Sexually Transmitted Diseases STDs Dehong Xu The Hospital

Sexually Transmitted Diseases STDs 性传播疾病 Dehong Xu The Hospital of Fudan University

Sexually transmitted diseases, or STDs, are some of the most common infectious diseases（传染病） in the United States.

There are more than 20 STDs, the most deadly being the HIV virus. Other Sexually transmitted diseases include syphilis ( 梅毒), gonorrhea (淋病), and Chlamydia(衣原体).

Causes of STDs

An infectious disease（传染病） is a disease that can be passed from one person to another. Sexually Transmitted diseases are a category of diseases that are spread via sexual activities, such as vaginal intercourse, oral sex (口交), or anal sex（肛交）.

Sexually transmitted diseases are caused by one of 3 types of organisms. 1. Parasites are very small animals that get nourishment from the person they infect. The infected person is called host(宿主). Pubic lice, also called crabs, are an example of sexually transmitted parasites.

2. Bacteria are organisms made of one cell. They cling together to feed from the body of their host. Gonorrhea (淋病), syphilis (梅毒), Chlamydia (衣原体), and Chancroid (软下疳) are examples of sexually transmitted bacteria.

3. Virus are complex molecules that can multiply (繁殖) when they invade the cell of their host. HIV, herpes(疱 疹), and hepatitis(肝炎) are sexually transmitted viruses.

Usually infections that are caused by a virus cannot be cured, but in some cases they can be controlled.

Parasitic infections can be treated with medications or over-the-counter drugs.

Bacterial infections can be treated with antibiotics.

Sexually transmitted diseases caused by viruses are not curable. TRUE OR FALSE STDs caused by viruses can only be controlled, but not cured.

Common Viral STDs

Three of the most common STDs are caused by viruses are AIDS, genital herpes (生殖器疱疹), and genital wart (生 殖器疣）.

Genital herpes affects about 60 million people in the United States. Herpes simple virus（单 纯疱疹病毒), or HSV, causes herpes infections.

The main sign (体征) of herpes (疱疹) is painful blisters (水 疱) or open sores in the genital area. Before these show up, the person may feel a tingling (刺痛) or burning sensation in the genital region, legs, and buttocks (臀部）.

In women, herpes sores could be hidden inside the vagina. Some women may not even know that they are infected.

This image displays small blisters of a herpes infection (toward the bottom of the picture). Herpes outbreaks often consist of blisters closely spaced together, sometimes with subtle blistering and more redness than fluid.

Patients with herpes simplex of the genitals typically experience early symptoms of itching and/or burning of the skin, and then blisters develop over days, which crust, scab, and resolve in about two weeks. This image displays large erosions and ulcers due to the herpes simplex virus on the penis on an immunocompromised patient.

This image displays blisters and swelling on the labia due to the herpes simplex virus. This image displays a grouping of blisters on the buttocks in a patient with herpes simplex.

Herpes sores usually disappear within 2 to 3 weeks, but the virus remains in the body forever, and the lesions（损害） may come back from time to time.

If the genital herpes lesions are severe or they frequently recur, they can be treated with prescription medications. These medications help control the symptoms, but do not eliminate the herpes virus from the body.

Human papilloma virus (人类乳头状瘤病毒), or HPV, causes genital warts (生殖器疣). This virus is related to the virus that causes common skin wart.

At first, genital warts（生殖器疣） small, hard, and painless bumps（隆起物） in the vaginal area, on the penis（阴茎）, or around the anus（肛门）. If untreated, the warts may grow and develop a fleshy cauliflower-like appearance（肉性菜花样外观）.

Genital warts (condyloma), can appear anywhere in the genital region. This image displays a large, darkened condyloma (wart) on the shaft(杆) of the penis.

This image displays condyloma (genital warts) on the groin（腹股 沟）. This image displays tiny elevations of the skin at the tip of the penis, typical of genital warts (condylomas).

