Transcript Gynecological Difficulties: STDs

Gynecological Difficulties: STDs
I.
II.
III.
IV.
Viral Infections
Bacterial Infections
Infestations
HIV
STD’s – absolutely NOT a good thing
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Physically, emotionally and spiritually
devastating
Ignorance is not bliss…
Risks have potential serious and long-term
complications
Women MUST know the risks associated
with STDs and practice assertive skills to
prevent unprotected sex
Assessing your STD risk
I. Viral Infections
A.
B.
C.
D.
Herpesvirus
Hepatitis
Cytomegalovirus
Human Papilloma virus
HIV – to be discussed later…
A. Herpesvirus
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Many individuals asymptomatic – 30% test positive,
but only 5% report a history of infection
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Difficult to estimate true incidence of disease
Transmission – intimate contact that brings mucous
membrane surfaces together during shedding period
(may be transmitted while asymptomatic)
Herpesvirus hominis – causes the herpes simplex
virus disease that can involve the skin, mucous
membranes & eyes (can be fatal in newborn infants)
1). Herpes Symptoms
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Primary infection: Flu-like symptoms, fatigue,
nausea, diarrhea, fever
Vulvar burning and pruritis precede the multiple
vesicles that appear next and usually remain intact
for 24-36 hours before evolving into painful genital
ulcers (painful blisters)
These ulcers may rupture and then crust over and
heal & require a mean of 10-22 days to heal
Recurrent episodes can occur as frequently as 1 to
6 times per year
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Sores or bumps on the
labia
Sores or bumps on the
urethra
Vaginal discharge
Urethral discharge
Sores on the thighs,
buttocks, scrotum, and/or
anus
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Other Symptoms
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Pain near the infection
Stiff neck
Headache
Other pains
May be passed on to infant & cause serious infections, even death
2). Treatment of Herpes
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NO CURE
There are several prescription antiviral
medications for controlling herpes outbreaks,
including aciclovir (Zovirax), valaciclovir
(Valtrex), famciclovir (Famvir), and
penciclovir.
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Aciclovir was the original and prototypical member
of this class and generic brands are now available
at a greatly reduced cost.
3). Prevention of Herpes
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Condoms can help prevent contracting herpes, but
do not work consistently because some blisters
might not be covered by the condom.
Abstinence is an effective way to prevent contracting
or spreading this disease (including abstinence from
oral sex).
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When one partner has herpes simplex infection and the
other doesn't, the use of valaciclovir, in conjunction with a
condom, has been demonstrated to further decrease the
chances of transmission to the uninfected partner
B. Cytomegalovirus (CMV)
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CMV- Belongs to the herpesvirus family, but rarely
produces overt symptoms
Transmission of CMV occurs from person to
person. Infection requires close, intimate contact
with a person excreting the virus in their saliva,
urine, or other bodily fluids.
Transmission of the virus is often preventable
because it is most often transmitted through infected
bodily fluids that come in contact with hands and
then are absorbed through the nose or mouth of a
susceptible person
Often transmitted to infant at birth and can cause
infection, may lead to hearing or mental problems.
C. Hepatitis B (HBV)
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Transmitted via saliva, blood, semen, & vaginal
secretions
can cause lifelong infection, cirrhosis (scarring) of
the liver, liver cancer, liver failure, and death.
Symptoms
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yellow skin or yellowing of the whites of your eyes
(jaundice)
Fatigue, loss of appetite, nausea, abdominal discomfort
dark urine, clay-colored bowel movements, joint pain
Prevention: VACCINE
Infants are at risk for chronic liver disease and they
should be vaccinated too…
D. Human Papilloma Virus – Genital
Warts, Condyloma
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Incidence - Approximately 20 million people
are currently infected with HPV.
 At least 50 percent of sexually active men and
women acquire genital HPV infection at some
point in their lives.
 By age 50, at least 80 percent of women will
have acquired genital HPV infection. About 6.2
million Americans get a new genital HPV
infection each year.
 http://www.cdc.gov/std/HPV/STDFactHPV.htm
 Symptoms - Patients usually present with
anogenital lesions that they have identified or
that have become pruritic or caused bleeding
Genital warts are soft, moist, or flesh colored and appear in the genital
area within weeks or months after infection.
Very contagious and are spread during oral, vaginal, or anal sex with an
infected partner.
They are transmitted by skin-to-skin contact during vaginal, anal, or
(rarely) oral sex with someone who is infected.
Also associated with potential disease in infants, women with HPV
types 6 & 11 can pass on laryngeal papillomatosis
Treatment of HPV
NO CURE
 Local excision
 Cryotherapy
 Topical trichloroacetic acid
Repeated weekly until all lesions are gone
 Topical treatments available for
“uncomplicated condyloma) Aldara and
Condylox
 Recurrence rate – 20%
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II. Bacterial Infections
A.
B.
C.
