How are sexually transmitted infections treated in women? Sexual infections - pathogens, routes of infection, classification, symptoms, principles of diagnosis, treatment and prevention. Tests for vaginal infections

Our expert - gynecologist Marina Vedeleeva.

Dangerous Thirty

The topic is very prosaic - sexually transmitted diseases (STDs). Almost every one of us has met them in person at least once in our lives. By the way, there are more than 30 of them: from the deadly HIV infection to the banal chlamydia, which, by the way, also cannot be called trivial. Moreover, in terms of prevalence in Russia, it is in second place after the flu.

Of course, most STDs are curable, but not all. For example, you will never be able to get rid of genital herpes - treatment only softens the course of the disease and reduces the frequency and severity of relapses. Only those under 25 have a chance to get rid of (HPV) forever. Later, it will not be possible to destroy the virus; the point of treatment is to eliminate changes in the tissues affected by the virus. By the way, it is believed that the human papillomavirus can cause cancer of the cervix, vagina, vulva and penis. The genital herpes virus also affects sperm, and if a woman is infected with it during pregnancy, it can cause severe congenital diseases of the fetus.

Treatment will be successful only if it is started without delay and completed. How to spot the very first danger signals?

The alarm has been declared!

There are seven main signs that you should not delay visiting a doctor if you discover them.

Itching and burning in the intimate area.

Redness in the genital area and anus, sometimes - ulcers, blisters, pimples.

Discharge from the genitals, odor.

Frequent, painful urination.

Enlarged lymph nodes, especially in the groin area.

In women - pain in the lower abdomen, in the vagina.

Discomfort during sexual intercourse.

However, for example, syphilis or chlamydia can appear several weeks after infection, and sometimes STDs can generally run latent for a long time, becoming chronic.

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Chlamydia

Symptoms. 1–4 weeks after infection with it, patients develop purulent discharge, painful urination, as well as pain in the lower abdomen, lower back, bleeding between menstruation in women, and pain in the scrotum and perineum in men.

Why is it dangerous? In women, it can lead to inflammation of the fallopian tubes, cervix, pathologies of pregnancy and childbirth, diseases of the liver, spleen; in men - to inflammation of the epididymis, prostate gland, bladder, and impaired potency. Newborns may develop conjunctivitis, nasopharyngeal lesions, and pneumonia.

Trichomoniasis

Symptoms. They can appear 4–21 days after infection, sometimes later. Women experience copious foamy discharge of a white or yellowish-green color with a pungent odor, causing severe itching and irritation of the genitals, as well as pain, burning during urination, and pain during sexual intercourse. Men experience a burning sensation when urinating, mucopurulent discharge from the urethra. However, this disease is often asymptomatic.

Why is it dangerous? In women, the cervix and inner layer of the uterus, fallopian tubes, ovaries, and urinary tract are affected. The infection can even cause peritonitis! In men, the prostate gland, testicles and their appendages, and urinary tract are affected.

Mycoplasmosis (in men - ureaplasmosis)

Symptoms. It may reveal itself 3 days after infection, or maybe a month later, manifested by itching and discomfort in the genital area, scanty transparent discharge, and painful urination.

Why is it dangerous? A common complication of trichomoniasis in women is inflammation of the genital organs; in men, a disorder of spermatogenesis.

Gonorrhea

Symptoms. 3–7 days after infection, women experience yellowish-greenish vaginal discharge, frequent, painful urination, pain in the lower abdomen, and sometimes bloody discharge. However, for most representatives of the fairer sex, the disease goes unnoticed for a long time. Men experience pain and burning when urinating, yellowish-greenish purulent discharge from the urethra.

Why is it dangerous? In women, the urethra, vagina, anus, uterus, ovaries, and fallopian tubes are affected. In men, the internal genital organs develop chronic inflammation of the epididymis, seminal vesicles, and prostate, which threatens impotence and infertility.

Syphilis

Symptoms. The incubation period of the disease is from 3 to 6 weeks. The first sign is a round ulcer (chancre). In women, it lives on the labia or vaginal mucosa (sometimes in the anus, in the mouth, on the lips), in men - on the penis or scrotum. In itself, it is painless, but a week or two after its appearance, the nearest lymph nodes enlarge. This is the time to start treatment! This is the first stage of the disease, when everything is still reversible. 2–4 months after infection, the second stage develops - a rash “spreads” throughout the body, high fever and headache appear, and almost all lymph nodes become enlarged. In some patients, hair falls out on the head, and wide condylomas grow on the genitals and in the anus.

Why is it dangerous? This disease is called slow death: if not fully treated in time, serious problems arise with the musculoskeletal system, irreversible changes occur in the internal organs and nervous system - the third stage of the disease begins, in which approximately a quarter of patients die.

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How are STDs diagnosed? First, an examination by a doctor, then tests and studies. The most modern method of DNA diagnostics: PCR (polymerase chain reaction). For examination, scrapings are taken from the urethra, vagina and cervix.

Doctors also use the ELISA method (blood is taken from a vein or a scraping is made and the presence of antibodies to STDs is determined), bacterioscopy (most often detects gonococci and trichomonas) and many other diagnostic methods.

STDs are treated with antibacterial drugs, as well as local procedures (washing the urethra in men, sanitizing the vagina in women and other procedures). At the end of the course of treatment, you must undergo a follow-up examination - take several tests to make sure there is no infection in the body.

How to protect yourself?

The classic self-defense against STDs is the condom. High quality and correctly sized.

Emergency drug prevention is also used - a one-time dose or injection of antibacterial drugs, which can only be prescribed by a dermatovenerologist. The procedure helps prevent gonorrhea, chlamydia, ureaplasmosis, mycoplasmosis, syphilis and trichomoniasis. But this method cannot be used often.

But as for douching after sexual intercourse with special gels or chlorine-containing antiseptics, most experts believe that this does not reduce the risk of infection.

Sexual infections are a number of infectious diseases that affect the genitourinary system. Most of the list of such diseases is occupied by sexually transmitted diseases (hereinafter referred to as STDs). However, the list of diseases called sexually transmitted infections is more extensive and contains various diseases transmitted in different ways. Genital infections in men have some differences from female diseases. This is due to the fact that the reproductive system, depending on gender, has significant differences. At the first signs of the disease, you should seek medical advice and get tested for sexually transmitted infections. Only a medical specialist can determine which treatment method to choose and prescribe medications. It is possible to cure most sexually transmitted infections; you just need to consult a doctor in a timely manner and begin treatment.

General signs

The symptoms of all sexually transmitted infections in men are quite similar, although there are differences. Sexually transmitted diseases are often asymptomatic in the early stages, but they can be noticed by certain signs. Common symptoms of sexually transmitted infections include:

• atypical discharge from the genital organ, changes in its consistency, appearance and smell;
• itching;
• sharp pain when emptying the bladder;
• impurities in the urine: blood, pus and others;
• inguinal lymphadenitis;
• painful sensations that occur during sexual intercourse and during ejaculation;
• nagging pain in the lower abdomen;
• atypical pigmentation on the genitals, skin ulcerations, the appearance of rashes, redness, pimples.

Such symptoms are characteristic of all sexually transmitted infections. The degree of their severity depends on the stage, type and severity of the disease.

Symptoms of some sexually transmitted infections in men may not appear for a long time after infection. Therefore, it is important to undergo preventive examinations regularly, at least once a year. If you have been tested and they did not reveal the presence of infections, but there are first signs, then you should take the samples again, since some infections are not detected in the early stages, even by laboratory tests.

