Sexually Transmitted Diseases

Sexually transmitted diseases (also known as STDs and once called venereal diseases or VD)
are infectious diseases that spread from person to person through intimate contact. STDs can
affect guys and girls of all ages and backgrounds who are having sex — it doesn't matter if
they're rich or poor.

Unfortunately, STDs have become common among teens. Because teens are more at risk for
getting some STDs, it's important to learn what can do to protect themself.

STDs are more than just an embarrassment. They're a serious health problem. If untreated,
some STDs can cause permanent damage, such as infertility (the inability to have a baby) and
even death (in the case of HIV/AIDS).

Transmission of STD

One reason STDs spread is because people think they need to have sexual intercourse to
become infected. That's wrong. A person can get some STDs, like herpes or genital warts,
through skin-to-skin contact with an infected area or sore. Another myth about STDs is that
person can't get them if he have oral or anal sex. That's also wrong because the viruses or
bacteria that cause STDs can enter the body through tiny cuts or tears in the mouth and anus,
as well as the genitals.

STDs also spread easily because patient can't tell whether someone has an infection. In fact,
some people with STDs don't even know that they have them. These people are in danger of
passing an infection on to their sex partners without even realizing it.

Some of the things that increase a person's chances of getting an STD are:

• Sexual activity at a young age. The younger a person starts having sex, the greater
his or her chances of becoming infected with an STD.

• Lots of sex partners. People who have sexual contact — not just intercourse, but
any form of intimate activity — with many different partners are more at risk than
those who stay with the same partner.
 • Unprotected sex. Latex condoms are the only form of birth control that reduce risk
of getting an STD. Spermicides, diaphragms, and other birth control methods may
help prevent pregnancy, but they don't protect a person against STDs.

Prevention and Treatment

As with many other diseases, prevention is the key. It's much easier to prevent STDs than to
treat them. The only way to completely prevent STDs is to abstain from all types of sexual
contact. If someone is going to have sex, the best way to reduce the chance of getting an STD
is by using a condom.

People who are considering having sex should get regular gynecological or male genital
examinations. There are two reasons for this. First, these exams give doctors a chance to
teach people about STDs and protecting themselves. And second, regular exams give doctors
more opportunities to check for STDs while they're still in their earliest, most treatable stage.

In order for these exams and visits to the doctor to be helpful, people need to tell their doctors
if they are thinking about having sex or if they have already started having sex. This is true
for all types of sex — oral, vaginal, and anal.

Not all infections in the genitals are caused by STDs. Sometimes people can get symptoms
that seem very like those of STDs, even though they've never had sex. For girls, a yeast
infection can easily be confused with an STD. Guys may worry about bumps on the penis that
turn out to be pimples or irritated hair follicles.

Chlamydia

It is a sexually transmitted disease (STD) that is caused by bacteria called Chlamydia

trachomatis. Chlamydia is one of the most common STDs. Because there often
aren't any symptoms, though, lots of people can have chlamydia and not know it.

The bacteria can move from one person to another through sexual intercourse, and possibly
through oral-genital contact. If someone touches bodily fluids that contain the bacteria and
then touches his or her eye, a chlamydial eye infection is possible. Chlamydia also can be
passed from a mother to her baby while the baby is being delivered. This can cause
pneumonia and conjuntivitis, which can become very serious for the baby if it's not treated.
Patient can't catch chlamydia from a towel, doorknob, or toilet seat.
Female S & S

It can be difficult for a girl to know whether she has chlamydia because most girls don't have
any symptoms. Chlamydia may cause an unusual vaginal discharge or pain during urination.
Some girls with chlamydia also have pain in their lower abdomens, pain during sexual
intercourse, or bleeding between menstrual periods. Sometimes a chlamydia infection can
cause a mild fever, muscle aches, or headache.

Male S & S

Like a girl, a guy can also have a difficult time telling whether he has chlamydia. Some guys
may have a discharge from the tip of the penis (the urethra — where urine comes out), or
experience itching or burning sensations around the penis. Rarely, the testicles may become
swollen. Many times, a guy with chlamydia may have few or no symptoms, so he might not
even know he has it.

Someone who has contracted chlamydia may see symptoms a week later. In some people, the
symptoms take up to 3 weeks to appear, and many people never develop any symptoms.

