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23 January 2006
STDs – Chances Are You’ve Probably Got One
by Katherine Burnett-Watson

While we’re all on the wheatgrass shooters and high-fiber diets to keep well, and getting pap smears and giving “the girls” their regular monthly once-over to stave off the big C, we’re probably missing the warning signs of the 19 million new infections that will affect Americans this year – sexually transmitted diseases (STD). And the reason we’re missing the warning signs? Quite often, there aren’t any.

The staggering truth is that half of all people will have an STD at some point in their lifetime, and it is estimated that over 65 million Americans are living with a viral STD.

The Center for Disease Control and Prevention estimates that one in four teenagers contract a STD, and even more alarming, one in two sexually active people will contract a STD by the age of 25. Given these figures, why is it that we’re not all pox-riddled horrors, too struck down with our afflictions to even get out of fetid bed in the morning? It’s because many of these infections have few or no symptoms, and the symptoms that do present themselves are either easy to ignore or attribute to some other cause.

For example, it’s estimated that one in four people have genital herpes, but up to 90 percent of these people are not aware they even have it, due to the infection not presenting itself in the usual form of sores or lesions. Similarly, the symptoms of chlamydia, syphilis, gonorrhea and human papillomavirus (HPV) can also be difficult to identify. The scary thing is, while many STDs are easy to treat if identified soon after infection, undiagnosed STDs can lead to serious health problems.

Chlamydia is one of the STDs that can lead to medical complications if left untreated. An estimated 3 million Americans are infected with chlamydia each year, and it’s so common in young women that, by age 30, 50 percent of sexually active women will have had chlamydia at some time. Chlamydia, once diagnosed, is treated with antibiotics, either in a one-off or a weekly course. Incredibly simple. But if left undiagnosed or untreated, the ramifications can be terrible.

The chlamydia bacteria often infect the cells of the cervix. If not treated, the infection can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). This happens in up to 40 percent of all women with untreated chlamydia. PID can cause permanent damage to the fallopian tubes, uterus, and tissues surrounding the ovaries. This damage can lead to chronic pelvic pain, infertility (affecting around 20 percent) and potentially fatal ectopic pregnancy.

There is evidence to suggest that pregnant women with chlamydia are at risk of premature delivery. Babies born when their mothers are infected can get chlamydial infections in their eyes and respiratory tracts. Chlamydia is a leading cause of early infant pneumonia and conjunctivitis in newborns. Compared with women who do not have chlamydia, women with the infection may also have a higher risk of acquiring HIV infection from an infected partner.

Gonorrhea, when left untreated, is also a major cause of PID, and people with gonorrhea are three to five times more likely to get HIV, if exposed.

Syphilis too, has relatively minor symptoms in women, but can have devastating health repercussions. Although a person with syphilis is only infectious for about two years after contracting the disease, in its late stages, untreated syphilis can cause serious heart abnormalities, mental disorders, blindness, other neurological problems, and death. And like chlamydia, pregnant women are likely to pass it on to babies during delivery.

In pregnancies where the mother has an active syphilis infection, around 25 percent result in stillbirth or neonatal death. Between 40 and 70 percent of such pregnancies will results in a syphilis-infected baby. Some babies with congenital syphilis may have symptoms at birth, but most develop symptoms between two weeks and three months later. These symptoms may include skin sores, rashes, fever, weakened or hoarse crying sounds, swollen liver and spleen, yellowish skin (jaundice), anemia and various deformities.

Sometimes the symptoms of syphilis go undetected in babies. As infected babies become older children and teenagers, they may develop the symptoms of late-stage syphilis including damage to their bones, teeth, eyes, ears, and brain.

So now we know the gory truth, what are these elusive symptoms we need to keep an eye out for? Both chlamydia and gonorrhea have vague symptoms like: unusual vaginal discharge, bleeding after intercourse or between menstrual periods and abdominal or pelvic pain. Seriously? These are supposed to warn you that you may have a STD? Who hasn’t had one or more of these symptoms at any given time, and not thought twice about it?

And syphilis presents itself as a small, painless sore at the site of infection, so if it’s in or around your vagina (where you’d expect a STD to appear), you’re probably not likely to see it, unless you’re a contortionist or regularly check yourself with a hand mirror. After this sore disappears, an all-over body rash, swollen lymph nodes, fever or tiredness may present as symptoms. Now, apart from the all-over body rash, which might raise concern, swollen lymph nodes, fever and tiredness sound just like symptoms of a bad cold or the ‘flu. And remember, these are just possible symptoms, so you may not break out in the tell-tale syphilis rash, but just think you’re coming down with a cold.

Avoiding a sexually transmitted disease is always the best line of defense, by both practicing safe sex, (condoms, dental dams, etc.) and limiting your sexual partners. But if the statistics are to be believed, we’ve probably all come into contact with an STD already.

If you are sexually active, consider getting screened regularly for STDs. The Center for Disease Control and Prevention (CDC) recommends that sexually active women have yearly screening tests for the most common STDs, including chlamydia, gonorrhea, syphilis, human papillomavirus and hepatitis B and C.

Common STDs, Their Symptoms and Treatment

Chlamydia

Stats: Three million new cases each year.

What is it? A bacterial infection spread through unprotected vaginal, anal or oral sex.

Symptoms: Symptoms may include abnormal vaginal bleeding (not your period), as well as unusual discharge or pain during urination within one to three weeks of having sex with an infected partner.

