Sexual Health
When you are sexually
active, pregnancy is usually the greatest concern. You may be afraid of
what your parents or boyfriend will do if you become pregnant. You may
also be concerned that you will not be able to finish school or pursue
your career. While pregnancy is something to be very concerned about,
sexually transmitted infections are equally, if not more, worrisome.
You are at risk for pregnancy if you have sex around ovulation (about 3
days a month), but you are at risk for getting an STI every time you
have sex.
The Basics
There are now more than a
dozen STIs (Sexually Transmitted Infections), several of which are
chronic, life-long infections. In the United States, it is estimated
that there are 19 million new infections each year - over half of these
occurring in young people ages 15-24i. Presently, over 70
million people in the U.S. are infected or have been infected with an
STI or STD (Sexually Transmitted Disease)ii.
STIs & STDs: What are they?
An
STI (Sexually Transmitted Infection) is an infection that does not show
any physical signs or symptoms. It is contracted from another infected
person through sexual activity. It becomes an STD (Sexually Transmitted
Disease) when symptoms appear. It's important to remember that not all
infected people will have signs or symptoms. The problem is that some
of these STDs can cause a lot of damage and can be passed to you
partner without your knowledge. You do not have to have symptoms to be
contagious; you can spread the disease at any time.
STDs & STIs: Prevention
Did
you know that some STIs can be spread through all forms of sex and/or
intimate skin-to-skin contact (oral sex, outercourse, anal sex, mutual
masturbation)? Condoms are not as effective as most think at preventing
the spread of STIs. Using a condom during sex can sometimes reduce the
risk for transmitting or contracting certain STIs, but using a condom
never eliminates the risk entirely.
Consistent condom use 100% of the time during vaginal sex reduces your risk for:
- HIV by 85%iii
- Gonorrhea by about 50%iv
- Chlamydia by about 50%v
- Herpes by about 50%vi
- Syphilis by about 50%vii
- HPV by 50% or lessviii
Few studies have been done to see whether condoms reduce the risk of STIs, including HIV, during oral sex or anal sexix.
Abstaining
from sexual activity is the only 100% guarantee you have to avoid
pregnancy and to avoid contracting an STI. If you feel that you are not
ready to have sex, or if you do not want to put yourself at risk for
pregnancy or an STI, then abstinence is your best choice.
What is Chlamydia?
Chlamydia
is a common STI caused by the bacteria Chlamydia trachomatis. It can
cause permanent and lasting damage to a woman's reproductive organs
(uterus, fallopian tubes, and ovaries) if left untreatedx. It is the most frequently reported bacterial STI in the United Statesxi. Often Chlamydia shows no signs or symptoms, yet can cause irreversible damage.
Chlamydia
can affect both men and women at any time regardless of age. It is
spread through body fluids during vaginal, oral, or anal sexxii;
condoms offer a measure of protection against Chlamydia, but even with
protection you can still contract the disease. Chlamydia can also be
found in the throats of women and men who have oral sex with an
infected partnerxiii.
What is Gonorrhea?
Gonorrhea
is caused by the bacteria Neisseria gonorrhea. The Centers for Disease
Control estimate that over 700,000 people in the U.S. develop a new
gonorrhea infection each yearxiv.
Gonorrhea can
be spread through contact with the penis, vagina, mouth, anus, and
mother to baby during delivery. Ejaculation does not have to occur for
it to be transmitted or acquiredxv.
Not all
people who contract gonorrhea experience symptoms, but an infection can
cause serious complications. Men may experience symptoms such as:
burning sensation while urinating, white, yellow or green discharge
from the penis, and sometimes pain and swelling in the testiclesxvi.
Some signs of gonorrhea in women may be: discomfort or burning while
urinating, increased vaginal discharge, and bleeding between periodsxvii.
Gonorrhea
can be cured with antibiotics, but may cause serious side effects. Some
forms of gonorrhea are drug-resistant, making treatment of this disease
more difficultxviii.
What is Genital Herpes?
Genital
Herpes (HSV-2) is a sexually transmitted infection. Many people
infected with this disease do not have any symptoms. When signs do
occur, they typically appear as one or more blisters on or around the
genitals or rectum. The blisters break leaving sores that may take two
to four weeks to heal the first time they occurxix. Infected people can also have pain or burning during urination.
HSV-1
most of the time is oral herpes, which causes cold sores. HSV-2 is
typically found in the genital area. HSV-1 isn't generally sexually
related; however, it is becoming common to find both versions of the
virus in the genital and oral areas due to oral sexxx.
There
is no cure for genital herpes; however, there are medications that can
help suppress and/or reduce outbreaks. A person with genital herpes may
be contagious and not be aware. Between outbreaks, it lies dormant in a
nerve root. A variety of stressors can cause the virus to emerge
resulting in an active infection. Even correct use of a condom does not
guarantee protection from getting or spreading genital herpes.
What is Syphilis?
Syphilis
is often referred to as "The Great Imitator" because its symptoms are
sometimes very similar to the symptoms of other disease or disorders.
It is passed through direct contact with a syphilis sorexxi.
