Sexually Transmitted Diseases (STD'S)
What are STDs?
STD stands for sexually transmitted disease. As the name implies, these are illnesses contracted by sexually contact. Sexual contact includes vaginal and anal intercourse, mutual masturbation and orogenital sex. The following is a list of common STD's along with their symptoms, diagnosis and treatment:

• Gonorrhea - This disease is caused by the bacterium Neisseria gonorrhoeae. It most commonly has no symptoms at all. Sometimes a foul yellowish green colored discharge may be present. The diagnosis is made by culture. It is treated with antibiotics. Ceftriaxone, cefixime or ofloxacin are usually given in a single dose. Since chlamydia is commonly colonized with gonorrhea, they are treated simultaneously. If untreated, gonorrhea may develop into pelvic inflammatory disease or may even infect joints, such as the knee. Partners should be treated.
• Chlamydia - This disease is caused by a bacterium called Chlamydia trachomatis. Most commonly there are no symptoms at all but it may present with a yellowish green discharge. The diagnosis is made by DNA probe assay, polymerase chain reaction, or culture. It is treated by using one of two antibiotics, either Doxycycline or Azithromycin. Partners should be treated.
• Trichomonas- Trichomonas vaginalis is the protozoan organism that causes this disease. The classic symptoms include frothy light green vaginal discharge and itching. Occasionally, there may be abdominal discomfort. The diagnosis is usually made by visualizing the organism on a slide prepared from a sample of vaginal fluid. It is treated with an antibiotic called Flagyl. Partners should be treated.
• Herpes - The herpes simplex virus (HSV) is responsible for this STD. The primary outbreak is characterized by a cluster of blisters accompanied by severe pain. The diagnosis confirmed by culture. Once you contract this virus, you will have it for life. The treatment goal in herpes is to decrease the frequency and duration of outbreaks. This is achieved using various forms of acyclovir, with brand names such as Valtrex or Famvir. Partners should be notified.
• Human Papilloma Virus (HPV) - This virus may present as genital warts or cervical dysplasia (abnormal cells on the Pap smear). Genital warts are diagnosed by clinical exam and/or biopsy. They are destroyed by applying a destructive agent to the visible wart or cervix. Please see the discussion on the management of abnormal Pap smears regarding HPV and dysplasia. No viruses can be eradicated once contracted.
• Human Immunodeficiency Virus (HIV) - This virus can be acquired by sexual contact, IV drug use or be passed from a pregnant woman to her baby. The diagnosis is made by detecting antibodies in a blood sample. Due to a delay in the development of antibodies*, the HIV test should be repeated 3 to 6 months after the initial screening. Signs may vary greatly but are all related to suppression of the immune system. These may include cervical dysplasia, recurrent yeast infections, pneumonia or Kaposi's sarcoma to name few. There is no cure for HIV. However, the incidence of transmission from mother to baby may be dramatically decreased with intensive treatment during pregnancy and labor. Partners should be notified.
• Syphilis - An organism called Treponema pallidum causes syphilis. The initial presenting sign is a painless ulcer. The patient can later develop a rash or neurological problems. Diagnosis is made by blood testing. The mainstay of treatment is penicillin. This disease can be passed on from mother to child. For this reason, all women are screened during pregnancy. Partners should be notified and treated.

What is PID?
Pelvic Inflammatory Disease (PID) refers to an infection of the uterus, fallopian tubes, and ovaries. This infection leads to inflammation and scarring that may affect any or all of these female organs. PID is one of the most serious complications of sexually transmitted diseases. Women at risk to contract PID often have multiple sexual partners, are not using contraception, have menstrual periods, and live in an area where the diagnosis is frequently made. The most common bacteria that cause PID are gonorrhea and chlamydia. The most common symptoms are abdominal pain and foul smelling discharge. This illness is treated with antibiotics. If the condition is severe enough it may require IV antibiotics, hospitalization and surgery. Some possible long-term effects of PID include tubal (ectopic) pregnancy, infertility and chronic pelvic pain from scar tissue.

*The window period refers to a time during which the human immunodeficiency virus is present but may not be detected in the blood. The blood test used to diagnose HIV actually detects antibodies, not the HIV virus. The body makes antibodies as a way to remove certain types of foreign material that may be harmful. The immune system must produce a certain number of antibodies before they can be detected by an HIV test. This may take 3 to 6 months. As a result, a person may actually have the HIV virus in her/his body but have a falsely negative HIV test. During this time, it is possible to infect another person despite having a negative HIV test. This window period is why it is recommended that HIV testing be repeated 3 to 6 months after the initial test.