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(STI) are trans­mit­ted from one per­son to another through sex­ual con­tact, and at times gen­i­tal con­tact. The in­fec­tion is usu­ally trans­mit­ted via vagi­nal in­ter­course, oral sex, and anal sex. Ac­cord­ing to Dr Duru Shah, Di­rec­tor, Gy­naec­world, Cen­ter for As­sisted Re­pro­duc­tion & Women’s health and panel con­sul­tant at Breach Candy, Jaslok and Global Hos­pi­tals and Hin­duja Health­care, STI can also oc­cur from mother to baby dur­ing child­birth or breast­feed­ing, or through blood trans­fu­sions and even with the use of un­ster­ilised IV drug nee­dles. Micro­organ­isms that ex­ist on the skin or mu­cus mem­branes of the male or fe­male gen­i­tal area can be trans­mit­ted, as can or­gan­isms in se­men, vagi­nal se­cre­tions or blood dur­ing sex­ual in­ter­course. Terms like Vene­real Dis­ease and Sex­u­ally Trans­mit­ted Dis­eases are now con­sid­ered passé, while STI sug­gests that a per­son can pass on the in­fec­tion with­out hav­ing a dis­ease—one does not have to be ill to in­fect oth­ers. The World Health Or­gan­i­sa­tion (WHO) es­ti­mated over 10 years ago that over 1 mil­lion peo­ple each day be­came in­fected with a sex­u­ally trans­mit­ted in­fec­tion, al­though most ex­perts be­lieve the fig­ure is a lot higher to­day. A ma­jor­ity of these new in­fec­tions oc­cur in young adults aged up to 25 years, while ap­prox­i­mately one third oc­cur among in­di­vid­u­als younger than 20 years of age. Glob­ally, girls aged 14 to 19 are al­most twice as sus­cep­ti­ble to STIs than boys of the same age. Ca­sual Sex, some­times with a part­ner one hardly knows, has be­come a com­mon fea­ture in mod­ern so­ci­ety, es­pe­cially amongst those who are ad­dicted to drugs and al­co­hol.

Hav­ing a dif­fer­ent sex­ual part­ner ev­ery few weeks or months is con­sid­ered ‘cool’ and an achieve­ment to be bragged about! But, how many women re­alise the kind of risks they are ex­pos­ing them­selves to when they live such a life? Many women find it dif­fi­cult to ask their part­ners to use con­doms, fear­ing that they may get of­fended at such a sug­ges­tion. There are oth­ers who pro­ceed with un­pro­tected sex, be­cause they would not like to dis­please their part­ners as many men find con­doms sex­u­ally un­sat­is­fy­ing. Un­pro­tected sex has two ma­jor risks for women, the first be­ing un­wanted preg­nancy and the other which is the riskier one, of get­ting in­fected with a sex­u­ally trans­mit­ted in­fec­tion. Young girls feel that an un­wanted preg­nancy can be eas­ily man­aged by pop­ping the ‘I Pill’ im­me­di­ately af­ter sex­ual in­ter­course. Lit­tle do they re­alise that it has a 10-15% fail­ure rate and that they could get preg­nant even af­ter they have taken the pill! On the other hand, there are women who would not even take that pre­cau­tion and act only af­ter they got preg­nant. Ter­mi­na­tion of preg­nancy is so eas­ily avail­able at such a low cost that sub­ject­ing them­selves to a pro­ce­dure, whether med­i­cal or sur­gi­cal, does not re­ally bother them. It is un­for­tu­nate that with ev­ery ter­mi­na­tion of preg­nancy, there is al­ways a pos­si­bil­ity of an in­com­plete abor­tion, whereby some of the preg­nancy tis­sue does not get ex­pelled and gets re­tained within the uterus, lead­ing to an in­fec­tion which may be so se­vere, it could even lead to death! If less se­vere, it could dam­age the fal­lop­ian tubes, lead­ing to in­fer­til­ity. Hence, it is nec­es­sary to have the pro­ce­dure taken care of at cen­ters which are hy­gienic, though pre­ven­tion of preg­nancy would def­i­nitely be the more ad­vis­able choice. The se­cond risk which women face with un­pro­tected sex is that of pick­ing up a sex­u­ally trans­mit­ted in­fec­tion (STI) from an in­fected sex­ual part­ner. There are var­i­ous STIs which ex­ist and they lead to var­i­ous symp­toms such as ex­ces­sive foul smelling vagi­nal dis­charge, se­vere vagi­nal burn­ing and itch­ing, fre­quent and painful uri­na­tion. These dis­tress­ing symp­toms force a vic­tim to seek ur­gent med­i­cal help and treat­ment of the in­fec­tion. It