Introduction

Introduction

Sexually transmitted diseases (STD) are a group of infections that affect the sex organs and genital areas. In the past, these infections were called venereal diseases or "VD."

STD are caused by germs. They are spread from person to person through intimate physical contact, usually sexual intercourse. Anyone who has intimate sexual contact with an infected person may develop STD. It can affect all types of people.

Most STD can be cured, but some cannot. The best way of preventing STD is to be informed and to take responsibility for your sexual activity by protecting yourself.

This means knowing the facts about STD. If you suspect you have been exposed to a STD or are worried, see your doctor, health centre or STD clinic. It is also important to tell your sexual partners about possible infection so they can get tested and treated early.

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General Information About STD 

What causes them?

STD are caused by germs or organisms such as bacteria, viruses, fungi, protozoa and parasites.

These germs need certain conditions in order to survive. They require a warm, dark and moist area to live and grow. The mucous lined openings of the body, especially in the genital area, provide these conditions.

STD germs cannot live away from the human body. They do not survive on objects such as:

• toilet seats
• telephones
• drinking cups
• in swimming pools

How are STD transmitted?

STD are spread from person to person during sexual intimacy. This usually occurs during vaginal and anal intercourse, or by oral sex. This direct contact allows STD germs of an infected person to be passed to the body openings of another susceptible person.

STD cannot be caught through casual social contact such as:

• kissing
• shaking hands
• sharing eating utensils
• using public washrooms

Women with an untreated STD can pass the infection to their unborn babies during pregnancy. The infant may also become infected during the birth process.

What parts of the body can be affected?

The most likely places for infections in males are the urinary opening, urethra (urine tube), and on the head and shaft of the penis. Infections can also occur on the scrotum or around the anal opening.

In the female the most common places for STD infections are the vagina (birth canal) and cervix (opening to the uterus or womb at the top of the vagina). The skin and mucous membrane linings of the genital and anal areas are also sites for some infections.

In both sexes, STD can occur in other body openings such as the throat or eyes.

How do people know they have STD?

Once STD germs have infected an individual, the body may start producing signs of infection (these are called symptoms).

Many people who have a STD do not develop any symptoms (these are called "asymptomatic infections"). It is important to know that these people can still develop complications and are still able to spread the disease to others.

Each STD causes different symptoms. There are several general changes or warning signs which can occur. These are:

• an abnormal discharge from the genital or urinary openings
• burning pain on urination
• itching or burning in and around the genitals
• the appearance of sores or warts on or around the sex organs
• in females, pain in the lower abdomen
• in males, pain in the testicles

If these symptoms or anything else unusual is noticed by sexually active people, immediate medical attention is necessary.

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Dealing with STD

How are STD detected and treated?

STD, if ignored, can cause serious damage to the body. They can be spread to others and can harm unborn children.

All STD need medical attention. In most cases they are curable. Those that cannot be cured can be managed with prompt and proper treatment. Doctors, clinics and health care professionals at STD clinics can diagnose and treat STD. In Alberta, visits to the STD clinic are confidential and free of charge.

It is important that the person with a STD follows the instructions given by the health care provider. This means taking all medication exactly as the health care provider tells you, abstaining from sexual contact for the required period of time and returning for any follow-up visits.

STD do not provide immunity or protection against future infections. This means, that even after treatment, an individual can still get a STD in the future. If symptoms return, medical attention is needed again.

What should be done for partners?

STD are contagious or communicable diseases. This means that sexual partners might also be infected. Treating STD also means treating any others who might be infected. Sometimes, partners may not have any symptoms and may not know they have an infection. It is important to inform partners so they can get medical attention. This will break the "chain of infection."

In some cases sexual partners may be contacted by specially trained nurses. All information will be kept confidential.

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Prevention of STD

STD can be prevented. 

The best way to prevent infection is to avoid any sexual activity. Although many people do make this choice, others who decide to be sexually active can reduce their chances of getting STD. This can be done by having sex with only one partner who is free of infection and who does not have any other sexual partners. People who run the greatest risk of acquiring STD are those who have unprotected sex with more than one partner or with casual partners.

