SEXUAL HEALTH

Lectured by
Abigail Perin Cruz, M.D.
 Scope of the Lecture:

 What is Sexual Health?

 Sexually Transmitted Infections
 Main Syndromes of Common STIs
 Common STIs
 Prevention of STIs
 What is Sexual Health?

 a state of physical, emotional,

mental and social wellbeing in
relation to sexuality; it is not
merely the absence of disease,
dysfunction or infirmity
Q u ic k T im e ª a n d a
T IF F (U n c o m p r e s s e d ) d e c o m p re s s o r
 requires a positive and
a re n e e d e d to s e e th is p ic tu re .

respectful approach to sexuality

and sexual relationships, as well
as the possibility of having
pleasurable and safe sexual
experiences, free of coercion,
discrimination and violence
 Sexually Transmitted
Infections
 are infections that are spread primarily
through person-to-person sexual contact
 there are more than 30 different sexually
transmissible bacteria, viruses and
parasites
 Several, in particular HIV and syphilis, can
also be transmitted from mother to child
during pregnancy and childbirth, and
through blood products and tissue transfer.
 Sexually Transmitted
Infections
Bacterial Viral Infections Parasitic Infections
Infections
Neisseria HIV Trichomonas
gonorrhoea vaginalis
Chlamydia Herpes Simplex Candida albicans
trachomatis Type 2
Treponema Human
pallidum Papillomavirus
Haemophilus Hepatitis B Virus
ducreyi
Cytomegalovirus
Main Syndromes of
Common STIs
 Urethral discharge
 Genital ulcers
 Inguinal swelling
 Scrotal swelling
 Vaginal discharge
 Lower abdominal pain
 Neonatal eye infection
Common STIs
 Gonorrhoea

 Caused by N.
gonorrhoea, that can
easily grow in warm,
moist areas of the
reproductive tract,
urine canal in both
men and women, as
well as in the mouth,
throat, eyes and anus
 How do people get
Gonorrhoea?
 Spread through
contact with the
penis, vagina, mouth
and anus
 Can also be spread
from mother to baby
during delivery
 Signs and Symptoms of
Gonorrhea in Men
 Burning sensation
when urinating
 White, green or yellow
discharge from the
penis
 Painful, swollen
testicles
 May take 5-30 days for
symptoms to appear
 Some may have no
symptoms at all
Signs and Symptoms of
Gonorrhoea in Women
 Painful or burning
sensation when
urinating
 Increased vaginal
discharge
 Vaginal bleeding
between periods
 Usually mild; most
women may have no
symptoms at all
 Gonorrhea: Rectal Infection in
both Men and Women

 Discharge, anal itching, soreness, bleeding, or

painful bowel movements
 Or…no symptoms at all
 Complications of
Gonorrhoea
 In women: Pelvic Inflammatory Disease which can
cause ectopic pregnancie and infertility
 In men: Epididymitis, a painful condition of the
ducts attached to the testicles that may lead to
infertility if left untreated
 In babies: Blindness, joint infection, severe blood
infection
 Can also infect the joints of adults: Gonococcal
Arthritis
How is Gonorrhoea
Diagnosed?
 Sample taken from
parts of the body
likely to be infected:
cervix, urethra,
rectum and throat
 Sample is then sent to
the lab for Gram
staining
 Chlamydia

 Caused by Chlamydia
trachomatis which can
damage a woman’s
reproductive organs
 Symptoms are usually mild
or absent, irreversible
damage may occur
“silently” before problems
are recognized
 Can also cause discharge
from the penis of an
infected man
How do people get
Chlamydia?
 Can be transmitted
through vaginal, anal,
or oral sex
 Can also be passed
from an infected
mother to her baby
during vaginal delivery
 Signs and Symptoms of
Chlamydia
 Known as the “silent”
disease because 3/4 of
women and 1/2 of
men infected have no
symptoms
 If symptoms do occur,
it appears 1-3 weeks
after exposure
 Signs and Symptoms of
Chlamydia in Women
 Abnormal vaginal discharge or burning
sensation when urinating
 Lower abdominal pain, lower back pain,
nausea, fever, pain during intercourse,
bleeding in between menstrual periods
 Infection of the cervix can spread to the
rectum
 Signs and Symptoms of
Chlamydia in Men
 Discharge from the penis or burning
sensation when urinating
 Burning and itching around the opening of
the penis
 Pain and swelling in the testicles are
uncommon
 How is Chlamydia
Diagnosed?
 A sample is taken from
infected organs such
as the cervix, anus,
mouth and throat
 Gram stain done and
analyzed under the
microscope
 Complications of
Chlamydia
 In women: Pelvic Inflammatory Disease, chronic
pelvic pain, ectopic pregnancy, infertility
 In men: Infection sometimes spread to the
epididymis causing pain, fever and rarely, sterility
 It rarely can cause arthritis accompanied by skin
lesions and inflammation of the eye and urethra
(Reiter’s syndrome)
 Can cause early pneumonia and conjunctivitis in
the newborn
 Syphilis

