What are sexually transmitted diseases (STDs)?
Sexually transmitted diseases (STDs) are infections that can be transferred from one person to another through any type of sexual contact. STDs are sometimes referred to as sexually transmitted infections (STIs) since they involve the transmission of a disease-causing organism from one person to another during sexual activity. It is important to realize that sexual contact includes more than just sexual intercourse (vaginal and anal). Sexual contact includes kissing, oral-genital contact, and the use of sexual "toys," such as vibrators. STDs probably have been around for thousands of years, but the most dangerous of these conditions, infection with the human immunodeficiency virus (HIV), was only recognized in recent decades.
Many STDs are treatable, but effective cures are lacking for others, such as HIV, HPV, and hepatitis B and C. Even gonorrhea, once easily cured, has become resistant to many of the older traditional antibiotics. Many STDs can be present in, and spread by, people who do not have any symptoms of the condition and have not yet been diagnosed with an STD. Therefore, public awareness and education about these infections and the methods of preventing them is important.
There really is no such thing as "safe" sex. The only truly effective way to prevent STDs is abstinence. Sex in the context of a monogamous relationship wherein neither party is infected with a STD also is considered "safe." Most people think that kissing is a safe activity. Unfortunately, syphilis, herpes, and other infections can be contracted through this relatively simple and apparently harmless act. All other forms of sexual contact carry some risk. Condoms are commonly thought to protect against STDs. Condoms are useful in decreasing the spread of certain infections, such as chlamydia and gonorrhea; however, they do not fully protect against other infections such as genital herpes, genital warts, syphilis, and HIV. Prevention of the spread of STDs is dependent upon the counseling of at-risk individuals and the early diagnosis and treatment of infections.
What is genital herpes?
Genital herpes, also commonly called "herpes," is a viral infection by the herpes simplex virus (HSV) that is transmitted through intimate contact with the mucous-covered linings of the mouth or the vagina or the genital skin. The virus enters the linings or skin through microscopic tears. Once inside, the virus travels to the nerve roots near the spinal cord and settles there permanently.
When an infected person has a herpes outbreak, the virus travels down the nerve fibers to the site of the original infection. When it reaches the skin, the typical redness and blisters occur. After the initial outbreak, subsequent outbreaks tend to be sporadic. They may occur weekly or even years apart.
Two types of herpes viruses are associated with genital lesions: herpes simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2). HSV-1 more often causes blisters of the mouth area while HSV-2 more often causes genital sores or lesions in the area around the anus. The outbreak of herpes is closely related to the functioning of the immune system. Women who have suppressed immune systems, because of stress, infection, or medications, have more frequent and longer-lasting outbreaks.
The U.S. Centers for Disease Control and Prevention (CDC) estimate that at least 45 million persons in the United States are infected with genital HSV. Genital herpes is spread only by direct person-to-person contact. The majority of people infected with viruses that cause genital herpes may not be aware of their infection, and those infected may have few or no symptoms. In many women, there are "atypical" outbreaks where the only symptom may be mild itching or minimal discomfort. Moreover, the longer the woman has had the virus, the fewer the symptoms they have with their outbreaks. Finally, the virus can shed from the cervix into the vagina in women who are not experiencing any symptoms. Men who do not have symptoms and who may not know they have been infected with the virus can also shed virus and can also infect others.
It is important to remember that herpes can be spread by individuals who do not have recognizable signs or symptoms of the infection and who may not know they are infected.
What are the symptoms of genital herpes?
Once exposed to the virus, there is an incubation period that generally lasts 3 to 7 days before a lesion develops. During this time, there are no symptoms and the virus cannot be transmitted to others. An outbreak usually begins within two weeks of initial infection and manifests as an itching or tingling sensation followed by redness of the skin. Finally, a blister forms. The blisters and subsequent ulcers that form when the blisters break, are usually very painful to touch and may last from 7 days to 2 weeks. The infection is definitely contagious from the time of itching to the time of complete healing of the ulcer, usually within 2-4 weeks. However, as noted above, infected individuals can also transmit the virus to their sex partners in the absence of a recognized outbreak.
How are genital herpes diagnosed?
Genital herpes is suspected when multiple painful blisters occur in a sexually exposed area. During the initial outbreak, fluid from the blisters may be sent to the laboratory to try and culture the virus, but cultures only return a positive result in about 50% of those infected In other words, a negative test result from a blister is not as helpful as a positive test result, because the test may be a false-negative test. However, if a sample of a fluid-filled blister (in the early stage before it dries up and crusts) tests positive for herpes, the test result is very reliable. Cultures taken during an initial outbreak of the condition are more likely to be positive for the presence of HSV than cultures from subsequent outbreaks.
