Sexually Transmitted Infections (STIs)

Sexually Transmitted Infections (STIs)

STIs are infections that are spread by having sex with someone who has an STI. You can get a sexually transmitted infection from sexual activity that involves the mouth, anus, vagina, or penis. Don’t worry, you usually cannot get these by touching or interacting with an infected person. But your chances of getting an STI are increased if you are sexually active, especially without protection, if you have more than one sexual partner, or a sexual partner that has had multiple sexual partner, not using condoms, or using alcohol and drugs.

The best way to protect yourself from STIs is to not have sex, and the second best way to protect yourself from STIs is to use condoms, and to learn the facts about the different types of STIs.

STIs are generally spread by

  • any sexual activity that brings a person in contact with bodily fluids from an infected person,
  • any sexual activity in which one person’s genitals contacts another person’s skin or mucous membranes, direct contact with open sores, or
  • A mother to her baby before or during birth, or during breast-feeding.

Rest assured, they are not spread by sharing eating utensils, holding hands, or using public toilets.

The best thing you can do for yourself is to know the facts on STIs and be prepared accordingly when you decide to be sexually active. Some STIs, such as herpes and HIV, cannot be cured. STIs while pregnant can cause serious and sometimes fatal damages to the fetus, such as infant blindness, deafness, heart defects, miscarriage and death.

There are many types of STIs, which we will list below. Please note that this is still a very high level overview, and there are other great virtual resources out there that can provide more information.

Bacterial STIs

Bacterial STIs include Chlamydia, Gonorrhea, Pelvic Inflammatory Disease (PID), and Syphillis. All of these STIs can be cured with antibiotics, but if left untreated can lead to serious or fatal consequences as well as transmitting to other sexual partner(s). A short description of each STI can be found below.

 

Chlamydia

Though curable, the challenge with chlamydia is that it can be asymptomatic in many women, which often makes it difficult to diagnose and is left untreated. If it does present, it may do so with painful urination, unusual discharge, vaginal bleeding.

Gonorrhea:

Gonorrhea is also curable by antibiotics, and has symptoms similar to chlamydia. It too, is capable of transmitting to sexual partner(s) if not treated. 

Pelvic Inflammatory Disease (PID):

Pelvic Inflammatory Disease is an infection of the fallopian tubes, ovaries, and uterus and presents after failure to treat or multiple infections of chlamydia and/or gonorrhea. Symptoms include abdominal pain, fever, and painful sex. Treatment is available through antibiotics for a cure, but it is important to note that because PID is the result of untreated or multiple infections of chlamydia and/or gonorrhea, it may pose serious consequences - such as infertility and/or ectopic pregnancy (when a fertilized egg implants outside the uterus – if left untreated.

Syphilis:

Syphilis often presents with a painless chancre (sore), rash, and/or fever. If left untreated, Syphilis can lead to serious complications  such as blindness, difficulty walking, and even death.

Viral STIs:

Viral STIs are generally incurable. While some of them can be treated or managed, once a person is infected, he/she carries the infection for life and can pass it on to his/her sexual partner. A brief description of the various Viral STIs is provided below.

Genital Warts:

Genital Warts are the most common STI and may appear on the genital region (and mouth if transmitted through oral sex). The warts are due to Human Papilloma Virus (HPV).   While there are over 100 types of HPV, we know that Types 6 and 11 cause most of genital warts and Types 16 and 18 can lead to cervical cancer.  A pap smear is done to test for these strains. Gardasil is the HPV vaccine that prevents you from HPV infection (specifically types 6, 11, 16, 18).  Please remember though, that it does not treat existing HPV infections.  While treatment is available to remove warts, it is important to remember that once a person is infected with the HPV, it’s for life and can be passed on to his/her sexual partner(s).

Genital Herpes

Genital Herpes are extremely painful sores on the genital region (and mouth if transmitted through oral sex). This infection also makes one more susceptible to HIV. There is treatment to remove the sores, but the infection is still for life.

HIV

Human Immunodeficiency Virus (HIV) destroys a key element in one’s immune system, called CD4 cells.  With a decrease in CD4 cells, one’s immune system is compromised and at great risk for many infections.  When an HIV-infected person reaches a CD4 count that is extremely low, they have progressed to AIDS.  Infection can occur through several routes, such as through sex (including oral and anal sex), sharing needles (drugs, tattoos, etc.), and through mother-child transmission.