Complications

If left untreated in girls, chlamydia can cause an infection of the urethra (where urine comes
out) and inflammation (swelling and soreness caused by the infection) of the cervix. It can
also lead to pelvic inflammatory disease (PID), which is an infection of the uterus, ovaries,
and/or fallopian tubes. PID can cause infertility and ectopic (tubal) pregnancies later in life.

If left untreated in guys, chlamydia can cause inflammation of the urethra and epididymis (the
structure attached to the testicle that helps transport sperm).

Treatment

If patient is diagnosed with chlamydia, the doctor will prescribe antibiotics, which should clear
up the infection in 7 to 10 days. Anyone with whom patient have had sex will also need to be
tested and treated for chlamydia because that person may be infected but not have any
symptoms. This includes any sexual partners in the last 2 months or last sexual partner if it
has been more than 2 months since last sexual experience. It is very important that someone
with a chlamydia infection abstain from having sex until they and their partner have been
treated.

If a sexual partner has chlamydia, quick treatment will reduce his or her risk of complications
and will lower chances of being reinfected if have sex with that partner again.
It's better to prevent chlamydia than to treat it, and the only way to completely prevent the
infection is to abstain from all types of sexual intercourse. If patient have sex, use a latex
condom every time. This is the only birth control method that will help prevent chlamydia.

Genital Herpes

Genital herpes is caused by a virus called herpes simplex (HSV). There are two different types
of herpes virus that cause genital herpes — HSV-1 and HSV-2. Most forms of genital herpes
are HSV-2. But a person with HSV-1 (the type of virus that causes cold sores or fever blisters
around the mouth) can transmit the virus through oral sex to another person's genitals.

It causes herpes sores in the genital area and is transmitted through vaginal, oral, or anal sex,
especially from unprotected sex. Because the virus does not live outside the body for long, it
cannot catch genital herpes from an object, such as a toilet seat.

Symptoms of a Genital Herpes Outbreak

Someone who has been exposed to the genital herpes virus may not be aware of the infection
and may never have an outbreak of sores. However, if a person does have an outbreak, the
symptoms can cause significant discomfort.

Someone with genital herpes may first notice itching or pain, followed by sores that appear a
few hours to a few days later. The sores, which may appear on the vagina, penis, scrotum,
buttocks, or anus, start out as red bumps that soon turn into red, watery blisters. The sores
may make it very painful to urinate. The sores may open up, ooze fluid or bleed, and then
heal within the next 2 to 4 weeks.

The entire genital area may feel very tender or painful, and the person may have flu-like
symptoms including fever, headache, and swollen lymph nodes. If someone has an outbreak
in the future, it will tend to be less severe and shorter in duration, with the sores healing in
about 10 days.

Someone who has been exposed to genital herpes will notice genital itching and/or pain about
2 to 20 days after being infected with the virus. The sores usually appear within days
afterward.

After the herpes blisters disappear, a person may think the virus has gone away — but it's
actually hiding in the body. Both HSV-1 and HSV-2 can stay hidden away in the body until the
next herpes outbreak, when the virus reactivates itself and the painful sores return.
Over time, the herpes virus can reactivate itself again and again, causing discomfort and
episodes of sores each time. Usually a person has about four to five herpes outbreaks each
year — but in some people, the number of outbreaks will lessen over time.

There is no cure for herpes; it will always remain in the body and can always be passed to
another person with any form of unprotected sex. This is the case even if blisters aren't
present on the genitals. Many cases of genital herpes are transmitted when symptoms are not
present.

Genital herpes also increases the risk of HIV infection. This is because HIV can enter the body
more easily whenever there's a break in the skin (such as a sore) during unprotected sexual
contact. In addition, if a pregnant woman with genital herpes has an active infection during
childbirth, the newborn baby is at risk for getting herpes infection. Herpes infection in a
newborn can cause meningitis (an inflammation of the membranes that surround the brain
and spinal cord), seizures, and brain damage.

Prevention

The only surefire way to prevent genital herpes is abstinence. Teens that do have sex must
properly use latex condoms every time they have any form of sexual intercourse (vaginal,
oral, or anal sex). Girls receiving oral sex should have their partners use dental dams as
protection. These sheets of thin latex can be purchased online or from many pharmacies.

If one partner has a herpes outbreak, avoid sex — even with a condom or dental dam — until
all sores have healed. Herpes can be passed sexually even if a partner has no sores or other
signs and symptoms of an outbreak.

