Healthy Living

Wednesday, February 10, 2010

Exactly Why STDs Are So Bad

One of the hardest parts of my job is calling a patient to tell her that she has a sexually transmitted infection (STD/STI). Every woman receives this news differently--shock, anger, horror, depression, resignation--but it always ruins her day and often sends her to the internet to find out what it means.

But STDs are not all alike (even if it always sucks to get one). This news may mean you need to take a single dose of antibiotics to cure it...or it may mean that your life is forever changed (HIV). In general, there's two kinds of STDs. Bacterial and parasitic infections include gonorrhea, chlamydia, trichomonas, and syphilis; these can be treated, and often cured, with medication. Viral infections infections are most often the big three: HIV, HPV and herpes. These infections cannot be cured, though their symptoms may be controlled.

Despite high school health class, and celebrity public service announcements, sometimes my patients are unaware of what exactly the consequences are of contracting a bacterial or parasitic STD. "You can just treat it, right? So what's the big deal?"

Short-term misery
.

  • The infections themselves - while they may be silent, they can cause vaginal discharge, vulvar itching, burning, and pain.
  • Abscesses - when certain STIs make their way up to your tubes and ovaries, they can create a pocket of pus the size of a golf ball or larger, often leading to....
  • Hospitalization, for both intravenous antibiotics and pain control. Sometimes time alone is enough to resolve an abscess, but sometimes you end up needing....
  • Drainage or surgery. It can be a needle passed through the wall of your belly to drain the pus, or actual surgery to remove the mess--either way it's a nightmare.

Long-term consequences.

  • Risk of surgical complications if surgery is needed--bleeding, further infection, damage to your bladder or bowels.
  • Infertility, if your fallopian tubes are scarred. Even surgery is often not alone to repair such damaged tubes, and you're then facing in-vitro fertilization (IVF) if you want to get pregnant in the future.
  • The "talk" with every future partner about your sexual history. First sexual encounters can be awkward enough, without having to talk about the chlamydia in your past.
  • Medical bills. Because these infections need to get treated, whether or not you've got insurance.

Finally, if you contract an infection, don't get treated, and then sleep with someone else in the future, you'll be spreading the STD wealth without knowing it. So if you're not in a monogamous relationship--or aren't sure if you are or not--please think twice about not wearing condoms. Use them for your health, both for now and for later.

Have any of you, or had someone close to you, had to deal with the consequences of an STD?

Read more about sexual health at Gynotalk.

[Photo credit: Getty Images]
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From the Community…

Comments 1-10 of 21
  • Ahleah G's Avatar
    Posted by Ahleah G Mon Jun 22, 2009 1:00pm PDT

    I'm sorry, but why do you need to tell future sex partners if you have had an STD in the past. Obviously that is a must disclose for viral infections, but why do they need to know if you had a bacterial infection that you treated. You no longer have it and you aren't going to pass it to them. Unless you have lasting effects like the fallopian tube scarring I don't think it's a necessary conversation. And even then I only see it as necessary if you are getting serious with someone as it affects your fertility.

    I do know someone who had chlamydia and didn't know for maybe a year. Her ex was sleeping around without condoms. She had no symptoms, and since she didn't know she had the infection and didn't get treated, she has fallopian scarring and probably infertility. Plus she had to contact the people she had dated since her ex just in case. Not fun.

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  • cutebanker's Avatar
    Posted by cutebanker Mon Jun 22, 2009 1:25pm PDT

    i had just turned 30 when i found out my boyfriend was cheating on me and gave me herpes. he denies it to this day (but i know it didn't come from me). it was devastating both mentally and emotionally. i truly thought this was a sign from God punishing me and that i would be alone forever.

    It took a long time to come to grips with what had happened to me. I spent time in a hospital because i was suicidal. i went to therapy. i took anti depressants. It was hard to deal with not only because i knew it could have been prevented, but also that someone i loved and cared about would do that to me. In addition, i have a reminder for the rest of my life of what this horrible man did to me. my health will always be affected and i will probably have to have c-sections when i have children.

    the only way i really got through was to tell myself that the man who loved me after all of this was going to be worth the hardship. and he is. we met on a website for people with std's. after trying to date and being treated like a leper, i found this was the easiest dating solution for me. the hardest part of dating, for me, was already out in the open. i not only didn't have to have "the talk" with my boyfriend, but he has it as well and knows exactly the pain i have gone through.

    in all honestly, he is wonderful to me and i am truly happy. we often say that the pain we went through has been worth it because it allowed us to meet each other. although i will never be comfortable with what has happened to me, i am grateful for the outcome it has had on my life.

    i am a firm advocate now of safe sex, regardless of the status of your relationship. i beleive all couples should get tested- at whatever time intervals they feel are necessary. i'm not a pessimist, i'm a realist. i want my friends and family to be safe in their relationships. i wouldn't wish what happened to me on my worst enemy. Protect yourselves by any means necessary, because you love yourself just as much as you should love your partner.

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  • boo's Avatar
    Posted by boo Mon Jun 22, 2009 1:37pm PDT

    "Viral infections infections are most often the big three: HIV, HPV and herpes. These infections cannot be cured, though their symptoms may be controlled."

    HPV can't be 'cured' through medical treatment, creams or a pill- true. And there are different types of HPV, some of which cause Cervical cancer, some of which cause 'warts'. But there are type of HPV that can be cleared from a healthy individuals system through their immunity. If the body learns how to kill the virus, it will- this can happen anywhere from 6 months, to 2 years from when diagnosed.

    You speak about individuals rushing to the internet to find out information about STD's after they are diagnosed, but you are another bad source of information that is only going to confuse individuals. There is too much conflicting information about HPV on the web already- don't add to it.

