What are common sexually transmitted diseases? What symptoms do they manifest themselves through? How is it treated and what are the chances of recovery? Not exactly a topic to talk about at a regular’s table or to discuss delicately between the first kisses on a date. In doing so, we should start normalizing talking about testing and our health. Especially with people we might want to become intimate with.
Especially in BDSM there is a higher potential for infection due to various factors such as lifestyle, materials, fetishes, practices and event or club visits. The only thing that helps here is education, correct hygiene, practicing safe sex and getting tested regularly.
The correct term would actually be “sexually transmitted diseases” or “infections”, in English “sexually transmitted diseases”, STD for short, and “sexually transmitted infections”, STI for short.
STI and STD: Does this affect me at all?
In fact, these are incredibly common. One in four adults in Germany has already had such an illness or infection. The problem: Many people don’t even know that they have or have had one, what effects it has, where help can be found and who to inform if in doubt. Information about the most common transmission routes can be found in Part I of this series. This article is dedicated to the eight most common STIs or STDs.
The good news: You can protect yourself from most of these diseases through safe sex and, if detected early, the chances of treatment and recovery are quite good for most of them. Safer sex means preventing the transmission of a wide variety of germs through physical barriers such as condoms, latex, femidomes, gloves and lick wipes. It also means taking into account not only your own health but also that of other people.
1. Chlamydia
Chlamydia infections are one of the most common STIs worldwide, affecting all genders equally. Infection with the spherical bacteria (“Chlamydia trachomatis”) usually occurs through unprotected sexual intercourse. Condoms can reduce the risk of infection. People who frequently change sexual partners should undergo regular examinations.
Transmission:
Through vaginal, anal, oral or other mucous membrane contact
Symptoms:
Consistent, clear or yellowish discharge from the vagina or penis. Itching, pain in the urogenital area (i.e. the pelvis and also the testicles). Symptoms usually appear one to three weeks after infection, but the infection is often asymptomatic.
Long-term effects:
Permanent narrowing of the urethra is possible in people with a penis. Premature births and miscarriages, as well as ectopic pregnancies and infertility can occur in people of childbearing potential.
Treatment:
Chlamydia infection is treated with antibiotics. You take these for one to two weeks, or for certain preparations only once.
Curable:
Yes. The infection can be cured with antibiotics.
2. Genital warts / HPV
HPV is short for human papillomavirus, which causes genital warts. Here too, all genders are equally affected. This means that virtually every unvaccinated adult in Germany is a potential carrier of this infection. About 20 percent of them are so-called “high-risk viruses,” which are linked to the development of cervical cancer. Girls have been vaccinated against this since 2007, and boys have also been vaccinated since 2018.
Transmission:
Body fluids such as blood, saliva, semen, vaginal fluid and direct skin-mucosal contact. Theoretically, it cannot be ruled out whether transmission also occurs when the genital mucous membranes come into contact with contaminated objects such as toilets, towels or shared soap.
Symptoms:
Sharp, light pink to gray patches of skin on the vagina, labia, penis and in the anus area.
Long-term effects:
In women with uterine cervical cancer and associated consequences.
Treatment:
In case of outbreak: freezing, ablation, active ingredient podophyllin. The vaccination is a health insurance benefit up to the age of 17; some health insurance companies also cover the costs beyond this age limit.
Curable:
No. HPV stays in the body forever and can break out again.
3. Genital fungal infections
Fungal diseases are also STIs. The most common here are yeast fungi called “Candida Albicans”, which can also occur in all genders.
Transmission:
sexual intercourse, mucous membrane contact with infected areas, disruption of the vaginal flora, poor or incorrect hygiene, incorrect detergents, unclean toys, unclean toilets, showers, baths.
Symptoms:
Swelling and redness of the labia and vagina. Yellowish, whitish-crumbly discharge and itching. Pain during sexual intercourse. Red dots on glans and foreskin. Whitish, unpleasant-smelling deposits under the foreskin.
Long-term effects:
damage to the vaginal flora, scarring of the inflamed tissue, long healing process in the case of recurring fungal infestation.
Treatment:
Fungals (antimycotics) as cream, gel, ointment and also as vaginal tablets, then building up the vaginal flora.
Curable:
Yes.
Curable:
Yes.
4. Gonorrhea
Gonorrhea, or commonly known as “tripper”, is caused by the bacterium “Neisseria gonorrhoea” and is extremely contagious. Here too, safe sex offers the best possible protection.