Treatment: Oral antibiotics

Left Untreated: Possible infertility and increased risk of HIV infection. It can lead to pelvic inflammatory disease (PID) and ectopic pregnancy.

Trichomoniasis

Stats: 7.4 million new cases each year.

What is it? A parasitic infection spread through unprotected vaginal sex or vulva-to-vulva contact.

Symptoms: Frothy, smelly, yellowish-green vaginal discharge and/or genital area discomfort, usually within 5 to 28 days after exposure to the parasite.

Treatment: Oral antibiotics

Left Untreated: Increased risk of infection for other STDs, including HIV. Can cause complications during pregnancy.

Gonorrhea

Stats: 700,000 new cases per year.

What is it? A bacterial infection spread through unprotected vaginal, anal or oral sex.

Symptoms: Most women show no symptoms. Those who do may experience a burning sensation while urinating, green or yellowish vaginal discharge, anal discharge or discomfort, and abnormal vaginal bleeding and/or pelvic pain.

Treatment: Oral antibiotics

Left Untreated: Increased risk of infection for other STDs, including HIV, and increased risk of infertility. Can also cause PID.

Human Papillomavirus (HPV)

Stats: 6.2 million new cases each year. At least 20 million people already have it.

What is it? A viral infection of more than 100 different types, 30 of which are STDs. It is spread through unprotected vaginal, anal or oral sex, or through touching an infected area.

Treatment: There is no cure, but warts can be treated by medication or can be removed through other methods. Even with such treatments, the virus stays in the body and can cause future outbreaks.

Left Untreated: Increased risk of infection for other STDs, including HIV. The persistent infection with certain HPV types (16 & 17) is the most important risk factor for cervical cancer.

Genital Herpes

Stats: One million new cases each year, with 45 million people already infected.

What is it? A viral infection of the genital or rectal area that also can occur around the mouth. It is spread through unprotected vaginal, anal or oral sex, or through touching an infected area. People can still be infections even when not showing symptoms.

Symptoms: Most people have no symptoms. Herpes 1 causes cold sores and fever blisters on the mouth but can be spread to the genitals; Herpes 2 is usually on the genitals, but can be spread to the mouth. During the first attack, flu-like symptoms-fever, headaches, and swollen glands-may occur.

Treatment: There is no cure, but medications can help reduce the pain, itching and frequency of recurrent outbreaks as well as reduce transmission to partners.

Left Untreated: Increased risk for infection by other STDs, including HIV. Recurring sores: the virus lives in the nerve roots and keeps coming back.

Syphilis

Stats: More than 70,ooo new cases each year.

What is it? A bacterial infection that can spread throughout the body. It is spread through unprotected vaginal, anal or oral sex. Can also be transferred by kissing if there is a lesion on the mouth.

Treatment: Antibiotics

Left Untreated: Increased risk for infection by other STDs, including HIV. Untreated, the symptoms will disappear, but the infection stays in the body and can progress into the third stage, damaging the brain, heart, and nervous system, and possibly causing death. Syphilis in women can seriously harm a developing fetus during pregnancy.

Hepatitis B (HBV)

Stats: An estimated 73,000 new cases each year.

What is it? A viral infection affecting the liver, Hepatitis B is contracted through unprotected vaginal, anal or oral sex, or through using contaminated hypodermic syringes.

Symptoms: Many people experience no symptoms. Others may experience tiredness, aches, nausea and vomiting, loss of appetite, darkening of urine, or tenderness in the stomach, usually within one to six months of exposure. Yellowing of the skin and the whites of the eyes (jaundice) can occur later.

Treatment: Most cases clear up within one to two months without treatment. Some people are contagious for the rest of their lives. A three-dose vaccine is now available.

Left Untreated: Increased risk for infection by other STDs, including HIV, as well as of Hepatitis C. Chronic, persistent inflammation of the liver and later cirrhosis or cancer of the liver. Pregnant women infected with HBV must have their babies immunized at birth.

HIV

Stats: 40,000 new infections each year, with around one million people already living with HIV in the United States.

What is it? Human immunodeficiency virus (HIV), the cause of AIDS, is transferred through unprotected vaginal, oral, and anal sex, through sharing contaminated needles, and during pregnancy and breast-feeding.

Symptoms: Many don't know they have it because symptoms may not appear for 10 years or longer. Others experience unexplained weight loss, flu-like symptoms, diarrhea, fatigue, persistent fevers, night sweats, headaches, or severe or recurring vaginal yeast infections.

Treatment: Antiviral medications can slow the progression of HIV infection and delay the onset of AIDS symptoms. There is no cure for AIDS and it is considered fatal.

Left Untreated: Increased risk for infection byother STDs. HIV is the deadliest STD of all and can weaken the body's ability to fight disease, making sufferers vulnerable to certain cancers and infections such as pneumonia.

Sexually transmitted diseases remain a major public health challenge in the United States. While substantial progress has been made in preventing, diagnosing and treating certain STDs in recent years, the CDC estimates that 19 million new infections occur each year, almost half of them among young people ages 15 to 24. If you’re a sexually active woman, and you haven’t been screened, you could be living with an STD right now, and not even know it.

Make it a part of your next general check up or pap smear – ask your health care provider to test you for any and all the above mentioned STDs, and one of two things will happen. You’ll either find you have an STD, and receive the all-important (usually simple) treatment, or you’ll be given the all clear. Either way, taking charge of your own health is incredibly important, and something that we as women need to do.

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