Q: What are the risks of sexually transmitted infections (STIs)? What are the different kinds?
A: At least one in four teens having sex will pick up a sexually transmitted infection. Here are some of the major infections (for more info on others, check out iwannaknow.org):
Gonorrhea: This is bacteria that live in the cells of the cervix (in women) or at the end of the urethra (in men) and sometimes causes a discharge. Left unattended in women, it can scar the fallopian tubes and cause chronic lower abdominal pain, as well as infertility. Most people don't know they have gonorrhea, so get screened with a simple urine test at least once a year if you're sexually active and three to six months after becoming intimate with a new partner.
Have a really bad sore throat a few days after oral sex? Gonorrhea could be the culprit, causing a nasty throat infection. The bad news: both partners need to be treated at the same time, or else it will transfer back and forth. The same goes for all bacterial STIs. For treatment, you'll take antibiotics, which can clear up the infection.
Chlamydia: A bacterial infection that hangs out in the urethra or the cervix, it can creep up the fallopian tubes and cause big problems such as pelvic inflammatory disease or infections in the uterus, ovaries or fallopian tubes, causing acute and chronic pelvic pain and infertility if not treated. However, if Chlamydia is treated with just a simple dose of a specific antibiotic, you can avoid future pelvic pain and infertility. Visit your doctor for a urine screening test at least once a year if you're sexually active, and three to six months after starting a new sexual relationship. The good news is that Chlamydia doesn't like saliva, so it won't cause a nasty sore throat.
Genital Warts: These are caused by a virus called HPV (human papillomavirus), which incorporates itself into the DNA of cells. Some of the more than 120 different types of HPV are linked to cervical cancer. The good news? You can now get a series of three shots between ages nine and 26 that can prevent several of the bad strains of HPV: types 16 and 18 (covered by both of the available vaccines, Gardasil and Cervarix), which cause 70 percent of cervical cancer and some forms of throat cancer; and types 6 and 11 (covered only by Gardasil), which cause 90 percent of laser-worthy, fungating external genital warts. We believe that you should get the Gardasil vaccine. Genital warts are not fun for either sex, and a guy who carries a cervical cancer-causing strain of HPV can pass it on to his partner.
In addition to cervical cancer, penile cancer and genital warts, HPV can cause anal cancer. For maximum protection, you need to get all three shots before becoming sexually active; the vaccine is less effective if you have already started having sex, but is still worthwhile. It's worth getting immunized with the HPV vaccine long before you are even thinking of having sex, because the doses must be spread out (the usual schedule is two months after the first one, two to four months after the second), and you need all three for maximum immunity.
Once genital warts have been diagnosed, a doc can freeze or burn off the cells. You may also be given a prescription topical cream, which kicks your immune system into high gear to fight off the virus. However, if the infection does not go away completely by the end of the treatment, discuss other options with your doctor; new medications are available. FYI: even if you have the warts treated, you still carry the virus for an undetermined period of time, so protect your partner by wearing condoms during oral, anal or vaginal sex.
Herpes Simplex Virus (HSV): We call herpes the gift that keeps on giving, since this virus incorporates itself into the DNA of certain nerves and then stays there forever, silently infecting others upon contact. This virus causes blisters on the lips (hsV-1) or the genitals (hsV-2). Herpes can also spread between the two areas if there is mouth-to-genital contact. You'll notice a tingling and burning, and then a blister that scabs over. An antiviral medicine can be taken to quell the outbreak.
Other medicines are also available, but the virus stays in the nerve root forever and can reactivate if you're stressed or there's some kind of trauma to the area, such as eating hot foods (for mouth) or too much friction. Some infected people never show symptoms, but they can then pass it on to someone else who gets frequent outbreaks.
Herpes can be hard on the ego. Unlike Gonorrhea and Chlamydia, the disease can be treated but not cured. Explaining an infection to a potential partner can be tricky. You want to tell the person before you two are sexually active, but you don't necessarily want the whole world to know. So you need to be comfortable and close to the person; don't reveal your infection too late (after engaging in foreplay or sexual activity), thus blowing his/her trust. On the good side, herpes infection can serve as a natural brake pedal, slowing down and building up your relationships.
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Michael F. Roizen, MD, is Professor of Internal Medicine and Anesthesiology, Chief Wellness Officer and Chair of the Wellness Institute at the Cleveland Clinic. He has co-founded 12 companies, including the popular websites RealAge.com and YOUBeauty.com.
Mehmet C. Oz, MD, is Vice-Chair and Professor of Surgery at Columbia University and director of the Cardiovascular Institute and Complementary Medicine Program at New York Presbyterian Hospital. His TV show—The Dr. Oz Show— recently won its third Emmy, with Dr. Oz his second as the best daytime talk show host.
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