Though incurable, treatment is available to inhibit the virus and many HIV patients live extremely fulfilling and long lives. 

Parasitic STIs:

Parasitic STIs are curable and can be transmitted to sexual partners if not treated. Trichomoniasis and Pubic Lice are two examples and descriptions are included below.

Trichomoniasis

Trichomoniasis generally has symptoms of discolored and unusually smelling vaginal discharge, painful urination, vaginal bleeding. The infection makes one more susceptible to HIV.

Pubic Lice (Crabs)

Pubic Lice (crabs) may be transmitted during sexual contact and the main symptom is intense itching.

If you think you have an STI, seek medical help right away. If you are a minor (under 17), you are granted confidentially with their doctor for the medical help of pregnancy, drug use, and STIs. For best results, make sure you complete the full course of medications, have follow-up testing done, avoid all sexual activity while being treated, and notify all sexual partners.

Other Common Infections

Every woman at one point or another becomes familiar with common infections such as Urinary Tract Infection (UTI) and Yeast Infection.  Sometimes, becoming sexually active can increase the likelihood of such infections, if proper care and hygiene is not followed. These infections are very common, and easily treatable. Moreover, there may be additional things you can do to help prevent such infections from occurring.

 

Urinary Tract Infection (UTI):

UTIs occur much more frequently in girls, particularly those around the age of toilet teaching, because a girl's urethra is shorter and closer to the anus. Symptoms include: pain, burning, or a stinging sensation when peeing, an increased urge to urinate or frequent urination (though only a very small amount of urine may be produced). Treatment should be started urgently, most commonly through prescribed anti-biotics or it can lead to serious and life-threatening infection or pyelonephritis (kidney infection). There are two preventive measures you can take to prevent UTIs:

1)    wipe front to back

2)    pee and wash after vaginal intercourse

 

Yeast infection:

Yeast can thrive in moist, dark environments, so clothing (especially underwear) that is too tight or made of materials like nylon that trap heat and moisture may lead to yeast infections. Symptoms include: pain, itching, redness, a thick white vaginal discharge, pain during urination, and sometimes whitish patches on the skin of the vaginal area.  Treatments include over-the-counter ointments and prescribed medicine.

Contraception

Contraception is a means of preventing pregnancy, either temporarily or permanently, and can also protect from contracting an STI.

There are two people that are important for you to be speaking to about contraception, which type is best for you, and how to best go about using it accurately.

1)    Your healthcare provider, and

2)    Your sexual partner

 

Your healthcare provider will be able to provide you with accurate information about the effectiveness of contraception and how to use them accurately. Contraceptives can come with side effects and not all are equally effective.  Talk to you doctor about which method will work best for you and your body. 

Similarly, it’s important that contraceptive use be discussed openly between both partners, so that both partners are on the same page and have similar expectations about preventing pregnancy and STIs.

Finally, you may also choose to speak with an Islamic reference should you want an opinion from them about whether the method you are thinking about using. Some contraceptives work at different times during the menstrual cycle – for example, some work before a fertilized egg is formed while others work after. If this is important to you, then we recommend seeking advice from an Islamic reference – one that also has an accurate understanding of how each type of contraceptive works – in order to help guide your decision. While Islam does encourage family planning, there are a number of different opinions depending on which school of thought you choose to follow. 

Contraception can prevent pregnancy through many ways: 

  • Prevent ovulation so no egg is released into the fallopian tube.
  • Prevent the sperm from being emitted into the vagina.
  • Decrease the sperm’s motility to reach the egg.
  • Prevent the zygote from implanting into the uterus.
  • Permanently cut off the travel routes of the egg and sperm.

 

Types of Contraception:

There are temporary and permanent methods of contraception. While all methods to prevent pregnancy from occurring to some degree of effectiveness, not all methods of contraception protect against STIs. As such, it may be helpful to use more than one method of contraception if you are interested in protecting yourself from both pregnancy and STIs. A brief description each type of contraception is provided below.

Temporary: 

Behavioral Methods:

-        Abstinence: Not engaging in sexual activity.  This is the only 100% effective method of birth control and prevention of STDs. 

Ovulation calculator: Tracking your cycle so you can keep track of your ovulation days. This method is more effective for those who have predictable, consistent cycles. Many women use ovulation sticks or by calculating the middle of your cycle. A great resource on this is here.

