Sexually transmitted infections: their types and methods of treatment. Sexual infections in women

List of STI infections in women, how tests are taken, first signs

• Smearfor microflora. A sample of discharge from 3 points of the genital canal is taken from a woman with a special probe. Next, the material is placed on glass, stained with a special acidic medium for a detailed study of the composition of the secretion, and carefully examined under a microscope. This method identifies pathogens of fungal and bacterial origin. Viruses cannot be detected using a genital swab.
• Culture of secretions. The culture procedure is carried out in a bacteriological laboratory and takes a long time (about a week). The result of this examination unmistakably indicates the presence of any disease.
• PCR (polymerase chain reaction). One of the most informative tests that allows you to accurately confirm a preliminary diagnosis. To perform it or pass a DNA pathogen test, a sample of discharge from the genital canals or urine is taken. The duration of a study using this method does not exceed two days, the accuracy of the analysis is up to 95%.
• ELISA – transcript (linked immunosorbent assay). If a woman has purulent inflammation, specialists prescribe ELISA. A sample of discharge taken from the vagina is examined. The study is carried out quite quickly, its result is ready 5-6 hours after taking the sample.
• Blood analysis. To determine specific antibodies, a venous blood test is prescribed. The purpose of such a study is to determine whether an immune response will occur to the presence of a particular pathogen. This method is effective when it is necessary to confirm the diagnosis of viral origin (genital herpes, HIV) and syphilis. The method is not used to diagnose bacterial infections, including chlamydia.

In addition to the tests listed, the venereologist prescribes a clinical and biochemical blood test, which can reveal an increase in ESR and leukocytosis. Not all sexually transmitted infections in women can be treated; for example, human papillomavirus infection and genital herpes can only be stopped.

The need for long-term treatment of these diseases and a wide range of complications should motivate you to consult a doctor in a timely manner.

Treatment

A number of pathogens of sexually transmitted diseases respond quite well to treatment with modern medications, but it is recommended to start treatment as early as possible, before serious inflammatory processes begin.

Appropriate therapy for STIs is prescribed according to a special scheme only by the attending physician based on the results of the examination. Depending on the pathogen, complex treatment is used, since the complex course of such diseases requires the use of not only drug therapy.

Most sexually transmitted diseases can be successfully treated, but today there are some that are incurable:

• herpes type 1 and 2;
• hepatitis C;

Important! To avoid relapse, after completing the course of treatment for an STI, a woman must take all tests again. This will ensure that the disease is cured.

Complications and consequences

Delayed treatment of sexually transmitted diseases in women or its complete absence, as well as self-medication, causes the following serious complications:

• transition of the disease to the chronic stage;
• spread of infection throughout the body;
• infertility;
• development of cancer of the cervix, rectum, etc.

Prevention

It is much easier to prevent any disease than to cure it, and diseases included in the list of STIs are no exception. You can protect yourself from these diseases by the following methods:

• using a condom protects against many infections;
• by avoiding contact with people at risk (alcoholics, drug addicts, etc.), you can avoid many risks;
• You can only engage in non-traditional forms of sex (anal, oral) with a partner with whom you have a trusting relationship and whose health there is no reason to doubt.

The additional use of special medications can help in some cases to cope with certain types of infection. However, these drugs have contraindications and side effects. They should be used irregularly, for example, at the first contact with a partner as additional protection along with a condom.

Sexually transmitted diseases are transmitted in most cases through sexual contact. It is important to remember: unprotected sex, promiscuity and a sick partner are a high risk of contracting such ailments. Diagnosis of such diseases is somewhat difficult due to the late onset of the disease and the paucity of symptoms. Their treatment is problematic, since the resistance of microorganisms to antibiotics is increasing every year.

STIs have severe complications, so the appearance of specific symptoms: rashes, discomfort, irritation, uncharacteristic discharge from the genitals is a signal to consult a doctor.

As can be seen from the definition, we are talking exclusively about infectious diseases that are caused by a specific pathogen - some pathogenic microorganism that affects the genitourinary organs of both men and women. Quite a large group of sexual infections includes a list of sexually transmitted diseases (STDs) that affect the same organs. Sexually transmitted infections are synonymous with sexually transmitted diseases.

However, a significant difference between the group of STDs and all sexually transmitted infections is that the latter can be transmitted not only sexually, but also through contact, and affect other organs and systems except the urinary system (for example, liver, immunity).

