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Sexually transmitted infections

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What are sexually transmitted infections?

Sexually transmitted infections (STIs) are bacteria, viruses, fungi or parasites that may cause people to experience various symptoms and complaints.

Most STIs damage, above all, human genitals. In the event of oral sex, infectious agents may also spread in the pharynx. Some STIs however, like HIV, hepatitis B and syphilis, may damage the entire body.

Since STIs often go without any symptoms, you should definitely go see your doctor if you have even the slightest of doubts.

Ways how STIs are transmitted

  • STIs usually spread during unprotected sex.
  • Infections through open wounds and sores also spread in skin-to-skin contact.
  • Exposure to blood, like by sharing syringes, is the way how HIV and hepatitis C are transmitted.
  • Most STIs may be transmitted from mother to child during pregnancy and delivery, and consequently harm the newborn. For instance, a sick mother may infect her newborn child with gonorrhoeal conjunctivitis that may cause blindness of the child without prophylaxis. In Estonia, pregnant women are tested for syphilis, HIV and hepatitis B and, where necessary, other STIs. If you are pregnant, be sure to tell your doctor if you or your partner have any complaints or if you have had unprotected sex. If needed, analyses can be arranged and also treatment to protect your health and your baby’s health.
  • Scabies and pubic lice spread through intimate physical contact and bedding.

How can you protect yourself from STIs?

The best protection against sexually transmitted infections is provided by the use of protection during sexual contact. Practise safe sex and don’t allow your partner’s sperm, blood or vaginal fluid end up in your body. The less sex partners you have, the lower the risk of getting infected. Some STIs can be prevented by vaccination.

How to find out whether you have any STIs?

You cannot rely on images or descriptions to determine whether you have an STI or whether your partner has one because the symptoms may vary greatly from person to person or you may experience none at all. For some STIs the symptoms come and go. This does not mean that the infection has regressed.

If you are experiencing any of the below symptoms, go and see a doctor (general practitioner, gynaecologist, andrologist, dermatovenerologist). Testing is the only sure way to know whether you have been infected.

STIs often go without any symptoms at all but even in that case the infection may be transmitted to the partner. Many STIs can be cured. But you will not be cured without treatment so make an appointment with your general practitioner, gynaecologist, andrologist or dermatovenerologist if you suspect having an STI.

What to do if you are diagnosed with an STI?

If you are diagnosed with an STI, be sure to follow your doctor’s advice and take your prescription drugs as ordered. If you stop your course of treatment, you may not get cured. The infectious agent may become resistant to drugs, which may complicate further treatment. If your doctor asks you to go in for a post-treatment check-up, be sure to go!

Kui sul avastatakse STLI, pead sellest kindlasti teavitama ka oma seksuaalpartnerit, et temagi võiks arsti juurde pöörduda ja ravi saada. Kui sinu partner jääb ravimata, seab see ohtu tema tervise ja võib-olla ka elu. Temaga vahekorras olles võid sa omakorda ise uuesti nakatuda.

Gonorrhoea, also known as the clap

What is it?

It is caused by bacteria called Neisseria gonorrhoea, which causes damage to the mucous membrane of the urethra in men and the mucous membrane of the cervix in women. It may cause damage to the pharynx and the rectum.

How is it manifested and when?

Symptoms:

  • A couple of days up to two weeks after getting infected women may experience ample vaginal discharge and pain when peeing.
  • Men may experience discharge from the penis or pain when peeing.

How is it transmitted?

It is transmitted during unprotected vaginal, anal and oral sex with a partner infected with gonorrhoea.

Gonorrhoea may also be transmitted by asymptomatic people.

What else should you know?

Possible complications if left untreated:
In men: inflammation of the epididymis or prostate.
In women: inflammation of the fallopian tubes, which may lead to infertility.
Getting this disease does not give lifelong immunity, meaning you may get infected over and over again.

Hepatitis B

What is it?

  • It is caused by a highly contagious hepatitis B virus (HBV) which causes inflammation of the liver and may cause chronic liver damage.

How is it manifested and when?

The symptoms appear in 60 to 150 days after becoming infected.

