STDs

Safer Sex

Safer sex includes all measures that reduce the risk of infection and the spread of sexually transmitted diseases . The aim is to avoid contact with, for example, semen or vaginal fluid or even blood. However, it is important to know that the term “safer sex” and not “safe sex” is for a reason, because there is unfortunately no such thing as absolute safety . Especially if you change partners frequently, you should pay attention to your own safety, because this always comes first.

The best-known method of practicing safe sex is through protected sex with condoms . Condoms create a barrier between the two partners that can prevent the transmission of many STDs. Female condoms, called femidomes , are also a good protection against the spread of sexually transmitted diseases, but are not very common in the western world. Many people forget that sexually transmitted diseases can be transmitted with any type of sexual contact – i.e. with vaginal, anal and oral sex. In the case of oral sex, condoms provide protection for men, or latex, intimate tissues or wet wipes for women.

Sexually transmitted diseases can not only be transmitted directly during sexual intercourse, but a smear infection , for example via the hands, is also possible. Make sure to clean your hands and genitals thoroughly after using condoms, femidoms or intimate wipes to prevent subsequent transmission.

The most common symptoms of STDs

Every sexually transmitted disease is triggered by a specific pathogen, be it a bacterium, a virus or a parasite. The symptoms can vary from disease to disease, but there are some symptoms that are caused by several STDs and require clarification. These include:

• Discharge from the urethra or vagina
• Unpleasant smelling, unusual discharge
• Painful or painless genital ulcers
• swelling of the groin or testicles
• abdominal pain
• pain when urinating
• bleeding disorders (in women)

Some sexually transmitted diseases are partially painless or completely symptom-free. These often go unnoticed and therefore untreated. In the long term, however, they can lead to serious complications. It is therefore important, especially after changing sexual partners, to have regular check-ups for sexually transmitted diseases in order to avoid spreading and long-term health problems.

Which sexually transmitted diseases are there? An overview

Since the symptoms of the various sexually transmitted diseases can differ, here is a small overview of the diseases that are mainly transmitted through sexual contact. Sexually transmitted diseases usually affect all genders, but can have different forms and consequences.

If you suspect that you have contracted an STD, you should consult a doctor immediately, as early treatment can prevent long-term damage.

chlamydia

Chlamydia is one of the most common sexually transmitted diseases caused by bacteria . This particularly affects sexually active teenage girls and women between the ages of 20 and 24 . Risk factors are:

• Frequently changing sex partners
• Unprotected sex.

A chlamydia infection can be symptom -free. However, if symptoms do occur, they usually begin 1 to 3 weeks after infection. Typical complaints are:

• Painful urination
• abdominal pain
• Discharge from the urethra / vagina
• pain during sexual intercourse
• spotting
• testicular pain (men)

If left untreated, a chlamydia infection can lead to irreversible adhesions in the fallopian tubes and thus to infertility. Rapid treatment is therefore of the utmost importance. Chlamydia infection during pregnancy can lead to premature rupture of membranes and premature birth. Transmission to the newborn is also possible. Chlamydia can cause conjunctivitis or pneumonia.

Gonorrhoe (Tripper)

Gonorrhea, popularly known as gonorrhea , is a bacterial sexually transmitted disease caused by Neisseria gonorrhoeae (gonococci). Men and women are affected with equal frequency. The disease occurs primarily in young adulthood and, as with chlamydia, frequently changing sexual partners and unprotected sexual intercourse are the main risk factors. If left untreated, gonorrhea can also become chronic and lead to infertility .

Typical complaints of gonorrhea are:

• Thick, cloudy/bloody discharge from penis or vagina
• Pain/burning when urinating
• Heavy menstrual bleeding, bleeding between periods
• Swollen, painful testicles
• pain during bowel movements
• Jucken am After

During oral and anal sex, the bacteria can also spread to the throat or rectum and cause symptoms there. If the newborn is infected with gonococci at birth, these can lead to purulent conjunctivitis.

Genitalherpes

Herpes genitalis, like cold sores , is triggered by the herpes simplex virus (HSV). Although the genital region is predominantly affected by HSV type 2 and the lip region by subtype 1, reverse infection is also possible. The viruses penetrate the skin and/or mucous membrane through small injuries. Once infected, the virus stays in the body for life and can, but does not have to, repeatedly lead to outbreaks of the disease. After the first infection, however, the symptoms are often at their worst.

The symptoms of cold sores are familiar to many – small, red, itchy blisters around the mouth that dry up and heal after a scab forms . The same symptoms are triggered by HSV viruses in the genital area:

• itchy/burning/painful blisters on a reddened surface
• Pain or itching in the genital area/buttocks/inner thighs.

