Sexually Transmitted Diseases are infections that can be contracted during sexual intercourse.
Some STDs are caused by bacteria and others by viruses.
It is always advisable to go to a specialist or gynecologist in case of suspecting an infection that may affect the reproductive system.
On Dra. Gómez Roig Institute we have specialists in gynecology and experts in STDs within our medical services.
STD prevalence
Sexually transmitted diseases ETS, constitute a public health problem worldwide.
According to World Health Organization, the WHO, more than a million people are infected daily.
It is estimated that each year there are more than 340 million new treatable cases in the population between 15 and 49 years of age.
STDs are infections caused by Treponema Pallidum, Neisseria Gonorrhoeae or Gonococcus, Chlamydia Trachomatis, and Trichomonas Vaginalis.
In addition, more than 500 million people have the herpes simplex or genital herpes virus, HSV.
And more than 290 million women are infected with the human papillomavirus, HPV.
In the European Union, there was a progressive decrease in STDs until the 1990s. This was mainly attributed to changes in behavior after the onset of AIDS, HIV.
On the other hand, from 1996 the declared cases of Gonococcus increase.
On the other hand, infections syphilis, chlamydia, genital herpes and genital warts have also increased in recent years.
Currently, the Chlamydia It is the most reported bacterial STD in the whole of Europe.
While, the Trichomoniasis, an infection caused by the parasite Trichomonas vaginallis, is the most common non-viral STD.
STDs can cause Vaginal Infections and vulvae, that is, vulvovaginitis, and even ascend through the female genital tract and cause infections of the uterus and fallopian tubes.
Causes of sexually transmitted diseases
Causes of sexually transmitted diseases include infections by bacteria and sometimes by viruses.
The most common are infections by:
- Chlamydia.
- Gonorrhea or gonococcus.
- Mycoplasma genitalium.
- Genital herpes, also called the herpes simplex virus or HSV.
- Genital warts, also called human papillomavirus or HPV warts.
- Hepatitis A, B and C.
- Syphilis.
- Trichomoniasis or Trichomonas.
- Human immunodeficiency virus, HIV or AIDS.
Many ETS They can be transmitted through any type of sex. HIV and hepatitis can also be transmitted by exposure to bodily fluids.
Who should be examined?
You should be examined and tested to rule out STDs people with risk factors or with symptoms of infection.
It is recommended to perform cytology in the gynecological review to detect HPV-associated cervical cancer.
Women who have had sex without a condom with more than one partner should be tested.
Men and women who have relationships, and do not have a stable partner, or have relationships with more than one partner should be examined periodically.
Anyone who has had sexual intercourse with a person infected with some type of STD should be visited.
Risk groups for sexually transmitted diseases
La Risk Assessment Individual screening for STDs is essential and requires a complete medical history.
Emphasizing: sexual behaviors, previous history of STDs, reproductive history: contraception, pregnancies and protection, drugs and vaccines.
Most vulnerable population
most vulnerable population, and with a greater number of risk factors, varies from one area to another, but we must pay more attention to:
- Risk behaviors: Men who have sex with men, who have multiple sexual partners, and who engage in unprotected anal intercourse. Young people under 25 years of age who are sexually active with different partners. prostitution; sex tourism; drug addicts, prisoners, etc.
- Risk of social exclusion: Refugees, victims of sexual violence, homeless children and youth.
- Pregnant: The importance of infections in this group requires screening in the first trimester protocolized in the pregnancy control. In the first analysis, some of these infections are ruled out.
- AIDS infection, HIV: The relationship between STDs and HIV infection is close and bidirectional. Presence of HIV can modify the clinical presentation of STDs, with a significant impact on severity. STDs increase the risk of coinfection with HIV due to several reasons: on the one hand, due to the risk behaviors that patients usually present and, on the other hand, to the presence of lesions that act as a gateway.
Screenings of the sexually transmitted infections in populations at risk.
These studies include the detection of Chlamydia, Gonococcus and Trichomonas. It is also common to request a screening for HIV, syphilis, hepatitis B virus and also hepatitis C virus to all patients with risk factors.
People who have crabs on the genitals. Crabs or pubic lice are spread through sexual contact.
People with STDs are more likely to get crabs.
At the same time, the virus of the hepatitis A in men who have sex with men or patients with risk practices for this infection.