Transmission:
Very easily transmitted through unprotected oral and sexual intercourse, as well as direct contact with mucous membranes via hands and sex toys.
Symptoms:
Pain when urinating, milky-purulent discharge, sore glans, sore throat, swollen glands, discharge from the urethra or anus, few symptoms for the first nine days, sometimes completely symptom-free.
Long-term effects:
Can become chronic and lead to infertility in all genders.
Treatment:
With antibiotics over several weeks. Gonorrhea and chlamydia often occur at the same time and are treated at the same time. As a precaution, all partners should also be treated
Curable:
Yes.
Curable:
Yes.
5. Syphilis
Syphilis is caused by bacteria of the “Treponema pallidum” type. The infectious disease occurs everywhere in the world. It affects more than twice as many men as women, but both primarily in young adulthood. However, since the advent of a functional antibiotic, the frequency has decreased worldwide.
Transmission:
Via sores and ulcers in the mouth and genitals as well as injuries or contact with weeping mucous membranes.
Symptoms:
After two weeks: small, painless, brown-red growths in the genitals or mouth, ulcers on the mucous membranes, inflammation of the lymph nodes.
After seven to ten weeks: General symptoms of illness such as headache or sore throat, flu-like symptoms such as fever, fatigue, loss of appetite, weight loss, joint pain.
At this point, the pathogen has already spread throughout the body. All lymph nodes can swell, brown-red spots (“exanthema”) or nodules (“papules”) appear on the skin, which can spread over large areas and various parts of the body and are very infectious. However, the symptoms soon subside. This is followed by a latency phase of approximately one year.
Long-term effects:
If left untreated, the ulcers heal, but often leave scars. Late syphilis hardly exists in the Western world anymore, as it is usually treated in the first stage. In late syphilis, serious damage to the skin, muscles and vessels occurs approximately five years after infection. Finally, the nervous system is attacked. If left untreated, the disease ends in death in approximately ten percent of cases.
Treatment:
Antibiotics such as penicillin.
Curable:
Yes.
Curable:
Yes.
6. Herpes
Transmission:
Easily transmitted through direct contact with blisters or ulcers or via droplet or smear infection such as coughing, sneezing, sharing a glass. It can also be transmitted via the mucous membranes and through secretions on the hands or skin during sex, licking, kissing, fingering, and sharing sex toys. Herpes can also be transmitted to newborns during birth.
Symptoms:
Typical blistering with watery contents or shallow ulcers on the lip or genital area (mucous membranes), rarely also fever, chills, swelling of the lymph nodes. Usually heal within two to three weeks. Initial infections often have no symptoms.
As it progresses, genital herpes usually affects the large and small vulval lips (labia), the cervix, glans, foreskin, penile shaft and anal area. This is followed by problems with urination and bloody discharge from the anus.
Long-term effects:
Recurring infection that breaks out during physical exertion.
Treatment:
Virus-inhibiting creams, long-term prophylaxis, and in particularly severe cases also tablets.
Curable:
No. The acute infection can heal, but the disease does not go away.
7. Hepatitis
Hepatitis literally means inflammation of the liver. This can have many causes, for example viruses and bacteria, but also alcohol and other drugs. Because there are several types of viral hepatitis, they are designated by the letters A, B, C, D and E.
The consequences of the infections are very different, transmission occurs in almost all cases primarily through blood, saliva, semen, vaginal fluid, urine, tears and breast milk, i.e. especially during vaginal, anal or oral sexual intercourse of any kind and contact with mucous membranes or minor injuries. In addition, shared and/or contaminated drug equipment such as needles, swabs, tubes, as well as the shared use of toothbrushes, razors, nail scissors, toys and even lubricants. There is also a risk when piercing and tattooing with non-sterile equipment.
Hepatitis A and E
Hepatitis A is the most common but also the least threatening form of viral hepatitis. It almost always heals on its own and leaves no lasting damage. Also known as travel hepatitis, hepatitis A, like hepatitis E, can also be transmitted through contaminated water and food.
Symptoms:
Two to four weeks after infection, flu-like symptoms occur: fatigue, loss of appetite, nausea, headache, muscle and joint pain, feeling of pressure on the right costal arch. In pregnant people, hepatitis E can lead to severe disease and even liver failure.
