What is ceftriaxone injection. How does ceftriaxone work against STDs. What are the common side effects of ceftriaxone. When should ceftriaxone not be used. How is ceftriaxone administered for STD treatment. What precautions should be taken with ceftriaxone injection. How effective is ceftriaxone against various STDs.

Understanding Ceftriaxone: A Powerful Antibiotic for STD Treatment

Ceftriaxone is a potent antibiotic belonging to the cephalosporin class of drugs. It is widely used in the treatment of various bacterial infections, including sexually transmitted diseases (STDs). Ceftriaxone works by interfering with the cell wall synthesis of bacteria, ultimately leading to their destruction.

As a broad-spectrum antibiotic, ceftriaxone is effective against a wide range of both gram-positive and gram-negative bacteria. This makes it particularly valuable in treating STDs, which can be caused by various pathogens.

How does ceftriaxone work against STDs?

Ceftriaxone’s mechanism of action involves binding to penicillin-binding proteins (PBPs) in the bacterial cell wall. This binding inhibits the final stage of peptidoglycan synthesis, a crucial component of the bacterial cell wall. As a result, the cell wall becomes weakened and unstable, leading to bacterial cell lysis and death.

In the context of STDs, ceftriaxone is particularly effective against Neisseria gonorrhoeae, the bacterium responsible for gonorrhea. It is also used in combination therapy for other STDs, such as chlamydia and syphilis.

Administration and Dosage of Ceftriaxone for STD Treatment

Ceftriaxone is typically administered as an intramuscular injection for STD treatment. The dosage and duration of treatment may vary depending on the specific infection being treated and the patient’s individual circumstances.

What is the standard dosage for STD treatment?

For uncomplicated gonorrhea, the Centers for Disease Control and Prevention (CDC) recommends a single 500 mg intramuscular dose of ceftriaxone. In some cases, particularly for more severe infections or in areas with high antibiotic resistance, higher doses or longer treatment courses may be necessary.

It’s crucial to note that ceftriaxone should always be administered under the supervision of a healthcare professional. The injection site should be rotated for repeated doses to minimize discomfort and potential complications.

Efficacy of Ceftriaxone in Treating Various STDs

Ceftriaxone has demonstrated high efficacy in treating several STDs, particularly gonorrhea. Its broad-spectrum activity and ability to achieve high concentrations in tissues make it a valuable tool in combating these infections.

How effective is ceftriaxone against gonorrhea?

Ceftriaxone remains highly effective against Neisseria gonorrhoeae, with cure rates exceeding 95% in most studies. However, it’s important to note that antibiotic resistance is an ongoing concern, and some strains of gonorrhea have shown reduced susceptibility to ceftriaxone in recent years.

To combat this issue, ceftriaxone is often used in combination with other antibiotics, such as azithromycin, to ensure complete eradication of the infection and prevent the development of further resistance.

Can ceftriaxone treat other STDs?

While ceftriaxone is primarily used for gonorrhea treatment, it can also be effective against other STDs when used in combination therapy. For example, in cases of concurrent chlamydia infection, ceftriaxone may be administered alongside doxycycline or azithromycin.

In the treatment of syphilis, particularly in its early stages, ceftriaxone can be an alternative to penicillin for patients with penicillin allergies. However, penicillin remains the preferred treatment for syphilis in most cases.

Side Effects and Precautions Associated with Ceftriaxone Injection

Like all medications, ceftriaxone can cause side effects in some patients. While most side effects are mild and transient, it’s important to be aware of potential adverse reactions.

What are the common side effects of ceftriaxone?

Common side effects of ceftriaxone injection may include:

• Pain or discomfort at the injection site
• Diarrhea
• Nausea
• Vomiting
• Headache
• Dizziness
• Skin rash or itching

Most of these side effects are mild and resolve on their own. However, if they persist or worsen, it’s important to consult a healthcare provider.

Are there any serious side effects to be aware of?

While rare, some patients may experience more serious side effects, including:

• Severe allergic reactions (anaphylaxis)
• Severe skin reactions (e.g., Stevens-Johnson syndrome)
• Clostridium difficile-associated diarrhea
• Blood disorders (e.g., hemolytic anemia)
• Gallbladder problems

These serious side effects require immediate medical attention. Patients should be informed about the signs and symptoms of these reactions before receiving ceftriaxone treatment.

Contraindications and Drug Interactions with Ceftriaxone

While ceftriaxone is generally safe and well-tolerated, there are certain situations where its use may be contraindicated or require special precautions.

When should ceftriaxone not be used?

Ceftriaxone is contraindicated in patients with:

• Known hypersensitivity to ceftriaxone or other cephalosporin antibiotics
• History of severe penicillin allergy (due to potential cross-reactivity)
• Neonates with hyperbilirubinemia
• Premature infants or neonates receiving calcium-containing intravenous solutions

In these cases, alternative antibiotic treatments should be considered.

What drug interactions should be considered with ceftriaxone?

Ceftriaxone may interact with certain medications, potentially affecting their efficacy or increasing the risk of side effects. Some important drug interactions to consider include:

• Calcium-containing solutions (risk of precipitation)
• Oral anticoagulants (may increase anticoagulant effect)
• Probenecid (may increase ceftriaxone levels)
• Oral contraceptives (may reduce effectiveness)

Healthcare providers should review a patient’s complete medication list before prescribing ceftriaxone to avoid potential interactions.

The Importance of Proper Follow-up and Partner Treatment in STD Management

Successful treatment of STDs involves more than just administering antibiotics. Proper follow-up care and partner treatment are crucial components of comprehensive STD management.

Why is follow-up care important after ceftriaxone treatment?

Follow-up care after ceftriaxone treatment for STDs is essential for several reasons:

1. To ensure the infection has been successfully eradicated
2. To monitor for any potential side effects or complications
3. To address any ongoing symptoms or concerns
4. To provide additional counseling on safe sex practices and prevention
5. To perform retesting, if necessary, to rule out reinfection

Patients should be advised to return for follow-up as recommended by their healthcare provider, typically within 1-2 weeks after treatment.

How should partners be managed in STD treatment?

Partner management is a critical aspect of STD control and prevention. The following approaches are commonly used:

• Patient referral: The patient informs their sexual partners of the need for evaluation and treatment
• Provider referral: Healthcare providers directly notify the patient’s partners
• Expedited partner therapy (EPT): Providing treatment to partners without prior medical evaluation

EPT has shown to be effective in reducing reinfection rates and is legally permissible in many jurisdictions for certain STDs, such as chlamydia and gonorrhea.

Emerging Challenges: Antibiotic Resistance and the Future of STD Treatment

The emergence of antibiotic-resistant strains of STD-causing pathogens poses a significant challenge to public health. This is particularly concerning for gonorrhea, where resistance to multiple antibiotics has been observed.

How is antibiotic resistance affecting STD treatment?

Antibiotic resistance in STDs, especially gonorrhea, has led to changes in treatment recommendations over time. The current use of high-dose ceftriaxone, often in combination with azithromycin, is a response to increasing resistance patterns.

Researchers and public health officials are actively monitoring resistance trends and exploring new treatment options to ensure effective STD management in the future.

What strategies are being employed to combat antibiotic resistance in STDs?

Several strategies are being implemented to address the challenge of antibiotic resistance in STDs:

• Surveillance programs to monitor resistance patterns
• Development of new antibiotics and treatment regimens
• Implementation of antibiotic stewardship programs
• Enhanced prevention efforts, including vaccination research
• Improved diagnostic tools for rapid and accurate pathogen identification

These multifaceted approaches aim to preserve the effectiveness of current treatments while developing new strategies to combat resistant infections.

Prevention and Education: Key Components in STD Control

While effective treatments like ceftriaxone are crucial in managing STDs, prevention and education remain the cornerstones of STD control efforts.

What are the most effective STD prevention strategies?

Effective STD prevention strategies include:

• Consistent and correct use of barrier methods (e.g., condoms)
• Regular STD testing and screening
• Limiting the number of sexual partners
• Vaccination against preventable STDs (e.g., HPV, hepatitis B)
• Pre-exposure prophylaxis (PrEP) for HIV prevention in high-risk individuals

Combining these strategies can significantly reduce the risk of acquiring and transmitting STDs.

How can healthcare providers improve STD education and awareness?

Healthcare providers play a crucial role in STD education and awareness. They can:

1. Provide comprehensive sexual health education during routine visits
2. Offer non-judgmental counseling on safe sex practices
3. Encourage open communication about sexual health concerns
4. Promote regular STD screening for sexually active individuals
5. Collaborate with community organizations to expand outreach and education efforts

By prioritizing prevention and education alongside effective treatments like ceftriaxone, healthcare providers can contribute significantly to reducing the burden of STDs in their communities.

In conclusion, ceftriaxone injection remains a vital tool in the treatment of STDs, particularly gonorrhea. Its effectiveness, combined with proper follow-up care, partner management, and comprehensive prevention strategies, forms the foundation of successful STD control. As we face challenges like antibiotic resistance, ongoing research and vigilance will be crucial in maintaining our ability to combat these infections effectively.

Chlamydia Treatment and Prevention | Everyday Health

If you are diagnosed with chlamydia, you will need to tell all of your sexual partners, because they will need the same treatment you are receiving.

In most states, a doctor or other healthcare provider can give you the medicine that your partner or partners will need to take. Then you can deliver it to those partners. This practice is called “expedited partner therapy” or “patient delivered partner therapy.”

These options can help a lot if your partner doesn’t have a healthcare provider or feels embarrassed about seeking care, says Dr. Dombrowski.

It’s natural to feel nervous or upset about having to tell your partner or partners about having an STD. Your healthcare provider can help with this problem. “They may even rehearse the conversation with you,” says Dombrowksi.

Learning about chlamydia and seeking advice from a healthcare provider about how to discuss it with your partner(s) can help you handle the conversation(s) with less anxiety and more confidence.

Remember, chlamydia is not just common: It is the most common infection reported to the Centers for Disease Control and Prevention (CDC). You are being helpful, mature, and responsible by telling your partners.

Put Sex on Hold During and After Chlamydia Treatment

If you were given a single dose of antibiotics to treat your chlamydia, you should not have any kind of sex for a full seven days after the day you took the medicine. If you’re taking antibiotics for a week, wait another seven days after the last day of your treatment. Be sure to take all of the medicine that is prescribed for you.

Not having sex for seven days after treatment is important so you don’t spread the infection to your partner or partners.

Medication stops the infection and can keep you from spreading the disease, but it won’t cure any permanent damage that the infection caused before you started treatment. In women, such damage can include blocking the fallopian tubes, causing infertility.

If you still have symptoms for more than a few days after you stop taking your medicine, go back to see your doctor or other healthcare provider so they can check you again.

Get Retested Following Treatment

Many people have more than one chlamydia infection. If you’re a girl or woman and your sex partners are not treated for the infection, you will be at high risk for reinfection. Repeated infections with chlamydia make it much more likely that your ability to have children will be affected. Repeated infections also raise your risk of painful complications, such as pelvic inflammatory disease.

Both women and men with chlamydia should be retested about three months after they are first diagnosed and treated. Go to be retested even if you think your sex partners were successfully treated.

Syphillis: What It Is and How It’s Treated

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 1999 Apr 15;59(8):2245-2246.

 
See related article on syphilis.

What is syphilis?

Syphilis (say: siff-uh-liss) is a serious infection. It’s passed from one person to another during sex. It’s caused by a bacteria (germ). You could get syphilis by touching the blood or sores of a person who has syphilis, especially sores on the person’s mouth, penis, vagina or anus (the opening to the rectum).

What are the signs of syphilis?

In men, the first sign of syphilis may be a sore on the penis. In women, the first sign may be a sore around or inside the vagina. You might not even notice the sore, because syphilis sores don’t hurt. The sores go away after three to six weeks.

If you don’t treat syphilis early, it spreads from the sore into your blood. When syphilis gets into your blood, it can cause many problems. The most common sign is a rash. The rash may show up, often on the palms of the hands or the soles of the feet, from two weeks to two months after the sore appeared. Other signs of syphilis include fever, sore throat and swollen lymph glands.

After many years, people with syphilis who don’t get treatment may begin to have problems in their brain and spinal cord. Syphilis may damage the heart and other organs, too.

Some people with syphilis don’t have any signs of infection. In other people, the signs may be very mild. They might not even know they have it. But even if the signs of infection go away on their own, the germs are still alive. They can cause serious health problems many years later.

How does my doctor know I have syphilis?

Blood tests can find out for sure. Sometimes other tests can show how far the syphilis has spread. For example, your doctor may want to look at your spinal fluid. This is a way to see if the syphilis germs have spread to your nervous system.

How did I get syphilis?

Syphilis is almost always passed through sex. It also can be passed from an infected mother to her baby during pregnancy.

Syphilis can sometimes be avoided through safer sex—using condoms, and using “dental dams” during oral sex. Syphilis sores have to be covered up with a bandage to keep the infection from spreading.

Should I tell my sex partner I have syphilis?

Yes. Then your partner can find out if he or she also has syphilis. If you’re not comfortable telling your sex partner, your doctor can help you. In some places, the local health department can tell sex partners that they may have syphilis and should get a test. If you wish, your name can be kept secret.

What is the treatment for syphilis?

Syphilis can be treated with penicillin. The penicillin is given as a shot. If you had syphilis for less than one year, you only need to get one shot. If you had syphilis for more than one year, you need three shots—one shot a week for three weeks. If you’re allergic to penicillin, be sure to tell your doctor.

If you have an advanced case of syphilis, you may need stronger treatment. You may get shots of penicillin every day for 10 days. This can be done in the doctor’s office or at a clinic. A few people have to go to the hospital to get penicillin put into their veins.

If you’re pregnant, it’s very important to get treated right away. Syphilis can hurt your unborn baby.

How will I know my syphilis has been cured?

After your treatment, your doctor will ask you to come back several times for blood tests. These tests will show if the medicine killed the syphilis germ.

What is the connection between syphilis, HIV and AIDS?

Syphilis can be passed from one person to another during sex. If you got syphilis, you could also have gotten HIV or another sexually transmitted disease, such as chlamydia or gonorrhea. If you have a syphilis sore, it’s easier for HIV infection to get into your body through the sore. If you have syphilis, you should be tested for HIV, chlamydia and gonorrhea.

A simple exam and some lab tests can show if you have these infections. If you have HIV and syphilis, make sure your doctor knows about the HIV, so you can get the right treatment and continued care.

