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Sexually Transmitted Diseases: Herpes, PID, BV, and HPV Dr. Nicholas Viyuoh, MD Board Certified OB/GYN Lock Haven Hospital Haven Health Care for Women Herpes What is it? Herpes is a viral infection caused by Herpes Simplex Virus. There are 2 types of Herpes: HSV 1 (oral), and HSV 2 (genital) Signs/Symptoms Burning/itching/tingling before an outbreak, then painful ulcers will break out. The first outbreak will typically occur 2 weeks after infection, and last from 2-4 weeks. Outbreaks can vary in severity and amount, but they typically decline as people age. Herpes How common is it? Herpes is one of the most common STDs. 1 in 4 women have genital herpes 1 in 5 men have genital herpes How is it transmitted? *statistics from the CDC* Sexual contact, whether a sexual partner is having an outbreak or not! Complications: HSV infection in pregnancy can result in transmission to fetus, which can be fatal (particularly if first outbreak during pregnancy) An infection with HSV can make you more susceptible to contracting HIV if exposed. Herpes Can herpes be treated? Unlike other STDs, Herpes cannot be cured, once infected, a person will never be free of the virus. Treatment is to limit the number and severity of outbreaks. Herpes outbreaks can be limited with antiviral drugs (Valtrex). Antiviral drugs can also help to prevent transmission to sexual partners Prevention: Abstinence is the only absolute prevention Condoms can help to reduce transmission, but are not 100% effective PID- Pelvic Inflammatory Disease What is it? What causes it? Pelvic Inflammatory Disease is an infection and inflammation of the uterus and/or fallopian tubes. Infection (untreated/undiagnosed) of Gonorrhea and/or Chlamydia, or other types of infection Signs/Symptoms Lower abdominal pain Painful intercourse Fever Discharge Burning with urination PID Complications? How many women get it? 1 million women/year 100,000 women become infertile each year from PID 150 women die each year from PID or complications of PID Treatment: Infertility due to damage/scarring of reproductive tracts Ectopic pregnancy: “tubal pregnancy” any pregnancy which implants outside the uterus, a life threatening condition for the mother! Treat underlying cause (Gonorrhea/Chlamydia/BV) Prevention: Do not douche Limit sexual partners Get annual STD screening, or screenings with new partners BV- Bacterial Vaginosis What is it? Signs/Symptoms Vaginal discharge with odor (usually fishy) Burning with urination, vaginal itching, pain Some women are asymptomatic What causes it? Overgrowth of bacteria in the vagina Multiple sexual partners, douching, etc How many women are affected? Up to 16% of women Most common in women of childbearing age BV- Bacterial Vaginosis How do you test for it? Treatment: BV can be treated effectively with antibiotics (orally or intravaginally) Complications: Vaginal culture during a pelvic exam Bacterial Vaginosis can make women more susceptible to other STDs as well as AIDS. It can also make women more susceptible to Pelvic Inflammatory Disease (PID). Prevention: Limit number of sexual partners Do not douche STDs and Pregnancy Center for Disease Control Estimates: STD Number of Women BV 800,000 Herpes 800,000 Chlamydia 200,000 Trichomoniasis 80,000 Gonorrhea 40,000 Hepatitis B 40,000 HIV 8,000 Syphilis 8,000 HPV-Human Papillomavirus What is it? A group of viruses that cause genital warts and cervical cancer. Numbers that cause cervical cancer include: 16, 18, 31, 33, 35, 39, 45, 51, 52, 58 HPV 16 is responsible for about 54% of cervical cancer cases HPV 18 is responsible for about 13% of cervical cancer cases Numbers that do not cause cervical cancer include: 6, 11, 40, 42, 43, 44, 54 Anogenital warts are associated with 6 and 11 HPV How common is it? 80% of people will have an HPV infection by age 50 In individuals 15-24 that are sexually active: 9.2 million people are affected HPV in the US-from American Cancer Society 9,710 new cases of cervical cancer1 3,700 deaths estimated in 20061 330,000 new cases of high-grade cervical dysplasia (CIN 2/3)2 CIN = cervical intraepithelial neoplasia. 1.4 million new cases of low-grade cervical dysplasia (CIN 1)2 1 million new cases of genital warts3 1. American Cancer Society. Cancer Facts and Figures 2006. Atlanta, Ga: American Cancer Society; 2006:4. 2. Schiffman M, Solomon D. Findings to date from the ASCUS-LSIL Triage Study (ALTS). Arch Pathol Lab Med. 2003;127:946–949. 3. Fleischer AB, Parrish CA, Glenn R, Feldman SR. Condylomata acuminata (genital warts):Patient demographics and treating physicians. Sex Transm Dis. 2001;28:643–647.