Sexually Transmitted Diseases (STDs)

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Charles Patrick Davis, MD, PhD
Synonyms and Keywords




sexually transmitted diseases, venereal diseases, STDs, chlamydia, genital
herpes, hepatitis, gonorrhea, syphilis, genital warts, HIV, AIDS, pubic lice,
crabs, chancroid, scabies, HIV symptoms, symptoms of HIV, symptoms of STDs,
types of STDs, sexually transmitted infections, STIs, STD transmission, male
herpes, STD facts, curable STDs, STD screening, list of STDs

• Sexually Transmitted Diseases (STDs) Overview
  
• Sexually Transmitted Diseases (STDs) Causes
  
• Sexually Transmitted Diseases (STDs) Symptoms
  
• When to Seek Medical Care
  
• Exams and Tests
  
• Sexually Transmitted Diseases (STDs) Treatment
  
• Self-Care at Home
  
• Medical Treatment
  
• Next Steps
  
• Follow-up
  
• Prevention
  
• Outlook
  
• For More Information
  
• Web Links
  
• Synonyms and Keywords
  
• Author and Editor
  
• Read more on Sexually Transmitted Diseases from Healthwise
  

Sexually Transmitted Diseases Overview (STDs)

Sexually transmitted diseases (STDs, venereal diseases) are among the most
common infectious diseases in the United States today. STDs are sometimes
referred to as sexually transmitted infections, since these conditions involve
the transmission of an infectious organism between sex partners. More than 20
different STDs have been identified, and about 19 million men and women are
infected each year in the United States, according to the CDC (2010).
Depending
on the disease, the infection can be spread through any type of sexual activity
involving the sex organs, the anus, or the mouth; an infection can also be spread
through contact with blood during sexual activity. STDs are infrequently
transmitted by any other type of contact (blood, body fluids or tissue removed
from an STD infected person and placed in contact with an uninfected person);
however, people that share unsterilized needles markedly increase the chance to
pass many diseases, including STD's (especially hepatitis B), to others. Some
diseases are not considered to be officially an STD (for example, hepatitis
types A,
C, E) but are infrequently noted to be transferred during sexual
activity. Consequently, some authors include them as STD's, others do not.
Consequently, lists of STD's can vary, depending on whether the STD is usually
transmitted by sexual contact or only infrequently transmitted.

• STDs affect men and women of all ages and backgrounds, including children.
  Many states require that Child Protective Services be notified if children are
  diagnosed with an STD.
  
• STDs have become more common in recent years, partly because people are
  becoming sexually active at a younger age, are having multiple partners, and do
  not use preventive methods to lessen their chance of acquiring an STD.
  
• People can pass STDs to sexual partners even if they themselves do not have
  any symptoms.
  
• Frequently, STDs can be present but cause no symptoms, especially in women
  (for example, chlamydia,
  genital herpes or
  gonorrhea). This can also occur in
  some men.
  
• Health problems and long-term consequences from STDs tend to be more severe
  for women than for men. Some STDs can cause pelvic infections such as
  pelvic
  inflammatory disease (PID), which may cause a tubo-ovarian abscess. The
  abscess,
  in turn, may lead to scarring of the reproductive organs, which can result in an
  ectopic pregnancy (a
  pregnancy outside the uterus),
  infertility or even death
  for a woman.
  
• Human papillomavirus infection (HPV infection), an STD, is a known cause of
  cancer of the cervix.
  
• Many STDs can be passed from a mother to her baby before, during, or
  immediately after birth.
  
• Because the method of becoming infected is similar with all STDs, a person
  often obtains more than one pathogenic organism at a time. For example, many
  people (about 50%) are infected at a single sexual contact with both gonorrhea
  and chlamydia.
  

