CHLAMYDIA, GONORRHEA, TRICHOMONIASIS AND GENITAL HERPES -WOMEN’S STD
Helena Corleta, MD. Gynecology & Obstetrics Specialist. General Surgery Specialist. Ph.D. in Human Reproduction by Ludwig Maximilian University-Germany.
Caused by a motile protozoon, Trichomonas vaginalis. It’s regarded as an STD (sexually transmitted disease). The most common symptom is a greenish or grayish, abundant, foamy and smelly flowing discharge. The direct examination of vaginal discharge demonstrates the protozoon. The treatment must be carried out with single-dose medication, and the partner must always be treated.
The infection caused by the bacteria known as Chlamydia trachomatis is the most common STD in the USA, affecting mainly young single women who have multiple sexual partners. The transmission is sexual, but, in infected pregnant women, it may lead to premature childbirth and be transmitted at delivery, causing conjunctivitis or even pneumonia in the neonate. Many times, chlamydial infection is asymptomatic and may persist over several years. Usually, it causes cervicitis (inflammation of the cervix’s cells), having as symptoms mucopurulent vaginal discharge and bleeding after sexual intercourse. The standard diagnosis is the culture of endocervical secretion or the new hybrid-capture tests, but it can be detected in the blood through immunofluorescence antibody assays. It can progress to a pelvic inflammatory disease, reaching the entire upper genital tract. It should always be diagnosed and treated, as its consequences are quite severe; it may lead to chronic infection, ectopic pregnancy or infertility. The recommended treatment consists of using systemic antimicrobial drugs and mandatorily includes the sexual partner’s referral to a doctor.
Prevention emphasizes a safe sexual practice, with correct use of condom as the only way to effectively protect oneself from contagion.
Gonorrhea is one of the most common infectious diseases all over the world. It’s caused by the bacteria known as gonococcus, easily transmitted during sexual relations (vaginal, anal or oral sex). It reaches the entire urogenital tract, and can often be asymptomatic. However, mainly in women, it may cause some symptoms, such as: vaginal discharge, dysuria (burning sensation when urinating), or abnormal uterine bleeding.
The number of infections has been increasing considerably in the past years, especially amongst the young.
The diagnosis can be made through the culture of endocervical secretion or by demonstrating the gonococcus by Gram-staining. The treatment is carried out using single-dose antibiotics for the couple; since simultaneous chlamydial infection is common, a similarly simultaneous treatment for this should be implemented.
Caused by Herpes Simplex, it’s a recurrent STD that manifests by genital ulcers. Once the individual is infected by the virus, this remains forever latent, dwelling on the nerve root, and causing symptoms only when it reappears.
The first infection presents, as symptoms, systemic manifestations of a viral syndrome, with fever and general discomfort. Later, vesicles, usually clustered, appear on the vulva, which get together and form shallow, painful ulcers. The outbreak is self-limited, and lesions heal spontaneously by around 14 days. The following episodes, as a rule, show shorter duration and milder symptoms, being preceded by itching or burning sensation. The outbreaks can be triggered by some change in the immune response, such as stress, pregnancy, menstruation, tiredness or an immunocompromised state.
The diagnosis is generally made by inspection, and a culture of the viral fluid from the vesicles can be conducted. Most frequent complications are acute urinary retention and herpetic encephalitis.
The treatment has the purpose of shortening symptom duration, preventing complications and recurrences, and decreasing transmission, since the virus cannot be completely eliminated. Oral or topic medication can be used to alleviate the symptoms, albeit being less effective.
As prevention, we must advise women to abstain from sexual relations from the beginning of the symptoms to the total reepithelization of ulcers, and always wear condom for greater protection.