Human papillomavirus (genital warts)

Human papillomavirus (HPV) has been in the media a lot due to vaccination. They are divided into high and low risk types . While the low-risk viruses are more likely to trigger the formation of genital warts (condylomata acuminata) , high-risk viruses can cause cervical cancer and other types of cancer (eg vulva, vagina, anus, oropharynx, penis, skin). The viruses are transmitted through sexual contact . Transmission is favored by moisture, eczema or scratches. Since an infection with high-risk HPV often does not cause any primary symptoms, this section will be limited to genital warts.

Genital warts appear as small, skin-colored or grayish pinhead-sized nodules in the genital area . If there are several warts next to each other, they can flow together and resemble a cauliflower. They can cause genital itching and bleeding during intercourse. Even if the small warts are annoying, they usually heal on their own .

Dellwarzen (Molluscum contagiosum)

The virus that causes warts belongs to the smallpox family. They are transmitted through close skin contact – including during sexual intercourse. Smooth, soft nodules form on the skin, dented in the center . When pressure is applied, a grey, mushy mass emerges from the nodules. The small warts are mainly found on the face, neck, armpits, back of the knees, arm bends and in the genital area. Children are more likely to be affected by mollusks than adults. If you have mollusc warts, avoid scratching them as this will allow bacteria to get in, leading to inflammation. Mollusc warts often regress spontaneously after a few months. If this does not happen, you can have the warts removed by a dermatologist.

HIV / AIDS

AIDS is an abbreviation for acquired immune deficiency syndrome text in bold , i.e. an acquired immune deficiency that occurs after infection with the HI virus ( human immunodeficiency virus ). The virus is transmitted through bodily fluids . The most important role here:

• Genital, oral, or anal sex with an infected person
• blood
• blood products
• Syringes that have been used multiple times
• breast milk

The most important protection against HIV infection is protection during sexual intercourse using condoms. Vaginal suppositories, vaginal creams and diaphragms are unsuitable for preventing the transmission of the HI virus. It is also possible to carry out pre-exposure prophylaxis (PrEP). Here, HIV-negative people can take anti-HIV medication before and after sexual contact with an infected person to protect themselves from infection. An infection via blood products has become extremely unlikely these days thanks to strict testing.

But how do you recognize an HIV infection? Initially, there are often no symptoms. The first symptoms are usually non-specific and resemble the flu . They usually pass after a few weeks or months. Complaints include:

• Fever
• headache
• Sore throat
• tiredness/fatigue
• rash

The further the virus multiplies, the more immune cells are destroyed by it. Slight infections or chronic symptoms can appear:

• lymph node swelling
• Diarrhea
• weight loss
• Fever
• Cough
• shortness of breath

Late signs of HIV infection are:

• Persistent, pronounced weakness
• night sweats
• Fever >38°C for several weeks
• Lymph node swelling for 3 months
• Chronic diarrhea
• Persistent headache
• Infections that only occur in immunocompromised people, called opportunistic infections

Even if an HIV infection cannot be completely cured, a so-called retroviral therapy can keep the viral load so low that the virus can no longer be detected in the blood.

Syphilis (slow, hard bone)

Syphilis is caused by the bacterium Treponema pallidum . Transmission is mainly via sexual intercourse . The bacterium is rarely transmitted through blood contact or during pregnancy. The disease has several stages :

Initially, a small, painless ulcer appears at the site of infection. Genitals, the anal area, the tongue or the lips are usually affected. After that, a variety of symptoms can occur:

• Rash: patchy, non-itching rashes on the trunk, arms, or legs (including the palms of hands and feet!). The spots are usually red or reddish brown and about the size of a coin.
• Fever
• lymph node swelling
• Fatigue
• General malaise.

If left untreated, the bacterium can spread further and cause serious symptoms, including:

• Coordination problems
• numbness
• paralysis
• blindness
• dementia

A special form of syphilis is neurosyphilis . Nervous system involvement can occur at any stage of the disease and can be associated with or without symptoms. Some of the numerous symptoms of neurosyphilis are:

• headache
• personality changes
• movement disorders

If syphilis is transmitted to the unborn child during pregnancy, congenital syphilis can occur. In many cases, the infection leads to miscarriage, stillbirth or the birth of a severely damaged child (deafness, bone abnormalities, etc.)

Hepatitis B

Hepatitis is the medical term for inflammation of the liver . There are several types of hepatitis, but the one most likely to be transmitted during sexual intercourse is hepatitis B. Other modes of transmission of the hepatitis B virus (HBV) include:

• Blood (ear piercing piercers used several times, syringes, tattoo instruments, etc.)
• breast milk
• Saliva.

