Curable Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) are passed on when a germ (bacteria, fungi, protozoa, viruses or parasite) moves to another person by vaginal intercourse, oral or anal sex. There’s a big difference between infection and disease. Infection means a germ that can cause disease is present inside your body, but you do not necessarily feel sick. Disease means the infection is causing you to feel sick or to notice something is wrong.

Most of the time, you don’t know you are infected with an STD until you start having symptoms. For many STDs, you can still spread the infection even with no signs of disease. STDs that can be cured are those that medicine can completely heal. STDs that cannot be cured are those that have symptoms treated, but you have the infection for life and can still pass it to another person.

The best way to avoid STDs is to not have sex or to have sex only in a long-term, mutually faithful relationship with an uninfected partner. Both partners should get tested for STDs, including HIV/AIDS, before having sex. If you have sex with a partner who hasn’t been tested or who is infected with an STD, a new condom should be used for each act of intercourse (insertive sex).

Testing is different for each STD: blood; visual exam (at times with a microscope); cultures (done by growing germs from vagina, anus, throat, etc. in a medical lab) are all methods of testing. Many STDs can also be transmitted WITHOUT having sex. You can get STD tests done by your doctor or free/low-cost at clinics run by healthcare agencies.

Bacterial STDs

All bacterial STDs are treated with antibiotics, carefully chosen by your doctor. You must follow the instructions exactly because each medicine is different. Sex partners, even those without symptoms, should be tested to see if they need treatment and if you can get infected again. Some infections need another visit to the doctor to be sure the treatment worked.

Chancroid

  • causes painful sores/ulcers
  • passed sexually or nonsexually by touching an open sore called soft chancre
  • symptoms usually within 10 days of infection
    • sore(s) start as a tender bump, become filled with pus and finally open
    • usually painful in men but women may not notice it
  • test is culture from a genital sore
  • complications
    • swollen lymph glands on one side of the groin can be so painful that surgery is needed
    • sores that burst can allow other kinds of infection to enter your body
    • uncircumcised men may need to be circumcised due to scar tissue
    • untreated chancroid makes it easier to be infected with HIV
    • someone infected with chancroid and HIV can transmit HIV more easily to a partner who is not infected

Chlamydia

  • can cause pelvic inflammatory disease (PID), ectopic pregnancy (fetus not in womb), ad infertility in women and men
  • passed by vaginal, anal and rarely, oral sex or mother to child before or during birth
  • symptoms, if present, usually show up 1-3 weeks after infection
    • women may have vaginal discharge
    • men often have discharge from the penis and/or pain or burning when urinating (peeing)
  • chlamydia can be misdiagnosed as gonorrhea if a culture is not done
  • many people with chlamydia also have gonorrhea and are routinely treated for both since it’s cheaper than testing

Gonorrhea “the clap”

  • can cause pelvic inflammatory disease (PID), ectopic pregnancy (fetus not in womb), infertility in women and men
  • passed by vaginal, anal or oral sex or from mother to child during birth
  • symptoms, if present, show up within 10 days for women, and within 1-30 days (most often within 2-5 days) for men
    • women may have vaginal discharge
    • men often have discharge from the penis and/or pain or burning when urinating (peeing)
  • 3 types of tests
    • Nucleic Acid Amplification tells if you have chlamydia or gonorrhea
    • Gram Stain test (only recommended for men)
    • cultures work for both genders
  • many people with gonorrhea also have chlamydia and are routinely treated for both since it’s cheaper than testing
  • some strains of gonorrhea are hard to treat so doctors pick medicine based on which strain you have
  • complications
    • infection/scarring of internal genitals (prostate, urethra, epididymitis, bladder, uterus, cervix)
    • can spread to blood, skin, heart, or joints
    • newborns can become blind

NGU/non-gonococcal urethritis

  • usually in male urethra (the tube urine goes out), caused by germs other than gonorrhea – most often, chlamydia
  • passed during sex, from mother to child during birth and by many nonsexual causes
  • symptoms, if present, show up 4 days to 6 weeks after infection, averaging 2-3 weeks
    • men have discharge from penis, burning/pain when urinating (peeing), itching, irritation, tenderness and underwear stain
    • females may have no symptoms or discharge from the vagina and burning/pain when urinating
    • anal NGU causes rectal itching and discharge or pain during bowel movement
  • you have NGU when your urethra is infected and you had a negative gonorrhea test
  • complications
    • joint, eye, skin and lung infections
    • pelvic inflammatory disease (PID)
    • ectopic pregnancy (fetus not in womb)
    • infertility in women and men