There are also blood tests that can detect antibodies to the herpes viruses that can be useful in some situations. These tests are specific for HSV-1 or HSV-2 and are able to demonstrate that a person has been infected at some point in time with the virus, and they may be useful in identifying infection that does not produce characteristic symptoms. However, because false-positive results can occur and because the test results are not always clear-cut, they are not recommended for routine use in screening low-risk populations for HSV infection.
Other diagnostic tests such as polymerase chain reaction (PCR) to identify the genetic material of the virus and rapid fluorescent antibody screening tests are used to identify HSV in some laboratories.
What is the treatment for genital herpes?
Although there is no known cure for herpes, there are treatments for the outbreaks. There are oral medications, such as acyclovir (Zovirax), famciclovir (Famvir), or valacyclovir (Valtrex) that prevent the virus from multiplying and even shorten the length of the eruption. Although topical (applied directly on the lesions) agents exist, they are generally less effective than other medications and are not routinely used. Medication that is taken by mouth, or in severe cases intravenously, is more effective. It is important to remember that there is still no cure for genital herpes and that these treatments only reduce the severity and duration of outbreaks.
Since the initial infection with HSV tends to be the most severe episode, an antiviral medication usually is warranted. These medications can significantly reduce pain and decrease the length of time until the sores heal, but treatment of the first infection does not appear to reduce the frequency of recurrent episodes.
In contrast to a new outbreak of genital herpes, recurrent herpes episodes tend to be mild, and the benefit of antiviral medications is only derived if therapy is started immediately prior to the outbreak or within the first 24 hours of the outbreak. Thus, the antiviral drug must be provided for the patient in advance. The patient is instructed to begin treatment as soon as the familiar pre-outbreak "tingling" sensation occurs or at the very onset of blister formation.
Finally, suppressive therapy with antiviral drugs may be given to decrease the number of outbreaks and reduce viral shedding, thereby reducing the possibility of spread to other persons.
| First Episode (Treat 7-10 days) | Recurrent Infection (Treat 3-5 days) | Suppressive Therapy | |
| acylovir (Zovirax) | 400 mg 3 times/day or 200 mg 5 times/day | 400 mg 3 times/day or 800 mg 3 times daily for 2 days | 400 mg twice/day |
| famciclovir (Famvir) | 250 mg 3 times/day | 125 mg twice/day | 250 mg twice/day |
| valacyclovir (Valtrex) | 1000 mg twice/day | 500 mg twice/day | 500 mg once/day (may be given twice daily or 1000 mg once/day in persons with 10 or more outbreaks/year) |
Herpes can be spread from one part of the body to another during an outbreak. Therefore, it is important not to touch the eyes or mouth after touching the blisters or ulcers. Thorough hand washing is a must during outbreaks. Clothing that comes in contact with ulcers should not be shared with others. Couples that want to minimize the risk of transmission should always use condoms if a partner is infected. Unfortunately, even when an infected partner isn't currently having an outbreak, herpes can be spread to another person. Couples may also want to consider avoiding all sexual contact, including kissing, during an outbreak of herpes.
Pregnancy is another special situation in regards to herpes infection. Since an active genital herpes outbreak (with blisters) during labor and delivery can be harmful to the infant, pregnant women who suspect that they have genital herpes should tell their doctor. Women who have herpes and are pregnant can have a vaginal delivery as long as they are not experiencing symptoms or actually having an outbreak while in labor.
Genital Herpes At A Glance
- There is no "safe" sex.
- Condoms do not necessarily prevent sexually transmitted diseases.
- Genital herpes is a viral infection that can cause painful genital sores and causes recurrent outbreaks.
- Many people are infected with herpes virus and are now aware of the infection.
- The herpes virus is spread by direct person-to-person contact.
- An infected person may transmit the virus to others even if no symptoms are present.
- There is no cure for genital herpes, but viral shedding and outbreaks can be reduced with antiviral medications.
Genital Herpes In Women Glossary of Terms
Abstinence: The voluntary self-denial of food, drink, or sex. Today, abstinence most commonly refers to denial of one's sexual activity.