Therefore, quite often sexually transmitted infections mean exclusively a group of sexually transmitted diseases, which is not entirely true. The list of sexually transmitted infections is quite wide, and the causative agent of the disease can be transmitted both through sexual contact and through everyday contact (for example, lack of personal hygiene, neglect of sterility rules in medical institutions, injuries, etc.).

It is impossible to accurately determine the time of occurrence of sexually transmitted infections. However, they have been known since ancient times - doctors from China, Rome, Greece, Egypt and India described various manifestations of this type of disease. Africa is considered the birthplace of many sexually transmitted infections, where microorganisms that are genetically and morphologically similar to pathogenic pathogens are found in the wild.

Pathogens of sexually transmitted infections – pathogenic and opportunistic
microorganisms

• Treponema pallidum (Treponema pallidum) is the causative agent of syphilis;
• Neisseria gonorrhoeae is the causative agent of gonorrhea;
• Trichomonas vaginalis is the causative agent of trichomoniasis (trichomoniasis);
• Chlamydia (Chlamydia trachomatis) is the causative agent of chlamydia;
• Herpes virus (Human herpesvirus);
• Human papillomavirus (HPV - Human Papillomavirus) is the causative agent of papillomas, condylomas, and cervical erosion.

The pathogen affects various organs of the reproductive system in women and men, always causing an inflammatory process. It should be remembered that a sexually transmitted infection is characterized by the fact that there is a certain pathogen (pathogenic microorganism) that penetrates the mucous membrane of various organs of the reproductive system, causing inflammation of the latter. This inflammatory process can occur in different ways, depending on the state of the immune system, the presence of other infections, etc. In order not to write a diagnosis, for example, “gonorrheal urethritis”, “gonorrheal vaginitis” or “gonorrheal adnexitis”, doctors decided to call the disease simply gonorrhea, specifying the affected organ (for example, gonorrhea, urethritis, etc.). The same is done in the case of other sexually transmitted infections - that is, they indicate the name of the disease as the main diagnosis and specify which organ is affected.

It should be remembered that sexually transmitted infections can affect several organs of the genitourinary tract at the same time. Or damage to one organ develops first, and then others become involved. In this case, we are talking about the generalization of the pathological process (complication), that is, the involvement of other organs in the inflammatory reaction.

Based on the organs affected, all genital infections can be divided into female and male. Thus, the following nosologies caused by a sexually transmitted infection can be classified as purely “male” pathologies:
1. Inflammation of the penis (for example, balanitis, balanoposthitis).
2. Inflammation of the prostate gland.

The following diseases caused by pathogens of sexually transmitted infections are purely “female”:
1. Inflammation of the ovaries.
2. Inflammation of the uterus.
3. Inflammation of the fallopian tubes.
4. Inflammation of the cervix.
5. Inflammation of the vagina (vaginitis).

Urethritis (inflammation of the urethra), cystitis (inflammation of the bladder), as well as inflammation of the kidneys or ureters are universal diseases that, when infected with a sexually transmitted infection, equally often affect both men and women.

Inflammatory foci of sexually transmitted infections can be located in the mouth, vagina, urethra, anus, rectum or perineal area, in both men and women. In this situation, the location of the inflammatory focus depends on the type of contact that resulted in the infection. For example, oral sex can lead to the development of oral gonorrhea, and anal intercourse, accordingly, will cause gonorrhea of ​​the anus or rectum, etc.

Urogenital infections - general characteristics

Almost any sexually transmitted infection is combined with a genitourinary infection, since urethritis is one of the main and most common signs of the development of STDs. Infection of the urinary organs with pathogens of sexually transmitted infections occurs due to their anatomical proximity. Thus, the urethra (urethra) is located next to the vagina in women and the vas deferens in men.

Urethritis in men is a more difficult condition to treat than in women because the length of the duct is much longer. Thus, the length of the male urethra is 12-15 cm, and the female urethra is only 4-5 cm. In this situation, urethritis in women is easier to cure, but the risk of complications is also higher, since the pathogen needs to travel a short distance to pass to other organs. In men, urethritis is more difficult to cure, but the risk and rate of development of complications is somewhat lower, since the pathogen must travel a considerable distance to other organs.