Syphilis “syph”

  • can spread through the body causing blindness, paralysis and problems with bones and internal organs, including the heart and brain
  • passed by sex, from mother to child before or during childbirth or nonsexually when a mucous membrane touches a lesion (sore)
  • symptoms are in 3 stages:
    • primary (10-90 days after infection): Chancre appears, a raised skin lesion which is painless and firm or rubbery to the touch, may not be noticed, or goes away within 1 to 5 weeks even without treatment – but you are still infected. Some people have swollen lymph glands on both sides of the groin.
    • secondary (17 days to 6 ½ months): Moist, raised lesions/warts in the genitals and/or patches of flat, rounded, grayish-white erosions on mucous membrane topped with red skin. Some people have spots/rashes on palms of hands or soles of feet or other areas, patchy hair loss and generally feeling sickly. Symptoms again go away in 2-6 weeks with or without treatment.
    • latent/late stage (2-30+ years after infection): Will still test positive but may not have symptoms for years or repeat the secondary stage symptoms. Can have tumors, heart problems and nervous system disorders such as blindness, insanity and paralysis.
  • blood tests look for syphilis antibodies or the syphilis bacteria in the fluid taken from lesions or swollen lymph nodes during primary or secondary stage. Cerebrospinal fluid (from spine) may need to be tested during late stage.

Vaginal Infections

Vaginitis is the diagnosis given to women with vaginal discharge, itching, burning and odor. Most women will have some kind of vaginitis at least once. Research is trying to understand how vaginitis relates to more serious conditions such as PID (pelvic inflammatory disease) and problems in pregnancy.

  • passed by sex or imbalance of vaginal environment, depending on the germ you have
    • the healthy vagina has a balance of many kinds of bacteria. “Good” bacteria keeps the vagina acidic enough to stop “bad” bacteria from growing too fast. Healthy vaginas make a mucus-like discharge that is clear or slightly milky, depending upon time of the monthly cycle.
    • when “bad” outnumbers “good” bacteria, infection happens. Discharge then has a funny color or a bad smell.
    • things that can upset the balance of the vagina:
      • antibiotics (bacteria killing drug)
      • pregnancy
      • douching
      • damp underwear
      • tight pants
      • poor diet
      • vaginal products (sprays, lubricants and birth control devices)
  • to find out if you have vaginitis see your doctor
    •  be sure not to schedule the exam during your period
    •  do not use douche or vaginal sprays 24 hours before the exam
    •  if you have sex less than 24 hours before the exam, use condoms
  • most common kinds of vaginitis
    •  bacterial vaginosis or BV
    •  yeast infection/genital candidiasis
    •  trichomoniasis

Bacterial Vaginosis/BV

  • BV is the most common cause of abnormal vaginal odor/discharge
  • linked to sex but women who have never had vaginal intercourse can also develop BV, due to an overgrowth of normal vaginal bacteria, such as gardnerella
  • symptoms, if present, show up within 12 hours to 5 days after bacterial increase
    • itching/burning, odor and thin, grayish white discharge
    • perhaps worse during or after intercourse
  • lab test of vaginal fluid and exam
  • untreated, can lead to more serious conditions such as PID (pelvic inflammatory disease) or complications of pregnancy

Yeast Infection/Genital Candidiasis

  • very common infection that occurs when there is overgrowth of the fungus (microscopic plant) called Candida
  • usually from overgrowth of your own Candida when body is stressed by
    • antibiotics
    • birth control pills
    • diabetes
    • being pregnant
  • can be passed by sex
    • intercourse
    • mouth to penis or vagina can infect throat as “thrush”
  • symptoms, if present, show up 2 days to several weeks after overgrowth begins
    • women usually have itching/burning, with “cottage cheese-like” vaginal discharge
    • rarely, men have an itchy rash on the penis
  • lab tests sample from the affected area
  • treatment can be applied directly, used inside the vagina or taken in pill form
    • these drugs work 80-90% of the time. Using them too long or too often can lessen their effectiveness and make treatment difficult
    • over-the-counter treatments (OTC) have resulted in as many as 2/3 of all OTCs sold to treat yeast being used by women without the disease – if you any doubt as to whether or not what you are experiencing is really a yeast infection, see your doctor!
    • HIV-infected women may have difficulty ending yeast infections

