Safest sex


You are all set for a steamy night with your partner. The soft light of fragranced candles falls on the bed; a bottle of wine lies on the bedside table and soft music plays in the background. It's hard to contain your excitement and anticipation. So what we're going to recommend may not be welcome, but we are going to do it all the same: Do go out and buy some condoms so that your night is as safe as it is exciting.
You may imagine that sexually transmitted diseases (STDs) are other people's problem and could never happen to you. You couldn't be more wrong. Your unprotected sexual exploits may lead to more than 25 STDs apart from HIV, and these may cause arthritis, memory loss, heart disease, eye inflammation and even cancer. You can catch a STD from the blood, semen or vaginal fluids of an infected partner. Ironically, it's possible to contract sexually transmitted diseases from people who seem perfectly healthy and those who may not even be aware that they have an infection. Doctors at major hospitals in the city say they see around 50 people with STDs in a month. There are lots more out there who are silent carriers and avoid seeing a doctor.
If you are a young woman, your chances of getting a STD are much higher than those of a man or middle- aged woman. "Young people are at a greater risk because they are more likely to indulge in unsafe sex and have multiple sex partners. Condoms provide some amount of protection, but it's important to avoid multiple partners," says Dr Shivani Sachdev, gynaecologist, Phoenix Hospital. Moreover, in young women the cervix is made up of constantly changing cells which make the cervix more vulnerable to certain STDs.
However, this does not mean you can't get an infection if you are old. In fact, the numbers of older women reporting to the doctors with STDs is on the rise, simply because of the misconception that they are not at risk. After menopause, there is a thinning of tissues in the female vagina and the natural lubrication also decreases. This can increase the risk of micro- tears and sexual transmission of certain diseases.
The immune system of older people is also less efficient, leading to an increased risk of sexually transmitted infections. Women are anatomically wired to be more likely to contract STDs because the average vaginal environment enables viruses and bacteria to grow. Moreover, it's relatively easier for an infection to penetrate the thin mucous membrane of the vagina as compared to the penis which is protected by its epidermis skin coating. While women are mostly infected with yeast infections, chlamydia and genital human papillomavirus (HPV), men usually report with gonorrhea, syphilis and chlamydia.
Hepatitis A and B are also known to spread through sexual transmissions. In addition to being more susceptible to infection, women are also more likely than men to experience some of the harmful side effects associated with STDs. Chlamydia, for example, is known to produce few complications among men whereas women with the disease can face problems like infertility, chronic pelvic pain, and potentially- fatal ectopic pregnancies if the condition goes untreated.
STDS may go undetected for long periods as they result in a number of confusing and misleading symptoms. While some may have no symptoms for very long, others may experience genital sores, pain and itching. "Around 80 per cent of STDs are detected by doctors when patients visit them for some other problem. For instance, I had a patient who had genital herpes but never reported that to me. It was a chance discovery. There are also several patients who come with problem of infertility and through tests we get to know they have been suffering from chlamydia," says Dr Sachdev.
While women with STDs may experience vaginal discharge, lower- abdominal pain and pain during intercourse, men generally experience a discharge from their penis, pain during urination besides testicular swelling and pain. Regular testing for STDs, especially chlamydia and HPV, is very common in the west but it's yet to pick momentum in India.
While a Pap smear test is recommended for HPV, blood tests and vaginal swab tests would tell if a woman has got any other STD. " For men, besides physical examination, blood tests and urine tests usually tell the presence of STDs," says Dr Kapil Juneja, consultant urologist, Moolchand Medcity.
Anal sex is very risky when it comes to STDs because it usually causes bleeding. Also your chances of getting an STD increases every time you break up with one partner and move on to another, even if each relationship is monogamous. Most people are silent carriers of STDs which can manifest later on. Though condom reduces chances of contracting STDs, being faithful to your partner is the best way to prevent it.
Any STD, if ignored, can do a lot of complications in later stages. "Men can suffer from urethral stricture which means obstruction in urine passage, infection of the testicles, prostrate and even infertility.
Some diseases if left untreated can also damage other body organs. For instance, syphilis infection may travel to the brain leading to memory loss, problems with mental function, walking and balance. It can also affect the heart, bladder control, and vision if left untreated," says Dr Anshuman Aggarwal senior consultant, urology, Fortis Hospital.
If somebody has untreated gonorrhea or chlamydia, he is also at risk of getting arthritis when infection moves to the joints. Once it does, it can cause excruciating pain and, in some cases, permanent joint damage and deformity.
A woman suffering from chlamydia can pass the infection from the vaginal canal to her child during delivery, causing pneumonia or an eye infection that can lead to blindness. The good news is all STDs are curable if detected on time.
Antibiotics can cure many sexually transmitted bacterial and parasitic infections, including gonorrhea, syphilis, chlamydia and trichomonas. Sexually transmitted viral infections like HIV are not curable, but HPV and hepatitis B are preventable with vaccines prior to exposure. The duration of the treatment would depend upon the stage and kind of STD you are suffering from.
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