General symptoms of all sexually transmitted infections

• discharge from the genitals that differs from normal (for example, copious, foamy, with a strong odor, unusual color, etc.);
• itching sensation in the genital and urinary organs;
• burning and pain in the genital and urinary organs;
• cloudy urine, change in the amount of urine, etc.;
• pus, leukocytes, epithelium, casts or red blood cells in a general urine test;
• feeling of discomfort in the lower abdomen (pulling pain, aching sensation, etc.);
• pain during sexual intercourse;
• enlargement of lymph nodes, primarily inguinal;
• development of various lesions on the skin - spots, pustules, blisters, ulcers, etc.

Routes of infection

In addition to sexual transmission, the pathogen can be transmitted through close household contact, or through contaminated instruments. For example, papillomavirus or trichomonas can be transmitted by sharing towels, sponges and other hygiene items. A scabies mite or pubic louse infects a healthy person simply through everyday contact with a sick person, through bedding, door handles, etc. A number of sexually transmitted infections can be transmitted from sick mother or father to child, for example, during childbirth.

A separate group of transmission routes for sexually transmitted infections are non-sterile medical instruments. In this case, the pathogen is transferred when the instrument is used first on an infected person, and then, without proper treatment, on a healthy one. AIDS and hepatitis can be transmitted through the transfusion of contaminated donor blood that has not been properly tested.

Can sexually transmitted infections be transmitted through oral sex - video

What tests can detect sexually transmitted infections?

• rapid test;
• bacteriological method;
• microscopy of a smear taken from the genitourinary organs;
• immune fluorescence reaction (IF);
• enzyme immunoassay (ELISA);
• serological method;
• ligase chain reaction;
• polymerase chain reaction;
• provocative tests.

A smear of genitourinary secretions can be performed quickly, but its reliability is determined by the qualifications of the laboratory technician and the correctness of the biological sample taken.

Enzyme immunoassay, immune fluorescence reaction, and serological method have a fairly high sensitivity, but the reliability of the results obtained depends on the type of pathogenic agent and the level of the laboratory. Some infections can be diagnosed very accurately using these methods, but for detecting other sexual diseases they lack sensitivity and specificity.

The most accurate, sensitive and specific methods for detecting any sexually transmitted infection are bacteriological culture on the medium and molecular genetic tests - ligase or polymerase chain reaction (LCR or PCR).

Provocative tests are carried out specifically to identify hidden chronic sexually transmitted infections. In this case, chemicals or food intake cause a short-term stimulation of the immune system, biological material is taken and the pathogen is determined using culture on a medium or polymerase chain reaction.

Principles of prevention

• use of condoms (male and female);
• the use of various topical agents that destroy the pathogen after unprotected sexual intercourse;
• regular testing for sexually transmitted infections;
• correct and effective treatment with subsequent monitoring when a sexually transmitted infection is detected;
• identification and treatment of sexual partners;
• sexual rest during the treatment period;
• informing your partner about existing sexually transmitted infections;
• use of vaccines against hepatitis and human papillomavirus;
• compliance with the rules of personal hygiene (availability of a personal towel, sponge, soap, razor, etc.).

Drugs for the treatment of sexually transmitted infections

• systemic quinolones;
• aminoglycosides;

• vamciclovir;
• alpizarin;
• Gossypol ointments;
• Megasyn;
• Bonafton;
• Alpizarin, etc.

• Naftifin, etc.

Which doctor will help diagnose and treat sexually transmitted infections?

Sexual infections and reproductive capacity

A woman suffering from a sexually transmitted infection that was not treated before or during pregnancy puts her child and herself at risk during childbirth. During childbirth, a child can be infected while passing through the genital tract. Inflamed tissues of the birth canal are poorly distensible, which leads to ruptures during childbirth, and this contributes to the penetration of pathogenic pathogens into the blood and the development of generalized inflammation with the threat of death or other complications. Sutures placed on inflammatory tissues heal poorly, fester, etc.

A man suffering from a chronic sexually transmitted infection can infect his pregnant partner, which is also unfavorable for the development of the unborn child and the course of labor.

Prolonged or massive course of sexually transmitted infection in a man or woman often leads to infertility caused by chronic inflammation, which prevents the normal course of the fertilization process, and the subsequent implantation of the embryo into the wall of the uterus. It should be remembered that sexually transmitted infections in both men and women can lead to infertility. In the vast majority of cases, to restore the ability to reproduce, it is enough to treat an existing sexually transmitted infection and take a course of vitamins in combination with proper nutrition and general strengthening measures.