Acyclovir : (Brand name: Zovirax) One of a group of antiviral drugs that acts against the herpes viruses, including:
- Herpes simplex 1 which causes cold sores
- Herpes simplex 2 which causes genital herpes
- Varicella-zoster which causes both chickenpox and shingles
- Epstein-Barr virus which causes infectious mononucleosis
Antibody: An immunoglobulin, a specialized immune protein , produced because of the introduction of an antigen into the body, and which possesses the remarkable ability to combine with the very antigen that triggered its production.
Antiviral: An agent that kills a virus or that suppresses its ability to replicate and, hence, inhibits its capability to multiply and reproduce.
Anus: The opening of the rectum to the outside of the body.
Atypical: Not typical, not usual, not normal, abnormal. Atypical is often used to refer to the appearance of precancerous or cancerous cells.
Blister: A collection of fluid underneath the top layer of skin (epidermis). One that is more than 5 mm in diameter with thin walls and is full of watery fluid is called a bulla or a bleb. There are many causes of blisters including burns , vesicant agents, friction forces, and diseases of the skin.
Blood: The familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system. Blood functions in two directions: arterial and venous. Arterial blood is the means by which oxygen and nutrients are transported to tissues while venous blood is the means by which carbon dioxide and metabolic by-products are transported to the lungs and kidneys, respectively, for removal from the body.
CDC: The Centers for Disease Control and Prevention , the US agency charged with tracking and investigating public health trends. The stated mission of the CDC is "To promote health and quality of life by preventing and controlling disease, injury, and disability." The CDC is a part of the U.S. Public Health Services (PHS) under the Department of Health and Human Services (HHS).
Centers for Disease Control and Prevention: The US agency charged with tracking and investigating public health trends. The stated mission of the Centers for Disease Control and Prevention, commonly called the CDC, is "To promote health and quality of life by preventing and controlling disease, injury, and disability."
Cervix: The cervix is the lower, narrow part of the uterus (womb). The uterus, a hollow, pear-shaped organ, is located in a woman's lower abdomen, between the bladder and the rectum. The cervix forms a canal that opens into the vagina, which leads to the outside of the body.
Chlamydia: A type of bacteria one species of which causes an infection very similar to gonorrhea in the way that it is spread, the symptoms it produces, and the long-term consequences.
Condition: The term "condition" has a number of biomedical meanings including the following:
- An unhealthy state, such as in "this is a progressive condition."
- A state of fitness, such as "getting into condition."
- Something that is essential to the occurrence of something else; essentially a "precondition."
- As a verb: to cause a change in something so that a response that was previously associated with a certain stimulus becomes associated with another stimulus; to condition a person, as in behavioral conditioning.
Contrast: Short for "contrast media." Contrast media are X-ray dyes used to provide contrast, for example, between blood vessels and other tissue.
Cure: 1. To heal, to make well, to restore to good health. Cures are easy to claim and, all too often, difficult to confirm.
2. A time without recurrence of a disease so that the risk of recurrence is small, as in the 5-year cure rate for malignant melanoma .
3. Particularly in the past, a course of treatment. For example, take a cure at a spa.
Diagnosis: 1 The nature of a disease ; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies . 3 The identification of any problem. The diagnosis was a plugged IV.
Genetic: Having to do with genes and genetic information.
Genital: Pertaining to the external and internal organs of reproduction. (Not to be confused with genetic.)
Genital herpes: A viral infection transmitted through intimate contact with the moist mucous linings of the genitals. This contact can involve the mouth, the vagina or the genital skin. The herpes simplex type 2 (HSV-2) enters the mucous membranes through microscopic tears. Once inside the body, HSV-2 travels to nerve roots near the spinal cord and settles there permanently. When an infected person has a herpes outbreak, the virus travels down the nerve fibers to the site of the original infection and when it reaches the skin, the classic redness and blisters occur.
Gonorrhea: A sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoea. Although gonorrhea is known primarily as a sexually transmitted infection (STI), it is not exclusively so, but can also be transmitted to the newborn during the birthing process.
Hepatitis: Inflammation of the liver from any cause.
Hepatitis B: Inflammation of the liver due to the hepatitis B virus (HBV), once thought to be passed only through blood products. It is now known that hepatitis B can also be transmitted via needle sticks, body piercing and tattooing using un sterilized instruments, the dialysis process, sexual and even less intimate close contact, and childbirth. Symptoms include fatigue, jaundice , nausea, vomiting, dark urine, light stools. Diagnosis is by blood test. Treatment is via anti-viral drugs and/or hepatitis B immunoglobulin (HBIG).
