Four Common Sexually Transmitted Diseases: Take Away Points
Sexually transmitted diseases (STDs) are common, contagious, and spreading widely in the U.S. And it’s not just HIV/AIDS. There are a wide array of highly transmittable and serious STDs for you to be aware of. Prevention, early detection, and proper treatment are key. If you are sexually active, be sure to talk to your healthcare provider about STD testing and which screening tests may be right for you.
Over 26 million new cases of STDs occur in the U.S. in 2018. In fact, 1 of every 5 people in the US have a sexually transmitted infection. Direct costs of these STDs are estimated to be over $16 billion. That’s pretty significant, not just for health care costs, but for society as a whole. It’s time to learn about some of the more common STDs to help protect ourselves - and others.
Young people ages 15 to 24 make up the largest group that contract STDs, roughly about 50% of all new cases. In addition, many young people do not realize they have an STD, as many infections have few, if any symptoms. When you’re not aware you have a sexually transmissible disease, you are more apt to spread it through unprotected sexual contact. The consequences of untreated STDs are often worse for young women, as it can affect fertility.
If you find out you have an STD, also get tested for HIV. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. For those at higher risk, CDC recommends getting tested at least once a year.
Chlamydia, trichomoniasis and gonorrhea are easily treated if caught early, but that’s not always the case. Read here to learn how to recognize the symptoms that may be linked with these STDs, and what action you should take.
No doubt you’ve probably heard of this STD due to the HPV vaccine. The human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. There were about 43 million HPV infections in 2018, many among people in their late teens and early 20s.
HPV is a virus almost everyone catches at some point or another; however; some types cause few symptoms and no medical problems, while others can lead to serious concerns like genital warts, cervical cancer and oropharyngeal cancer (cancer of the throat).
- HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. HPV causes over 10,000 cervical cancers in US women each year.
- It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).
- It takes roughly 20 to 25 years for a new HPV infection to cause cervical cancer. That is why screening with a Pap, HPV or both tests regularly is important.
Take away points:
- Vaccination can protect both women and men from HPV, and the resultant cancers caused by HPV, including cervical cancer. HPV vaccination is most effective if started before the individual gets infected with HPV and before they have sex for the first time.
- There are several HPV vaccines, but in the U.S., the one available since 2016 is known as Gardasil 9. Gardasil 9 vaccine prevents genital warts and cancers caused by nine different subtypes of HPV. It is used in both boys/men and girls/women from ages 9 through 45. It is given as an intramuscular injection in a 2- or 3-dose series.
- The CDC recommends HPV vaccine for all boys and girls ages 11 to 12 years old. It can be started as early as 9 years of age. If the HPV vaccine is started before age 15, two doses (6 months apart) can be used instead of three doses.
- In adolescents and adults 13 to 26 years old who have not had the vaccines or who have not completed the vaccine series, catch-up vaccination is recommended. If you are younger than 45 years of age, ask your doctor or pharmacist if Gardisil-9 is right for you.
Genital warts can be treated with locally applied medications that destroy the tissue, freezing (cryotherapy), or surgical removal. Cancers may not be caught until screening.
If you have not been vaccinated, reduce your risk of genital HPV by using latex condoms; however, the throat and other exposed skin areas may still be at risk for HPV. Genital skin-to-skin contact may increase risk. A monogamous (same person) relationship with a disease-free partner is the best way to prevent HPV if you are not vaccinated.
Women should undergo routine cervical cancer screening (Pap test) between ages 21 and 65 years of age. An HPV DNA test can identify certain HPV types on a woman’s cervix and may be used with a Pap test. Even women who are vaccinated need cervical screening. You will need to repeat your Pap test every 3 or 5 years.
There is no approved routine HPV test for men.
See Also: HPV Support Group
Chlamydia is the most common “reportable” STD in the U.S. Reportable STIs must be documented to the local health departments when it is diagnosed to help track trends and control future outbreaks. In 2019, over 1.8 million cases of Chlamydial trachomatis infections were reported to CDC. Rates of reported chlamydia are highest among adolescents and young adults ages 15 to 24 years of age (61%).
How do you get chlamydia? Chlamydia is spread via oral, anal, or vaginal sex. Gay, bisexual, and other men who have sex with men are also at risk since chlamydia can be spread through oral and anal sex.
Most people with chlamydia do not show symptoms. Symptoms of chlamydia in men include discharge from penis, burning urination, testicular pain and swelling. In women, burning urination and vaginal discharge can occur. Chlamydia can affect the rectum as well, with symptoms of rectal pain, discharge, and bleeding.