Complaints that can be caused by an HBV infection are:

• nausea and vomiting
• Abdominal pain, especially in the upper right abdomen
• Appetitverlust
• Fever
• Dark urine
• muscle and/or joint pain
• itch
• jaundice

Filzlausbefall (Phthirus pubis)

Pubic lice live mainly in the pubic hair or other hairy parts of the body and feed on blood. They are mainly transmitted through sexual contact, but can also spread through bed linen, blankets and mattresses. A louse can only survive for a maximum of 24 hours without a host, so transmission via a hotel bed, for example, is rather unlikely. Once the lice have established themselves, they cause:

• Itching with subsequent scratch marks
• redness
• Visible nits (shiny white egg shells)
• “Rust spots”: Rust spots are red-brown stains in the laundry that are caused by small skin injuries or lice excrement
• Blue discoloration of the skin due to small hemorrhages.

In order to treat a pubic lice infestation, special shampoos from the pharmacy must be used. A treatment with vinegar water is not sufficient, but can be used as a preparation for the treatment.

Scabies (Scabies)

Scabies is caused by tiny mites that burrow into the top layers of skin and lay their eggs there. Inflammation, severe itching and subsequent scratching occur. The injured skin serves as an easy entry point for other bacteria that lead to purulent rashes. In addition, skin eczema and small nodules form as a reaction to the mites. The itchy nodules and crusts are mainly found in:

• interfinger spaces
• flexor sides of the wrists
• elbow
• armpits
• Breast
• genital area

With consistent therapy, the prognosis is very good, even if the itching often lasts longer.

Trichomoniasis vaginalis (Trichomonaden-Kolpitis)

Trichomonad vaginitis is rare in Germany, but one of the most common vaginal infections worldwide. The disease-causing parasites are primarily transmitted during sexual intercourse, although they are also rarely spread through used towels or the sauna. With a good immune system, an infection can be asymptomatic. Typical symptoms of a trichomoniasis infection are:

• Inflammatory changes in the vagina
• Increased discharge: The discharge is often greenish/yellowish, frothy, thin and sometimes sticky. An unpleasant odor from the discharge is noticeable .
• Itching (also possible in the penis)
• Burning (also possible in the penis)
• pain during sexual intercourse
• Discharge from the urethra (male)
• pain when urinating

A trichomoniasis infection is treated with antibiotics.

Ulcus molle (soft chancre)

Ulcus molle (soft ulcer) is caused by the bacterium Haemophilus ducreyi and is a problem especially in the tropics. In Central Europe, infection is very rare. Transmitted during sexual intercourse, the bacterium enters the tissue via small injuries to the skin or mucous membrane and leads to a painful ulcer at the point of entry. The ulcer is usually about the size of a coin, bordered in red, and may bleed or fester. Men suffer from Ulcus molle more often than women. The disease is treated with antibiotics.

Candidiasis/Soor (Hefepilzinfektion des Genitale)

A transmission of yeast fungi during sexual intercourse is rather the exception. As a rule, one becomes infected via a smear infection from the intestine or the yeast fungi overgrow in the case of an immune deficiency.

Blue Waffle / Blue Waffle

The myth of the “blue waffle” STD has been around for a number of years. It is a sexually transmitted disease that only affects women who have a lot of sexual intercourse and/or poor hygiene. It leads to a blue discoloration of the vagina with sometimes disfiguring inflammation and crusts. Luckily, this STD doesn’t really exist and is purely an internet phenomenon .

When should I go to the doctor?

As soon as you suspect that you have an STD, you should see a doctor as soon as possible , because all STDs can be treated in the early stages with a good prognosis. Some are completely curable, others, especially viral ones, can be contained well with early treatment. Doctors you can contact if you have any suspicions:

• gynecologist
• Dermatologist: inside
• General practitioners
  The health department also often gives free, confidential and anonymous advice on sexually transmitted diseases.

It is also important that the sexual partner is also treated in order to avoid mutual reinfection, the so-called ping-pong effect . If there is a sexual partner switch, it may be worth getting tested for an STD to allow treatment before the infection is passed on.

What can I do myself if I have STDs?

The most important measure you can take to protect yourself against STDs is to practice safe sex . You can also get vaccinated against HPV to significantly reduce the risk of HPV-associated cancer.

Therapy of sexually transmitted diseases

Since every venereal disease is triggered by a specific pathogen, there is no general therapy for all venereal diseases. A precise questioning of the symptoms and a physical examination can lead to the suspicion of a specific disease, which can then be treated in a targeted manner.

Mandatory reporting of STD/STI

In Germany, since 2001, only one infection with HIV or with syphilis has to be reported. The laboratories are obliged to anonymously send positive laboratory results directly to the Robert Koch Institute. A gonococcal infection is only notifiable in Saxony.

Here’s how Med-Healths can help

STDs are still a topic that is reluctant to be talked about. Via Med-Healths you can discuss your complaints directly from your home in a video consultation with a doctor. He/She can give you an initial assessment of the severity of the condition and whether a physical examination is necessary. You can also send the doctor a photo of the affected body region directly via Med-Healths so that he/she can get an idea of ​​the findings. If the causative venereal disease is known, he/she can also issue you a prescription for the appropriate therapy.