The best way to prevent STD or reduce risk of infection is to choose:

• not to have sex (abstinence)
• risk free activities such as:

• hugging
• body massage
• masturbation

• delaying sexual activity until entering into a long term relationship where both partners are free of infection, and do not have sex with other partners or share intravenous drug equipment
• safer sex

Avoid high risk activities such as vaginal or anal sex without a condom. Do not share sex toys. Do not have sex with someone who has anything unusual in the genital area (such as sores, discharge or warts).

If you choose activities such as vaginal, anal or oral sex and use a condom properly there is little risk of exposure. Kissing is a low risk activity.

Condoms, when used consistently and properly, can minimize the risk of getting most STD. The condom acts as a barrier and blocks germs from passing from the sexual organs of one person to those of another. It is most effective when put on before any genital contact occurs. However, even if used properly, condoms do not provide 100% protection. Infection can happen if sores or warts are located on an area of the genitals that the condom does not cover. Sometimes sores or warts can be on the scrotum or in the pubic area.

About the male condom

• Use a condom each time you have sex.
• Put condoms on before any genital touching.
• Use condoms made of latex. Do not use condoms made of "natural" membrane because STD germs can travel through tiny pores in natural membrane condoms.
• Some people are allergic to latex and should see their health care provider for information on how to deal with this.
• Some condoms are prelubricated with a spermicide. Spermicides provide extra protection against some STD germs. However, spermicides can cause vaginal and rectal irritation that makes it easier for STD/HIV germs to cause infection. For this reason, condoms containing a spermicide should be used only if vaginal irritation does not occur. They should not be used for rectal sex. In these cases, condoms without a spermicide should be used.
• If a lubricant is needed use one that is water soluable (e.g. K-Y Jelly® or Astroglide®). Do not use oil-based lubricants like vaseline, baby oil or vegetable oil because they damage latex condoms.
• Read the instructions in the condom package about proper use. You may want to practice to feel comfortable using them.
• Check the expiry date.
• Keep condoms in a cool, dry place. Don’t carry them in a wallet in your back pocket.
• Don’t test condoms by stretching or inflating them. All are inspected prior to sale.
• Condoms cannot be re-used.
• Discard condoms in the garbage rather than flushing them down the toilet.

About the female condom

A female condom is now available in Canada. It is made of polyurethane and is shaped like a pouch. The female condom acts as a barrier and blocks germs from passing from the sexual organs of one person to those of another. When it is used consistently and properly for vaginal intercourse it provides some protection to prevent the transmission of STD. Like the male condom, a new female condom is used each time you have sex. It is available in drugstores. For more information about the female condom ask your health care provider or staff at the STD clinic.

Sexual health and responsibility

Choosing to be sexually active means making choices and accepting responsibilities. Practicing safer sex will help to maintain or improve your sexual health. If you suspect you have been exposed to a sexually transmitted disease or are worried about STD:

• Seek testing and medical treatment at the STD clinic or from your doctor.
• Do not have any sexual contact until treatment is completed and any follow-up examination is done.
• Inform your partner(s) of your infection and encourage them to seek treatment. Re-infection and further spread of STD can be avoided by prompt examination and treatment of your partner(s).

The two most important aspects of STD prevention are:

• be aware of STD
• take positive steps to avoid infection

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Chlamydia

Chlamydia (pronounced klamid-ia) is the name of the bacteria that causes the most common bacterial STD. Chlamydia is very similar to gonorrhea. In fact, in the past the two diseases were often confused with each other. The most common place for infection is the urethra in males and the cervix in females. In both sexes the eyes and rectum can be infected.

What are the symptoms?

Males:

• One to three weeks after sexual contact with an infected person, there might be a clear mucous discharge from the penis.
• Discomfort or a burning sensation in the urethra may be noticed at any time but is most frequently present during urination. These symptoms are most noticeable early in the day and usually recur if the disease is not treated.
• Up to 50% of males might not develop any symptoms of chlamydia.

Females:

• Females might notice an unusual vaginal discharge, irregular menstrual bleeding or discomfort during intercourse.
• Most often a female is told of her possible infection by her male partner who has sought medical attention.

Are there complications?

In females untreated chlamydia can infect the fallopian tubes and the ovaries causing pelvic inflammatory disease. Males with untreated chlamydia can develop infections in the prostate gland and testicles.

Babies born to females with untreated chlamydia infections are at risk of developing eye or lung problems after birth. All newborns have special antibiotic ointment put in their eyes to prevent possible infection.