Sexually Transmitted Diseases (STDs) Causes

Depending on the disease, STDs can be spread with any type of sexual
activity. STDs are most often caused by viruses and bacteria. The following is a
list of the most common STDs, their causes and other infections (see STDs with
asterisk mark*) that may be transmitted on occasion by sexual activity, but are
frequently not considered primarily to be an STD by many investigators:
STDs caused by bacteria

• Chancroid (Haemophilus ducreyi)
  
• Chlamydia (Chlamydia trachomatis)
  
• Gonorrhea (Neisseria gonorrhea)
  
• Granuloma inguinale (Calymmatobacterium granulomatis)
  
• Lymphogranuloma venereum (Chlamydia trachomatis)
  
• Syphilis (Treponema pallidum
  

STDs caused by viruses

• Genital herpes (herpes simplex virus)
  
• Genital warts (human
  papillomavirus
  virus [HPV])
  
• Hepatitis B and D, and infrequently, A*,C*,E* (hepatitis viruses, types A-E)
  
• HIV/AIDS (human immunodeficiency
  virus [HIV virus])
  
• Molluscum contagiosum* (poxvirus)
  

STD caused by protozoan

• Trichomoniasis (Trichomonas vaginalis)
  

STD's* caused by fungi

• Jock itch (Tenia cruris)*
  
• Yeast infections* (Candida albicans
  

STD's caused by parasites

• Pubic lice or crabs
  (Pediculosis pubis)
  
• Scabies* Sarcoptes scabiei
  

For details about the pathogens that cause the diseases, the reader is urged
to search the specific disease by simply clicking on it.
Sexually Transmitted Diseases (STDs) Symptoms


Common STDs have a variety of symptoms (if symptoms develop at all) and many
different complications, including death.
Symptoms of STDs caused by bacteria
Chancroid Symptoms

• Are not common in the United States but common in developing countries.
  
• Symptoms include painful ulcers on the genitals.
  
• Can be confused with syphilis or herpes
  
• Is treatable with antibiotics
  

Chlamydia symptoms

• Most common of all STDs caused by bacteria.
  
• Cause no symptoms in about 80% of women and 50% of men
  
• When symptoms are present, commonly there is discharge from the vagina or
  the penis, and burning or pain during urination.
  
• Is transmitted through vaginal, oral, or anal sexual contact
  
• Ectopic pregnancy and infertility for women are potential serious
  complications.
  
• Is treatable with antibiotics
  

Gonorrhea symptoms

• Discharge from the vagina or the penis
  
• Over 50% of infected women have no symptoms, but they can still transmit
  the disease to others.
  
• Painful urination
  
• Ectopic pregnancy, pelvic inflammatory disease (PID), infertility for
  women, Fitzhugh-Curtis syndrome (perihepatitis) and death are potential serious
  complications.
  
• Is treatable with antibiotics
  

Granuloma inguinale (donovanosis) symptoms

• Not common in the U.S.
  
• Symptoms are painless genital ulcers in the groin area.
  
• Is treatable with antibiotics, usually for three or more weeks
  

Lymphogranuloma venereum

• Not common in the U. S.
  
• Symptoms are abscesses (buboes) in the groin, rectum or other areas; fistulas
  that drain pus may occur and are treatable with antibiotics.
  

Syphilis

• Symptoms are mild and often go undetected initially
  
• Starts with a painless genital ulcer that goes away on its own
  
• Rash,
  fever,
  headache, achy joints
  
• Is treatable with antibiotics
  
• More serious complications associated with later stages of the disease if
  undetected and untreated
  

Symptoms of STDs caused by viruses
Genital herpes

• Recurring outbreaks of blister-like sores on the genitals
  
• Can be transmitted from a mother to her baby during birth
  
• Reduction in frequency and severity of blister outbreaks with treatment but
  not complete elimination of infection.
  
• Can be transmitted by a partner who has herpes even if no blisters are
  present.
  

