Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are STDs and how can their spread be prevented?
Sexually transmitted diseases (STDs) are infections that
are transmitted during any type of sexual exposure, including intercourse
(vaginal or anal), oral sex, and the sharing of sexual devices, such as
vibrators. In the professional medical arena, STDs are referred to as STIs
(sexually transmitted infections). This terminology is used because many
infections are frequently temporary. Some STDs are infections that are
transmitted by persistent and close skin-to-skin contact, including during
sexual intimacy. Although treatment exists for many STDs, others currently are
usually incurable, such as HIV, HPV, hepatitis B and C, and HHV-8.
Furthermore, many infections can be present in, and be spread by, patients who
do not have symptoms.
The most effective way to prevent the spread of STDs is abstinence.
Alternatively, the diligent use of latex barriers, such as condoms, during
vaginal or anal intercourse and oral-genital contact helps decrease the spread
of many of these infections. Still, there is no guarantee that transmission will
not occur. In fact, preventing the spread of STDs also depends upon appropriate
counseling of at-risk individuals and the early diagnosis and treatment of those
infected.
In this article, the STDs in men have been organized
into three major categories: (1) STDs that are associated with genital lesions;
(2) STDs that are associated with urethritis (inflammation of the urethra, the canal through which
urine flows out); and
(3) systemic STDs (involving various organ systems of the body). Note, however,
that some of the diseases that are listed as being associated with genital
lesions (for example, syphilis) or with urethritis (for example, gonorrhea) can also have systemic involvement.
Diseases Associated With Genital Lesions
Chancroid
What is chancroid?
Chancroid is a bacterial infection with the bacteria Hemophilus ducreyi.
The infection initialy manifests in a
sexually exposed area of the skin. The infection typically appears on the penis
but also occasionally occurs in the anal or mouth area. Chancroid starts out as a tender bump that
emerges 3 to 10 days (the incubation period)
after the sexual exposure. The bump then erupts into an ulcer (an open sore),
which is usually painful. Often, there is an associated tenderness of the glands
(lymph nodes), for example, in the
groin of patients with penile bumps or ulcers. Chancroid is a relatively rare
cause of genital lesions in the U.S., but is much more common in many developing
countries.
How is chancroid diagnosed?
The diagnosis of chancroid is usually made by a culture
of the ulcer to identify the causative bacteria. A clinical
diagnosis (which
is made from the medical history and
physical examination) can be made if the patient has one or more painful ulcers
and there is no evidence for an alternative diagnosis such as syphilis or
herpes. The clinical diagnosis
justifies the treatment of chancroid even if cultures are not available.
Incidentally, the word chancroid means resembling a "chancre," which is the
medical term for the painless genital ulcer that is seen in syphilis. Chancroid
is also sometimes called "soft chancre" to distinguish it from the chancre of
syphilis, which feels hard to the touch.
How is chancroid treated?
Chancroid is almost always cured with a single oral dose
of 1 gram of azithromycin (Zithromax) or a single injection of ceftriaxone
(Rocephin). Alternative medications are ciprofloxacin (Cipro), 500 mg taken
twice per day by mouth for three days, or erythromycin, 500 mg taken four times
per day by mouth for 7 days. Whichever treatment is used, the ulcers should
improve within 7 days. If no improvement is seen after treatment, the patient
should be reevaluated for other causes of the ulcers. HIV-infected individuals
are at an increased risk of failing treatment for chancroid. They should
therefore be followed especially closely to assure that the treatment has
worked. In addition, someone diagnosed with chancroid should be tested for other
sexually transmitted diseases (such as chlamydia and gonorrhea), because more than one
infection can be present at the same time.
What should a person do if exposed to someone with chancroid?
A health care practitioner should evaluate anyone who has had
sexual contact with a person with chancroid. Whether or not the exposed
individual has an ulcer, they should be treated if they were exposed to their
partner's ulcer. Likewise, if they had contact within 10 days of the onset of their partner's ulcer, they
should be treated even if their partner's ulcer was not present at the time of
the exposure.
Scabies are itch mites that burrow under the skin and produce intense itching that's usually worse at night. Symptoms of scabies are small bumps and blisters on the wrists, knees, between the fingers, on the back of the elbows, in the groin and on the buttocks. Treatment involves applying a mite-killing cream, antihistamines for itch relief, washing bedclothes and linens.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch, and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
HIV (human immunodeficiency virus) is the cause of AIDS (acquired immunodeficiency syndrome). HIV is a type of virus called a retrovirus, which infects humans when it comes in contact with a break in the skin or tissues such as those that line the vagina, anal area, mouth, or eyes.
Sexually transmitted diseases, or STDs,
are infections that are transmitted during any type of sexual exposure,
including intercourse (vaginal or anal), oral sex, and the sharing of sexual
devices, such as vibrators. Women can contract all of the STDs, but may have no symptoms, or have different symptoms than men do.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Prostatitis is a painful condition of the prostate gland. There are four types of prostatitis, acute bacterial, chronic bacterial, chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Diagnosis is made with a digital rectal exam, urinalysis, ultrasound, MRI, biopsy, or blood test. Treatment depends upon the type of prostatitis.
