treatment, but often clears in 4-8 weeks. But some people remain contagious for the rest of their lives.

Herpes – this is one of the infections where I encourage you, if you think you might have herpes, do get some more information – I cannot give you all the details at this point here. But I will give you the National Herpes Hotline number – it is 919-361-8488. And again we will have the phone number written down for you. They are open from 9 AM to 6 PM Eastern Standard Time, Monday through Friday. They can give you a lot of information about herpes. And basically, just very briefly, there are two types of herpes virus – Type 1 and Type 2. Type 1 is the one that’s associated with cold sores, maybe around the mouth, but really both types, both Type 1 and Type 2, can be transmitted sexually. And what happens is people get a recurring rash, and it’s small clusters of tiny, itchy, painful blisters that turn into sores. And they can be on the vagina, the cervix, on the penis, around the mouth, around the anus, buttocks, or really anywhere on the body you can have these outbreaks. And usually when these blisters break open – first you get these little blisters, and then they break, and it’s at that time when they break that it’s highly contagious, and it’s until they then heal completely it’s highly contagious. The first outbreak usually is associated with pain and discomfort – itching, burning during urination, maybe the glands are swollen, the glands in the groin, maybe you have a fever or headache. So the first outbreak, usually there’s a lot of pain and discomfort with that. Then the virus stays in the body throughout your life and once in a while you might get another outbreak from this. And a lot of times these outbreaks are triggered through some kind of stress, either emotional, physical, or health stress. And while these blisters are open, it’s important to wash your hands a lot, and keep hygienic. And again, I encourage you to call the Herpes Hotline and get more information, to really know how you can best protect yourself and your partner(s). And again, it’s very important that while you are in the contagious phase, do refrain from any sexual contact during this time. Talk to your health provider more – get all the details, because there’s also the possibility of asymptomatic shedding, which is shedding of the virus even though you don’t have any symptoms. So I encourage you to seek out all the information you can about herpes if you think you might have herpes. It’s a virus, again, and at this time we don’t have any cure, but you can relieve a lot of the symptoms – they can be relieved with medication such as acyclovir. So do go and seek help for this condition.

Next I want to talk a little bit – and again, just the basics – about HIV, which is the Human Immunodeficiency Virus. Most people know about HIV – it’s the most dangerous Sexually Transmitted Infection that we have. It’s affecting men and women, and it’s affecting all ages. I always want to emphasize that individuals over 50, definitely, they still also get exposed to viruses. And a lot of people get don’t think about that – a lot of health providers don’t encourage the older generation to use safer sex methods, because they may not think about this. But it is important to always keep safer sex in mind.

Briefly, the very last stage of HIV infection is called AIDS. And sometimes people have no symptoms for maybe 10 years, maybe even longer, when they have HIV. But some of the symptoms – I’m just going to list a few of them – are unexpected weight loss; diarrhea; lack of appetite; fatigue; fevers; night sweats; a dry cough; lightheadedness; headaches; thrush on the tongue or mouth; and recurring vaginal yeast infections can be signs and symptoms of HIV. HIV is spread through blood – and again, don’t share drugs, don’t share needles – it’s spread through semen, and through vaginal fluids. Condoms are very highly effective, both the male and the female condom, in preventing transmission of HIV. It also can be transmitted through breastmilk. You can go and get tested and the diagnosis involves detecting antibodies in your body. And at this time and age there is no cure for HIV, even though there are a lot of medications now available to manage some of the AIDS-related conditions, but there is no cure at this point. But do remember that condoms are effective at preventing HIV transmission.

Now I want to talk a little bit about genital warts, the human papilloma virus, or HPV. There are more than 100 different types of HPV and 30 of these are genital and they can affect the reproductive organs, and a few of these can cause genital warts. You will not be in doubt – they are little tiny, almost cauliflower-like warts that are itchy, and they can actually grow and become quite uncomfortable. And then some of the HPV infections can cause cancer of the cervix, vulva or penis, and we don’t really know why some people develop these long term complications, but I do want to emphasize that many people recover from HPV infections with no health problems at all. HPV spreads through vaginal or anal intercourse, or oral sex, and there are various treatments available, but I do want to emphasize that sometimes you might get treatment and you might find that the warts recur, and then you will need more treatment. So just treating them once doesn’t always mean that they’re gone forever. So they may recur, but some of the treatment options out there – and it will depend on your health practitioner, what he or she recommends – are application of podophyllin, or acid, or you can have surgery, you can have laser, or freezing, or injections. Those are the treatment options. And again, condoms may help, but the virus also can be shed in areas that are not protected by condoms. So it really depends on where these warts are located.

Finally – we’re getting to the end – pubic lice, it’s also called crabs. It’s intense itching in the genitals or the anus. Usually there’s some mild fever associated with pubic lice. And you will actually see the little lice or the small egg sacks in the pubic hair. And if this happens to you, just go to the pharmacy and get the over the counter medication and be sure to follow the directions on the package. One thing that’s really important – and it says this on the instructions too – is to wash the bedding, wash towels, wash clothes, anything that has come in contact with the pubic lice and the pubic area needs to be washed.

Scabies also causes intense itching and it actually usually gets worse at night. You’ll see small bumps or rashes that appear, it’s almost like dirty looking small curly lines that can be on the penis, it can be between fingers, on the buttocks, under the breasts, on the wrists, thighs, really anywhere. Maybe around the navel – those are some of the more common areas where you will see scabies. You will need a prescription for medication, either Kwell or other medication, and again it’s very important to wash the bedding, wash towels, and wash anything that has come into contact with you.

Finally we have syphilis. The number of cases in the United States has dropped because very effective antibiotic treatment is available, and also people use more condoms. But syphilis still does exist and if you think you might have been exposed or you think you might have syphilis, be sure to get treatment. This is one of the diseases you definitely want to have treated, and there are effective antibiotics for syphilis. If it’s untreated, if you don’t treat it, it can lead to disfigurement, problems with the nervous system, and even death. And syphilis happens in different phases. Usually the first stage or the first phase is a painless sore or it can be an open, wet ulcer, and then usually people have swollen glands. So again, if you think you might have been exposed, if you think you might have syphilis, seek treatment, because it’s easy to treat. And again it’s spread through vaginal, anal, or oral intercourse.

The very last one I want to talk about is trichomoniasis. And this is a very common vaginal infection. You will see a very frothy, unpleasant discharge, and itching in and around the vagina. There might be blood in the discharge and swelling in the groin area. Also again painful and frequent urination. It’s spread by vaginal intercourse, and even though men a lot of times don’t have symptoms, both partners need medication.

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