Treatment

Right now, there is no cure for genital herpes, but a doctor can prescribe antiviral medication
to help control recurring HSV-2 and clear up the painful sores. The doctor can also tell how to
keep the sores clean and dry and suggest other methods to ease the discomfort when the
virus reappears.

Genital Warts (HPV)

Genital warts are warts that are located near or in the genital areas. In a female, that means
on or near the vulva (the outside genital area), vagina, cervix, or anus. In a male, that means
near or on the penis, scrotum, or anus.
Warts appear as bumps or growths. They can be flat or raised, single or many, small or large.
They tend to be whitish or flesh colored. They are not always easy to see with the naked eye,
and many times a person with genital warts doesn't know that they are there.

Genital warts are caused by a group of viruses called HPV (short for human papillomavirus).
There are more than 100 types of HPV. Some of them cause the regular kind of warts you see
on people's hands and feet — these common warts usually are caused by types of viruses that
are different from those that cause genital warts.

More than 30 types of HPV cause genital warts. Genital warts can be passed from person to
person through intimate sexual contact (vaginal, oral, or anal sex). In some rare cases, genital
warts are transmitted from a mother to her baby during childbirth. You cannot catch genital
warts from a towel, doorknob, or toilet seat.

HPV infections are common in teens and young adults. As many as 1 in 2 people can have
them. The more sexual partners someone has, the more likely it is that the person will get an
HPV infection.

Signs and Symptoms

Most HPV infections have no signs or symptoms. So someone can be infected and pass the
disease on to another person without knowing. However, some people do get visible warts.

People often don't have any symptoms from genital warts — the warts usually do not hurt or
itch, which is one reason why people may not know they have them. Doctors can diagnose
warts by examining the skin closely (sometimes with a magnifying glass) and using a special
solution to make them easier to see. A Pap smear and other tests can help diagnose an HPV
infection.

Experts believe that when a wart is present, the virus is active and more likely to be
contagious. When the wart disappears, the virus is still there but may be less likely to spread.

A person who has been exposed to genital warts may have warts appear any time from
several weeks to several months after exposure. Sometimes warts can take even longer to
appear; the virus can live in the body for a very long time without causing any symptoms.
Because many people who are infected with HPV don't show any symptoms, it's important for
anyone who is having sex to get regular medical checkups.

Complications
Sometimes, if left untreated, genital warts may grow bigger and multiply. Often, they go away
on their own without treatment — but this doesn't mean people can ignore genital warts.
Some types of genital warts are especially worrisome for girls because HPV can cause
problems with the cervix (the opening to the uterus that is located at the top of the vagina)
that may lead to cervical cancer.

Since HPV can have such serious consequences, girls who have had sex should see a
gynecologist, who can test for HPV with a Pap smear.

Prevention

The only surefire way to prevent genital warts is abstinence (the decision not to have sex).
Teens that do have sex can get some protection by properly using latex condoms every time
they have any form of sexual intercourse (vaginal, oral, or anal sex). Condoms may not give
complete protection because the virus can spread from the areas of the genitals not covered
by the condom. Condoms also reduce the risk of other sexually transmitted infections as well
as pregnancy.

Treatment

There is no cure that will get rid of the HPV virus completely. But treatments can reduce the
number of warts — or help them go away faster. When the warts disappear, the HPV virus is
still there, though it may not spread as easily. If the warts are not obviously visible, doctors
can detect the presence of HPV in girls through a Pap smear.

There are a number of different treatments. Depending on where the warts are located, how
big they are, and how many there are, doctor can treat them in several ways. Some genital
warts can be treated by putting special medications on them. If warts are large, the doctor
may carefully "freeze" them off by using a chemical or laser treatment to remove them.

Not all bumps on a person's genitals are warts. Some can be pimples; some can be other
types of infections or growths. An exam by a doctor can help determine what a bump is.

Gonorrhea

It is STD caused by bacteria called Neisseria gonorrhoeae. The bacteria can be passed from
one person to another through vaginal, oral, or anal sex, even when the person who is
infected has no symptoms. It can also be passed from a mother to her baby during birth.
Patient cannot catch gonorrhea from a towel, a doorknob, or a toilet seat.
Female S & S

A girl who has gonorrhea may have no symptoms at all or her symptoms may be so mild that
she doesn't notice them until they become more severe. In some cases, girls will feel a
burning sensation when they urinate, or they will have a yellow-green vaginal discharge. Girls
may also experience vaginal bleeding between menstrual periods.

