Truth or Consequences
Don't become a victim of hidden STDs
you completely certain that you don't have a sexually transmitted
disease? For most men and women, the answer is a confident "yes"
-- they are sexually inactive, monogamous, practice safe sex, and/or
get checked regularly by their doctor. But others, who may assume
they're clear because they don't show any obvious STD symptoms,
may be raising their risk of cancer and AIDS, flirting with liver
disease, or threatening their fertility.
Thankfully, many sexually transmitted diseases can now be treated
and cured when they're diagnosed. However, knowing that you've been
infected is sometimes harder than you might imagine.
Chlamydia, the most common STD in the United States, is caused
by a bacterium that can be spread through vaginal, anal, or oral
sex. Though symptoms can include stomach pain, fever, testicular
pain, urethral or vaginal discharge, itching, redness, and painful
urination, chlamydial infection often shows no symptoms. According
to the Centers for Disease Control and Prevention (CDC), in Atlanta,
approximately 75 percent of women and 50 percent of men show no
symptoms when infected.
course, the best way to deal with any STD is to prevent
catching it in the first place. "Condoms provide excellent
protection for most common STDs. While not universally
preventive, they are the best precaution available --
upwards of 95 percent or higher," says Dr. Celentano.
"Chlamydia is probably, for women, the most commonly undetected
STD," says David D. Celentano, Sc.D., an expert in STDs at Johns
Hopkins University. "Chlamydia has been associated with ectopic
pregnancy (a painful and potentially deadly condition in which the
fertilized egg cannot descend through the fallopian tube, usually
requiring surgical removal of the pregnancy), and more rarely, with
pelvic inflammatory disease, which is associated with infertility,"
he says. Chlamydia can also be passed from infected mothers to their
babies during childbirth. Luckily, chlamydia is treatable with antibiotics.
Gonorrhea, the most commonly reported STD in the United States,
is also caused by a bacterium and can infect the genitals, throat,
and anus. At highest risk are sexually active men and women between
20 and 24 years old.
Like chlamydia, gonorrhea can lurk silently in the body, especially
in women. When symptoms are present, they often include a yellow-green
vaginal or urethral discharge, fever, painful and frequent urination,
testicular pain, and genital irritation. Untreated, gonorrhea can
spread through the body and cause sterility in men and PID and infertility
"The good news is that when it is detected, it responds almost
completely to single-dose [antibiotic] therapy," says Dr. Celentano.
Because gonorrhea and chlamydia often travel together, doctors often
treat gonorrhea patients for possible chlamydia infection, just
to be safe.
The commonplace human papilloma virus (HPV), the virus that causes
genital warts, infects 24 million Americans a year, making it the
most common viral STD in the United States. While most HPV infections
are not a serious threat, some strains can increase the risk of
cervical cancer in women -- and most of these strains do not cause
visible genital warts. The Pap smear is the standard method for
diagnosing cancerous cells of the cervix. Fortunately, women who
get regular Pap smears will virtually eliminate their risk of cervical
Twenty years after it was first reported in the United States,
there is still no cure for the human immunodeficiency virus (HIV),
which causes the fatal disease AIDS. Unfortunately, many people
do not develop any symptoms upon infection with HIV. Some people,
however, develop a flu-like illness within a month or two after
exposure to the virus. They may develop fever, headache, malaise,
and enlarged lymph nodes, which usually disappear within a week
to a month and are often mistaken for symptoms of another viral
infection. The danger of remaining sexually active while infected
with HIV is obvious, and anyone who suspects that they may be infected
needs to be tested.
Approximate Number of Americans Affected by STDs
Genital Warts (HPV)
40 million affected, with as many as 500,000
new cases each year
1 million affected, with as many as 45,000 new
AIDS cases reported each year
American Social Health Association
Hepatitis B is usually caused by a viral infection in the liver.
Estimated to be 100 times more contagious than AIDS, hepatitis B
can cause cirrhosis and scarring of the liver. It also increases
the risk of liver cancer 200-fold. Many hepatitis B carriers, however,
show no symptoms. Others may show signs of jaundice, nausea, vomiting,
fever, or loss of appetite. Like chlamydia, hepatitis B can be passed
from mother to child. There is no cure for this disease, but there
are drugs available to reduce liver irritation and swelling.
Less of a worry
Some hidden STDs do not have such serious consequences. Certain
people infected with genital herpes, a relatively harmless but permanent
viral infection, show no symptoms at all. Signs of herpes infection
usually develop within 2 to 20 days after contact with the virus.
But a first attack with the virus can be so mild that it goes unnoticed.
Also in the category of relatively harmless is trichomoniasis,
or "trich," infection. It is usually transmitted through sexual
contact but can also be transmitted by wet clothes or towels. Men
usually have no symptoms and, if left untreated, trichomoniasis
infection can produce urethral and bladder infections in both men
A less prevalent STD, syphilis, does not show up right away either.
Once among the most dangerous of STDs, syphilis can be easily treated
with antibiotics if caught before permanent damage occurs. It does,
however, up the chances for contracting HIV, so anyone diagnosed
with syphilis should be tested for HIV.
If you are not sure that you're safe, you should cast shyness to
the wind and ask your doctor for the appropriate STD tests. It's
the only way to know for certain that you don't have any hidden
STDs. Jorma Paavonen, M.D., of the University of Helsinki, in Finland,
recommends a few specific tests for sexually active individuals.
"Sexually active people should get tested for chlamydia and gonorrhea,
and they should also have a baseline HIV antibody test. Women should
additionally undergo a vaginal wet mount (used to determine different
causes of vaginal irritation and discharge) and a Pap smear," says
Of course, it's best to avoid catching an STD in the first place.
"Condoms provide excellent protection for most common STDs. While
not universally preventive (for example, they do not provide full
protection from herpes or HPV), they are the best precaution available
-- upwards of 95 percent or higher," says Dr. Celentano.
Women also have the option of using a female condom. "The female
condom appears to provide about the same protection as the male
latex condom when used properly," says Dr. Celentano. "Topical vaginal
microbicides are also a novel option that may provide additional
protection against STDs," says Dr. Paavonen.
The unfortunate and ironic thing about STDs is that the least painful
ones can be the most threatening in the long run. To ensure long-term
good health, taking a trip to the doctor's office for a few tests
seems like a small price to pay - doesn't it?
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