Types of sexually transmitted infections and routes of transmission

Ureaplasmosis

A disease that affects the mucous membrane of the penis and organs of the urinary system, transmitted in most cases through sexual contact. The danger of ureaplasmosis lies in the fact that this disease does not have a clear clinical picture and often occurs in the absence of pronounced symptoms. Without experiencing any signs of the disease, the man does not consult a doctor and does not treat the disease, and in the meantime the amount of pathogenic microflora increases, which leads to the development of urethritis (an inflammatory process of the urinary tract). Urethritis manifests itself with more pronounced symptoms, such as a feeling of itching in the genital organ, severe sharp pain when emptying the bladder and discharge with an ammonia odor.

Chlamydia

Chlamydia, entering a man’s body, masters itself within three to five days. After this, pathogenic microorganisms infect the tissues of the epithelium of the genital organs, destroying cellular structures. Symptoms of chlamydia in men include clear, thin discharge from the genitals and sharp pain when emptying the bladder. In the absence of proper treatment, chlamydia causes urethritis, as well as inflammation of other reproductive organs and organs of the urinary system.

Trichomoniasis

It is the most common disease of the reproductive system. In the early stages it occurs without visible manifestations. If left untreated, it leads to the development of infectious prostatitis, urethritis, and cystitis. Very often, trichomoniasis occurs in conjunction with other sexually transmitted infections. The first sign of this disease in men is painful urination. In some cases, itching, irritation, and redness on the skin of the penis may occur.

Mycoplasmosis

A very dangerous infectious disease of bacterial origin. Men, as a rule, are carriers of pathogenic mycoplasmas. The disease is characterized by the absence of pronounced symptoms, but can manifest itself against the background of a weakened immune system or after prolonged stress. Often leads to inflammation of the prostate or testicles. Some types of pathogenic mycoplasmas cause complications in the form of damage to the respiratory tract and lungs.

HIV infection

Today, it is one of the most severe infections, most often transmitted through sexual contact with an infected partner. The main danger of the human immunodeficiency virus is that modern medicine does not have a cure for this disease. There are drugs to suppress the activity of the virus, but it is impossible to destroy it. HIV destroys the cells of a person's immune system and makes him defenseless against bacteria. If a man does not treat the infection or take pills to boost immunity, this leads to the development of the dangerous disease AIDS and death. You can live a full life with HIV infection and even produce offspring who will not show symptoms if you strictly follow the recommendations given by your doctor.

Human papillomavirus

According to WHO, a third of the world's population is currently affected by this virus. Like HIV, it is incurable. Depending on the type of virus and a person’s protective capabilities, papillomavirus can manifest itself with such signs as the appearance of condylomas, papillomas and other neoplasms on the genitals. They subsequently spread throughout the body. The danger of this disease is that neoplasms can be malignant and lead to the development of oncology.

Gonorrhea

Gonococcus affects the mucous membranes and provokes inflammatory processes in the organs of the reproductive system. Spreading deeper into the body, the disease leads to prostatitis and inflammation of the testicles. The first signs of gonorrhea are itching and burning in the penis. Subsequently, pus flows from the male genital organ, in the first stages it can be noticed by pressing on the head, then the pus flows continuously. Gonorrhea is often complicated by a combination of other diseases. The infection affects the male genitourinary system and, in the absence of proper treatment, causes erectile dysfunction, impotence and infertility.

Syphilis

Syphilis is a particularly dangerous infectious disease. It is easy to identify, since, unlike other common sexually transmitted infections, the symptoms of syphilis have pronounced signs from the very beginning. Progressive syphilis leads to dangerous pathologies of the male genital organs, multiple inflammatory processes, and in the absence of timely treatment causes damage to the nervous system and musculoskeletal system. Tertiary syphilis leads to necrosis of soft tissues of various organs. Syphilis also “loves” cartilaginous tissue; everyone has probably heard about a collapsed nose at the last stage of disease progression. In rare cases, advanced syphilis causes necrosis of the tissue of the penis, which leads to amputation of the affected organ.

Genital herpes

The first sign of genital herpes is the appearance of small pimples and blisters on the genitals. Ulcerations and erosions of the skin may then appear. The disease is manifested by burning and itching of the genital organ, swelling, redness of the skin, and inguinal lymphadenitis. In the absence of adequate treatment, it leads to bacterial damage to the external genital organs, a decrease in the immune properties of the affected area and the body as a whole. With advanced genital herpes, diseases that affect the nervous system develop, as well as chronic prostatitis.

In most cases, the above diseases are transmitted sexually. Infectious agents are not able to survive in an open environment, so they are transmitted only through close contact and exchange of fluids between partners. However, some microorganisms, for example, the papilloma virus and Trichomonas, can be transmitted through household means, through shared towels, washcloths, bed or underwear. There are known cases of contracting sexually transmitted infections through poorly sterilized medical instruments or through untested blood transfusions.

Diagnostics

Infections of the genital organs in men are treated by a urologist or venereologist. First, complaints are analyzed and the patient is examined. Due to the fact that the symptoms of various sexually transmitted infections in men are quite similar, the disease can be accurately diagnosed solely on the basis of laboratory tests. The doctor will suggest a general blood and urine test, as well as a specific test for sexually transmitted infections. Bacteriological studies of a smear from the genital organ are also carried out. The most reliable and sensitive diagnostic methods at the moment are PCR tests and bacteriological urine culture. If any sexually transmitted infections (hereinafter referred to as STIs) are detected, the doctor also prescribes a test for hidden infections.

It is necessary to seek medical help immediately after the first symptoms appear. The sooner an accurate diagnosis is made and treatment is started, the greater the chance that the cure will be quick and effective. Advanced sexually transmitted infections lead to the development of severe complications and entail dangerous consequences that manifest themselves over a long period of time.

Treatment of all sexually transmitted infections in men involves complete abstinence from sexual contact during the course of therapy. Most infectious diseases can be successfully treated with broad-spectrum antibiotics. In each specific case, the doctor selects the appropriate drugs for the man to combat the causative agent of the disease. In addition to antibacterial, antifungal, or antiviral therapy, medications may be prescribed to relieve symptoms. Along with the main treatment, a course of immunomodulatory drugs is administered to strengthen the body’s general and local defenses.

Various medications are used to treat sexually transmitted infections; their choice is made by the attending physician; self-medication in such cases is unacceptable. Also, you should not listen to the advice of friends who have suffered from venereal diseases, and do not take the pills that they used to treat them. This can lead to dangerous health consequences, since each case is individual, and treatment should be carried out under the supervision of a doctor.

Complications

In the absence of timely and adequate treatment, sexually transmitted infections cause various complications. Basically, they affect the male sexual sphere, potency and ability to conceive. Often, sexually transmitted infections lead to prostatitis and the development of prostate adenoma. In case of infection of the genitourinary system, the pathogen can penetrate through the ascending pathway into the kidneys and cause renal failure, pyelonephritis, cirrhosis and other serious diseases.

Some infections affect not only the human reproductive system and urinary tract, but can also penetrate other organs. Thus, syphilis, if left untreated, can cause severe organic damage to the brain, leading to the development of mental illness. A disease such as herpes cannot be completely cured and remains with a person forever, periodically reminding itself.

