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California State University, Long Beach
Health Resource Center, Student Health Services
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Sexually Transmitted Infections

  • Sexually transmitted infections (STIs) affect more than 12 million men and women in the United States each year. Many are teenagers or young adults.
  • Using drugs or alcohol increases your chances of getting STIs because these substances can interfere with your judgment and your ability to negotiate safe sex.
  • The more sexual partners you have, the higher your chance of being exposed to HIV or other STIs.
  • Many STIs have no symptoms (asymptomatic).

CHLAMYDIA

According to the Centers for Disease Control, there are an estimated 4 million new cases of Chlamydia among adolescents and adults each year. About 75% of women and 50% of men with Chlamydia do not show any symptoms. If left untreated in women, Chlamydia can spread to the upper reproductive tract and may result in serious complications. The infection in women usually begins in the cervix and can spread to the fallopian tubes or ovaries. It may also cause Pelvic Inflammatory Disease, which can scar and block the fallopian tubes. This blocking of the fallopian tubes can result in infertility. In such cases, fertilized eggs may not reach the uterus because of tubal blockage, causing an ectopic pregnancy, the fertilization of eggs and development in the tubes. Infertility in men can also be a problem, with more than 250,000 cases diagnosed annually. This condition is called epididymitis, which happens when Chlamydia spreads from the urethra to the testicles. When symptoms do occur, they can show in as little as 5 to 10 days after infection.

Symptoms

bleeding between menstrual periods vaginal bleeding after intercourse abdominal pain pain during intercourse low grade fever painful urination

Testing and Treatment

Men and women can be tested for Chlamydia using a simple urine test. Swabbing the urethra, anus, vagina and throat are also common testing methods. Chlamydia can be cured with antibiotics. Make sure that all antibiotics are taken correctly as directed by your medical provider. Tell your sex partner(s) so that they can be tested and treated as well. Otherwise you risk getting re-infected.

HUMAN PAPILLOMA VIRUS

Approximately 40 types of human papilloma virus (HPV) are sexually transmitted. Most genital HPV infections do not cause warts and are asymptomatic, meaning they don't show any symptoms. Genital HPV can be transmitted through vaginal, anal or oral sex with an infected person. It is spread through skin to skin contact, through any open tears and abrasions during sexual activity. Genital warts are considered low risk for cancers.

HPV that affects mucus membranes can be low risk or high risk for certain cancers. Some of the cancers that HPV are associated with are cervical, vaginal, vulvar, penile, rectal, anal and oral. Having HPV does not mean that you will die from cancer.

Symptoms

Usually Genital Warts can be seen and felt in the outer genitalia, but can grow inside the anus, vagina, urethra, cervix, or throat, making detection more difficult. They are usually small, soft, flesh-colored, and cauliflower-like growths that may be found by themselves or in clusters. They are usually painless, but can cause itching and irritation. HPV affecting mucus membranes often causes no symptoms, except for lesions that are not easily seen by the naked eye.

Testing

There is no FDA-approved test for men at this time. Women can be diagnosed with HPV on the cervix if they are having Pap tests. If the test result is abnormal, this is often due to HPV. Further testing is necessary to determine if the patient has high risk types of HPV. If it is high risk HPV, then she will then have another procedure conducted called a colposcopy. During the colposcopy, a small amount of tissue is collected for more lab tests.

Genital warts can only be visually diagnosed by a medical provider when there are apparent symptoms.

Treatment

Genital warts are usually treated by freezing them off with liquid nitrogen or a cream will be prescribed for application by the patient.

There are several treatments for HPV that affects the cervix. Cryotherapy involves freezing the cervix with liquid nitrogen allowing the cells to slough off and leave behind new mucus membrane. A Loop Endocervical Excision Procedure (LEEP) involves the removal of a small amount of tissue from the end of the cervix using a tool. Both of these procedures can be conducted in outpatient settings.

GONORRHEA

Gonorrhea is caused by gonococcus, a bacterium that grows and multiplies quickly in moist and warm areas of the body such as the cervix, urethra, mouth, or rectum. This STI can be passed from during sexual activity (vaginal, oral, or anal intercourse) leading to infections of the cervix, vagina, and urethra. If gonorrhea is left untreated in men, it can spread to the reproductive tract, causing prostatitis (prostate inflammation) and epididymo-orchitis (inflammation of the epididymis and testes). For women, untreated gonorrhea can lead to serious complications such as pelvic inflammatory disease (PID).