How is it detected?

Chlamydia requires immediate medical attention and is diagnosed with special tests. These tests will detect chlamydia even when the infected person has no symptoms.

How is it treated?

Chlamydia is curable. It is treated with antibiotics. The antibiotics used are different than those used to treat gonorrhea. Sexual partners must be treated at the same time to ensure re-infection does not occur.

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Crabs

Crabs (pubic lice) are tiny insects that live on or around body hair, usually in the pubic area. They are about the size of a pinhead. Crabs can be seen with the naked eye and range in color from light grey to reddish brown. Although they prefer the hair of the pubic area, they may occasionally be found on the hair of the thighs, chest and underarms. The adult crabs lay eggs, called nits, on the shaft of the pubic hair. These nits appear as tan colored dots or specks and usually can’t be pulled or washed off the hair.

How do you get them?

Crabs are commonly spread from one person to another through intimate physical touching, usually sexual contact. Since crabs can live away from the body for up to two days, it is also possible to get them by sharing unlaundered bedding, towels or underclothing of an infected person.

How can you tell if you have them?

Both crabs and their nits can be seen with the naked eye. They are frequently detected because the affected area becomes very itchy. The itchiness, often worse at night, results from the bites on the skin by the adult crabs. Bluish spots may also appear on the skin of the affected area. Specks of blood may also appear on the underwear as a result of the bites. A person might have crabs for two to three weeks before noticing them.

How do you treat them?

Although no serious complications will result from untreated crabs, they are annoying and can be spread to others.

Only specific medicated lotions or shampoos can be used to treat crab lice. They are available without a prescription at most drug stores. The instructions for their use are included in the package. These instructions should be followed carefully.

Medications can be toxic and can irritate the skin. They should not be used more often than the directions indicate. After treatment, a fine toothed comb can be used to remove the nits.

At the time of treatment, all recently used bedding, towels and underclothing should be washed in hot soapy water. If desired, mattresses and upholstery can be vacuumed or sprayed with a household disinfectant.

Anyone who has intimate contact or shared a bed, personal towels or clothing with an infected person should undergo the same treatment at the same time.

Crabs will frequently recur if all the directions for their treatment are not closely followed.

Are there special concerns for children and pregnant women?

The medicated lotion used to treat crabs should not be used on children or by pregnant women. Women who are pregnant and who have crabs should see their health care provider or ask the pharmacist for a lotion that can be used safely in pregnancy.

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Genital Warts

Genital warts are flesh colored growths which may appear on or around the genital and anal areas. They are caused by the human papilloma virus (HPV). There are many different types of HPV. Some types of HPV cause warts on the hands or feet. Other types cause genital warts. Important consequences of HPV infection can include cancer of the cervix and vulva in females, and cancer of the penis and anus in males.

What are the symptoms?

Warts may appear within a few weeks or several months after contact with an infected partner or they may never appear. Not all genital warts look alike. They vary in size, shape and number. On the dry skin surface of the genitals, they are often small, pointed and firm, resembling warts seen elsewhere on the body. On the moist genital areas, they are usually pink and soft, sometimes growing together so they have a cauliflower-like appearance. They are occasionally itchy and may bleed.

Males:

• Genital warts occur most often on the head and shaft of the penis or in the anal area. Sometimes they affect the scrotum.

Females:

• They usually appear on the external genitals and anal area. They may also be found internally on the vaginal walls and cervix.

How do you get genital warts?

HPV is passed by direct skin to skin contact during vaginal, anal or oral sex with someone who has the infection. Sometimes people with genital HPV do not know they have it.

Are there special concerns for women?

Important consequences of HPV infection can include cancer of the cervix and vulva in females. HPV and other factors called co-factors make an individual more likely to develop genital cancer. These co-factors include: first intercourse at an early age, multiple sexual partners, smoking and other STD.

Are there special concerns for pregnant women?

Warts often appear for the first time during pregnancy. If they were present before pregnancy they may increase in size and number due to hormonal changes. They frequently shrink or disappear completely after the baby is born. Infants born to women with HPV may be exposed to HPV during the birth process. These infants may develop warts on the genitals or benign tumors of the larynx, but this is extremely rare. A woman does not need a cesarean-section unless the warts are blocking the birth canal.

How are they detected?