Prevention

The surest method of preventing sexually transmitted infections for men is to avoid unprotected sexual intercourse and maintain an orderly sex life with a regular partner. The most reliable method of protection against sexually transmitted infections remains the use of a condom. It is recommended to use various local postcoital agents that have a suppressive effect on infections. A good means of prevention is to follow the rules of personal hygiene, use individual washcloths and sponges for washing, razors, and separate towels. You should be careful when visiting public baths, swimming pools, and saunas. You can catch an infection by simply sitting on a shelf or sofa without first laying down a sheet or towel.

Some sexually transmitted infections can be protected through vaccination. It is also necessary to undergo regular medical examinations and be tested for the most common infectious agents. Prevention of sexually transmitted infections includes educational conversations in educational institutions, since the main risk group is sexually active youth.

Criminal liability

The legislation of the Russian Federation provides for liability for intentional infection with an STI. Lawyers distinguish two types of intentional infection of a sexual partner: criminal act and criminal inaction. A criminal act is understood as refusing to use protective equipment during sexual contact, and attempting to infect someone through sharing dishes, washcloths, linen, towels and other things. Criminal inaction is understood as a deliberate omission before sexual contact about the presence of a sexually transmitted disease.

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Female genital infections are classified as a group of diseases whose transmission route is sexual. These are pathologies that can be caused by bacterial infection, protozoa or viruses. Such pathologies include: papillomavirus, herpes, mycoplasma, ureaplasma, gonococcal, chlamydial infections, trichomoniasis, etc.

The peculiarity of STIs is that they can be transmitted in other ways (for example, by contact). They can affect both the reproductive and other organ systems, causing pathological processes in them. Infection of the female genital organs can manifest itself in various clinical manifestations. They depend not only on the type of pathogen, but also on its location.

The causative agents of the inflammatory process of the genitals include not only pathogenic, but also opportunistic microflora. As a rule, pathogenic flora is always absent in the normal vaginal biocenosis.

If it penetrates the vaginal microflora, it begins to multiply and causes inflammation characteristic of this type of pathogen.

In women, genital tract infections are caused by the following types of pathogenic microorganisms:

• HPV (papillomavirus, human papillomavirus) causes the appearance of neoplasms on the skin and mucous membranes, and provokes the development of an erosive process in the cervix. In the absence of timely treatment, the process can lead to cancer.

• Herpes virus.
• The causative agent of chlamydia (chlamydia).
• Trichomonas leading to trichomoniasis.
• Gonococci are the causative agents of gonorrhea.
• The causative agent of syphilis (treponema pallidum).

Conditionally pathogenic flora, when activated, can cause inflammation. But the diseases they cause are not sexually transmitted.

Opportunistic microorganisms are natural inhabitants of the vaginal flora.

When the acid-base balance of the vaginal environment shifts, these microorganisms contribute to the development of the inflammatory process in the genitourinary system.

The group of opportunistic flora that provokes the development of colpitis, urethritis of a nonspecific nature, and bacterial vaginosis includes:

• gardnerella;
• streptococcal infection;
• staphylococci;
• yeast-like fungi, etc.

Causes of infection in women

The occurrence of genital infections in women is associated with the penetration of the pathogen into the body.

Risk factors that contribute to infection include:

• sexual contact with partners leading an antisocial lifestyle and promiscuous sex;
• insufficient or lack of personal hygiene;
• use of low-quality contraceptives;
• blood transfusions during operations;
• organ transplantation;
• donation

Provoking factors are weakening of the immune defense and abuse of bad habits.

Also, nutritional disorders (lack of vitamins and microelements), physical fatigue, frequent stress. Infection of the body with STIs contributes to poor health. They can even lead to serious consequences, such as infertility and even death.

How do infections of the female genital organs manifest?

In the vast majority of cases, women experience the following symptoms of a sexually transmitted infection:

• pain during urination;
• fairly frequent trips to the toilet, while daily diuresis does not change;
• the presence of foul-smelling leucorrhoea discharged from the genital tract;
• pain and discomfort during sexual intercourse.

Symptoms of infection appear characteristic of a specific type of pathogen of the genital organs. Eg:

• papillomavirus pathology is characterized by the formation of warty growths and condylomas in the anogenital zone;
• for a fungal infection (candidiasis) – the presence of a cheesy white discharge with the smell of sour milk and severe itching;
• for syphilis - the formation of ulcerative lesions (chancre) on the genitals and enlargement of the inguinal lymph nodes;
• Gonorrhea is characterized by purulent discharge and hyperemia of the vulvar mucosa;
• for trichomonas colpitis - the presence of foamy discharge with the smell of rotten meat;
• Genital herpes is characterized by the presence of blisters with transparent contents and a strong burning sensation in the affected area. An increase in body temperature is often observed.

In most cases, the symptoms of infection in women depend on where the lesion occurs.

• If the infection is localized in the urethra, there will be complaints of frequent visits to the toilet, as well as pain and discomfort when urinating.

• Symptoms of an infection of the labia will include hyperemia and swelling of the mucous membrane, as well as pain when touched.
• If the cervical canal is damaged (cervicitis), a woman will complain of bleeding during or after sexual intercourse.
• inflamed endometrium (endometritis) will make itself felt by pathological manifestations of menstrual irregularities in the form of painful sensations in the lower abdomen.

The timing of the appearance of the first signs of infectiousness varies depending on the type of pathology.

The incubation period for STIs varies for different diseases. It can be several days or stretch over time up to several months and even years. In some cases, the disease may occur without any characteristic symptoms. As a rule, in about 20-40% of cases and even more often, signs of infection do not appear.

Diagnosis of female genital infections

Treatment will not be prescribed based solely on the characteristic signs of the disease.

Until it becomes clear what type of pathogen provoked the inflammatory process. Therefore, no matter what the sexual infection, symptoms alone cannot serve as a basis for making a diagnosis. Treatment should be prescribed only based on the results of laboratory diagnostics.

To clarify the diagnosis, the following types of tests are performed:

• Bacterioscopic examination is effective if the infection is localized in the vagina and urethra.
• Bacterial culture of vaginal and urethral discharge.
• Carrying out PCR diagnostics to detect the genetic material of the pathogen, regardless of where the infection is localized.
• A blood test for the presence of antibodies to a pathogen that could cause a woman to develop a genital infection.

Where do tests for female genital infections come from?

The bacterial infection can be detected in swabs taken from the genital tract. It may also be present in the mouth and anus if a woman has oral or anal sex. In this case, sexually transmitted infections in women may show signs of oral inflammation. For example, in the form of stomatitis, sore throat, pharyngitis. As well as the rectum (symptoms of proctitis). Therefore, if these symptoms are present, the doctor should take a swab not only from the mouth, but also from the anus.

Where the doctor will take the biomaterial for research depends on:

• data from the medical history collected by the doctor, i.e., what type of sexual contact the patient might have had with a sexual partner infected with a contagious disease;
• the data obtained as a result of the examination and the woman’s complaints (the presence of rashes, hyperemia, swelling and pain in the throat, as well as the nature of the discharge from the anus).

Which doctor treats female genital infections

Treatment of infectious lesions of the reproductive system in women is carried out not by one specialist, but by different ones. This approach to treatment is explained by the ability of pathogens to affect both the genitals and other organ systems.

Treatment of pathological processes caused by infection of the female reproductive system is usually carried out by the following specialists:

• dermatovenerologist;
• gynecologist;
• infectious disease specialist;
• hepatologist;
• gastroenterologist;
• rheumatologist.

