Basics
What is meant by sexually transmitted diseases?
Sexually transmitted diseases are transmitted through sexual intercourse. In particular, people who change their sexual partner relatively often risk contracting a sexually transmitted disease. The best way to prevent infection is to take protective measures, such as using condoms. Most sexually transmitted diseases are curable and have a good prognosis, but early diagnosis is necessary for successful treatment. Since the signs of most sexually transmitted diseases appear relatively late, an early diagnosis is unfortunately not always possible.
What are sexually transmitted diseases?
STDs are specifically five sexually transmitted diseases:
- Syphilis (Lues)
- Gonorrhoea (gonorrhea)
- Ulcus molle
- Lymphogranuloma inguinale
- Granuloma venereum
These diseases were notifiable until 2001. Today, only HIV and syphilis are reportable sexually transmitted diseases. Although many people use the terms "sexually transmitted diseases" and STDs synonymously, it should be noted that STDs refer to five specific sexually transmitted diseases.
What are the sexually transmitted diseases?
The most common sexually transmitted diseases include:
Chlamydia infections
Among both men and women, chlamydial infections are among the most common sexually transmitted diseases. Chlamydia is a bacterium that is characterized by its spherical shape. Furthermore, these bacteria can only survive within human cells. In many cases, however, a chlamydia infection does not trigger any symptoms, which is why it often goes undetected. As a result, there is a risk that a permanent infection will develop and that the bacterium will be able to multiply without any problems.
Chlamydia can usually be well controlled by appropriate antibiotic therapy, although treatment of the sexual partner should also be considered to avoid a new infection by the partner. In order to determine the complete elimination of any pathogens in the body, a smear test should be taken a few weeks after the start of the therapy, as well as after three months, and examined for chlamydia. Furthermore, the affected person should also be examined for the presence of other sexually transmitted diseases, as chlamydial diseases promote additional infections.
Gonorrhoea
Gonorrhoea is a sexually transmitted disease caused by spherical bacteria, namely gonococci (Neisseria gonorhoeae). These bacteria primarily infect the genital organs, as well as the urinary tract, but can also infect the throat through oral sex and the rectum through anal sex. In both men and women, the infections can ascend to the internal sex organs, which can lead to an inability to conceive. In gonorrhea, it is also possible to progress without signs of illness, which means that the infection often goes unnoticed. However, if a whitish-yellow discharge from the external genital organs is noticed, this could be indicative of gonorrhoea. Gonorrhea can also develop into a chronic disease.
An infection with gonococci can be treated very well with antibiotics in most cases. It is also important to treat the sexual partner in order to prevent a new infection. The success of the treatment should also be checked by means of a smear test a few weeks after the start of the therapy.
Genital herpes
This disease is caused by the herpes simplex virus type 2 and mainly damages the internal and external genital organs. In addition, the virus can sometimes cause herpes blisters in the mouth area.
A typical feature of the herpes virus is that it withdraws into the cell bodies of certain nerves (dorsal root ganglia) and can remain latent there for years or even decades, i.e. without triggering any symptoms. The herpes virus is regulated there by the immune system, which means that no symptoms of disease occur. However, if this control becomes unbalanced, for example due to another infection, stress or UV radiation, the herpes virus can be reactivated and the symptoms can reappear. Although a complete elimination of the virus is not possible with antiviral drugs, at least the symptoms of reactivation and the extension of the herpes blisters can be reduced. Suitable antivirals for the treatment of a herpes infection are aciclovir, valaciclovir and famciclovir, which should be taken over a period of at least five days. In addition, pain-relieving medication or soothing baths can be helpful in alleviating the symptoms.
HIV infection/AIDS
AIDS is a life-threatening disease that can result from an HIV infection. In principle, the HI virus can be transmitted through all body fluids, but the number of virus particles is relatively large, especially in blood and sperm. The HI virus can usually penetrate the body through the smallest mucosal damage and multiply there in cells of the immune system. A significant factor that promotes infection is the concentration of the HI virus in the respective body fluid.
In order to detect an HIV infection, the blood of the affected person is examined for specific antibodies. Here, the so-called diagnostic window must be taken into account: the antibodies can only be detected about 6-12 weeks after the infection. A control test should be carried out as soon as possible after a possible contact with the HI virus and a further test should be carried out after about three months due to the diagnostic window. Until the final result is available, appropriate contraception must be used in any case.
If you suspect that you have been infected with HIV, you should take post-exposure prophylaxis within 72 hours. In any case, an emergency room should be visited, where an antiviral therapy lasting several weeks is usually started.
Unfortunately, HIV infection or AIDS cannot be cured in principle, but the course of the disease can be positively influenced by diagnosing and treating it as quickly as possible. In the meantime, there are medicinal treatment methods with which the virus multiplication can be suppressed, which improves the quality of life of those affected.
Genital warts (condylomas)
Condylomas (genital warts) develop through infection with the human papilloma virus (HPV). In addition to condylomata, this virus can promote the development of carcinomas of the genital organs, especially cervical cancer or penile cancer. In addition, HPV can also promote the development of tumors in the anal area.
Genital warts have a cauliflower-like or flat appearance. They are most commonly found on the penis or labia, but can also occur in the anal area. Rarely, condylomas are also found in the mouth or throat.
The condylomata can be treated locally with podophyllotoxin in the form of ointments (e.g. Wartec®) or solutions (e.g. Condylox®) or with Imiquimod (Aldara®). Furthermore, genital warts can also be surgically removed using laser therapy, current treatment or liquid nitrogen. In this case, too, the sexual partner should be examined for infection with the human papilloma virus.
In the meantime, vaccination against the most common forms of the virus is also possible. This is recommended especially for girls before they become sexually active, but boys should also be vaccinated for better protection of the general population.
Syphilis
Syphilis (lues) is also a sexually transmitted disease and is caused by the bacterium Treponema pallidum. Especially in recent years, the incidence of the disease has increased. The bacterium can cause a generalised infection after spreading locally via the bloodstream. An infection with Treponema pallidum is best treated with penicillin. However, if there is an allergy to penicillin, other antibiotics such as macrolides (e.g. erythromycin) or tetracyclines (e.g. doxycycline) can also be used.
How can sexually transmitted diseases be prevented?
The most important measure to avoid infection with sexually transmitted diseases is "safe sex", i.e. the use of condoms, for example. It should be noted that the condom is used from the very beginning and also during anal or oral sex.
When is a visit to the doctor necessary?
You should see a doctor in any case if
- the above symptoms occur.
- you have had unprotected sexual intercourse and want to rule out infection with a sexually transmitted disease.
- you want more information on prevention (safer sex) or the infections themselves.