If the infection becomes more widespread and moves into the uterus or fallopian tubes, it may
result in PID, which can cause abdominal pain, fever, and pain during sexual intercourse, as
well as the symptoms above.

Male S & S

Guys who have gonorrhea are much more likely to notice symptoms, although a guy can have
gonorrhea and not know it. Guys often feel a burning sensation when they urinate, and
yellowish-white discharge may ooze out of the urethra (at the tip of the penis).

Symptoms usually appear 2 to 7 days after a person has been exposed to gonorrhea, and in
girls they may appear even later.

Complications

Gonorrhea can be very dangerous if it is left untreated, even in someone who has mild or no
symptoms. In girls, the infection can move into the uterus, fallopian tubes, and ovaries
(causing PID) and can lead to scarring and infertility (the inability to have a baby). Gonorrhea
infection during pregnancy can cause problems for the newborn baby, including meningitis and
an eye infection that can result in blindness if it is not treated.

In guys, gonorrhea can spread to the epididymis, causing pain and swelling in the testicular
area. This can create scar tissue that might make a guy infertile.

In both guys and girls, untreated gonorrhea can affect other organs and parts of the body
including the throat, eyes, heart, brain, skin, and joints, although this is less common.

Treatment

If patient is diagnosed with gonorrhea, doctor will prescribe antibiotics to treat the infection.
Anyone with who patient have had sex should also be tested and treated for gonorrhea
immediately. This includes any sexual partners in the last 2 months or last sexual partner if it
has been more than 2 months since last sexual experience. If a sexual partner has gonorrhea,
quick treatment will reduce the risk of complications for that person and will lower chances of
being reinfected if have sex with that partner again.

Hepatitis

It is a disease of the liver. It is usually caused by a virus, although it can also be caused by
long-term overuse of alcohol or other toxins (poisons).

Although there are several different types of hepatitis, hepatitis B is a type that can move
from one person to another through blood and other bodily fluids. It can be transmitted
through sexual intercourse and through needles — such as those shared by intravenous drug
or steroid users who have the virus, or tattoo needles that haven't been properly sterilized. A
pregnant woman can also pass hepatitis B to her unborn baby. You cannot catch hepatitis B
from an object, such as a toilet seat.

Symptoms

Someone with hepatitis B may have symptoms similar to those caused by other viral
infections, such as the flu — for example, tiredness, nausea, loss of appetite, mild fever, and
vomiting — as well as abdominal pain or pain underneath the right ribcage where the liver is.

Hepatitis B can also cause jaundice, which is a yellowing of the skin and the whites of the
eyes, and may cause the urine to appear brownish.

Someone who has been exposed to hepatitis B may have symptoms 1 to 4 months later.
Some people with hepatitis B don't notice symptoms until they become quite severe. Some
have few or no symptoms, but even someone who doesn't notice any symptoms can still
transmit the disease to others. Some people carry the virus in their bodies and are contagious
for the rest of their lives.

Complications

Hepatitis B can be very dangerous to a person's health, leading to liver damage and an
increased risk of liver cancer. Of babies born to women who have the hepatitis B virus,
90% will have the virus unless they receive a special immune injection and the first dose of
hepatitis B vaccine at birth.

Prevention
Because hepatitis B can easily be transmitted through blood and most body fluids, it can be
prevented by:

• abstaining from sex (not having oral, vaginal, or anal sex)

• always using latex condoms for all types of sexual intercourse
• avoiding contact with an infected person's blood
• not using intravenous drugs or sharing any drug paraphernalia
• not sharing things like toothbrushes or razors

Tattoo parlors sometimes reuse needles without properly sterilizing them, so be sure to
research and choose tattoo and piercing providers carefully.

To help prevent the spread of hepatitis B, health care professionals wear gloves at all times
when in contact with blood or body fluids, and are usually required to be immunized against
the hepatitis B virus.

There is an immunization (vaccine) against hepatitis B. The immunization is given as a series

of three shots over a 6-month period. Teens who see their health care provider for yearly
exams are also likely to be given the hepatitis B immunization if they haven't had it before.
Immunization programs have been responsible for a significant drop in the number of cases of
hepatitis B among teens over the past 10 years.

