DR Raewyn Teirney
– sex columnist
What are Sexually Transmitted Infections?
Sexually Transmitted Infections (STI’s) are frequently as common as the cold. They can occur from both viral and bacterial infections. The good news is that most Sexually Transmitted Infections are easily treatable, but because they are transmitted through sexual contact, they have historically been associated with stigma.
Thankfully, times are changing and as society becomes more open minded and knowledgeable, the stigma isn’t as strong surrounding Sexually Transmitted Infections.
However, it is very important that you empower yourself with knowledge about your body and sexual health. This includes safe sex and the prevention of STIs that could impact on your life and future family aspirations. Knowledge is key when taking control of your sexual health.
This is unique to each infection, however it’s important to note that not all STIs have symptoms. People may have the infection but do not know it. They can be what we call ‘asymptomatic’.
If you think you have contracted an STI, the first thing to remember is it doesn’t make you dirty. However, you do need to see your doctor for testing, as if it’s left untreated it may affect your long-term health. Testing typically involves having a blood test, a urine test and a vaginal or penile swab test.
What are the Common Symptoms of Sexually Transmitted Infections?
What if I want to have a baby and I have a Sexually Transmitted Infection?
The importance of screening prior to and in early pregnancy is that prompt treatment occurs to reduce any adverse outcome.
If you have an STI and you are thinking about having a baby, you will need to discuss your options with your fertility specialist.
This is because pregnant women can spread an STI to their baby in the womb, which can lead to miscarriage, pre-term birth, fetal death, still birth, and infection in their new-born (what we call a neonatal infection).
Women often don’t know that they have an infection, so screening them for STIs when they are thinking about planning a pregnancy is important. Every couple I see in my fertility clinic is screened for STIs.
If screening hasn’t occurred before conception, then STIs are generally picked up in testing at a pregnant women’s first antenatal pregnancy clinic with their Obstetrician or hospital clinic.
What are the common Sexually Transmitted Infections
This is a bacterial infection that can be asymptomatic in both males and females. If symptoms do occur, they may include vaginal discharge, pelvic pain, pain during sex, pain when passing urine and intermenstrual bleeding.
When chlamydia is left untreated in females, it can lead to Pelvic Inflammatory Disease and blocked fallopian tubes, which can cause infertility.
Chlamydia is the most common STI in females under 30 years of age and it’s the most common STI I see in my clinics.
I always recommend females be tested for STIs when visiting their doctor for regular pap smears, or even for general health checks, because many are asymptomatic. Chlamydia is easily treated with a course of antibiotics, but it’s also important to let your partner/s know you have contracted it, so they can be treated as well.
If you are thinking of having a baby, you should be aware chlamydia can be passed on to a baby during birth. When this occurs, they contract Chlamydia Conjunctivitis, which is also treatable.
.This is also a bacterial infection transmitted by vaginal, anal and oral sexual intercourse. Symptoms may include a sore throat from oral sex, vaginal discharge, painful sex from vaginal intercourse and occasionally conjunctivitis. It can also cause Pelvic Inflammatory Disease, blocked fallopian tubes and infertility in females. Again, it is often asymptomatic.
Treatment is antibiotics for both Genital, Anal and Oral Gonorrhoea in men and women.
Herpes Simplex (HSV) is a virus and there are two main types. HSV1 which causes Oral Herpes and cold sores on the mouth and HSV II which causes Genital Herpes and sores on the labia and vulva, or penis. However, HSV1 can spread to the vaginal by oral sex.
There is no cure for HSVI and HSVII but both can be well managed through anti-viral medication and healthy lifestyle and diet.
If females have herpes and get pregnant, it is reassuring that there is a very low transmission to your baby. However, if you have an active herpes lesion in the genital area during labour there is a risk of that lesion shedding the virus to your baby.
This would be assessed by the midwives and doctors and a Cesarean section is the recommended mode of delivery to prevent herpes infection in your baby. A herpes infection is dangerous in new-borns.
Your doctor would also recommend to you the antiviral medication Famcvyclivir (orally twice a day) from 36 weeks onwards to reduce the risk of any Herpes outbreak.
