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Why is sexual health – and especially STDs – so awkward to talk about? We're helping break down that barrier by answering all of your questions about sexually transmitted diseases.

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June 4, 2020

According to the Centers for Disease Control and Prevention (CDC), sexually transmitted diseases, or STDs, are on the rise. In fact, according to the CDC's 2018 report on the state of STDs in the United States, STD rates have increased for the fifth year in a row and are now at an all-time high.1 That means that now more than ever, it's important to know the facts about STDs and to take steps to prevent them.

First, let's start with the basics. Sexually transmitted diseases are – just as the name suggests – spread from person to person through sexual contact. Many people may think that sexual intercourse is the only way to contract a sexually transmitted disease, but that's not actually true. STDs are really spread through contact with any infected bodily fluids which can range from semen and vaginal fluids to blood and other mucous membranes (like the ones found in the mouth). That means that no matter what, if you're sexually active, it's important to talk to your partner about possible STDs and always practice safe sex (more on that later).

But we know STDs can be difficult to talk about with your partner, parents, friends, and even your friendly neighborhood healthcare professional. Plus, it can be difficult to know where to turn for the right information. Luckily, you've found a really good place to start. We're here to help answer all of the questions you might think are awkward, but we think are so important.

1. What's the Difference Between an STD and an STI? And What's a Venereal Disease?

What the heck is the difference between an STD, STI, and venereal disease, you ask? Let's not overcomplicate it. The short answer is that they're all describing the same thing – diseases or infections that are spread from person to person through sexual contact. Historically, and still most commonly today, these kinds of infections were called venereal diseases, sexually transmitted diseases, or STDs.

More recently, though, the term sexually transmitted infection, or STI, has started popping up. According to the American Sexual Health Association (ASHA),2 replacing the word "disease" with "infection" may help end the stigma that all sexually transmitted diseases are lifelong diseases that have no cure.

There's an important difference between a disease and infection. An infection, for example, is often temporary and many times be treated or goes away on its own. A disease, on the other hand, occurs when there's damage to cells in the body – sometimes as a result of an infection – that can cause ongoing or future health issues. In many cases, STDs are infections that can be diagnosed, treated, if needed, and cured and do not have long-term health impacts.

For our purposes, we'll continue to use the term sexually transmitted diseases, or STDs, as it continues to be the most widely accepted and understood phrase to describe diseases or infections that are spread through sexual contact.

2. What Are the Most Common STDs?

a man holding a condom

It's no wonder that STDs are so common – there are more than 30 different bacteria, viruses, and parasites that are known to be spread through sexual contact, according to the World Health Organization (WHO).3 However, not all 30 of these infections are that common. In fact, there are only about eight infections that pop up most frequently, including syphilis, gonorrhea, chlamydia, trichomoniasis, hepatitis B, herpes, HIV, and HPV.

Today, we'll cover just a few of the ones our patients often have the most questions about.

Chlamydia

Chlamydia is an incredibly common STD that can infect both men and women. While it can be easily cured when diagnosed quickly, if left untreated, it can cause serious reproductive issues for women and make it difficult to get pregnant. The infection, like many STDs, can even be passed to babies during delivery.

Keep an eye out for chlamydia symptoms like abnormal discharge from the vagina or penis, a burning sensation when urinating, and, for men, pain or swelling in the testicles. It's also possible to get infected with chlamydia in the rectum through anal sex or when it spreads from another area of the body, like the penis. While rectal infections often don't cause any obvious symptoms, rectal pain, discharge, and bleeding are all signs you should get to a healthcare professional immediately.

The great news is that chlamydia is one of the STDs that can be easily cured with the right treatment. Your healthcare professional will likely run a lab test with a urine sample or take a swab of the infected area to determine your diagnosis. It's important to take all of the medication just as it is prescribed. Then, make an appointment with your primary care physician or swing by your local MedExpress to get rechecked in three months after treatment to make sure you don't require additional care. Make sure your sexual partner(s) visits a healthcare professional to get checked, too.