Sometimes, if someone has been recently exposed to the hepatitis B virus, a doctor may
recommend a shot of immune globulin containing antibodies against the virus to try to prevent
the person from coming down with the disease. For this reason, it's especially important to see
a doctor quickly after any possible exposure to the virus.

Treatment

If doctor diagnoses hepatitis B, patient may get medicines to help fight it. Sometimes, people
need to be hospitalized for a little while if they are too sick to eat or drink. Most people with
hepatitis B feel better within 6 months.

AIDS

AIDS is one of the most serious, deadly diseases in human history. More than 20 years ago,
doctors in the United States identified the first cases of AIDS in San Francisco and New York.
Now there are an estimated 42 million people living with HIV or AIDS worldwide, and more
than 3 million die every year from AIDS-related illnesses.
AIDS is caused by the human immunodeficiency virus (HIV). HIV destroys a type of
defense cell in the body called a CD4 helper lymphocyte. These lymphocytes are part of the
body's immune system, the defense system that fights infectious diseases. But as HIV
destroys these lymphocytes, people with the virus begin to get serious infections that they
normally wouldn't — that is, they become immune deficient. The name for this condition is
acquired immunodeficiency syndrome (AIDS).

As the medical community learns more about how HIV works, they've been able to develop
drugs to inhibit it (meaning they interfere with its growth). These drugs have been successful
in slowing the progress of the disease, and people with the disease now live much longer. But
there is still no cure for HIV and AIDS.

Hundreds of U.S. teens become infected with HIV each year. HIV can be transmitted from an
infected person to another person through blood, semen (also known as "cum," the fluid
released from the penis when a male ejaculates), vaginal fluids, and breast milk.

The virus is spread through high-risk behaviors including:

• unprotected oral, vaginal, or anal sexual intercourse

• Sharing needles, such as needles used to inject drugs (including needles used for
injecting steroids and those used for tattooing.

People who have another sexually transmitted disease, such as syphilis, genital herpes,
chlamydia, gonorrhea, or bacterial vaginosis are at greater risk for getting HIV during sex with
infected partners.

If a woman with HIV is pregnant, her newborn baby can catch the virus from her before birth,
during the birthing process, or from breastfeeding. If doctors know an expectant mother has
HIV, they can usually prevent the spread of the virus from mother to baby. All pregnant teens
and women should be tested for HIV so they can begin treatment if necessary.

A healthy body is equipped with CD4 helper lymphocyte cells (CD4 cells). These cells help the
immune system function normally and fight off certain kinds of infections. They do this by
acting as messengers to other types of immune system cells, telling them to become active
and fight against an invading germ.

HIV attaches to these CD4 cells, infects them, and uses them as a place to multiply. In doing
so, the virus destroys the ability of the infected cells to do their job in the immune system.
The body then loses the ability to fight many infections.
Because their immune systems are weakened, people who have AIDS are unable to fight off
many infections, particularly tuberculosis and other kinds of otherwise rare infections of the
lung (such as Pneumocystis carinii pneumonia, the surface covering of the brain (meningitis)
or the brain itself. People who have AIDS tend to keep getting sicker, especially if they are not
taking antiviral medications properly.

AIDS can affect every body system. The immune defect caused by having too few CD4 cells
also permits some cancers that are stimulated by viral illness to occur — some people with
AIDS get forms of lymphoma and a rare tumor of blood vessels in the skin called Kaposi's
sarcoma. Because AIDS is fatal, it's important that doctors detect HIV infection as early as
possible so a person can take medication to delay the onset of AIDS.

S&S

Once a person's blood lacks the number of CD4 cells required to fight infections, or the person
has signs of specific illnesses or diseases that occur in people with HIV infection, doctors make
a diagnosis of AIDS.

Severe symptoms of HIV infection and AIDS may not appear for 10 years. And for years
leading up to that, a person may not have symptoms of AIDS. The amount of time it takes for
symptoms of AIDS to appear varies from person to person. Some people may feel and look
healthy for years while they are infected with HIV. It is still possible to infect others with HIV,
even if the person with the virus has absolutely no symptoms. You cannot tell simply by
looking at someone whether he or she is infected.