Where can I get more information?

For more information about syphilis, call your local health department (look in the Yellow Pages) or call the National STD Hotline at 1-800-227-8922.

Chlamydia – Treatment – NHS

Chlamydia can usually be effectively treated with antibiotics. More than 95% of people will be cured if they take their antibiotics correctly.

You may be started on antibiotics once test results have confirmed you have chlamydia. But if it’s very likely you have the infection, you might be started on treatment before you get your results.

The two most commonly prescribed antibiotics for chlamydia are: 

Your doctor may give you different antibiotics, such as amoxicillin or erythromycin, if you have an allergy or are pregnant or breastfeeding. A longer course of antibiotics may be used if your doctor is concerned about complications of chlamydia.

Some people experience side effects during treatment, but these are usually mild. The most common side effects include stomach ache, diarrhoea, feeling sick, and thrush in women.

When can I have sex again?

If you had doxycycline, you shouldn’t have sex – including vaginal, oral or anal sex, even with a condom – until both you and your partner(s) have completed treatment.

If you had azithromycin, you should wait 7 days after treatment before having sex (including oral sex).

This will help ensure you don’t pass on the infection or catch it again straight away.

Will I need to go back to the clinic?

If you take your antibiotics correctly, you may not need to return to the clinic.

However, you will be advised to go back for another chlamydia test if:

• you had sex before you and your partner finished treatment
• you forgot to take your medication or didn’t take it properly
• your symptoms don’t go away
• you’re pregnant

If you’re under 25 years of age, you should be offered a repeat test for chlamydia 3 to 6 months after finishing your treatment because you’re at a higher risk of catching it again.

Testing and treating sexual partners

If you test positive for chlamydia, it’s important that your current sexual partner and any other recent sexual partners you’ve had are also tested and treated.

A specialist sexual health adviser can help you contact your recent sexual partners, or the clinic can contact them for you if you prefer.

Either you or someone from the clinic can speak to them, or the clinic can send them a note to let them know they may have been exposed to a sexually transmitted infection (STI).

The note will suggest that they go for a check-up. It will not have your name on it, so your confidentiality will be protected.

Page last reviewed: 01 September 2021
Next review due: 01 September 2024

Gonorrhea – Diagnosis and treatment

Diagnosis

To determine whether you have gonorrhea, your doctor will analyze a sample of cells. Samples can be collected by:

• Urine test. This can help identify bacteria in your urethra.
• Swab of affected area. A swab of your throat, urethra, vagina or rectum can collect bacteria that can be identified in a lab.

For women, home test kits are available for gonorrhea. They include vaginal swabs for self-testing that are sent to a specified lab for testing. You can choose to be notified by email or text message when your results are ready. You can view your results online or receive them by calling a toll-free hotline.

Testing for other sexually transmitted infections

Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea.

Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well.

Treatment

Gonorrhea treatment in adults

Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated with the antibiotic ceftriaxone — given as an injection — with oral azithromycin (Zithromax).

If you’re allergic to cephalosporin antibiotics, such as ceftriaxone, you might be given oral gemifloxacin (Factive) or injectable gentamicin and oral azithromycin.

Gonorrhea treatment for partners

Your partner also should go through testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you’ve been treated for gonorrhea, a partner who isn’t treated can pass it to you again.

Gonorrhea treatment for babies

Babies born to mothers with gonorrhea who develop the infection can be treated with antibiotics.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

You’ll likely see your family doctor or a general practitioner. Here’s some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there’s anything you need to do in advance, such as restrict your diet.

Make a list of:

• Your symptoms, if you have any, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began
• All medications, vitamins or other supplements you take, including doses
• Questions to ask your doctor

For gonorrhea, questions to ask your doctor include:

• What tests do I need?
• Should I be tested for other sexually transmitted infections?
• Should my partner be tested for gonorrhea?
• How long should I wait before resuming sexual activity?
• How can I prevent gonorrhea in the future?
• What gonorrhea complications should I be alert for?
• Are there brochures or other printed material that I can have? What websites do you recommend?
• Will I need a follow-up visit?

Don’t hesitate to ask other questions.

What to expect from your doctor

Questions your doctor is likely to ask you include:

• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• Have you been exposed to sexually transmitted infections?

What you can do in the meantime

Abstain from sex until you see your doctor. Alert your sex partners that you’re having signs and symptoms so that they can arrange to see their doctors for testing.

Oct. 05, 2021

Where Can I Get Treated For Gonorrhea?

Gonorrhea can be easily cured with antibiotics. Your sexual partners need to be treated, too. If you don’t treat gonorrhea, it can lead to serious health problems.

What’s the treatment for gonorrhea?

Gonorrhea is usually super easy to get rid of. Your nurse or doctor will prescribe antibiotics to treat the infection. Some strains of gonorrhea resist the antibiotics and are hard to treat, so your doctor may give you two antibiotics, in shot and pill form. Sometimes you only have to take one pill. Other gonorrhea pill treatments are taken for 7 days. Your doctor will help you figure out which treatment is best for you.

If you’re treated for gonorrhea, it’s really important for your sexual partners to get treated also. Otherwise, you may pass the infection back and forth, or to other people. Sometimes your doctor will give you medicine for both you and your partner.

What do I need to know if I get treated for gonorrhea?

If you’re getting treated for gonorrhea:

• Take all of your medicine the way your doctor tells you to, even if your symptoms go away sooner. The infection stays in your body until you totally finish the antibiotics.

• Your partner(s) should also get treated for gonorrhea so you don’t re-infect each other or anyone else.

• Don’t have sex for 7 days. If you only have 1 dose of medication, wait until a week after you take it to have sex. If you’re taking medicine for 7 days, don’t have sex until you’ve finished all of your pills.

• Get tested again in 3 months to make sure your infection is gone.

• Don’t share your medicine with anyone. Your doctor may give you a separate dose of antibiotics for your partner. Make sure you both take all of the medicine you get.

• If you still have symptoms after you finish your treatment, call your doctor.

• Even if you finish your treatment and the gonorrhea is totally gone, it’s possible to get infected with gonorrhea again. Gonorrhea isn’t a one-time-only deal. So use condoms and get tested regularly.

What happens if you don’t get treated for gonorrhea?

Even though gonorrhea is common and doesn’t always cause symptoms, it can become a big deal if it’s not treated.

Gonorrhea can spread to your uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID might not have any symptoms at first, but it can cause permanent damage that may lead to chronic pain, infertility, or ectopic pregnancy. Getting tested for gonorrhea really lowers your chances of getting PID.

If you have a penis, an untreated gonorrhea infection can spread to your epididymis (a tube that carries sperm from your testicles), and can cause pain in your testicles. Rarely, it can make you infertile.

Having gonorrhea also increases your chances of getting or spreading HIV, the virus that causes AIDS. Rarely, untreated gonorrhea may spread to your blood, skin, heart, or joints and lead to serious health problems, or even death.

If you have gonorrhea while you’re pregnant and don’t treat it, it can be passed to your baby when you’re giving birth. This can lead to problems for the baby, including blindness, joint infections, or blood infections which can be deadly.

The best way to avoid all these problems? Get tested and treated early.

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Gonorrhea Evades Antibiotics, Leaving Only One Drug To Treat Disease : Shots

Health officials say they’re worried that one day there will be no more antibiotics left to treat gonorrhea.

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Health officials say they’re worried that one day there will be no more antibiotics left to treat gonorrhea.

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There’s some disturbing news out today about a disease we don’t hear about much these days: gonorrhea. Federal health officials announced that the sexually transmitted infection is getting dangerously close to being untreatable.

As a result, the federal Centers for Disease Control and Prevention issued new guidelines for how doctors should treat gonorrhea. The guidelines are designed to keep one of the remaining effective antibiotics useful for as long as possible by restricting the use of the other drug that works against the disease.

“We are sounding the alarm,” said Gail Bolan, who heads the CDC’s division of STD prevention.

Gonorrhea has been plaguing humanity for centuries. But ever since penicillin came along a dose of antibiotics would usually take care of the disease.

“Gonorrhea used to be susceptible to penicillin, ampicillin, tetracycline and doxycycline — very commonly used drugs,” said Jonathan Zenilman, who studies infectious diseases at Johns Hopkins.

But one by one, each of those antibiotics — and almost every new one that has come along since — eventually stopped working. One reason is that the bacterium that causes gonorrhea can mutate quickly to defend itself, Zenilman said.

“If this was a person, this person would be incredibly creative,” he said. “The bug has an incredible ability to adapt and just develop new mechanisms of resisting the impact of these drugs.”

Another reason is that antibiotics are used way too frequently, giving gonorrhea and many other nasty germs too many chances to learn how to survive.

“A lot of this is occurring not because of treatment for gonorrhea but overuse for other infections, such as urinary tract infections, upper respiratory tract infections and so forth,” Zenilman said.

It got to the point recently where doctors had only two antibiotics left that still worked well against gonorrhea — cefixime and ceftriaxone.

But on Thursday, federal health officials announced that one of their worst fears had come true: Evidence had emerged that gonorrhea had started to become resistant to cefixime in the United States.

“We’re basically down to one drug, you know, as the most effective treatment for gonorrhea,” Bolan said.

Cefixime and ceftriaxone are in the same class of antibiotics. That means it’s only a matter of time before ceftriaxon goes, too, she says.

“The big worry is that we potentially could have untreatable gonorrhea in the United States,” Bolan said.

That’s already happened in other countries. Totally untreatable gonorrhea is popping up in Asia and Europe.

So the CDC declared that doctors should immediately stop using the cefixime.

“We feel we need to a take a critical step to preserve the last remaining drug we know is effective to treat gonorrhea,” Bolan said.

About 700,000 Americans get gonorrhea every year. If untreated, gonorrhea can cause serious complications, including infertility and life-threatening ectopic pregnancies.

“I think it should be a real clarion call to every American that we’ve got a looming public health crisis on our hands and potentially hundreds of thousands of cases of untreatable gonorrhea in this country every year,” said William Smith, who heads the National Coalition of STD Directors.

Officials know adopting the new guidelines won’t be easy. For one thing, ceftriaxone is an intra-muscular shot instead of a pill. And they want doctors to give it along with at least one other antibiotic and test patients to make sure they’re cured.

But they know that all this will help only for a while, and that they can’t stop the clock from ticking on the one drug left.

“We think it’s only a matter of time based on the history of this organism until resistance does develop,” Bolan said.

So scientists are searching for new combinations of antibiotics that might work. And officials are pushing for new weapons that might stay one step ahead of gonorrhea and the growing list of antibiotic-resistant infections.

Gonorrhea | Michigan Medicine

Topic Overview

What is gonorrhea?

Gonorrhea is an infection spread through sexual contact. In men, it most often infects the urethra. In women, it usually infects the urethra, cervix, or both. It also can infect the rectum, anus, throat, and pelvic organs. In rare cases, it can infect the eyes.

Gonorrhea does not cause problems if you treat it right away. But if it’s left untreated, it can lead to serious problems.

For a woman, untreated gonorrhea can move into the uterus, fallopian tubes, and ovaries. This can cause painful scar tissue and inflammation, known as pelvic inflammatory disease (PID). PID can cause infertility or ectopic pregnancy.

Sometimes gonorrhea is called the clap, drip, or GC.

What causes gonorrhea?

A certain kind of bacteria causes gonorrhea. Gonorrhea is a sexually transmitted infection, or STI. This means it can spread from one partner to another during vaginal, anal, or oral sex.

A woman who is pregnant can pass the infection to her newborn during delivery.

What are the symptoms?

Many people have no symptoms, so they can pass gonorrhea to their sex partners without knowing it.

If there are symptoms, they may include:

• Pain when you urinate.
• Abnormal discharge from the penis or vagina.

Gonorrhea infection in the throat may cause a sore throat, but it usually does not cause symptoms.

Symptoms in men usually are easier to notice than symptoms in women. But some men have mild or no symptoms.

In women, the early symptoms may be so mild that they are mistaken for a bladder infection or a vaginal infection. When an untreated infection moves into a woman’s pelvic organs, symptoms can include lower belly pain, pain during sex, vaginal bleeding, and a fever.

The time from exposure to gonorrhea until symptoms begin usually is 2 to 5 days. But it may take as long as 30 days before symptoms start.

You can spread gonorrhea even if you don’t have symptoms. You are contagious until you have been treated.

How is gonorrhea diagnosed?

Your doctor will ask you questions about your past health and your sexual history, such as how many partners you have. Your doctor may also do a physical exam to look for signs of infection.

Urine or fluid from the infected area will be tested for gonorrhea. You may also be tested for other sexually transmitted infections (STIs) at the same time. Testing can be done with a Pap test.

As soon as you find out you have gonorrhea, be sure to let your sex partners know. Experts recommend that you notify everyone you’ve had sex with in the past 60 days. If you have not had sex in the past 60 days, contact the last person you had sex with.

How is it treated?

Antibiotics are used to treat gonorrhea. It’s important to take all of the medicine as directed. Otherwise the medicine may not work. Both sex partners need treatment to keep from passing the infection back and forth.

Getting treatment as soon as possible helps prevent the spread of the infection and lowers your risk for other problems, such as pelvic inflammatory disease.

Many people who have gonorrhea also have chlamydia, another STI. If you have gonorrhea and chlamydia, you will get medicine that treats both infections.

Avoid all sexual contact while you are being treated for an STI. If your treatment is a single dose of medicine, you should not have any sexual contact for 7 days after treatment so the medicine will have time to work.

Having a gonorrhea infection that was cured does not protect you from getting it again. If you are treated and your sex partner is not, you probably will get it again.

Finding out that you have an STI may make you feel bad about yourself or about sex. Counseling or a support group may help you feel better.

How can you prevent gonorrhea?

It’s easier to prevent an STI like gonorrhea than it is to treat it.

• Use a condom every time you have sex. Latex and polyurethane condoms keep out the viruses and bacteria that cause STIs.
• Don’t have more than one sex partner at a time. The safest sex is with one partner who has sex only with you. Every time you add a new sex partner, you are being exposed to all of the diseases that all of that person’s partners may have.
• Be responsible. Don’t have sex if you have symptoms of an infection or if you are being treated for an STI.
• Wait to have sex with a new partner until both of you have been tested for STIs.

Cause

Gonorrhea is caused by the bacteria Neisseria gonorrhoeae.