Who should be screened for chlamydia? Sexually active women under 25 years of age should be screened for chlamydia and gonorrhea each year, as well as women 25 years of age and older at increased risk for infection (such as women with new or multiple sex partners), per the U.S. Preventive Services Task Force (USPSTF)
Gay, bisexual, and other men who have sex with men; as well as pregnant women should also get tested for chlamydia. In some cases, more frequent testing may be needed in other high risk groups.
Chlamydia can be treated with antibiotics, but you can still get it again. If untreated, chlamydia can affect a woman's ability to get pregnant.
Take away points:
- Symptoms may not always be present, so testing for chlamydia may be needed with new partners. Condom use can lower the risk for getting chlamydia.
- Chlamydia can cause pelvic inflammatory disease. If left untreated, chlamydia can affect a woman’s reproductive system and make it difficult or impossible to get pregnant in the future.
- If you are pregnant, you can give chlamydia to your baby during childbirth. Get tested at your first prenatal visit.
- To help prevent chlamydia, use a condom each tome you have sex, get all sexual partners (within the last 60 days) treated, do not have sex if you have chlamydia symptoms, and schedule a doctor appointment to be checked if you do have symptoms.
- Chlamydia can be tested for and treated easily.
- Oral doses of azithromycin (Zithromax) and doxycycline (Vibramycin) are commonly used to treat chlamydia. Do not have sex for week after finishing your medicine to help prevent a re-infection. Pregnant women should not use doxycycline.
- Azithromycin is the easiest because it is given as a one-time dose; doxycycline requires a 7-day treatment period. Be sure to finish all of your medicine.
- If you are infected with chlamydia, you may also be infected with gonorrhea, so you may need to be tested and treated for both STDs.
- It’s important your partner is treated, too. Your doctor may give you prescriptions for both you and your partner. Also, wait 7 days after you and your partner have been treated to have sex again.
See Also: Chlamydia Infection Support Group
Trichomoniasis (often abbreviated to “trich”) is a common sexually transmitted disease that is caused by infection with a protozoan parasite called Trichomonas vaginalis. In the U.S., about 2 million people had the infection in 2018.
As with many STDs, people with trichomoniasis often have no symptoms. But luckily for anyone who contracts this infection, trichomoniasis is considered one of the most easily curable STDs. All sex partners should get treated with antibiotics at the same time to help avoid a re-infection.
Take away points:
- About 70% of infected people do not have any signs or symptoms, so it’s often hard to know if you or your partner have the infection. It can be spread during sex in men and women.
- In those that develop symptoms, itching, redness, burning after urination, or an unusual discharge may occur in the vagina or around the vulva in women and in the penis for men. Symptoms may develop within one to four weeks, or may not develop until later. Sex can be uncomfortable.
- Trichomoniasis can increase the risk of spreading other STDs, such as HIV. Pregnant women are at risk for preterm or low-weight babies.
- An examination and lab work by your doctor can diagnose trichomoniasis.
- Treatment is given whether symptoms are present or not if trichomoniasis is detected. Treatment for trichomoniasis is easy and straightforward.
- A 7-day oral course of either metronidazole (Flagyl) or tinidazole (Tindamax), is now recommended when possible (instead of single dose therapy) due to better overall cure rates and better tolerabiloty. Single-dose secnidazole (Solosec) is also an option but is expensive and not available generically.
- Metronidazole is an option for pregnant women or women with HIV; a 7-day course is often used.
- Depending upon which medicine you take, you'll need to avoid consumption of alcohol for 24 to 72 hours after treatment to help reduce side effects. Follow the directions provided on your bottle and ask your pharmacist.
- Partners should also be treated. Wait 7 days after you and your partner have been treated, and symptoms are gone, to have sex again.
- Trichomoniasis screening should be conducted at least annually for all HIV-infected women.
See Also: Trichomoniasis Support Group
Gonorrhea is the third most common STD in the U.S. It commonly occurs in younger people between the ages of 15 and 24. In 2017, over 555,000 cases of gonorrhea were reported to the CDC.
New treatment guidelines for gonorrhea were released from the CDC in 2021.
While gonorrhea can be treated successfully, delay in treatment can result in serious medical complications. Not only does untreated gonorrhea increase a person’s risk of getting HIV, but it can also lead to pelvic inflammatory disease (PID) in women. PID can lead to infertility and increase the risk of having an ectopic pregnancy. Women may also transmit the infection to their child. Gonorrhea can also cause rectal infections.
Gonorrhea can occur in the genitals, rectum, and throat. Both women and men with gonorrhea are at risk of developing serious complications, including infertility.
Symptoms are not always present in people with gonorrhea. In fact, many men and most women do not usually have symptoms. Symptoms may include:
- burning while urinating
- discharge from the penis or vagina
- swollen or painful testicles in men (uncommon, may occur when complicated by epididymitis)
- bleeding between periods in women
- rectal gonorrhea symptoms may include discharge, anal itching, soreness, bleeding, and painful bowel movements.
