SEXUALLY TRANSMITTED DISEASE - Full extract 

Sexually transmitted disease (STD) is a topic that some people shy away from, as if it is something that happens only to others. However, it is only through open discussion that the spread of STDs can be effectively reduced. 

An STD is any infective condition that is passed on through any type of sex. Although STDs have been around since earliest recorded history it is only in the last few decades that highly effective treatments have become available. During this time the pattern of STDs has changed considerably. Although syphilis and gonorrhoea should always be kept in mind, other STDs have become more prominent. And while this has been occurring, the spectre of HIV / AIDS has brought the whole subject of STDs into a sharper focus. 

The importance of safer sex in reducing the risk of getting HIV is vital. However, there are less life-threatening conditions that are more likely to be acquired, and condoms are very effective in preventing these conditions as well. 

Chlamydia  is an infection that has been increasingly recognized in recent years. In women it is a common cause of pelvic infection and may produce symptoms such as pelvic pain, spotty bleeding and occasionally a vaginal discharge. However, there are often no symptoms at all, and infertility from chronic infection may result. In men chlamydia often causes urinary burning and a slight discharge. If chlamydia is suspected, special swabs should be taken so that the diagnosis can be positively confirmed. Antibiotic treatment is required for 10 to 14 days. It is very important for the person's sexual contacts to see their doctor to check whether they too have the infection. (further information)¹

Genital herpes  is a condition that may cause a great deal of pain and trauma. It is caused by a viral infection and produces lesions similar to coldsores. They occur in crops of blisters and sores and may recur several times a year. The initial attack can be extremely painful and distressing, especially for women. 

Genital herpes can be acquired from a partner who does not have any obvious blisters or sores present at the time of sexual contact. Active herpes infection may be present without symptoms.

When women are pregnant there is a risk of transmitting the infection to the baby at the time of vaginal delivery. Although this is more likely to occur with an obvious current infection, any history of herpes in either the women or her partner should be discussed with the obstetrician. In some cases an alternative method of delivery may be advised.

Fortunately, several highly effective medications such as Acyclovir are now available to treat both the acute attack and further recurrences. They are very expensive and swabs are required to confirm the diagnosis, so that subsequent authorizations for medication can be arranged. Antiviral medications have dramatically improved the treatment of genital herpes. However, it is essential for people with herpes to use condoms, especially when active lesions are present. It is important to be aware that infective viral particles can still be passed on even when no obvious blisters or sores are visible. (further information)¹

Genital warts  have long been known to be spread by sexual contact. They are caused by the human papilloma virus (HPV). Some types of HPV cause warts on the hands while others have been shown to cause genital warts. It seems that HPV infection may predispose to the development of cancer of the cervix. 

In men, warts may appear on along the penis and and near the anus. In women the warts may be present in the vulval and anal area but they can also extend into the vagina and be harder to treat. Topical paints are often tried initially. More difficult warts might need to be frozen off with liquid nitrogen or burnt off with electric diathermy. Sometimes a general anaesthetic is required. (further information)¹

There are many other types of STDs. The presence of one STD should alert us to the possibility of other infections. Infestations like scabies and pubic lice can be passed on through sexual contact. Then there are general infections such as viral hepatitis that are spread by contact with body fluids. 

Younger heterosexual males can be rather blase about STDs and sometimes a little reluctant to use condoms. Some men also fear that women might think they are specially at risk if they produce a condom, rather than just being sexually responsible. For people not having sex and for those in long-term monogamous relationships, the whole question of STDs may have no relevance at all. 

We need to get rid of double standards when talking about safer sex. It should not be considered precocious, cheap or provocative for a woman to carry condoms with her, whether she has had sex before or not. Likewise, young men should not feel embarassed about having some condoms in the glovebox. Just because you carry a spare tyre in your car doesn't mean you put it on each week...but it's nice to know it's there if you need it. 

When being treated for an STD it is important to discuss with the doctor whether sexual partners should be notified. There are standard notification letters to suggest that partners see their own doctor for a check. Notification and follow-up is a vital part of any program to reduce the spread of STDs. People at risk of any type of STD should see their doctor for detailed discussion and advice, or make an appointment at a special STD clinic. 

Health Tips:
* If you choose to have sex, make sure it is safer sex. Even the remotest possibility of getting an STD is a very good reason to use condoms.

* Any symptoms such as genital sores, blisters or a discharge should always be promptly checked with your doctor. You may have an STD that requires treatment.

Web links:
¹ www.nevdgp.org.au/info/std_misc/Chlamydia.htm
  www.herpes.on.net/genital_herpes/default.htm
  www.nevdgp.org.au/info/std_misc/GenitalWarts.htm
 

Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: December 11, 2004