CSI News South Africa

Sexually transmitted infections can devastate women

Sexually transmitted infections (STIs) are a “silent condition” that if left untreated can also have a devastating impact on a woman's health, her ability to bear children and the well being of unborn children.

That's according to Professor Anwar Hoosen, Head of the Department of Medical Microbiology at the University of Pretoria.

“In South Africa there is likely to be a strong correlation between a woman's socio-economic status and the chances of her falling prey to one of the many infections that are common in the country,” said Professor Hoosen.

Hoosen also said the primary aid to the spread of STI's is unprotected sex common among particularly lower socio economic groups where women are pressured into intercourse without the protection of condoms. “Matters are made more serious when the women concerned report late to clinics for treatment, or their first antenatal clinic visit is in the later stages of their pregnancy. By then the damage is done and, depending on the type of STI, permanent damage may have already been done to the unborn child”, he said.

According to Hoosen, there are several types of STI's prevalent in South Africa, but the most common amongst young women is Chlamydia. This infection is caused by the Chlamydia trachomatis bacteria. This infection is often undetectable with up to 75 percent of infected women displaying no symptoms. “Antibiotics are used to treat and cure chlamydia. A single dose of azithromycin™ or a week of doxycycline™ are the most commonly used treatments,” Prof Hoosen said.

But he warned that if left untreated, this disease can lead to pelvic inflammatory disease (PID) resulting in permanent damage to the fallopian tubes and uterus, chronic pelvic pain, infertility and a potentially fatal ectopic pregnancy (pregnancy in the fallopian tubes instead of the uterus). “PID is caused by bacteria moving up from a woman's vagina and in turn infecting her tubes, ovaries and then the womb. Chlamydia and gonorrhea are the most usual causes of PID”, he said.

“Sexually active women under 25 years are most likely to suffer from PID. Chances of infection increase further if they've had an STI, have more than one partner, use douches or an intrauterine contraceptive devise,” said Hoosen. “Many women have PID and don't know it, simply because sometimes PID doesn't display any symptoms. When symptoms do occur the most common is pain in the lower abdomen. Fever, smelly vaginal discharge, painful sex and urination, irregular periods and pain in the upper right abdomen may also occur.”

Hoosen strongly advised for a thorough medical examination and treatment with antibiotics to treat this problem. But he said there could be exceptions in severe cases where the fallopian tubes are blocked and swollen, in which case abscesses may develop with scarring of tissue and surgery may be required. He added that gonorrhea, another silent condition and the most cause of PID can also lead to loss of fertility, arthritis and even heart problems. Babies born to mothers with the disease may also contract gonnorhea and suffer from blindness, joint infections or blood infections.

“Another common vaginal infection in women of childbearing age is called Bacterial vaginosis, also called BV. This occurs when the balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain harmful bacteria,” Professor Hoosen said. “The cause of this is not known. Although it is not sexually transmitted, it is thought that sexual contact may disrupt the balance between ‘good' and ‘harmful' bacteria that protect the vagina from infection.”

He said that in most cases, BV does not cause any problems. But if left untreated complications may arise including premature deliveries and low birth weight babies, increase the risk of Pelvic Inflammatory Disease.

He mentioned that genital herpes was another common type of STI. This is usually caused by the herpes simplex virus type 2 (HSV2), or sometimes by herpes simplex virus type 1 (HSV1), which is characterised by cold sores around the mouth. “In some cases, genital herpes causes blisters and pain in the genital area. It can also, however, cause no symptoms, so someone who is infected could unknowingly pass it on to others, Hoosen said.

“There is no cure to eradicate herpes. An infection with the herpes virus stays in the body and, although medications can alleviate and limit outbreaks, herpes stays with the patient forever. Herpes usually begins with pain, tenderness, or itching in the genital area and may also include fever and headache. Blisters or vesicles (little water-filled pimples) may appear on the vagina, thighs or buttocks. Blisters soon open to form painful sores that can last for several weeks.”

“Recurring bouts of herpes tend to follow other infections (such as colds), stress, hormonal changes or menstrual periods.”

Another very important and common infection is syphilis. “This infection starts as an ulcer (a break in the skin or lining of the vagina) and can lead to complications of meningitis, arthritis and even heart problems. It is also silent-often presenting no obvious symptoms. Pregnant women with syphilis face the prospect of infecting their unborn child leading to stillbirths and pre-term labour. Babies born to mothers with this disease may also suffer from blindness, blood infections, joint and bone infections”, Hoosen said.

Hoosen also noted that primary symptoms of STI were similar across infections varying from vaginal itching and discomfort, unusual vaginal discharges, pain during urination, bleeding between periods, pain during sex, abdominal and back pains, severe pelvic pain, blisters, open sores or rashes. “Women experiencing any of the STI symptoms should visit a doctor or clinic immediately. Treatment is effective, good drugs are available to fight most infections, but early treatment is the greatest aid to recovery”, he said

“Leading a healthy lifestyle and practicing safe sex are some of the trusted methods in the prevention of STI”, he concluded.

Pfizer South Africa
www.pfizer.com
Solly Mabotha



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