A health care provider will visually examine any unusual growths. A special instrument called a colposcope might also be used for examining the cervix. It magnifies the area so warts can be seen easier.

A Papanicolaou test or Pap test is a screening test used to detect early precancerous cell changes on the cervix. It is important for all women to have regular Pap tests to screen for cancer of the cervix.

How are they treated?

Genital warts must be treated under medical supervision. There are a variety of treatments available. These treatments include:

• cryotherapy (freezing the wart with liquid nitrogen)
• chemicals or creams (applied to the surface of the wart)
• electrocautery (destroying the wart with an electric current)
• laser therapy (using a beam of light to destroy the wart)
• surgery

The treatment depends on the patient, the location of the warts, the size and number, and how long the patient has had them. Often treatment requires several visits to the health care provider. The treatment may get rid of the wart but the virus may still be present on the skin. Warts might also return after treatment and may require attention again. Sometimes warts disappear on their own.

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Gonorrhea

Gonorrhea (pronounced gon-or-ee-a), is sometimes referred to as the ‘dose’ or ‘clap.’ It is caused by a bacteria called, Neisseria gonorrhoea. These infections are most commonly found in the urethra in males and the cervix in females. The throat, rectum and eyes of both sexes can also be affected. The gonorrhea bacteria is easily passed from one infected person to another during vaginal and anal intercourse, and by oral sex.

What are the symptoms?

Males:

• Symptoms will usually show up within a week following sexual contact with an infected person.
• A discharge of pus from the urethra and mild to severe burning pain when urinating are common signs.
• Up to 20% of infected men will not have
• any symptoms.

Females:

• An unusual vaginal discharge may occur.
• Pain on urination may occur.
• 80% of infected women will not notice any symptoms.

In both sexes, gonorrhea infections of the throat do not usually produce symptoms. Anal infections may cause a discharge of pus or blood from the rectum, but often there are no symptoms.

Are there complications?

Untreated gonorrhea can lead to serious problems of the reproductive organs. Females, often unaware they have gonorrhea, may develop an infection of the fallopian tubes and ovaries. This is called pelvic inflammatory disease (PID). It can cause lower abdominal pain, vaginal discharge, fever and painful intercourse.

If not treated, internal scarring and blockage of fallopian tubes can cause sterility, tubal pregnancies, chronic pelvic pain and menstrual irregularities.

An untreated pregnant female can pass gonorrhea to her baby’s eyes during childbirth. This type of infection, which may cause blindness, can be prevented by special drops. These drops are put into the eyes of all newborns at birth.

Although not common, gonorrhea in males can cause pain and swelling in the testicles which may result in sterility.

How is it detected?

Gonorrhea requires immediate medical attention and is diagnosed with special tests. These tests will detect gonorrhea even when the infected person has no symptoms.

How is it treated?

Gonorrhea is curable. It is treated with antibiotics. Sexual partners must be treated at the same time to ensure re-infection does not occur.

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Hepatitis B

The word hepatitis means "an inflammation of the liver." There are different types of hepatitis. They include: hepatitis A, B, C, D and E. This sexually transmitted disease is caused by the hepatitis B virus (HBV). The virus is found in the body fluids of an infected person.

How is Hepatitis B transmitted?

The virus is spread in the following ways:

• sexual intercourse with an infected partner
• exposure to infected blood
• from infected mother to baby at birth or during breastfeeding

The risk of getting hepatitis B from a blood transfusion is very low because all blood and blood products are tested in Canada. Hepatitis B is not spread by casual contact such as hugging, shaking hands and sharing bathroom facilities.

What are the symptoms?

The incubation period (the time from exposure to the virus until symptoms appear) ranges from 45 to 160 days. Symptoms usually develop slowly and might consist of:

• loss of appetite
• nausea
• vomiting
• mild abdominal pain
• jaundice (yellowing of the skin and whites of the eyes)
• occasional skin rashes and pains in the joints

Many people who are infected with the hepatitis B virus do not have any symptoms. However, these people are still infectious and can pass the virus to others.

How can you tell if you have it?

Hepatitis B needs medical attention and is diagnosed by a special blood test.

How is it treated?

There is no cure for hepatitis B. About 90 per cent of people with hepatitis B will get well and develop lifelong immunity without any medicines or treatment. The remaining 10 per cent of people are chronic carriers and may develop cirrhosis or cancer of the liver over a period of years. Carriers may not have symptoms but remain infectious and might transmit the disease to others. A small number of people who get hepatitis B will die from it.

