Diagnostics and treatment of sexually transmitted infections

Sexually transmitted diseases (STDs) are sexually transmitted infectious diseases. Many different pathogens, such as bacteria, viruses, fungi or parasites, may be sexually passed from one person to another. As these pathogens are very sensitive to external conditions (they perish when the temperature changes, when they dry out etc.), it is not possible to become infected with a sexually transmitted infection in the sauna, by sharing a toilet or some other similar manner.

Sexually transmitted diseases may be generally classified as (a) diseases that cause genital ulceration (genital herpes, syphilis), (b) diseases that cause genital inflammation (chlamydia, trichomoniasis, gonorrhoea, ureaplasmosis, mycoplasmosis) and (c) diseases that affect the entire body (HIV, hepatitis B or C). Below is a list of some signs or situations when we recommend you to test for STDs:

  • you have or your partner has several sexual partners;
  • your partner is diagnosed with an STD;
  • you have had unprotected sex with a new or casual partner;
  • before you begin a new sexual relationship;
  • when you are planning pregnancy and/or at the start of pregnancy (STDs may be transmitted from an infected mother to her baby during pregnancy or childbirth causing miscarriage or the new-born being infected along with the resulting complications);
  • if you suspect that you have an STD: the most common signs are discharge (from the vagina in women, from the urethra in men), change in the discharge (e.g. smell), burning sensation when urinating, pain during sexual intercourse, bleeding after sexual intercourse, blisters or ulcerations in the genital area, rectal discharge.

The sexually transmitted diseases we diagnose most often are chlamydia and genital herpes.

Chlamydia

Chlamydia is caused by the bacterium Chlamydia trachomatis. Similar to other STDs, this infection is transmitted only by direct sexual contact. Often people infected with chlamydia do not experience any symptoms (the person is infected but has no symptoms). Chlamydia infection does not cause any symptoms in 75% of infected women and in 50% of infected men.

The main symptoms of chlamydia in women are painful urination and increased vaginal discharge. There may be bleeding outside of the menstrual cycle and after sexual intercourse. The symptoms in men are itching and burning sensation in the urethra and pain when urinating, very rarely also discharge from the urethra. If the rectum is infected, pain and discharge (also bleeding) from the rectum may occur.

The disease is cured with antibiotics. A person cured from chlamydia does not acquire immunity against the disease and he or she can be infected repeatedly. The correct use of condoms protects against infection! If left untreated, chlamydia may cause chronic inflammation of the genitals, chronic abdominal pain and infertility.

Genital herpes

Genital herpes is a sexually transmitted infection caused by the herpes virus. In most cases, the pathogen that causes the infection is Herpes simplex virus type 2 (HSV2). HSV1 virus type usually causes damage on the lips (cold sores), the mucous membranes of the mouth or in the eyes, but may be also transmitted to the genital area via oral sex.

The characteristic signs of genital herpes both in men and women are red, extremely painful small blisters that break after some days and heal by themselves in a couple of days or up to a week. The first outbreak in women usually causes blisters and sores on the labia majora, vagina and cervix. Men may have blisters and sores not only on their genitals, but also in the urethra. The infection may cause general weakness, fever, muscle pain and painful urination.

The virus remains in the body after infection. After recovery from the first outbreak, genital herpes may repeat. During a repeat outbreak, the symptoms are usually the same, but typically less severe and shorter in duration. Sometimes pain or discomfort (burning or itching sensation) may occur in the affected area before or after blisters develop. It is not possible to completely cure genital herpes but effective antiviral drugs reduce the length of outbreaks considerably and alleviate discomfort. To avoid this infection, you should use condoms, abstain from sexual intercourse during outbreaks (when blisters appear) and avoid oral sex when cold sores appear on the lips.