The Sexually Transmitted Disease Epidemic
A major epidemic of sexually transmitted disease (STD) has developed during the last 30 years. In the 1960's syphilis and gonorrhea, both easily treated with penicillin, were the only significant STDs. Today there are over 20 diseases with 12 million newly infected persons each year.1 It is estimated that 1 in 5 Americans is now infected with a viral STD.2 This does not include the bacterial diseases such as chlamydia, syphilis, and gonorrhea, which are at very high levels. Tragically, 63% of these infections occur in persons under age 25.3
• What is the cause?
What caused this dramatic change in a period of just 30 years? The answer is simple: increased sexual mixing of the population. As more and more people have multiple sexual partners, the inevitable result is an acceleration in the spread of STD’s. The problem is compounded by the fact that 80% of the persons infected have no noticeable symptoms4 and, therefore, cannot know they are contagious.
• What is the effect on young people?
Unfortunately, STDs are not equal opportunity diseases. Adolescents have a higher degree of susceptibility than do older people. The ectropion of the cervix of a female teenager is more likely to become infected than that of a woman in her 20's.5 Indeed, researchers have estimated that a sexually active 15 year old has a 1 in 8 chance of developing pelvic inflammatory disease (PID), but that by age 24 the probability has decreased to 1 in 80.6 PID is the most rapidly increasing cause of infertility in the United States and is a primary reason for the 600% increase in ectopic pregnancies since 1970.7
• Are condoms the solution?
Although touted by many as the solution to the problem of STD and unwanted pregnancy, condoms definitely are not. They have a poor record for prevention of pregnancy, with failure rates of up to 13% 8 or more per year. The American College of Obstetrics and Gynecology has referred to them as an "antiquated system of birth control."9 Different studies show different failure rates, but we must consider the result of an individual relying on condoms over several years of their sexual activity. Whatever the failure rate for one sexual act with a condom, it is unacceptable when compounded over 5 to 10 years using condoms. In addition, experts agree that condoms are useless in the prevention of some diseases. One such disease is human papillomavirus, which infects over 40% of some groups10 and which is the precipitating agent for the vast majority of cancers of the cervix, vulva, vagina, and penis. "Several studies have shown that condoms do not protect against this virus."11
• Is there a solution?
Postponing sexual activity until marriage with an uninfected mate is the only way for adolescents to be 100% sure of avoiding STD infection and pregnancy. Most of them can accomplish this if properly instructed and encouraged. In fact it was the normal expectation until the "sexual convulsion" of the 1960's. Likewise, single adults, including those with previous sexual experience, would be wise to save sex for a mutually monogamous lifetime partner. It is unrealistic to expect people to use condoms consistently and correctly with every act of intercourse for a long period of time. Delaying sex until marriage is the most medically sound advice we can give people in today's environment.
1 Facts in Brief, New York: The Alan Guttmacher Institute, 1993. 2 Ibid. 3 Ibid. 4 Moscicki, B., et al, "The Use and Limitations of Endocervical Gram Stains and Mucopurulent Cervicitis as Predictors for Chlamydia Trachomatis in Female Adolescents," American Journal of Obstetrics and Gynecology, 157:1, July, 1987. 5 Anderson, J.R. and Wilson, M., "Caring for Teenagers with Salpingitis," Contemporary OB/GYN, August, 1990. 6 Westrom, I. and March, P., Pelvic Inflammatory Disease, New York: McGraw Hill Book Company, 1992. 7 Barber, Hugh, Female Patient, Vol. 14, April, 1989. 8 Sondheimer, S., OB/GYN Diagnosis, 6:3, 1987. 9 American College of Obstetricians and Gynecologists Newsletter, March, 1991. 10 Bauer, H., et al, "Genital Human Papillomavirus Infection in Female University Students as Determined by a PCR-Based Method," Journal of the American Medical Association, 265:4, January, 1991. 11 Noller, K.L., OB/GYN Clinical Alert, September, 1992. © Medical Institute for Sexual Health, 1994. Used with permission. For more information, contact MISH at: Medical Institute for Sexual Health, P.O. Box 4919, Austin, TX 78765-4919; Telephone: (800) 892-9484; FAX (512) 472-7062
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Listing of Sexually Transmitted Diseases
According to the Centers for Disease Control (1993) there are 12 million cases of sexually transmitted disease (STD) cases reported annually.