Are there special concerns for pregnant women?

In Alberta, all pregnant women are tested for the hepatitis B virus. Babies born to mothers who have hepatitis B are given immune globulin to prevent them from developing the disease. These babies are also given the hepatitis B vaccine so that they will develop lifelong immunity.

How can you protect yourself?

Hepatitis B can be prevented by using safer sexual practices and not sharing injection drug equipment. There is a safe, effective vaccine available for hepatitis B.

People can get vaccinations for hepatitis B from their doctors, health clinics and the STD clinic. Some people who might consider getting hepatitis B vaccination include:

• people with a recent history of a STD
• individuals who have multiple sexual partners
• sexually active men who have sex with men, and men who have sex with both men and women
• sexual partners of hepatitis B carriers
• health care workers
• people who work in other occupations where they come in contact with blood (police officers, firefighters)
• sexual assault victims
• sex trade workers
• injection drug users
• residents and staff of institutions for the mentally challenged

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Herpes

Genital herpes is caused by one of two viruses, herpes simplex type 1 (HSV-1) or herpes simplex type 2 (HSV-2). These two types of herpes are responsible for both the common "cold" sore on the mouth and for genital herpes infections involving the sex organs.

Herpes is passed during direct physical contact with the open sores or blisters of an infected person. It can also be passed when there are no signs of the infection and the skin looks and feels normal. If cold sores on the mouth of one person come into contact with the genital area of another during oral sex, genital herpes may occur.

What are the symptoms?

Symptoms of genital herpes sometimes occur within one to three weeks following intimate sexual contact with an infected person. Often the infection may not appear until weeks or months later. Some people come into contact with the virus but do not develop any symptoms or signs of the disease.

Often the symptoms begin with a tingling or burning sensation in the genital area. Fluid-filled blisters appear and soon break to form shallow, painful ulcers on the skin. This first outbreak of herpes may include: headache, fever, swollen glands or a flu like feeling.

Females usually have outbreaks on the vulva, near the anal opening or internally on the vaginal walls or cervix. Herpes infections of the cervix are usually painless, but may produce a vaginal discharge and bleeding after intercourse.

In males, the blisters and sores appear most often on the penis, on the scrotum or near the anus.

Does it recur?

In both males and females the sores usually heal on their own within 2 to 4 weeks. After the sores disappear, the herpes virus becomes dormant, or goes into a "sleeping state," in the body. Sometimes it becomes active again, causing the blisters and sores to reappear. Usually with each new outbreak the discomfort is less severe and the healing time is faster.

The frequency of repeat outbreaks varies from person to person. The type of herpes virus can also affect the frequency of repeat outbreaks. Over time, outbreaks tend to be less often. Fever, sunlight, menstruation, sexual activity and emotional stress may trigger recurrent outbreaks.

Are there special concerns for pregnant women?

Females with genital herpes can and do become pregnant and have healthy babies. The greatest risk of serious infection in the baby is if the mother acquires the herpes virus for the first time during pregnancy or if she has an outbreak at the time of labour.

Pregnant women who know or think they have genital herpes, or have partners with the infection should tell their doctor. Pregnant women and their partners may benefit from taking special medication during the pregnancy. The medication may decrease the risk of transmission of the virus from the male partner to the pregnant woman. It may also decrease the risk of an outbreak occurring at the time of delivery. A Cesarean delivery may be needed if the herpes virus is active at the time of labor.

Is it highly contagious?

Individuals are most infectious when blisters and ulcers are present. They can sometimes pass the virus to their partner even though there are no signs of an outbreak and the skin looks normal. This is called "asymptomatic shedding." Asymptomatic shedding is greater if someone is infected with HSV-2. The greater number of outbreaks an individual has, the greater the chance of asymptomatic shedding. It is important for infected people to abstain from sexual contact during an outbreak. This means from the time tingling or burning starts, and sores develop, until the sores have completely healed and the skin is normal. However, it is also very important to practice safer sex at all times because the herpes virus may be active without any symptoms or signs of an outbreak.

How is it detected?

Genital herpes requires medical attention and is diagnosed with special tests.

How is it treated?