Legal liability for contracting sexually transmitted infections

By active action, lawyers mean a deliberate refusal to use condoms, drinking together or eating from the same container, etc. That is, active actions aimed at close contact, during which the causative agent of a sexually transmitted infection will be transmitted to a partner with a high degree of probability. By criminal inaction, lawyers understand silence and failure to warn a sexual partner about an existing sexually transmitted infection.

In modern medicine, the term “genital infectious diseases” means all diseases that affect the organs of the reproductive and urinary systems. The causative agents of this group of diseases are various pathogenic microorganisms.

People sometimes confuse sexually transmitted infections and sexually transmitted diseases (STDs). Sexually transmitted diseases are indeed included in the concept of sexually transmitted infectious diseases. But the main difference is that infections can be transmitted not only sexually, but also through contact (for example, through the use of the same hygiene items by the carrier and the infected person). In addition, STD pathogens can penetrate almost all human organs.

These diseases themselves do not depend in any way on the gender of the patient, but the symptoms of genital genitalia are much more vivid and pronounced than in women. That is why experts call such manifestations “manifest”, that is, declaring themselves.

Pathogens of sexually transmitted infections

Sexual infections have been known to humanity since ancient times. They were described by doctors of Ancient Rome and Greece, China, India, and Egypt. Many believe that Africa is the birthplace of this type of disease. But this statement is, to say the least, controversial. Indeed, scientists have discovered microorganisms in the wild nature of this continent that are similar in some ways to infectious agents. But this fact does not yet indicate the origin of the disease.

Today, the list of sexually transmitted infectious diseases is quite wide. Each of them causes its own pathogen, but mainly they are pathogenic or opportunistic microorganisms.

This is their main difference from opportunistic microorganisms that are present in the microflora of every living organism. But under normal conditions they do not cause any harm. In order for bacteria or fungi to become the cause of an infectious-inflammatory process, a number of certain factors are needed (for example, a general weakening of the human immune system).

All sexually transmitted diseases are caused by pathogenic microorganisms. The most famous and widespread today are:

• The causative agent of syphilis is the spirochete (bacterium) tryponema pallidum;
• the causative agent of gonorrhea is Proteobacteria neisseria;
• the causative agent of trichomoniasis is Trichomonas vaginalis;
• causative agent of chlamydia - chlamydia;
• The causative agent of genital herpes is the herpes virus HSV-2.

The most common are the so-called papillomaviruses, which cause papillomas, genital warts and other forms of tissue proliferation. According to experts, more than 63% of people are carriers of this virus.

It must be remembered that these microorganisms are transmitted sexually, but certain types are also spread through contact. For example, papillomaviruses can become infected by self-infection, that is, the virus is transferred from one part of the human body to another. This can happen, for example, when shaving or epilating.

Opportunistic microorganisms include various bacteria and yeasts, which, in the presence of certain factors, cause inflammatory processes. Their number is so large that it is almost impossible to single out the most common ones.

Classification of sexually transmitted infections

Depending on the type and causative agent of the disease, all sexually transmitted infections are usually divided into the following groups:

Sometimes experts seek to separate sexually transmitted infections depending on the gender of the patient. This gradation is due to the fact that the symptoms of diseases in men and women may differ from each other. But differences in external manifestations do not yet indicate a different type of disease. Therefore, there is no official division into female and male sexually transmitted infections.

These diseases are caused by the same pathogens. The course and symptoms of the disease depend on the structure of the patient’s genitourinary system (naturally, it is different for men and women). Pathogenic microorganisms affect the pelvic organs, reproductive and urinary systems, causing infectious inflammation.

The course of the disease itself depends not only on the gender of the patient and the type of pathogen, but also on many other factors:

• the state of the patient's immune system;
• the presence of other infections;
• the presence of other diseases (including chronic ones);
• patient's age.

When making a diagnosis, the doctor indicates the name of the disease and specifies the affected organ or organs. It must be remembered that inflammation caused by sexually transmitted infections can affect not one, but several individual organs, and they do not always belong to the genitourinary system. As a rule, with incorrect or untimely treatment, generalization of pathological processes occurs. That is, complications accompanying the underlying disease develop when inflammatory reactions involve organs remote from the site of infection.

According to the type of organs affected, sexually transmitted infections can really be divided into male and female.

