STI

Treatment for STIs/STDs (sexually transmitted diseases)

Sexually transmitted infections (STIs or STDs, although this terminology has now deprecated) are diseases that are passed between people during sexual intercourse.

We use the word infection because the individual can be a carrier of bacteria, microbe or virus without necessarily developing the disease, and infections in the plural because there are many types, of which the severity varies.

Our site provides an update on the different types of sexually transmitted infections, symptoms and treatments available.

Understanding sexually transmitted infections (STIs / STDs)

Figures from the World Health Organization are striking. Every day, more than one million people contract an STI, the most common being chlamydia, gonorrhoea, syphilis or trichomonas, affecting 357 million people each year.

The consequences can be severe, e.g. HPV causes 266,000 deaths due to uterine cancer it causes, while chlamydia and gonorrhoea increase the patient’s susceptibility to becoming sterile. As for AIDS, it kills as many as it infects, at around 6,000 people every day. Finally, some STIs are transmitted to the foetus, such as syphilis, causing birth defects, or neonatal death.

Symptoms vary greatly from one infection to another but have a common base. If you experience fever, pain in the lower abdomen, and notice any abnormal phenomena in your genitals, there is a likely risk that you are carrying an infection.

The phenomena are:

• Discharge from the vagina or penis
• Redness of the same genitals
• Itching, rash
• burning sensation when urinating

If you feel pain during or after sex, it is also a sign that you have contracted a sexually transmitted infection. Be careful, however, as many infections cause no symptoms and can only be detected when the wearer has already reached a serious stage. It is, therefore, important to test yourself after behaving riskily or to have an examination. These are also a major cause of STI transmission: Healthy carriers, who do not develop symptoms and do not practice tests, will transmit their infection to others who will develop the disease.

A full list of the different STIs/STDs

They are firstly classed according to origin: whether they are caused by bacteria, fungi or yeasts, protozoa or viruses.

Bacterial STIs

Gonorrhoea manifests itself in humans as a discharge of pus from the penis and burning when urinating. In women, it is asymptomatic, so the risk of transmission is higher. The incubation period is 24 hours to 15 days. Existing treatments are very effective, but if the infection is not treated, it can cause irreversible infertility.

Chlamydia is among the most common infections especially among young people, particularly because the incubation period is very long (over 15 days) and clinical signs are seemingly minor (white discharge in women, mild itching and burning in men). Yet it is devastating for women’s fertility if left untreated. The treatment of chlamydia infection with antibiotics is very effective and fast.

Also caused by chlamydia is Nicolas-Favre’s disease or Lymphogranuloma venereum, considered rare in Europe and America but endemic in tropical areas in Africa and Asia.

Mycoplasma infections are other urogenital infections, the first of which is urethritis. The symptoms are urethral discharge, inflammation of the urethral or ureteral area, or difficulty during urination (dysuria).

Warning, some STIs can also be transmitted through the mouth!

Syphilis is a sexual infection that is essentially transmitted sexually and directly, as it is through the presence of genital or extragenital lesions. It is also very misleading because its incubation periods are very long, and increases in time, with 3 stages of development up to believe cures or disappearance of the bacteria.

1. The first stage is the appearance of a chancre sore, which occurs after 3 weeks to 3 months of incubation, and is manifested by the appearance of a red, hollow sore on the genital, anal or oral areas, and ends by disappearing.
2. The second stage is then initiated, with an incubation period of 3 to 6 months, which concludes with the occurrence of pink spots (roseola), on the thorax and limbs. These spots are accompanied by nausea, headaches, body aches and severe fatigue, and contagious oral mucosa. Again, if nothing is done, the roseola eventually disappears, and the 3rd stage of development appears after an interruption of 3 to 10 years.
3. This stage is neurological syphilis, resulting in cardiac and neurological disorders (personality disorders, paralysis), and destruction of organ tissue. Syphilis thus leads to endangerment of life-threatening and death, while the treatment is effective and fast when done in stage 1 of the disease. In addition, it spreads very easily to child during pregnancy, so it is important to seek treatment and follow downstream.

Chancroid is a rarer sexually transmitted infection (widespread in tropical and subtropical countries) but creates a fertile ground for the emergence of other STIs. It is often associated with the appearance of other sexually transmitted diseases. It is manifested by the appearance of pustules containing pus, evolving into ulcers and causes agitated itching. A greyish skin should alert the individual who has it. The lymph nodes in the groyne appear 2-3 weeks later and turn into abscesses. The disease is serious when it evolves into gangrene of the penis and requires amputation of the genitals.