At present there is no cure for genital herpes. Medication can be prescribed to relieve discomfort and speed up the healing process. These medications can be taken in a variety of ways. They can be taken during an outbreak, or just before an outbreak might occur, or to prevent outbreaks. The medication and how it is taken depends on the individual and the health care provider. Keeping the affected area clean and dry promotes the healing process.

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HIV Infection/AIDS

Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immunodeficiency Syndrome (AIDS).

When HIV infects the body, it weakens the immune system by destroying certain immune system cells. The infected person can get unusual infections and cancers. When the immune system becomes damaged beyond repair, these infections and cancers overwhelm the body. This is the final stage of HIV infection called AIDS.

As a result of new treatments and medications HIV infection is becoming a chronic long term condition. A person can be infected with the virus and live for many years before becoming ill. Therefore, in Canada less people are being diagnosed with AIDS but still are infected with HIV and are capable of transmitting the virus to others.

How is HIV transmitted?

The virus is found in all body fluids of an infected person. It is only transmitted in blood, semen, vaginal secretions and breast milk. This means it is transmitted in the following ways:

• sexual contact with an infected person
• exposure to infected blood (This may occur during activities such as sharing injection drug use equipment; tattooing, body piercing or acupuncture (using unsterilized equipment); or activities where people may share each other’s blood)
• from infected mother to unborn or breastfed baby

In Canada, since 1985, all blood and blood products are screened for HIV antibodies. The risk of infection through a blood transfusion is extremely low.

HIV is not spread by casual contact such as hugging, shaking hands and sharing bathroom facilities, or on objects such as drinking fountains, telephones or clothing.

What are the symptoms?

An infected person may not have any symptoms or signs. They are still capable of passing the virus on to others.

An infected person may experience the following:

• Initial infection — flu-like symptoms may occur two to four weeks after infection.
• Infected and well — no symptoms or signs are present, but the blood test is positive.
• Infected and ill — a combination of persistent symptoms may occur such as weight loss, fatigue, fever, night sweats, dry cough, diarrhea, swollen lymph glands, memory loss, confusion and depression. (Persistent means these symptoms last many weeks or months).
• Infected and diagnosed with certain infections or cancers.

A diagnosis of AIDS is made by a doctor based on symptoms, special blood tests and/or the presence of unusual infections or cancers.

How is it detected?

There is a blood test for HIV antibodies. (It is not a test for the virus nor is it a test for AIDS). Antibodies are markers that are produced by the body after the virus enters the blood stream. After a person comes in contact with HIV it may take up to 6 months for the blood test to become positive. However, 95% of tests will become positive in three months. The time between being exposed to the virus and testing positive is called the "window period."

HIV antibody testing is available from your doctor or at the Sexually Transmitted Disease Clinic. The test is free and confidential. Your health care provider will tell you your test results.

How is it treated?

A variety of drugs are now available which improve health and life expectancy. At this time there is no vaccine to prevent HIV infection and there is no cure once a person is infected.

How can you protect yourself?

HIV infection can be prevented. Since most people with HIV infection look healthy, it is impossible to know who is infected. Safer sexual practices will prevent spread of this infection and must be used at all times.

Contaminated blood must enter another person’s blood stream to cause infection. To prevent HIV infection through blood contact it is very important to:

• never share needles, syringes, other injection drug equipment, razors, or toothbrushes
• avoid unsterile equipment used for tattooing, body piercing and acupuncture
• never intentionally exchange blood with anyone

Are there special concerns for pregnant women?

Recent studies have shown that the rate of transmission from an infected mother to her unborn baby can be decreased significantly if the mother takes special medication during the pregnancy.

In Alberta, all pregnant women will be counselled and offered confidential testing for HIV antibodies.

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Mucopurulent Cervicitis (MPC)

Mucopurulent Cervicitis is the name of a common STD in females. MPC causes an inflammation of the cervix. MPC is caused by an organism other than chlamydia or gonorrhea. In many cases the organism that causes MPC cannot be identified.

What are the symptoms?

Females might notice an unusual vaginal discharge, irregular menstrual bleeding or discomfort during intercourse.

Are there complications?

Untreated MPC can cause infections of the fallopian tubes and ovaries, resulting in pelvic inflammatory disease.

How is it detected?

MPC requires immediate medical attention and is diagnosed with special tests.

How is it treated?

