Sexually Transmitted Diseases
Sexually Transmitted Diseases (STDs) are a group of diseases that are transmitted through sexual contact. In particular, sexual conduct which causes direct or indirect contact with bodily fluids.Some STDs exhibit a well documented pathology and are symptomatic of this pathology from infection/inception.Others have a peculiar "gender based" symptomology, such as gonorrhea, in which a male pt is able to almost conclusively identify a diagnosis and seek medical attention. The prognosis for a female pt is much more grave. The reasons behind these statistics lead the lay person hearing of them in all their disarray that it is highly unlikely anyone knowsw that is going on.
In female vs male gonorrhea pts, such a disparity of scenarios has been offered as sound, scientific proof that many in the medical community responding in kind with the lay community. Just a few of these rationales are: A. A woman has a shorter urethra than an male, therefore she has less infection; B. Due to, once again, that short urethra, a female is more prone to bladder infections and may misinterpret they symptoms, which are similar; C. Females are supponsed to assume the "higher moral ground" when confronting issues of sexuality and wold therefore be ashamed to admit to having participated in intercourse; D. (which goes hand in hand with C): if a woman were to contract gonorrhea from having an affair, she would be less likely to own up to the fact if she's a "good girl"; and E. unmarried females generally cannot afford health insurance but do not qualify for medical, so they are in the "soup proper" when they get sick with anything and need to see a doctor.
As scientifically weak "old fashioned", politically incorrect and gender-biased as these statements are, sadly there is likely to be a bit of truch in all of them. If for no other reason, it is that statistics don't lie. More women than men die from stds. More women than men have long term disabilities related to initial infectons of SSTDs, and no matter how politically incorrect it may be to say, antepartum deaths and defects related to STDs can, with early recognition and treatment, be remarkably deceased and the women are the ones still getting pregnant and having the babies.
Since sexually transmitted diseases pose a threat during pregnancy, practitioners screen for chlamydia, syphilis, and gonorrhea at the initial visit to the practitioner. The testing for chlamydia and syphilis are done by obtaining a culture from the vagina with a swab during a pelvic exam. Women who have annual vaginal exams will probably have experienced these relatively painless tests. Syphilis is diagnosed with a blood test. If a woman is found to have a sexually transmitted disease she will be treated with antibiotics. Prompt treatment can protect the developing baby from the dangers of infection during birth. Treatment can also reduce the risk of birth defects and prematurity that are associated with some diseases.
If you are considering pregnancy and have a history of a sexually transmitted disease or pelvic inflammatory disease speak to your provider about your plans. PID can cause infertility. While STDs still carrry some stigma within our society it is important to be honest with your provider.
The practitioner may recommend a "wait and see" attitude or the provider may suggest some initial testing to evaluate the health of your uterus and fallopian tubes.
Here is a list of Sexfually Transmitted Diseases which can have an impact on fertility, pregnancy, or childbirth:
Chlamydia, Gonorrhea, Hepatitis, Herpes, HIV/AIDS.
Chlamydia is the leading sexually transmitted disease in the United States with an estimated 4 million new cases occuring annually. More than 10% of sexually active adolescents become infected each year and about 50% of all women between the ages of 18 and 30 have Chlamydia. The bacterial disease is asymptomatic in 75% of women and 50% of men. Yet, without treatment, the disease can cause pelvic inflammatory disease and infertility in women. In fact, about 50% of all cases of PID are attributable to Chlamydia. Chlamydia increases the risk of contracting HIV by three to five-fold. If Chlamydia is present at birth, the new born can get conjunctivitis and/or neonatal pneumonia.
Chlamydia can be diagnosed with a vaginal swab culture.. Results take three days. There is also a new, rapid , and slightly less accurate diagnostic test. The bacterial infection is treated with antibiotics. In order to avoid reinfection, both sexual partners must be treated. While there are a variety of antibiotics that can be used in the non-pregnant female, erythromycin is the most common choice for pregnant women. As with all antibiotics, it is important to complete the full course of medication. Since chlamydia is frequently asymptomatic, sexually active women should be sure to be tested regularly for infection.
Herpes Simplex Virus (HSV) is an infectious viral disease that is characterized by recurrent episodes of painful blisters which most commonly appear in the vagina. The lesions may also occur in the rectum. HSV is usually caused by sexual contact. Currently, there is no cure for Herpes. There are between 200,000 and 500,000 new cases of Herpes reported annually and as many as 20 million people are already infected. The disease can be contracted from an infected individual through sexual contact, even in the absence of a lesion.
In the presence of active lesions, genital herpes can be transmitted to the newborn during vaginal delivery. In the United States, there are 400-1000 cases of neonatal herpes reported annually. Herpes is a very serious disease. It can cause central nervous system or visceral infection in the newborn. Without treatment, the disease causes death in 65% of infants and impaired development in 90% of surviving babies with nervous system infection.Even with treatment, the prognosis is guarded. The risk of the infant is greatest if the mother has her first infection, called the primary infection, at the time of birth. Reactivation poses less threat to the baby. The prevention of newborn herpes is difficult because 70-80% of all cases occur in women with no history of herpes and no active lesions at the time of birth.
According to the American College of Obstetricians and Gynecologist, women with Herpes can deliver vaginally if there are no visible lesions at the onset of labor. In the presence of HSV lesions, a cesarean is performed to prevent transmissiion to the newborn. Since many women may not know that they have the disease, the College also recommends that all pregnant women with active lesions be tested for HSV. Women with Herpes do not require weekly surveillance cultures during pregnancy in the absence of active lesions. In fact, routine cultures in the absence of lesions have been found to be ineffective. Likewise, even though 70-80% of infants with neonatal herpes are born to women with no history or lesions at the time of delivery, screening of all women would not be an effective diagnostic tool in the absence of lesions. However, all women with a history of herpes should report this history to their health care provider.
Syphilis is a sexually transmitted disease which is caused by the spirochete Treponema pallidum. the incidence of both acquired and congenital syphilis has increased dramatically in the United States since 1986. In the absence of effective treatment, syphilis can be transmitted to a fetus or newborn baby. A baby with congenital syphilis suffers from a variety of symptoms and exhibits multi-system organ damage. Syphilis can also cause stillbirths. To reduce the incidence of congential syphilis, all states require that women be tested for syphilis at the beginning of prenatal care. Testing is done from a blood sample. Many practioners will test women who fall into high risk categories, including women with a history of exposure with suspicious lesions, sexually promiscuous women, and women in highest risk groups again at the beginning of the third trimester. In some cases a third test may be done at delivery.