Family Medical Practice – Dr Olga Sambolska*
As a gynecologist working in Southeast Asia, I see there is a need for clear information regarding sexually transmitted diseases (STDs). Here is some more information on the most widespread diseases:
1. Syphilis: a bacterial infection (Treponema pallidum) that is transmitted through oral, vaginal or anal sexual contact. Symptoms appear a few weeks or even a few months after unprotected sex. Symptoms include sores, rashes, fever and swollen lymph nodes. Untreated syphilis can lead to serious health problems, including damage to the brain, nerves, and organs. Syphilis can also be transmitted during pregnancy from the mother to the baby or even at birth and can lead to miscarriage, stillbirth, preterm labour or congenital abnormalities in the baby. Timely detection and treatment are key. In Southeast Asia, syphilis rates are highest among men who have sex with men (MSM), but the infection is also common among heterosexual populations.
2. Chlamydia: a bacterial infection that is spread through sexual contact. In many cases, this infection stays asymptomatic (no symptoms) for years, but this infection can lead to serious health problems like pelvic inflammatory disease (PID) and permanent damage of the reproductive system and infertility, or increased risk for HIV transmission. The main symptoms of this infection are painful urination or intercourse, vaginal bleeding after sex or between periods. Chlamydia rates are highest among young people aged 15-24 years old, who are more sexually active, all women under 25 should be tested for Chlamydia yearly.
3. Gonorrhea: a bacterial infection that is spread through sexual contact. Symptoms usually show up during the first two weeks after unprotected intercourse and depend on the type of sexual contact. It can be sore throat, abnormal vaginal discharge, pain during urination, and pelvic pain. But one in 10 infected men and half of infected women do not experience any symptoms. Just like for Chlamydia, young sexually active people under 25 should be tested for Gonorrhea annually. Untreated gonorrhea leads to PID or infertility in 10-20 per cent of cases. Gonococcal infection during pregnancy is linked to pregnancy complications and high risk for newborn neonates if left untreated.
4. Chancroid: Haemophilus Ducrei bacteria causes painful genital lesions just 4 to 10 days after transmission. Fever, chills, swollen or painful groin lymph nodes can be present at the same time. For women however, this infection is almost always asymptomatic. Chancroid is a very contagious infection and major genital ulcer disease in Africa, Southeast Asia and Latin America. Treatment is very easy by short course of antibiotics.
5. Mycoplasma: Mycoplasma genitalium infection can cause symptomatic and asymptomatic urethritis (inflammation of the urethra) among men with chronic complications like prostatitis or epididymitis which can lead to infertility. Among women mycoplasma infection has been associated with cervicitis, spontaneous miscarriage, preterm delivery and chronic pelvic inflammatory disease (PID). Mycoplasma infection has become increasingly common during the last few decades in Southeast Asia, particularly among young people. According to a study published in the Journal of Infection in Developing Countries, the prevalence of mycoplasma genitalium infection among female sex workers in Southeast Asia ranged from 2.8 to 20.4 per cent.
In conclusion, STDs are a significant health issue in Southeast Asia, with syphilis, chlamydia, gonorrhea, chancroid, and mycoplasma being among the most common infections. These infections can have serious health consequences if left untreated, including infertility, PID, and an increased risk for HIV transmission. The good news is that they are mostly very treatable when detected early. Regular health checks are in order, particularly if you are sexually active or have multiple partners. I would also encourage you to visit a doctor after possibly risky intercourse, or when you notice even small changes. You do not need to wait for strong symptoms like painful intercourse or high fever to go for a consultation.
And of course, prevention is even better, using condoms during sexual activity is crucial to reduce the spread of these infections. Family Medical Practice