On the other hand, it is essential to highlight the importance of human papillomavirus screening, HPV, due to its role in the prevention of cervical cancer.
What symptoms can I have
In general, you should watch out for any type of genital itching, burning, sores, or discharge. Keep in mind that many ETS They do not cause any symptoms.
If you have a sexually transmitted disease, you will need treatment which may include antibiotics or medicines called antivirals.
Treatment will cure the infection or prevent it from getting worse. It will also reduce the chances of infecting others.
Genital yeast infection or vulvovaginal candida, which also itch the vagina or vulva, is not considered an STD.
Prevention of Sexually Transmitted Diseases
Historically, the AIDS epidemic, HIV, worldwide gave the alert of the magnitude of the problem and the need for sexual education as the beginning of correct prevention.
Due to AIDS, the recommendations were proposed SPC What do they mean: abstinence; be faithful, which refers to the monogamy as a protective factor and condom condom.
Over time, the advice has been renewed in order to optimize the prevention of different STDs.
In this context, it is necessary to address the sex education as the main measure and target young people, in order to ensure good prevention.
Prevention measures can be aimed at primary prevention, secondary or tertiary prevention.
types of prevention
When it comes to the prevention of any disease, we talk about:
- Primary prevention: Prevents the acquisition of the disease through vaccination, elimination and control of risk factors, health education, etc.
- secondary prevention: Aimed at detecting the disease in the initial stages in which the treatment may imply the cure or progression of the disease.
- Tertiary prevention: Includes measures aimed at the treatment and rehabilitation of a disease to slow down its progression and, with it, the appearance of complications, trying to improve the quality of life.
In sexually transmitted diseases, STDs, the most important prevention is primary since some of these diseases are incurable.
Similarly, the importance of secondary prevention is not negligible because in the case of human papilloma virus,HPV.
Its screening by cytology plays an important role in the prevention of malignant disease of the cervix.
Primary prevention
Many Public Health Programs and initiatives to inform how you can avoid contracting an STD.
- Vaccination
- Hepatitis B virus vaccine, HBV: Since 1982, a vaccine against HBV has been available, with an efficacy of 95%. In 1993, it was added to the vaccination schedule for adolescents and in 2005, for newborns of pregnant women who are infected.
- Hepatitis A virus vaccine, VHA: It is recommended in people with risk practices. Especially in men who have sex with men and sex tourism.
- Human Papillomavirus Vaccine, HPV: It is included in the vaccination calendar since 2007. There are three vaccines. All three protect against infection by the most common cancer subtypes of the HPV, 16 and 18, and are authorized in Spain from the age of 9. Currently in Catalonia, vaccination is carried out in girls from 11 to 12 years of age and recommended in boys, but not financed. It is also recommended in cases of conization due to cervical pathology, in men who have sex with men, promiscuity or HIV infection.
- barrier methods
There is sufficient evidence that condoms, when used correctly and consistently, effectively protect against the transmission of AIDS. They also reduce the transmission of many other STDs: syphilis, chlamydia, gonococcus, etc.
Although the female condom It is effective and safe, presenting greater prevention against HPV than the male one. It has not reached its full potential in prevention programs because its cost is relatively high.
Trials are underway to assess the effectiveness of diaphragms in protecting the cervix against infection by AIDS and other STDs.
Secondary and tertiary prevention
secondary and tertiary prevention they should aim to offer effective interventions for people with STDs to prevent new infections and also long-term complications.
To offer this prevention it is essential to detect the infected people and perform optimal screening according to:
- History of known disease.
- Effective treatment in the pre-symptomatic stage.
- Simple, fast, minimally invasive, cost-effective and good performance test.
- Well-informed population where the disease is prevalent.
La epidemiological surveillance of sexually transmitted infections in Catalonia uses compulsory notification systems.
In Public Health, one of the main reasons for considering a notifiable disease. It is the possibility of having prevention measures to reduce transmission to contacts.
Contact study is the process by which sexual partners of a patient diagnosed with an STD are identified and informed of their exposure.
Is offered care and treatment to sexual partners, with clear clinical benefits: avoid reinfection of the initial case.
Diagnose and treat generally asymptomatic infected partners. Break the chain of transmission of sexually transmitted infection at the population level.
It is essential to carry out the study as soon as possible and take into account diagnostic tests to rule out other sexually transmitted diseases.