When a person's immune system is overwhelmed by AIDS, the symptoms can include:

• extreme weakness or fatigue

• rapid weight loss
• frequent fevers that last for several weeks with no explanation
• heavy sweating at night
• swollen lymph glands
• minor infections that cause skin rashes and mouth, genital, and anal sores
• white spots in the mouth or throat
• chronic diarrhea
• a cough that won't go away
• trouble remembering things

Girls may also experience severe vaginal yeast infection that don't respond to usual treatment,
as well as PID.
Prevention

One of the reasons that HIV is so dangerous is that a person can have the virus for a long
time without knowing it. That person can then spread the virus to others through high-risk
behaviors. HIV transmission can be prevented by:

• abstaining from sex (not having oral, vaginal, or anal sex)

• always using latex condoms for all types of sexual intercourse
• avoiding contact with the bodily fluids through which HIV is transmitted
• never sharing needles

Treatment

People can also get tested for HIV/AIDS at special AIDS clinics around the country. Clinics
offer both anonymous (meaning the clinic doesn't know a person's name) and confidential
(meaning they know who a person is but keep it private) testing. Most AIDS testing centers
will ask you to follow up for counseling to get your results, whether the test is negative or
positive.

There is no cure for AIDS, which makes prevention so important. Combinations of antiviral
drugs and drugs that boost the immune system have allowed many people with HIV to resist
infections, stay healthy, and prolong their lives, but these medications are not a cure. Right
now there is no vaccine to prevent HIV and AIDS, although researchers are working on
developing one.

Pubic Lice (Crabs)

Pubic lice are tiny insects that can crawl from the pubic hair of one person to the pubic hair of
another person during sexual intercourse. People can also catch pubic lice from infested
clothing, towels, and bedding. Once they are on a person's body, the insects live by sucking
blood from their host. Pubic lice are sometimes called "crabs" because when seen under a
microscope they look like tiny crabs.

Symptoms

Pubic lice cause intense itching. A person who has been exposed to pubic lice may notice tiny
tan to grayish-white insects crawling in their pubic hair. He or she may also see tiny oval-
shaped, yellow to white blobs called nits clinging to the hair. Nits are about the size of a
pinhead, and are the louse eggs. Nits can't be easily removed from the hair with the fingers —
"nit combs" made especially to remove the eggs are sold at drugstores and many grocery
stores.
Someone who has been exposed to pubic lice will usually notice symptoms within a week. But
it can take up to 2–3 weeks for the mature lice to appear. That means itching may start in the
first week, but people may not actually notice the lice for 2–3 weeks after they have been
exposed. The primary symptom of pubic lice is itching, but lice can also leave bluish-grayish
marks on the thighs and pubic area from bites.

Complications

It's unusual for pubic lice to create any serious health problems, but the itching can be very
uncomfortable, and it's easy to transmit pubic lice to others. The female louse survives an
average of 25 to 30 days and each can lay 20 to 30 eggs. Lice can also live away from the
body for 1 to 2 days. So it's important to get properly diagnosed and treated, or it can take
forever to get rid of them.

Treatment

Patient will also need to dry clean or use very hot water and a hot dryer cycle to wash and dry
all bedding, towels, or recently worn clothing to properly kill the lice and their eggs. Anyone
with whom had sex should also check for pubic lice immediately. Although condoms help
protect against other STDs, a partner could still get pubic lice because the condom does not
cover the entire pubic area.

Syphilis

It is STD caused by a type of bacteria known as a spirochetespirochete (through a

microscope, it looks like a corkscrew or spiral). It is extremely small and can live almost
anywhere in the body.

The spirochetes that cause syphilis can be passed from one person to another through direct
contact with a syphilis sore during sexual intercourse (vaginal, anal, or oral sex). The infection
can also be passed from a mother to her baby during pregnancy. You cannot catch syphilis
from a towel, doorknob, or toilet seat.

In the 1990s there was a decrease in the number of people infected with syphilis. However,
more recently there has been a steady increase in reported cases of syphilis, especially in
young adults and in men who have male sexual partners.
In its early stages, syphilis is easily treatable. However, if left untreated, it can cause serious
problems — even death.

Symptoms

Syphilis occurs in several different stages:

Primary Syphilis

In the first stage of syphilis, red, firm, and sometimes wet sores that don't hurt appear on the
vagina, rectum, penis, or mouth. There is often just one sore, but there may be several. This
type of sore is called a chancre. Chancres appear on the part of the body where the
spirochetes moved from one person to another. Someone with syphilis may also have swollen
glands during this first stage.

