Taking care of your sexual and reproductive health (SRH) is crucial for every woman, no matter what your age. This is not only for the sake of better maternal outcomes and child health parameters, but also for the lifelong prevention of diseases. How seriously you take SRH can have a direct impact on your quality of life, beginning in your teenage years to well after menopause.
However, there is still a lot of stigma attached to SRH, especially when it comes to sexually transmitted infections (STIs), reproductive tract infections (RTI), or any other illness or dysfunctionality associated with female sexual health. This often results in women being unaware of how to approach emerging health issues, making it even more difficult to access healthcare systems, and deliver treatments and care on time. Awareness about these health issues is, therefore, vital.
To ensure you know exactly what you need to about STIs and RTIs, we talked to Dr Asha Dalal, the director of the department of obstetrics and gynaecology, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai. Here’s everything you need to know.
The basics of infections
The first thing you need to understand is what these infections are basically about. An infection occurs when microorganisms—these could be bacteria, parasites, fungi, and viruses—that are not normally supposed to be in your body, invade it and multiply. No matter what the base cause, an infection can present symptoms that can help with a clinical diagnosis (and hence, quick and proper treatment). Often, the symptoms are subclinical or not apparent at all, which can make a timely diagnosis and treatment more difficult or delayed.
Dr Dalal explains that when such infections occur in the reproductive tract, they are called RTIs, and include STIs as well as other infections which may not be due to sexual contact. “STIs, which are also called sexually transmitted diseases (STDs), are infections which are generally transmitted through sexual contact with an infected person,” she explains. “However, STIs may be transmitted by sharing drug needles, or sometimes from mother to child.” She also explains that when an infection spreads further to involve the fallopian tubes, ovaries, or the pelvic peritoneum, it is called pelvic inflammatory disease (PID), which is also a type of RTI and can lead to infertility if left untreated.
Common STIs to beware of
Dr Dalal lists the following as the most common STIs:
• Gonorrhoea, also known as clap, is a bacterial STI that can affect the warm, moist areas of the body.
• Chlamydia is another bacterial STI that can cause serious and permanent damage to a woman’s reproductive system, to the extent that the risk of infertility and ectopic pregnancy (a pregnancy that occurs outside the womb) increases manifold.
• Syphilis is also a bacterial STI which causes painless sores to appear on your genitals, rectum, or mouth. Syphilis can spread from person to person if you come in contact with these sores.
• Trichomoniasis, also called trich, is caused by a small protozoan parasite. One of the complications of this disease is premature labour and delivery in pregnant women.
• Human papilloma virus (HPV) usually leads to warts on the genitals, mouth, or throat, and is responsible for some cancers like oral, cervical, and vulvar. Though there are several types of HPV,Type 16 and Type 18 are commonly implicated.
• Human immunodeficiency virus (HIV) damages your immune system, and can lead to acquired immune deficiency syndrome (AIDS). This can be transmitted by sharing syringes, unprotected sex with an infected person, and from mother to child.
• Genital herpes is caused by the herpes simplex virus (HSV). There are two types: HSV 1 usually causes oral lesions, often called cold sores, but can cause genital herpes too through oral sex. HSV 2, on the other hand, is usually associated with genital herpes where you see blisters which are very painful. Herpes can be transmitted from mother to child too.
• Pubic lice (crabs) is also an STI, which is caused by parasites getting attached to pubic hair and skin.
There are also other STIs which include:
• Chancroid
• Lymphogranuloma venerium
• Granuloma
• Molluscum contagiousness
• Hepatitis B and C
Common symptoms and treatment of STIs
While each STI comes with its own set of symptoms, and many present with no symptoms at all, the following are some that women may experience:
• Pain during sex or while peeing
• Burning sensation while peeing
• Sores, ulcers, bumps, warts, or rash around the genitals, or in the mouth
• Vaginal discharge, which is coloured or smelly
• Itching in the vaginal area
• Pain in lower abdomen
The treatment of STIs depend entirely on the root cause, which is why getting tested as soon as symptoms show up is vital. Dr Dalal says that STIs which can be treated with antibiotics include gonorrhoea, chlamydia, syphilis, trochomoniasis, and crabs. STIs caused by viruses, like HPV, HIV, and genital herpes, cannot be cured, but can be managed with antiviral medications that can also decrease their spread.
Other RTIs you should know about
Apart from STIs, there are a number of RTIs you should take precautions against. These include candidiasis or thrush, and bacterial vaginosis, both of which are caused by the overgrowth of microorganisms that cause disturbances in the equilibrium of the vaginal flora. “Rarely, RTIs can be caused by iatrogenic infections due to unclean hands or instruments used during a medical procedure, like child delivery or IUD insertion, especially in underdeveloped and poor countries,” Dr Dalal explains.
She also notes that adolescents are more susceptible to STIs and RTIs due to a number of reasons:
• Sexual relations are often unplanned and unprotected
• Lack of knowledge of STIs
• Access to preventive aids like condoms is limited
• Vaginal mucosa is still immature
• Some may be forced into sex
• Poor genital hygiene, menstrual hygiene, and general hygiene
No matter which of these reasons cause the contagion, STIs and RTIs among adolescents can cause lifelong damage, as it can lead to infertility, increased risks of getting HIV, AIDS, miscarriages, stillbirths, preterm birth, and congenital infections. Dr Dalal also points out that these can also lead to psychological problems in both adolescents and adults, making the prevention of all RTIs a necessity.
How to prevent RTIs and STIs
Dr Dalal highlights the fact that having basic awareness about STIs and RTIs, and not shying away from seeking help if you feel you have one, is vital for women as well as men of all ages. The following are some steps that can help you prevent these infections:
• Responsible sexual behaviour by safe sex practices and avoiding multiple partners
• Avoiding sexual contact with a partner with STI
• Ensuring complete treatment of both partners
• Do not neglect a discharge which is unusual
• Ask for information about STIs from your local health care provider
• Go to a safe place for contraception or abortion advice
• Maintain personal and menstrual hygiene