How to treat sexually transmitted infections? Symptoms of sexually transmitted infections. Causes and treatment of the most common sexually transmitted infections

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 later 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”

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 swabs 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

• the most common diseases,
• treatment of hidden infections in women - drugs that are advisable to take,
• what general medications involve the treatment of genital infections and urinary tract infections,
• is there a disease that is resistant to certain types of drugs, and how can it be cured,
• the most effective treatment – ​​sexually transmitted infections and the most effective medicine.

Bacterial infectious diseases

Bacterial vaginosis

Bacterial vaginosis (BV) is a common vaginal infection that increases the risk of contracting other sexually transmitted infections and may occur along with them. First mentioned in 1955 as “nonspecific vaginitis” (Gardner and Dukes). The term "bacterial vaginosis" has been coined since 1984.

Etiology

Gardnerella vaginalis is a multiplied, facultative anaerobic bacterium with a high concentration of Mobiluncus SPP, Prevotella SPP, Peptostreptococci, Fusobacterium SPP, Bacteroides SPP, aerobic bacteria, alpha-hemolytic streptococci, etc. C The most common is the “combination” with Trichomonas.

Clinical picture

• The infection is asymptomatic in 50%.
• The disease is usually characterized by copious sticky discharge with a fishy odor.
• Involvement of the cervix leads to acute purulent cervicitis, which is manifested by grayish-white discharge of a denser consistency.
• Irritation of the skin and mucous membranes of the genital organs, swelling, erosions, ulcers
• Nonspecific urethritis.
• Possible complications: inflammation of the pelvic area, complications after abortion and hysterectomy, premature birth.

Diagnostics

• White-gray, homogeneous, sticky discharge.
• Microscopic examination - native drug and Gram method (clue cells - epithelial cells with granular cytoplasm - presence of bacteria).
• Vaginal pH is greater than 4.5.
• positive amine test - characteristic fishy odor upon alkalization of fluorine with 10% KOH.

How to treat?

Metronidazole (nitroimidazole chemotherapy drugs - bactericidal effect on anaerobic bacteria and protozoa, for example, Trichomonas):

• orally: 500 mg 2 times a day for 5-7 days, possibly 2 g once,
• intravaginally: Klion D 1-2 vaginal tablets/day for 10 days (combined product with fungistatic imidazole and fungicidal antifungal miconazole 150 mg + Metronidazole 100 mg),
• Clindamycin (lincosamide bacteriostatic antibiotic with an antibacterial spectrum),
• orally: 300 mg 2 times a day, for 7 days,
• intravaginally: 2% cream 5 g/day for 7 days.

Chlamydial infection of the reproductive system

Genital chlamydia is the most common sexually transmitted infection. It accounts for a total of 50-60% of all cases of nonspecific urethritis. The highest incidence is in women aged 16-19 years, and men aged 20 to 24 years. Factors associated with an increase in the prevalence of chlamydial infection increase during periods of increased sexual activity and when alternating sexual partners, especially in the case of unprotected sex.

Etiology

Chlamydia has an affinity for columnar epithelium (serotype D-K causes urogenital infections). The incubation period is 7-21 days.

Diagnosis of chlamydial infection is based on the direct detection of chlamydial antigens, isolation of chlamydia in cell cultures, the presence of chlamydial DNA (hybridization methods or ligase chain reaction, which are one of the most sensitive research methods. A smear is performed from the affected mucosa, urine collection (the first portion), ejaculate.