Gonorrhea is spread during vaginal, anal, or oral sex with an infected partner. A pregnant woman may pass the infection to her newborn during delivery.

Gonorrhea can be transmitted at any time by a person who is infected with the bacteria Neisseria gonorrhoeae, whether or not symptoms are present. A person who is infected with gonorrhea is always contagious until he or she has been treated.

Having a gonorrhea infection once does not protect you from getting another infection in the future. A new exposure to gonorrhea will cause reinfection, even if you were previously treated and cured.

Symptoms

It is fairly common for gonorrhea to cause no symptoms, especially in women. The incubation period, the time from exposure to the bacteria until symptoms develop, is usually 2 to 5 days. But sometimes symptoms may not develop for up to 30 days.

Gonorrhea may not cause symptoms until the infection has spread to other areas of the body.

Symptoms in women

In women, the early symptoms are sometimes so mild that they are mistaken for a bladder infection or vaginal infection. Symptoms may include:

• Painful or frequent urination.
• Anal itching, discomfort, bleeding, or discharge.
• Abnormal vaginal discharge.
• Abnormal vaginal bleeding during or after sex or between periods.
• Genital itching.
• Irregular menstrual bleeding.
• Lower abdominal (belly) pain.
• Fever and general tiredness.
• Swollen and painful glands at the opening of the vagina (Bartholin glands).
• Painful sexual intercourse.
• Sore throat (rare).
• Pinkeye (conjunctivitis) (rare).

Symptoms in men

In men, symptoms are usually obvious enough that they will cause a man to seek medical treatment before complications occur. But some men have mild or no symptoms and can unknowingly transmit gonorrhea infections to their sex partners. Symptoms may include:

• Abnormal discharge from the penis (clear or milky at first, and then yellow, creamy, and excessive, sometimes blood-tinged).
• Painful or frequent urination or urethritis.
• Anal itching, discomfort, bleeding, or discharge.
• Sore throat (rare).
• Pinkeye (conjunctivitis) (rare).

Other Symptoms

Disseminated gonococcal infection (DGI) occurs when the gonorrhea infection spreads to sites other than the genitals, such as the joints, skin, heart, or blood. Symptoms of DGI include:

• Rash.
• Joint pain or arthritis.
• Inflamed tendons.

What Happens

Gonorrhea causes no long-term problems if it is treated early in the course of the infection before any complications develop. Left untreated, gonorrhea can lead to serious complications.

Complications in women

Women with untreated gonorrhea may have the following complications of the female reproductive system:

• Pelvic inflammatory disease (PID). The risk of infertility increases with each episode of PID.
• An abscess in or near the ovaries (tubo-ovarian abscess)
• Inflammation of the Bartholin glands
• An ectopic (tubal) pregnancy
• Chronic pelvic pain
• Infertility
• Fitz-Hugh–Curtis syndrome (rare)

Complications in pregnant women

Problems related to untreated gonorrhea in pregnant women include:

• The possibility of a miscarriage.
• Preterm labor. The woman may be given medicines to prevent premature birth, which could require a stay in the hospital.
• Premature rupture of the membranes (PROM), which happens before labor contractions start. The amniotic sac breaks open, causing amniotic fluid to gush out, or less commonly, to slowly leak.
• Premature delivery. A premature infant has an increased risk of health problems.
• Infection of the lining of the uterus (endometritis).

If a woman has gonorrhea when she gives birth, her newborn can be infected.

Women with untreated gonorrhea and infected newborns are more likely to develop long-term complications of gonorrhea.

Complications in newborns

Newborns of women with untreated gonorrhea may have any of the following complications:

• Pinkeye (conjunctivitis). Most newborns who have gonorrhea also get pinkeye.
• An infection in the bloodstream (sepsis)
• Inflammation of a joint (arthritis)
• Scalp infections at the site of a fetal monitoring device
• Infection of the fluid and tissues that surround the brain and spinal cord (meningitis)

Complications in men

Men with untreated gonorrhea may develop:

• Epididymitis, an inflammation and infection of the epididymis—the long, tightly coiled tube that lies behind each testicle and collects sperm.
• An inflammation of the prostate gland (prostatitis).

Complications of untreated gonorrhea in other areas of the body

Disseminated gonococcal infection (DGI) occurs when the gonorrhea infection spreads to sites other than the genitals, such as the joints, skin, heart, or blood. Complications of DGI include:

• Fever.
• Skin infection (cellulitis).
• An infection in the bloodstream (sepsis).
• Inflammation of a joint (arthritis). It most often affects the knees and hands.
• An infection and inflammation of the heart valves and the chambers of the heart (endocarditis).
• An infection of the fluid and tissues that surround the brain and spinal cord (meningitis).

Because many women do not have early symptoms of gonorrhea that cause them to seek treatment, they are more likely than men to have more serious complications from gonorrhea spreading to other parts of the body.

Having a gonorrhea infection once does not protect you from getting another infection in the future. A new exposure to gonorrhea will cause reinfection, even if you were previously treated and cured.

What Increases Your Risk

Risk factors for getting gonorrhea include:

• Having multiple sex partners (more than one sex partner in the past year).
• Having a high-risk partner (partner has other sex partners, unprotected sex, or gonorrhea-infected sex partners).
• Having unprotected sexual contact (not using condoms).

Any child with gonorrhea needs to be evaluated by a doctor to find out the cause and to assess for possible sexual abuse.

When should you call your doctor?

Gonorrhea causes no long-term problems if it is treated early in the course of the infection before any complications develop. Untreated gonorrhea can lead to many complications.

In women:

Call your doctor immediately if you have the following symptoms.

• Sudden, severe pain in the lower belly
• Lower belly pain with vaginal bleeding or discharge and a fever of 100°F (38°C) or higher
• Urinary burning, frequent urination, or inability to urinate and a fever of 100°F (38°C) or higher

Call your doctor to find out when an evaluation is needed if you have the following symptoms.

• Vaginal discharge that has become yellowish, thicker, or bad-smelling
• Bleeding between periods that occurs more than once when periods are usually regular
• Pain during sexual intercourse
• Bleeding after sexual intercourse
• Sores, bumps, rashes, blisters, or warts on or around the genital or anal area
• Anal itching, discomfort, bleeding, or discharge.
• Burning, pain, or itching with urination or frequent urination lasting longer than 24 hours
• Pelvic or lower belly pain that occurs without a known cause, such as diarrhea or menstrual cramps
• Pinkeye (conjunctivitis)

Call your doctor or clinic if you have unprotected sex with someone who has, or who you think may have, a sexually transmitted infection.

In men:

Call your doctor immediately if you have the following symptoms.

• Discharge from the penis and a fever of 100°F (38°C) or higher
• Urinary burning, frequent urination, or inability to urinate and a fever of 100°F (38°C) or higher
• Pain, swelling, or tenderness in the scrotum and a fever of 100°F (38°C) or higher

Call your doctor to find out when an evaluation is needed if you have the following symptoms.

• Sores, bumps, rashes, blisters, or warts on or around the genital or anal areas
• Burning, pain, or itching with urination or frequent urination lasting longer than 24 hours
• Suspected exposure to a sexually transmitted infection
• Abnormal discharge from the penis
• Pinkeye (conjunctivitis)
• Anal itching, discomfort, bleeding, or discharge.

Call your doctor or clinic if you have unprotected sex with someone who has, or who you think may have, a sexually transmitted infection.

Watchful waiting

Watchful waiting is a period of time during which you and your doctor observe your symptoms or condition without using medical treatment. Watchful waiting is not appropriate for a gonorrhea infection. Gonorrhea causes no long-term problems if it is treated early in the course of the infection before any complications develop. But untreated gonorrhea can lead to many complications. Avoid sexual contact until you have been examined by your doctor so that you will not infect someone else.

If you know you have been exposed to gonorrhea, both you and your sex partner(s) must be treated. You need treatment even if you don’t have symptoms.

As soon as you find out you have gonorrhea, be sure to let your sex partners know. Experts recommend that you notify everyone you’ve had sex with in the past 60 days. If you have not had sex in the past 60 days, contact the last person you had sex with.

If you are unable to contact your sex partners or you are uncomfortable doing so, health departments and sexually transmitted infection (STI) clinics can help with this process.

Who to see

Health professionals who can diagnose and treat gonorrhea include:

Low-cost diagnosis and treatment of gonorrhea is usually available at local health departments and family planning clinics, such as Planned Parenthood.

Some people are not comfortable seeing their usual doctor for sexually transmitted infection treatment. Most counties have confidential clinics for diagnosing and treating gonorrhea and other sexually transmitted infections.

Exams and Tests

Diagnosis of gonorrhea includes a medical history and a physical exam. Your doctor may ask you the following questions.

• Do you think you have been exposed to any sexually transmitted infections (STIs)? How do you know? Did your partner tell you?
• What are your symptoms?
  • Do you have any discharge? If you have discharge from your vagina or penis, it is important to note any smell or color.
  • Do you have sores in your genital area or anywhere else on your body?
  • Do you have any urinary symptoms, including frequent urination, burning or stinging with urination, or urinating in small amounts?
  • Do you have any unusual belly or pelvic pain?
• What method of birth control do you use? Do you use a condom to protect against STIs every time you have sex?
• Do you or your partner engage in certain sexual behaviors that may put you at risk, such as having multiple sex partners or having sex without using a condom (except if you’re in a long-term relationship)?
• Have you had an STI in the past? How was it treated?

Your doctor will ask you questions about your medical history. Then:

Several gonorrhea tests can be used to detect or confirm an infection. Your doctor will collect a sample of body fluid or urine to be tested for gonorrhea bacteria ( Neisseria gonorrhoeae). Most tests give results within a few days.

Other sexually transmitted infections may be present with a gonorrhea infection. Your doctor may recommend testing for:

• Chlamydia, a bacterial infection of the urethra in men, and the urethra, the cervix, or the upper reproductive organs (or all three) in women.
• Syphilis, a bacterial infection in which the most common symptom is a painless sore called a chancre (say “SHANK-er”) that develops on the genitals.
• Hepatitis B, a viral infection that causes the liver to become swollen and tender (inflamed).
• Human immunodeficiency virus (HIV), a virus that attacks the immune system, making it difficult for the body to fight off infection and some diseases.

In the United States, your doctor must report to the state health department that you have gonorrhea.

Early detection

The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend gonorrhea screening for all sexually active women ages 24 and younger. The CDC and USPSTF also recommend screening for women older than 24 who have risk factors for gonorrhea.^{footnote 1, footnote 2}

You may want to consider being tested once a year for gonorrhea even though you don’t have symptoms if you have increased risks for STIs. These include having multiple sex partners or having sex without using a condom (except if you’re in a long-term relationship). Testing will allow gonorrhea to be quickly diagnosed and treated. This helps reduce the risk of transmitting gonorrhea and avoid complications of the infection.

The CDC also recommends screening for pregnant women who engage in high-risk sexual behaviors to prevent them from transmitting gonorrhea to their babies. If a pregnant woman is at high risk for gonorrhea, she may be tested again during the third trimester before delivery, to prevent transmitting the infection to her newborn.^{footnote 2}

Treatment Overview

Gonorrhea causes no long-term problems if it is treated early in the course of the infection before any complications develop. Untreated gonorrhea can lead to many complications.

Initial treatment

Gonorrhea is treated with antibiotics. Treatment is recommended for:

• A person who has a positive gonorrhea test.
• Anyone who has had sexual contact in the past 60 days with a person diagnosed with gonorrhea, whether or not they have symptoms or used condoms.
• A newborn whose mother has gonorrhea at the time of delivery.

If you are prescribed more than one dose of an antibiotic, be sure to take your antibiotic exactly as directed. If you miss doses or don’t take the full course of medicine, the gonorrhea infection may not be cured.

Do not have sexual contact with anyone:

• While you are being treated.
• Until both you and your partner(s) have been tested and treated. If you are treated for gonorrhea and your sex partner is not, you will probably become infected again.

If your treatment is a single dose of antibiotic, wait at least 7 days after taking the dose before having any sexual contact.

Always use a condom when you have sex. This helps protect you from sexually transmitted infections.

Treatment if the condition does not get better

Symptoms that do not go away after treatment may be caused by another gonorrhea infection or treatment failure.

Certain strains of the gonorrhea bacteria have become resistant to some antibiotics and sulfa drugs. When bacteria become resistant to an antibiotic, they no longer can be killed by that medicine.

If you have been treated for gonorrhea and don’t get better, you may be retested with a gonorrhea culture to see if there is bacterial resistance to the antibiotic you were taking. If there is bacterial resistance, you will need another antibiotic to cure the infection.

What to think about

To prevent reinfection, don’t have sex until any partner that might be infected is tested and treated.

Some people who have gonorrhea also have chlamydia. The U.S. Centers for Disease Control and Prevention (CDC) recommends that drug treatment for gonorrhea also include antibiotics that are effective in treating chlamydia. For more information, see the topic Chlamydia.

Pelvic inflammatory disease (PID) is a serious complication of gonorrhea that can lead to infertility, chronic pelvic pain, and ectopic pregnancy. To prevent PID, prompt treatment of gonorrhea is important. For more information, see the topic Pelvic Inflammatory Disease (PID).

Disseminated gonococcal infection (DGI) occurs when the gonorrhea infection spreads to sites other than the genitals, such as the joints, skin, heart, or blood. Treatment of DGI usually requires hospitalization and antibiotic treatment given intravenously (IV) or into a muscle (intramuscularly, IM).

In the United States, your doctor must report to the state health department that you have gonorrhea.

Prevention

You can take measures to reduce your risk of becoming infected with gonorrhea or another sexually transmitted infection (STI). You can also reduce the risk of transmitting gonorrhea to your sex partner(s).

Practice safer sex

Preventing a sexually transmitted infection (STI) is easier than treating an infection after it occurs.

• Talk with your partner about STIs before beginning a sexual relationship. Find out whether he or she is at risk for an STI. Remember that it is quite possible to be infected with an STI without knowing it. Some STIs, such as HIV, can take up to 6 months before they can be detected in the blood.
• Be responsible.
  • Avoid sexual contact if you have symptoms of an STI or are being treated for an STI.
  • Avoid sexual contact with anyone who has symptoms of an STI or who may have been exposed to an STI.
• Don’t have more than one sexual relationship at a time. Your risk for an STI increases if you have several sex partners at the same time.