The following nosological forms are typically masculine:

1. Inflammation of the penis (for example, balanoposthitis with trichomoniasis).
2. Inflammation of the prostate gland (for example, with gonorrhea).

Inflammatory diseases of the urinary system are universal and do not depend in any way on the gender of the patient. These include:

1. Infectious inflammation of the urethra - urethritis.
2. Infectious inflammation of the bladder - cystitis.
3. Infectious inflammation of the kidneys.

The source of inflammation in men can be not only the penis. The site of infection can be located in the mouth, anus, urethra, or perineum.

The term “genitourinary infection” is often used as a synonym for sexually transmitted infections. However, in modern medicine these concepts are strictly distinguished.

A genitourinary infection is a disease caused by pathogens of sexually transmitted infections, but the inflammation spreads only to the organs of the urinary system, without affecting the reproductive and pelvic organs. These include diseases such as cystitis, pyelonephritis, urethritis and the like.

But in any case, the cause of infectious inflammation is the same pathogenic microorganisms. Almost any sexually transmitted infection is accompanied by inflammation of the urinary system. For example, urethritis is one of the most indicative symptoms of a person having a sexually transmitted disease.

Frequent infection of the urinary organs by pathogens of sexually transmitted infections is due to their anatomical proximity to each other. For example, the male urethra is located next to the vas deferens.

In this case, the course of the disease, the speed and effectiveness of treatment, directly depend on the gender of the patient. For example, it is much more difficult to treat than in women, but the risk of complications is much lower. This is due to anatomical features. The fact is that the length of the male urethra is 11-16 cm, while the female urethra is only 3.4-5.5 cm. Since the causative agent of inflammation in the first case has to travel a greater distance, it is much less likely to affect other organs.

Symptoms of infectious diseases

Despite the fact that each sexually transmitted infection has its own individual characteristics, the signs of a particular disease in a man are common. These include:

• atypical discharge from the penis (foamy, pungent odor, unusual color, etc.);
• itching and burning in the penis and urinary organs (for example, the urethra);
• painful sensations when urinating;
• changes in the appearance and quality of urine (for example, changes in the amount of urine);
• discomfort or pain in the lower abdomen (pulling or aching pain);
• discomfort or pain during sexual intercourse;
• enlarged lymph nodes in the groin area;
• the appearance of various lesions on the skin (spots, blisters, ulcers, etc.).

The presence of one or more of the above signs is a reason for immediate consultation with a specialist. Remember that self-medication is unacceptable in any case! Most often, such measures only lead to the development of complications. It is much wiser to seek help from a urologist or venereologist when the first symptom appears. With the current level of development of pharmacology, most sexually transmitted infections can be treated effectively and quickly enough. Advanced forms of the disease can lead to very negative consequences.

Laboratory research methods

Today, medicine has a fairly wide range of different methods for detecting the presence of a sexually transmitted infection and the type of its causative agent. The need for a particular study in each specific case is determined by the doctor. Therefore, if you are prescribed tests, take them all.

The most common types of research now are:

• express method (test);
• bacteriological diagnostics;
• microscopic examination of a smear;
• auxiliary studies (RIF, ELISA, serological method, etc.).

To independently determine whether you have a sexually transmitted infection, rapid tests that can be purchased at a pharmacy are suitable. Outwardly, they are very similar to those used to determine pregnancy. The resulting analysis result is displayed in a similar way: 2 bars mean a positive result (sexually transmitted infection is present), 1 bar means a negative result (infection not detected).

However, you should not rely entirely on this technique. It can produce both false positive and false negative results. It is much wiser to consult a doctor who will prescribe laboratory tests for you.

Treatment of sexually transmitted infections

Sexual infections are often transient. That is, signs of the disease may appear and, after some time, disappear. This does not mean that self-healing has occurred. Pathogenic microorganisms that cause inflammation continue to carry out their destructive activities. They cannot “dissolve” on their own. Therefore, the infection must be treated without fail. But at the same time it is necessary to strictly observe a number of rules.

Competent and effective treatment can only be prescribed by a specialist - a urologist or venereologist. Under no circumstances should you self-medicate, even if the symptoms you experience are similar to the signs of a disease that you have treated before. It is unacceptable to make changes to the prescribed treatment regimen or stop taking medications on your own. Such actions can lead not only to the transition of the disease to the chronic stage, but also to the development of insensitivity to medications in the pathogen. And such complications are much more difficult to treat.