Treatment

• Antibiotics that suppress the protein synthesis of bacterial cells (tetracyclines, macrolides) act on most clinical forms of the disease, and are one of the first choice drugs in the treatment of chlamydial infection.
• Tetracycline antibiotics (have a bacteriostatic effect and a wide antibacterial spectrum: aerobic and anaerobic bacteria, chlamydia, mycoplasma, rickettsia, spirochetes and protozoa. The disadvantage is the development of resistance in some types of microorganisms). They penetrate well into the tissues and secretions of the central nervous system. Excreted in bile and urine. To obtain the most effective pharmacokinetic properties, Doxycycline is most often used.
• Macrolides (bacteriostatic against gram-positive microorganisms, chlamydia, mycoplasma, spirochetes and others). They have good penetration into tissues and secretions, do not penetrate the central nervous system. Excreted in urine and bile. Macrolides of the second generation are mainly used due to their favorable pharmacokinetic properties: Azithromycin, Clarithromycin, Roxithromycin. Second generation macrolides have better gastrointestinal tolerance and are characterized by less interaction with other drugs than first generation macrolides, which include, for example, Erythromycin, Spiramycin, Josamycin.
• Quinolone antibiotics (bactericidal active quinolones of the third generation have a wide spectrum of activity against gram-positive microorganisms, act on mycoplasmas, chlamydia and mycobacterium tuberculosis). They penetrate well into tissues and are excreted from the body with bile and urine. For example, Ofloxacin has been used in the alternative treatment of chlamydial infection.

Mycoplasma infections of the genitourinary system

Mycoplasmas are gram-negative bacteria without external cell walls, similar in size to large viruses (100-150 nm). They are often part of the normal microflora (present in approximately 70% of sexually active individuals), in patients with urogenital infection their concentration is 2-4 times higher, and can be the main pathogen, especially in the case of immunodeficiency of the body.

Etiology

Mycoplasmas of the human urogenital system include: Mycoplasma hominis, Mycoplasma genitalium, Mycoplasma fermentas, Mycoplasma incognitum, Ureaplasma urea lyticum.

Clinical picture

Mycoplasmas are part of the mixed flora of nonspecific urethritis, where Mycolasma Hominis makes up more than 20%, and Ureaplasma urealyticum makes up more than 52%.

• Bacteria are directly involved in the development of nonspecific urethritis (18-45%). Clinically manifests itself as pollakiuria. Characteristic features include creamy discharge, erythema and swelling of the urethral opening. If the disease develops, bacteria can cause prostatitis and epididymitis.
• Women may experience mucopurulent cervicitis or pyelonephritis.
• Bacteria may contribute to the formation of Reiter's syndrome.
• The disease may be asymptomatic.

Diagnostics

Diagnostics is quite complex; liquid and solid media (PPLO soil), enzyme-linked immunosorbent assay (ELISA) are used, and nucleic acids are detected using the PCR (polymerase chain reaction) method. Discharge from affected mucous membranes, semen, and urine are examined.

Treatment

Mycoplasma does not have a cell wall; its surface is formed by a three-layer membrane rich in lipids (the bacterium is resistant to penicillin and other antibacterial substances that destroy peptidoglycan or inhibit its synthesis as an essential component of the cell wall). Treatment of the disease is identical to the treatment of chlamydia.

Mycoplasma is characterized by general resistance to Macrolides; the drug of choice is Doxycycline (100 mg 2 times/day for 7 days), another possibility is represented by the drug Clindamycin (300 mg 2 times/day for 7 days).

Viral infections

Genital warts (condylomas acuminata, venereal warts)
Genital warts occur in 10-20% of the population aged 16-49 years. The maximum prevalence is among women during sexual activity, aged 20-24 years, and men aged 25-34 years.

Etiology

Human papillomavirus (HPV). Approximately 25 HPV genotypes have a “preference” for the anogenital region. HPV types are classified into low or high oncogenic potential. The incubation period of the disease ranges from 2 weeks to 9 months.

Clinical picture

The infection affects the skin and mucous membranes. In men, in most cases, it is localized at the opening of the urethra, on the head of the penis and scrotum. In women, it most often affects the labia.

Extragenital localization, very common, especially among homosexual couples, is most often represented by the perianal. A frequent occurrence, for example, localization in the corners of the mouth, on the legs and other less obvious places, often associated with various sexual activities.

Clinical form: small whitish or pink very fragile wart papules that bleed slightly when injured. They can occur either singly or (in most cases) in a focal manner.

