You Have an STI - What Now?

In the United States, more than 9 million humans with vaginas are diagnosed with an STI each year - 9 million is a lot of people.

It usually goes something like this…

A patient walks into the doctor’s office with vaginal discharge and irritation in the vulvar area. Eventually after talking with the patient and doing an exam, I determine a diagnosis of trichomoniasis, or trich.

The patient is devastated. They trusted their partner and had been under the impression that using birth control would be enough to protect her from any sexually transmitted infection. I then explain that birth control pills, or any birth control other than condoms, do not protect against sexually transmitted infections.

I’ve seen this same situation at least a dozen times in the last 5 years in my practice.

In My Opinion (IMO)

We are here to help you live healthily. Healthily, is that a word?

Nobody is going to judge you. You are your own worst critic. In the medical field, we don’t shame you because you are sexually active or because you got an STI.

I have a job because people have sex.

The only time I will be upset is if you don’t talk about it or come in when you need help. If you leave an STI untreated, it can have horrible consequences for humans with vaginas especially. Many of these infections can cause internal scarring leading to lifelong issues of pain and sometimes infertility.

Prevention first and foremost (information on STI prevention) #SafetyFirst

But I’m standing here waiting if you need treatment.

Common Types of STIs & Treatment Options

HPV, or Human Papilloma Virus, is the most common STI on earth. You’ve probably heard of HPV because of abnormal Pap smears and the HPV vaccine. HPV can cause abnormal cells on the cervix which can lead to cancer and warts. There are many types of HPV.

Treatment: I highly recommend the vaccine. If it’s too late for that, my recommendation is to work with your doctor on a treatment plan based on your HPV type and symptoms. The good news, is there are treatments available.

Gonorrhea and Chlamydia are both bacteria. Many people with vaginas experience these infections with no symptoms at all. They can get into the cervix and cause inflammation, which creates a feeling of irritation and vaginal discharge. These infections can even spread to the cervix and uterus and out of the tubes into the pelvis where it can cause scarring of tubes and chronic pain issues.

Treatment: Gonorrhea and Chlamydia can be treated with antibiotics. These can be given in tablet form or as an injection. We usually recommend treating your partner at the same time. Some of us, not all, will do a test of cure to make sure the bacteria is gone.

Genital herpes causes painful ulcers. Unfortunately, once you are infected with the herpes virus, you cannot get rid of it. It stays inside the cells forever. Most of the time it stays quiet, but there are times where it acts up and causes ulcers which suck because it can cause pain.

Treatment: Herpes is one of those infections that once you get it, you cannot get rid of it. It cannot be cured. We can treat the outbreaks with antiviral drugs. This will help get rid of the ulcers and limit the time of outbreaks only, but not completely get rid of the virus from your body.

Trichomoniasis is a parasite. Usually patients come in with vaginal discharge and/or a fishy odor. They may be completely without symptoms, or be completely irritated in the vaginal area. The infection gets into the vagina only and does not get past that area (unlike gonorrhea and chlamydia).

Treatment: Trichomoniasis is also treated with antibiotics. Once again, we recommend treating your partner at the same time.

HIV is an infection caused by a virus that attacks the immune system. There are about 40,000 new infection every year in the United States. About 20% of these people do not know they are infected. It is transmitted with exposure to bodily fluids, like blood and semen. Once in the blood, HIV attacks the immune system and the person cannot fight off infections.

Treatment: HIV has no cure. There are treatments that can suppress the virus, but once the virus is in the body, we cannot get rid of it. There are many people who are on long term treatments to control the virus. This helps them live longer lives and it decreases the transmission from one person to another.

Hepatitis is an infection that gets into the liver and cause inflammation. Hepatitis B and C can be transmitted sexually. Hepatitis B is transmitted by direct contact with body fluids. Hepatitis C is transmitted by direct contact with blood. They both can travel from pregnant mother to fetus as well. Hepatitis B and C are lifelong infections. However, recently there have been some awesome breakthroughs with treatment of Hepatitis C.

Treatment: For Hepatitis B and C, currently we do not have any treatments. Interestingly, recent treatments for Hepatitis C have been promising as some people have cleared the virus from their system.