Trichomoniasis

  • vaginal infection with trichomonas germ
  • passed by sex or rarely from mother to child during birth
  • symptoms, if present, show up within 4-28 days
    • women have odor, frothy green discharge from the vagina, itching or redness, painful intercourse, lower abdominal discomfort and the urge to urinate (pee)
    • men, rarely, have discharge, urge to urinate and burning during urination. Symptoms in men usually go away, but you can still pass on trichomoniasis
  • exam and lab test finds this germ
    • harder to identify in men than in women
    • in women, a pelvic exam can find small red sores in the vagina or cervix
  • treatment works well but all your sexual partners must be treated or you will become infected again
    • metronidazole-brand name (Flagyl®) is given in 1 or 7-day doses
    • alcohol can cause nausea/vomiting with Flagyl
    • pregnant women should consult a doctor before taking Flagyl
  • if left untreated, can increase risk for HIV infection, cause pregnancy complications and inflammation of the prostate and bladder in men

Ectoparasitic Infections

Ectoparasitic infections are intense itching caused by tiny bugs passed on by close physical contact, including sex.

Crabs/pubic lice

  • these tiny cousins of head lice live on hair in the genitals (penis, vagina, anus)
  • usually passed during sex by pubic hair, even without sexual penetration. You can get crabs without human contact from infested beds, towels or clothing.
  • symptoms of itchy genitals start in a few days to several weeks, depending upon the number of crabs passed on
  • you can usually see crabs by looking closely, but you might need a magnifying glass
    • look like tiny versions of crabs you see on the beach
    • may notice crab eggs (nits) attached to where a hair comes out of your body
    • “blue spots” can appear, which are the result of crab bites
    • if uncertain, have a health care provider examine you
  • crabs can be treated by over-the-counter lotions or by prescription
    • even if treatment works, you may still have some itching, for which you can use hydrocortisone cream
    • treatment should NOT be applied to the eyes, unless it is made just for eyes
    • bedding/clothing should be machine-washed, machine-dried using the heat cycle, or dry-cleaned, or removed from body contact for 2 weeks by keeping in plastic bag
  • complications
    • sometimes, secondary bacterial infections happen due to harsh scratching
    • untreated partner(s) can give you crabs again

Scabies

  • skin disease caused by a mite (bug too small to be seen except with a microscope)
    • scabies that bothers humans is different than the type that infests dogs and other animals, called mange
  • passed by direct, continued, skin-to-skin contact – NOT a quick handshake/hug
    • more likely to be passed from spending the night together than from brief sex
    • nonsexually, passed by prolonged contact with infested linens, furniture or clothing
  • if you never had scabies before, the symptoms start 4-6 weeks after infection. But if you HAVE had scabies before, the symptoms start in 1-4 days.
    • intense itching over most of your body that’s worse at night
    • zigzag or “S” patterns on skin (burrows where the mite lives)
    • sores caused by scratching which can become infected
  • several tests, all look for either the mite or signs that prove it is there
  • several lotions are available to treat scabies
    • follow directions from doctor or inside package insert
    • apply lotion to a clean body from the neck down to the toes and leave overnight/8 hours
    • after 8 hours, take a bath or shower to wash off the lotion and put on clean clothes
    • all clothes, bedding and towels used 2 days before treatment should be washed in hot water then dried in a hot dryer
    • a second treatment may be necessary 7-10 days later
    • often, pregnant women and young children are treated with milder lotion
  • sex partners and anyone you have close, prolonged contact with should also be treated
    • everyone should receive treatment at the same time to prevent passing it back and forth
    • itching may continue for 2-3 weeks and does NOT mean that you still have scabies
    • doctor may give medicine for severe itching
    • no new burrows or rashes should appear 24-48 hours after effective treatment
    • do without close contact including sex until treatment is completed successfully
  • complications
    • sometimes, secondary bacterial infections happen due to harsh scratching
    • people with weak immune systems and the elderly can get a more severe form of scabies, called Norwegian or crusted scabies

If you feel embarrassed about getting tested for STDs, don’t let that stop you. Putting it off and hoping symptoms will disappear is not the answer. Avoiding the doctor may allow disease to cause permanent damage. If you think you or a partner may have an STD, you should be checked right away, whether you have symptoms or not. Every day that you wait means increased risk to your health. If you find you do have an STD, you are not alone – by age 21, almost 1 in 5 Americans gets treated for an STD. Be sure to tell your sex partner(s) as soon as possible so they can be tested and treated, too.

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