Genital warts (condyloma) can circle the opening of the penis This image displays condyloma acuminatum (anal warts) on the anus and rectum.

In addition to cause genital warts（生殖器疣）, certain HPV viruses can cause cancer of the cervix（宫颈癌） and other genital cancers（生殖器癌）.

There now is a vaccine available to try to prevent HPV infections in women.

Genital warts（生殖器疣） are treated with a topical（局 部的） drug that is applied right on the skin. They can also be treated with cryosurgery（冷冻手术）, which is freezing with a very cold probe（低温探针）.

If warts come back, interferon injection（干扰素注射液） may be given. Interferon(干扰素) is a medication that may help kill the warts by boosting the patient’s immune system and by interfering with the replication of the virus（病毒复 制） inside the human cells.

Large warts（疣） can be removed by surgery.

Common Bacterial STDs

Three of the most common STDs that are caused by bacteria are Chlamydia(衣原体), gonorrhea(淋病), and syphilis(梅毒).

Chlamydia(衣原体属) is caused by bacteria. It is the most common bacterial STD.

In both men and women chlamydial (衣原体) infection cause an abnormal genital discharge（排出物）and burning during urination. If Chlamydia goes untreated in women, it may lead to pelvic inflammatory disease, which can cause a woman to become infertile (不育) or to have ectopic pregnancies(宫外孕). A chlamydial infection of a woman’s cervix

An ectopic pregnancy (宫外孕) is when the fetus attaches itself to the inside of the Fallopian tube (输卵管) instead of uterus (子宫). Since the Fallopian tube (输卵管) does not have room for a full-grown fetus, the tube becomes swollen. This causes severe pain the tube could actually rip apart.

Sometimes ectopic pregnancies have to be determined surgically, which scars the Fallopian tube and decreases the chance of the woman becoming pregnant again. A procedure like this also increase the chance of more ectopic pregnancies.

It is common for people with Chlamydia(衣原体) to have few or no symptoms of infection. Chlamydia(衣原体) can be treated with antibiotics.

Bacteria also cause gonorrhea (淋病). The most common symptoms of gonorrhea are: • discharge from the vagina or penis. • painful or difficult urination.

The most common and serious complications of gonorrhea ( 淋病) occur in women. They include pelvic inflammatory disease (盆腔炎), increase risk of ectopic pregnancies (异 位妊娠), or infertility (不育).

New powerful antibiotics can be used to treat gonorrhea (淋病).

Syphilis (梅毒), like gonorrhea(淋病) and Chlamydia(衣原 体), is also caused by bacteria. 梅毒螺旋体

Syphilis(梅毒) may go undetected at first because the symptoms usually start out very mild and can disappear suddenly. The earliest symptom is a painless, open sore that may appear: • on the penis • around or in the vagina • near the mouth • near the anus, or • on the hands

• On the penis Primary stage syphilis sore (chancre) on glans (head) of the penis.

• around or in the vagina Primary stage syphilis sore (chancre 下疳) inside the vaginal opening

• near the mouth Primary stage syphilis sore (chancre) on the surface of a tongue.

If untreated, syphilis(梅毒) may advance to more serious stages. A temporary rash develops at first, but eventually the heart and central nervous system may become infected. The full course of the disease can take years.

Penicillin is the most effective drug used to treat syphilis (梅毒).

Parasitic STDs

The most common STD that is caused by parasites is called pubic lice, or crabs.

Pubic lice infect pubic hair and live by sucking blood. They are spread through sexual activity but can be passed from clothing or objects, such as toilet seats and bed blankets.

Pubic lice cause the person infected to itch as the lice suck blood. The lice do not produce a rash, but scratching the skin constantly could cause irritation（发炎） as the skin become raw（擦破皮）. In addition, some people have an inflammatory skin reaction to the lice’s bite.

The lice can be seen by naked eye upon close inspection. With a magnifying lens, the eggs can be seen; they are usually attached to the base of pubic hairs.