Herpes: A family of viruses. Herpes also refers to infection with one of the human herpesviruses, especially herpes simplex types 1 and 2.
HIV: Acronym for the Human Immunodeficiency Virus , the cause of AIDS (acquired immunodeficiency syndrome). HIV has also been called the human lymphotropic virus type III, the lymphadenopathy-associated virus and the lymphadenopathy virus . No matter what name is applied, it is a retrovirus. (A retrovirus has an RNA genome and a reverse transcriptase enzyme. Using the reverse transcriptase , the virus uses its RNA as a template for making complementary DNA which can integrate into the DNA of the host organism).
Human immunodeficiency virus : HIV, the cause of AIDS. HIV has also been called the human lymphotropic virus type III, the lymphadenopathy-associated virus and the lymphadenopathy virus. No matter what name is applied, it is a retrovirus. (A retrovirus has an RNA genome and a reverse transcriptase enzyme. Using the reverse transcriptase, the virus uses its RNA as a template for making complementary DNA which can integrate into the DNA of the host organism). Although the American research Robert Gallo at the National Institutes of Health believed he was the first to find HIV, it is now generally accepted that the French physician Luc Montagnier (1932-) and his team at the Pasteur Institute discovered HIV in 1983- 84.
Immune: Protected against infection. The Latin immunis means free, exempt.
Immune system: A complex system that is responsible for distinguishing us from everything foreign to us, and for protecting us against infections and foreign substances. The immune system works to seek and kill invaders.
Immunodeficiency: Inability to mount a normal immune response. Immunodeficiency can be due to a genetic disease or acquired as in AIDS due to HIV.
Incubation period: In medicine, the time from the moment of exposure to an infectious agent until signs and symptoms of the disease appear. For example, the incubation period of chickenpox is 14-16 days.
Infant: A child up to 2 years (24 months) of age.
Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
Itching: An uncomfortable sensation in the skin that feels as if something is crawling on the skin or in the skin, and makes the person want to scratch the affected area.
Labor: Childbirth, the aptly-named experience of delivering the baby and placenta from the uterus to the vagina to the outside world. There are two stages of labor. During the first stage (called the stage of dilatation), the cervix dilates fully to a diameter of about 10 cm. In the second stage (called the stage of expulsion), the baby moves out through the cervix and vagina to be born.
Laboratory: A place for doing tests and research procedures and preparing chemicals, etc. Although "laboratory" looks very like the Latin "laboratorium" (a place to labor, a work place), the word "laboratory" came from the Latin "elaborare" (to work out, as a problem, and with great pains), as evidenced by the Old English spelling "elaboratory" designating "a place where learned effort was applied to the solution of scientific problems."
Lesion: Pronounced "lee-sion" with the emphasis on the "lee," a lesion can be almost any abnormality involving any tissue or organ due to any disease or any injury.
Medication: 1. A drug or medicine. 2. The administration of a drug or medicine. (Note that "medication" does not have the dangerous double meaning of "drug.")
Microscopic: So small it cannot be seen without the aid of microscope. As opposed to macroscopic (large enough to be seen with naked eye). A tiny tumor is microscopic while a big tumor is macroscopic.
Mouth: 1. The upper opening of the digestive tract, beginning with the lips and containing the teeth, gums, and tongue. Foodstuffs are broken down mechanically in the mouth by chewing and saliva is added as a lubricant. Saliva contains amylase, an enzyme that digests starch. 2. Any opening or aperture in the body. The mouth in both senses of the word is also called the os, the Latin word for an opening, or mouth. The o in os is pronounced as in hope. The genitive form of os is oris from which comes the word oral.
Nerve: A bundle of fibers that uses chemical and electrical signals to transmit sensory and motor information from one body part to another.
Onset: In medicine, the first appearance of the signs or symptoms of an illness as, for example, the onset of rheumatoid arthritis . There is always an onset to a disease but never to the return to good health. The default setting is good health.
Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia . Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
Pregnancy : The state of carrying a developing embryo or fetus within the female body. This condition can be indicated by positive results on an over-the-counter urine test, and confirmed through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. Pregnancy lasts for about nine months, measured from the date of the woman's last menstrual period (LMP). It is conventionally divided into three trimesters, each roughly three months long.
Pregnant: The state of carrying a developing fetus within the body.
