It is relevant to have a test for sexually transmitted infections not only at an increased risk but prophilactically as well – once a year and before starting a new close relationship.
*Services are only available in Vilnius.
**During the tests we required dermatovenereologists consultation.
GENERAL INFORMATION ABOUT SEXUALLY TRANSMITTED DISEASES
Sexually transmitted diseases (STD) are sexually transmitted infections. This concept includes classic STD such as syphilis, gonorrhea, soft chancre, granuloma inguinale (donovanosis), lymphogranuloma venereum (LGV) as well as other fairly young diseases like chlamydia infection, HIV and AIDS, bacterial vaginosis, candidiasis, trichomoniasis, ureaplasmosis, mycoplasmosis, genital herpes (herpes), genital warts (condyloma acuminata etc.). Moreover, some diseases should be kept in mind, such as molluscum contagiosum (MC), scabies, pubic lice infestation, hepatitis B.
Why are sexually transmitted diseases dangerous?
Sexually transmitted infections are dangerous because they are incurable, or if they are cured improperly they can cause long-term or even incurable health changes such as infertility, impotence and so on. During pregnancy, an unborn baby can get STD: an infected mother can transmit the infection to her child. Therefore, it is very important that doctors could diagnose and timely treat all STD.
What are the most common symptoms of sexually transmitted diseases?
Symptoms for men:
● Tingling feeling and pain during urination
● Discharge from the male genital
● Rash in the genital area
Symptoms for women:
● Abnormal discharge from the vagina
● Unpleasant smell of vaginal discharge
● Tingling and itching in the genital area
● Blood-tinged vaginal discharge between menstrual periods and (or) after sexual intercourse
● Pain during urination
● Pain during sexual intercourse
● Pain in the lower abdomen
● Rash in the genital area
Symptoms, which are common to both men and women:
● Pain in the throat
● Pain and discharge from the rectum
Candidiasis is a fungal infection, which is caused by yeasts that belong to the genus Candida. This agent is usually found in the normal human flora, in the mouth, gut and genital mucosa. Sometimes (when a patient suffers from diabetes mellitus, or there is immunodeficiency, or especially after antibiotics course) this fungus multiplies and causes genital redness, cracks, itching, pain, and vaginal discharge that are similar to cottage cheese. Sometimes it is possible to contract this fungal infection through sexual intercourse.
Bacterial vaginosis – the change of normal vaginal microflora when anaerobic bacteria start to dominate. It is not a sexually transmitted disease; however, it is often (but not always) related to the number of sexual partners. If bacterial vaginosis recurs, sexual partners are tested and treated.
How are sexually transmitted diseases diagnosed?
Laboratory diagnostics play a significant role in the venereology. It is important to realize that none of laboratory diagnostic methods are perfect. Each method has its advantages and disadvantages. Therefore, it’s not always true that every positive result shows the presence of the disease and vice versa – every negative result shows the absence of the infection.
A cervical screening test (a smear test) is the simplest and most affordable method. For men the research substance is discharge from the urethra. For women the substance is taken from three places (the urethra, cervix, and vagina). The essence of the method – a thin layer of the research substance is placed on a microscope slide; after that, it is dried, painted with special paint and examined under the microscope.
Depending on the amount of white blood cells (leukocytes) in the standard smear, it becomes clear whether or not there is an inflammation, and if there are any present manifestations of it. Moreover, the standard smear test gives information about the nature of microflora in the urethra, cervix, and vagina. Information about microflora is more important while testing women as changes in vaginal microflora cause most infections (vaginal candidiasis, bacterial vaginosis).
The most extensive data is obtained when a patient hasn’t urinated at least for 4 hours, when a woman hasn’t used any intravaginal preparations at least 48 hours before the research and hasn’t washed her vagina for 24 hours, and she is on her 18th-21st day of the menstrual cycle.
Methods that determine STD antigens consist of ELISA (enzyme-linked immunosorbent assay) and DIF (direct immuno-fluorescence). For men the research substance is discharge from the urethra, for women – discharge from the urethra, cervix, and vagina. Low cost and fast performance (a couple of hours) are typical of these tests. It’s quite a well-established method. However, such methods achieve low accuracy (about 70%).
Methods that determine the DNA pathogen (the so-called DNA diagnostics) consist of the polymerase chain reaction. The research substance can be discharge from the urethra, cervix, vagina as well as urine. These methods are very modern and high accuracy (90-95%) is typical of them. The time from taking the sample until receiving the results usually takes 1-2 days.
