Over the years, most of these columns have been G rated. Don’t worry, this one’s not really any more than PG-13; but it is about a delicate subject, so if your kids read the paper, talk this through with them.
The Centers for Disease Control and Prevention’s (CDC) most recent report on sexually transmitted diseases (STDs) outlined troubling news: After years of decline, new cases of several STDs are on the rise. In fact, more than 2 million new cases of chlamydia, gonorrhea and syphilis were reported in 2016—that’s an increase of nearly 18 percent for syphilis alone.
Why STD rates are rising
It seems that there are several factors that contribute to the rise in STDs. Some are improvements in medicine and others are societal.
The first is improved screening. Many STDs do not present noticeable symptoms, making them historically difficult to track. Today, modern screenings may uncover problems earlier and more often.
In addition, researchers have determined which groups are more vulnerable to some STDs. For example, young women are most at-risk for chlamydia, so they are being tested in higher numbers.
Another reason rates are rising may be deficits in modern sex education. Many teens aren’t made aware that STDs can be passed through oral sex and anal sex. This is of particular concern to homosexual and bisexual couples who may be less likely to use condoms during sexual intercourse.
Finally, the rise in dating apps and anonymous sexual experiences make tracking potential exposures difficult.
Casual or anonymous encounters make it harder for public health officials to track down and test the partners of those in whom STD diagnoses are made.
Three infections on the rise
The CDC’s report found that chlamydia, gonorrhea and syphilis are all on the rise, with 1.6 million new cases of chlamydia, 470,000 cases of gonorrhea and 28,000 cases of syphilis in 2016 alone. This news is particularly jarring, as these three infections were thought to be near elimination.
While all three of these infections can usually be cured with antibiotics, they can be dangerous if left untreated. Early detection is necessary to prevent permanent damage.
Treatment is also vital for pregnant women or those who may become pregnant, as infections can be passed from the mother to the baby and have serious health consequences.
• Chlamydia is one of the most common STDs in the country. It is spread through infected genital fluids, and often does not present symptoms. If left untreated, chlamydia can cause damage to the Fallopian tubes and infertility in women. It can also be passed to an infant during childbirth, which could result in a serious eye infection or pneumonia. Women with this infection may notice abnormal vaginal discharge or bleeding, painful periods, itching, burning or abdominal pain. Men may notice discharge from the penis, painful urination, itching and burning around the genitals. Your doctor can diagnose chlamydia by testing blood, urine test or fluid discharge. With antibiotic treatment, chlamydia can clear up in as little as a week.
• Gonorrhea is an infection that results in painful urination, discharge and abdominal or genital pain, as well as unusual vaginal bleeding in women. Gonorrhea can be spread through sexual contact with the penis, vagina, mouth or anus of an infected partner, though ejaculation isn’t necessary for transmission. Gonorrhea can be diagnosed through a urine test or examining swabs from the cervix or urethra (the urinary opening). Untreated gonorrhea can spread to a woman’s uterus or Fallopian tubes and cause a serious infection called pelvic inflammatory disease (PID), as well as internal abscesses and chronic pain. In extreme cases, PID can cause infertility or lead to ectopic pregnancy. Having untreated gonorrhea also makes you more susceptible to HIV.
• Syphilis is an extremely contagious infection that can be spread through prolonged contact with a syphilis sore on the penis, vagina, anus, rectum or mouth. In the first stage of the infection, these sores appear firm, round and painless, often going unrecognized by the infected person or their partner. If the infection goes untreated, you may notice a skin rash, fever, swollen lymph glands, hair and weight loss, muscle aches, headaches or fatigue. Years later, if it continues to go untreated, syphilis can become latent (inactive and hidden) and exhibit no symptoms. Rarely, 10-30 years after the initial infection, a person with syphilis will develop tertiary syphilis, which can affect the heart, blood vessels, brain and other internal organs. This phase can be deadly. Syphilis can be diagnosed with a blood test or swab of a suspected sore. It can be cured with antibiotics, but depending on the stage of syphilis, treatment won’t reverse damage already caused by the infection.
Tough to talk about but worse if ignored. Anyone with a suspicion that they might have one of these infections should put fear of embarrassment aside and get care. The consequences of “wishful thinking” and denial can be life-changing.
Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]