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
Chlamydia, a type of bacteria that causes an infection, is spread through sexual contact. Most of the time, women with chlamydia have no symptoms. Antibiotics are an effective treatment for chlamydia.
Abdominal aortic aneurysm is a ballooning or widening of the main artery (the aorta) as it courses down through the abdomen. The most common cause of aortic aneurysms is
"hardening of the arteries" called arteriosclerosis.
E. coli is the most common cause of bladder infections. Bladder infection symptoms and signs include frequent urination, burning urination, and foul smelling urine. Mild bladder infections may go away by increasing one's intake of fluid. More severe infections may be treated with a few days of antibiotics.
Pelvic inflammatory disease (PID) is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include: fever, vaginal discharge with a foul odor, abdominal pain, including pain during intercourse, and irregular vaginal bleeding. Pelvic inflammatory disease can scar the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. Pelvic inflammatory disease treatment includes several types of antibiotics.
Blood in semen is also known as hematospermia. Blood in semen can be caused by many conditions affecting the tubes that distribute semen from the testicles (seminal vesicles) or the prostate gland. Symptoms that may accompany blood in semen include blood in the urine, fever, painful urination, pain with ejaculation, tenderness, and swelling in the testes or groin area. Urinalysis, ultrasound, and MRI may be used to diagnose blood in the semen. Treatment depends upon the underlying cause of blood in the semen.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Cervical dysplasia is a condition in which the cells of the inner lining of the cervix have precancerous changes. There are two types of cervical dysplasia; 1) squamous intraepithelial lesion, and 2) cervical intraepithelial neoplasia. Cervical dysplasia is caused by infection of the cervix with HPV (human papillomavirus). There are various diagnostic measures for cervical dysplasia. Treatment generally depends upon the progression of the dysplasia, mild, moderate, or severe.
Testicular pain, or pain in the testicle or testicles are caused by a variety of diseases or conditions such as testicular trauma, testicular torsion, testicular cancer, epididymitis, and orchitis. Common symptoms of pain in the testicle or testicles are abdominal pain, urinary pain or incontinence, fever, nausea, vomiting, and pain in the scrotum or testicle. Treatment depends on the cause of the testicular pain or pain in the testicles.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Pubic lice (crabs) are parasitic insects found in the genital area, and are primarily spread through sexual contact. Symptoms of crabs include itching and visible nits (lice eggs) and crawling lice. Treatment includes using lice-killing shampoo and washing bedding and clothing in hot water.
Trichomoniasis is a sexually transmitted disease (STD) caused by a parasite passed from person to person. Trichomoniasis can be picked up from contact with damp, moist objects like towels, wet clothing, or toilet seat. Symptoms include yellow, green, or gray vaginal discharge with a strong odor, painful intercourse or urination, genital irritation and itching, and lower abdominal pain. Medication is the only treatment for trichomoniasis.
The HPV virus (genital warts) in men can cause health problems. Genital warts are confined primarily to the moist skin of the genitals or around the anus. Genital warts are caused by the human papillomaviruses (HPVs), which are transmitted through sexual contact.
Aortic dissection is a small tear in the large blood vessel that leads from the heart and supplies blood to the body. There are two types of aortic dissection, type 1 and type 2. Signs and symptoms of aortic dissection include a tearing or ripping pain, nausea, sweating, weakness, shortness of breath, sweating, or fainting. Treatment depends on the type of aortic dissection, and the severity of the tear in the aorta.
The time when boys and girls begin the process of sexual maturation is called puberty. During this time, both sexes undergo a series of biological changes that include a rapid increase in height, bone growth, weight increase, the growth of pubic hair, breast development and the onset of menstruation in girls, and testicle, penis, and muscle enlargement in boys.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci, tuberculosis, toxoplasmosis, seizures, weakness, meningitis, yeast infection of the esophagus, and Kaposi's sarcoma. Anti-retroviral therapy (HAART) is used in the treatment of AIDS.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
A urethral stricture, or narrowing of the urethra, may cause decreased urine output. Symptoms include painful urination, urinary retention, and pelvic pain. Surgery is the only treatment for people with uncontrolled symptoms of urethral narrowing.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
*Abdominal adhesions facts Medically Edited by:
William C. Shiel, Jr., MD, FACP, FACR
Abdominal adhesions are bands of scar tissue that form between abdominal
tissues and organs, causing them to stick together.
Symptoms caused by abdominal adhesions vary; however, most adhesions do not
cause symptoms.
Typical symptoms of obstruction caused by abdominal adhesions include
abdominal discomfort around the belly button that is cramp-like followed by
distention of the abdomen.
Abdominal surgery is the most frequent cause of abdominal adhesions. Other
causes of abdominal adhesions include inflammation of an organ such as
cholecystitis or appendicitis, peritonitis, foreign objects left inside the
abdomen at the time of surgery, bleeding into the peritoneal cavity, or
inflammatory conditions such as pelvic inflammatory disease.
At the sites of where abdominal adhesions occur...
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