STI WEEK 2022 – STIs HAPPEN, BE PROUD TO TEST
Dr. Tariq Jagnarine
Family Medicine, Endocrinology and Diabetes
The terms “sexually transmitted infections” (STIs) and “sexually transmitted diseases” (STDs) are often confused, but they aren’t the same thing. An infection — which is when bacteria, viruses, or parasites attack the body —comes before a disease; and while an infection may result in zero symptoms, a disease always comes with clear signs.
Think of it this way: An STD will always start as an STI, but not all STIs turn into STDs.
STD SYMPTOMS
If an STD starts with a symptomatic STI, a patient might first experience:
* Pain or discomfort during sexual activity or urination
* Sores, bumps or rashes on or around the vagina, penis, testicles, anus, buttocks, thighs or mouth
* Unusual discharge or bleeding from the penis or vagina
* Painful or swollen testicles
* Itchiness in or around the vagina
* Unexpected periods or bleeding after sexual activity
But remember that not all STIs have symptoms.
If an STI progresses to an STD, symptoms can vary. Some of them may be similar to the above, such as pain during sexual activity, pain during urination, and irregular or painful periods. But other symptoms can be quite different, and, depending on the STD, they can include:
* Fever
* Recurring pain
* Fatigue
* Memory loss
* Changes in vision or hearing
* Nausea
* Weight loss
* Lumps or swellings
STD CAUSES
These infections are usually transmitted through sexual contact, including through body fluids or skin contact via vaginal, oral, or anal sex. Some of them never become a disease, especially if they’re treated, and they can even go away on their own. But if the pathogens that caused the infection end up damaging cells in the body and disrupting its functions, an STI will progress to an STD.
TYPES OF STDS
While the list of STIs is pretty lengthy, there are fewer STDs. They range from pelvic inflammatory disease (PID), caused by STIs like chlamydia and gonorrhoea, to some forms of cancer, caused by human papillomavirus (HPV).
PELVIC INFLAMMATORY DISEASE
Gonorrhoea, chlamydia, and trichomoniasis are common STIs that can lead to PID if left untreated. But not all cases of PID are caused by an STI, as other bacterial infections can play a role.
Although this infection of the female reproductive organs is classified as a disease, some people have no symptoms. Those who do have symptoms may experience:
* Pelvic or lower abdominal pain
* Pain during penetrative vaginal sex, or when urinating
* Irregular, heavy, or painful vaginal bleeding
* Unusual vaginal discharge
* Nausea
* High temperature
Antibiotics can successfully treat PID if it’s diagnosed early enough. However, they won’t treat any scarring on the fallopian tubes that may have occurred.
TERTIARY SYPHILIS
The early stages of syphilis —a relatively uncommon infection — are considered an STI.
The infection first appears as one or more small round sores on the genitals, anus, or mouth. If left untreated, syphilis will move to the latent phase, which has no symptoms. However, around a quarter of people will go on to develop tertiary syphilis from here — a process that can take between 10 and 30 years after the initial infection.
This disease can have serious consequences for several organ systems in the body, leading to:
* Loss of vision
* Loss of hearing
* Memory loss
* Mental health conditions
* Infections of the brain or spinal cord
* Heart disease
The earlier syphilis is diagnosed and treated, the less damage it does. While penicillin injections are typically used to treat tertiary syphilis and remove the bacteria from the body, they can’t reverse any damage that’s already occurred.
CANCER
Although some strains of HPV tend to cause no disease, other strains can cause abnormal cell changes. This can lead to cancer, including:
* Oral cancer
* Cervical cancer
* Vulvar cancer
* Penile cancer
* Anal cancer
GENITAL WARTS
Some lower-risk strains of HPV can cause a disease called genital warts. These skin-coloured or white bumps show up on the genitals or anus, with over 350,000 people developing them every year. They are treatable, but not curable, as the virus that causes them may remain. (In some cases, HPV disappears on its own.)
AIDS
HIV can damage the immune system, and increase the risk of contracting other viruses or bacteria and developing certain cancers. Many people with HIV live long, healthy lives with today’s treatments. But if left untreated, the virus can lead to AIDS, where the body becomes vulnerable to serious infections and illnesses.
People with AIDS may experience:
* Rapid weight loss
* Extreme fatigue
* Sores
* Infections
* Neurologic disorders
* Cancers
STD DIAGNOSIS
It’s hard for healthcare professionals to diagnose an STD based on symptoms alone, so they’ll need to do some tests and examinations. Depending on the suspected STD, this may involve:
* Physical examinations
* Swabs of bodily fluids
* Blood tests
* Specialist procedures, such as keyhole surgery or a colposcopy
STD TREATMENT OPTIONS
STDs can have varied effects on the body. Depending on the condition, there are several treatment options, including:
* Antibiotics
* Other oral or topical medications
* Surgery
* Laser
Lifestyle alterations, such as abstaining from sex until treatment is completed, may be needed.
With most STDs, it’s not possible to undo any damage that the disease has already caused. And some STDs, such as genital warts and AIDS, aren’t curable.
STD PREVENTION
The best way to avoid an STD is to prevent STIs. And the only foolproof way to do that is to avoid sexual contact.
But there are ways to make sex safer and reduce the risk of contracting an STI. Here are some ways:
* Have an open discussion about sexual history with a new partner before engaging in any sexual activity, and decide what you’re each comfortable with.
* Get tested regularly for STIs, especially if having a new partner or multiple partners. Ask any partners to do the same.
* Use a condom properly during vaginal, anal, and oral sex, to help prevent STIs that spread through fluids. Dental dams can also protect oral sex.
* Consider getting vaccinated for HPV and Hepatitis B.
* If one is at a higher risk of contracting HIV, think about taking PrEP medication every day.
Many STDs are treatable, but not all of them are curable. Some can be life-threatening, while others have less serious effects. They are, however, all caused by an STI. So, the best way to prevent them is to get regular screening and to practise safer sex. If tested positive for any STI, seek treatment as soon as possible.
