STD

Chlamydia & Gonorrhea: Symptoms, Screening, and Treatment

My first job as a teenager was spent working in my dad’s clinic filing away patient charts in the back. Every day after school I’d head to “the dungeon,” as we used to call it, and spend a few hours filing a way a few hundred charts, reorganizing entire sections, and refitting old/worn out folders.

 

The tedious "dungeon" days.

After a while, I got to move up and work in the front office, answering phones and scheduling patient appointments. The big jump for me came when I was allowed to help bring back patients and take down their information. I’d jot down things like height, weight, pulse and blood pressure. Getting to interact with them was always fun for me because I’d always be exposed to something different, whether they were elderly or a young child.

 Our clinic was situated in a rural town called Perris, an hour and a half east of Los Angeles. Comprised of primarily first generation Hispanic families, the median household income was just shy of $50,000 and most never studied beyond a high school education, choosing instead to begin working right away to help with the bills and other expenses.

Scorching hot summers guaranteed.

While I spent my teenage years living out here, I went to a private school, so the class/playground environment was dramatically different from other schools nearby. We didn’t have problems with drugs, gangs, or teen pregnancies—everyone was usually trying to get on the honor roll or earn scholarships to college.

 The public high school programs were a different story: Friends of mine who attended them often talked about the pressures they faced to get a girlfriend, sleep with her, and “be a man,” and anyone who failed or didn’t aspire to have a girlfriend was teased for “probably being gay.” Fitting in became a distracting burden that kept them from focusing on anything else.

 What resulted from this pressure was a large number of parents bringing in their son or daughter to the clinic for issues such as pregnancies and STDs. The conversations were always uncomfortable for everyone involved, as the parents were usually oblivious to what their kids were doing in private. Because of the strong Catholic tradition held within most Hispanic families, sex is rarely, if ever, discussed between parents and their kids. “¿Como es possible?” (“How is this possible?”) they’d say. “My son/daughter was raised better, they’d never do that!”

 The problem wasn’t whether it was right or wrong, rather, it was a lack of understanding: You had a group of kids with no clue what sexual health was, thrown in together into a larger population of middle/high school peers, some of whom they’d naturally find attractive, at a time when puberty was hitting them all full throttle with no idea how to manage themselves or their hormones.

Add in the element of peer pressure, and they didn’t stand a chance. They’d submit themselves to the consequences of unprotected sex without a second thought. 

In light of this issue, I wanted to reach out to these schools and help raise sexual health awareness beyond the tired methods of sex-ed that was being taught. Sometimes making a difference in the community can be as simple as providing more information. I wanted to design health fairs in the clinic parking lots, and get people more open about discussing the questions they had or peer pressure situations they found themselves in, and their reactions to these situations. Current methods of sex ed seemed outdated, uncomfortable, and sometimes scary.

 

What resulted was a complete failure. Despite my passion for the subject, I had no idea how to coordinate with schools, purchase rental equipment, or advertise functions. No one wants to talk to an acne-ridden teenager over the phone about sexual health programs—what do they know, anyway? 

Fast forward many years and experiences later, I saw my chance to make it right. When I had the opportunity to start MYLABFAX, I decided I’d try to provide as much information as I could on sexual health among other health issues; from how to protect yourself from unwanted pregnancies or STDs, to how to find out if your body is ready to have a child. On my website, there are tests that I advertise for people to purchase, but my first goal isn’t to sell people on a product, it is to help educate them on how to avoid catching something in the first place and having to get tested.

Education about one’s health, combined with the freedom to choose what tests you want to buy when YOU want to—not your doctors, nurses, or hospitalists in the ER want you to pay for—is what the core of this blog and our business is all about. If someone can walk away from this blog not have purchased anything, but learned how to better protect themselves from a potential life-changing event, then I’ve won in my book.

 

Chlamydia & Gonorrhea

This post is gonna be a bit longer than most because I’m going to combine both 40 to 50% of individuals affected by Gonorrhea also get infected with Chlamydia. This is why whenever you visit a hospital or clinic, health professionals often test you for both.

What Is Chlamydia & Gonorrhea?

 Chlamydia and Gonorrhea are STDs (Sexually Transmitted Diseases) that can be transmitted from one individual to another through any kind of sexual contact. They are both a form of bacteria (versus a virus like HIV, Hepatitis, or Herpes) that can reside even in the back of the throat and rectum as well as the genitals, making oral/anal sex a risky endeavor for those who may be trying to “abstain” from traditional sex. As per a popular myth, Gonorrhea cannot be transmitted through kissing, toilet seats, or sharing towels.