Warts can grow and merge with each other. Pressure, friction, and sweat lead to destruction of their surface, leakage and secondary infection with a strong odor. In case of neglect, possibly in immunodeficiency conditions (for example, in the presence of HIV and cancer), warts become more widespread and grow to large sizes - giant condyloma (associated with HPV 16, 18 - precancerous and malignant lesions).

Subclinical form: flat lesions, can be visualized with 3-5% acetic acid (whitish areas).

Latent type: cytological diagnosis, hybridization. Complications may include balanitis, balanoposthitis, phimosis and paraphimosis.

Diagnostics

Clinical examination, anamnesis. In case of doubt, histological examination or hybridization methods can be performed. A venereologist always performs a full examination aimed at excluding overlap with other sexually transmitted diseases, including a serological study.

Treatment

• Surgical: abrasion (more suitable for single lesions), general excision of large deposits. The disadvantage is a possible relapse in the scar, and further, already complex, treatment.
• Physical: cryo-destruction with liquid nitrogen (very effective, often long-term, painful, destructive method, requiring regular re-treatment), electrosurgical ablation, electrodiathermocoagulation.
• Chemical: 10-25% solution of Podophyllin, Podophyllotoxin (0.15%), bi- and trichloroacetic acid.
• Immunomodulatory, antiviral, cytostatic: Aldara (Imiquimod 5%), alpha-interferon, 5-fluorouracil.
• Laser.

Conclusion

Treatment of any sexually transmitted disease belongs to the hands of a specialist! Insufficient therapy, as well as self-medication, can lead to serious complications requiring long-term, expensive treatment!

It is advisable for prevention purposes to always give preference to safe sex. Proper personal hygiene is important.

Some diseases (for example, gonorrhea) can be treated with the use of antiseptics. They are inserted into the urethra and vagina.

Washing the genitals with antiseptics allows you to quickly destroy pathogenic bacteria. Within 2 hours of unprotected sex, they can prevent infection.

Can be carried out at home. For this, chlorhexidine, Miramistin, and silver preparations are used.

Antiseptics are injected into the urethra every other day or every day. If in treatment of sexually transmitted infections, deep instillations are used with the introduction of antiseptic substances into the bladder; such procedures are not carried out independently. Medical assistance is required as medications are administered through a catheter.

Sex in the treatment of sexually transmitted infections

Some doctors prescribe to their patients sexual rest in the treatment of infections.

The reasons for this are obvious:

• by having sex, you infect other people;
• the infection can spread to overlying organs;
• you can injure already damaged mucous membranes.

Plus, sex is uncomfortable. The inflamed mucous membrane of the urethra and vagina hurts and sometimes bleeds. An unpleasant-smelling discharge appears, which does not add sexual arousal. But if that kind of sex suits you, you can have it. Just remember to use a condom.

Treatment of sexually transmitted infections during pregnancy

Not all drugs can be used during pregnancy. Some are toxic to the fetus. Therefore, therapy is carried out with the participation of an obstetrician-gynecologist.

Tetracyclines and fluoroquinolones are prohibited for use. Of the antiviral agents, only acyclovir can be used.

Among macrolides during pregnancy for treatment of sexually transmitted infections in women Azithromycin is preferred. For gonorrhea, ceftriaxone is used.

Most penicillins are not toxic to the fetus, as they do not even penetrate the amniotic fluid. Therefore, it can be performed at any stage of pregnancy.

Traditional treatment of sexually transmitted infections

Despite the rapid development of medicine in recent years, traditional methods of treating various diseases are still popular in Russia. Often treatment of sexually transmitted infections, carried out according to “grandmother’s recipes”. There are many ways.

If you believe traditional healers, then there are no plants or food products in the world that could not rid you of trichomoniasis, gonorrhea, chlamydia and other sexually transmitted diseases in a week.

Treatment of sexually transmitted infections in men often involves not only ingesting herbal decoctions, but also rinsing the “manhood” in medicinal baths.