Chlamydia
La infection by Chlamydia, Chlamydia trachomatis, has become the most frequently diagnosed bacterial STD in the West in the last two decades, mainly in developed countries.
According to the surveillance report of the ECDC: European Center for Disease Prevention and Control, this infection is the most declared disease in the European Union.
In 2016, an incidence of 185 cases per 100.000 inhabitants was estimated.
Continuing the upward trend.
This fact is largely explained by the implementation of screening programs. In addition to improving the diagnostic methods and surveillance systems.
In Catalonia, the overall rate of Chlamydia it has increased from 9,5 cases per 100.000 inhabitants in 2011 to 55 cases in 2016, being twice as high in women as in men.
El incubation period is between 2 and 6 weeks, so the infection can be transmitted during the asymptomatic period.
As complications, Chlamydia can produce gynecological pathology such as pelvic inflammatory disease, which has implications for the female fertility.
Its detection is recommended in:
– Women with leucorrhoea, whose treatment has failed.
– Women with abnormal flow postpartum or after an abortion.
– Abnormal vaginal discharge with an intrauterine device, IUD, 3 weeks.
– Pregnant women aged 25 or under 25.
– Suspected pelvic inflammatory disease.
gonococcus
La infection by gonococcus, Neisseria Gonorrhoeae, is one of the most prevalent bacterial sexually transmitted diseases along with Chlamydia.
In fact, its incidence has been increasing in recent years.
As of 2010, according to European Center for Disease Prevention and Control. A total of 12,6 cases per 100.000 inhabitants are described in 2011.
La gonococcal infection It is more prevalent in men, especially homosexuals.
In Catalonia, the global rate of gonococcus has increased from 5,3 cases per 100.000 inhabitants in 2007 to 38 cases per 100.000 inhabitants in 2016.
Comparatively, the increase in cases is greater in women than in men.
In addition, there has been a significant increase in incidence in men who have sex with men.
La Gonococcal detection It will be done in the same cases as Chlamydia.
Screening, in female cases, is recommended in:
– Women 25 years of age or younger who are sexually active.
– Risk of contracting STDs, especially with risk of gonorrhea.
– Diagnosed with other sexually transmitted diseases.
– In sexual partners of people infected by Gonococcus.
– Pregnant women at high risk of infection by Neisseria gonorrhoeae in the first trimester, and also in the third trimester if the risk remains high.
Syphilis
infection by Syphilis, Treponema Pallidum, represents the third most declared sexually transmitted disease in the European Union.
Syphilis is characterized by presenting a fluctuating course. With phases of activity separated by periods of latency or rest.
This bacterium can cause serious obstetric complications. In addition to fetal implications for congenital syphilis.
Its incidence has been on a progressive increase over the last ten years, even though effective and economical treatment is available.
The overall rate of syphilis has increased in Catalonia from 2007 to 2016, going from 3,2 per 100.000 inhabitants to 20,6 cases per 100.000.
It has been observed that this increase has been three times higher in men than in women.
The indications for detection and screening of Syphilis in women are recommended in:
– Ulcers or lesions suspicious of Syphilis.
– Sexual partners of people with Syphilis.
– Asymptomatic women at high risk of contracting sexually transmitted diseases.
– Diagnosed with other STDs.
– All pregnant women.
– Recommended in women infected with AIDS, HIV.
Human Papilloma Virus, HPV
La Human Papilloma Virus infectionHPV is the most common sexually transmitted infection worldwide.
A higher incidence occurs in the first years of sexual life in both men and women.
The presence of this virus affects 20-30% of women under 30 years of age.
It is estimated that 80% of sexually active women come into contact with at least one type of HPV at some point in their lives.
In addition, it is important to take into account that 80% of these infections are transient and resolve spontaneously within a year.
The importance of the study of human pigeon virus, HPV, lies in the pathologies that can produce: vulvar and genital warts, or premalignant lesions and also gynecological cancer.
In fact, it is estimated that HPV is involved in 5% of all cancers and in women it accounts for 10% of them: cancer of the cervix, anus, vagina, penis, oropharynx, etc.
Specifically the cervical cancer it is the 2nd most frequent among women between 15 and 44 years of age. Diagnosing about 500.000 cases annually in the world and constituting the 3rd cause of death from cancer.