If you or your partner have had several sex partners within the past year, or you are a man who has unprotected sex with men, talk to your doctor about screening for gonorrhea and other STIs even if you don’t have symptoms.

Condom use

Condom use reduces the risk of becoming infected with an STI, especially gonorrhea, chlamydia, and HIV. Condoms must be in place before beginning any sexual contact. Use condoms with a new partner every time you have sex, until you know from test results that he or she does not have an STI. You can use either male or female condoms.

Even if you are using another birth control method to prevent pregnancy, you can use condoms to reduce your risk of getting an STI. Female condoms are available for women whose male partners do not have or will not use a male condom.

Home Treatment

There is no home treatment for gonorrhea. It requires medicine prescribed by a doctor.

Prescription antibiotic medicine normally cures gonorrhea infections. Gonorrhea does not cause long-term problems if it is treated before any complications develop. But gonorrhea can lead to many complications if it is not treated.

If you have been diagnosed with gonorrhea:

• Take the full course of antibiotics as prescribed by your doctor. If you skip doses or do not complete the treatment, the infection may not be cured.
• Do not have sexual contact with anyone while you are being treated. If your treatment is a single dose of antibiotics, wait at least 7 days after taking the dose before having any sexual contact.
• Make sure your partner knows that he or she needs to be treated even if there are no symptoms. You can spread the infection to others even if you do not have symptoms.
• Call your doctor if your symptoms continue or reappear after treatment or if new symptoms develop. You may need a different antibiotic medicine or further tests.

Finding out that you have gonorrhea may cause you to have negative thoughts or feelings about yourself or about sex. Talking to a counselor or joining a support group for people who have sexually transmitted infections (STIs) may be helpful.

Medications

Antibiotics, if taken exactly as directed, normally cure gonorrhea infections. If antibiotics are not taken properly, the infection will not be cured. Prompt antibiotic treatment also prevents the spread of the infection and decreases complications, such as pelvic inflammatory disease (PID).

Avoid all sexual contact while you are being treated for a sexually transmitted infection (STI). People taking a single dose of medicine should not have any sexual contact for 7 days after treatment to give the medicine time to work. Exposed sex partners need treatment whether they have symptoms or not.

What to think about

There is an increasing number of strains of gonorrhea that can’t be killed by (are resistant to) certain antibiotics. If your doctor finds that your gonorrhea is resistant to the drug you are taking, he or she might prescribe another antibiotic to cure the infection. If you continue to have symptoms after you have been treated for gonorrhea, you will need to be retested with a gonorrhea culture to find out whether there is bacterial resistance to the antibiotic you were taking.

Call your doctor if symptoms continue or new symptoms develop 3 to 4 weeks after treatment.

Treatment in a hospital with intravenous (IV) medicines may be needed for women who have pelvic inflammatory disease (PID) and men who have epididymitis. In many cases, these conditions can be treated outside of the hospital with oral antibiotics and close follow-up by your doctor. For more information, see the topic Pelvic Inflammatory Disease.

References

Citations

1. U.S. Preventive Services Task Force (2014). Chlamydia and gonorrhea screening: Final recommendation statement. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening. Accessed October 14, 2014.
2. Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03): 1–137. http://www.cdc.gov/std/tg2015. Accessed July 2, 2015. [Erratum in MMWR, 64(33): 924. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a9.htm?s_cid=mm6433a9_w. Accessed January 25, 2016.]

Other Works Consulted

• Abramowicz M (2010). Drugs for sexually transmitted infections. Treatment Guidelines From The Medical Letter, 8(95): 53–60.
• Centers for Disease Control and Prevention (2012). Update to CDC’s Sexually Transmitted Diseases Treatment Guidelines, 2010: Oral Cephalosporins No Longer a Recommended Treatment for Gonococcal Infections. MMRW, 61(31) 590-594. Available online:http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a3.htm?s_cid=mm6131a3_w.
• Centers for Disease Control and Prevention (2015). Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(RR-03): 1–137. http://www.cdc.gov/std/tg2015. Accessed July 2, 2015. [Erratum in MMWR, 64(33): 924. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6433a9.htm?s_cid=mm6433a9_w. Accessed January 25, 2016.]
• Ison C, et al. (2010). Gonorrhea. In SA Morse et al., eds., Atlas of Sexually Transmitted Diseases and AIDS, 4th ed., pp. 24–39. Philadelphia: Saunders.

Credits

Current as of:
February 26, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Kevin C. Kiley MD – Obstetrics and Gynecology

90,000 Recommended treatment for sexually transmitted infections revised to reflect increasing levels of antibiotic resistance

\ n

In response to the growing threat of antibiotic resistance, the World Health Organization (WHO) has released new treatment guidelines for three common sexually transmitted infections (STIs).

\ n

\ n Chlamydia, gonorrhea and syphilis – all of these infections caused by bacteria are usually cured with antibiotics.However, these STIs are often underdiagnosed and are increasingly difficult to treat as some antibiotics have lost their effectiveness as a result of misuse or overuse. An estimated 131 million people develop chlamydia every year, 78 million with gonorrhea and 5.6 million with syphilis.

\ n

\ nIn recent years, antibiotic resistance of these STIs has rapidly increased and the choice of treatment has narrowed. Among these STIs, the greatest antibiotic resistance has developed in gonococci.Strains of multidrug-resistant gonococci have already been identified that do not respond to any available antibiotics. In the case of chlamydia and syphilis, antibiotic resistance is also observed, albeit to a lesser extent, and this jeopardizes prevention and prompt treatment.

\ n

\ n STIs that are not identified and treated can lead to serious complications and long-term health problems in women, such as pelvic inflammatory disease, ectopic pregnancy and miscarriage, and gonorrhea and chlamydia, if left untreated, can lead to infertility in both men and women.Chlamydia, gonorrhea and syphilis can also increase the risk of HIV infection by two to three times. An STI left untreated in a pregnant woman increases the likelihood of stillbirth and newborn death.

\ n

\ n “Chlamydia, gonorrhea and syphilis are significant public health problems worldwide – affecting the quality of life of millions of people, causing serious illness and sometimes death. New WHO guidelines emphasize the need for timely treatment of these STIs with the right antibiotics at the correct doses to limit their spread and improve sexual and reproductive health.To do this, national health services need to monitor patterns of antibiotic resistance in these infections in their countries, ”said Ian Askew, director of the WHO Department of Reproductive Health and Research.

\ n

\ nThe new recommendations are based on the latest available evidence on the most effective drugs for the treatment of these three sexually transmitted infections.

\ n

Gonorrhea

\ n

\ nGonorrhea is a common STI that can lead to infection of the genitals, rectum and throat.With each new class of antibiotics for the treatment of gonorrhea, antimicrobial resistance has emerged and increased. Due to widespread resistance, older and cheaper antibiotics have lost their effectiveness in treating the infection.

\ n

\ n Due to the growing threat of antibiotic resistance, WHO strongly recommends that countries update their national gonorrhea treatment guidelines. National health authorities should monitor the prevalence of antibiotic resistance in the gonococcal strains circulating in their populations.The new guidance calls on health authorities to recommend that doctors prescribe whichever antibiotic is most effective in the context of local resistance patterns. According to new WHO guidelines, the use of quinolones (a class of antibiotics) is not recommended for the treatment of gonorrhea due to widespread high levels of resistance.

\ n

Syphilis

\ n

\ nSyphilis is spread by contact with a wound on the genitals, anus, rectum, lips and mouth, or from mother to child during pregnancy.Infection transmitted to the fetus by a woman with untreated syphilis often leads to fetal death. In 2012, an estimated 143,000 early fetal deaths / stillbirths, 62,000 neonatal deaths and 44,000 preterm / low birth weight babies were due to mother-to-child transmission of syphilis.

\ n

\ nNew WHO guidelines strongly recommend the use of a single dose of benzathine penicillin, an injectable antibiotic that a doctor or nurse injects into the buttock or thigh muscle of an infected patient, to treat syphilis.It is the most effective drug for syphilis, more effective and cheaper than oral antibiotics.

\ n

\ nAt the Sixty-ninth World Health Assembly in May 2016, benzathine-penicillin was recognized as one of the essential medicines, the stocks of which have been severely lacking over the past several years. WHO receives reports of shortages from antenatal care providers and providers in countries with a high burden of syphilis in three WHO regions.WHO is working with partners to identify countries with shortages of the drug and is helping to monitor the global availability of benzathine-penicillin to bridge the gap between national demand and supply of the antibiotic.

\ n

Chlamydia

\ n

\ n Chlamydia is the most common bacterial STI, and people with this infection often have gonorrhea as a coinfection. Chlamydia symptoms include discharge and a burning sensation when urinating, but most people are asymptomatic.Even in the absence of symptoms, the infection can have negative consequences for the reproductive system.

\ n

\ n WHO urges countries to move immediately to the updated guidelines, in line with the Global Health Sector Strategy on STIs (2016-2021) recommendation (2016-2021), endorsed by governments at the World Health Assembly in May 2016. The new guidelines are also in line with the Global Action Plan to Combat Antimicrobial Resistance, which was adopted by governments at the World Health Assembly in May 2015.

\ n

\ nWhen used correctly and consistently, condoms are one of the most effective methods of protecting against STIs.

“,” datePublished “:” 2016-08-30T00: 00: 00.0000000 + 00: 00 “,” image “:” https://www.who.int/images/default-source/imported/gonorrhoea-310×200- jpg.jpg? sfvrsn = c6d341a8_0 “,” publisher “: {” @ type “:” Organization “,” name “:” World Health Organization: WHO “,” logo “: {” @ type “:” ImageObject “,” url “:” https://www.who.int/Images/SchemaOrg/schemaOrgLogo.jpg “,” width “: 250,” height “: 60}},” dateModified “:” 2016-08-30T00: 00: 00.0000000 + 00: 00 “,” mainEntityOfPage “:” https://www.who.int/ru/news/item/30-08-2016-growing-antibiotic-resistance-forces-updates-to-recommended-treatment- for-sexually-transmitted-infections “,” @context “:” http://schema.org “,” @type “:” NewsArticle “};

90,000 Treatment of sexually transmitted diseases, sexually transmitted diseases

Sexually transmitted diseases I – diseases of infectious origin, sexually transmitted diseases .There is no division of these diseases into male and female – they affect both sexes. Symptoms may vary due to the structural features of the genitourinary system in 90,041 men and women.

Symptoms of sexually transmitted diseases

The key to successful treatment of venereal diseases is a timely appeal to a competent specialist ( urologist , gynecologist ). With the help of modern laboratory research methods, he will determine the type of pathogen and select drugs that are effective in combating it.The signal for contacting a venereologist (gynecologist, urologist) is the following symptoms:

• itching and burning in the genital area;
• hyperemia and edema of the genitals;
• painful urination;
• Frequent urge to urinate;
• discomfort, pain in the lower abdomen;
• Changes in the nature of discharge from the genital organs (color, odor, consistency).

The disease may not be accompanied by all the signs, there are often cases when the disease develops almost asymptomatically.An unnoticed and untreated infection becomes a chronic form that is much more difficult to treat. As it spreads in the body, it covers new organs, causing serious complications that can threaten infertility.

Types of STIs and their diagnosis

Depending on the type of pathogen, sexually transmitted infections are divided into bacterial, viral, fungal, protozoal, parasitic. In addition to infection directly during intercourse, there is a likelihood of some pathogens entering the human body by contact, in everyday life.

The type of microorganism that caused the disease can be determined by laboratory diagnostic methods, including:

• Microscopic examination of a smear from the urethra, vagina, cervical canal;
• bacterioscopy;
• enzyme immunoassay;
• polymerase chain reaction.

If a disease is detected in one of the sexual partners, the second must be examined even in the absence of symptoms of the disease.It is desirable to carry out the treatment at the same time, and until the complete recovery of both partners, it is necessary to exclude sexual contacts.

Treatment of sexually transmitted diseases

Syphilis, gonorrhea, chlamydia, chancre, lymphogranuloma venereum, donovanosis, ureaplasmosis, mycoplasmosis are bacterial infections for which antimicrobial agents are used. When choosing a drug, the doctor relies on the results of inoculation for sensitivity to antibiotics, focuses on the general condition of the patient, his individual characteristics.The presence of concomitant infections is also important, which are treated in this case in combination.

In the fight against infections of a viral nature, agents are used that activate the immune system, increase immunity. In addition to drugs – immunostimulants, immunomoduators, dietary supplements, amino acids, vitamins, ozone therapy is successfully used.

For the treatment of candidiasis, a variety of oral and topical antifungals are available.

In addition to the systemic effect on the body, for the treatment of venereal diseases , local treatment is prescribed in the form of washing, douching, baths using antiseptic, antimicrobial agents, suppositories and vaginal tablets. These procedures are aimed at combating the pathogen and improve the patient’s condition by relieving unpleasant symptoms.

Physiotherapeutic methods can increase the effectiveness of drug treatment, which have an anti-inflammatory effect on tissues affected by infection and improve blood flow in the pelvic region.

Sexually transmitted diseases should be treated by a qualified professional. Thorough diagnostics a and well-chosen treatment, carried out under the supervision of the attending physician, will avoid the consequences of the infection and its recurrence.

drugs for the treatment of acute and chronic forms – Dobrobut clinic

Symptoms of gonorrhea in women and men

Gonorrhea is a sexually transmitted infection.The causative agent of gonorrhea is the bacterium Neisseria gonorrhoeae. The disease spreads through sexual contact with an infected person. Gonorrhea can be contracted through vaginal, oral, and anal sex. It is also passed from mother to child during childbirth. A person does not have congenital or acquired immunity to gonococcal infection, therefore, repeated infections are possible.

About 0.8% of women and 0.6% of men suffer from gonorrhea. According to statistics, from 33 to 106 million new cases of the disease are registered annually.Gonorrhea is the second most common sexually transmitted infection.

How gonorrhea manifests itself

The incubation period is 2 to 14 days. Usually, the first signs of gonorrhea appear 2-6 days after infection. 50% of infected women do not have any manifestations of the disease. They may not know they have contracted gonorrhea and therefore may not seek medical attention. This increases both the risk of complications and the likelihood of the infection spreading.

Symptoms of gonorrhea in women:

• burning and pain when urinating;
• vaginal discharge;
• painful intercourse;
• high fever and pain in the lower abdomen (when the infection spreads).

Symptoms of gonorrhea in men:

• painful and frequent urination;
• discharge from the urethra;
• redness and swelling of the external opening of the urethra.