Recurrent: Back again. A recurrent fever is a fever that has returned after an intermission: a recrudescent fever.
Sensation: In medicine and physiology , sensation refers to the registration of an incoming ( afferent ) nerve impulse in that part of the brain called the sensorium , which is capable of such perception. Therefore, the awareness of a stimulus as a result of its perception by sensory receptors. (Sensory is here synonymous with sensation.)
Skin: The skin is the body's outer covering. It protects us against heat and light, injury, and infection. It regulates body temperature and stores water, fat, and vitamin D. Weighing about 6 pounds, the skin is the body's largest organ. It is made up of two main layers; the outer epidermis and the inner dermis.
Spinal cord: The major column of nerve tissue that is connected to the brain and lies within the vertebral canal and from which the spinal nerves emerge. Thirty-one pairs of spinal nerves originate in the spinal cord: 8 cervical , 12 thoracic , 5 lumbar, 5 sacral, and 1 coccygeal. The spinal cord and the brain constitute the central nervous system ( CNS ). The spinal cord consists of nerve fibers that transmit impulses to and from the brain. Like the brain, the spinal cord is covered by three connective-tissue envelopes called the meninges . The space between the outer and middle envelopes is filled with cerebrospinal fluid ( CSF ), a clear colorless fluid that cushions the spinal cord against jarring shock. Also known simply as the cord.
Sporadic: Occurring upon occasion or in a scattered, isolated or seemingly random way.
Stage: As regards cancer , the extent of a cancer, especially whether the disease has spread from the original site to other parts of the body. See also: Staging .
STD: Sexually transmitted disease.
Stress: Forces from the outside world impinging on the individual. Stress is a normal part of life that can help us learn and grow. Conversely, stress can cause us significant problems.
Symptom: Any subjective evidence of disease. Anxiety, lower back pain, and fatigue are all symptoms. They are sensations only the patient can perceive. In contrast, a sign is objective evidence of disease. A bloody nose is a sign. It is evident to the patient, doctor, nurse and other observers.
Syphilis: A sexually transmitted disease caused by Treponema pallidum, a microscopic organism called a spirochete. This worm-like, spiral-shaped organism infects people by burrowing into the moist mucous membranes of the mouth or genitals. From there, the spirochete produces a non-painful ulcer known as a chancre. There are three stages of syphilis:
Therapy: The treatment of disease .
Topical: Pertaining to a particular surface area. A topical agent is applied to a certain area of the skin and is intended to affect only the area to which it is applied. Whether its effects are indeed limited to that area depends upon whether the agent stays where it is put or is absorbed into the blood stream.
Ulcer: An area of tissue erosion, for example, of the skin or lining of the gastrointestinal (GI) tract. Due to the erosion, an ulcer is concave. It is always depressed below the level of the surrounding tissue.
Vagina: The muscular canal extending from the cervix to the outside of the body. It is usually six to seven inches in length, and its walls are lined with mucus membrane . It includes two vaultlike structures, the anterior (front) vaginal fornix and the posterior (rear) vaginal fornix . The cervix protrudes slightly into the vagina, and it is through a tiny hole in the cervix (the os) that sperm make their way toward the internal reproductive organs. The vagina also includes numerous tiny glands that make vaginal secretions.
Viral: Of or pertaining to a virus. For example, "My daughter has a viral rash ."
Viral infection: Infection caused by the presence of a virus in the body. Depending on the virus and the person's state of health, various viruses can infect almost any type of body tissue, from the brain to the skin. Viral infections cannot be treated with antibiotics; in fact, in some cases the use of antibiotics makes the infection worse. The vast majority of human viral infections can be effectively fought by the body's own immune system , with a little help in the form of proper diet, hydration, and rest. As for the rest, treatment depends on the type and location of the virus, and may include anti-viral or other drugs.
Virus: A microorganism smaller than a bacteria, which cannot grow or reproduce apart from a living cell. A virus invades living cells and uses their chemical machinery to keep itself alive and to replicate itself. It may reproduce with fidelity or with errors (mutations)-this ability to mutate is responsible for the ability of some viruses to change slightly in each infected person, making treatment more difficult.
Viruses: Small living particles that can infect cells and change how the cells function. Infection with a virus can cause a person to develop symptoms. The disease and symptoms that are caused depend on the type of virus and the type of cells that are infected.
Zovirax: Brand name of Acyclovir.
Via: www.medicinenet.com
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