After a few weeks, the chancre will disappear, but that's not a sign that the disease has gone
away. In fact, if the infection hasn't been treated, the disease will continue to get worse.

Syphilis is highly contagious during this first stage. Unfortunately, it can be easy to miss
because the chancres are painless and can appear in areas that may not be easy to see, like in
the mouth, under the foreskin, or on the anus. This means that people may not know that
they are infected, and can pass the disease on to others without realizing it.

Secondary Syphilis

If syphilis hasn't been treated yet, the person will usually break out in a rash (especially on
the soles of the feet and palms of the hands) and may also notice flu-like symptoms, such as
fever and achiness. Sometimes the rashes associated with syphilis can be very faint or look
like rashes from other infections and, therefore, may not be noticed. Sores sometimes appear
on the lips, mouth, throat, vagina, and anus — but many people with secondary syphilis don't
have sores at all.

This secondary stage usually lasts 1 to 2 weeks and will go away with or without treatment.
But if the infection hasn't been treated, the disease will continue to progress. Syphilis is still
contagious during the secondary stage.

Latent Syphilis

If syphilis still hasn't been treated yet, the person will have a period of the illness called latent
(hidden) syphilis. This means that all the signs of the disease go away, but the disease is still
very much there. Even though the disease is "hiding," the spirochetes are still in the body.
Syphilis can remain latent for many years.

Tertiary Syphilis

If the disease still hasn't been treated at this point, it becomes known as tertiary (or late-
stage) syphilis. This means the spirochetes have spread all over the body and can affect the
brain, the heart, the spinal cord, and bones. Symptoms of late syphilis can include difficulty
walking, numbness, gradual blindness, and possibly even death.

A person who has been exposed to the spirochetes that cause syphilis may notice a chancre
from 10 days to 3 months later, though the average is 3 weeks. If the syphilis is not treated,
the second stage of the disease may occur anywhere from about 2 to 10 weeks after the
original sore (chancre). It's important to keep in mind that many people never notice any
symptoms of syphilis.

Complications

Syphilis can be very dangerous to a person's health if left untreated. In both guys and girls,
the spirochetes can spread throughout the whole body, infecting major organs. Brain damage
and other serious health problems can occur, many of which can't be treated. A woman who is
pregnant and hasn't been effectively treated is at great risk of putting her baby in danger.
Untreated syphilis can also cause major birth defects. Syphilis also increases the risk of HIV
infection because HIV can enter the body more easily when there's a sore present.

Treatment

Depending on the stage, the doctor can make a diagnosis by examining the discharge from
chancres under a special microscope or by doing a blood test to look for signs of infection.

Early stages of syphilis are easily cured with antibiotics. Someone who has been infected for a
while will need treatment for a longer period of time. Unfortunately, damage to the body from
the late stage of syphilis cannot be treated. However, even in the late stage, it is important to
get treatment. This can prevent further damage to the body

Prevention

The best way to prevent any STD is to not have sex. However, for people who decide to have
sex, it's important to use protection and to have as few sexual partners as possible. Latex
condoms are effective against most STDs; however, if there are any sores or rashes that
cannot be covered by the condom, it's wise to not have sex until rashes or other skin breaks
have healed.

Trichomoniasis

It is one of the most common STD. The parasite that causes

trichomoniasistrichomoniasis can be passed from one person to another during sexual
intercourse.

Unlike most STDs, the parasite can live for about an hour on damp towels, washcloths, and
bathing suits. If someone uses these towels or washcloths or puts on the bathing suit, the
disease may be passed on that way. The good news is that trichomoniasis is curable.

Female S & S

A girl with trichomoniasis can get vaginitis, which is the medical term for inflammation of the
vagina. A girl who has trichomoniasis will usually have vaginal discharge that can be gray or
yellowish green, and may be foamy. This discharge may have a foul odor, and a girl's vagina
may feel very itchy.

A girl with trichomoniasis may find it very painful to urinate. Trichomoniasis can also cause an
achy abdomen and pain during sexual intercourse.

Male S & S

In most cases, guys won't notice any symptoms. However, a guy who has trichomoniasis may
notice some temporary irritation inside his penis or a mild burning feeling when he pees.