The disease can cause skin lesions, arthritis, endocarditis, meningitis. Gonorrhea can also be contracted through oral sex with an infected partner. How is oral gonorrhea infection manifested? This infection causes no symptoms in 90% of people. The rest of the patients experience a sore throat (gonococcal pharyngitis).

Analysis for genital gonorrhea

The diagnosis of “gonorrhea” is made on the basis of the test results and the clinical picture of the disease. It is recommended to conduct annual testing of women and men who frequently change sexual partners.Laboratory tests for gonococcal infection:

• swab for gonorrhea;
• culture of vaginal discharge, cervical canal, rectum, urethra;
• PCR.

Chronic gonorrhea is diagnosed with pyrogenal provocation. Patients must be warned about the reaction to the administration of the drug: fever, muscle pain, weakness.

Analysis of genital gonorrhea by microscopic examination of discharge with Gram stain does not give an accurate result in the diagnosis of pathology in women.The sensitivity of the method is about 30-50%. Therefore, for laboratory diagnosis of gonorrhea in women, PCR and culture are more often used.

How to treat gonorrhea

Antibacterial drugs are used to treat gonococcal infection. The regimen is prescribed by the doctor. This can be either a single loading dose of an oral antibiotic or a standard dosage over seven days. The drugs of choice are ceftriaxone (injection) and azithromycin (capsules, tablets). Treatment of gonorrhea in men and women is carried out according to the same scheme.

After a course of antibiotic therapy, it is necessary to take another test for gonococcus. Retesting is recommended three months after treatment.

How to treat gonorrhea depends on the form of the disease. A course of antibiotics is usually sufficient to treat acute gonorrhea. If the infectious process has spread or the disease has become chronic, long-term treatment is required. In addition to antibiotics, immunomodulators, hepatoprotectors, and vitamins are prescribed.

Gonorrhea is called “hussar rhinitis”.But the disease is not so harmless and in the absence or improper treatment is fraught with serious complications. Possible complications of gonorrhea in women:

• cervical erosion;
• bartholinitis;
• joint damage;
• obstruction of the fallopian tubes;
• Chronic pelvic pain;
• Irregular menstrual cycle;
• ectopic pregnancy;
• infertility;
• miscarriage, premature birth;
• infection of a child during childbirth.

The main complications of gonorrhea in men are narrowing of the urethra, abscess, prostatitis, infertility. A history of gonorrhea increases the risk of prostate cancer.

Prevention is the best defense against illness

Prevention of gonorrhea is similar to other STDs. Read more about STD prevention on our website https://www.dobrobut.com. Avoiding casual sex is the only surefire way to avoid catching an infection.

Safe sex means taking measures to prevent transmission of infection from one partner to another before and during sexual intercourse.Safe sex practices include screening for STIs of all sexual partners, using condoms, and reducing the number of sexual contacts.

The likelihood of developing gonorrhea increases:

• if you have multiple sexual partners;
• if the regular partner has already been treated for STIs;
• for alcohol or drug abuse;
• if not using a condom during sex.

To avoid infection, you should follow the rules of intimate hygiene, regularly get tested for STDs and be examined by a doctor.At the slightest suspicion of infection, and even more so if any deviations from the norm are found, you must immediately contact a medical institution.

Related services:

Gynecological Check-up
Colposcopy

90,000 sexually transmitted infections

STIs – sexually transmitted infections

Sexually transmitted infections (STIs), or sexually transmitted diseases (STDs) – this term refers to infectious diseases, the most common route of infection with which is sexual.

`Love is a magical land, only there is happiness in it`. Lovers, as you know, are patronized by the most beautiful of the goddesses, the goddess of love, Venus. That is why the classic STDs, or sexually transmitted diseases, which have been known to people for a long time, are named after the goddess of love – Venus. Classic venereal diseases are syphilis, gonorrhea, chancre, lymphogranulomatosis venereal disease and donovanosis. Chancre, lymphogranulomatosis venereal disease and donovanosis are diseases that are quite rare in our latitudes – they are mostly common in tropical countries.

Sexually transmitted diseases are among the most common infectious diseases in the world. For example, more than 250 million people a year are infected with gonorrhea worldwide.

Modern statistics on bacterial and viral STDs, no matter how hard the statistics try, do not show the true picture of the incidence. There are several reasons for this. Often people do not go to doctors because they do not know about their illness: if syphilis and gonorrhea have been known since ancient times, have obvious symptoms, they are afraid and treated, then many do not even suspect about such new venereal diseases as chlamydia, trichomoniasis, mycoplasmosis.Yes, these infections are virtually asymptomatic, especially in women.

Meanwhile, new venereal diseases are dangerous because not only sexual partners get sick with them – they are transmitted to the fetus in utero, through mother’s milk, through blood transfusions. These microbes, entering the body, are capable of infecting a variety of organs through the blood, lymph, and even capture the body completely.

New venereal diseases often manifest themselves as inflammation.`New` venereal diseases are chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis (trichomoniasis), genital herpes, human papillomavirus (genital warts), HIV infection. The `new ‘STDs also include sexually transmitted diseases of the intestine, as well as sexually transmitted skin diseases – scabies, head lice (pubic lice), molluscum contagiosum.

New sexually transmitted diseases have also existed for a very long time, and people have been ill with them since time immemorial.However, their pathogens could be detected relatively recently (chlamydia – 1907, cytomegalovirus infection was discovered in 1956, ureaplasmosis (urogenital mycoplasmosis) – in the 40-50s of the twentieth century). Therefore, these diseases as independent `appeared` for people recently.

Diseases that are not `of the nerves`

Sadly, many infections deliberately choose the most subtle and intimate sphere of human relations for their spread.Unlike the causative agents of hepatitis and AIDS, which can also be transmitted through blood, such harmful creatures as Trichomonas, chlamydia, mycoplasma, gardnerella, genital herpes virus, human papillomavirus and cytomegalovirus clearly prefer to be transmitted sexually. In addition, in the human body, they usually behave much more secretively than the microbes that cause syphilis and gonorrhea. That is why, when speaking of “hidden infections”, they most often mean the causative agents of trichomoniasis, chlamydia, mycoplasmosis, gardnerelliosis and some viral infections.And although the incubation period for the development of these infections in the human body is usually from 5 to 30 days, in about 60% of people the disease lasts for a long time, with practically no visible symptoms, which is the main danger.

`Centaurs` of microbiology

Some features of latent infections are amazing. For example, chlamydia is one of the `leaders’ in terms of prevalence among sexually transmitted infections (chlamydia is found in 10-20% of women and men).These peculiar microorganisms are neither bacteria nor viruses. They do not know how to move themselves, therefore they stick to the membranes of the cells lining the urogenital organs. The cell itself “swallows” its enemy. Once inside the cell, chlamydia “exchanges” its genetic information with it, and the cell grows inside itself almost a hundred new chlamydia, while protecting them from any drugs. Then the cell is destroyed, and the “newborns” look for a new target for defeat. A person infected with chlamydia easily transfers these microorganisms to the people around him.

`Adjuster`

Trichomonas is a unicellular parasite with unique adaptability. She knows how to change shape, become similar to blood cells, which interferes with diagnosis, is able to mutate, acquiring resistance to the measures used against her. It can even exist outside a person for some time, so trichomoniasis can also be infected through wet objects: a swimsuit, a bathrobe, a washcloth, even a toilet seat, although this is very rare.But Trichomonas cannot stand dryness, temperatures above 40 ° C and the sun’s rays. It is especially dangerous when infected with trichomoniasis, without consulting a doctor, to self-medicate with antibiotics. Trichomonas adapt to life in an aggressive environment for them, but the disease takes on latent, atypical forms, when it is much more difficult to diagnose and treat it. In addition, Trichomonas turns into a more aggressive form: it is irritated by smoking, alcohol, drugs and some medications, and it begins to actively multiply.

STIs are usually named after the microorganism (bacteria, virus) that causes them. Almost all microorganisms (they are called pathogens) that cause STIs are absolute parasites for humans. This means that they are not found in a healthy person and their detection in the body always speaks of a disease. In total, the STI group includes more than 20 diseases. Their number is constantly changing. Replenished with new ones. Their number can also increase due to already known diseases, in which, as a result of scientific research, the sexual route of spread has also been identified.

STI pathogens can inhabit not only the tissues of the genitourinary system, but also on the mucous membrane of the eyes, oral cavity, and intestines. Therefore, the disease can affect any of these organs (intestines, eyes, oral cavity, urogenital organs). These infections can be carried by hand from one mucous membrane to another. So most often, in violation of hygiene standards, secondary infection with chlamydia and gonococcus of the mucous membrane of the eyes occurs. This spread of pathogens to other mucous membranes complicates treatment and can lead to complications.

STI symptoms and signs

Getting into the urethra, gonococci, Trichomonas, chlamydia, ureaplasma and mycoplasma, multiplying, can cause inflammation (urethritis), which can proceed acutely, with purulent discharge, painful urination, or erased, with scanty mucous or mucous-mucous secretions (usually in the morning), mild discomfort along the urethra, and sometimes subclinical (no symptoms).There may also be redness, sores or warts in the genital area or anus, frequent and painful urination, pain during intercourse, unusual bleeding or discharge from the genitals, itching. The severity of symptoms depends on the aggressiveness of the pathogen and the state of the patient’s immunity. STIs can exist in the body for a very long time, without causing noticeable manifestations, but causing progressive changes in the genitourinary organs.

The incubation period of sexually transmitted diseases (from the moment of infection to the appearance of the first clinical manifestations) ranges from several days to several weeks.After this period, men often experience symptoms of urethritis (burning, pain during urination and discharge), women – symptoms of colpitis and urethritis (itching, burning, pain during urination, vaginal discharge). If infection occurs through oral contact, angina often develops. When infected during anal sex, an inflammatory process of the rectum often develops – proctitis.

People think that the symptoms are so mild as to pay attention to them, and do not go to the doctor.

If the acute form of STDs is not treated, it becomes chronic. Symptoms of the disease in a chronic form disappear: they are expressed very little or are absent at all. Often, the patient believes that there has been an arbitrary self-healing, and the need to see a doctor, thus, disappears – you can forget about the alarming symptoms.

In fact, the disease, having passed into a chronic form, has firmly established itself in you, and it does not need to manifest itself as symptoms, which in the acute stage indicated that the body is actively resisting the penetration of infection into itself.So a person becomes a carrier of infection. From now on, this person is a time bomb. Firstly, no doctor can predict when and how an infection will manifest itself, diseases of which organs and what complications STIs will cause. Most chronic inflammatory diseases of the genitourinary organs begin this way. Secondly, starting from the `muffling ‘or disappearance of the expressed symptoms, a person becomes seriously dangerous for all his partners – he will spread the disease further and further.

Even in the acute form, the symptoms of sexually transmitted diseases are often very mild and, as doctors say, nonspecific. This term means that the symptoms that STDs exhibit are characteristic of several STIs at once – from gonorrhea to chlamydia: it is impossible to establish only on the basis of the symptoms of the causative agent of the infection. This requires high-quality modern diagnostics – to be tested for STIs. In the overwhelming majority of cases, if a person is infected with something, then he immediately contracted a whole bunch of diseases.Nevertheless, in order to treat this `bouquet ‘, you need to know which pathogen caused the disease and at what stage the disease is. Each infection and disease requires a different treatment regimen. That’s why, if you suspect you have an STI, you need to get tested for several infections – at least 10 of the most common.

What is the danger of STDs – sexually transmitted diseases.

The problem associated with sexually transmitted diseases is much more serious than the pain and discomfort caused by infection.The main danger lies in the consequences of STDs – in their complications. They are dangerous for both male and female health.

But STDs are especially dangerous for women’s health, for subsequent pregnancy – many infections can be transmitted through the placenta or during childbirth to the fetus, causing serious diseases and complications in newborns.

Some time after infection, and it may take weeks, and maybe years or even decades, complications of the disease develop.Sexually transmitted diseases are dangerous because these infections cause numerous inflammatory diseases, disrupt their functions, especially significantly the reproductive function of both men – erectile dysfunction, premature ejaculation, erased orgasm, and women – miscarriage, threat of miscarriages, risk of premature birth up to infertility.

It is imperative to prevent these consequences.

Chlamydial infection is a very dangerous cohabitant.It affects not only the genitals, but also non-sex organs, leading to conjunctivitis, pneumonia, cholecystitis and inflammation of the liver membrane. Chlamydia provokes the development of inflammatory diseases of the genital area, which, untreated, can lead to infertility in both men and women. During pregnancy and / or during childbirth, they can be transmitted to the fetus, causing inflammatory diseases of the eyes and respiratory organs in newborns.

In some cases, chlamydia leads to the development of such a serious disease as Reiter’s syndrome.This is a complex disease in which chlamydia simultaneously affects the joints, urethra, and conjunctiva of the eyes.

`Human papillomavirus (HPV)`, in combination with a decrease in the local immunity of the patient, can cause the appearance of genital warts on the skin of the penis and (or) on the mucous membrane of the urethra, which often require surgical treatment. The human papillomavirus is associated with the possibility of developing cancer of the cervix, vagina, vulva and penis.

`Syphilis` is a bacterial infection with confusing and not always obvious symptoms. Three weeks after infection, ulcers and a dense formation (chancre) form on the genitals, anus or mouth. Then they disappear. A rash appears all over the body, which also disappears by itself, then reappears. These symptoms are often difficult to notice. Treponema pallidum – the causative agent of syphilis is capable of penetrating almost any organ of the body – the heart, liver, stomach, kidneys, lungs, nervous system.There she lives, feeds and reproduces, leading to numerous failures in the work of this organ. In severe cases, syphilis can lead to disability and death.

`Genital herpes` – a viral infection manifested by small blisters on the genitals. The vesicles break open, forming multiple and painful ulcers. Herpes cannot be cured, but the severity and frequency of recurrence can be significantly reduced. The herpes simplex virus, settling for a long time in the peripheral ganglia of the human nervous system, in the acute period causes damage to the skin of the penis, which makes it almost impossible to have sex.Genital herpes, and occasionally cytomegalovirus, can also cause urethritis. When the herpes virus is transmitted in utero, it causes severe fetal pathologies.

`Hepatitis B` – a viral liver disease, transmitted including sexually through unprotected sex. Symptoms may resemble the flu – fatigue, chills, lack of appetite, nausea, etc. There is a vaccine for hepatitis B.