Treatment must begin with a full and detailed diagnosis of the disease. Passing all tests prescribed by the attending physician is mandatory. Only on the basis of laboratory tests can adequate therapy be prescribed. Perhaps a specialist will prescribe an ultrasound for you. It is carried out in order to eliminate possible complications.

If you have been diagnosed with 1 sexually transmitted infection, you must be tested for other sexually transmitted diseases.

During treatment, refrain from any sexual contact, even completely protected ones. And after finishing therapy, be sure to take all repeat tests. The absence of signs of sexually transmitted infection does not indicate complete recovery.

If the causative agents of the disease are found in one sexual partner, both people should undergo treatment, even if the second does not have any signs of the disease. This rule must be strictly observed, otherwise re-infection cannot be avoided. Both partners must also take control tests.

With timely and competent treatment, a sexually transmitted infection cannot cause much harm to your health.

Moreover, 30% of stable married couples are infected with sexually transmitted infections. The diseases were discovered during diagnostic tests for. It should be emphasized that common genital infections can be contracted even without sexual contact. To do this, close tactile contact of the skin, the use of common household items and ordinary kisses are sufficient. Such infections include herpetic, papillomavirus and cytomegalovirus, as well as syphilis.

Our doctors recommend that you adhere to strict sexual hygiene and exclude unprotected contacts with casual partners. Sexual infections in men lead to terrible and sometimes irreversible consequences, including death. In addition, they have a detrimental effect on reproductive function and potency.

If you discover at least one strange symptom, we advise you to immediately contact a specialist for adequate differential diagnosis and early effective therapy. Our doctors have extensive experience in the treatment of chronic sexually transmitted diseases and acute sexually transmitted infections. Modern medicine has made dramatic strides forward, and we are ready to assure you: any disease is not a death sentence at all!

Common sexually transmitted infections in men

Today, doctors identify the following diseases that are “popular” among men who are promiscuous:

You need to contact a specialist if you notice the following symptoms:

• Any neoplasms on the penis (wounds, cracks, vesicular plaques, papillomas);
• Itching and burning of the external genitalia;
• Pain when urinating;
• Separation of mucus from the urethra;
• Hyperemia and swelling in the genital area;
• Pain syndrome localized in the groin and anus;
• Inflammation of the testicles.

The main prerequisite for the development of STIs can be any type of unprotected sexual contact (vaginal, oral, anal). If you live a promiscuous sex life, know: illness is your negligent attitude towards your own health.

Diagnostics in our clinic

If you discover characteristic signs of an STI, we recommend that you consult a doctor immediately. Our qualified specialists will conduct a number of diagnostic studies to identify the presence of the disease and provide effective therapy:

• Scraping the mucous tissue of the urethra with further transfer to a test tube with a reagent;
• PCR (polymerase chain reaction) study.
• RPR Antibodies to cardiolipin antigen;
• Blood test for hepatitis;
• General urine analysis;
• Clinical blood test;
• Taking a smear for further microscopic examination (Gram stain);
• Blood test for HIV;
• Brief conversation with the doctor.

Treatment in our clinic

Our competent specialists will select the optimal treatment regimen for you, depending on your problem and the course of the disease:

1. Antibacterial therapy;
2. Selection of immunomodulatory drugs;
3. Selection of delicate hygiene products for subsequent use.

As a rule, such therapy is sufficient. If necessary, it can be repeated as prescribed by the doctor. Our specialists will also give you all the important recommendations during the intensive treatment period.

Genital infections in men are not only uncomfortable sensations, but also a direct path to severe complications from the health and reproductive system. Contact a specialist for help in a timely manner if you discover an alarming symptom. Our clinic will always help you find health and protect yourself from relapses.

Our specialists

• the most common diseases,
• treatment of hidden infections in women - drugs that are advisable to take,
• what general medications involve the treatment of genital infections and urinary tract infections,
• is there a disease that is resistant to certain types of drugs, and how can it be cured,
• the most effective treatment – ​​sexually transmitted infections and the most effective medicine.

Bacterial infectious diseases

Bacterial vaginosis

Bacterial vaginosis (BV) is a common vaginal infection that increases the risk of contracting other sexually transmitted infections and may occur along with them. First mentioned in 1955 as “nonspecific vaginitis” (Gardner and Dukes). The term "bacterial vaginosis" has been coined since 1984.