Gonorrhea
Syphilis
Chlamydia
A. Gonorrhea
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CDC estimates that more than 700,000
persons in the U.S. get new gonorrheal
infections each year.
caused by bacteria called Neisseria
gonorrhoeae carried in semen and
vaginal fluids - spread through contact
with the penis, vagina, mouth, or anus.
the cervix, is the first place of infection.
The disease can spread into the uterus
and fallopian tubes, resulting in pelvic
inflammatory disease (PID).
Treatment - a single dose of one of
several antibiotics, however, some
strains are becoming resistant!
Symptoms
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Bleeding associated with vaginal intercourse
Painful or burning sensations when urinating
Yellow or bloody vaginal discharge
More advanced symptoms, which may
indicate development of PID, include cramps
and pain, bleeding between menstrual
periods, vomiting, or fever.
PID – infection of the upper portion of the reproductive tract beyond the cervix.
Nearly 15% of all women between the ages 15-44 experience 1 incidence of PID.
Antibiotics used to treat PID, but it’s often a chronic problem and the cause of
infertility among 150,000 women each year.
B. Syphilis
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Caused by Treponema pallidum spreads from the initial ulcer (sore) of an
infected person to the skin or mucous
membranes (linings) of the genital area,
mouth, or anus of an uninfected sexual
partner. It also can pass through broken
skin on other parts of the body.
Between 2001 and 2002, the number of
reported cases increased 12.4 %
however, rates in women continued to
decrease, and overall, the rate in men
was 3.5 times that in women
Diagnosis - Identifying syphilis bacteria
under a microscope
Treatment - penicillin, given by injection.
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Primary infection - chancre appears within 10 days to 3 months after
exposure, but it generally appears within 2 to 6 weeks.
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Secondary stage - A skin rash, with brown sores about the size of a
penny, often marks this chronic stage. The rash appears anywhere from
3 to 6 weeks after the chancre appears.
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the chancre may be painless and may occur inside the body, it may go
unnoticed.
It usually is found on the part of the body exposed to the infected partner's
ulcer, such as the vulva or vagina.
The chancre disappears within a few weeks whether or not a person is
treated.
While the rash may cover the whole body or appear only in a few areas, it is
almost always on the palms of the hands and soles of the feet
If untreated, syphilis may lapse into a latent stage during which the
disease is no longer contagious and no symptoms are present.
Tertiary stage - Approximately 1/3 of people who have had secondary
syphilis go on to develop the complications in which the bacteria
damage the heart, eyes, brain, nervous system, bones, joints, or almost
any other part of the body. This stage can last for years, or even for
decades.
Late syphilis can result in mental illness, blindness, other neurological
problems, heart disease, and death.
Secondary syphilis symptoms
Transmitted to infants during pregnancy with devastating effects –
accounting for 40% of fetal and perinatal deaths in affected infants in
addition to physical and developmental disabilities.
C. Chlamydia
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Caused by Chlamydia trachomatis that persist in
vaginal fluid and in semen Transmitted via oral,
vaginal, or anal sexual contact with an infected
partner
Chlamydia is one of the most widespread
bacterial STIs in the U.S. The CDC estimates that
more than 3 million people are infected each year
Mild symptoms of abnormal discharge (mucus or
pus) from the vagina or pain while urinating
usually appear within 1 - 3 weeks post infection.
Eventually bacteria can infect the cervix, fallopian
tubes, and urine canal in women, where they can
cause pelvic inflammatory disease (PID)
Treatment - antibiotic such as azithromycin (taken
for one day only) or doxycycline (taken for 7
days). Or, erythromycin or ofloxacin may also be
used.
Lymphogranuloma venereum
May be passed on to infants, causing
severe problems
Severe trachoma in an infant
III. Infestations
A.
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“Crabs” – Pubic Lice
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Nit: Nits are pubic lice eggs. They are hard to see and
are found firmly attached to the hair shaft. They are
oval and usually yellow to white. Nits take about 1
week to hatch.
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Nymph: The nit hatches into a baby louse called a
nymph. It looks like an adult pubic louse, but is
smaller. Nymphs mature into adults about 7 days after
hatching. To live, the nymph must feed on blood.
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Adult: The adult pubic louse resembles a miniature
crab when viewed through a strong magnifying glass.
Adult lice need feed on blood. If the louse falls off a
person, it dies within 1-2 days.
Transmitted via sexual contact, occasionally can be
passed via infected bedding or toilet seats
Symptom – ITCHING
Treatment – Lindane or Kwell lotion/shampoo
B.
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Scabies - infestation of the skin
with the microscopic mite
Sarcoptes scabei
Symptoms - Pimple-like
irritations, burrows or rash of
the skin, Intense itching,
especially at night and over
most of the body. Sores on the
body caused by scratching.
Treatment - Several lotions are
available to treat scabies
PREVENTING STD’s
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The surest way to avoid transmission of
STDs is to not have sexual contact or to be in
a long-term mutually monogamous
relationship with a partner who has been
tested and is not infected.