 Caused by the
bacterium Treponema
pallidum
 has often been called
“the great imitator”
because so many of
the signs and
symptoms are
indistinguishable from
those of other
diseases.
 How do People Get
Syphilis?
 It is passed from person to person through direct
contact with a syphilitic sore during oral, vaginal or
anal intercourse
 Sores occur mainly on the external genitals,vagina,
anus, or in the rectum, lips and in the mouth.
 Infected pregnant women pass it to their baby
during vaginal delivery
 Cannot be spread through contact with toilet seats,
doorknobs, swimming pools, hot tubs, bathtubs,
shared clothing, or eating utensils
Signs and Symptoms of
Syphilis
Primary Stage: Chancre
 Firm, round, small and
painless sore
 Time between
infection and 1st
symptom can range
from 10-90 days (ave.
21 days)
 Sore lasts for 3-6
weeks, heals w/o
treatment then
progresses to 2nd
stage
 Secondary Stage:

 Characterized by skin rash and

mucous membrane lesions
usually appearing when the
chancre is healing or has
healed
 May also appear as rough, red
or reddish brown spots on
palms and soles of the feet
 Presence of swollen lymph
glands, fever, sore throat,
patchy hair loss, headache,
weight loss, muscle pain and
fatigue
 Late and Latent Stages
of Syphilis
 Latent (hidden) stage: Begins when primary and
secondary symptoms disappear. Without
treatment, the infected person will continue to
have syphilis even though there are no signs or
symptoms; the infection remains in the body
and lasts for years.
 Late stage: Can develop in about 15% of
infected persons w/ syphilis who did not
receive treatment and can develop 10-20 years
after the infection was 1st acquired
 Signs and symptoms of late stage syphilis
include difficulty coordinating muscle
movements, paralysis, numbness, gradual
blindness and dementia.
Genital Herpes

 The most common STI

 There are more than
40 types that can
infect the genital areas
of men and women
 “Low Risk” HPV types
are wart-causing
 “High Risk” HPV types
are cancer-causing
 How do People get
Herpes?
 Passed on through genital contact, mostly through vaginal
and anal sex
 A person can have HPV even if years have passed since he or
she had sex.
 A pregnant woman with genital herpes may pass it on to her
baby during vaginal delivery.
 How does HPV cause
Genital Warts and Cancer?

 HPV can cause normal cells on infected skin or

mucous membranes to turn abnormal.
 In most cases the body fights off HPV naturally and
the infected cells then go back to normal.
 How to Prevent HPV

 Get vaccinated against HPV vaccine (females between

13-26 y.o.)
 Use of condoms (areas not covered by the condom can
get infected)
 The only sure way to avoid getting HPV is to avoid all
sexual activity.
 Chances of getting HPV are lowered by being in a
mutually faithful relationship with someone who has had
no or few sexual partners.
 There is currently no vaccine licensed to prevent HPV-
related disease in men.
 How to Prevent HPV-
Related Disease
 HPV vaccine
 Pap smear (screening tool)
 HPV DNA test
 No approved screening test to find early
penile or anal cancer
 Some experts recommend yearly anal Pap
tests for gay and bisexual men and HIV-
positive persons because cancer is more
common in these populations
Trichomoniasis

 Caused by the single-

celled protozoan
parasite Trichomonas
vaginalis
 The vagina is the most
common site of
infection in women,
and the urethra (urine
canal) in men.
 How do People Get
Trichomoniasis?
 Sexually transmitted through penis-to-
vagina intercourse or vulva-to-vulva (area
outside the vagina) contact with an
infected partner
 Women can acquire the disease from
infected men or women
 Men usually contract it only from infected
women
Signs and Symptoms:
Men
 Most do not have signs
and symptoms
 Temporary irritation in
the penis, mild
discharge, slight
burning after urination
or ejaculation
 Signs and Symptoms:
Women
 Frothy, yellow-green
vaginal discharge with a
strong odor
 Discomfort during
intercourse and urination
 Itching and irritation in the
genital area
 Lower abdominal pain
 Symptoms usually appear
within 5-28 days of
exposure
 Prevention of
Trichomoniasis
 Abstain from sexual contact
 Be in a long-term mutually monogamous relationship with a
partner who has been tested and known to be uninfected
 Proper use of male condoms
 Abstaining from sex until treatment has been completed
Bacterial Vaginosis

 The most common

vaginal infection of
women in the
childbearing age
 How do Women Get
Bacterial Vaginosis?
 The cause is not fully understood
 Associated with an imbalance in the
bacteria normally found the woman’s
vagina
 Normally there is more “good” bacteria
than “bad” bacteria
 An increase in “bad” bacteria leads to BV
 Activities that can Affect the
Normal Balance of Bacteria in
the Vagina:
 Having a new sex
partner
 Multiple partners
 Douching
 Signs and Symptoms of
BV:
 Abnormal vaginal discharge with an
unpleasant odor (strong fish-like odor
usually after intercourse)
 White or gray thin discharge
 Burning during urination
 Itching around the outside of the vagina
 Most women report no signs or symptoms at
all
 How Can BV be
Prevented?

 Be abstinent
 Limit the number of sexual partners
 Do not douche
 Use all of the medicine prescribed for the
treatment of BV, even if the signs and symptoms
go away
 STIs…

 Are the main preventable cause of

infertility, particularly in women
 If untreated, lead to pregnancy outcomes
associated with premature deliveries, low
birth weight, still birth or neonatal
death,neonatal blindness and spontaneous
abortion
 Increase the risk of both acquisition and
transmission of HIV by a factor of up to 10
 The End

THANK YOU
And
HAVE GOOD, SAFE SEX!!!