( By Dr. Vithal Prabhu )

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Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases (STDs) were previously known as “venereal diseases.” This is a group of diseases that are passed from one person to another through sexual intercourse. Some of them are curable if the treatment is started soon; while some being of virus origin are not curable. Some limit locally, some mutilate the natural anatomy of the sex organs, while some spread throughout and destroy every organ in the body.

Earlier there was a saying, “A moment with Venus and life time with Mercury”, when mercury salts were used for the treatment. The scene has changed since the introduction of Penicillin and other antibiotics, However, one does not know which disease the person will catch—curable or incurable. The best way would be to avoid the risk by having only one sex partner by not soliciting sex workers (prostitutes), and if at all inevitable, to have protected sex (e.g., use of condom).

Going to public latrin or using utensils and clothes of an infected person does not cause STD. The only way is through sexual contact. The difference between the other diseases and STDs is that the other diseases catch you without warning, while you go and catch STDs on your own. It is not uncommon for boys to try once and once only to take an experience of what the charm of sex is like.

Or the youth who intends to get married in near future would like to “test” himself whether he can do the act of intercourse successfully or not. But his one single experience can prove to be disastrous and shocking. The disaster is not only of getting on STD but also of the successive events that occur. He being a novice to the red light area, with a pounding heart he looks around repeatedly to exclude any familiar face and he quickly makes an entry into the den.

The woman in front undresses herself and asks him to finish the act quickly. To his surprise, he finds that his penis is loose still. Even if he gets erection, he ejaculates soon. While he dresses up, seeing his penis the sex worker passes a casual remark, “Only this much?” He comes out dejected and depressed. What he had thought to be a heaven turns out to be a hell. He goes from piller to post trains and from quacks to eminent specialist for his treatment. Why this happens so? The reasons are many.

Sexual response is not a vountary action, but is an autonomous, situational reflex response. The fear of detection, the fear of infection, the fear of performance, the fear of failure and the fear of morality, all these fears create tension. To add insult to injury is the dirty, dingy place of the sex worker, her attitude of ‘here and now’ and the greed for money.

Everything sums up in his mind and culminates into loss of erection or premature ejaculation. The fear, shame, guilt, hatred remain. These are antagonistic to the erection of penis in later times. All this is in addition to a STD or HIV infection. Even if he does not get a STD/HIV, he lands up into a psychological condition called “Venerophobia”, an obscession of catching a venereal disease, no matter even if all the investigation reports are normal.

The story does not end here. He is afraid to get married, thinking that the episode will recur and his wife would hate him for his impotence. All this could have been prevented only if he had resisted that single attempt of going to the sex worker. Sex is not something that clicks at the spur of the moment. It is not merely the union of penis and vagina. It requires love, romance, privacy, clean and pleasant surrounding, an interested and interesting partner, foreplay, a healthy body and a healthy mind. Again the first few experiences of sex are as in probationership, for learning by trial and error.

The following is the list of some of the commonly known STDs.

  1. Syphilis Syphilis is the “king” of STDs. It can make the person premanently disabled. If not treated in time, it can affect brain, heart, eyes, ears, bones, joints, liver, practically every organ in the body. The disease may be transmitted to children through the mother. Syphilis progresses in 3 stages. The first stage begins at the time of intercourse with the infected person. The germs enter through the surface of mucus membrane covering the glans of the penis or of vagina. This not so tough covering; wetness present there and the minute cracks developed during the intercourse, facilitate the entry of germs.

    After a period of two to four weeks a button like and painless ulcer called “chancre” is developed at the site of entry of the germs. The skin is resistant to the entry of germs unless there is a crack that makes the entry of germs easy. That is how a syphilitic ulcer may be seen on the scrotum. A male can be identified as suffering from syphilis by seeing the chancre, while a female cannot be identified as suffering from the same if she develops chancre in her vagina, where it is not visible. Therefore, the person having sex with such infected female is unaware that he will be infected by syphilis.

    The ulcer heals within a week even without any treatment. Patient feels that he has recovered on his own, but disease progresses to the second stage. The second stage begins after six to eight weeks of the exposure. By then the germs have spread all over the body. The infected person gets a copper coloured rash all over his body. He gets fever. The lymph nodes get enlarged. Ulcers are formed in the mouth. He complains of aching of bones, loss of hair and swelling of the testes. These symptoms too disappear and the patient progresses to the third stage of the disease. The third stage of syphilis begins anytime after two to twenty years.

    All the organs wherever the germs have settled, get destroyed. The patient lands into a heart problem or a blood vessel disease, blindness, deafness, paralysis or madness. Such infected person may pass the infection to his wife, who when pregnant will infect her child. Such children are born dead or with blindness and an ugly face.

    There are individuals who may not be having any sign or symptom of syphilis. However, their blood examination will indicate the presence of the disease. The blood test done to diagnose syphilis is called “V.D.R.L.” (Veneral Disease Research Laboratory) Test. Syphilis can be cured completely if it is treated at an early stage. Inj. Penicillin is the drug of choice. Both, husband and wife should be treated simultaneously.

  2. Gonorrhoea:The germs enter in through the urinary passage during the sexual intercourse with an infected person. For a week after the exposure, there may not be any symptom. Afterwards the person complains of burning urination. Pus comes out from the urethral opening and the glans of the penis becomes red. He gets fever, retention of urine and joint pains. The infection passes into the seminal vesicle, prostate and testes. These organs get swollen and painful.