A dermatovenerologist is a specialist who can conduct an examination and prescribe an appropriate course of treatment.

A woman can contact this specialist in the following cases:

• if you had sex with an infectious sexual partner;
• in the presence of contact without the use of protective equipment with a man about whose health there are doubts;
• when rashes or ulcers appear on the genital mucosa or the skin of various parts of the body;
• the occurrence of skin neoplasms;
• if condylomas appear on the mucous membranes.

In addition to the examination, you can discuss the optimal methods of contraception with a dermatovenerologist. Also ask for help in choosing preventive treatment (drug prevention) for venous diseases.

But, as a rule, any woman initially tries to visit a gynecological office.

The reasons that prompt a woman to visit a doctor are most often:

• the appearance of pathological leucorrhoea;
• soreness in the genital area;
• the presence of an unpleasant odor from the genital tract;
• discomfort during sexual intercourse;
• abnormal pregnancy;
• inability to conceive (infertility).

The gynecologist also resolves issues related to complications of the infectious process and pathology of the woman’s reproductive function.

An infectious disease specialist treats people with HIV, hepatitis B and C, herpes and cytomegalovirus infections.

Gastroenterologists and hepatologists are specialists who treat diseases of the gastrointestinal tract, including the liver.

Their main role is the treatment and monitoring of patients affected by viral hepatitis B and C.

A rheumatologist is a doctor whose patients are patients with autoimmune pathologies.

Also with diseases that contribute to the destruction of connective tissue. For example, chlamydial infection can cause Reiter's syndrome. This is a disease that manifests itself as damage to the joints, conjunctiva of the eyes and genital mucosa.

How and with what to treat female genital infections

The method of therapy depends on the type of infection that caused the pathological process.

Infection of the female genital organs is caused by various groups of microorganisms.

Therefore, depending on the disease, certain drugs are prescribed.

• Diseases that are caused by bacteria (chlamydia, syphilis, gonorrhea) are treated with antibacterial drugs. The doctor will tell you what antibiotics to take after a full examination. Due to the fact that every year sexually transmitted infections develop more and more resistance to antibiotics, diseases become more difficult to treat, as pathogens become resistant to antibiotics that previously dealt with them perfectly. Thanks to it, it becomes more and more difficult to cope with the infection each time and there are practically no therapeutic options left. They can be used in different forms: injections or tablets. Monural is used to treat cystitis. For syphilis, penicillin antibiotics are prescribed. They are administered intramuscularly. To treat gonorrhea, Ceftriaxone is used, which is prescribed intravenously or intramuscularly.
• For genital herpes and HIV infection, drugs with antiretroviral action are used. They are able to weaken the impact of the virus, but cannot completely rid a person of the infection. The virus remains in the body forever.
• For trichomoniasis, protozoal drugs are prescribed. For example, Tinidazole or Ornidazole.
• To treat hepatitis, immunomodulators and antiretroviral drugs are prescribed. Immunomodulators help protect the liver from the toxic effects of antiviral drugs.
• To treat fungal pathologies, drugs with a fungicidal effect are used. Systemic and local drugs are prescribed. The use of topical treatment is essential for candidiasis. Vaginal suppositories or tablets are prescribed. Prescribed drugs for internal use with fluconazole or Clindamycin. Their effectiveness is noted in 90% of cases. If there is no effect after treatment, tests are taken to culture the biomaterial for sensitivity to antimycotic drugs. Based on the results obtained, further therapy is carried out.
• Therapy for diseases caused by viruses depends on the type of pathogen. In case of HPV, tumors are removed with further administration of immunomodulators.

Instillation of the urethra for female genital infections

To treat some sexually transmitted infections (for example, gonorrhea), rinsing the vagina or bladder with antiseptic solutions is indicated. They are injected into the vagina or urethra. Washing with antiseptic solutions helps to quickly destroy pathogenic flora. Instillation must be carried out within the first two hours after unprotected sexual intercourse, in this way infection can be prevented.

Miramistin, Chlorhexidine, and preparations containing silver have a preventive effect as antiseptics.

Solutions are injected into the urethra daily or every other day.

Instillations into the bladder are carried out only in a treatment room, so they require the use of a catheter.

Treatment of genital tract infections during pregnancy

Treatment of infections during pregnancy presents some difficulties for the gynecologist. Since in this state not all possible means can be used. Many of the drugs are toxic to the fetus.

During pregnancy, a ban on the use of fluoroquinolones and tetracyclines has been introduced. Antiviral treatment can only be carried out with Acyclovir.

Of the macrolides, Azithromycin is the least dangerous.

For gonococcal infections, preference is given to Ceftriaxone.

Fortunately, most penicillin drugs are not toxic.

Because are not even able to penetrate the amniotic fluid.

In this regard, antibiotic therapy for syphilis is indicated at any stage of pregnancy.

Female genital infections and traditional medicine

Medicine has come a long way in recent years. And treatment methods using folk remedies do not become a thing of the past and remain relevant.

There are many methods of treatment using “grandmother’s methods”. According to traditional healers, there are no plants in the world that cannot cure a sexually transmitted infection in a woman. Herbalists recommend preparing herbal decoctions using medicinal plants. They are used not only for oral administration, but also for douching.

Perhaps herbal decoctions can simply saturate the body with minerals and vitamins. Thus, they will improve the immune defense, but will not be able to destroy pathogens in the body. That is, this method is completely untenable.

In addition, self-medication can cause certain complications:

• spread of infection along the ascending path;
• lead to infertility;
• contribute to the transition of the disease to a chronic state;
• negatively affect internal organs and organ systems.

As a result of such consequences, the patient will sooner or later have to go to the doctor.

But an advanced condition will take much longer and more difficult to treat. In severe cases, hospitalization may even be required.

Is it possible to have sex while a woman is being treated for infections?

During the treatment process, sexual abstinence is attributed.

This is explained by the following reasons:

• so that a sick person cannot become a source of infection for other people;
• in order to prevent the spread of infection through the body;
• preventing further injury to mucous membranes that are already damaged.

In addition, during illness, for many women, sexual relations are only a burden.

Because they cause discomfort:

• Patients feel pain when touching the genital mucosa.
• Bleeding of the mucous epithelium may be observed.
• The discharge has an unpleasant odor, which can repel a sexual partner.

If a woman is ready for such sensations, then she has the right to disobey the doctor and have sex.

But, in any case, you must use a condom.

Prevention of female genital infections

To prevent the possibility of contracting STDs, you can now get vaccinated against such dangerous diseases as HPV and hepatitis B.

In addition, you can protect yourself from sexually transmitted infections if:

• avoid sexual contact with strangers whose health is in doubt;
• using a condom;
• minimize non-traditional forms of sex, especially with untested partners;
• the use of special means of protection, especially during sexual intercourse with a new partner.

Where to go to get treatment for sexually transmitted infections

If you show signs of infection with any sexually transmitted infection, you should immediately consult a doctor. This can be a local gynecologist, or a venereologist who conducts an appointment at a clinic or dermatovenous dispensary. The specialist will give a referral for tests, the results of which will allow the doctor to prescribe the correct treatment.

Treatment in Moscow can be done not only at your place of residence, but also in one of the private clinics.

Among the advantages of this choice are:

• the availability of in-depth diagnostics to identify hidden infections;
• high level of qualification of specialists;
• polite attitude of the medical staff;
• maintaining anonymity.