is im­per­a­tive to men­tion some of the most com­mon sex­u­ally trans­mit­ted in­fec­tions: 1) Chlamy­dia, also known as chlamy­dial in­fec­tion, is an STI caused by Chlamy­dia Tra­choma­tis, a bac­terium that in­fects hu­mans ex­clu­sively. Chlamy­dia is the most com­mon in­fec­tious cause of gen­i­tal and eye dis­eases glob­ally—it is also the lead­ing bac­te­rial sex­u­ally trans­mit­ted in­fec­tion. Ac­cord­ing to a study, 6.8 per cent of girls aged 14 to 19 years have Chlamy­dia to­day. Chlamy­dia pa­tients do not usu­ally have signs or symp­toms. If there are any, they are usu­ally non-spe­cific and may in­clude: Cys­ti­tis A change in vagi­nal dis­charge Mild lower ab­dom­i­nal pain If the Chlamy­dia is left un­treated, it may lead to the fol­low­ing signs and symp­toms Pelvic pain Painful sex­ual in­ter­course, either in­ter­mit­tently or all the time Bleed­ing be­tween men­strual pe­ri­ods Can lead to in­fer­til­ity or ec­topic preg­nancy if the fal­lop­ian tubes are af­fected Ch­ly­ma­dia silently in­vades the fe­male re­pro­duc­tive sys­tem and causes havoc by dam­ag­ing the fal­lop­ian tubes, lead­ing to in­fer­til­ity or ec­topic preg­nan­cies. 2) Gen­i­tal her­pes: This STI is caused by the her­pes sim­plex virus (HSV) and af­fects the skin, cervix, gen­i­tals, and some other parts of the body. Her­pes is a long-term (chronic) con­di­tion. A sig­nif­i­cant num­ber of in­fected in­di­vid­u­als never show any symp­toms and do not know about their her­pes sta­tus. HSV is eas­ily trans­mis­si­ble from hu­man to hu­man by di­rect con­tact. Most com­monly, trans­mis­sion oc­curs through vagi­nal, oral or anal sex. In most cases, the virus re­mains dor­mant af­ter en­ter­ing a hu­man be­ing. It can be trans­mit­ted to the baby dur­ing de­liv­ery if there are ac­tive li­aisons in the vagi­nal area. Her­pes in­fec­tion can stay within the sys­tem for years and get passed on to the de­vel­op­ing baby within the uterus, lead­ing to prob­lems in the healthy de­vel­op­ment of the baby’s brain and var­i­ous other or­gans. The signs and symp­toms as­so­ci­ated with gen­i­tal her­pes may in­clude: Blis­ters and ul­cer­a­tion on the cervix Vagi­nal dis­charge Pain on uri­nat­ing Fever Gen­er­ally feel­ing un­well (malaise) Cold sores around the mouth Red blis­ters—these can be painful, es­pe­cially af­ter they burst and leave ul­cers on the ex­ter­nal gen­i­tal area, rec­tum, thighs and but­tocks 3) HPV in­fec­tion is the cause of 80 per cent cases of cervix can­cer. Be­sides, such in­fec­tions may cre­ate ugly growths around the gen­i­tal area, which can be­come ex­tremely embarrassing and re­pul­sive. TREAT­MENTS Bac­te­rial STIs can be eas­ily treated with an­tibi­otics, though vi­ral in­fec­tions can only be sup­pressed. It is ex­tremely im­por­tant that treat­ment should be taken by both the sex­ual part­ners so as to nip it in the bud be­fore it reaches hu­mungous pro­por­tions. When both the part­ners don’t take the treat­ment si­mul­ta­ne­ously, the in­fec­tion can have a domino ef­fect, with an in­fected part­ner pass­ing it on to all his or her un­sus­pect­ing part­ners. The male part­ners usu­ally do not have any symp­toms, hence are re­luc­tant to take the treat­ment. In such a sit­u­a­tion, the in­fec­tion can be­come chronic and re­sis­tant to any treat­ment. Sex­u­ally trans­mit­ted in­fec­tions like HIV, Hep­ati­tis B, Hep­ati­tis C and HPV are silent in­fec­tions, with­out any symp­toms, but lead to life long dis­abil­ity and can­cer. Sex­u­ally trans­mit­ted in­fec­tions may cause painful symp­toms such as gon­or­rhoea, which makes the per­son rush to the doc­tor im­me­di­ately. So, the acute ones get treated quickly, whilst the silent ones re­main in­side for years and are de­tected only when the dis­ease has caused harm. Yes, men don’t have to worry about get­ting preg­nant, but they should re­alise that they can pass on their dis­eases picked up through un­pro­tected ca­sual sex, some­times with com­mer­cial sex work­ers, to their fu­ture wives and through them, to their fu­ture chil­dren!

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