Guest Author - Denise Howard, M.D., M.P.H.

Sexually Transmitted Infections (STI) are more common in young adults but can occur in sexually active women of any age. It is important to be aware of this and take the necessary precautions to prevent these infections as they can have potentially life-threatening consequences. This is part 1of 2 of a review of some of the most common infections.

Chlamydia and Gonorrhea are two of the most commonly sexually transmitted infections. They are caused by the bacteria Chlamydia trachomatis and Neisseria gonorrheae which can be transmitted through vaginal, anal and oral intercourse. The bacteria can infect the cervix, urethra, anus and the throat. In many cases a woman and a man can have the infection and not demonstrate any symptoms. If symptoms are present they may include vaginal discharge, urinary frequency, vaginal irritation or burning, abnormal bleeding and pain with urination. These infections can be detected through routine test that can be taken at the time of a pelvic examination. Treatment with an antibiotic taken by mouth is generally effective however all sexual partners must be treated otherwise the risk of reinfection exists.

If these infections go untreated the infection can ascend into the uterus and fallopian tubes causing a pelvic inflammatory condition called Pelvic inflammatory disease or PID. The symptoms include lower abdominal pain, fever, nausea and vomiting. It can sometimes be confused with appendicitis. If treatment is not initiated promptly the risk of developing a life threatening blood infection is quite high. Sometimes hospitalization is required to control these infections.

Herpes is a sexually transmitted infection which is caused by the virus Herpes Simplex type 1 and 2. It is transmitted during vaginal, anal and oral intercourse. Typically it occurs when one partner has active herpes lesions however the virus can be transmitted when there aren’t any apparent sores. A first infection typically occurs 7-10 days after exposure and presents with multiple vesicular genital sores that ulcerate. The sores are preceded by fever, fatigue, swollen lymph nodes and tingling or burning of the genitalia. The sores are usually quite painful and can sometimes cause difficulty with urination and a copious discharge. If left untreated the symptoms generally resolve within 2-3 weeks. Meningitis can occur in a person with a weak immune system. In some cases the initial outbreak may not be so dramatic.

This infection can be recurrent. Some people experience frequent recurrences, some infrequent and others may never experience another outbreak after the first one. The recurrences tend to be shorter and less painful. The virus can be transmitted to a sexual partner during these outbreaks. The virus can also be transmitted to an infant if active lesions are present at the time of vaginal birth. Treatment in the form of antiviral oral medication is available to shorten the course of an initial and recurrent infection and to prevent recurrences. The medications are safe and generally well tolerated.

See next weeks article for a further discussion of common sexually transmitted infections.