Self-medication usually leads to the following consequences:

• spread of infection to the overlying organs of the genitourinary system;
• infertility;
• chronicity of the pathological process;
• complications (abscesses, joint damage, etc.).

As a result, the patient is still forced to see a doctor. But an advanced disease takes longer and is more difficult to treat.

Hospitalization and intensive antibiotic therapy may be required.

Clinic for the treatment of sexually transmitted infections

If you have symptoms of sexually transmitted infections, treatment you can get it from a venereologist in a good private clinic.

Advantages of this approach:

• wide diagnostic capabilities – identification and treatment of hidden sexually transmitted infections;
• painless smear taking;
• affordable prices;
• highly qualified doctors;
• possibility of maintaining anonymity.

One of the services offered by venereology clinic – treatment of sexually transmitted infections together with a partner. In this case, situations in which infection will occur again are excluded. Therapy is prescribed to both partners simultaneously.

If you suspect sexually transmitted infections, contact competent venereologists.

Genital (vaginal) infection, or vaginitis, is an inflammation of the vagina, resulting in abnormal discharge, odor, irritation or itching. Vaginitis is not easy to detect because it has many different causes. To treat itching, discharge and discomfort caused by this infection, women Various over-the-counter products are used.

The most common symptoms of various forms of vaginitis are vaginal discharge, itching and burning. Although the symptoms of these infections can be very similar, there are some differences in the color and smell of the discharge.

Some vaginal discharge is quite normal for women of childbearing age. Normally, the glands of the cervix produce a cleansing mucous secretion, which flows out of the body, mixing with bacteria, separated vaginal cells and the Bartholin gland of the vaginal vestibule. These substances give the mucus a whitish color depending on the amount of mucus, and the discharge turns yellow when exposed to air. There are times during the menstrual cycle when the glands in the cervix produce more mucus than others, depending on the amount of estrogen produced. This is fine.

In women, sexual arousal and emotional stress also affect normal vaginal discharge. Such discharge is a clear substance similar to mucus.

If your discharge has changed in color, for example, turned green, is accompanied by an unpleasant odor, changes in consistency, or has significantly increased or decreased in quantity, then you may be developing a form of vaginitis.

• Bacterial vaginosis may cause pathological discharge with an unpleasant odor. Some women have a strong fishy odor, especially after sexual intercourse. The discharge is usually white or gray in color and may be thin. This may be accompanied by a burning sensation when urinating or itching in the vaginal area, often both. Some women have no symptoms of bacterial vaginosis at all.
• Yeast infection or candidiasis lead to a thick white-gray “curdy” discharge and are accompanied by itching. There may be severe itching in the genital area. In this case, pain during urination and sexual intercourse is common. Vaginal discharge may not always be present. Men with genital candidiasis may have an itchy rash on the penis. In men, this infection does not cause any symptoms or other infections.
• Trichomoniasis is the cause of foamy vaginal discharge, which may be yellow-green or gray, accompanied by itching and irritation in the genital area, burning when urinating, which is often mistaken for a urinary tract infection. During sexual intercourse, discomfort and unpleasant odor may occur. Because trichomoniasis is a sexually transmitted disease, symptoms may appear within 4-20 days after sexual intercourse. Symptoms are rare in men, but when they occur, they may include a thin, whitish discharge from the penis, pain, or difficulty urinating.
• Pain itself is not a common symptom of vaginal infections, other than itching. But this is a sign that you need to see a doctor.
• If you have vulvodynia, it may be accompanied by burning, sharp pain, irritation, and sores on the genitals, but without infections or skin diseases of the vulva or vagina. The pain may come and go. This is a completely different disease that requires further measures and consultation with a doctor.

When to Seek Medical Help

You should seek medical help if you have pain. Although vaginal infections may cause uncomfortable itching, they are not painful.

Make an appointment with your doctor the first time you experience symptoms of a yeast infection unless you are sure it is a yeast infection. And if you are sure, then you need to undergo a course of treatment with over-the-counter medications. But if your symptoms do not go away after this treatment, you may have a yeast infection.

