Sexually Transmitted Infections (STIs), including Chlamydia and Gonorrhea are a relatively common experience. Especially so in younger (under 25) sexually active people. Though that may be due to their being tested more frequently. Incidentally, the highest rate of STIs is in the elderly. A study by consultant Dr Ranjababu Kulasegaram of St Thomas’ Hospital, London found that post-menopausal women were more vulnerable to STIs due to physical changes. Meanwhile men using erectile dysfunction drugs have a significant increase in diagnosis within the first year of using such drugs.
Yet not everyone has access to sufficient education on the subject. Here is a beginners’ guide about two of the most common STIs in today’s population; Chlamydia and Gonorrhea*.
* Gonorrhoea is the UK English spelling, whilst Gonorrhea is the US English spelling. As this article has been primarily authored by Amber Mallery the US variant is used in this article.
Disclaimer: the following information is based on the United States Center for Disease Control (CDC) National STD (Sexually Transmitted Disease) Curriculum. This program teaches about nine STDs. The program is free continuing-education credit through the University of Alabama School of Medicine. Keep in mind when discussing target population / statistics in this article, the root is in the United States. However, it does not dismiss the importance of this information for people outside of the United States.
Chlamydia is a bacterial infection. Bacteria are single-celled microorganisms that are treatable with antibiotics. Some STIs are viral, (e.g. HIV, human papilloma virus (HPV), Hepatitis B/ C). Viruses are smaller than bacteria, requiring living hosts to thrive. Viral infections require more complex treatment, focussing on both minimizing transmission and alleviating symptoms.
Chlamydia is most prevalent in sexually active people under 25. Typically, the infection is asymptomatic, so it can go undetected. For men, symptoms include:
• discharge, (of any kind without pus).
• epididymitis, which is swelling, tenderness, and pain in or around the penis.
• Inflammation of the testis, in conjunction with epididymitis is known as Epididymo-orchitis.
Women infected with Chlamydia may experience
- urethritis; frequent, painful urination and unusual vaginal discharge.
- Lower abdominal pain.
- Pain (with or without bleeding) during or after sex.
Be aware, these symptoms can mimic a urinary tract infection (UTI) so be sure to ask to be tested for Chlamydia when you see your doctor.
Left untreated, Chlamydia can be a precursor to Pelvic Inflammatory Disease, (PID). The bacterial infection reaches the upper genital tract and leads to reproductive system damage. PID symptoms include lower abdominal pain, cervical tenderness, fallopian tubal scarring, and possible ectopic pregnancy.
Testing for Chlamydia and informing previous sexual partners
The CDC recommended standard for testing is through a urine test or blood, but typically urine. The Nucleic Acid Amplification Test (NAAT) is routinely used for urine, and can distinguish between Chlamydia strains. If you receive a positive result, you will likely have a one-time dose of Azithromycin. It will be necessary to abstain from sex with partners for 7 days. Another suggestion; make sure your porous sex toys go in the bin after an infection! Better still, only buy body-safe non-porous toys that can be boiled or bleached to sterilize.
The CDC recommends contacting anyone you have had sexual contact with during the last 60 days of symptoms or leading to your positive test result. In the U.S. there is an anonymous option but unsurprisingly it is not legal in every state. Be sure to check out your state laws online. This is called “Expedited Partner Therapy.” E.P.T. will notify the partner(s) with medical information about the infection alongside pharmaceutical information, symptoms, complications/allergy options, and so on. If this is a legal option where you are, should you feel too nervous to have the conversation yourself then this is a great option.
Not telling someone is obviously not an option; do not let your fear impact someone else’s life in such a manner. You are not just hurting them, but all those to follow. We are adults and STIs need not be taboo. Most important is to be safe, and know your status.
Another bacterial STI, that has a growing strain of antibiotic-resistance. Gonorrhea predominates in sexually active people under 25. In terms of transmission, people often overlook oral and rectal infection. This ‘super strain‘ of Gonorrhea transmits orally, though that it is not the only method of contracting Gonorrhea. It is more simply that people omit to utilize oral protective methods (for example, condoms or dental dams). Gonorrhea contracted orally can cause symptoms mimicking Strep throat (Streptococcal pharyngitis).
Genital symptoms of Gonorrhea in men tend to be overt;
- painful urination.
- Discharge from the penis that is yellow/ green.
- Less commonly, pain in the testicles.
In women, Gonorrhea is predominantly asymptomatic. Symptoms can include:
- Abnormal vaginal discharge that may smell unusual or be yellow / green.
- Pain during or after sexual intercourse.
- Bleeding between periods.
Testing and treatment for Gonorrhea
As with Chlamydia, if untreated an infection with Gonorrhea can lead to PID or Fitz-Hugh-Curtis Syndrome. The latter is inflammation of the stomach lining and the tissues surrounding the liver. If you are experiencing upper right abdominal pain or abnormal liver function (for example yellowing of the skin, changes in urine), seek medical advice immediately.
Testing for Gonorrhea is as simple as it is for Chlamydia testing. It is usually detected through a urine sample. Further tests may be necessary in the case of antibiotic-resistant strains. These may include urethral swabs for males or cervical swabs for females. Such tests exist in countries where antibiotic resistance is prevalent. Presently, the top three countries with the highest number of incidences are Spain, France and Japan.
Your doctor may require further testing if initial antibiotics do not work. Antibiotics often are necessary in combination, to effectively combat resistant strains. Combinations of two or more of Ceftriaxone, Cefixime, and Azithromycin are administered orally or via intramuscular injection. In serious cases they may be administered intravenously.
Prevention is better than the cure
Education of STI risk and treatment can disband the taboo surrounding infection. By utilizing safe sexual practices we can minimise risk to our own health and that of our partners.
We can do the following:
• Undergo regular testing, if engaging in sexual practises with new partners.
• Have open communication on the subject of sex.
• Use protective barriers such as condoms, gloves, and dental dams.
One should never feel guilt after consensual sex. Being honest with your partner/s (both past or present) is beneficial for all involved. We need to cooperate in order to sexually express ourselves in a responsible way.
- Refer to the CDC’s website: https://www.std.uw.edu
- The World Health Organization website provides factsheets, and regional information: http://www.who.int/mediacentre/factsheets/fs110/en/
- In the UK, the NHS Choices site has information on Chlamydia and Gonorrhoea.
- For finding local sexual health information and support services in the UK, please visit this site.
This article has been co-authored. Primarily written by Amber Mallery, with editing by myself. It is hoped that all content is as factually accurate as possible, though should there be any gross discrepancy, we do apologise. Feedback is welcome in such cases (as it is otherwise). This post is unsponsored and contains no affiliate links.