- a throat infection usually has no symptoms, but can cause a sore throat.
Take away points:
- Your doctor can diagnose gonorrhea using a urine sample or a swab from the throat, rectum, or genitals.
- Due to increasing levels of drug resistance, treatment now involves a single 500 mg intramuscular ceftriaxone injection. For individuals who weigh ≥150 kg, a 1 g dose is suggested. Ceftriaxone plus oral azithromycin (Zithromax) is no longer recommended, per the CDC. Learn more about antibiotic-resistant gonorrhea here.
- Treatment for chlamydia should be instituted when needed, as this infection also commonly occurs with gonorrhea.
- Most, but not all, states allow prescribers to provide prescriptions for gonorrhea treatment (and other select STDs) to be delivered to a partner by the patient. This is known as expedited partner therapy (EPT). Co-treatment of the other sex partner at the time of first diagnosis is necessary to prevent reinfection. Discuss this important action with your doctor.
The CDC recommends yearly gonorrhea screening for all sexually active women younger than 25 years, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. Screening high-risk mothers at the first prenatal visit in pregnancy is recommended, as well.
In sexually active gay men, bisexual men, and other men who have sex with men (MSM) screening for gonorrhea is recommended at least once a year per the CDC. The USPSTF states that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men.
See Also: Gonorrhea Support Group
Prevention is key with STDs, but it’s not an easy task. Think hard before engaging in sex with someone unfamiliar to you whose sexual history you do not know. Discuss the possibility of STD testing with your partner prior to an initial sexual encounter, and keep condoms within reach.
Schedule an appointment with your doctor to be screened for STDs, and consider you may need to repeat these if you have multiple sexual partners. While medication treatment is easy with some STDs, others can be more involved, require surgery, or lead to fertility problems, in both women and men.
Talk to your doctor about vaccines that can prevent STDs: currently, the HPV vaccine, Hepatitis A, and Hepatitis B vaccines all work to prevent STDs. Other vaccines, like an HIV vaccine remain under study.
Take away points:
- The only sure way to prevent getting or spreading an STD is to avoid sex or stay in a monogamous relationship with a disease-free partner. However, this cannot always be assured.
- Using a latex condoms correctly each time you have sex can be useful to help prevent STDs but are not always 100% effective.
- Speak with your partner before your first sexual encounter to determine the level of risk you are comfortable with, and consider testing for each prior to having sex the first time.
- If questions arise, always consider speaking with a healthcare provider who can provide confidential advice.
Consider joining the Drugs.com Sexually Transmitted Diseases Support Group to discover others with similar conditions and related medications, read more up-to-date news, and share your own experience, too.
Learn More About STDs
- Workowski K, Bachmann L, Chan P. et al Sexually Transmitted Infections Treatment Guidelines, 2021. Centers for Disease Control and Prevention (CDC). Accessed Sept. 19, 2021 at https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf
- Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States. Centers for Disease Control and Prevention (CDC). Accessed Sept. 20, 2021 at https://www.cdc.gov/std/statistics/prevalence-incidence-cost-2020.htm
- US Preventive Services Task Force. Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(10):949–956. doi:10.1001/jama.2021.14081
- Chlamydia and Gonorrhea: Screening. US Preventive Services Task Force (USPSTF). Final. Sept. 14, 2021. Accessed Sept. 20, 2021 at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/chlamydia-and-gonorrhea-screening#fullrecommendationstart
- Genital HPV Infection - Fact Sheet. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/std/hpv/stdfact-hpv.htm
- Sobel J et al. Trichomoniasis. Up to Date. Updated July 22, 2021. Accessed Sept. 20. 2021 at https://www.uptodate.com/contents/trichomoniasis
- Centers for Disease Control and Prevention (CDC). Antibiotic-Resistant Gonorrhea Basic Information. Accessed Sept. 29, 2021 at https://www.cdc.gov/std/gonorrhea/arg/basic.htm
- HealthyPeople.gov. Accessed June 21, 2019 at https://www.healthypeople.gov/2020/topics-objectives/topic/sexually-transmitted-diseases
- Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2019. Centers for Disease Control and Prevention (CDC). Accessed June 22, 2019 at https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf
- Chlamydia-CDC Fact Sheet. Centers for Disease Control and Prevention (CDC). Accessed Sept. 20, 2021 at https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
- Gonorrhea-CDC Fact Sheet. Centers for Disease Control and Prevention (CDC). Accessed Sept. 20, 2021 at https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm
- Trichomoniasis – CDC Fact Sheet. Centers for Disease Control and Prevention (CDC). Accessed Sept. 20, 2021 at https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm
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