It cannot be contracted through contact with objects like toilet seats,
doorknobs, swimming pools, bathtubs, clothing, or eating utensils.
Syphilis
symptoms occur in three stages, but people infected with Syphilis may
not show any symptoms for years. However, they are at risk of suffering
health complications later if they do not receive treatment. Even if a
person has no symptoms, they can still pass and spread the disease.
If
caught early Syphilis can be cured with antibiotics, but not without
the possibility of it causing serious damage. The use of a condom does
not guarantee protection from getting or spreading Syphilis.
What is the Human Papillomavirus (HPV)?
The Human Papillomavirus is the most common sexually transmitted infection with about 20 million American's infectedxxii. About half of sexually active men and women will acquire an HPV infection at some point in their lifexxiii.
Currently, there are over 40 different types that can infect the
genital areas of both men and women. Most people who have HPV do not
know that they have the infection. Even if there are no symptoms it can
still be spread to your partner. This disease is important because it
is responsible for abnormal pap smears and is the cause of cervical
cancer.
Those who have symptoms of HPV may experience;
Genital
warts - Genital warts usually appear as small bumps or groups of bumps
most often in the genital area. They can be raised or flat, single or
multiple, small or large, and sometimes cauliflower shaped. Warts may
appear within weeks or months after sexual contact with an infected
person. Or, they may not appear at all. If left untreated, genital
warts may go away, remain unchanged, or increase in size or number.
This form of the disease will not turn into cancerxxiv.
Cervical
Cancer - Cervical cancer does not have symptoms until it is quite
advanced. For this reason, it is important for women to get a regular
pap test to detect it earlyxxv. The pap test detects
microscopic changes that HPV causes. Usually, these changes can be
picked up and treated long before cancer develops.
HPV is contracted through genital contact. In 90% of cases a person's body is able to clear the HPV infection on its ownxxvi,
but a person will still be contagious until the infection is cleared.
There are no tests for a general HPV infection. The only test on the
market is used for cervical cancer screeningxxvii. The best
way to protect yourself from HPV is not engaging in sexual activity
until marriage and remaining faithful to your partner after marriage.
Human Papillomavirus Vaccination
In
June of 2006, the FDA approved the vaccine, Gardasil, which was
developed for the prevention of cervical cancer, pre-cancer and genital
warts due to human papillomavirus (HPV) infectionxxviii. The
vaccine is designed to prevent the types of HPV that cause
approximately 70% of cervical cancers and 90% of genital warts casesxxix.
It does not protect against less common strains not yet discovered.
Additionally, it cannot protect someone who has already contracted the
HPV types included in the vaccine.
The most commonly reported adverse reactions of the vaccine were: fever, nausea, dizziness, and injection-site painxxx. Serious adverse reactions were: Guillain-Barré Syndrome, blood clots, and 27 reported deathsxxxi.
Abstaining from sexual activity prior to marriage and fidelity after marriage is the best way to prevent STIs including HPV.
Hepatitis B
Hepatitis
B is a disease that affects the liver. It is a sexually transmitted
infection, but it can also be spread through blood or other body
fluids. There is no cure for Hepatitis once contracted, but before
contraction a vaccine is available to protect against it.
Many
people with the Hepatitis B infection do not know they have the
disease. Commonly people do not look or feel sick, but they are still
able to pass the disease to other sexual partners. If symptoms do
occur, people may experience fever, fatigue, loss or appetite, nausea,
vomiting, and morexxxii. Since the majority of people do not have symptoms, it's important to talk to your doctor about being tested.
The use of a condom does not guarantee protection against Hepatitis B.
What is Pelvic Inflammatory Disease (PID)?
Pelvic
Inflammatory Disease is a serious infection that usually involves the
fallopian tubes and can be caused by many different bacteria. In
addition to infecting the fallopian tubes (the tubes that carry the
eggs from the ovaries to the uterus), PID can also infect the tissues
around and in the uterus and ovariesxxxiii. It is caused by
a number of different bacteria, but is most frequently caused by
Gonorrhea and Chlamydia often both at the same time.
One way
that Pelvic Inflammatory Disease can occur is when bacteria (in many
cases from a sexually transmitted infection) move from the vagina into
the uterus. This can result in serious consequences including
infertility, ectopic pregnancy (a pregnancy in the fallopian tube or
elsewhere outside of the womb), abscess formation, and chronic pelvic
painxxxiv.
The symptoms of PID can range from none to severe. About two-thirds of the time, PID goes undetected by health care providersxxxv.
If symptoms occur they may include: lower back pain, unusual discharge,
odor, painful urination, and irregular menstrual bleedingxxxvi.
If PID is left untreated it can cause serious, permanent damage. If
detected it can be treated with antibiotics, but the possibility of
long-term damage still exists.
If you have had PID before,
you are more at risk for another episode, which will cause further
damage to your reproductive organs. One out of every 10 women is left
infertile after one episode of PIDxxxvii.
Sex and Dating.
There
are many pros and cons to dating, and it all depends on how you
approach your relationships. If you feel that you are not ready or
interested in having a committed relationship, you may want to postpone
dating until you feel that you are ready. There is no rush to start
dating.
