OutLive
by Michael Stewart

WHAT A DRIP

The second of the STD 101 articles looks at two common maladies

Early one morning, you try to go to the bathroom and almost scream with pain. Relax, you’re not alone: Chlamydia and gonorrhea, also known as the Clap or the Drip, are the two most common sexually transmitted diseases.

Chlamydia is normally caused by the bacteria Chlamydia trachomatis, and gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Both bacterial infections are normally associated as sexually transmitted diseases of the urethra and cervix, but they can also infect (often with few symptoms) the throat, rectum, and eyes.

Chlamydia trachomatis

Chlamydia is the most commonly diagnosed sexually transmitted disease. The symptoms of chlamydia vary from person to person and depending on where the infection occurs. Chlamydia trachomatis infection of the eyes causes recurrent eye infections that can lead to blindness if not correctly diagnosed and treated. Infections of the rectum and throat are often without symptoms or symptoms are discounted as minor; however, the disease can be easily transmitted to other sexual partners through unprotected oral or anal sex.

Infection of the urethra can cause painful urination, fluid discharge ranging in color from clear to milky yellow, tenderness around the opening of the urethra, and in advanced cases, lower back pain. In women, chlamydia infection can also cause an increase in odor. If left untreated, chlamydia infection in women can lead to pelvic inflammatory disease, infertility, ectopic pregnancy, and vertical transmission to the baby during birth. In men, it can cause an inflammation of part of the reproductive system called the epididymis, leading to difficulties ejaculating.

Chlamydia is highly contagious. Although your partner might not have any symptoms, you may still be infected through unprotected sex. Also, despite the lack of symptoms, long-term damage may still occur. Treatment options include many different types of antibiotics; ciprofloxin, doxycycline, and azithromycin are commonly prescribed to treat infection. The particular treatment that your physician chooses is the product of many years of experience. Recurrent infections are most commonly the result of either failure to treat all sexual partners or treatment non-compliance.

Neisseria gonorrhoeae

Gonorrhea is the second most commonly diagnosed sexually transmitted disease. Gonorrhea can infect the cervix, urethra, rectum, throat, and eyes, with symptoms ranging in severity from unnoticeable to debilitating. The symptoms of gonorrhea are similar to that of chlamydia, and they are often both present in those who test positive for one or the other. Like chlamydia, gonorrhea can also be transmitted through unprotected oral or anal sex. If left untreated, gonorrhea can lead to pelvic inflammatory disease and infertility in women, and in rare cases can create symptoms similar to rheumatoid arthritis and meningitis.

Gonorrhea is very sensitive to specific antibiotics. While there are resistant strains, infections can be treated with a single dosage of azithromycin or a series of any of a number of antibiotics.

One more bad Trich

Trichomonas vaginalis, a single-cell anaerobic protozoa flagellate (a one-cell organism that is not a bacteria, moves around using a tail-like structure, and needs an oxygen-free environment to live), is a sexually transmitted disease that is rarely talked about, but is very common. Trich is asymptomatic in 50 percent of women and 90 percent of men, but is still infectious despite the lack of symptoms. In women, trich can cause a vaginitis, including a yellow vaginal discharge, odor, vulvar itching, redness of the vulva and vagina, and painful urination and pain during penetrative intercourse. In men, when symptoms are present, they include abnormal discharge, irritated tip of the penis, and burning with urination.

Because symptoms often are very mild or transitory, many ignore the symptoms and continue to spread the illness to subsequent sexual partners. Women often erroneously self-diagnose trich as a stubborn yeast infection and unsuccessfully use over-the-counter treatments. Once diagnosed, however, trich is easily treated with an anti-microbial agent called metronidazole.

Remember that while symptoms often disappear within the first few days of treatment, the entire course of medication must be completed in order to cure the infection. Regardless of the disease, the most important part of an effective treatment is to make sure that all partners are notified of the possibility that they might also be infected and receive treatment. It is pointless to treat one partner if the other(s) are left infected and not treated. If all potentially infected persons are tested and treated, the chances of reinfection are significantly reduced.

If you happen to have a partner who has been diagnosed with an infection, in order for your physician to make an accurate diagnosis, it is important that you are honest and open about your sexual practices. If your doctor does not know you practice unprotected oral or anal sex, for example, the appropriate tests will probably not be performed. If you feel queasy talking with your doctor about your sexual practices, find one you are comfortable with. Most physicians are aware of GLBT issues and are able to offer superior care when they know their patient’s risk factors.

A positive test for any sexually transmitted disease is considered an indication of unsafe sex practices and should be followed with an HIV antibody test.

Michael Stewart began his series on sexually transmitted diseases in OutSmart’s April issue.

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