-        Body temperature: tracking your body temperature using an internal thermometer as body temperature rises during ovulation.

A great resource on this is here.

-        Cervical mucus consistency: Tracking your cervical mucus to determine which days your body is ovulating. Discharge has an egg-white consistency during ovulation. A great resource on this is here.

-        Coitus interruptis: When the man withdraws his penis from the vagina before ejaculation occurs. It is important to note that pre-ejaculation fluid may still contain sperm, and therefore pregnancy can still occur.

There are four main ways that various types of contraception prevent pregnancy. They may prevent fertilization from occurring, inhibit ovulation, prevent sperm motility and/or implantation, or a some combination of these things. Each of these methods are described below.

 

Contraceptive methods that prevent Fertilization:

-        Condom Barrier: this is a thin rubber sheath worn on a man’s penis. Condoms are 93% effective in preventing pregnancy and can also protect against the transmission of STIs. They are available in many different types and sizes so keep trying until you find one that suits both you and your partner. One thing to note is that those with a latex allergy may not be able to use condoms as a consistent form of contraception.

-        Diaphragm Barrier: A dome-shaped cup that fits over the opening to the cervix. It is XX% effective in preventing pregnancy and does/does not protect against STIs

 

Contraceptive methods that inhibit ovulation:

-        Birth Control Pill, Patch, Injection, Ring: All of these methods protect against pregnancy by preventing ovulation. The birth control pill is a prescribed medication containing hormones and is ingested daily. The patch is worn on the arm and is replaced every week. The injection, also known as Depo-Provera is effective for three months. The ring is inserted in the vagina and releases hormones to prevent ovulation from occurring. The ring is to be removed after three weeks of usage, fourth week is your period, and then use a new ring for the next cycle. Keep in mind that the ring can be dislodged, increasing your risk for pregnancy. None of these methods protect against STIs. Side effects include risk of clot, bloating, acne, and weight gain.

 

Contraceptive methods that prevent Sperm Motility and/or Implantation:

-        Copper Intrauterine Device (IUD) is a small, T-shaped plastic device that is wrapped in copper and impairs mobility of sperm to prevent fertilization. The IUD is inserted into your uterus by your doctor. A plastic string tied to the end of the IUD hangs down through the cervix into the vagina.13 This method can be effective for up to ten years.

Mirena and Skyla Intrauterine Device is another type of IUD that contains hormones.  One of the ways it may prevent pregnancy is by preventing a fertilized egg to implant.

 

A mix of methods:

-        Morning After Pill14: the morning after-pill, also known as emergency contraception is taken within 72 hours and preferably within 12 hours after a contraceptive accident or unprotected sex. It typically prevents pregnancy in 1 of 3 ways:

o   Temporarily stops the release of an egg from the ovary.

o   Prevents fertilization.

o   Prevents a fertilized egg from attaching to the uterus.

 

Permanent (Sterilization): 

Often women may consider permanent methods of sterilization if she does not want to have any more children, if her life is at risk by bearing children, or if she is suffering from a medical illness requiring removal of reproductive organs. Both males and females can explore permanent sterilization methods. Males can consider a vasectomy, which is severing the vas deferens in males or females can consider tubal litigation, which severs the fallopian tubes in females. In both cases, pregnancy can no longer occur.

 

Resources

Books

Coming of Age: A Muslim Girl's Guide by Hedaya Hartford

Websites

 HEART Women & Girls, www.heartwomenandgirls.org

Ask a Question! http://heartwomenandgirls.org/ask-a-question/

This is a great way for you to anonymously ask questions that you may have about your body, puberty, or sex.

Bybconversations.com

A Virtual Health Guide on Pelvic Health for Girls and their Families!

Girlshealth.gov

Kidshealth.org

Go Ask Alice, http://www.goaskalice.columbia.edu/

A Q/A site focused on many topics, with a focus on health

Bedsider.org

A Virtual guide that allows you to explore and compare different forms of contraception

13 Intrauterine Device (IUD) for Birth Control. http://www.webmd.com/sex/birth-control/iud-intrauterine-device. September 24, 2014

14 HOW DOES THE PLAN B® MORNING-AFTER PILL WORK? http://www.planb.ca/how-it-works.html.