Symptoms: nausea, flu-like symptoms, stomach ache, yellowness of the eyes and skin, dark-coloured urine and light-coloured faeces.

How is it transmitted?

It is transmitted during unprotected vaginal, anal and oral sex and upon exposure to blood (also through shared needles and syringes).

How is it treated?

In the acute phase of the disease only the symptoms are treated. Various drugs are used to treat chronic hepatitis B. The hepatitis B virus cannot be cured; it disappears from the system on its own for most people, but not for all.

What else should you know?

There is a vaccine for hepatitis B!

As of 2003, all newborns were vaccinated in Estonia under the national immunisation schedule. As of 2018, children are vaccinated at the age of 3 months. Before 2003, children were vaccinated at the age of 13 years. It is also possible to get vaccinated at a later age. If you have hepatitis B, your regular partner must definitely get vaccinated.

Herpes

What is it?

It is caused by the Herpes simplex virus (HSV). Being infected with the herpes virus may lead to blisters on the site of infection.

The most common form of herpes is the cold sore that develops on the lips or the mucous membrane in the mouth. If small blisters caused by the herpes virus appear on or around genitals, it is called genital herpes.

How is it manifested and when?

You may get blisters in or around your vagina or anus, likewise on your penis or testicles. You may also have swollen groin lymph nodes and experience pain when peeing. The first time you may also experience flu-like symptoms with a fever. Symptoms may be recurrent. But they are usually milder in next episodes. The symptoms will clear up on their own in a week or two but the virus will persist in your body.

How is it transmitted?

Genital herpes spreads during vaginal, anal and oral sex. Infection may occur upon exposure to:

  • another person’s herpes blisters;
  • the saliva of someone with oral herpes;
  • a person’s skin in an area where there is currently a herpes rash.

How is it treated?

There is no cure for herpes. The existing drugs ease the symptoms, shorten the presence of a rash and may prolong the period between rashes. People who get no rash need no treatment. But since a person carrying the herpes virus may infect their partner even when that person has no visible rash themselves, it is always necessary to use a condom or safety membrane film during sexual contact.

What else should you know?

A pregnant woman with herpes may infect her newborn child during delivery. A woman giving birth should inform her doctors if she has herpes blisters or sores when going into labour.

Chlamydia

What is it?

It is caused by a bacterium called Chlamydia trachomatis, which causes inflammation of the urinary organs and genitals.

How is it manifested and when?

When infected with chlamydia women may notice vaginal discharge, irregular vaginal bleeding (especially after sex) or pain in lower abdomen. Men may experience discharge from the penis or pain when peeing.

How is it transmitted?

It is transmitted during unprotected vaginal, anal and oral sex.

How is it treated?

Chlamydia is treated with antibiotics.

What else should you know?

Possible complications if left untreated:

In men: inflammation of the epididymis or prostate.

In women: may be the cause of infertility or ectopic pregnancy, and a pregnant woman who has chlamydia may infect her newborn child during delivery.

Getting this disease does not give lifelong immunity, meaning you may get infected over and over again.

Mycoplasmosis

What is it?

Mycoplasmosis is caused by a bacterium called Mycoplasma genitalum, which causes inflammation of the genital tract similar to chlamydia.

How is it manifested and when?

Mycoplasma may cause increased discharge, post-sex bleeding and lower abdominal pain in women. Men may notice mucous discharge from the urethra or pain when peeing.

How is it transmitted?

It is transmitted during unprotected vaginal, anal and oral sex.

How is it treated?

Mycoplasma is treated with antibiotics. If mycoplasma is not caught and treated in time, it may cause an inflammatory disease of the lesser pelvis and ectopic pregnancy in women, and infertility in men and in women.

Human papilloma virus (HPV)

What is it?

The human papilloma virus is a virus that causes pale pink skin-coloured papules or wart-like formations in the genital area. These may have different sizes and shapes, quite often resembling cauliflower.

How is it manifested and when?

In both men and women, the papules may cause itching, soreness, discharge, slight bleeding, cracked skin and other inflammatory manifestations, especially in combination with another infection. Usually there are many small skin-coloured papules that may grow and spread. Condylomata may occur weeks, and even years, after infection and they usually don’t clear up on their own.