Symptoms

The early symptoms of gonorrhea are often mild, and most women who are infected have no symptoms of the disease. If symptoms of gonorrhea develop, they usually appear within 2 to 10 days after sexual contact with an infected partner, although a small percentage of patients may be infected for several months without showing symptoms.

Male symptoms include: Discharge from the urethra, redness of the urethra, frequent urination, pain or burning during urination.

Symptoms for women include: abnormal vaginal discharge, burning sensation during urination, more advanced progression PID may develop, including abdominal pain, bleeding between menstrual period, vomiting, and fever, and bleeding between periods.

Testing and Treatment

You can be tested for gonorrhea using a urine sample or the swab method. Gonorrhea is curable with antibiotics. Often two antibiotics are prescribed in order to ensure that the infection is completely healed.

HEPATITIS B

The Hepatitis B virus (HBV) was originally recognized as the source of hepatitis caused by contaminated blood transfusions. Exposure to any bodily fluids -- especially semen and saliva -- can transmit the virus. In the U.S., HBV is typically spread during sexual activity, as well as through needle sharing among intravenous drug users.

HBV infection can show no symptoms, or it can result in acute hepatitis or chronic hepatitis. In addition, some people can become chronic "carriers" of HBV without ever developing hepatitis. This latter group, which includes over 200 million people worldwide, does not have signs and symptoms of hepatitis. However, they serve as walking reservoirs of hepatitis infection and can pass HBV to others.

Symptoms

  • First stage of Hepatitis (acute): nausea, vomiting, stomach pain, headache and fever
  • Second Stage of Hepatitis (chronic): swelling of lymph nodes "swollen glands", liver damage, yellowing of eyes and skin (jaundice)
  • Other symptoms may include: vomiting blood, dark and bloody stool, weight loss, abdominal pain, and sleep disturbance

Prevention of Sexual Transmission of HBV

Immunization

Immunization programs are expected to have a significant effect on lowering the number of HBV infections in the next decade. Young people who are immunized now will be protected from HBV infection during adolescent and young adulthood.

SYPHILIS

Syphilis is a sexually transmitted or congenital infection caused by the bacterium Treponema pallidum, which enters through broken skin or mucous membranes. Transmission is most often caused by sexual contact, but can also be transferred to the fetus via the placenta after the tenth week of pregnancy. Syphilis has three stages of symptoms.

Primary Symptoms (usually start about 21 days after being infected)

painless sores on genitals, rectum, mouth, or fingers enlarged lymph nodes in the area containing the sores sores heal in 3-6 weeks

Secondary symptoms (may show up as chancre or sores are healing and up to several weeks later)

skin rash, extensive lymph node enlargement, mucous patches (painless silvery ulcerations of mucous membranes), headache, aches and pains in bones, loss of appetite, fever and fatigue

Latent symptoms (Tertiary stage) begins when primary and secondary stage are complete

tumors of skin, bones, or liver cardiovascular syphilis, which affects the aorta causing aneurysms or valvular disease, central nervous system disorders, blindness, and/or dementia

Testing and Treatment

Testing for syphilis is done with a blood sample. Syphilis can be cured with antibiotics. If damage has already been done to the body, this cannot be reversed.

PREVENTION OF STIs

It is obvious to most people that the best way to avoid STIs is to not have sex. However, if you are sexually active here are some prevention tips.

  • Use a condom every time you have sex with all of your sex partners from start to finish.
  • Use water based lubricants. Oil based lubricants can cause the condom to tear.
  • Talk to your partners about STIs, HIV, safer sex and pregnancy prevention BEFORE you have sex.
  • Avoid using words like “clean” when you talk about STIs or STI testing. Simply state the question “Have you ever been tested for an STI or HIV?” If you have been tested and your results were negative, then tell your partner “I was tested last month and my results were negative.”
  • Communicate with your sex partner about your needs and boundaries.
  • Talk about what you like and what you don’t like to do. If your partner does not respect your wishes, this partner does NOT respect you! You deserve to be respected!
  • Develop trust in your relationship.
  • Even if a partner looks good, that doesn’t mean they are STI and HIV negative.
  • Go get yourself tested! There are plenty of free or low cost testing clinics available.
  • You should test at least once a year if you are having sex with new partners, sometimes you may have to test more often. Your medical provider can advise how often is necessary.

References

Centers for Disease Control (2010). Sexually Transmitted Diseases. Retreived from http://www.cdc.gov/std/

Mayo Clinic. (2010). STD Prevention. Retrieved from http://www.mayoclinic.com/health/sexual-health/MY01464/DSECTION=std-prevention