Symptoms usually appear 5 to 28 days after a person has been exposed.

Trichomoniasis by itself isn't very dangerous to a person's health, but it can be uncomfortable.
It can also make someone more susceptible to getting other STDs. In pregnant women,
trichomoniasis can cause the baby to be born early or to be born with a low birth weight.

If a patient has trichomoniasis a doctor will typically also test for gonorrhea and chlamydia
because these STDs sometimes occur together.

Treatment
Doctors usually prescribe antibiotics for people who are diagnosed with trichomoniasis. Sexual
partners should be treated at the same time, and people being treated should not have sex
until they have finished their treatment and no longer have symptoms.

It's better to prevent trichomoniasis than to treat it, of course. The only way to completely
prevent infection is to not have any type of sexual intercourse (called abstinence). People who
choose to have sex should use a latex condoms every time. This is the only birth control
method that will help prevent trichomoniasis.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease, sometimes called PID, is a progressive (meaning it becomes

worse over time) infection of the fallopian tubes, uterus, cervix, or ovaries. Most girls develop
PID as a result of sexually transmitted diseases (STDs), such as chlamydia or gonorrhea.

In the United States, each year more than a million women will develop PID, with the highest
infection rate amongst teenagers. Teen girls with multiple partners and those who don't use
condoms are most likely to get STDs and are at risk for PID. If PID goes untreated, it can lead
to internal scarring that can result in chronic pelvic pain, infertility, or a tubal pregnancy.

Symptoms

PID can cause severe symptoms or very mild to no symptoms. Teens that do have symptoms
however, may experience:

• pain and tenderness in the lower abdomen

• large amounts of foul-smelling or abnormally colored discharge

• pain during sexual intercourse

• heavier than normal periods

• more painful periods with more cramps than usual

• spotting between periods

• chills, fever, and vomiting

 • increased tiredness

• loss of appetite

• backache and perhaps even difficulty walking

• painful or more frequent urination

Complications

Any teen girl with symptoms of an STD should get medical care as soon as possible. An
untreated STD has a greater chance of becoming PID.

If it is not treated or goes unrecognized, the PID can continue to spread through a girl's
reproductive organs and may lead to long-term reproductive problems:

• PID can cause scarring in a girl's ovaries, fallopian tubes, and uterus, and widespread
scarring may lead to infertility (the inability to have a baby). A teen girl or woman
who has had PID three times (or more) has an almost 50% chance of being infertile.

• If someone who has had PID does get pregnant, scarring of the fallopian tubes may
cause the fertilized egg to implant in one of the fallopian tubes rather than in the
uterus. The fetus would then begin to develop in the tube, where there is no room for
it to keep growing. This is called an ectopic pregnancy. An untreated ectopic
pregnancy could cause the fallopian tube to burst suddenly, which might lead to life-
threatening bleeding in a pregnant woman.

• Untreated PID also puts a woman at risk for a tubo-ovarian abscess (TOA). A TOA is
a collection of bacteria, pus, and fluid that occurs in the fallopian tube. It is most often
seen in teens. A TOA is also more likely to occur in teens or adult women who use
intrauterine devices (IUDs) as birth control. A teen girl with a TOA often looks sick and
has a fever and pain that makes it difficult to walk. The abscess will be treated in the
hospital with antibiotics, and surgery may be needed to remove it.

Treatment

Patient may be given antibiotics to take for a couple of weeks. It's very important that he take
every dose of the medication to completely treat the infection. It's also important to be
rechecked 2-3 days after you have begun treatment to make sure that he is starting to
improve because PID can be difficult to treat.
Girls who have more severe cases of PID - for instance, if they have a fever or look ill - are
often treated in the hospital for a few days with antibiotics given directly into a vein. Surgery
is sometimes needed for cases of PID that do not get better with antibiotics or if a girl has an
abscess. Ectopic pregnancies can require emergency surgery.

Also, it's very important that anyone with who patient had sex be checked for STDs right
away, so they can get treatment. An untreated partner is likely to give the same STD again,
even after you've been treated.

Prevention

The best way to prevent STDs or PID is to not have sex. However, for those who choose to be
sexually active, it's important to use protection and to have as few sexual partners as
possible. Using a latex condom effectively and consistently helps protect against most STDs.