Sexually Transmissible Infections (STI’S)

Click here to view an explanation about what STI’s is.

Infections discussed in this unit are all contagious and are sexual diseases but can be acquired through other routes too. The germs causing these diseases readily penetrate the delicate skin and moist membranes they come into contact with during or soon after sexual arousal or intercourse. Once the germs have invaded one’s tissue they propagate and spread to other tissues, even throughout the body in some other cases.

Once the disease establishes itself in a human body, it persists. If untreated, it will persist for the rest or the person’s life or might even cause blindness, paralysis, madness or death. Effective remedies are available for most sexually transmitted infections except for Herpes, where only the pain can be controlled but the disease itself is there for the rest of the person’s life.

Sexual disease descriptions are arranged in three groups: A (being diseases causing abnormal discharges), B (diseases causing ulcers) and C (diseases associated with lumps and bumps in affected areas of the body).

The most common sexual infections are Gonorrhea, syphilis and herpes.

Gonorrhoea

Click here to view an explanation about what the symptoms of Gonorrhea in Men vs. Women are.

Gonorrhoea is the subtlest of the serious sexual diseases with symptoms varying from case to case and from time to time. 50% of infected people are not even aware that they are infected or ignore the first signs till they disappear. 10% of infected men are silent carriers who are even more dangerous not only to their sexual partners but also to themselves as the ensuing complications due to non-treatment are even fatal.

The classic symptom in females appears within 3 to 10 days after exposure. They are pain during urination, pain in the vagina, profuse vaginal discharge yellowish-greenish in colour and very smelly. In males the symptoms appear earlier, within 2 to 6 days. Symptoms are itching of the outlet of the urethra (tip of penis), burning urine and thick smelly yellow discharge from the penis.

A gonorrhoeal infection may be transmitted carelessly to other members of the family/household. Contaminated hands, clothing or towels in the bathroom can infect young girls, infants and people in charge of cleaning the home. Such infections affecting the eyes might cause blindness.

Other complications resulting from gonorrhoeal infections are salpingitis (which might lead to ectopic pregnancies), Pelvic inflammation disease, sterility, prostatitis in men, strictures (narrowing) of the urethra, skin lesions, septic arthritis, involvement of the heart and liver.

Treatment of gonorrhoea should be prompt and intensive and treatment of resistant strains to be bombarded with special types of medication as per laboratory antimicrobial testing. After course of treatment, laboratory tests should be done to determine if the infection is completely eradicated.

Syphilis

Syphilis has long been considered the most serious of STI’s because of its persistence in the human body when infection is not treated or not properly treated. It has various incapacitating and destructive effects on the human body’s tissues or organs.

The germs of syphilis can enter the body through some break in the skin or through an intact moist membrane such as lines of the vagina, mouth or eye. Most frequently, the disease is acquired through sexual intercourse but contamination with infected materials has been known to infect a percentage of people.

Syphilis evolves in 3 stages: primary, secondary and tertiary stages:

Primary Stage - Is characterized by appearance of ulcerated skin lesions called chancres. The chancres appear on the site of infection. If it was sexual intercourse it will be on the genitals and if it was oral sex it will be on the mouth and with anal sex the chancre will be around the anal area. The chancre appears 5 to 8 days after exposure to syphilis.

Secondary Stage - Evolves 2 to 4 weeks after the primary stage. A characteristic syphilitic fever is usually followed by symptoms of fever, headache, malaise and a sore throat.

Tertiary Stage - This stage only develops in 30% of syphilitic patients. After a spontaneous clearing of the secondary stage, a long asymptomatic latent phase can end up in tertiary syphilis. This stage is characterized by cardiovascular and neural involvement. Damage occurring at this stage is critical and irreversible.

Click here to view an explanation about what the stages of syphilis are.

Neurophathic Syphilis

Inflammation and thickening of the meninges with progressive degeneration of the cerebral cortex 10 to 20 years after the initial onset of the infection. Associated symptoms include confusion, irritability, tiredness, depression, seizures and possibilities of paralysis.

Degeneration of the posterior columns and roots of the spinal cord specifically referred to as “tabes dorsalis”. It is characterized by the loss of peripheral reflexes and sharp visceral pain.

Herpes

Herpes ranks in prevalence with Gonorrhea and syphilis but recent research show that herpes may be more common than Gonorrhea and syphilis. Herpes is more common amongst the middle and upper socio-economic classes.

Genital herpes occurs either as a primary or recurrent disease. Primary genital infection may be asymptomatic, mild or severe. An infected individual may experience general malaise prior to pain that will be followed by the appearance of the vesicles. These vesicles may be grouped together and form large bulous lesions containing clear serum and they tend to spontaneously disrupt forming shallow ulcers with clean margins and red bases. Lesions may persist for 7 to 21 days especially if area is not kept clean and dry.

Treatment is reassurance of the patient and pain relief. The use of agents like Acyclovir is for the quicker eradication of the lesion and the reduction of pain. When the lesion has disappeared, it does not mean the patient is healed. Once a person is infected with herpes it will be in their system for life. It will reoccur even without re-infection through sex but at any point especially during emotionally stressful periods of an infected person’s life or when their immunity is compromised.

Relationship of Sexually Transmitted Infections and HIV/AIDS

In all the STI’s mentioned in this manual, there is mention of lesions and it has been mentioned that HIV enters a person’s system through lesions. STI’s make a person extremely susceptible to HIV infections especially if indulging in unprotected sex. These STI’s cause malaise, which depletes a person’s immunity and make it very easy for the virus to manifest itself in a human’s body. The progression from HIV to AIDS is even faster due to the presence of other STI’s.