If you suspect female genital infections, contact experienced gynecologists and venereologists at our medical center.

Since many diseases do not have characteristic symptoms, and for those that do have them, special medical education is necessary for recognition, I will give all the conditions that may indicate the presence of a sexually transmitted infection in a person. These are:

• The appearance of itching, discomfort, burning, pain, pain in the urethra or vagina
• Frequent and/or painful urination
• Presence of any discharge from the genitourinary organs
• The appearance of any rash on the genitals
• Any rash on the torso, palms, soles, or oral mucosa
• Enlarged lymph nodes
• Hair loss

The following group of symptoms is observed with complications of sexually transmitted infections

• Heaviness, tingling, pain in the lower abdomen, perineum, testicles
• Menstrual irregularities
• Difficulty urinating
• Premature or prolonged ejaculation
• Changes in sperm quantity and color
• Barren marriage

All sexually transmitted infections in some cases can be asymptomatic. Therefore, in the absence of signs of the disease, it is always necessary to undergo examination in the following cases:

• If you have had casual sex without using a condom, even in the absence of the above symptoms, regardless of the type of sexual contact
• If a sexually transmitted infection has been detected in a regular sexual partner

In some cases (for example, when planning a pregnancy), so-called screening for sexually transmitted infections is indicated in order to identify and treat them (for example, before pregnancy)

Where to contact

Currently in Russia you can get medical care:

• In municipal clinics (dermatology and venereal disease clinics) at the place of residence
• In various specialized medical commercial medical centers
• From private practitioners

Our advice is to carefully ask your acquaintances and friends whether such problems have happened to them and where they were treated, try not to advertise your illness, refer to “that a friend is sick, where should he/she go?” etc. Remember that the news that you are sick can negatively affect your reputation in the team. Once you find out where they were treated and reviews about the doctor, go there.
If this option does not suit you, contact a clinic or specialized medical centers.

Municipal clinic (dermatovenerological dispensary)

when applying, you will need a passport and an insurance policy, if you suspect that the cause of your illness is a sexually transmitted infection, contact a dermatovenerologist, of course, women can contact a gynecologist, and men can contact a urologist (andrologist), but a venereologist can quickly recognize the skin manifestations of syphilis, which can occur together with genitourinary infections. In a municipal clinic (dispensary) you can receive medical care completely free of charge (with the exception of additional paid tests), in cases of syphilis or gonorrhea you will have to sign a “Warning to the patient about a sexually transmitted disease”, from the moment of signing which you will bear legal responsibility liability for intentional infection with a venereal disease, after completion of treatment you will be registered and you will be required to regularly attend control examinations without fail.

Specialized Medical Center

A simpler and more reliable option is to visit a specialized medical center, which are now available in almost any city. Narrow specialization and experience in diagnosing and treating sexually transmitted infections allow the doctors working there to quickly make a diagnosis and prescribe quality treatment. The only drawback is that you have to pay for everything. When visiting the center, ask whether there is a license, what services the institution can provide in accordance with it, there must be an approved price list.
When paying, keep the payment document (receipt, check) issued to you; you may need it later. If you agree to be treated at the center, immediately discuss with your doctor what guarantees he can provide. Of course, medicine is not a watchmaking workshop, but the concept of a guarantee should include free repeat course of treatment if the first is unsuccessful.

Private practitioner

How to behave at a doctor's appointment

First of all, the doctor is interested in complaints and the timing of the disease. Complaints must be stated clearly; if the discharge is bothering you, you must immediately clarify its quantity, color, time of appearance, if pain - its location, severity, connection with urination, sexual intercourse. It is important to accurately determine the onset of the disease , expressions like “It started for me when I was at sea” do not convey any information, but only lengthen the appointment time. There is no need to be shy about the doctor - if you have had unconventional sexual contacts - oral or anal - be sure to inform - this will give additional information and will help make the correct diagnosis.

Inspection

If syphilis is suspected, it is necessary to examine all the skin, scalp, mucous membranes of the mouth, anal area, and not just the genitals. If a genitourinary infection is suspected in men, the head of the penis, the external opening of the urethra, the scrotum are examined, if indicated - rectally ( through the anus) prostate gland. In women - the vestibule of the vagina,
external opening of the urethra, cervix using a vaginal speculum.

What tests need to be taken

The diagnosis of any sexually transmitted infection must be confirmed laboratory. An exception is made only for two diseases: the diagnosis of genital herpes and scabies can be established on the basis of clinical signs (Order of the Ministry of Health of the Russian Federation No. 403 of 2003). Basically, the necessary studies are prescribed based on the data obtained during a survey of the patient and an external examination. Research can be divided into laboratory (for their implementation it is necessary to collect biological material from the patient) and instrumental (the use of special instruments to examine various organs of the patient directly). Sometimes a so-called screening examination is carried out - in the absence of visible clinical signs to exclude hidden pathology and carriage of pathogenic microorganisms.

Laboratory research

If syphilis is suspected, a serological test of blood from a vein is prescribed (CSR, ELISA, RPGA, RIT, RIF), in the presence of ulcers or erosions on the mucous membranes - a dark-field study

If genitourinary infections are suspected, a bacterioscopic smear from the urethra in men; urethra, vagina and cervical canal in women is required (in addition to identifying the pathogen, the smear is used to determine the presence or absence of an inflammatory process in the genital organs). Many pathogens cannot be determined using this examination , therefore, in addition, he must be examined using the cultural method (bacteriological culture) or polymerase chain reaction (DNA diagnostics). This is due to the fact that a combination of several infections (mixed infections) often occurs. For example, gonorrhea and chlamydia - gonorrhea is easily determined by a smear, and to diagnose chlamydia, a study using PCR is required. For the purpose of topical diagnosis (which organs of the reproductive system are affected), a general urine test, glass urine samples, examination of prostate secretions, spermograms are prescribed. Sometimes an immunological blood test is prescribed - enzyme immunoassay analysis for the presence of antibodies of various classes against pathogens of sexually transmitted infections. This study sometimes helps to determine the infection if the pathogen is located in the fallopian tubes in women, the prostate gland and epididymis in men, but is not decisive in establishing an etiological diagnosis.

Instrumental studies

They are prescribed for topical diagnosis of the disease and to identify complications. Mainly prescribed are urethroscopy (examination of the urethra), colposcopy (examination of the vagina and cervix) and ultrasound examination of the prostate gland, organs of the scrotum, uterus and uterine appendages.

What are the special requirements for testing?

When taking smears from the genital organs and PCR, men do not urinate for 3 hours or more, women do not do the morning toilet and douching.
During a serological examination for syphilis using the CSR method (Wassermann reaction), blood from a vein is donated on an empty stomach
When testing for syphilis and other sexually transmitted infections using ELISA, there are no special requirements
When submitting prostate secretions and spermogram, abstain from ejaculation for 3-5 days.

How are sexually transmitted diseases diagnosed?

The data from the survey, examination and laboratory tests are summarized by the doctor and he makes a diagnosis of a sexually transmitted infection. The diagnosis must comply with the International Classification of Diseases, X revision. In addition to indicating the pathogen that caused the disease, the diagnosis must indicate which organ of the reproductive system is affected (urethra, vagina, bladder and .etc.).Many diagnoses that are made by doctors are currently not legally competent, but are more understandable to patients. For example, the diagnoses of gardnerellosis, ureaplasmosis, mycoplasmosis are acceptable in popular scientific literature, but their use in official documents (medical record, history illness, discharge, certificate) is unacceptable.