Etiology

Gardnerella vaginalis is a multiplied, facultative anaerobic bacterium with a high concentration of Mobiluncus SPP, Prevotella SPP, Peptostreptococci, Fusobacterium SPP, Bacteroides SPP, aerobic bacteria, alpha-hemolytic streptococci, etc. C The most common is the “combination” with Trichomonas.

Clinical picture

• The infection is asymptomatic in 50%.
• The disease is usually characterized by copious sticky discharge with a fishy odor.
• Involvement of the cervix leads to acute purulent cervicitis, which is manifested by grayish-white discharge of a denser consistency.
• Irritation of the skin and mucous membranes of the genital organs, swelling, erosions, ulcers
• Nonspecific urethritis.
• Possible complications: inflammation of the pelvic area, complications after abortion and hysterectomy, premature birth.

Diagnostics

• White-gray, homogeneous, sticky discharge.
• Microscopic examination - native drug and Gram method (clue cells - epithelial cells with granular cytoplasm - presence of bacteria).
• Vaginal pH is greater than 4.5.
• positive amine test - characteristic fishy odor upon alkalization of fluorine with 10% KOH.

How to treat?

Metronidazole (nitroimidazole chemotherapy drugs - bactericidal effect on anaerobic bacteria and protozoa, for example, Trichomonas):

• orally: 500 mg 2 times a day for 5-7 days, possibly 2 g once,
• intravaginally: Klion D 1-2 vaginal tablets/day for 10 days (combined product with fungistatic imidazole and fungicidal antifungal miconazole 150 mg + Metronidazole 100 mg),
• Clindamycin (lincosamide bacteriostatic antibiotic with an antibacterial spectrum),
• orally: 300 mg 2 times a day, for 7 days,
• intravaginally: 2% cream 5 g/day for 7 days.

Chlamydial infection of the reproductive system

Genital chlamydia is the most common sexually transmitted infection. It accounts for a total of 50-60% of all cases of nonspecific urethritis. The highest incidence is in women aged 16-19 years, and men aged 20 to 24 years. Factors associated with an increase in the prevalence of chlamydial infection increase during periods of increased sexual activity and when alternating sexual partners, especially in the case of unprotected sex.

Etiology

Chlamydia has an affinity for columnar epithelium (serotype D-K causes urogenital infections). The incubation period is 7-21 days.

Diagnosis of chlamydial infection is based on the direct detection of chlamydial antigens, isolation of chlamydia in cell cultures, the presence of chlamydial DNA (hybridization methods or ligase chain reaction, which are one of the most sensitive research methods. A smear is performed from the affected mucosa, urine collection (the first portion), ejaculate.

Treatment

• Antibiotics that suppress the protein synthesis of bacterial cells (tetracyclines, macrolides) act on most clinical forms of the disease, and are one of the first choice drugs in the treatment of chlamydial infection.
• Tetracycline antibiotics (have a bacteriostatic effect and a wide antibacterial spectrum: aerobic and anaerobic bacteria, chlamydia, mycoplasma, rickettsia, spirochetes and protozoa. The disadvantage is the development of resistance in some types of microorganisms). They penetrate well into the tissues and secretions of the central nervous system. Excreted in bile and urine. To obtain the most effective pharmacokinetic properties, Doxycycline is most often used.
• Macrolides (bacteriostatic against gram-positive microorganisms, chlamydia, mycoplasma, spirochetes and others). They have good penetration into tissues and secretions, do not penetrate the central nervous system. Excreted in urine and bile. Macrolides of the second generation are mainly used due to their favorable pharmacokinetic properties: Azithromycin, Clarithromycin, Roxithromycin. Second generation macrolides have better gastrointestinal tolerance and are characterized by less interaction with other drugs than first generation macrolides, which include, for example, Erythromycin, Spiramycin, Josamycin.
• Quinolone antibiotics (bactericidal active quinolones of the third generation have a wide spectrum of activity against gram-positive microorganisms, act on mycoplasmas, chlamydia and mycobacterium tuberculosis). They penetrate well into tissues and are excreted from the body with bile and urine. For example, Ofloxacin has been used in the alternative treatment of chlamydial infection.

Mycoplasma infections of the genitourinary system

Mycoplasmas are gram-negative bacteria without external cell walls, similar in size to large viruses (100-150 nm). They are often part of the normal microflora (present in approximately 70% of sexually active individuals), in patients with urogenital infection their concentration is 2-4 times higher, and can be the main pathogen, especially in the case of immunodeficiency of the body.