Genital warts

• Caused by a virus related to skin warts, human papillomavirus (HPV)
  
• Small, painless bumps in the genital or anal areas (sometimes in large
  clusters that look like cauliflower)
  
• Various treatments available (for example, freezing or painting the warts
  with medication)
  
• Vaccines are available against the most common types of HPV
  

Hepatitis

• Hepatitis B and D are most often associated with sexual contact,
  hepatitis A,
  C, E are less frequently transmitted by sexual contact.
  
• Both may be transmitted via contact with blood; for hepatitis B, sexual
  transmission is believed to be responsible for 30% of the cases worldwide.
  
• The hepatitis B virus can cause both an initial (acute) and a chronic form of
  liver inflammation. Only 50% of acute infections with the hepatitis B virus
  produce symptoms. The initial phase of infection lasts a few weeks, and in most
  people (90%-95%), the infection clears.
  
• Acute infection can cause
  yellowish skin and eyes,
  fever, achy, tired (flu-like symptoms).
  
• Severe complications in some people, including
  cirrhosis and liver cancer
  may occur in a small percent of individuals infected with HBV.
  
• Treatments are available
  and remission is possible with some aggressive
  medications.
  
• Immunizations are available to prevent hepatitis B.
  

HIV/AIDS

• Spread primarily by sexual contact and from sharing IV needles
  
• Can be transmitted at the time a person becomes infected with other STDs
  
• No specific symptoms or physical signs confirm HIV infection.
  
• The average time from infection to the development of symptoms related to
  immunosuppression (decreased functioning of the immune system) is 10 years.
  
• Fatigue,
  night sweats, chills, or fever lasting several weeks,
  headaches,
  and cough may occur a few weeks after contracting the virus initially.
  
• Serious complications of AIDS include unusual infections or cancers, weight
  loss, intellectual deterioration (dementia), and death.
  
• No current cure but medications are available to slow disease progression.
  

Molluscum contagiosum

• Small (2-5mm) raised areas (papules) on the skin
  
• Contagious, usually by direct skin to skin contact
  
• Self-limited over months to years; treated with some
  topical creams
  
• Often cryotherapy (freezing) or surgical removal is performed
  

Symptoms of STDs caused by protozoan
Trichomonas

• Frothy vaginal discharge with a strong odor
  
• Treated with antibacterial/antiprotozoal medicines
  

Symptoms of STDs* caused by fungi
Jock itch (genital itching or Tenia cruris)* (not always an STD)

• Itchy groin skin, sometimes has a reddish color
  
• Is treated with topical antifungal medicines
  

Yeast infection (Candidiasis)* (not always an STD)

• Cheese-like vaginal discharge or whitish exudates sometimes with a reddish
  hue to the skin; it may occur around the foreskin of infected males; common
  symptoms are itching and burning sensation of the vagina or penis.
  
• Is treated with topical antifungal medicines in most cases
  
  

Symptoms of STDs caused by parasites
Pubic lice

• Very tiny bugs that are found in pubic hair, sometimes referred to as
  "crabs"
  
• Can be picked up from clothing or bedding
  
• First noticed as itching in the pubic area
  
• Are treatable with creams, anti-lice agents, and combing
  

Scabies

• Skin infestation caused by a tiny mite
  
• Highly contagious
  
• Intense itching is the primary symptom, which worsens at night
  
• Spread primarily by sexual contact or from contact with skin, infested
  sheets, towels, or furniture
  
• Is treated with creams
  
• When to Seek Medical Care
  
  A medical examination may be necessary if a person believes he or she may
  have an STD or if he or she may have been exposed to someone with an STD. Being
  seen by a doctor as soon as possible after exposure to an STD is important;
  these infections can easily spread to others and can have serious complications.
  
  Go to a hospital's emergency department in these circumstances if:
  
• an STD problem worsens;
  
• a fever develops with other symptoms; or
  
• if it will be a couple of days before the individual can be evaluated by
  a doctor.
  