The decision to have sex is a very important one,
and there are lots of things to think about. Sexual relationships
affect your physical, emotional, and spiritual well-being. Whether you
are considering sexual activity, or you have already had sex, there are
risks for pregnancy and STIs even when using birth control or condoms.
The only sure way to avoid getting an STI or to prevent pregnancy is to
practice abstinence. Once you are in a long-term, mutually monogamous
and committed relationship with an uninfected partner (in marriage),
you will have no reason to worry about getting an STI.
Do you want to talk with someone about your relationship? We are here for you. Please feel free to contact us.
This
information is intended for general educational purposes only and
should not be relied upon as a substitute for professional medical
advice.
i Centers for Disease Control and Prevention. STD Surveillance 2006. http://www.cdc.gov/std/stats/trends2006.htm#ref1. (Accessed 10/31/08)
ii Centers for Disease Control and Prevention, Tracking the Hidden Epidemics: Trends In STDs In The United States, 2000.
iii-ix The Medical Institute for Sexual Health. The Facts About Sexually Transmitted Infections (STIs) http://www.medinstitute.org/content.php?name=stifacts. (Accessed 11/19/08).
x Centers For Disease Control and Prevention, Chlamydia Fact Sheet, 2006.
xi Centers For Disease Control and Prevention, Chlamydia Fact Sheet, 2006.
xii Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xiii Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xiv Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xv Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xvi Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xvii Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xviii Centers For Disease Control and Prevention, Chlamydia Fact Sheet. http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm. (Accessed, 10/31/08)
xix Centers for Disease Control and Prevention, Genital Herpes Fact Sheet. http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm. (Accessed, 11/3/08)
xx Genital Herpes; Get Your Facts Straigh [brochure], Austin, Texas: The Medical Institute for Sexual Health.
xxi Centers for Disease Control and Prevention, Syphilis Fact Sheet. http://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm. (Accessed, 11/3/08)
xxii Centers for Disease Control and Prevention, Human Papillomavirus Fact Sheet. http://www.cdc.gov/std/HPV/STDFact-HPV.htm. (Accessed, 11/4/08)
xxiii Centers for Disease Control and Prevention, Human Papillomavirus Fact Sheet. http://www.cdc.gov/std/HPV/STDFact-HPV.htm. (Accessed, 11/4/08)
xxiv Centers for Disease Control and Prevention, Human Papillomavirus Fact Sheet. http://www.cdc.gov/std/HPV/STDFact-HPV.htm. (Accessed, 11/4/08)
xxv Centers for Disease Control and Prevention, Human Papillomavirus Fact Sheet. http://www.cdc.gov/std/HPV/STDFact-HPV.htm. (Accessed, 11/4/08)
xxvi Centers for Disease Control and Prevention, Human Papillomavirus Fact Sheet. http://www.cdc.gov/std/HPV/STDFact-HPV.htm. (Accessed, 11/4/08)
xxvii Centers for Disease Control and Prevention, Human Papillomavirus Fact Sheet. http://www.cdc.gov/std/HPV/STDFact-HPV.htm. (Accessed, 11/4/08)
xxviii
Food and Drug Administration. FDA News: FDA Licenses New Vaccine for
Prevention of Cervical Cancer and Other Disease in Females Caused by
Human Papillomavirus. http://www.fda.gov/bbs/topics/NEWS/2006/New01385.html. (Accessed, 11/5/08)
xxix Centers for Disease Control and Prevention, HPV Vaccine Information for Clinicians. http://www.cdc.gov/std/HPV/STDFact-vaccine-hcp.htm. (Accessed, 11/4/08)
xxx Merck, Guardasil Prescribing Information. http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf. (Accessed, 11/5/08)
xxxi Centers for Disease Control and Prevention. Reports of Health Concerns Following HPV Vaccination. http://www.cdc.gov/vaccinesafety/vaers/gardasil.htm. (Accessed, 11/5/08)
xxxii
Centers for Disease Control and Prevention, FAWs for the Public;
Hepatitis B. http://www.cdc.gov/hepatitis/B/bFAQ.htm#bGAQ29. (Accessed,
11/5/08)
xxxiii Centers for Disease Control and Prevention, Pelvic Inflammatory Disease Fact Sheet. http://www.cdc.gov/std/PID/STDFact-PID.htm. (Accessed, 11/5/08)
xxxiv Centers for Disease Control and Prevention, Pelvic Inflammatory Disease Fact Sheet. http://www.cdc.gov/std/PID/STDFact-PID.htm. (Accessed, 11/5/08)
xxxv Centers for Disease Control and Prevention, Pelvic Inflammatory Disease Fact Sheet. http://www.cdc.gov/std/PID/STDFact-PID.htm. (Accessed, 11/5/08)
xxxvi Centers for Disease Control and Prevention, Pelvic Inflammatory Disease Fact Sheet. http://www.cdc.gov/std/PID/STDFact-PID.htm. (Accessed, 11/5/08)
xxxvii Centers for Disease Control and Prevention, Pelvic Inflammatory Disease Fact Sheet. http://www.cdc.gov/std/PID/STDFact-PID.htm. (Accessed, 11/5/08)
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Sexual Health