    The semen may be devoid of sperms leading to infertility. The urinary passage may become narrow leading to difficulty in passing urine. If the female gets infection of gonorrhoea, she complains of burning urination, pus discharging from urinary and vaginal passages, swelling and pain in labia majora due to infection in the Bartholin’s glands.

    The germs may pass into uterus, Fallopian tubes and ovary leading to infertility. The man may receive the infection through a sex worker and may give it to his wife. If the pregnant woman has gonorrhoeal infection, the germs pass to the eyes of the newborn during the childbirth and the child becomes blind. The infection can successfully be treated if the treatment is taken early, fully and by both the partners. Inj. Penicillin or Tab. Norfloxacin are the drugs of choice.

  3. Chancroid: The germs enter through the mucus membrane of the glans as in case of syphilis during the sexual intercourse with the infected person. About a week later several painful, pus-discharging ulcers appear on the penis. The difference between a syphilitic ulcer and a chancroid ulcer is that the chancroid ulcer is soft, painful and are multiple.

    The lymph nodes in the groin become painful and get enlarged. They get burst and discharge pus. Though this disease is painful, it is not as harmful as syphilis or gonorrhoea, since the germs do not enter into the blood. The female gets the infection while having sex with the infected male. She gets similar ulcers in the vagina or on the vulva and gets enlargement of lymph glands. The drugs of choice are Sulpha and Tetracycline.

  4. Herpes Progenitalis: The germs enter through the mucus membrane covering the penis. After a week or so, there appears redness and vesicles filled with fluid, associated with burning pain and itching. The vesicles break, form ulcers and heal within two to three weeks.

    The lymph nodes in the groin get enlarged. After a quiescent period of a few months, the entire episode recurs because the germs had travelled along the nerves to the spinal cord, had remained there in a dormant condition and have come down to penis now. The recurrence of the disease is throughout life.

    The infected person may pass on the infection to his wife and in return she may pass it to her baby during the delivery. The baby is to be delivered by Caesarean section to escape the infection. Herpes progenitalis being a virus infection does not respond to the treatment, though “Acyclovir” ointment and tablets are supposed to attenuate the infection.

  5. Granuloma Inguinale (Donovanosis): This is an uncommon sexually transmitted disease. It is caused by bacterial infection which grows slowly. It takes anytime from one to twelve weeks. An ulcer is formed on the penis, on labia or in vagina. It bleeds easily on touch. The ulcer is painless, spreading and bright red. There may be single or multiple ulcers. The ulcers heal with scarring. It may narrow the urethral or vaginal passage. Septran, chloramphenicol or tetracycline are effective on this disease.

  6. Lymphogranuloma Venerium (LGV): It is caused by germs called Chlamydia. It is highly destructive infection of lymph glands and surrounding tissues.The lymph glands become soft and form multiple abscesses which open up and discharge the contents. The rectum becomes narrow. It is associated with body ache, fever and chills. It is treated with septran or tetracycline.

  7. Venereal Warts: This is caused by virus. It grows in cauliflowerlike clusters and therefore also named as “Condylomata accuminata.” Venereal warts are only transmitted sexually and are highly contageous. The warts appear after 6 weeks to 6 months of exposure. If they are not treated, they multiply. The warts are found on penis, urethra, anus, vulva, labia or in vagina. The warts are treated by application of Podophyllin, by cauterization or by surgical excision.

  8. Candidiasis, Trychomoniasis, Non Gonococcal ure-thritis, Pubic lice, Hepatitis B (jaundice) are also the diseases transmitted through sexual intercourse. There is a myth that the veneral disease gets cured if the infected organ is rubbed against the genitals of a virgin girl. This has caused a number of inncocent children suffer from STD and is simply terrifying. It is worth remembering that

    1. STDs are dangerous.
    2. Identification of STD by merely look of the sex organs of the female partner is not possible.
    3. A person when infected may not show any sign of STD for days.
    4. It is not possible to predict which STD a person will catch. One can have more than one STD at a time.
    5. STD infection is possible only after having an intercourse (oral, anal or vaginal) with infected person.
    6. STDs are not necessarily spread by sex workers alone. Any person having multiple sex partners can get it.
    7. The toilet seat, clothes, utensils and soap used by the infected person do not spread the disease.
    8. Certain STDs could be cured, if prompt and cmplete treatment is taken. Persons feel shy to tell the doctor; they hide the disease or ignore it, or resort to self medication. All these are dangerous and delay the proper treatment.
    9. The best way of prevention of STDs is to avoid extra marital sexual relations.

Will too much of sexual relations with the same person lead to STD? The answer is NO, unless one of them receives infection from the infected outsiders. STD infection is like “Passing the Parcel” game. You don’t get it unless somebody gives it to you, and then you give it to others. Some boys ask the question, “I have been having a strong desire for sex.

What if I use a condom and go to a sex worker?.” The answer is “Will you set the house on fire merely because the fire station is at the next door?.” The damage done cannot be anticipated. It is always better not to take a risk. Once if you have experienced the pleasure of sex, you will be tempted to have it again and again. That apart, what about the psychological trauma? Having sex out of wedlock is something like playing with a live bomb. It is highly risky. The better way is to channelise your energy towards developing a hobby, taking part in sports and striving for an excellence in it. If this sublimation does not relieve your sex tension, resort to masturbation as and when necessary, but without feeling guilt, shame or fear about it.

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