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Sexually Transmitted Infections

While it can be an embarrassing subject for patients to discuss, it is very important to know as much as possible about sexually transmitted infections (“STIs”).  You need to know how to protect yourself and how to recognize symptoms. If you think you may have been exposed to a STI, talk with your gynecologist to get treated and to learn how to protect your sexual health.

If you are sexually active, you ARE at risk for getting STIs.

Sexually Transmitted Infections (STIs) are infections that you get from having sex with someone who has the infection. Wearing condoms and practicing other safe sex precautions dramatically lowers, but does not eliminate, your risk of becoming infected.  Both women and men are at risk of contracting STIs.

The number of cases of STIs have increased in recent years, especially among 16- 24 year-olds.  In addition, young people are less likely to go to the doctor.   Some ignore their symptoms hoping they will just go away, while others are embarrassed or afraid to be seen at a clinic.

STIs are caused by bacteria, parasites, and viruses. There are more than twenty types of STIs. Among the most common are chlamydia, gonorrhea, HPV and genital herpes. 

If STIs are not treated, STIs can cause serious health issues.  The good news is that many STIs can be treated with antibiotics, but it is important to get treated immediately before serious side effects occur.  For example, chlamydia and gonorrhea can cause infertility or serious problems with pregnancy. Babies born to mothers infected with chlamydia or gonorrhea can get eye infections and pneumonia and other serious conditions.  Complications can occur from active herpetic lesions during delivery.  HPV can cause cervical cancer and other less common, but serious, cancers.  

Not all STIs cause symptoms. As a result, a person may be unaware that they are infected, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

For example, HPV, which is the most common STI, has no symptoms. Most people who become infected with HPV do not even know they have it or that they are passing on the virus to a partner.  A person can have HPV even if years have passed since he or she had sexual contact with an infected person.

If you have symptoms suggestive of an STI, or have no symptoms, but suspect you may have been exposed to the infection, you should contact your physician.  There are two goals in treating a sexually transmitted disease, especially one that is easily spread (like gonorrhea). The first is to cure the infection in the patient. The second is to locate and test all of the other people the person had sexual contact with and treat them to prevent further spread of the disease.

In addition to using condoms, people can lower their chances of getting a sexually transmitted infection by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners.

Vaccines are available to protect against the types of HPV that cause most cervical cancers.  While the relatively new vaccination for HPV has made a difference in infection rates, there is still stigma attached to the immunization. Parents or providers may be reluctant to offer the vaccination to children because they believe it is associated with sexual activity.

At the same time, vaccination does not necessarily mean protection.  While the shot prevents most common strains of HPV, there are still others that can cause the disease. Women should also get a regular Pap smear to test for infection, as early detection can save lives.

Some of the ways we can improve detection and treatment of sexually transmitted infections include:

Privacy Matters -  Doctors must stress confidentiality in every single appointment, with every single patient. If a young person fears disclosure of their status, their lifestyle choices or their questions, they may not be honest and they will not receive the care they need.

 

Patient Interview/Modesty - The patient interview, when a provider collects any health history and asks questions about various lifestyle practices, should be done before a patient undresses.  And the patient should be given a gown to wear so that she does not feel vulnerable, and therefore more anxious about discussing personal information.

 

Offer full explanations - Providers should ensure that all patients, but especially young people, are informed of the screenings offered, as well as how and why they are performed.  For example, when patients understand that they will not need a pelvic exam in order to be tested for STIs, they may be more open to getting tested.

 

Talk to, and be honest with, your health care provider – Just as health care professionals have a responsibility to be open, honest and communicative with their patients, the same responsibility falls on the patient.

There is still a general apprehension around getting tested for STIs. This may be due to many reasons, including a fear of disclosing information to a health care provider, a fear of discovering that you ARE positive for an STI, and a fear of needing to inform sexual partners of your status.

There are many social attitudes that enforce bad behavior, but patients should understand is that "it's not about getting the STIs, it's about what you do, moving forward."

Patients Need to be Educated - It is extremely important for people (especially young people) to educate themselves.  Patients should know the symptoms of an STI, its long-term impacts, the treatment options, and how to best protect themselves. While I do not want to contribute to any stigmatization of contracting an infection, I do want to stress the seriousness of even a common and treatable condition like chlamydia.  Untreated infections can lead to chronic pelvic pain, scarring and even infertility.  Effective and complete treatment for the patient and her partner is very important and necessary to prevent re-infection.

Bottom line: Get tested, talk about sex honestly, educate yourself and take protection seriously.