What is the prescribed treatment for sexually transmitted diseases?

Depending on the established diagnosis, treatment is prescribed.
For a number of infections (syphilis, gonorrhea, chlamydia, trichomoniasis, candidiasis, herpes,
anogenital warts, bacterial vaginosis) The Ministry of Health has developed standard methods. If for genitourinary infections changes in treatment methods are allowed by the attending physician, then treatment of syphilis must be carried out exactly according to the instructions in order to evaluate the results of treatment during dynamic observation.
Treatment of sexually transmitted infections is carried out by prescribing certain antibiotics depending on the diagnosis. Treatment without antibiotic therapy is unacceptable. The use of various homeopathic drugs, physiotherapeutic devices, immunostimulating agents without antibiotic therapy leads to chronicity of the process and the appearance of complications.

Usually the doctor prescribes a list of medications needed for treatment, which the patient buys at the pharmacy himself. In some medical centers, the cost of the course of treatment includes the cost of medications purchased by the medical center itself. Although from a legal point of view this is somewhat illegal, from a practical point of view the patient is exempt from searches for the necessary drugs in pharmacies and, most importantly, the center’s doctors take responsibility for the outcome of treatment - i.e. interested in a quick and complete cure of the patient with the drugs they purchased.

What to do with sexual partners

Sexual partners of patients with sexually transmitted infections are subject to mandatory examination. If the causative agent of the disease is not found in them, they must either receive preventive treatment or undergo periodic clinical and laboratory examinations over a certain period of time (depending on the diagnosis)

What not to do during treatment for sexually transmitted diseases

During the course of treatment, unprotected sexual intercourse (including orogenital and anogenital). Taking some antibiotics is incompatible with a number of medications. No connection has been established between alcohol consumption and the resulting low effectiveness of antibiotic therapy (see)

How to find out if there has been a cure for sexually transmitted diseases

After the course of treatment, it is necessary to determine whether a cure has occurred. Monitoring of the cure is carried out after a certain period of time after the end of treatment (depending on the diagnosis). There are:

Etiological cure

When the pathogen is not determined during laboratory examination within a certain period after treatment for each disease

Clinical cure

When there are no clinical signs (symptoms) of the disease

Complete cure

Sexually transmitted diseases are infectious, that is, arising due to the introduction of various pathogens. They are broadcast from person to person only contact and mainly during sex.

The generally accepted definition does not raise questions among doctors, but for patients it is better to decipher it point by point:

• Pathogens can be bacteria, protozoa, fungi, rickettsiae or viruses. Mixed infection is possible - infection by several types of microorganisms at once.
• A sexually transmitted disease is a local and general manifestation of the impact of infection on a person.
• For infection, you need a source of infection (the patient or a carrier) and the route through which the pathogens are transmitted. Infection with a sexually transmitted disease is possible if there is:
  1. Sexual transmission during any sexual activity (traditional, oral or anal intercourse). Pathogens are transmitted from the skin or mucous membranes of the genitals, anus (anus), lips and oral cavity.
  2. Transmission - infection through blood - through transfusion of whole blood, red blood cells; infection from needles or instruments on which the blood of a patient or a carrier of infection remains.
  3. Contact and household route: through linen or objects that are contaminated with infectious secretions.

The word “venereal” is associated with the name of Venus, the Roman goddess of love: it emphasizes that diseases are more often transmitted through sexual contact.

What diseases are considered sexually transmitted, their classification

Modern sources provide a list of sexually transmitted infections. The list includes only two dozen diseases. Among them are 5 original venereal diseases:

And a number of STDs, which today are conventionally called “venereal”, based on the sexual route of infection:

• , And , , .
• Some sources also classify intestinal giardiasis and amebiasis as STDs, although sexual transmission (mainly anal) is not the main route for them.

Sexually transmitted diseases are classified in very different ways:

According to etiological principle(based on the reasons for the development of diseases), ailments are divided into viral, bacterial, fungal, etc.

According to the effect on the body There are genital types of sexually transmitted diseases (for example, gonorrhea, vaginal trichomoniasis), skin types (pediculosis pubis, scabies, condylomas) and those affecting other organs and systems of the human body (viral hepatitis B and C, amoebiasis, AIDS, giardiasis).

In accordance with the age of the description of the signs distinguish between classic, known even before our era, venereal diseases - syphilis, gonorrhea, donovanosis, chancroid and lymphogranuloma venereum (all of them are oral infections), and the so-called new venereal diseases - the rest of the list.

The names of some classic STDs have historical roots: the godfather of gonorrhea was an ancient Roman doctor Galen, who observed the "flow of seed" and used Greek words to describe this feature. The word “syphilis” is associated with a myth according to which the gods, offended by disrespect, punished a shepherd named Syphilus with a genital disease. There was even a poem dedicated to this plot, where the main symptoms were described in detail. A later name is lues ( lues) – translated from Latin means “contagious disease”, and it appeared after the syphilis epidemic in Europe, which lasted about 50 years (late 15th – mid 16th centuries). The names of new STDs are derived from the names of pathogens (trichomoniasis, chlamydia, etc.) and virus serovars (viral hepatitis B and C), main manifestations (scabies, condylomas) or symptom complexes (AIDS).

Prevalence and risk groups

Top lines of the world rankings, including the most common sexually transmitted diseases , Trichomoniasis and chlamydia are firmly occupied: up to 250 million cases are identified annually, and the proportion of those infected is about 15% of the total population of the Earth. They are followed by gonorrhea (100 million “fresh” cases of the disease per year) and syphilis (up to 50 million). The graphical representation of the incidence resembles a wave, the peaks of which occur during times of social change for the worse and the post-war years.

Reasons causing an increase in the incidence of STDs:

1. Demographic – population growth, an increase in the proportion of young and sexually active people, traditions of early sexual activity.
2. Progress in the socio-economic sphere - labor migration, tourism development, more free time and money, youth attraction to cities and availability of sexual contacts.
3. Behavioral norms are changing: more divorces, easy change of sexual partners; women are emancipated, and men are in no hurry to start a family.
4. Medical reasons - frequent cases of self-medication and the transition of diseases into a latent form; women and men feel safe using condoms and instant STD prevention.
5. Prevalence of drug addiction and alcoholism.

Traditional risk groups include prostitutes, homeless people, illegal migrants, alcoholics and drug addicts leading a “non-prestigious” lifestyle. However, they are confidently being overtaken by the growing incidence rate among quite successful people: personnel of companies operating abroad; those employed in the tourism business and tourists; sailors, pilots and flight attendants are also included in the list of unreliable STDs.

Incubation period

The appearance of visible changes at the site of infection is the result of the reproduction and vital activity of STD pathogens. A small number of infectious agents can be rebuffed by the immune system and die, and for the development of signs of the disease, the law of the transition of quantity into quality needs to work. Therefore, any infectious diseases have an incubation period - a period of time necessary for the number of pathogens to increase and the first visible symptoms of infection to appear (for STDs - rash, discharge).

Typically, the incubation period figures are given in days, for viral infections - in hours. Incubation time may vary, which is associated with the duration of contact, the amount of a single dose of pathogens, the route of transmission and the state of the immune system of the recipient person. The incubation period (IP) is shortened in elderly and weakened patients, with transmission of pathogens and in patients with immunodeficiency syndrome.