• Although a yeast infection is uncomfortable, it is not a life-threatening condition. But you need to see a doctor. Moreover, seek medical help if you:
• Vaginal discharge is yellow and has an unpleasant odor
• Abdominal or lower back pain
• Nausea or fever
• Symptoms return within two months
• You should check for other pelvic conditions with similar symptoms by contacting an emergency room doctor. Seek medical attention if the following symptoms occur:
• If vaginal discharge is accompanied by fever, nausea or abnormal pain, or if there is blood in the discharge, it is not considered a normal menstrual period - you should go to the emergency room.
• If symptoms have not improved after three days, the discharge continues in large quantities or if the initial symptoms have worsened.
• You have greenish or heavy discharge or a fever.
• You are taking antifungal medications for yeast infections, your skin and eyes have turned yellow (the whites of the eyes), or you have pale stools.
• Pathological changes and rashes appear everywhere, that is, painful, red, pus-filled bumps that can spread to the thighs and anus.
• I felt dizzy.

Tests for vaginal infections

Your doctor will ask you about your symptoms and perform a physical examination. Most likely, you will need to submit urine and smears of discharge for analysis.

• You may be asked the following questions:
• When did the first symptoms appear? Were there any changes in discharge during the month?
• What does this discharge look like? What color and consistency are they? Is there a smell?
• Do you have pain, itching or burning?
• If you have a sexual partner, does he also complain about discharge from the penis?
• How many sexual partners do you have?
• Do you use condoms?
• What relieves the symptoms of discharge? How often do you take baths? Have you taken over-the-counter medications? Will you douche?
• What other symptoms do you have?
• What medications do you take for other diseases?
• Have you changed the detergents and soaps you use?
• Do you often wear tight underwear, trousers or jeans?
• During a pelvic exam, the doctor examines the vagina and cervix for discharge and inflammation. During a pelvic examination, your doctor will determine the size and location of your uterus and cervix, and will determine whether you have pain or tenderness to movement of the cervix and uterus or in the area adjacent to it, which corresponds to the fallopian tubes and ovaries.
• To examine the cervix, a speculum is inserted into the vagina. To determine whether a woman's infection is fungal (thrush), protozoal (trichomoniasis), or bacterial (bacterial vaginosis), a smear of any discharge is taken. The laboratory then examines a sample of vaginal discharge under a microscope to determine the presence of microorganisms that cause vaginal infections.
• In some cases, a Pap test is performed to rule out the possibility of cervical cancer. For this test, a swab is sent to a laboratory and results are available within a week.
• You may be prescribed a colposcopy or biopsy if your doctor determines that your cervix is ​​pathological. Colposcopy uses an illuminating microscope to obtain a magnified image of the surface of the cervix. In the case of a biopsy, tissue samples are taken for analysis.
• Some blood tests may show antibodies to yeast, an infection that causes Candida white. This test is not very reliable and is only needed if the infection affects the patient's entire body.
• If Trichomonas is detected and confirmed by laboratory tests, the doctor may prescribe additional tests to detect other sexually transmitted diseases (STDs).

Treatment of sexually transmitted infections in women

The diagnosis is usually made based on symptoms and the results of urine tests and vaginal microflora cultures, that is, smears examined in the laboratory. Treatment is prescribed based on the type of microorganism causing the infection. Depending on the cause of the infection, your doctor may prescribe vaginal suppositories, antifungal tablets, or antibiotics in tablet or injection form. Treatment varies and depends on the type of vaginitis, the severity, duration and frequency of the infection, and whether you are pregnant.

Treatment at home

Bacterial vaginosis and trichomoniasis will not go away if you treat yourself with over-the-counter medications. This requires antibiotics. You need to see a doctor.

Only a yeast infection can be treated with over-the-counter medications. If you have never had such an infection and think you may have one, it is important to have a doctor diagnose it before you try self-treatment at home or take over-the-counter medications. Typically, the first case of yeast infection should be treated by a doctor.