 For Chlamydia, the age group most at risk is the 15-24 category, with 1 in 20 sexually active people having the disease. Think about that for a moment. An average high school student body is around 800-1200 students. That means on average, 40 to 60 people are walking around infected. A college campus of 20,000 may have around 1,000 infected.

WHAT ARE THE SYMPTOMS?

One thing to remember is that it's possible to get infected and show zero symptoms, also known as being asymptomatic. This can be dangerous because, as you’ll see below, leaving it untreated can lead to severe health problems.

Neisseria gonorrhoeae under micrograph

Initial Symptoms of Gonorrhea

 

Normally, the symptoms start appearing 2 to 5 days after the transmission but can take up to 30 days to become noticeable. The first symptom of Gonorrhea in men is burning sensation or pain during urination. As the disease progresses, the symptoms may include increased frequency of urination, swelling or redness of the penis, and pus-like discharge.

 

Women most often will not develop overt symptoms of Gonorrhea. If they do, they appear more like a bacterial infection or vaginal yeast which makes it all the more difficult to identify. Some of these symptoms are so mild that they are often be ignored. Symptoms of Gonorrhea in women include pain during urination, fever, pain in lower abdomen, having to urinate more frequently, discharge from vagina, sore throat, and pain during sexual intercourse.

 

Advanced Symptoms of Gonorrhea

 

Epididymitis is most commonly the result of untreated gonorrhea in men. This is where the spongy coil-like tubes surrounding the testicles become swollen and inflamed. This can lead to chronic pain in the area but more importantly, can lead to infertility. Hypogonadism can also occur which results in lowered testosterone, something that brings with it a whole host of problems for men.

 

For women, the infection can spread to the uterus or fallopian tubes leading to pelvic inflammatory disease (PID). Symptoms can include: lower abdominal pain, fever, vaginal discharge/odor, burning while urinating, and bleeding between periods. Most women reading this will recognize these symptoms as belonging to other less threatening issues (yeast infection, urinary tract infection, spotty periods) and is why it can be difficult to spot as something abnormal. Ignoring these symptoms can also lead to infertility.

 

The best thing to do is visit a doctor or get tested IF you’ve had a recent history of sexual partners. More often than not, there’s no cause for alarm if you’ve abstained from sex or consistently use protection, but of course, it's better to be safe than sorry. In addition to it being one of the most commonly occurring STDs, Gonorrhea has recently become excellent in resisting antibiotics, prompting many doctors to advocate young people to get tested.

Chlamydia viewed under a microscope.

Initial Symptoms of Chlamydia

Symptoms of Chlamydia (Chlamydia trachomatis) for men and women are going to be the same as above. One symptom that’s unique to Chlamydia is eye discharge if the eye comes in contact with the disease.

Advanced Symptoms of Chlamydia in women

As with Gonorrhea, infertility can occur in both men and women if Chlamydia is left untreated. Contact with the eyes can lead to blindness, which at one point consisted of 15% of all cases worldwide. Arthritis can also occur in young men, with 15,000 new cases each year in the U.S. alone.

Testing for Gonorrhea and Chlamydia

 Most have heard horror stories of inserting swabs inside the urethra or cervix (ouch!). MYLABFAX offers a non-swab, less painful way of testing.

 

If caught early, Chlamydia can be cured by antibiotics, typically with either azithromycin or doxycycline, costing a total of around $40 without insurance. With treatment, the infection should clear up in a week or two. It’s extremely important to complete the course of antibiotics given to prevent the bacteria from becoming drug resistant.

After the antibiotics course is completed, the patient should be re-tested after a period of 3 months. It goes without saying that in the meantime you should avoid any sexual contact with others.

 Recently, Gonorrhea has become more of a problem than Chlamydia, as the disease has become resistant to more and more forms of traditional antibiotics used to fight it. Back in the day, all you needed was a shot of penicillin, but the disease has slowly become to almost all available antibiotics. The  CDC currently recommends a combination of both oral azithromycin and an injection of ceftriaxone

While these two STDs tend to be the most commonly occurring, they are also the easiest to protect yourself from. As long as you wear condoms properly, you will be protected. Having an open discussion with your partners can help keep you both safe from spreading a disease that, for the moment, is one of the easier STDs to treat. In our next post, we’ll discuss some situations when condoms may not be enough.

Until next time,

 Dimitri

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