STIs from unicellular fungi and protozoa

Genitourinary candidiasis is an infection caused by fungi or yeast. They are transmitted sexually to men, but not only sexually in women, who can also contract it from a contraceptive or antibiotic treatment, or from dirty clothes and lack of hygiene. Clinical signs are the of whitish discharge, itching, and burning in the vulva amongst women, in the glands amongst men. This occurs after an incubation period of 1 day to 1 month. Candidiasis is treated dermatologically (cream, gel) or with the insertion of pessaries into the vagina.

Protozoa (trichomoniasis) has very similar clinical signs to candidiasis amongst women (yellowish and foul-smelling discharge, burning and itching) whilst in men, they are often non-existent and has a 2 to 20-day incubation period.

Viral STIs

Venereal warts are caused by HPV and can progress to cervical cancer in women. The best treatment to this day remains the vaccine. Condylomata is clinically diagnosed by—often imperceptible and inconspicuous—warts on the genitals (on the penis and glands in men, and on the vulva and cervix in women) after a variable incubation period of 1 to 10 months.

Genital herpes concerns 10 to 15% of sexually transmitted infections (or STIs) and its complications are rare (only in pregnancy), but its biggest problem resides in its ability to promote other STIs, and in its persistence. Indeed, there is no treatment for this viral disease, which manifests itself as small and painful skin blisters on the genital areas (penis and balls, vagina and vulva) two to twenty days after intercourse. This STI becomes chronic in 40% of cases and punctuates the lives of herpes carriers with regular breakouts. These breakouts are accompanied by fever, intense fatigue, and an increase in the lymph nodes. During breakouts, antivirals available in the form of either cream and pills can reduce their frequency, duration and intensity.

Infectious mononucleosis is mainly spread by oral contact, causing extreme fatigue, fever, pharyngitis, sore throat and swollen glands. These symptoms appear after an incubation period of 6 weeks, on average. Depending on the body, this disease can install itself temporarily and quickly, or it can be enduring and intense, requiring the person to cease their activities for several months. There is no specific treatment, as antibiotics are not effective and only prolonged rest can be recommended.

Hepatitis B is transmitted sexually but also by blood, saliva, semen, and vaginal secretions. It is also transmitted to the child during pregnancy. Clinical signs appear after an incubation period of 1 to 6 months, and manifest as asthenia, accompanied by fever and muscle aches, and a discoloration of stools, as well as jaundice (icterus). Treatments do not exist; only rest can be recommended. However, an effective vaccine exists, however, if performed beforehand.

AIDS is the best known and the most recent sexually transmitted infection (one commonly speaks of AIDS as an STD). It is a human immunodeficiency virus (HIV), the most lethal to date. It is transmitted through sex, sperm, and through infected blood contact, as well as from mother to child (during pregnancy or after via breast milk).

1. In many cases, AIDS first appears as asymptomatic and hence goes undetected, making it even more devastating. So do not rely on symptoms, but on screening tests after sex, and 3 months after, to confirm their reliability.
2. The virus attacks the white blood cells, playing a key role in the immune system. The body becomes unable to defend against infection.
3. It also destroys the nerve and muscle cells, and its strength lies in its rapid replication capacity and the fact that the human’s antibodies do not recognise the virus. Triple therapy and antiretroviral drugs exist, their goal being to slow the disease’s progression to the AIDS stage, which is the final stage characterising the collapse of the entire immune system and the occurrence of opportunistic diseases.

Sex, therefore, comes with the risk of carrying an infection, whether genital or oral. There is a risk of transmission as soon as there has been contacted and an exchange of genital fluids. This is why you must be well protected and carry out an adequate response in the case of contagion.

Prevention

The best prevention is to use a condom. Whether male or female, they remain the most effective protection to date. Also, even if we consider there to be a smaller risk of catching a sexually transmitted infection during oral sex, this risk does exist, and it is helpful to always use a condom for oral sex, too.

Also adopt self-protection reflexes because your partner will not always perceive the risk that they, and others, might incur. It is also possible for their carelessness to cause you harm. Avoid contact if you find lesions, rashes or abnormal redness on your partner’s genitals.

Also, it is important to have regular assessments and screening tests, and for women, visits to the gynaecologist and smear tests are good ways to identify infections and treat them early. It is estimated that 30,000 people in UK are unaware that they are carriers of the AIDS virus.

Treatment is also another way to prevent the spread of infections, and even after remission, you remain particularly subject to contract another STI, so stay vigilant. It is also necessary to warn your partners so they too can protect themselves and reduce the risk of developing the infection. The existence of certain vaccines also finally allows people to effectively fight against the spread and contraction of certain infectious virus (HPV and hepatitis B).

Sources

• Sexually Transmitted Diseases: Medlineplus.gov
• Introduction about STDs: NHS
• STD symptoms: Common STDs and their symptoms: Mayoclinic.org

Other information

Medical review on January 7, 2021 by Dr. Davis Taylor