• If the infection appears for the second time, and you have no doubt that it is a yeast infection, then you can self-treat with over-the-counter medications, for example, miconazole (trade name Monistat, etc.) and vaginal antifungal medications.
• Due to the availability of over-the-counter medications, many women self-diagnose that they have a yeast infection. When in fact, about two-thirds of all yeast infection remedies purchased at pharmacies were used by women who did not actually have one. Using medications when they are not needed can lead to infection resistance. Such infections are very difficult to treat with modern drugs. If in doubt, consult your doctor.
• Many of today's over-the-counter medications are designed for mild illness. The success rate for treatment with over-the-counter medications is 75%-90%.
• The drugs are sold in the forms of vaginal suppositories or creams. They are inserted into the vagina using an applicator, usually every day for a week. Higher dosages can only be used for 1-3 days. Most women can treat a yeast infection at home with the following medications:
• Miconazole (Monistat-7, M-Zole)
• Tioconazole (Vagistat Vaginal)
• Butoconazole (Femstat)
• Clotrimazole (Femizol-7, Gyne-Lotrimin)
• Introduce these products with massage movements into the vagina and apply to surrounding tissues for 1-7 days, or insert the suppository into the vagina in accordance with the form and instructions. If there is increasing irritation in the area of ​​application, stop taking the drug immediately.
• If you are pregnant, consult your doctor before starting to use the drug.
• If symptoms continue for more than 1 week, consult your doctor. You may have a more severe form of a yeast infection or another condition that has symptoms similar to those of a yeast infection.
• Methods for treating infections in women at home have been used for many years, although scientific research has not confirmed their effectiveness.
• Douching with vinegar. Although women douche to cleanse after a menstrual period or sexual intercourse, doctors do not approve of this method. The vagina is designed in such a way that it cleans itself. Douching can also flush out healthy bacteria from the vagina. Trying to treat pathological vaginal discharge with douching can worsen your condition. If your discharge is abnormal, do not douche without telling your doctor and do not douche 24 hours before visiting your doctor.
• Eating yogurt that contains live lactobacilli acidophilus or the same bacteria in capsules. Yogurt creates an environment for certain beneficial bacteria to thrive. Despite popular belief, research on the benefits of consuming lactobacillus acidophilus in preventing yeast infections has produced controversial results. The benefits of consuming yoghurt cultures have not been scientifically proven.
• Other retail products contain antihistamines or local anesthetics, which only mask symptoms and do not treat infections in women.

Drugs for sexually transmitted infections

• Bacterial vaginosis: Your doctor may prescribe the antibiotics metronidazole (Flagyl) or clindamycin (Cleocin). Male partners are not usually treated for this condition. Many women with symptoms of bacterial vaginosis do not seek medical help, and those women who do not have symptoms do not receive treatment. This disease does not go away on its own without treatment.
• Yeast infection: If you have a yeast infection for the first time, you should consult your doctor before starting home treatment with over-the-counter medications. Typically, your doctor will recommend the use of vaginal creams and other products more often than oral medications. Pregnant women with this infection are treated longer and under close supervision.
• More severe infections require antifungal medications, which are usually taken orally in one dose. This may be fluconazole (Diflucan) or itraconazole (Sporanox). These medications have a treatment success rate of over 80% and can be prescribed for 3-5 days. The drugs may cause liver disorders. Symptoms of the disorder in some cases may include yellow skin and eyes, pale stools. If you experience any of these symptoms, contact your doctor immediately. He will most likely immediately stop taking the medications, order a blood test, and prescribe a liver function test.
• In cases of less severe infection in women, vaginal tablets or creams with an applicator may be prescribed as medications. An example would be nystatin (Mycostatin) with a treatment success rate of about 75% - 80%. The treatment success rate for Micnazole (Monistat-7, M-Zole) and clotrimazole (Micelex, Gyne-Lotrimin) is about 85%-90%.
• In some cases, a single dose of the drug has been shown to be effective in treating yeast infections. In other cases, a longer dose of the drug may be prescribed for 3 to 7 days.
• If the infection occurs periodically, i.e., more than 4 cases per year, then it may be necessary to use drugs such as fluconazole and itraconazole orally or clotrimazole inserted into the vagina for 6 months.
• Pregnant women require a longer course of treatment. It is very important to consult your doctor before starting treatment.
• Trichomoniasis: For trichomoniasis, metronidazole is prescribed. It is usually taken in a single dose. Do not drink alcohol while taking this drug because these two substances may cause severe nausea and vomiting in some cases. This drug is prescribed to both partners, even if they do not have symptoms of this disease.