IP for some common sexually transmitted infections (per day):

• Chlamydia: 7-21 days;
• Trichomoniasis: 7-28 days;
• Gonorrhea: 2-10 days;
• Urea and mycoplasmosis: 21-35 days;
• Syphilis: 21-28 days;
• Genital herpes: from 1 to 26, usually 2-10 days;
• (pointed): 30-90 days.

The main manifestations of classical venereal diseases

Symptoms of sexually transmitted diseases are divided into primary signs that appear on the skin or mucous membranes at the site of entry of pathogens, and are common associated with their toxic effects on the body. For example, - these are local manifestations of sexually transmitted infections, and fever is a general symptom.

Syphilis

The causative agent of syphilis ( Treponevapallidum, spiral-shaped bacterium or spirochete) is predominantly transmitted through sexual contact. The risk of infection during unprotected sex reaches 30%. In the external environment, spirochetes are unstable; to maintain activity they require certain temperatures and humidity. The mucous membrane of the genital organs, mouth or rectum serves as such an “incubator”. The infection can also be transmitted in utero - to the child from the mother, or through a transfusion of contaminated blood.

Primary a sign of syphilis infection: it appears at the site of direct introduction of treponemes and does not initially cause concern. A compaction appears, then in its place a round ulcer with a hard bottom and raised edges appears. There is no pain, but the chancre can be small in size - from 1 cm in diameter. After a couple of weeks, the lymph nodes, which are located closer to the chancre, enlarge, but they are also painless and do not bother the patient. The chancre heals on its own in 1-1.5 months. after appearance, however, the infection remains in the body and syphilis goes into the secondary period.

Start secondary syphilis is a symmetrical venereal rash ( roseola), which often appears even on the feet and palms. When the rash occurs, the temperature rises and the lymph nodes enlarge throughout the body. Characteristic is the alternation of deterioration and improvement of the general condition - periods of exacerbations and remissions. Among skin manifestations, warts (condylomas lata), which are localized in the perineum and anus, can attract the patient’s attention; Hair loss on the scalp is also noticeable.

syphilitic roseola

Tertiary the period of syphilis is associated with severe internal diseases that develop within several years after infection. If left untreated, about 1/4 of patients die.

Gonorrhea

The causative agent is paired cocci, which under a microscope look like coffee beans, with their concave side facing each other. The name is sonorous - Neisseriagonorrhoeae, given to microbes in honor of their discoverer, venereologist A.L. Neisser. Gonococci are introduced exclusively through the mucous membranes, more often - the genitals, rectum and orally, less often - the eyes (gonoblepharrea of ​​newborns when a child is infected from the mother). The household route of transmission of infection is impossible, because gonococci are very sensitive to temperature and humidity conditions.

in the photo: gonorrheal discharge in men and women

Basicsigns infections - purulent inflammation of the mucous membranes. When transmitted sexually, both partners almost always develop (inflammation of the urethra). Gonorrhea is distinguished by (urination), ; even at rest they can. The discharge during the acute period is profuse and purulent, the color ranges from white to yellow. When transitioning to the chronic form, there is little discharge, they become whitish and thick.

Important: in contrast, with gonorrhea they are often minor, they can be mistaken for a symptom of nonspecific urethritis, cystitis or. Be sure to make an appointment with a doctor if the discharge occurs for more than one cycle and has a putrid odor; if there is bleeding between menstruation; if you “don’t have the strength” and your lower back is constantly aching.

Complications are associated with ascending urogenital infection. In women, gonococci affect the uterus, tubes and ovaries, in men - the testicles, epididymis (), and prostate. The standard result of chronic gonorrhea is adhesions internal organs. If adequate treatment is not received or the immune system has failed, gonococcal infection is possible. sepsis(blood poisoning) with a fatal outcome or the infection spreading to internal organs (liver, heart, brain) and an unclear prognosis for future life. The sad, although not fatal, result of chronic gonorrhea is 100% male and female infertility.

Soft chancre (shacroid)

The causative agent is a bacillus Haemophilusducreyi. The disease is mainly “associated” with countries where there is a warm and humid climate (Africa, Asia, South America); it is rare in European countries. Infection occurs through sexual contact, through anal and oral sex. The chances of getting an infection during one time of unprotected sex are 50 to 50.

differences between soft chancre and hard chancre (syphilitic)

Signsinfection: the primary manifestation is a red spot, indicating the locus of infection. Then a purulent blister appears and turns into an irregularly shaped ulcer, soft and painful. The diameter of the ulcer varies from 3-5 mm to 3-10 cm or more. Then the lymph vessels become inflamed ( lymphangitis), forming painful subcutaneous cords. In men they are palpated on the back of the penis, in women - on the skin of the labia majora and on the pubis. After 7-21 days, inflammation spreads to the lymph nodes ( lymphadenitis); dense buboes appear, which later turn into soft ulcers and open. Complications- swelling of the foreskin, pinching of the glans penis, gangrene of the genitals.

With chancre, skin manifestations are numerous and are at different stages of development: spots, ulcers and scars are visible at the same time.

Lymphogranuloma venereum (inguinal lymphogranulomatosis)

The causative agent of lymphogranuloma venereum - some serotypes Chlamydiatrachomatis. The disease is quite rare in Europe; mainly “imported” infections and cases associated with port cities are recorded. The possibility of becoming infected through everyday life exists, but transmission of the infection mainly occurs through sexual contact.

in the photo: signs of lymphogranulomatosis venereum - inflamed inguinal lymph nodes in women and men

Basicmanifestations: 1-3 weeks after infection, a vesicle appears at the site of chlamydia penetration, which disappears without treatment and may go unnoticed. Then the regional lymph nodes enlarge, merging with each other; the skin over the source of inflammation is purple-violet, palpation causes pain. Next, suppuration occurs, the formations are opened with the flow of yellowish pus.

Complications inguinal lymphogranulomatosis – fistulas anal, scrotum, urethra, recto-vaginal, between the rectum and bladder. Later development is possible elephantiasis genitals due to local lymphostasis, strictures(narrowing) of the rectum and urethra.

in the photo: manifestations of donovanosis on the genitals

Donovanosis (venereal (inguinal) granuloma)

Donovanosis is an exotic disease native to the tropics. The causative agents are callimatobacteria or corpusclesDonovan, they become infected through sexual and household contact. Symptoms develop slowly. It begins with the formation of a red nodule on the skin or mucous membrane of the genitals, mouth, or anus. Then the nodule turns into an ulcer with a velvety bottom and raised edges, the size of the defect increases over time. Strictures urethra, vagina and anus, elephantiasis– main complications of donovanosis.

Signs of infection with new STDs

photo: typical discharge from chlamydia

Chlamydia

Primary signs of infection atmen– urethritis with characteristic morning discharge in the form of a transparent drop. Uwomen– urethritis, inflammation of the cervix with scanty and cloudy secretions, associated pain and acyclic bleeding. Transmission of the infection is possible only through sexual contact; oral transmission is unlikely. Impossible become infected through contact and household contact (through pool water, toilet seats, bathhouses or bed linen.). Newborns can get chlamydial conjunctivitis or pneumonia from their mother during childbirth.

Trichomoniasis

The infection is transmitted sexually or by everyday means(the only one of the sexually transmitted diseases! although such cases are extremely rare), oral and anal infections are uncommon. In men, symptoms of urethritis and colpitis prevail, in women – colpitis. Trichomoniasis is characterized by yellowish, profuse, foamy discharge with an unpleasant odor, itching in the perineal area, pain during sexual intercourse and when urinating.