Treatment for MPC is with antibiotics. They are different from the ones used to treat gonorrhea. Partners need to be told so they can receive the same treatment.

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Non-Gonococcal Urethritis (NGU)

Non-gonococcal urethritis is the name of a common STD in males. It causes an inflammation of the urethra. NGU is an infection that is not caused by gonorrhea. In almost half of the cases of NGU the organism that causes it cannot be identified.

What are the symptoms?

• One to three weeks after sexual contact with an infected person, there might be a clear mucous discharge from the penis.
• Itching, discomfort or a burning sensation in the urethra might be noticed at any time but is most frequently present during urination. These symptoms are most noticeable early in the day and usually recur if the disease is not treated.

Are there complications?

In a small number of cases the infection spreads to the testicles. It can cause pain and swelling resulting in infertility.

How is it detected?

NGU requires immediate medical attention and is diagnosed with special tests.

How is it treated?

Antibiotics are used to treat NGU. They are different from the ones used to treat gonorrhea. Partners need to be told so they can receive treatment. In some cases, the infection might persist, even if the medication is taken properly, and all sex partners have been treated. If the symptoms persist or re-occur, it is important to see your health care provider again.

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Scabies

Scabies is a common, very contagious skin condition caused by an almost invisible insect or mite that burrows under the skin. The disease is sometimes called "the itch" because the main symptom is moderate to severe itching of the affected skin.

The scabies mite is easily passed from person to person by direct skin contact. In sexually active people this frequently occurs during physical intimacy. It is also possible to get scabies by sharing the clothing, bedding or towels of an infected person.

What are the symptoms?

The itching, more severe at night, results from the female mite burrowing under the skin to lay her eggs. This also produces small red bumps or streaks on the skin surface. These appear most commonly in the skin folds between the fingers, at the elbows, in the armpit and groin. People who acquire scabies through sexual contact may notice these symptoms in the genital area or on the buttocks or abdomen.

How is it detected?

Scabies should only be diagnosed by a health care provider because the itching and rash can be confused with other skin disorders. In order to identify scabies, a small scraping of skin may be needed to look for the mite under a microscope.

How is scabies treated?

Scabies is treated using specific medicated lotions available at most drug stores without a prescription. Close contacts such as household members and sex partners should also be treated as they too, may be infected. Clothing, bedding and towels should be thoroughly washed with hot, soapy water. Although scabies responds readily to treatment, it frequently recurs because people fail to carefully follow these instructions.

Are there special concerns for children and pregnant women?

The medicated lotion used to treat scabies should not be used on children or by pregnant women. Children and pregnant women who have scabies will receive a special lotion that is safe for their use.

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Syphilis

Syphilis is caused by a germ called Treponema pallidum. It cannot survive outside the body. This germ is passed on during direct contact with a syphilis sore or rash during sexual activity.

Syphilis is a disease that can involve many parts of the body. If not treated it can result in very serious long term consequences.

What are the symptoms?

Syphilis passes through three stages. The symptoms of each stage can be mistaken for other illnesses. The symptoms are the same for both males and females.

First Stage — Primary Syphilis

Anywhere from 9 to 90 days (usually 3 weeks) after sexual contact with an infected person, a sore called a chancre (pronounced shang-ker) will develop on any part of the body where the germs entered. This is usually on or around the sex organs but can also be inside the mouth or rectum.

The chancre is a painless sore that can range from pin point size to as large as a quarter. Women and men who have sex with men may unknowingly have the disease because the chancre may be hidden inside the vagina or rectum.

Primary stage syphilis can be easily transmitted because the chancre contains the syphilis germ on its surface. Although the chancre will heal without treatment in 2 to 4 weeks, the disease is still active.

Second Stage — Secondary Syphilis

This stage lasts 2 to 6 weeks. It follows the appearance of the chancre. This stage occurs 2 to 6 months after the initial contact with an infected person.

A rash, resembling measles or a heat rash, breaks out anywhere on the body. It often produces little bumps on the hands and feet, or red patches on the skin. There may be a loss of appetite, tiredness, fever, hair loss and swollen glands.

The disease is very contagious during this stage and can easily be passed to sexual partners. Even without treatment, these symptoms will disappear and the disease becomes hidden. However, the syphilis germs are still alive in the body and the disease can progress to the third stage.