Pubic lice can be treated and destroyed with one application of a prescription medication or with over-the counter shampoo.

Test Your Knowledge

Which of the following sexually transmitted diseases could attack the brain? • A Syphilis(梅毒) • B Pubic lice • C Genital warts

Which of the following sexually transmitted diseases could damage the Fallopian tube, leading to an increased risk of ectopic pregnancies? • A Chlamydia(衣原体) • B Gonorrhea(淋病) • C A and B

Which of the following sexually transmitted diseases can cause cancer? • A Pubic lice • B AIDS/HIV • C Both A and B

Sexually transmitted diseases can be transferred from a pregnant mother to her baby. TRUE OR FALSE

STDs in pregnant women cause: • Spontaneous abortion • Low birth weight • Premature birth • Permanent neurological damage to newborn.

Symptoms and Diagnosis

If you are at risk of being infected with STDs, you should have regular checkups for STDs, even if you do NOT notice symptoms. These tests can be done during a routine visit to your doctor’s office. This is particularly important when you begin a new sexual relationship.

You should also learn to recognize common symptoms of STDs. Seek medical help immediately if any suspicious symptoms develop, even if they are mild.

These symptoms may include: • • Burning in the genital area Itching in genital area Discharge from the urethra（尿道） or the vagina Sore in genital, anal or oral areas

Signs of STDs may also include: • Warts in the genital or anal areas • Lumps in the genital or anal areas • Foul smell from genital area • Painful bowel movements

If not treated, syphilis(梅毒) could infect the brain and central nervous system causing paralysis（瘫痪） and dementia（痴呆）.

In women, STDs sometimes spread to the pelvis（骨 盆） area and cause pelvic inflammatory diseases（盆 腔炎）, or PID. In addition to pain and infections, PID can also cause scarring of the Fallopian tubes(输卵管) that may result in ectopic pregnancies（宫外孕） or infertility（不孕）.

A pregnant women with STDs can infect her baby. Syphilis(梅毒) and AIDS can be transmitted to the fetus before delivery（分娩）. Gonorrhea(淋病), chlamydia 　 (衣原体), hepatitis B(乙型肝炎), and genital herpes(生 殖器疱疹) can be transmitted to the baby during a vagina delivery（阴道分娩）.

STDs can always be recognized by clear symptoms（症 状）. TRUE OR FALSE Some STDs, such as HIV do not have any early warning Symptoms（症状）.

Since many STDs do not have symptoms（症状） that are easy to recognize, sexual active people should have regular medical checkups.

Many somptoms（症状） like sores（疼痛）, rashes （皮疹）, and discharges（排出物）, come and go. If the symptoms（症状） disappear, it does not mean that the person is cured. Many virus sleep and reattack from time to time. Symptoms　 ＜＝＞　No symptoms

Medical check-up consists of a detail sexual history, as well as a detail medical examination.

The exam includes a through check of the genital area, oral cavity（口腔）, and rectum(直肠). Many STDs can involve the mouth or rectum(直肠), especially when oral or anal sex(口交或肛交) are practiced.

Swabs from open sores or discharges may be taken and tested for various microorganisms

Women will have a pelvic (盆腔的） examination. 　Swabs from inside the vagina and the cervix（子宫） may be taken to check for infection. Swabs from the cervix is similar to a Pap smear (巴氏涂片）. .

If your doctor tells you that you have an STD, you need to let your sexual partner know. This gives them the opportunity to get tested and treated.

If you do not tell your sexual partner, they will be at risk of serious sickness and you will risk being re-infected.

Open communications about STDs is a difficult part of a sexual relationship. However, it is needed to help stop the transmission of these diseases.

Treatment and Prevention

The treatment recommended by the doctor depends on the diagnosed STD. Infecton caused by bacteria and parasites 　 (寄生虫) are usually treated with antibiotics. Syphilis　(梅 毒), gonorrhea(淋病), chlamydia(衣原体), chancroid(�下 疳), and trichomonas(毛滴虫) are treated this way.