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  • Dr. Kate's Avatar
    Posted by Dr. Kate Mon Jun 22, 2009 6:57pm PDT

    Boo, thanks for your comment about HPV. What I meant was that there's no medical treatment that can get rid of HPV - you just have to wait until your body clears the infection. And while most people with a healthy immune system do clear the virus, it doesn't ALWAYS clear this way - which is why some women then develop cervical cancer.

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  • pixie's Avatar
    Posted by pixie Tue Jun 23, 2009 5:26am PDT

    "Viral infections infections are most often the big three: HIV, HPV and herpes. These infections cannot be cured, though their symptoms may be controlled."

    I BEG TO DIFFER I HAVE CURED MY HPV!!! ALTERNATIVE MEDICINE IS WONDERFUL AND CAN AND DOES CURE MANY MANY ISSUES. IF PEOPLE WOULD TAKE CONTROL OF THEIR OWN HEALTH AND STOP LETTING DOCTORS AND BIG PHARMA CONTROL THEM.

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  • AngelicaC's Avatar
    Posted by AngelicaC Tue Jun 23, 2009 7:30am PDT

    I agree with pixie..I worked in a dr. office and the dr I worked for did a little procedure called a loop(dr goes in the vagina burns the warts off the cervix) It can be cured. You still have to get tested every 6 mths to a year(pap). But, thats normal. Truth be told, men carry this disease and don't even know. They have no symptoms, so they spread it. Bottom line, wear a condom be safe.

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  • boo's Avatar
    Posted by boo Tue Jun 23, 2009 8:03am PDT

    ok-

    Condoms don't prevent the spread of HPV- it can spread through contact with the genitals- it can also live in the mucous membranes of the mouth- so oral sex can spread it too (that is both ways, a person with HPV giving or recieving oral sex can spread the infection). It can spread by using a hand on another person, and then using that hand on yourself.

    Condoms can help reduce the risk of transmission- but the possibility is still there.

    and it's a LEEP procedure.

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  • Ona's Avatar
    Posted by Ona Tue Jun 23, 2009 11:45am PDT

    My cousin died at 24 from cervical cancer from the HPV her husband gave her. It was hard to watch her waste away. But had she been careful to get her annual exams, she would still be alive to day. Personally, even when my Dr tries to tell me I can go 3 years between Paps, I don't listen. I have watched her die and will never forget that. We were both too old to benefit from the vaccine.

    I got an abnormal pap for the first time this year and am crawling the walls waiting for the results of my biopsy. It's scary, especially knowing the outcome of a positive test.

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  • Turtle's Avatar
    Posted by Turtle Tue Jun 23, 2009 9:08pm PDT

    Check out Herpes-Control.com for treatment.

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  • L.B.'s Avatar
    Posted by L.B. Wed Jun 24, 2009 12:28am PDT

    I was diagnosed with HPV at the age of 19. My (then boyfriend, now husband) unknowingly gave it to me. He had a single wart - that was not diagnosed correctly when he went to sick bay at the naval hospital on his USMC base. Getting that diagnosis at such a young age was pretty devastating....sometimes I wonder if I stayed with him because I figured "Who is going to want me now?" It took about a year for the 2 of us to be "clear" of the visible signs (warts). What an uncomfortable process.

    Fast forward 16 years and 2 kids...and I developed post-coital bleeding. The majority of the times we were intimate, I would bleed afterwards. My ob/gyn couldn't give me an answer as to why, so after a year of this, I ended up with another ob/gyn...turns out I'd developed cervical cancer.

    Cancer. The word still makes my mouth go dry - still puts a knot in my stomach after all this time. I'm now almost 4 years out from the surgery. I ended up having a radical hysterectomy at 37 years old.

    You see, I hadn't told anyone about my HPV - no one. Of course the hubby knew, but I certainly didn't feel the need to tell my parents or siblings about it. So when I was told I had cancer I had to then share this info with my family. Tell my Dad - who had a cancer battle of his own going on at that time - lung cancer - that I was sick, that I would have surgery & after that who knows? What they found after the hysterectomy would determine chemo or radiation, if anything. G*d how I really didn't want to put that on them. But I had to - I was going to need help with my kids/errands/housework for a while after the surgery.

    I am so blessed that my Mom & sister were both able to come to my home - away from their lives - and help me. I wasn't even allowed to drive for 2 weeks after the surgery. Of course just walking was an odd experience. When you get cut open hip bone to hip bone there is a major disconnect between the upper and lower halves of the body - at least there was for me.

    I was lucky in that the entire cancer was actually removed during my biopsy. I still had to have the hysterectomy - that was understood, but to hear that everything else came back clear in the pathology report was a major relief. I cried when the doctor told me. No radiation, no chemo. The surgery took care of it.

    The thing I wasn't expecting was the toll it would take on me emotionally & mentally. My sexuality was affected - think about it - my genitals - my "sex" was "diseased"....I felt so undeserving of any kind of intimate pleasure - was afraid to be intimate with my husband. Afraid that I would somehow make him sick.

    And my husband - to this day won't forgive himself for passing that d@mn virus to me.

    In talking with my Dr. - who is a gynecologic oncologist - we discussed whether the body could purge the virus...now my doc - she's bloody brilliant - the best in the business, IMO. She said there really isn't any way to truly determine that - no test that will show if it's still in a person's system. So if you've had it - you sort of have to always figure there is a possibility of passing it. As far as me, I haven't had any outbreaks since 1987. But I will never say I'm HPV free.

    Since I'm married, there's no possibility of me passing HPV along to another. For you singles out there - you still need to be careful - and up front/honest with new partners that this is a part of your history. Let them make a truly informed decision as far as being intimate with you - it's the right thing to do.

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