Aftercare

If you are diagnosed with vaginitis, then make sure that the genital area remains clean and dry. Take a shower instead of a bath. This will also prevent future infections. During the course of treatment, do not douche or use feminine hygiene products in the form of aerosols. Avoid sexual intercourse during treatment.

After returning from your doctor, abstain from sexual intercourse until treatment is completed and symptoms have subsided.

Further observation

Ask your doctor for the results of your cervical tests and Pap tests. It is recommended to have a full physical examination every year, regardless of the presence of symptoms.

• The chemical balance in the vagina is very sensitive, so it is better to let the vagina cleanse itself on its own. This cleansing process occurs naturally through the secretion of mucus. It is best to clean the outside of the vagina using warm water and mild, unscented soap while taking a bath or shower. Products such as intimate hygiene soaps, powders and sprays are not at all necessary, they can even be harmful.
• Douching is washing or cleansing the vagina by squirting water or another solution into the vagina, such as a vinegar solution, baking soda, or a douching solution that can be purchased at the pharmacy. Water or solution is sold in a bottle and injected into the vagina using a special device with a nozzle. Although women in the United States often use douching, doctors do not recommend this procedure for cleansing the vagina. Douching changes the sensitive chemical balance of the vagina, making women more likely to develop vaginal infections. Research shows that women who douche frequently are more likely to develop vaginal infections than those who do not douche at all or do so very rarely.
• Douching does not help prevent pregnancy; there is no need to do it after sexual intercourse.

Prevention of sexually transmitted infections in women

• The best ways to prevent bacterial vaginosis are not yet known. However, a connection has been established between bacterial vaginosis and a woman’s change of sexual partner or with the presence of several partners. This disease is rarely found in women who have never had sexual intercourse. The main methods of preventing the disease include using condoms, limiting the number of partners, abstaining from douching, and taking all prescribed medications, even if symptoms have disappeared.
• In most cases, yeast infections can be easily prevented.
• Keep your vagina dry, especially after showering.
• After using the toilet, wipe from front to back.
• Wear looser cotton underwear.
• Change your swimsuit after swimming.
• Don't wear skinny jeans or tights.
• Pregnant women should consult a doctor immediately if any symptoms appear.
• Do not use deodorized tampons; they contain chemical irritants. Do not douche or use feminine hygiene products. Regular bathing is usually sufficient to cleanse the vagina.
• Trichomoniasis can also be prevented. If you are diagnosed with this infection, your partner also needs to be examined. He or she may have other sexually transmitted diseases, and there is a possibility of reinfection if the partner is not treated. Safe sex using condoms and counseling about sexually transmitted diseases will help reduce the risk of infection and re-infection.

Forecast for sexually transmitted infections

With proper diagnosis and treatment, all forms of vaginitis usually respond well to treatment, and symptoms will decrease and disappear completely. If symptoms do not go away or return again, you should be re-examined by a doctor.

• Bacterial vaginosis is associated with pelvic inflammatory disease, which leads to infertility and ectopic pregnancy. Bacterial vaginosis can lead to premature birth and low birth weight babies. Your doctor will monitor you closely if you are pregnant or if you have already had preterm labor. Bacterial vaginosis poses a risk for gonorrhea and HIV infection.
• A connection has been established between trichomoniasis and an increased risk of HIV transmission, as well as with the birth of children with low body weight and premature birth.