The ABCs of STDs

STDs, Part 2

What to look for:
Chlamydia is known as the "silent epidemic" because as many as 85 percent of infected women and 40 percent of infected men with chlamydial infections report no symptoms, according to the CDC. If not adequately treated, 20 to 40 percent of women with chlamydia develop pelvic inflammatory disease (PID), which in turn causes problems such as infertility, ectopic pregnancy, and chronic pelvic pain.

When there are symptoms, look for discharge from the penis or vagina and a burning sensation when urinating. Women may have lower abdominal pain or pain during intercourse and bleeding between menstrual periods. Men may feel burning and itching around the opening of the penis and/or pain and swelling in the testicles.

How can you tell?
There are two kinds of test for chlamydia. One involves collecting a small amount of fluid from an infected site (cervix or penis) with a cotton swab. These tests are universally available. New tests, which use only urine samples, will be available soon and will make testing much easier and less uncomfortable.

What is the treatment?
There has been major progress in the treatment of chlamydia with antibiotics over the past few years. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments.

How Can I Prevent It?
You can get and spread chlamydia through unprotected vaginal and anal sex.

Human Papillomavirus (HPV) Infection
An estimated 20 million people in the United States are infected with HPV, and as many as 5.5 million new infections occur each year. Cervical infection of HPV is associated with more than 80 percent of cases of invasive cervical cancer. However, only some strains of the virus can lead to this disease.

What To look for:
Most HPV infections are subclinical, meaning that there are no visible signs. Subclinical HPV infections can cause abnormal cell growth on a woman or girl's cervix. Visible signs of the infection include genital warts, which range from soft, pink, and cauliflower-like, to hard, smooth, yellow-gray warts. In women, they may develop inside the vagina, where they are hard to detect. They may also appear on the lips of the vagina or around the anus.

In men, they usually appear on the penis, but are sometimes found on the scrotum (the sac that holds the testicles) or around the anus. If there are visible signs, you will notice them within 3 weeks to 6 months after having sex with someone who is infected. This time period can make it difficult to track the infection as it is passed from partner to partner.

How can you tell?
Your health care provider can check closely to detect warts on men and women. For women, the Pap smear is designed to detect precancerous changes in the cervix and may show changes caused by HPV infection.

What is the treatment?
There are several ways to remove visible genital warts, but the underlying HPV infection can't be cured by medical treatment. The virus that causes genital warts stays in your body and can cause warts to appear in the future. A doctor can get rid of smaller warts by freezing them (cryotherapy) or by burning them off with an acidic chemical such as podophyllin. In severe cases, wart treatment may require laser surgery. All three procedures can typically be done in a doctor's office with local anesthetic.

How can I prevent it?
Genital warts are transmitted when the HPV virus is passed from an infected person to another person during sex. People who have many sexual partners put themselves at higher risk. Latex condoms do not provide protection. Regular yearly Pap smears are necessary for any sexually active females to detect abnormal changes in the cervix that can lead to cervical cancer. Thankfully, there is now a vaccine for the most dangerous strains of HPV, and it is available to young women through their physicians.

The Consortium of State Physician Resource Councils estimates that 5.5 million people will be infected each year. Now Congress is considering an amendment to a women's health bill that will add a warning label to condoms stating that they do not prevent HPV transmission and linking HPV to cancer.

Each year, almost 13,000 women are diagnosed with cervical cancer, and 5,000 die from the disease. Yet critics note that early detection from annual Pap smear tests result in an almost 100 percent cure rate. And while genital warts are ugly, they are not associated with cervical cancer. Health experts from the CDC and Prevention and the National Institutes of Health believe that most HPV infections are banished by the immune system within several years.