Gonorrhea

Gonorrhea is another really common STD that's spread through sexual contact. It can easily be treated when properly diagnosed, but it can have serious health impacts for both men and women when left untreated. Untreated gonorrhea can make it difficult for women to get pregnant due to pelvic inflammation disease, or PID. In men, untreated gonorrhea can cause a condition that affects the tubes attached to the testicles. While rare, gonorrhea can be life-threatening when the infection spreads to the blood or joints.

Gonorrhea can be difficult to identify as it often shows no symptoms in men and women – so make sure to get tested regularly (we've said this already, but that's just how important it is!). However, men can experience symptoms like burning when urinating, painful, swollen testicles, and may notice a white, yellow, or green discharge from the penis. Women, on the other hand, may mistake gonorrhea symptoms, which are often mild, for a urinary tract infection because they can be so similar. Women should be on the lookout for pain or burning while urinating, increased or abnormal vaginal discharge, and bleeding between periods.

Gonorrhea can often be diagnosed using a urine sample. Sometimes, though, your healthcare professional may collect a swab from other parts of the body, like the throat, rectum, urine canal, or cervix. Just like chlamydia, gonorrhea can be easily treated when diagnosed quickly.

MedExpress Pro Tip: If gonorrhea symptoms continue for more than a few days after treatment has started, talk to your healthcare professional. There is such a thing as a drug-resistant strain of gonorrhea, so your doctor may recommend a different course of treatment.

Herpes

Okay, we know you've heard about this one before. Maybe you even read about it in our first Awkward Questions blog. We're here to remind you again that oral herpes, while technically caused by one of the viruses that causes genital herpes, isn't necessarily only passed from person-to-person through sexual contact. In fact, many people with oral herpes, which often appear as cold sores or blisters around the mouth, are infected as a child through contact with saliva.

Now that that's out of the way, let's talk a little bit more about genital herpes. Genital herpes is an STD caused by the herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). These viruses are spread through vaginal, anal, or oral sex.

There is no known cure for genital (or oral) herpes. But don't let that stop you from visiting a healthcare professional if you notice symptoms like blisters or sores around the genitals, rectum, or mouth. These sores can break and spread (sometimes called an "outbreak") that may cause other symptoms like fever and body aches.

When properly diagnosed, genital herpes can be controlled, and outbreaks can be shortened or even prevented with the help of a daily medication. This anti-herpes medicine may even make it less likely that the infection will spread to your sexual partner(s) – but it's still really important to always practice safe sex.

Speaking of safe sex, let's talk about condoms and genital herpes. Depending on the location of the infection, condoms may not fully protect you or your sexual partners from being exposed to it. For example, genital herpes sores and blisters can appear in areas around the genitals that would not be covered by a condom. Always, always talk to your sexual partner before engaging in any type of sexual activity to make sure that you're going to be protected from STDs.

Like with all STDs, it's really important to get the treatment and care you need right away if you suspect you have genital herpes. Herpes can spread really easily to other parts of the body, so it's vital to manage your outbreaks with daily medicine prescribed by your healthcare professional. Also, if you're pregnant or trying to become pregnant and have been exposed to genital herpes, you should talk to your OB-GYN.

HPV

Here we go – the big one. With 79 million Americans infected, human papillomavirus, or HPV, is the most common sexually transmitted disease in the U.S., according to the CDC.4 To make matters worse, there are often no signs or symptoms of HPV, and at this time, there is no test to detect HPV in men – which means that even if you do get tested regularly for STDs (give yourself a pat on the back!), HPV may still go undetected for some time.  

We do have some good news, though. In most cases, HPV completely clears up on its own. When it doesn't, though, it can cause genital warts and, in some cases, cancer of the vulva, vagina, penis, or anus. Sometimes, it can cause cancer in the back of the throat.

Luckily, there are many preventative measures you can take to help lower your risk of getting HPV (more great news!) A good first step is to make sure you've received the HPV vaccination, which is recommended at age 11 or 12 and through the age of 26.

Women should also make sure to routinely get screened for cervical cancer, which is most commonly caused by HPV. And, of course, practice safe sex.