- Some Common Sexually Transmitted Diseases
- Chlamydia - Chlamydia is a very dangerous STD as it ususally has no symptoms; 75% of infected women and 25% of infected men have no symptoms at all.
- Gonorrhea - Gonorrhea is one of the most frequently reported STD. 40% of it's victims contract PID if not treated, and it can cause sterility.
- Hepatitis B - a vaccine exists, but there's no cure; can cause cancer of the liver.
- Herpes - painful and episodic; can be treated but there's no cure.
- HIV/AIDS - AIDS is the sixth leading cause of death among young men and women. The virus is fatal involving a long, painful death.
- Human Papalloma Virus (HPV) & Genital Warts - 33% of all women have this virus, which can cause cervical or penile cancer and genital pain.
- Syphllis - untreated, can lead to serious damage of the brain or heart.
- Some Less Common Sexually Transmitted Diseases
- Bacterial Vaginosis - causes pain during urination, and untreated can result in kidney failure.
- Candidiasis Candidiasis - or yeast infection, is not a true STD but can be contrated sexually, causing burning, itching and discomfort. It is treatable with over-the-counter medication, although it is commonly recurrent.
- Chancroid - a large, painful blister or ulcer which appears in genital area; may rupture.
- Granuloma Inguinale - causes painless ulcers which enlarge and easily bleed.
- Lymphogranloma Venereum - rare in this country; causes lesions, aching and abcesses in the groin.
- Mucopurulent Cervicitis (MPC) - 33% of all women have this virus, which can cause cervical or penile cancer and genital pain.
- Molluscum Contagiosum - this virus causes smooth, shiny lesions, which must be individually removed by a doctor.
- Nongonococcal Urethritis (NGU) - afflicts men and causes urinary problems, can be caused by chlamydia.
- Trichomoniasis - can cause foamy vaginal discharge or no symptoms at all. Can cause premature birth in pregnant women.
Some Consequences of Sexually Transmitted Disease
- Consequence and Symptoms:
Ectopic Pregnancy is the implantation of a fertilized ovum outside the uterine cavity. This potentially life-threatening condition occurs most often in the fallopian tubes.
- Sudden persitent pain in the lower abdomen
- Bleeding and abdominal pain after a missed or light period
- Persistent fainting or dizziness (could signal internal bleeding) Ectopic pregnancy is more likely to occur if a woman has had a pelvic infection, a previous ectopic pregnancy, surgical abortion, or has become pregnant with an IUD in place.
- Consequence and Symptoms:
Pelvic Inflammatory Disease (PID) is a general term for a bacterial infection in the female pelvic organs. Specific types of PID include salpingitis (infection of the fallopian tubes), endometritis (infection of the uterine lining), and cophoritis (infection of the ovaries).
- Persistent cramps
- Pain during or after sexual intercourse
- Temperature of 102 - 104 degrees F
- Unusual vaginal bleeding or foul smelling discharge
- Tenderness in the lower abdomen
Prompt treatment of PID is important. Infection of the fallopian tubes may lead to scarring and adhesions (bands of scar tissue) that can obstruct the tubes, causing infertility. Over one in twelve women are left infertile after a first episode of PID, one in five are infertile after a second episode, and 40% are left sterile after three or more episodes of PID.
- Consequence and Symptoms:
Cervical Cancer occurs when cells on the cervix which grow in an abnormal way. Have regular Pap tests to check for this condition as it can be fatal.
- Abnormal bleeding, such as between periods or after intercourse
- Foul smelling vaginal discharge
- Discomfort during intercourse
Risk factors include:
- Early onset of intercourse, women who begin having sex before age 20 are more vulnerable to cell changes.
- Three or more sexual partners in one's lifetime. The greater the number of sexual partners, the greater the risk of acquiring a high risk type of HPV.
- Having a male sex partner who has had other partners, especially if a previous partner had cervical cancer.
- History of Genital Warts which are caused by the HPV virus.
What to do if you have an STD
If you think you may have an STD or any of the conditions listed above, see a doctor right away.
• Medical Institute for Sexual Health: http://www.medinstitute.org/
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