`Hepatitis C` – a viral liver disease transmitted through blood or sexually, during traumatic sexual practices – often together with HIV.It develops very slowly and is asymptomatic. Subsequently, it turns into fibrosis, cirrhosis and liver failure; liver cancer is also possible. Symptoms of chronic hepatitis C include general weakness, fatigue, nausea, loss of appetite, irritability, depression, pain in the liver, joints and muscles.

There is now direct evidence that STDs increase the risk of sexual transmission of HIV, since STDs affect the mucous membrane of the genitourinary organs and make it more vulnerable.

You can always protect yourself by getting tested for STDs and, if any, treat them in the early stages.

Transmission routes.

The main feature of STIs is the high susceptibility of pathogens to environmental conditions, and therefore close contact of the mucous membranes is required for infection. All STIs are transmitted through unprotected sexual intercourse (vaginal, anal, most and oral) and in very rare cases in the household.It is important to understand that sexual intercourse involves more than normal intercourse (vaginal and anal sex). Sexual contact includes kissing, oral sex, and the use of sex toys such as vibrators. However, other transmission routes are possible, although they are quite rare. In particular, it is possible to become infected with HPV-papillomavirus through close household contact; Trichomonas can retain its infectious properties for a long time in humid environments (wet towels, smooth surfaces).The vertical route of transmission implies infection of the child during the passage of the birth canal.

Risk groups for STDs.

How pleasant it is sometimes to have fun in nature or in a tavern with a charming stranger! However, the possible consequences of such an acquaintance are unpredictable. Nobody knows what you gain and what you lose. Not all sexually transmitted diseases manifest themselves as symptoms.Therefore, the infected person himself may not even suspect that he is sick and infectious. That is why it is unacceptable to focus only on the external signs of sexually transmitted diseases.

Before sexual intercourse, it is very important to understand for yourself how dangerous it is and how great the risk of infection is. Of course, you won’t get off with observations alone, you will also have to ask the person with whom you want to have sex.

STIs are not considered either your status or age.It is very easy to get an infection, especially with unprotected sexual intercourse, because more than 25 types of pathogens can be transmitted at a time.

Traditionally, the risk groups include prostitutes and young people who often change sexual partners, who do not have the opportunity (or desire) to be tested for STDs and receive treatment. For a long time it was believed that sexually transmitted infections (STIs) affect exclusively women of easy virtue and men who have promiscuous sex lives.However, today they are classified as a risk group for classic, or sexually transmitted diseases.

The risk group for new sexually transmitted diseases, especially chlamydial infection, is much wider. These include most young people who are sexually active. Almost all people of any age who are sexually active are at risk for genital herpes and HPV, the human papillomavirus.

Yes, the peak of sexually transmitted infections falls on twenty-five years – this is due to the peak of sexual activity of the population.The risk group for STDs also includes women suffering from inflammatory diseases of the genital organs, especially those that constantly recur (relapse). Inflammatory diseases are all diseases ending in it: colpitis, salpingitis, salpingo-oophoritis, cervicitis.

Oddly enough, people over 50 are now also at risk. According to epidemiologists, those over 50, on average six times less likely to use condoms and five times less likely to be tested for AIDS than the younger generation, although the risk their infection is approximately the same.Especially STDs threaten women who have gone through menopause. Even correctly selected HRT – hormone replacement therapy does not completely eliminate vaginal dryness. Natural lubrication of the vagina is one of the main obstacles to infection in the direction of the reproductive system. This is why it is easier to contract a sexually transmitted disease when the vagina begins to suffer from dryness, becomes more fragile and less acidic.

The degree of risk of contracting one of the sexually transmitted diseases does not depend in any way on your age.STIs are transmitted through homo- and heterosexual contact – vaginal, anal and oral. The more sex partners you and your partner have, the higher your risk of contracting an STI. At the same time, only one sexual contact may be enough to get infected !!!

`There can be many reasons for a partner to remain silent about an STI:`

Doesn’t know about his infection;

Afraid that you will tell others;

Doesn’t want to lose you;

And much more.

Therefore, it is important for you to take care of your safety yourself !!!

The best partner – beloved, permanent and unique;

Before having sexual intercourse, decide for yourself if you can talk to your partner about safety. If not, then it is better to abstain from sexual intercourse altogether;

Always use a condom. Even once can be fatal; Do not have sex under the influence of alcohol or drugs, as they reduce self-control;

Visit only licensed healthcare professionals, dentists, tattoo artists.

`Your partner is potentially dangerous:`

• If he injects drugs into a vein. HIV, syphilis, hepatitis B are transmitted through a non-sterile needle used by several people.

• If his work is related to blood. These are professions such as nurses, doctors, dentists, etc.

• Potentially dangerous are people who have undergone blood transfusion or hemodialysis (blood purification using an artificial kidney apparatus for patients with renal failure).

• If your partner has group sex.

• If your partner prefers a `one-night ‘relationship (in the parlance of venereology, this is called promiscuous sexual intercourse).

• Even if you are presented with ‘clean’ test results for infections, this does not mean anything: any infection has an incubation period in which even the most sensitive laboratory diagnostic methods will not be able to catch it.

• You yourself, without reason, potentially distrust him and place him at risk.Trust your feelings. It’s not worth the risk. By the appearance of a man, for example, it is very difficult to determine whether he is sick or not. His reproductive system is designed in such a way that all possible secretions are washed off during urination. Any suspicious discharge can be noticed only in the morning.

Today, the prevalence of sexually transmitted diseases has reached the level of the epidemic. Thus, STDs are in third place in the group of infectious diseases – immediately after colds and flu.And these diseases can seriously damage your health and ruin your life. This is the reason why venereologists and gynecologists today believe that all women of childbearing age should be tested for sexually transmitted infections.

Responsibility Intentionally infecting another person with a venereal disease is a crime and criminal liability has been established for this act.

The method of contracting a venereal disease does not matter for the qualification of the crime.Infection with a venereal disease should be understood as the transmission of this disease by a person who knew that he had such a disease by performing any actions that, as a general rule, lead to infection: sexual intercourse, kissing, eating from one dish, non-observance of other hygienic rules by a person suffering from a venereal disease.

STI prevention measures

STI prevention is a complex social and biomedical problem in which pressing issues of sex education, morality and ethics are interconnected.

It is important to remember that STIs do not leave immunity, and therefore you can get sick with syphilis, gonorrhea and other STIs several times, and sometimes several infections at once. Safe behavior during sexual intercourse is the prevention of STIs. In particular, this is the use of a condom for vaginal, oral and anal intercourse, latex napkins for cunnilingus, or non-penetrating sex (mutual masturbation, petting). Rinsing with water or antiseptics and interrupted intercourse are ineffective.

The type of sexual practice is the most important factor in STI transmission. Genital contact during menstruation is a factor contributing to the transmission of STIs and HIV infection, due to the presence of these pathogens in the blood. Traumatic sexual intercourse with elements of violence contributes to the transmission of various STI pathogens. For example, defloration or forced sexual intercourse increases the risk of contracting STIs by 3-7 times.

Male condoms do not cover the entire exposed surface.Vaginal bactericidal contraceptives have found use for the prevention of STIs. Pharmatex (benzalkonium chloride) is a contraceptive that is both a spermicide and an antiseptic. The spermicidal effect is due to the ability of the drug to damage the membranes of spermatozoa. Effective against gonococci, chlamydia, mycoplasma, trichomanad, herpes virus. The drug does not affect the normal vaginal microflora and the hormonal cycle.

An equally important factor contributing to the spread of genital infections is the emergence of new contraceptives.Instead of a condom, which significantly reduces the risk of contracting STIs, hormone pills and intrauterine devices have been used. Hormonal contraceptives (pills, injections) with a purely spermicidal effect are very often associated with HIV infection and other cervical STIs. A reliable mechanical barrier to protect against STIs is the female condom, which is a lubricated polyurethane sheath with a ring at both ends placed in the vagina. The female condom should be used in situations where the male condom cannot be used.

To exclude from the practice of personal hygiene detergents that cause dryness and microcracks of mucous membranes. So the frequent use of detergents leads to the formation of microcracks in the mucous membrane (microcracks are a prerequisite for the penetration of the virus into the mucous membranes), which can be felt as a slight burning sensation, as well as a decrease in local immunity. The use of underwear that is intimate to the anus (thongs), against the background of frequent use of detergents, dramatically increases the frequency of bacterial vaginosis (even in the absence of sexual activity).

Here a person is required, on the one hand, very much, on the other – very little: to have a constant, beloved, faithful, only sexual partner, who is healthy himself. If it’s not destiny, and you don’t have this – always use a condom.

Adequate sex assumes that two emotionally mature people care for each other, listen to the wishes of the partner, trying to please each other. Our culture discourages frank conversations about sex.Despite this, it is important to talk – to discuss with your partner your own sexual desires, expectations from sex or relationships, to ask your partner about his readiness for sex, for certain sexual practices.

Raising awareness of one’s health and responsibility to society, critical attitude to one’s behavior, knowledge of personal and social prevention measures will play an essential role in combating the massive spread of STIs.

How to avoid the consequences and complications of STDs

The currently known method of preventing the complications and consequences of STDs is only one – to avoid contracting sexually transmitted infections.If infection is possible, the algorithm of actions is as follows:

• prophylaxis immediately after sexual intercourse;

• drug prevention;

• STI diagnostics;

• treatment of STDs at the earliest stages.

Acute illness is treated much easier than a chronic illness – with less stress on the body and, possibly, without any consequences at all. Chronic, advanced infection often leaves its ‘marks’ in our body and irreversible changes in tissues caused by inflammation.These “traces” remain in the body even after the cure of sexually transmitted infections, requiring long-term and serious treatment.

It should be recognized, however, that not the entire list of STD complications will be observed in every infected person. Perhaps even some rare lucky ones will be able to avoid them altogether. But who, in the first place, will give you a guarantee that you will be among the scanty number of `lucky ones`? Secondly, sooner or later, after several years or even decades, at the slightest failure in your body, complications will appear.Only finding out the cause and treating it will be much more difficult. And the last thing. Even if the infection is not complicated, you can still transmit it to those around you – loved ones, your family members, and even children. Thus, you endanger the health of those closest to you, who are innocent and unsuspecting about anything.

Avoiding STDs is possible only by changing sexual behavior.

Self-medication is no less dangerous when the patient, on the advice of friends or advertising, begins to take various “miraculous” or exotic remedies.

What to do if the tests are positive and the disease was confirmed

If your doctor’s suspicions are confirmed, and the test results are positive, then your partner is also recommended to take tests – it is possible that he will be found to have some infections that you have not identified. Be sure to treat STDs with your partner.

Sexual intercourse is not recommended during treatment, although it is possible, but ONLY with the use of condoms after obtaining permission from your doctor.

Only the test results for STDs can give one hundred percent confidence that you are healthy – in sexually transmitted infections, the symptoms are very mild. It is better to detect and treat genital infections in the early stages, when nothing bothers you – this will allow you to avoid serious complications and consequences. Your health is also a guarantee of the health of your loved ones, your loved ones.

For diagnosis, examination of the patient is used, identification of typical symptoms (pain during urination, discharge from the genitals) and analysis of smears and blood samples.Physical symptoms (pain, discharge) may be absent, and for some diseases (genital warts) they are absent altogether. Diagnosis is difficult, since all research methods have an error and do not clearly indicate the disease, therefore, the diagnosis should be carried out by a qualified doctor.

Treatment

Important:

Without excluding the reasons for the development of the disease, treatment is ineffective and long-term.Starting treatment without first analyzing these reasons is not only unprofessional, but also detrimental to the patient’s health. This leads to an increase in the frequency of visits to the clinic, an increase in the cost of treatment and the spread of infectious diseases among the population (unfortunately, with the development of the institute of private medicine, this practice has become widespread).

When treating STIs, it is necessary to simultaneously sanitize the entire sexual community.

A magic pill that instantly cures STIs has not yet been invented.STI treatment is difficult and time-consuming work. In addition to the qualifications of a doctor, it requires a conscientious attitude on the part of the patient, that is, carefully fulfilling all medical recommendations by him: treatment, lifestyle, time of a timely visit to the doctor.

In order to destroy the focus of inflammation, and at the same time crush all repeated outbreaks in the embryo, the doctor usually prescribes an individual complex treatment: antibacterial and immunostimulating therapy, vitamin therapy, instillation of the urethra, massage of the prostate gland (in men).Thanks to new antiviral and antibacterial drugs, the course of antibiotic treatment has been reduced to five to seven days, and the frequency of taking them has decreased from six to eight times a day to one or two. The entire course takes from two weeks to several months, with the obligatory condition of treating both partners. Otherwise, the infection may recur.

The cost of condoms will save you the money you have to spend on STI testing and treatment.

And finally…

It is important to analyze the reasons for the increase in the incidence of the above infections. These include early onset of sexual activity, sexual freedom, low sexual culture, economic and social stratification of society, insufficient awareness of the population on various STIs, the corrupting influence of pornographic, erotic print and video products, the intensive formation of a wide network of sex services, the spread of drug addiction and alcoholism. , insufficient advertising and use of personal protective equipment.All this can be described as moral immunodeficiency.

Further – more. The flow of information on the topic of sex inevitably erodes moral foundations, adolescents are gradually inclined to think that sexual needs should be satisfied as simply as the need for food is satisfied – easily, without unnecessary spiritual torment and reflection. The informational pressure that young people are experiencing today is so strong that some doctors cannot resist it, even if they rely on the help of law enforcement agencies, spiritual work is needed here.

Still, sane people should understand that only a healthy family can become the basis of the state and only in a full-fledged family can a child receive the correct spiritual and moral education

Prevention of STDs after accidental unprotected relationships “Medical Center Alta Almaty

Unfortunately, the number of people starting early sexual activity is growing every day. And, accordingly, there are more and more patients with sexually transmitted diseases (STDs).Young people often turn to doctors with various questions. We will try to answer the most common ones.

Which sexual intercourse is considered unprotected?

Unprotected is considered
intercourse without using a condom or condom
had mechanical damage. In this case, there is a high probability of infection and
development of STDs. If you do not know or do not remember how the potentially dangerous
sexual intercourse (intoxicated, rape, etc.)etc.), then
it should be considered unprotected and all preventive measures should be taken
sexually transmitted diseases.