How is it transmitted?

It is transmitted through sexual contact and in skin-to-skin contact.

How is it treated?

HPV infection cannot be cured. Condylomata however respond to treatment fairly well if treated with special medication. Sometimes other techniques are also called for, such as cryotherapy, hyperthermia, laser treatment. Partners need to be treated if presenting with condylomata.

What else should you know?

Certain strains of the human papilloma virus cause cervical cancer, and on rare occasions they may cause cancer in other sites in both men and women. Getting infected with the common strains of the human papilloma virus and the diseases caused thereby can be prevented with anti-HPV vaccine.

Pubic lice

What are they?

Pubic lice (Phthirus pubis) are grey-brown parasites about 2–3 mm in length who live on pubic hair and reproduce by laying egg.

How are they manifested and when?

Pubic lice cause itching in pubic hair a few days or a couple of weeks after intimate physical contact with someone who has pubic lice.

How are they transmitted?

They are transmitted during vaginal, anal and oral sex, but also through other close physical contact and shared bedding.

How are they treated?

There are anti pubic lice drugs that you can buy from a pharmacy but be sure to strictly follow the instructions. You have to wash all your clothes, linens and towels to destroy the lice and their eggs. Your partner also has to be treated.

What else should you know?

It is best not to share your underwear with other people and to always use clean bedding.

Getting this disease does not give lifelong immunity, meaning you may get infected over and over again.

Scabies

What is it?

The scabies mite causing scabies (Sarcoptes scabiei var Hominis) is a small parasite almost invisible to the naked eye.

How is it manifested and when?

About 2 to 3 weeks after getting infected you will develop a strong itch that usually gets worse before falling asleep at night. The mites are usually found in places with delicate skin: around genitals, on the scrotum, in armpits, between fingers, on the arms, breasts, stomach and thighs.

How is it transmitted?

Infection takes place in direct contact with an infected person and indirectly through bedding and items of clothing.

How is it treated?

A special cream is used for treatment. Be sure to follow the instructions and wash your clothes, linens and towels. Everyone who have come into close contact with an infected person must get treated, regardless of whether or not they have an itch.

What else should you know?

Don’t share your underwear with other people and always use clean bedding.

Getting this disease does not give lifelong immunity, meaning you may get infected over and over again.

Syphilis

What is it?

It is caused by a bacterium called Treponema pallidum. Primary syphilis damages the genitals but if left untreated, it may also cause damage to other organs.

How is it manifested and when?

Usually 2 to 3 weeks, but sometimes as long as 12 to 13 weeks after getting infected you will develop one or more thick, usually painless, pink-red sores or ulcers. After a while the lymph nodes in the area will swell up, which is also painless. The sores and ulcers may heal on their own but the disease will keep progressing.

Some may feel worse than usual, experience tiredness, and so on. These manifestations may clear up on their own and then re-surface.

How is it transmitted?

It is transmitted during unprotected vaginal, anal and oral sex. It may also be transmitted through blood or from an infected mother to her foetus during pregnancy or delivery.

How is it treated?

Syphilis can be treated with a course of antibiotics, but this only applies to primary and secondary syphilis.

What else should you know?

If untreated, possible complications include damage to the central nervous system and the cardiovascular system.
Getting this disease does not give lifelong immunity, meaning you may get infected over and over again.

Trichomoniasis

What is it?

It is caused by a protozoa parasite called Trichomonas vaginalis.

How is it manifested and when?

The trichomoniasis parasite causes inflammation in the mucous membrane of the vagina or urethra.

In women: stinky frothy vaginal discharge that may sometimes contain blood. There may also be genital swelling and soreness.
In men: often there are no symptoms at all, but sometimes men can present with discharge from and pain in the urethra or pain when peeing.

How is it transmitted?

Trichomoniasis is transmitted mainly through sexual contact.

How is it treated?

Trichomoniasis is treated with a course of antibiotics.

What else should you know?

Getting this disease does not give lifelong immunity, meaning you may get infected over and over again.