Mycoplasmosis

"sexual" types of mycoplasmas

Mycoplasmas occupy an intermediate position between bacteria and viruses and can live in the body of humans, animals and even plants. Capable of multiplying on the mucous membranes of the mouth and pharynx, and organs of the genitourinary tract. Often detected in healthy people, up to 50% of women are carriers of mycoplasmas. Mycoplasmahominis And M. genitalium are the cause of the development of urethritis in men, and bacterial vaginosis in women ( gardnerellosis), inflammation of the fallopian tubes and ovaries. Mycoplasma pyelonephritis may also develop. Infection occurs through sexual contact; transmission of the infection is unlikely through household contact.

Ureaplasmosis

Pathogens - Ureaplasmaparvum And U. urealyticum, causing urethritis in men and inflammation of the uterus and ovaries in women. Urolithiasis develops as a complication; spontaneous abortion or early birth is possible during pregnancy. Many completely healthy people become carriers of the infection; more often these are women.

Genital herpes

The causative agent is the herpes simplex virus ( Herpessimplex); Sexual transmission occurs through oral, anal and genital contact. Household spread of this virus is unlikely. The first sign of the disease is a painful spotty-bubble rash at the site of virus introduction; the patient feels sharp pain and burning, local swelling increases. At the same time, the general condition worsens, the temperature rises and a headache begins. The bubbles transform into erosions, from which a yellowish liquid is released. After 5-7 days, the erosions heal, leaving pigmentation. Relapse of the disease or reinfection is always possible.

HPV (human papillomavirus)

HPV causes a spectrum of different skin lesions, including pointedcondylomas. The cause is sexually transmitted infection, including oral infection, with HPV serotypes 6 and 11. Epithelial outgrowths resembling cockscombs form on the genitals. Formations can merge and increase in size. In women, genital warts are most often found in the vulva and vagina, in men - on the penis and inner leaf. preputium(foreskin). Warty growths are possible in the corners of the lips and on the tongue.

skin manifestations of papillomavirus infection - papillomas

Candidiasis (thrush)

Candidiasis is the result of rapid proliferation of fungi (genus Candida), which are normally always present in healthy people on the mucous membranes of the mouth, urogenital and intestinal tracts. It is classified as a sexually transmitted disease due to the possible sexual transmission and skin manifestations that are often observed in the genital area. Candidiasis can develop after treatment with antibiotics and corticosteroids (prednisolone, dexamethasone), with diabetes, AIDS, after prolonged stress, in the third trimester of pregnancy. Symptomsgenital candidiasis in women - curdled, sour-smelling vaginal discharge, pain when urinating and during sexual intercourse. In men, a whitish coating is visible on the head of the penis, pain is present during miction and after sexual intercourse.

Laboratory diagnostics

Laboratory examination using various techniques is the basis for diagnosing sexually transmitted diseases. Previously, preference was given visualidentification of pathogens, performing (cervix, vagina, urethra, rectum, pharynx) followed by microscopy. The technique is quite accurate, but the result takes at least a week, and the loss of time is a serious problem for the attending physician and the patient.

It is done quickly, the method is inexpensive and simple. The discharge is taken with a sterile swab: in men - from the urethra, in women - from three standard points (urethra, vestibule of the vagina, cervix). The material is then applied to a glass slide, stained, and examined under a microscope. You can determine the degree of inflammation by the number of leukocytes and evaluate the qualitative composition of the microflora. Viruses cannot be seen with light microscopy.

Modern diagnostic options in venereology - PIF analyzes ( straightimmunofluorescence), (immunoenzyme). The material is secretions; the doctor receives the examination results within a few hours. The methods are cheap and widely available, but the accuracy is disappointing - only up to 70%. Therefore, these tests are used for preliminary diagnosis.

The final diagnosis is made based on the results, which means “ polymerasechain reaction"or a DNA test for the pathogen. The material is excretions and urine, the time to obtain the analysis result is up to 2 days, the accuracy is up to 95%. Preferably PCR is used to determine. In case of acute purulent inflammation, it is recommended to do PIF, ELISA, and culture.

(material – venous blood) indicates that there is an immune response to the presence of this pathogen, i.e. infection is determined by indirect signs and is not detected directly. Mainly used to determine viral diseases (genital herpes, HIV, viral hepatitis, cytomegalovirus) and syphilis. Antibodiesto bacteria remain in the blood for a long time; they are present even after complete recovery, which is why this method is never used to test for bacterial venereal diseases, chlamydia and ureaplasmosis.

Treatment

Treatment for bacterial STDs is carried out antibiotics, additionally including local procedures (urethral instillations), immunotherapy and physiotherapy. For combined infections (gonorrhea and chlamydia, syphilis and gonorrhea), drugs are used that act simultaneously on several pathogens. Viral infections (HIV, hepatitis B or C virus, herpes simplex virus) are treated with special agents, and antibiotics are prescribed only for accompanying complications caused by bacteria. It should be remembered that antibiotics do not work on viruses!

• Treatment acuteuncomplicated gonorrhea: tablets cefixime, ofloxacin (0.4 g once) or ciprofloxacin (0.5 g once).
• Chlamydia: doxycycline tablets 0.1 g x 1, or azithromycin 0.1 x 2, course 1 week.
• Soft chancre: once - azithromycin tablet. 1.0 g, or ciprofloxacin tab. 0.5 g x 2 courses for 3 days, or erythromycin tab. 0.5 g x 4 - course 1 week.
• Venereallymphogranulomatosis: tab. doxycycline (0.1 g x 2, course 3 weeks) or erythromycin (tablet 0.5 g x 4, course 1 week).
• Donovanosis: trimethoprim (0.16 g x 2) or doxycycline (0.1 g x 2), course up to 3 months.
• Ureaplasmosis: azithromycin tab. 1.0 g once, or doxycycline (tablet 0.1 g x 2, course 1 week).
• Candidiasis: for skin lesions - clotrimazole cream, twice a day, course 5-7 days. Orally – fluconazole tablets, 50-100 mg per day, course 5-7 days. For women - vaginal suppositories (clotrimazole, isoconazole). Suppositories betadine, polzhinax, terzhinan are considered ineffective against candidiasis, and can also cause vaginal dysbiosis and, as a result, the development of gardnerellosis.
• Herpetic rashes in the genital area: antiviral agents (acyclovir, Valtrex, farmciclovir). Oral and intravenous administration of the solution is more effective than local use in the form of ointments or creams. It is impossible to completely get rid of the herpes simplex virus; symptoms reappear when there are problems with the immune system (stress, acute respiratory infections and acute respiratory viral infections, AIDS).
• Condylomas acuminata removed (laser, cryotherapy, electrocoagulation), interferon injections are prescribed at the base of each wart. Antivirus pharma. the remedies are ineffective. Approximately a third of patients recover without treatment within 1-3 months; 25% experience a relapse after therapy or removal of genital warts.

Prevention of STDs

Spermicidal drugs (contraceptin, pharmatex) have not undergone clinical trials regarding protection against STDs, therefore their use as a means of prevention is not recommended.

The only and guaranteed way not to get sexually transmitted infections is a traditional monogamous relationship, a happy life with one partner.

Video: sexually transmitted diseases – “Health Expert”