Long-term effects:
Later, the urine turns dark and the feces light. The skin and eyes turn yellow and itching occurs. Approximately one in five pregnant people with hepatitis E will develop a severe course of liver failure. There is then a danger to life.
Treatment: You can be vaccinated against hepatitis A, but not against E. Both infections usually heal on their own. But: Unlike hepatitis A, having hepatitis E does not leave you immune. So you can always get infected again.
Curable:
Yes.
Hepatitis B and D
Hepatitis D cannot occur alone, but needs the hepatitis B virus to multiply. The symptoms, course and treatment of hepatitis B and D are identical.
Symptoms:
The course of the disease is very individual. Two thirds of those affected are asymptomatic. Two to three months after infection, flu-like symptoms usually occur: Fatigue, loss of appetite, nausea, headache, muscle and joint pain, upper abdominal pain, nausea, vomiting and skin changes. In around a third of cases, the skin and eyes also turn yellow.
Long-term effects:
Hepatitis B can become chronic and lead to liver failure in severe cases.
Treatment:
Vaccination against hepatitis A and B can prevent the disease. The disease itself usually heals on its own. Chronic hepatitis B is treated with medication for months or years.
Curable:
Yes.
Hepatitis C
Three weeks to six months pass after infection. Only in a few cases do flu-like symptoms or yellowing of the skin and eyes occur.
Long-term effects:
Fatigue, upper abdominal discomfort, reduced performance, itching and joint problems. One third suffer from liver inflammation and remodeling of the connective tissue or scarring of the liver (fibrosis). Possible liver cirrhosis, liver failure or liver cancer. Some infections heal within six months, but most become chronic. Chronic infections can also heal spontaneously later.
Treatment:
None in the acute phase (six months). Thereafter, in the case of chronic hepatitis, drug treatment for eight to twelve weeks.
Curable:
Yes.
8. HIV infection / Aids
AIDS is considered the most dangerous sexually transmitted disease and is characterized by a weakening of the immune system. It is triggered by the HIV virus (human immunodeficiency virus), which is now mainly transmitted through unprotected sexual intercourse. HIV-positive means that you are infected with the virus, but is not the same as AIDS, which is a disease.
Transmission:
Fluid transmission through blood, semen, anal and vaginal secretions, breast milk. These must get into the bloodstream or onto mucous membranes, which usually happens through unprotected sexual intercourse. It can be transmitted at birth and also through non-sterile hypodermic or tattoo needles.
Symptoms:
No symptoms initially or sometimes for years. If left untreated, a typical course looks like this:
Two to four weeks after infection, flu-like symptoms such as fever, fatigue, tiredness or malaise, night sweats, diarrhea, swollen tonsils and lymph nodes, muscle pain, rash. This is followed by a symptom-free or low-symptom phase.
At some point the immune system is so weakened that symptoms such as swollen lymph nodes, night sweats, fever, diarrhea, weight loss, fainting, fatigue, shingles, fungal infection of the mouth, throat, vagina, nerve damage in the arms and legs with pain, tingling or numbness occur.
Long-term effects:
Weakening of the immune system to fewer than 200 helper cells per microliter of blood and certain serious diseases such as pneumonia, fungal infection of the esophagus and trachea, certain types of cancer (e.g. Kaposi’s sarcoma). Then we talk about AIDS.
Treatment:
Medications such as PrEP (pre-exposure prophylaxis) can be taken as a preventive measure or, if a high-risk encounter is suspected, PEP (post-exposure prophylaxis) within 48 hours.
Thanks to special medications, it is now possible to live well and for a long time even with an HIV infection.
Curable:
No. Although HIV can now be treated so that it is “undetectable” in the blood, there is no absolute and definitive cure for HIV.
Further:
Anonymous reporting obligation applies to HIV diagnosis, AIDS illness and death. Testing for the HIV virus is only possible with informed consent. This means that the person being tested must always know about the subject and consequences of the test. In principle, there is no obligation to disclose information to doctors, employers or other bodies. This means that the infection does not have to be disclosed to anyone.
The situation is different with sexual contacts. They must be informed about the infection beforehand and protected with condoms. The extent to which these can be omitted through treatment with medication due to a low viral load is not yet clearly regulated legally.
This was Part II of the Deviance series on sexually transmitted infections. Also interesting:
STI and STD Part I: how they’re transmitted
STI and STD Part III: misconceptions and Clichés
STI and STD Part IV: risks of infection in BDSM
STIs and STDs Part V: safer sex and BDSM