What to do after unprotected intercourse with
a casual partner?

In this case, you can
adhere to three strategies of behavior:
1. Carry out preventive treatment (drug prophylaxis) during
several days after unprotected intercourse. In this case, apply
antibacterial agents that prevent the development of bacterial
sexually transmitted diseases such as chlamydia, mycoplasmosis,
gonorrhea, ureaplasmosis, syphilis, trichomoniasis.A must-have treatment
appoint a specialist, carried out according to the schemes of therapy for a fresh infection without
complications.
2. Treatment is not carried out, but after 3-4 weeks it is necessary to undergo an examination at
venereologist. This time is necessary for the end of the incubation periods.
most sexually transmitted diseases, so go to the clinic earlier and
taking tests does not make sense. All this time you should consider yourself
potentially infected and lead an appropriate lifestyle (it is recommended
refrain from intercourse with a regular partner).
3. If possible, persuade your casual sex partner to surrender
tests and be examined by a venereologist for STDs.
You should choose the most suitable option for you, while it is best
make this choice in conjunction with a venereologist who can assess the risk
infection is more adequate.

How dangerous are drugs used for medicinal
STD prevention, and can there be complications?

For preventive
treatment, as a rule, antibiotics are used, when taking which really
some complications may develop.At the same time, for the majority
drugs in this case, a single dose is provided in the form of an injection or inside.
With such a single use, the likely side effects (dysbiosis,
candidiasis) will not have time to develop, because for the death of beneficial microflora
intestines need a longer course of antibiotic treatment (a week and
more). However, from complications of an allergic nature (urticaria, Quincke’s edema,
anaphylactic shock) no one is insured, therefore, if you know about the presence of
you are allergic to certain medications, be sure to inform about
to this prophylactic prescribing physician.

How often can preventative
treatment and can they replace other methods of prevention of sexually transmitted
diseases?

Antibacterial
means used in drug prevention, despite their
effectiveness, have a number of side effects, and with repeated repeated
application can not only sensitize the body (develops
an allergic reaction to them) or cause the development of intestinal dysbiosis and
vagina, but also lead to a decrease in the sensitivity of STD pathogens, which
will drastically reduce the effectiveness of such treatment and increase the risk of complications.
Preventive treatment should be treated as a last resort
prevention of sexually transmitted diseases, and for everyday prevention it is better
condom and legibility in relationships have not yet come up with anything.

Is it possible to hope for the effectiveness of drug
prevention?

Preventive
treatment is only effective against bacteria-related STDs and is effective in
in this case it approaches 100%. However, only rely on
drug prophylaxis should not be followed because it is completely ineffective
to prevent viral diseases such as HIV infection, hepatitis B and
C, genital herpes, papilloma virus.This is another argument in favor of
use of condoms for the prevention of STDs.

How long to wait after preventive treatment,
before resuming sex with a regular partner without
condom?

Effect from
preventive treatment, as a rule, occurs within five days. Of this
enough to kill all the bacteria that cause STDs. Until that time follows
use a condom. Do not forget about the possibility of infection
viral diseases, therefore, before resuming unprotected contacts
with a regular partner, you should undergo additional tests: for HIV not earlier
less than a month (preferably 3 months) after unprotected intercourse, for hepatitis
– in 4-5 weeks.

Are there other methods of preventing STDs after
casual unprotected sex? What is their effectiveness?

Other methods
prevent contracting STDs after unprotected contact:
• Rinsing the vagina or rectum with a syringe, enema, or shower.
The effectiveness of this method is questionable, since there is a high probability of lifting
pathogens in the upper sections of the female genital organs.
• Washing the vagina, rectum or urethra with solutions of preparations containing
chlorine (miramistin, gibitan).The efficiency is slightly higher than that of the previous one
method, but there is still a risk of the infection moving up. Besides,
chlorine-containing antiseptics are detrimental to the normal microflora of the vagina and
contribute to the development of dysbiosis.
You should not rely only on these prevention methods, but you can use them.
together with drug prevention.

More information
you can ask the specialists of MC Alta.

How to properly prepare for the delivery of tests

Published: 03.10.2018 Updated: 10.03.2021 Views: 92 399

The research result is influenced by many factors not related to the quality of reagents and laboratory performance. Read about how to properly prepare for laboratory tests in our review.

Myth number 1. Any container is suitable for collecting biomaterial

In fact: No, it is not so

You cannot collect biomaterial in containers that are not intended for this.The sample may contain components that can contaminate the sample and therefore potentially affect the test result. For delivery of urine, feces, ejaculate, sputum, saliva, special sterile containers are used. They can usually be purchased from a health center.

Myth number 2. Before taking blood, you can eat an apple or drink a glass of juice

Fact: No, you can’t

Even a light breakfast like a serving of fruit or a little granola can skew research results.
There are a number of mandatory restrictions on food intake:

• On an empty stomach: at least 4 hours after the last (not plentiful!) Meal.
• Strictly on an empty stomach: at least 8 hours after the last meal. In newborns and children of the first months of life, it is allowed to take blood no earlier than 2 hours after eating.
• Fasting: no food intake for at least 12 hours, it is not recommended to fast for more than 14 hours. It is advisable not to overeat 1-2 days before blood sampling, if possible, exclude fatty, fried foods, alcohol from the diet.If a feast took place the day before, reschedule the laboratory test for a couple of days.
• Drinking regime. It is not recommended to consume juice, tea and coffee before taking blood for any type of research. You can drink plain water, not mineral and still.

Myth number 3. You can take tests at any time

In fact: No, you can’t

For example, blood counts can change during the day, so blood sampling is usually done in the morning.For this period, reference intervals have been calculated for many laboratory parameters. This is especially important for hormonal and biochemical studies.

Myth number 4. Menstruation is not an obstacle for testing

Actually: No, hindrance

Firstly, the sample may be contaminated with secretions, and secondly, the results of studies, especially a general blood test, hormonal and biochemical ones, may be inaccurate. For example, when taking blood for sex hormones, the phase of the cycle must be indicated.If urine is to be examined, it is recommended to collect it before menstruation or 5-7 days after its end and not earlier than 7 days after cytoscopy.

Myth number 5. Sports activities do not affect the research result

In fact: No, they do.

Exercise causes hormonal and biochemical changes that affect blood counts. Stop any training two days before analysis. Also, immediately before taking blood, exclude physical stress (brisk walking, climbing stairs, running).

Myth number 6. Emotional stress affects research outcome

In fact: Yes, it does

Strong anxiety and even mild excitement cause an increase in stress hormones, a violation of the acid-base state of the blood. Therefore, before taking blood and some other types of biomaterial, you need to calm down and rest for 15–20 minutes. In order not to worry, ask your doctor in advance how, quickly or slowly, painfully or not, the procedure takes place.

Myth number 7. Blood can be donated after X-ray and ultrasound

In fact: No, you can’t

These types of research can lead to the activation of metabolic processes and distortion of research results. It is strongly not recommended to conduct laboratory studies not only after X-rays, ultrasound, but also after surgery, injections, infusions, blood transfusions, punctures and biopsies of various localization, massage, ECG, hemodialysis, ergometry, immunoscintigraphy, procedures that use ionizing radiation, endoscopic research.

Myth number 8. Can’t take medicine

In fact: This is partly true

The effect of drugs on laboratory test results is diverse and not always predictable. It is almost impossible to accurately predict the dependence of the results on any drug. The general recommendation is to refuse to take medications a day before the delivery of the biomaterial. If it is necessary to conduct an analysis, then it is performed before taking / administering the next dose of the drug.

Myth number 9. No smoking

In fact: Yes, you can’t

It is recommended not to smoke at least 30-60 minutes before blood collection, in some cases 2 hours before the test.

Myth number 10. Bacteriological examinations are carried out before starting antibiotic treatment

In fact: Yes, it is

Any type of biomaterial (urine, sputum, gynecological or urological smears) is taken before starting antibiotics or no earlier than 10-14 days after they are stopped.Failure to comply with this rule can lead to a false-negative result, which is fraught with misdiagnosis and the appointment of ineffective drugs.

Author:
Baktyshev Alexey Ilyich, General practitioner (family doctor), ultrasound diagnostics doctor, chief physician

90,000 Treatment of chronic cystitis in a clinic in Moscow

How to forget about pain forever

We publish the expert opinion of the Candidate of Medical Sciences, doctor of the highest category of urologist, urogynecologist Khalafyants Eduard Alexandrovich.

For your convenience, we have divided the article into subsections so that you can easily find answers to your questions.

How to understand that cystitis is chronic , What is cystoscopy , Modern methods of treatment , Causes and symptoms , Prevention , Cost of examination and treatment

Can chronic cystitis be cured?

Yes, I say recovery is possible.

I solve the problem of chronic cystitis resistant to antibiotics and all previous treatments.

Correctly established diagnosis, modern protocols of evidence-based medicine and effective drugs of the latest generation allow obtaining results even in the most advanced cases.

Usually they come to me after several unsuccessful courses of therapy, when it seems that nothing is helping. The story is roughly always the same:

• I have been suffering from cystitis for more than 3 years.In the last months, life can be compared to hell when you drink the best antibiotics on the advice of your doctor, but nothing helps!
• A few days of respite – and in a maximum of a week everything starts all over again! Constant terrible discomfort and pains such that I’m ready to scream. If you suffer, you go to the doctor again, to another. Prescribes other antibiotics. Injecting injections. You think – well, several courses should definitely work, these are not iron bacteria.
• And so these often recurring cystitis tortured me, I have no strength.I run to the toilet every 15 minutes, it’s uncomfortable in front of my colleagues, I go home with stops near every McDonald’s, because there are toilets. I won’t even stutter about my personal life …
• I don’t understand why cystitis often recurs: the legs are always dry, the coat is long. Why do these seizures occur? Maybe this is psychosomatics? What to do, what to take so that this nightmare does not happen again? How to live if it is impossible to live like that ???

The fact is that acute and chronic cystitis are inherently different diseases.If in the acute form it is enough to get rid of the bacteria, and “everything will pass”, then with the chronic form, for many reasons, this number does not work. There are no pills for chronic cystitis.

You need to mentally prepare yourself for the fact that effective treatment of chronic cystitis is a complex, not quick and painstaking process that will require trust, patience, your assistance and self-discipline.

But the result, believe me, is worth it! Subject to certain rules, cystitis very often leaves my patients forever.

How to understand that cystitis is chronic

Before diving into the question, I propose to clarify the terminology. In the modern International Classification of Diseases (ICD 10), we find the only mention of chronic cystitis – a diagnosis under the code N30.2 – “other chronic cystitis”. Why alone? After all, there are many cystitis? The point is that the term “chronic” is outdated. Now the term “recurrent” is used instead. The old name is used by doctors and patients out of habit.And below I will also allow myself to use it loosely.

The problem of chronic cystitis is very serious. During life, every second woman encounters the disease, and in about 60% it becomes chronic. We can say that any cystitis is an inflammation of the bladder. This is where the similarities of cystitis end. And if an acute one can be cured with antibiotics, then with a chronic one it is useless and even sometimes harmful.

If inflammation of the bladder occurs no more than once every six months or twice a year, then each of the relapses is treated in the same way as the first acute attack.More frequent relapses – three or more cases per year – are already considered a chronic condition. In this case, the symptoms are usually persistent or disappear for a very short period. They acquire a “worn out” character – the urge to urinate ceases to be painfully intrusive, the pains are often less pronounced and more like “discomfort”.

And now, about everything in order.

In case of illness, bacteria settle in the bladder, most often Escherichia coli. Due to the anatomical features of a woman, the intestinal flora, under certain conditions, through the urethra can enter the bladder and cause inflammation in it.The task of the bacteria is to gain a foothold and multiply. But normally, the epithelium of the bladder (urothelium) is covered with a protective layer against bacteria and toxic urine components – irritants. To survive, they need to neutralize the protective layer. Its destruction is one of the main causes of chronic cystitis.

Bacteria multiply at a tremendous rate – a whole generation grows in 45 minutes. Consequently, one, entrenched in a suitable environment for her, turns into a colony of millions of individuals in a few hours.

Of course, immunity is on guard – and if a person is healthy, then most likely there will be no cystitis. But colds, fatigue, hormonal imbalances, any chronic diseases, and even just wet feet and hypothermia – and bacteria begin to build their colony.

In order to protect against our immunity (and at the same time antibiotics), a colony of microorganisms creates an “invisibility cloak” – a biofilm, or biofilm from mucus. It is impervious to drugs, and under it, without knowing fear, they multiply until they are ready to invade new areas of the urothelium.Therefore, even after shock doses of antibiotics, recovery does not occur.

Purely theoretically, they can be destroyed, but the protective layer of the urothelium is restored very slowly. Aggressive components of urine continue to “eat away” the walls of the bladder, provoking pain. And literally every new bacterial attack on a defenseless urothelium can result in a new inflammation.

This is how the chronic form of cystitis develops, in which any remedy for the acute form stops working.At the same time, there may not be terrible exacerbations, but the woman feels the sluggish process constantly – with perhaps insignificant periods of relief. At this stage, women go to the doctor for YEARS, receive more and more antibiotics, treat exacerbations on their own, but the problem is not solved. However, urine tests may not show any infection. In parallel, a process is going on in our body that resembles a horror movie. On the one hand, incessant inflammation begins to change the very structure of the bladder, turning the mucous tissue into scar tissue.In this case, all the protective functions of the urothelium disappear with it. The regeneration necessary for recovery does not occur. At this stage, the chronic process, if not dealt with, begins to reproduce itself in an endless cycle.

Similar changes occur under the influence of genital infections (if cystitis was provoked by these pathogens). They also destroy the structure of the mucous membrane. Trying to protect itself from the toxic effects of pathogens, the body builds a “wall” of cells of stratified squamous epithelium.This condition is called squamous metaplasia (degeneration) of the epithelium of the mucous membrane of the bladder. As a result, the so-called leukoplakia of the bladder develops. An independent disease, which is often mistaken for cystitis, it also manifests itself in a variety of pains and urinary disorders.

On the other hand, the use of antibiotics makes bacteria resistant – that is, insensitivity to them. Bacteria inherit their ability to synthesize antibiotic breakdown enzymes.Therefore, if it is necessary to treat the infection, more and more powerful drugs have to be used. But this is a road to nowhere.

At recent conferences, all pharmaceutical companies unanimously declare that there will be NO NEW ANTIBIOTICS in the next 20 years.