STDs caused by viruses usually cannot be cured. Medical treatment aims at keeping them under control, but even that 　 may not be very successful. These diseases include HIV, herpes (疱疹), hepatitis (肝炎), and human Papilloma virus (人�乳�状瘤病毒）.

Crabs (阴虱), or pubic lice (阴虱), can be totally cured. TRUE OR FALSE Crabs, or pubic lice (阴虱) can be totally eliminated with topical medications (局部用� ). Even if treated successful, STDs can recur if no precautions are taken to prevent re-infection.

If you never take part in any kind of sexual activity, there is essentially no risk of getting an STD. However, AIDS or other STDs can be transmitted by sharing IV needles.

If you have only one sexual partner who has had no other sexual partner, there is virtually no risk of getting infected with STDs, as long as you do not engage in non-protected anal sex(肛交).

If you or your sexual partner has sex with many people, you are at risk of being infected with STDs. Your risk of getting an STD is higher when: l there are more sexual partners involved. l illegal drug habits are involved. l you know very little about your partner’s sexual history.

The following are 7 tips that can help prevent STDs: 1. Correctly and consistently use a male condom(避孕套). Condoms are not a 100% guarantee, but they greatly reduce the risk of getting STDs.

2. If, along with a condom(避孕套), you use a lubricant, it should be a non-oil-based lubricant, such as water or K-Y jelly（K-Y凝胶）, oil-based lubricant, such as petroleum jelly (vasline凡士林油) , lotions（护肤液）, or massage or baby oil, should be avoided because they can weaken the condom(避孕套) material.

3. Wash your genital area with soap and water after sex. This may flush parasites(寄生虫), such as pubic lice (阴虱) or other germs.

4 Urinate after sex. This could wash away some germs that have entered urinary tract（尿道）.

5. Avoid having sex during menstruation（月经）. Women who have HIV are more infectious and women who do not have HIV are more susceptible（易受…感染的） to STDs during this time.

6. Avoid douching(冲洗) because it removes most of the normal protective bacteria in the vagina and increases the risk of getting STDs.

7. Avoid anal intercourse（肛交）. If it is preferred, use a male condom(避孕套). The rectum(直肠) and anus（肛门 ） bear a great deal of germs; these germs can cause STDs in both men and women. The mouth, female genitalia, or male genitalia should not be exposed to any object or body part that has been in contact with the anus or rectum(直肠).

STDs are transmitted only during anal intercourse. TRUE OR FALSE STDs are transmitted through vaginal, and oral sex. However, the risk of transmitting STDs is higher with anal sex(肛交). Anal sex often causes bleeding, which makes it easier for germs that travel in blood to get transmitted.

Abstaining from sex (禁欲) is the most effective way to prevent STDs. TRUE OR FALSE Even though it might sometimes be an unpopular choice, not having sex at all is definitely the most effective way to prevent STDs.

Summary

STDs are some of the most common infectious diseases. Not only can they cause sores and foul smelling discharge （气味难闻的排出物）, they can lead to serious complications, such as liver failure（肝功能衰竭）, cancers, neurological problems（神经学问题） and death!

Preventing STDs is possible by following simple sexual hygiene（卫生）. The higher the number of sexual partners you have and the less you know about their sexual and drug habits, the higher your risk of getting an STD is.

Thanks to advance in medicine, most STDs caused by bacteria and parasites(寄生虫) can be cured and their complications（并发症） limited if treated EARLY.

STDs caused by viruses can sometimes be controlled. However, to benefit from treatment, people who have sex with more than one partner should learn to recognize the symptoms（症状） and have regular medical checkups.

Thank you! Questions? Information in this presentation is provided by National Institute of Health. http: //www. nlm. nih. gov/medlineplus/tutorials/sexuallytransmitteddiseases/htm/_no_50_no_0. htm