This method has been approved in diagnosing chronic and non-symptomatic infections. When there is a large quantity of discharge (especially purulent discharge), the accuracy of this method significantly decreases. When there is purulent discharge, enzyme-linked immunosorbent assay (ELISA) / direct immuno-fluorescence (DIF) techniques and culture are employed.
The culture. The essence of this method is to sow the research substance in a special nutritious medium, which is suitable for growth of microorganisms. The research substance – discharge of the urethra, cervix, vagina, pharynx and rectum. Very high accuracy (95-100%) is typical of that culture. A major drawback of this method is that the answer is obtained only in 7-10 days.
Determining antibodies for the pathogen. These methods determine not the agent itself, but its antibodies (it is the body’s immunological response to the pathogen). Research substance – blood. These methods are widely used to diagnose syphilis and viral infections (genital herpes, hepatitis B and C, HIV infection).
Antibodies in blood can remain for a long time after bacterial infections have been treated. Therefore, when diagnosing bacterial infections (except for syphilis) these methods are not appropriate since they do not allow to distinguish the infection that you have already had from the infection you are currently suffering from.
In recent years, it has become trendy to use methods, which determine antibodies needed for the pathogen while diagnosing Chlamydia and Ureaplasmosis. However, it isn’t correct as it is difficult to distinguish the current infection from the one you have already suffered from. According to the majority of methodologies, these methods are not recommended to utilize when diagnosing Chlamydia and Ureaplasmosis. The only exception occurs when there is a need to determine a number of antibodies to Chlamydia while giving treatment for female infertility.
It is important to take samples properly and timely. The tests, which are conducted during the incubation period as well as 3-4 weeks after the course of antibiotics, can be inaccurate. Such test results can be interpreted individually. It should always be kept in mind that there is the probability of getting false-positive and false-negative results.
Dermatovenerologists are the most prepared for these purposes. As a rule, urologists and gynecologists have a more simplified understanding of the sexually transmitted infections diagnosis.
How are STD treated?
- Sexually transmitted infections are treated with oral medications, intramuscular or intravenous injections and locally applied preparations.
- During the treatment, while there is the risk of reinfection or transmission of STD to other people, patients should avoid sexual intercourse. After the treatment is finished, patients should come for screening again.
- It is necessary to inform their sex partners about STD, which has been diagnosed. Partners must always be examined and tested.
The myths of sexually transmitted diseases (STD):
Myth № 1
Oral sex is safe.
It’s false. Most sexually transmitted diseases can be transmitted during oral sexual intercourse without a condom. However, it should be noted that the risk of getting infection is lower than during contact through the vagina.
Myth № 2
Sexual intercourse with a married man (a married woman) reduces the risk of contracting STD.
Sexual intercourse with a married man (a married woman) does not exclude the risk of contracting STD. STD can often be asymptomatic (especially with women). A person does not even suspect that he/she has developed a disease as a consequence of a sexual intercourse that took place many years ago.
Myth № 3
Sexual intercourse with people, who are periodically tested for STD, eliminates the risk of contracting sexually transmitted diseases.
You can hardly agree with that. First of all, such mass screening consists only of standard smear tests as well as serologic tests for syphilis. Consequently, there is the probability of missing a number of sexually transmitted infections (such as Chlamydia, Mycoplasma, Ureaplasma and viral infections), which can grow unchangeably in the routine smear. Second, such screening tests often take place formally or virtually.
Myth № 4
You can catch the majority of sexually transmitted infections in the swimming pool or using a common bathroom.
It’s false. STD pathogens are nonresistant to the environment. They die very quickly when they are not in the human body. Furthermore, individual microorganisms cannot usually cause a disease. A greater number of microorganisms is required to cause a disease, which can get into the body only during sexual intercourse.
Myth № 5
Immediate vagina washing after sexual intercourse can greatly reduce the risk of sexually transmitted infections for women.
According to the contemporary beliefs, vagina washing does not reduce the risk of STD. Moreover, it contributes to the movement of pathogens to the higher layers of the genitals. As a result, it causes complications (inflammation of the uterus). It should be noted that this method is a risk factor in developing bacterial vaginosis.
Myth № 6
Urination and immediate ablution of the genital parts after sexual intercourse can greatly minimize the risk of transmission of sexual diseases for men.
There is a probability that the risk of catching an infection will be reduced to some extent; however, its level is not established yet. Such preventive measures will certainly do no harm. However, it is not worth relying solely on them.
Myth № 7
Condoms have small holes which let HIV and STD pathogens pass through.
It’s false. Modern researches have indicated that latex condoms reliably protect against HIV and STD pathogens when they are used correctly.
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