Sexually Transmitted Diseases in Women

STD’s in Women 

Sexually transmitted diseases (STDs) are infections that can be transferred through sexual contact between infected person and a healthy individual. Some infections usually do not cause any specific symptoms, especially viral infections and sometimes are totally asymptomatic in women.

The common known STDs in women include Chlamydia, Gonorrhea, HPV, and genital Herpes. These diseases can be transferred through sexual contact which not only includes sex, but also oral-genital contact, use of sexual toys, and in some cases, kissing too.  Simply putting, STDs can transfer with exchange of bodily fluids.

There is no 100% effective way to prevent the transfer of STD other than abstinence (staying away from Sexual contact with un-trusted/unfamiliar/new contacts). Condoms are an effective way to reduce the spread of certain infections such as Chlamydia and Gonorrhea but they do not fully protect against other infections such as genital herpes, genital warts, syphilis, and AIDS. 

The most common sexually transmitted diseases in women were recorded to be Chlamydia, Genital herpes, Syphilis, and HPV.  Syphilis, Gonorrhea, Chlamydia was on the rise in the years 2017 & 2018 since 1991 and the number of Chlamydia cases recorded was higher than ever. 

Some of the common symptoms of STD in women include

• Abnormal vaginal discharge (thick, thin, milky white, yellow or green)
• Vaginal itching
• Vaginal blisters or blisters in the genital area
• Vaginal rash or rash in the genital area
• Burning or painful urination 
• Pain during intercourse

If you are having any of the above-mentioned symptoms make sure to visit your gynaecologist / sexologist / sexual health specialist for proper testing, diagnosis, and treatment. You can also be affected by these less common STDs whose symptoms include irregular bleeding, painless ulcers, pelvic pain, lower back pain, fever, nausea, etc. If shown up, symptoms usually appear within days or weeks of exposure to an STD. Sometimes symptoms may appear and then fade away or even go unnoticed, but it is important to get tested for any sexually transmitted infections if you are sexually active. Make sure you keep your visits to the gynecologist regular and keep a note of all the changes that are happening to your body. 

The most common STDs in women and what to look out for are:

1) Gonorrhoea

It is a bacterial infection that is transmitted by sexual contact and is known to be one of the oldest sexually transmitted disease. It is estimated that over one million women are currently infected with Gonorrhoea. Among those, a significant percentage are also infected with Chlamydia and other types of bacterial intrusions that cause STDs. Gonorrhea cannot be transmitted from toilet seats, or hands as per the contrary belief the bacteria cannot live outside the body for longer than a few minutes. It can only survive on moist surfaces within the body and can be commonly found in the vagina and the cervix.

Symptoms of Gonorrhoea include burning urination, frequent urination, yellowish vaginal discharge, redness and swelling of the genitals, and vaginal itching or burning. 

If untreated, Gonorrhoea in women can cause severe pelvic infection with inflammation of the fallopian tubes and ovaries. This infection can spread through the body to affect joints to cause gonococcal arthritis. It may also lead to pelvic infections which result in difficulty in becoming pregnant. 

2) Chlamydia 

Chlamydia in women is caused by a bacterium Chlamydia trachomatis which causes an infection similar to gonorrhea, and like gonorrhea, the bacterium is found in the cervix and urethra and can also live in the throat or rectum. Both infected women and men frequently lack symptoms of Chlamydia and it can go un-noticed which results in unknowingly spreading the disease to others. 

Majority of women infected with this do not have any symptoms. Cervicitis is the most common manifestation of the infection. While half of them do not have symptoms, the other half experience vaginal discharge or abdominal pain. 

Chlamydia is very destructive to the fallopian tubes, which can cause fertility problems and tubal pregnancy. Chlamydia infection is also associated with an increased incidence of premature birth and other complications such as infection during passage through the infected birth canal. It can lead to serious eye damage or pneumonia to the infant. 

3) Syphilis: 

Syphilis has been around for centuries, caused by a bacterium called spirochete which is a worm-like, spiral-shaped organism that wiggles when viewed under a microscope. Syphilis infects the person by burrowing into the moist, mucous covered lining of the mouth or genitals. The spirochete produces a classic, painless ulcer known as a chancre. 

There are three stages of syphilis:

The formation of ulcer is the first stage of syphilis which can occur anytime from 10 to 90 days of infection. The average time is 21 days after when the first symptoms of the STD start to develop, syphilis is highly contagious when an ulcer is present. 

In most women, the ulcer can resolve without treatment but can reoccur as a secondary stage of infection called “secondary” syphilis which occurs weeks to a month after the primary stage and lasts from four to six weeks. The most common symptom in this stage is usually a skin rash, which appears on the palms of the hands, or bottom of your feet. Some of the other symptoms include hair loss, sore throat, fever, headaches, and white patches in the nose, mouth and vagina. There may also be lesions present which looks like genital warts, these warts along with the rash are highly contagious and can be transmitted through contact. 

Some patients will continue to carry this infection and experience a so-called latent stage in which they will continue to carry on the infection without any symptoms. With or without this stage, the tertiary stage of syphilis can develop. At this stage, syphilis usually is no longer contagious. This systematic stage of the disease can cause a variety of problems throughout the body.

Ways that STD impact women differently than men are 

• A woman’s anatomy can place her at a unique risk for STD when compared to a man. The vagina is a good environment for bacteria to grow. 
• Women are less likely to have symptoms of common STD, such as Chlamydia and Gonorrhoea
• Women are more likely to confuse STD symptoms for something else, like a yeast infection or common vaginal discharge. 
• Women may not see symptoms as easily as men.Genital warts may easily show up in men than women. 
• STDs can lead to serious health problems, and affect future pregnancies and cause birth complications 
• Women who are pregnant can pass STDs to their babies. Harmful effects of STDs can include congenital defects, premature birth or worse, still birth
• HPV is one of the most common STIs present in women and is the main cause of cervical cancer, luckily there is a vaccine which is readily available for HPV

The most important thing to remember is that all sexually transmitted diseases are preventable and there are various treatments available to lower the long-term effects of these infections. The use of condoms can help decrease the risk of transmission of certain infections, but not all of them. If you are having an active sex life and enjoying it, good for you but as the saying goes “Prevention is better than cure”, use necessary precaution and be safe.

Dr. Manu Lakshmi ( Best Gynecologist in chennai)