For this reason, Pap smears are currently recommended for women between 21 and 65 years of age. With the aim of preventing the appearance of cancerous lesions.
The new guidelines propose as an alternative the possibility of detecting HPV in women between 30 and 65 years of age.
Herpes Simplex Virus, HSV
El Herpes Simplex VirusHSV is the most common cause of vulvar ulcer in the sexually active population of developed countries.
There are two types of HSV families: type 1 and type 2.
The transmission type of the two VHS families is different:
- HSV-1: oro-labial transmission.
- HSV-2: sexual and genital route.
Although the route of transmission is often different, both types can cause genital herpes.
In recent years, an increase in infection has been described.
Largely due to sociocultural changes, changes in the sexual practice of adolescents with oro-labial and oro-genital contact. as well as ignorance of diseases sexually transmitted STDs, because they are asymptomatic in some cases.
La World Health Organization, WHO, describes that worldwide there are 417 million people of reproductive age infected with HSV-2 (11%).
In Catalonia, the overall rate of herpes simplex has increased, going from 5 cases per 100.000 inhabitants in 2011 to 11 cases in 2016.
This increase has been double in women than in men.
In the case of HSV-2, it is thought to be due to a greater efficiency of transmission from the male to the woman, and in HSV1, due to the practice of oral sex.
Screening in sexual partners of people with a history of genital herpes is recommended, especially in pregnant women.
In addition, HSV typing is recommended for those presenting with genital herpes for the first time.
Trichomoniasis
La Trichomoniasis It is the most common non-viral STD in the population. It is caused by a parasite called Trichomonas vaginalis.
It is transmitted through sexual intercourse.
And it can affect both men and women.
In women the parasite resides in the genital tract. In men it can be found in the prostate or urethra.
The infection in men is usually asymptomatic, while in women, the infection can be asymptomatic or cause more severe symptoms.
To date, there have also been reported cases of vertical transmission (mother to son).
Untreated trichomoniasis can last from months to years.
In the pregnant women The presence of infection has been linked to premature rupture of membranes, preterm births, and restricted intrauterine growth (IRG).
It seems that infection by trichomonas vaginalis increases the risk of contracting HIV and HPV.
In women with HPV infection it would increase the risk of uterine cancer, and in men of the prostate.
Although Trichomoniasis is little known, it is quite common and could cause serious sequelae. Therefore, if symptoms appear or another STD is suspected, screening should be done in order to prescribe the appropriate treatment.
Human Immunodeficiency Virus (HIV) and AIDS
The human immunodeficiency virus (HIV) is the cause of HIV infection. HIV is a lentivirus of the retrovirus family.
this virus attacks the immune system of the infected person, and if left untreated, it can cause acquired immunodeficiency syndrome (AIDS).
HIV is associated with other sexually transmitted diseases. That is, it is contracted more easily if there are injuries caused by other STDs.
For example, ulcerative lesions caused by syphilis or genital herpes can be a gateway for this virus.
A person infected with HIV You can transmit the infection through blood, precum, semen, vaginal secretions, and breast milk.
There is effective treatment to be able to lead a normal and healthy life and at the same time protect the partners of infected people.
Antiretroviral treatment (ART) is recommended for all people infected with HIV to prevent progression of the disease and reduce transmission of the virus.
There is currently a practice of very dangerous behaviors with HIV-infected people.
There are people today who consciously acquire HIV infection. It is very popular among men who have sex with other men.
The prevention of HIV infection consists of reducing risky practices and the use of condoms.
It is important to continue making the population aware of the seriousness of sexually transmitted diseases.
Today it is recommended do the HIV test to everyone who requests it. Also to women who want to become pregnant, during pregnancy, suspected of risk exposure or if they have suffered an STD infection. Similarly, women who have suffered sexual assault or prostitution.
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Controls and Tests
On Institute of Dra. Gómez Roig we do the controls and tests needed to diagnose STD cases.
If you have discomfort or problems, do not hesitate to consult our team, who will assist you professionally.
It will offer you prevention recommendations and also the most appropriate treatment in case of need.
It is important carry out the checks, contact tracing and adequate treatment of the Sexually transmitted diseases.
Where can you find us
Other entries of interest
Menstrual disorders
Urinary incontinence
Cancer and Precancerous Diseases of the Reproductive Organs
- About the Author
- Last tickets
Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.