Etiology

Mycoplasmas of the human urogenital system include: Mycoplasma hominis, Mycoplasma genitalium, Mycoplasma fermentas, Mycoplasma incognitum, Ureaplasma urea lyticum.

Clinical picture

Mycoplasmas are part of the mixed flora of nonspecific urethritis, where Mycolasma Hominis makes up more than 20%, and Ureaplasma urealyticum makes up more than 52%.

• Bacteria are directly involved in the development of nonspecific urethritis (18-45%). Clinically manifests itself as pollakiuria. Characteristic features include creamy discharge, erythema and swelling of the urethral opening. If the disease develops, bacteria can cause prostatitis and epididymitis.
• Women may experience mucopurulent cervicitis or pyelonephritis.
• Bacteria may contribute to the formation of Reiter's syndrome.
• The disease may be asymptomatic.

Diagnostics

Diagnostics is quite complex; liquid and solid media (PPLO soil), enzyme-linked immunosorbent assay (ELISA) are used, and nucleic acids are detected using the PCR (polymerase chain reaction) method. Discharge from affected mucous membranes, semen, and urine are examined.

Treatment

Mycoplasma does not have a cell wall; its surface is formed by a three-layer membrane rich in lipids (the bacterium is resistant to penicillin and other antibacterial substances that destroy peptidoglycan or inhibit its synthesis as an essential component of the cell wall). Treatment of the disease is identical to the treatment of chlamydia.

Mycoplasma is characterized by general resistance to Macrolides; the drug of choice is Doxycycline (100 mg 2 times/day for 7 days), another possibility is represented by the drug Clindamycin (300 mg 2 times/day for 7 days).

Viral infections

Genital warts (condylomas acuminata, venereal warts)
Genital warts occur in 10-20% of the population aged 16-49 years. The maximum prevalence is among women during sexual activity, aged 20-24 years, and men aged 25-34 years.

Etiology

Human papillomavirus (HPV). Approximately 25 HPV genotypes have a “preference” for the anogenital region. HPV types are classified into low or high oncogenic potential. The incubation period of the disease ranges from 2 weeks to 9 months.

Clinical picture

The infection affects the skin and mucous membranes. In men, in most cases, it is localized at the opening of the urethra, on the head of the penis and the scrotum. In women, it most often affects the labia.

Extragenital localization, very common, especially among homosexual couples, is most often represented by the perianal. A frequent occurrence, for example, localization in the corners of the mouth, on the legs and other less obvious places, often associated with various sexual activities.

Clinical form: small whitish or pink very fragile wart papules that bleed slightly when injured. They can occur either singly or (in most cases) in a focal manner.

Warts can grow and merge with each other. Pressure, friction, and sweat lead to destruction of their surface, leakage and secondary infection with a strong odor. In case of neglect, possibly in immunodeficiency conditions (for example, in the presence of HIV and cancer), warts become more widespread and grow to large sizes - giant condyloma (associated with HPV 16, 18 - precancerous and malignant lesions).

Subclinical form: flat lesions, can be visualized with 3-5% acetic acid (whitish areas).

Latent type: cytological diagnosis, hybridization. Complications may include balanitis, balanoposthitis, phimosis and paraphimosis.

Diagnostics

Clinical examination, anamnesis. In case of doubt, histological examination or hybridization methods can be performed. A venereologist always performs a full examination aimed at excluding overlap with other sexually transmitted diseases, including a serological study.

Treatment

• Surgical: abrasion (more suitable for single lesions), general excision of large deposits. The disadvantage is a possible relapse in the scar, and further, already complex, treatment.
• Physical: cryo-destruction with liquid nitrogen (very effective, often long-term, painful, destructive method, requiring regular re-treatment), electrosurgical ablation, electrodiathermocoagulation.
• Chemical: 10-25% solution of Podophyllin, Podophyllotoxin (0.15%), bi- and trichloroacetic acid.
• Immunomodulatory, antiviral, cytostatic: Aldara (Imiquimod 5%), alpha-interferon, 5-fluorouracil.
• Laser.

Conclusion

Treatment of any sexually transmitted disease belongs to the hands of a specialist! Insufficient therapy, as well as self-medication, can lead to serious complications requiring long-term, expensive treatment!

It is advisable for prevention purposes to always give preference to safe sex. Proper personal hygiene is important.