This is a bacterial infection that has three stages. In the first stage it causes painless genital sores called chancres. However, over half of people with Syphilis do not present with these symptoms.
nervous system and leads to death.andSyphilis can then become latent (quiet) in the second stage or present as a rash or sore throat, and tiredness which then clears and represent itself again years later as the third stage called Tertiary Syphilis where the bacterium affects the heart, brain
A Syphilis infection can be spread via sexual intercourse during the first two stages, and if pregnant, it can also be passed to your baby. All antenatal testing includes Syphilis testing.
It is very important to treat Syphilis. It is a notifiable disease where every effort is made to contact all previous partners. It is a very treatable STI with just three courses of Penicillin injections.
Many people think Syphilis is a disease from centuries ago, however it is still very prevalent. Safe sex prevents the spread.
Hepatitis B (Hep B) is a virus that infects and damages the liver. You can get Hep B through body fluids such as blood or sexual intercourse.
A mother can also pass it on to her baby in pregnancy. If you have Hep B in Pregnancy then your baby will be given a Hep B vaccine in the first 12 hours of life to give it protection.
Hep B cannot cause infertility, however acute Hepatitis B can lead to chronic Hepatitis in five percent of people. This is where it stays in your liver, potentially causing liver failure and liver cancer.
If you don’t have Hep B, there is now a safe and effective vaccine that can protect you from getting it. I recommend all men and women be tested for their immunity and have the vaccine which is three injections over a few months.
This is a parasite infection. It is often asymptomatic in both male and females, but in women it can present as a frothy vaginal discharge and a bad odour, and vaginal/vulval itch. Interestingly, older women are more likely to have this infection than younger women. In pregnancy it can cause premature rupture of the membranes, pre-term birth and low birth weight babies. It is treatable with a course of antibiotics.
HPV is a very common viral STI, spread through sexual intercourse. Condoms do provide some protection. There are many types of HPV viruses, most of which are asymptomatic. Some are quite benign or low risk and do no harm and some are considered high risk and can lead to cancers.
For many people, the HPV is cleared naturally by the immune system, which means a healthy lifestyle and diet that boosts immunity is important.
HPV is responsible for nearly all of the cervical cancers, vaginal and vulval cancers and anal cancers. There is now the Gardasil Vaccine which protects against the high-risk HPV virus 16 and 18. Gardasil is given to all girls and boys from the age of 12 at school.
It is the HPV 16 and 18 which causes most of the cervical cancers in females and anal cancers in males. All females should commence pap smear testing of their cervix from the ages of 24 to 75 years to check for the high-risk HPV 16 and 18. This needs to continue every five years.
According to the World Health Organisation (WHO), “HIV or The Human Immunodeficiency Virus targets the immune system and weakens people's defence systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient.
Immune function is typically measured by CD4 cell count. Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off.
The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take from 2 to 15 years to develop if not treated, depending on the individual. AIDS is defined by the development of certain cancers, infections or other severe clinical manifestations.”
WHO also states that: “HIV can be transmitted via the exchange of a variety of body fluids from infected people, such as blood, breast milk, semen and vaginal secretions. HIV can also be transmitted from a mother to her child during pregnancy and delivery. Individuals cannot become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water.
Modern HIV medication has reduced the number of HIV infections that develop into full blown AIDS and as such the number of AIDS related deaths has also been dramatically reduced.
People can protect themselves against the virus by always using a condom when having sex, whether it is anal, vaginal or oral, and not sharing needles if injecting illicit drugs. It’s also important for people considering getting tattoos that they see a reputable tattoo artist who only uses properly sterilised equipment.
How To Safeguard Against STIs
Always practice safe sex by using condoms, unless you are in a monogamous relationship where you have both been tested and you are using other forms of birth control (unless trying for a baby).
Females should have regular pap smears for the HPV virus - every 5 years in Australia.
Schedule regular STI tests with your GP if you’re sexually active and not in a monogamous relationship.
Be sure to have antenatal testing to check for the STIs if you are thinking of planning a family.
Don’t feel ashamed if you contract an STI. Empower yourself with knowledge, get treated and when you do have sex again, be sure to use a condom.