• Exams and Tests
  
  Some STDs can be diagnosed without any tests at all (for example, pubic
  lice). Other STDs require a blood test or a sample of any unusual fluid (such as
  an abnormal discharge from the vagina or the penis for gonorrhea or chlamydia)
  to be analyzed in a lab to help establish a diagnosis. Some tests are completed
  while a person waits; other tests require a few days before a person may obtain
  the results (for example, syphilis).
  
• Sexually Transmitted Diseases (STDs) Treatment
  
  Self-Care at Home
  
  Home treatment of STDs is not recommended because prescription medications
  are usually necessary.
  
• Medical Treatment
  
  The treatment of an STD varies depending on the type of STD. Some STDs
  require a person to take antibiotic medication either by mouth or by injection;
  other STDs require a person to apply creams or special solutions on the skin.
  Often, reexamination by a doctor is necessary after the treatment to confirm
  that the STD is completely gone.
  Some STDs, such as genital herpes and HIV (which leads to AIDS), cannot be
  cured, only controlled with medication.
  For treatment of individual STD types, the reader is urged to click on the
  individual disease listed above.
  
• Follow-up
  
  Sometimes people with STDs are too embarrassed or frightened to ask for help
  or information. However, most STDs are easy to treat. The sooner a person seeks
  treatment and warns sexual partners about the disease, the less likely the
  disease will do permanent damage, be spread to others, or be passed to a baby.
  
  If diagnosed with an STD, follow these guidelines:
  
• Seek treatment to stop the spread of the disease.
  
• Notify sexual contacts and urge them to have a
  checkup.
  
• Take all of the prescribed medication, even if symptoms stop before all of
  the prescribed medication(s) are taken.
  
• Sometimes, follow-up tests are important so comply with the instructions
  given by the health care practitioner.
  
• Consult a doctor with specific needs and any questions about reinfection,
  sexual partner notification, and prevention.
  
• Avoid sexual activity while being treated for an STD.
  
• Prevention
  
  The best way to prevent STDs is to avoid sexual contact with others. If
  people decide to become sexually active, they can reduce the risk of developing
  an STD in these ways:
  
• Practice abstinence (refrain from sex entirely) or be in a monogamous relationship
  (both sexual partners are each other's only sexual partner).
  
• Delay having sexual relations as long as possible. The younger people are
  when they become sexually active, the higher the lifetime risk for contracting
  an STD. The risk also increases with the number of sexual partners.
  
• Correctly and consistently use a male latex condom. The spermicide
  nonoxynol-9, once thought to protect against STDs as well as to prevent
  pregnancy, has been proven to be ineffective for disease prevention. Do not rely
  on it. In addition, condoms are only about 90% effective in preventing STDs
  
• Have regular medical checkups even if you do not have symptoms of an STD.
  
• Learn the symptoms of STDs.
  
• Avoid douching because it removes some of the natural protection in the
  vagina.
  
• Vaccines against HPV and hepatitis B are available and effective.
  
• Outlook
  
  Most of the common STDs can be cured with treatment.
  
• In addition to the discomfort of the infection, some STDs can cause other,
  more serious, long-term problems, including infertility and problems in newborns
  infected by their mothers during pregnancy such as blindness, bone deformities,
  mental retardation, and infrequently, death.
  
• HIV can only be slowed, not eliminated, and may cause death.
  
• Authors and Editors
  
  Author:
  
  Melissa Conrad Stöppler, MD
  Editor:
  
  Charles Patrick Davis, MD, PhD
  
  REFERENCES:
  
  Centers for Disease Control and Prevention. April is STD Awareness Month.
  
  Centers for Disease Control and Prevention. The National Center for HIV/AIDS,
  Viral Hepatitis, STD, and TB Prevention.
  
  Previous contributing authors and editors: Author: Dave C Smith, DO, Consulting Staff, Department of Emergency Medicine,
  Great River Medical Center. Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor,
  Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco
  Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Thomas Rebbecchi, MD,
  FAAEM, Program Director, Assistant Professor, Department of Emergency Medicine,
  University of Medicine and Dentistry of New Jersey.