July 19, 2018

The More You Know – Preventing and Treating STDs

By Gabriel Cade, MD

Sex is a personal matter. Where it overlaps with medicine is sexual health and the many “side effects” of sex, like pregnancy, and its many joys and tribulations, like sexually transmitted diseases (STDs), which is the not-so-joyful part.

Basically, if you choose to have sex and you don’t want bugs or babies, get tested and use reliable barrier contraception. But we know that STDs happen (the CDC noted in a 2016 report that Americans were infected with more than 2 million new cases of gonorrhea, syphilis and chlamydia) – and that they are preventable and treatable.

There are four primary STDs – do you know the differences? How are they contracted, prevented or treated? There is no shame in being educated and aware of STDs, or even contracting an STD. With the right resources and the more you know, the more informed decisions you can make, conversations you can have and treatment you can seek when needed.

Gonorrhea and Chlamydia

Beware of anyone who can spell gonorrhea right the first time.

Gonorrhea is characterized by thick discharge from the penis or vagina, one to 14 days after exposure. It may also infect the rectum, throat, eyes, blood, skin and joints. Fifty percent of women and 10 percent of men have no symptoms, but usually show up with discharge, frequent or painful urination, or irregular vaginal bleeding. Gonorrhea and chlamydia are both bacterial infections. They often exist as a coinfection, so are often treated together.

Chlamydia is one of those “silent” diseases. Up to 95 percent of women and 50 percent of men have no symptoms at all. Chlamydia and gonorrhea are not physically transmitted, like by kissing, handshaking or casual contact. You prevent them with a condom, and they are treated with oral antibiotics and/or a shot.


What’s the difference between true love and herpes? Herpes is forever.

Herpes is a viral infection and there two types. Herpes simplex virus-1 and virus-2 are transmitted through sex, kissing or touching any affected area. HSV-1 causes blisters on the lips, mouth or nose. HSV-2 starts to show symptoms five to 20 days after exposure, with burning in the genitals or with urination, low back pain and red bumps on the genitals, which become painful blisters. Periodic outbreaks go on for life, which can be caused by stress, sunburn or even certain foods. There is no cure, but there are prescribed medicines (oral and topical antivirals) that can reduce outbreaks and help with symptoms.


Syphilis is another bacterial infection characterized first by sores that are not painful. It shows up one to three months after direct contact including sex, kissing or blood exposure. Like chlamydia, the symptoms can be mild at first, delaying diagnosis. Syphilis progresses to a rash on the palms and soles, and also to flu-like symptoms. A shot or oral antibiotics is usually required for treatment. Untreated syphilis can further lead to serious damage to the brain and nervous system. Pregnant woman are at especially high-risk of complications.

Diagnosis and Treatment

These, and other STDs, can be diagnosed and treated by your primary care physician at a walk-in clinic or other health department. Anyone you’ve had sex with in the last 60 days should also be treated.

Sometimes people feel uncertain or ashamed to seek medical help and get checked for these symptoms. But, like many conditions or illnesses, if something goes unchecked, the more danger and risk you pose on your health.

This month is STD Awareness Month. As healthcare providers, we want to help individuals make healthy and safe decisions about their health. Our job is only to help, never to judge you – don’t be afraid to talk to a healthcare provider, seek healthcare resources or ask for help.

Gabriel Cade, MD, is the Medical Director in the Emergency Department at Blue Ridge Regional Hospital.

Learn more about STD Awareness Month and the CDC at cdc.gov/std.
If you have concerns about STDs, seek medical treatment immediately. Visit your primary care provider or find a walk-in clinic near you at missionmycarenow.org.
If you do not have a primary care provider, find your preferred doctor using our Provider Finder at missionhealth.org.