Third Stage — Tertiary Syphilis

This stage develops anywhere from 2 to 40 years after the symptoms of the second stage have disappeared. Even though there are no obvious symptoms or signs, the syphilis germs may be invading and damaging vital organs. This can cause serious problems such as blindness, paralysis, deafness, and brain or heart disease.

Are there special concerns for pregnant women?

A pregnant woman with untreated syphilis may pass the disease on to her unborn child. Possible complications of syphilis during pregnancy are premature birth, miscarriage, stillbirth and birth defects.

How is it detected?

Syphilis requires immediate medical attention and is diagnosed with special tests.

How is it treated?

Syphilis is treated with antibiotics. It can always be cured regardless of the stage. The earlier treatment begins the less chance of serious complications developing. Partners need to be told so they can receive the same treatment.

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Vaginitis

Vaginitis is an inflammation of the vagina. It has several causes but the three most common are Yeast, Trichomoniasis, and Bacterial vaginosis.

These infections result in abnormal and unusual vaginal discharge and genital itching. The discharge is quite different from the normal discharge that occurs in females. The normal discharge, is clear or slightly creamy in color, scant, odorless and causes no discomfort.

Although the symptoms of vaginitis appear in the female, the male can also be infected and not know it. In some cases he becomes a carrier and can re-infect his partner after she has been treated. With this in mind, he should also be examined and treated if necessary.

What is yeast?

A yeast infection is caused by a fungus called Candida. It is often found in the vaginas of healthy women. Sometimes, due to changes in body chemistry, yeast may be stimulated to overgrow and produce symptoms of vaginitis. Some factors influencing this overgrowth are antibiotics, birth control pills and environmental factors. These environmental factors include: tight non-breathing clothing, scented feminine hygiene products and coloured toilet paper.

What are the symptoms?

The symptoms of a yeast infection are a curdy white vaginal discharge, itching and redness in the genital area.

How is it detected?

Yeast infections need medical attention. Yeast is diagnosed with an examination, swab test and the use of a microscope.

How is it treated?

Yeast is treated with vaginal creams, ovules or with oral medication. Treatment for yeast is now available over the counter, but it is recommended that women see their health care provider for an examination. Symptoms of yeast may be similar to other STD.

What about males and yeast infections?

This infection can also be passed to the male partner during intercourse. The male usually does not develop symptoms, although sometimes he might notice genital itching and a fine rash on the penis. It is usually treated with the same cream as used to treat females.

What is trichomoniasis?

Trichomoniasis or "Trich," is a type of vaginitis caused by a microscopic protozoa called Trichomonas vaginalis. It is acquired during sexual intercourse with an infected partner.

What are the symptoms?

One to three weeks after sexual contact, females usually develop a foul smelling greenish or yellowish vaginal discharge accompanied by itching in the genital area. Pain during intercourse may also occur.

How is it detected?

Trichomoniasis needs medical attention. It is diagnosed with an examination, swab test and the use of a microscope.

How is it treated?

The treatment can be either oral medication or vaginal cream. All regular sexual partners should be treated at the same time.

What about males and trichomoniasis?

The infected male partner usually does not have symptoms but may experience a slight urethral discharge or burning on urination. For males the treatment is oral medication.

What is bacterial vaginosis?

Bacterial vaginosis (BV) is very common. It is caused by an imbalance or overgrowth of the female’s normal vaginal flora.

What are the symptoms?

The symptoms are a "fishy" smelling, thin watery gray colored vaginal discharge. Often the odor is worse after sexual intercourse.

How is it detected?

Bacterial vaginosis needs medical attention. It is diagnosed with an examination, other special tests and the use of a microscope.

How is it treated?

The treatment is either oral medication or vaginal cream.

What about males and bacterial vaginosis?

Males rarely develop any symptoms or require treatment.

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Where should you go if you need information or help?

The following clinics or your doctor can provide information along with confidential diagnosis and treatment of sexually transmitted diseases.

Calgary
STD Clinic Telephone: (403) 297-6562

Edmonton
STD Clinic Telephone: (780) 413-5156

Fort McMurray
STD Clinic Telephone: (780) 791-6263

For STD/HIV information call:
1-800-772-2437

• toll free
• 24 hour
• confidential
• you can speak directly to a registered nurse during regular business hours (Monday to Friday)

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