I repeat: if you want to cure chronic cystitis and forget it like a bad dream, you cannot do with pills. We will need to restore the urothelium and the protective properties of the bladder in full, and this requires a number of procedures.

This is what I’m doing. First, I make a precise diagnosis. Then I restore the mucous membrane of the bladder. If necessary, I treat the infection.

Cystoscopy, finding out what we are dealing with

Before you understand how to treat this or that type of cystitis, it is necessary to conduct a very thorough examination. The disease can have a very different nature and manifestation. Therefore, before starting, we need to understand who the enemy is and what we will fight.

At the reception I will ask you:

• Describe your complaints – tell if any symptoms persist between exacerbations.Recall the frequency of urge to urinate, the intensity of pain in the urethra and vagina.
• Talk about hygiene practices (this is extremely important!) And your sexual habits.
• Recall the time of the onset of the first episodes of cystitis.
• Tell about past infectious diseases, including genital infections.
• Describe, if possible, what therapy was given earlier.

Carry out the following surveys:

• General urinalysis with culture for flora and determination of antibiotic susceptibility.
• Examination “on the chair” with the O’Donnel test – it allows you to exclude the anatomical cause of the disease.
• Get examined by a gynecologist.
• Study of urine and blood sediment for sexually transmitted infections (STIs).
• Ultrasound of the urinary and reproductive system.
• Tests for hormones.
• Uroflowmetry – according to indications.
• Cystoscopy with targeted bladder biopsy and biopsy examination.

Why cystoscopy?

It allows you to accurately establish the diagnosis.Without cystoscopy, a woman can undergo many ineffective treatments for years. After a series of unsuccessful attempts, doctors shrug their shoulders and are often inclined to assume mental illness in such patients.

I think this cry from the forum will be more convincing than any of my words:

• Recommend a competent, experienced urologist who can help treat chronic cystitis.
• It is good if the doctor is a surgeon and does a cystoscopy with a biopsy. That is, you need a serious doctor who deals specifically with the problem of cystitis.
• Unfortunately, I did not find such a thing, everything is sent only for ultrasound of the kidneys (CT scan has already been done) and for urine analysis (it is also normal). But the problem has not been resolved, constant exacerbations with hematuria. The area is not important.

Cystoscopy is an obligatory stage in the diagnosis of chronic cystitis. It is better if it is performed by the same doctor who will carry out the treatment.

With its help, the doctor gets the opportunity to visually assess the state of the urothelium and, taking into account the results of the biopsy, to prescribe a competent treatment.Knowing the initial state of the mucous membrane, after the end of treatment, it will be easier for a specialist to assess the effectiveness of therapy. Conventional diagnostic methods are not enough for chronic cystitis. And that’s why. For example, in the vast majority of cases, if there are problems with the mucous membrane and bacterial biofilms, there are no signs of inflammation in urine tests. And ultrasound of the bladder, even against the background of leukoplakia, does not show any signs of changes in its walls. The fact is that in a chronic process, pathogenic organisms are not detected in urine tests.These are the so-called adherent microorganisms, which means that they coexist with the urothelium cell already at the membrane level. If, at the same time, you do not conduct an endoscopic examination, that is, you do not see the changes in the mucous membrane with your own eyes, but rely only on the test results, then there is a great risk of missing the true picture of the disease and making the wrong diagnosis.

There is another very important reason. The symptoms of chronic cystitis are not specific, and with the help of cystoscopy, we can identify other diseases, which means that we can prescribe competent effective therapy.

For my research I use a rigid cystoscope with the finest tip. A rigid mechanism has many advantages – it is stable, makes the procedure manageable and allows selective (targeted) biopsy to be taken accurately from suspicious areas.

I perform cystoscopy as delicately and accurately as possible, without pain. I will not be cunning: after the procedure, you will experience discomfort, which, however, goes away within a few hours. My patients never complain of acute pains during urination – everything is quite tolerable.

What is visible on cystoscopy?

My task is to investigate the urothelium in detail. By the nature of its changes, it is possible to understand whether the protective functions of the bladder mucosa are preserved.

Normally, the mucosa should be pink or pink-yellowish, smooth and glossy. In chronic cystitis, the picture is different: the mucous membrane of the bladder is changed and can be whitish, villous, bullous – covered with pimples and balls, like pebbled skin. “Simple” inflammation is also different in appearance from squamous cell metaplasia.

Cystoscopy allows you to take a targeted biopsy – a piece of tissue from an altered part of the urothelium – for histological examination. In the laboratory, the doctor will study the characteristics of the diseased area and help to accurately diagnose for signs of squamous metaplasia of the bladder mucosa. Also, the procedure allows you to take material contaminated with bacteria for analysis (I have already said that in a simple analysis of urine microflora from biofilms is not determined).

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Chronic cystitis – treatment.

I have already spoken about this above, but I consider it necessary to repeat it. The trouble is that many doctors organize the treatment of recurrent cystitis as well as the acute form of the disease. Unfortunately, antibiotics, pain relievers and physical therapy bring only temporary relief, since they do not affect the CAUSE of the disease. Only more or less prolonged remission is possible, which after each new course will be shorter and shorter.

With this approach, a woman’s life turns into hell and is built exclusively within the reach of the toilet – without any hope for personal life, companionship and career. Endless restrictions leave an imprint on the character – it is difficult to be an agreeable, kind and gentle cat when every day is against you, and even the night does not bring relief. Meanwhile, chronic cystitis is successfully treated if correct diagnosis is carried out before starting.

So, let’s get down to the main thing.If the chronic process has not passed into an advanced stage, I always give preference to non-surgical methods. I prescribe preparations from weakened strains of E. coli. Also called the urologic vaccine, it works in the same way as the flu shot. These are tablet preparations that are absorbed in the intestine and are incorporated into the mucous membrane of the entire urinary system with blood currents. The necessary immune response is formed, the defense mechanisms of the bladder mucosa are restored. Now, as soon as E. coli tries to attach to the wall, it will receive a reliable rebuff.

Along with the vaccine for three months, I prescribe an antibiotic at an interval of 10 days. Thus, infectious agents that can enter the bladder are destroyed by a targeted blow. When using this scheme, the intestinal and vaginal microflora does not suffer, since the balance of the intimate and intestinal flora is disturbed only against the background of a long, continuous course of antibiotic therapy. This is a tactic recommended by the European Urological Association and works well.

If, as a result of culture of a portion of urine taken during cystoscopy, pathogenic bacteria are found, I prescribe a course of antibacterial drugs, which I inject directly into the bladder cavity by instillation. This therapy has an effective effect on biofilms and restores the urothelium of the bladder.

By attacking on all fronts, we take control of the disease – and in the vast majority of cases, recovery occurs. Painful urination and burning sensation, pulling pains in the lower abdomen, pain during sexual intercourse disappear from your life.Compliance in the future with fairly simple recommendations regarding the way of life allows us to talk about a lifelong recovery. Three months after treatment, it will be necessary to pass tests again and perform a second cystoscopy.

Treatment of chronic cystitis in women after 50

Chronic cystitis occurs more often in women after 50 years than in young women. The reason is that the health of the bladder lining, its thickness, and the ability to resist infection are inextricably linked to estrogen levels.After 40-50 years, the production of estrogen decreases. The so-called hypoestrogenia develops – a chronic estrogen deficiency. As a result, tissue elasticity decreases, mucous membranes become thinner. The bladder becomes more vulnerable to pathogenic microorganisms. Immune defenses are also weakened, and literally “any little thing” can provoke a relapse.

Therefore, I try to prescribe at least topical estrogen preparations. This approach allows you to improve the structure of the mucous membrane and restore its ability to resist invasions of pathogenic bacteria.

The role of hormones in women for the preservation of the barrier function of the urothelium is today considered one of the key ones. Even a whole line of study of chronic cystitis is developing at the junction of urogynecology and gender endocrinology.

Reasons

Neither hypothermia nor wet feet by themselves lead to cystitis, no matter what our grandmothers say about this. This disease is initially bacterial in nature, and any weakening of the body (due to wet feet as well) simply gives it additional chances.Here is an incomplete list of factors that contribute to its development:

• Pol. Cystitis is more common in women – this is due to the peculiarities of the anatomy. The short and wide urethra is an open door for pathogens, and their natural reservoirs – the anus and vagina – are very close.
• Stagnation of blood in the small pelvis during sedentary work.
• Constipation tendency.
• Consumption of significant doses of alcohol, salty and spicy foods, addiction to junk food.
• Attempts to self-medicate genital infections. Their particular danger is that inflammation against their background is asymptomatic for years. At the same time, they cause damage and degeneration of the mucous membrane, which persists even after successfully getting rid of STIs.
• Any other chronic infections (caries, tonsillitis, pyelonephritis, gastrointestinal problems …).
• Violation of hygiene rules: from wearing tight underwear made of artificial fibers to improper washing.
• Hormonal changes: pregnancy, menopause, menstruation.
• Endocrine diseases – diseases of the adrenal glands and thyroid gland.
• Stress, lack of sleep, chronic fatigue syndrome and other situations that weaken the immune system.
• Early onset of sexual activity, frequent change of sexual partners.
• Gynecological diseases: inflammatory processes, vaginal dysbiosis, etc.
• Older age, although recently cystitis has clearly “rejuvenated”.
• Genetic predisposition and anatomical features.
• Diseases of the stomach, intestines and liver, affecting the ability to absorb antibiotics and leading to a decrease in immunity.
• Taking antibiotics without sufficient reason and using substandard generic drugs (analogues).
• Emergence of pathogens resistant to a wide group of antibiotics.

Any of these factors can cause exacerbation of a chronic “sluggish” disease.

Symptoms

The disease is insidious in that it has many “masks”.It is difficult for a woman to understand that the symptoms are caused by cystitis, and not urethritis, cervicitis, vaginitis or leukoplakia, so at the first suspicion it is worth contacting a urologist. In order to develop effective treatment tactics, it is very important to exclude diseases that are similar in terms of symptoms and to make the correct diagnosis. In the acute stage, the signs of chronic cystitis do not differ from the symptoms of acute:

• Frequent urination.
• Difficulty intermittent outflow of urine, which is accompanied by pain and burning, and ends with a feeling of incomplete emptying.
• Inability to urinate with a full bladder.
• Urinary incontinence. The outflow of fluid occurs involuntarily. Moreover, the urge can either arise unexpectedly or be absent altogether.
• Soreness and cramps when urinating in the lower abdomen, in the urethra or in the bladder, during sexual intercourse.
• Pelvic pain, discomfort in the pubic region.
• Aching and drawing pains when filling the bladder.
• Blood at the end of the act of urination.
• Sometimes the temperature rises, other indirect manifestations of cystitis occur.
• Appearance of night urges to use the toilet.
• Burning pains after urination.

These symptoms occur individually or in different combinations, if one of them appears, I recommend that you urgently see a doctor.

Based on patient complaints, chronic cystitis is divided into:

• Chronic latent. This form has very different manifestations.In one case, the inflammatory process is present, but it is detected only during cystoscopy, and does not manifest itself in any way with unpleasant sensations or in analyzes. In other cases, this form is occasionally exacerbated with manifestations of the type of acute.
• If laboratory tests, all symptoms and examination results indicate cystitis, but the reservoir function (that is, the function of filling and retaining fluid) of the bladder is not impaired, they speak of persistent.
• If there is a violation of reservoir function on the face: the bladder fills with a sharp pain, it is impossible to endure, which is why a woman goes to the toilet “often and a little bit” – this is interstitial cystitis.

How to avoid relapse

After treatment, we always give the most detailed recommendations on how to behave, what to eat, what to drink and what to take.

• Hygiene: shower twice a day, washing after defecation – strictly from front to back with previously washed hands.
• Change your synthetic underwear for breathable models – they can also be very beautiful and seductive.
• Don’t sit all day. A healthy bladder requires walking and adequate physical activity.
• Don’t overcool, dress for the weather.
• Treat all infectious and viral diseases in time – from ARVI and agnin to caries.
• After any antibiotic treatment, take care of the restoration of the intestinal microflora and “feed” her regularly – she loves sugar-free white yoghurts, fruits, vegetables and whole grains.
• The same applies to the microflora of the vagina – the gynecologist will tell you about the drugs.
• Observe the mode of urination – you need to urinate regularly, every two hours, at least.Take this recommendation literally: even if your bladder does not seem to be full enough, go to the toilet literally “by the hour.”
• Observe the drinking regime: in the morning – 2 glasses of clean water (not carbonated or sweet). Then every hour you need to drink literally a few, in order to collect about 2 liters of water per day.
• Frequent, fractional and balanced diet. Hunger strikes are strictly prohibited: dieting is stress for the body. Refusal of proteins / fats / carbohydrates leads to a violation of the biochemistry and protective properties of the urothelium.If you need to fast, all restrictions must be introduced and monitored by a doctor.
• It is worth swimming only in a clean reservoir with warm enough water.

It is very important that the flora of the vagina and intestines is also stable and healthy. Therefore, against the background of the treatment of cystitis, we recommend visiting a gastroenterologist and gynecologist.

Are there any dietary restrictions?

A special diet is not needed, but I strongly recommend adjusting the nutrition. “Thank you” will tell you not only the bladder:

• Observe your drinking regime: two liters of water a day helps to eliminate uric acid and bacteria.
• Limit alcohol and eliminate colored sodas.
• Give up processed products and everything canned – chips, canned food, sausages. Products must be natural. These are foods that can be eaten raw and those that need to be cooked.
• What can you do? Dairy products without sugar, white poultry meat, cereals, legumes and vegetables, fish, leafy vegetables.

How to have sex to avoid relapse?

The following paragraphs are excerpts from the official recommendation of the European Association of Urology.Some of them seem strange at first glance, but each point is justified.

• With a new partner, you need to get tested for STDs. Before obtaining results and 6 months after it is necessary, it is recommended to use condoms with intimacy (6 months is the incubation period of HIV infection).
• In addition to general hygiene procedures, it is recommended to brush your teeth well and use a mouthwash: the microflora of the mouth can cause inflammation of the urethra.
• Do not use saliva as a lubricant.
• If you want to continue having sex after anal penetration, you need to change the condom, wash your hands and genitals well.
• Be sure to urinate immediately after intercourse: nature has endowed us with a powerful defense mechanism. “Do not want”? Drink some water.
• Avoid hard sex.