Pubic Lice (Crabs)

Pubic lice are itty bitty little insects (yes, insects) that are typically found in or around the genital area or on pubic hair. They actually look quite a bit like crabs you might find at the beach, which is how they got their very appropriate and not-so-creative nickname, crabs. Like other STDs, they're most often spread through sexual contact. Sometimes, these little buggers (literally) can spread to other types of coarse hair on the body, like armpit hair, beards, or chest hair. And, as you can imagine, they cause quite a bit of itching.

You may be thinking, "Gee, that sounds a lot like head lice. Are they the same?" Nope. Well, a little bit. While it's really unlikely to get crabs on your head, just as it's really unlikely that you'll get head lice on your pubic hair, these pesky bugs can be treated using similar methods. Over-the-counter shampoos, gels, and lotions work really well to get rid of pubic lice. It's still a good idea to get checked out by a healthcare professional, who may want to prescribe a stronger treatment in the form of a prescription medication.

3. How Quickly Can You Show STD Symptoms after Exposure? What Are the Most Common Symptoms?

Depending on the specific infection, STD symptoms can appear anywhere from a few days to months or even years after exposure – doesn't really narrow it down, does it? And what can make it even more difficult is the fact that some STDs may not have any signs or symptoms, which is why it's so important to get checked regularly (cough cough, get checked regularly). Men and women should both be tested for STDs at least once a year or more depending on your level of sexual activity. MedExpress centers are ready and equipped to help you get tested and treated.

STD symptoms can differ slightly depending on gender and type of infection, but the most common signs and symptoms including painful urination, lower abdomen pain, pain during sexual intercourse, burning, itchiness, or irritation around the genitals, and rash, bumps, blisters, or sores around the genitals.

Women should also keep an eye out for vaginal discharge and menstrual bleeding or spotting between periods, while men should be on the lookout for painful, swollen testicles, and discharge from the penis.

Always trust your gut and listen to your body. It can be easy to shrug off symptoms that worry you, but when it comes to your sexual health, you're the only one in control. No matter what your signs or symptoms are, if something feels off and you could have been exposed to an STD, get it checked out sooner rather than later. There's no shame in that game.

4. I'm on the Pill. Am I Protected From STDs?

a woman holding a package of contraceptive pills

Hormonal birth control does not prevent the spread of STDs. When used correctly, hormonal birth control methods – like the pill, shot, patch, or ring – can be very effective in preventing pregnancy, easing period pains, reducing hormonal acne, and regulating menstrual cycles. However, it cannot – we repeat, cannot – prevent the spread of STDs.

You know what does help lower your risk for STDs? Safe. Sex.

While the best way to protect yourself from STDs is to abstain from sexual intercourse, practicing safe sex – or safer sex – can be another really effective way to keep your body in tip-top shape. How can you make sex safer, you ask? A great place to start is by always using a condom made of latex or polyurethane during sexual intercourse. And yes, we mean always.

Remember when we talked about how STDs can be spread other sneaky ways, too, beyond just sexual intercourse? One of those ways is through oral sex. Some STDs, like herpes, can spread through skin-to-skin contact – not just through vaginal fluids or semen – and are easily transmitted during oral sex. A dental dam is an important step to making sure oral sex is safer sex, too.

Last, but certainly not least, use discretion. Don't engage in any sexual activity until you've talked about the risks of STDs with your partner and the last time your partner was tested.

We know it can be difficult to talk about STDs, but it doesn't have to be. Finding a healthcare provider that you trust, like MedExpress, is a really great place to start. At MedExpress, we put the "care" in healthcare and make sure that you receive the respect you expect and deserve when you visit us for your STD diagnosis, treatment, and advice needs.


References:

1 Centers for Disease Control and Prevention (CDC): Sexually Transmitted Disease Surveillance 2018. Accessed February 10, 2020.

2 American Sexual Health Association (ASHA): STDs/STIs. Accessed February 10, 2020.

3 World Health Organization (WHO): Sexually transmitted infections. Accessed February 6, 2020.

4 CDC: Genital HPV Infection – Fact Sheet. Accessed February 9, 2020.

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