Venereal diseases.

Gardnerellosis, Hepatitis B, Genital herpes, Gonorrhea, Infection caused by human immunodeficiency viruses (HIV infection, AIDS), Candidiasis, Molluscum contagiosum, Pubic lice, Mycoplasmosis, Genital warts, Syphilis, Trichomoniasis, Chlamydia, Cytomegalovirus infection, Scabies, Chancroid, Principles of treatment and prevention of sexually transmitted diseases

General symptoms. The first sign is discharge from the genital organs, ulcers and “abrasions” on their surface, but sometimes the disease does not manifest itself in anything for the time being. It happens that it does not develop at all, but a person carries the pathogen within himself and can infect his sexual partners; intrauterine transmission of the microbe from mother to child is also possible.

Serious consequences should be remembered: in newborns - eye damage (conjunctivitis), pneumonia, sepsis and meningitis, birth defects, disability and even death; in women - inflammatory diseases pelvic organs, ectopic pregnancy, miscarriages, premature births and stillbirths; in men - narrowing of the urethra, impotence; in both cases, infertility. Some types of pathogens contribute to the development of cancerous tumors of the cervix, skin and internal organs.

Sexually transmitted diseases have never been considered only with medical point point of view, they have always been associated with ethical standards: the infected person is to blame himself. The sexual revolution, radically changing views on sex life, led to a significant increase in such patients - there are about 1 billion of them in the world. In other words, every fifth inhabitant of the Earth suffers from sexually transmitted diseases. Recently, the most terrible thing has been added to them - AIDS. The danger is quite great. Therefore, it is necessary to have at least a minimum of knowledge about these diseases - their manifestations, course and consequences, means of treatment and prevention.

Gardnerellosis. Inflammation of the vagina (vaginitis). Transmitted sexually. It has now been established that the cause is a special microorganism called gardnerella. The patient develops a foul-smelling leucorrhoea (the smell of rotten fish), which intensifies after sexual intercourse. With such discharge, you should definitely consult a doctor, and your sexual partner should also be treated so as not to become infected again from him.

Hepatitis B. One of the serious liver diseases. It is transmitted through blood, as well as sexual contact, which is what “supplies” a significant number of patients. The risk of contracting hepatitis B is extremely high in people who have promiscuous sex. It was detected in 1/3 of homosexuals and bisexuals (who have sex with both men and women), while among men who have sex only with women - only in 6%. Almost 300 million people in the world are carriers of the disease virus.

Patients with hepatitis B experience yellowness of the skin, eyes, pain in the liver, changes in the color of urine, feces, deterioration general well-being. However, the disease is often asymptomatic, without jaundice or other signs. A serious complication is primary liver cancer, which in some regions of the globe is the most common form malignant neoplasms, especially among men (see also chapter Infectious diseases).

Genital herpes(genitals). IN recent years is becoming increasingly common in many countries around the world. For example, in the USA, 200-500 thousand patients are registered annually. According to the UK Venereal Diseases Service, women suffer from genital herpes 6 times more often than men.

Symptoms and course. Usually through 3-6 days after infection, blisters appear on the skin and mucous membranes. Sometimes there are no signs of the disease for quite a long time. In men, blisters appear on the penis, especially on the glans and foreskin. Before this, patients feel a burning, itching, tingling sensation. The same rashes can occur in the mouth as a result of oral sexual intercourse. The bubbles, merging and bursting, turn into small wounds. Some patients experience discharge from the urethra, pain when urinating, and even urinary retention. The temperature may rise and headache, general malaise, enlarged lymph nodes.

In women, blisters and ulcerations appear on the genitals, in the perineum and around anus. Then the bubbles disappear, and after a while they appear again.

A sick woman infects her baby during childbirth. The newborn may develop damage to the nervous system, skin, mouth and internal organs. Most children who become infected with herpes die. Survivors experience severe complications from the nervous system. If genital herpes is detected in women in the late stages of pregnancy, | They are trying to perform a caesarean section on her to protect the baby from infection when passing through the birth canal.

Gonorrhea. An infectious disease, also called gonorrhoea, caused by gonococcus. Neisser, the scientist who discovered this pathogen in 1879, said: “I do not hesitate to declare that in terms of its consequences, gonorrhea is a disease incomparably more dangerous than syphilis.” Indeed, gonorrhea brings a lot of suffering to people sexually active age. This was especially noticeable during the period when medical practice There were no antibiotics yet. Its main danger stems from | a frivolous attitude that one can be cured easily, even without a doctor - with the help of advice from “experienced” friends and acquaintances. Of course, gonorrhea is not as destructive as; syphilis, but the likelihood of infertility (in both men and women), sexual disorders in men, and infection of children during childbirth is extremely high. It should be added that gonorrhea is much more common than syphilis. You can get sick with it, just like with syphilis, several times. Many, not suspecting that they are sick, continue! live sexually, infecting their partners, are not treated, and the disease progresses; leading to severe complications. Infection occurs during various forms of sexual contact: during “regular” sexual intercourse, during “incomplete” (when there is only mutual contact of the genital organs, without insertion of the penis into the vagina), during orogenital (contact of the genital organs and the mucous membrane of the mouth) , with anal. Men are not always in favor; are affected by women with gonorrhea.! With a small number of gonococci they | may not fit into the narrow opening of the urethra. If they do get in, they can be thrown away or washed off with urine. Most often, a woman infects a man during menstruation I or immediately after it, during prolonged sexual intercourse, during its violent end, when gonococci are removed from the deep parts of the glands.

Unlike men, women “catch” gonorrhea in almost all cases of sexual intercourse with a sick person.

A child can become infected from the mother when passing through the birth canal. At the same time, the mucous membrane of the eyes is affected, and in girls, the genitals are also affected. Newborn blindness is caused by gonorrhea in 56% of cases. Gonococci can also be introduced into the genitals of girls by contaminated mother's hands, towels, sponges, bed linen, etc.

Symptoms and course. Gonorrhea affects the genitourinary organs, rectum, mucous membrane of the eyes, mouth and pharynx, sometimes joints, heart and other organs. In men, usually 3-5 days after infection, abundant purulent, mucus appears. purulent discharge accompanied by itching, pain or pain when urinating. The discharge is either spontaneous or appears when pressure is applied to the head of the penis. Yellow-green stains remain on underwear. The lips of the urethra become inflamed, swollen, and slightly painful. If the disease is not treated, the process spreads to the entire canal, prostate, seminal vesicles, testicles. Painful, frequent, difficult urination appears. The temperature may rise, chills, and pain during bowel movements may occur. A severe complication of gonorrhea, often leading to infertility, is testicular damage. Usually it becomes swollen, sharply painful, and increases in size. After gonorrheal inflammation of the epididymis (epididymitis), sperm formation is disrupted and, with a bilateral process, the possibility of fertilization sharply decreases. Undesirable consequences can be avoided only with timely treatment, strict adherence doctor’s recommendations, temporary cessation of sexual activity, abstinence from alcohol, etc.

"5 A 29-year-old man was transferred to the venereology department of the hospital from the surgical hospital. He walked on crutches due to enlargement and severe pain in the ankle joint. He had slight cloudy mucous discharge from the urethra. He fell ill suddenly: he went to bed healthy, and in the morning joint pain, fever, chills, and weakness forced him to call the ambulance, which took him to the surgical department. The patient is unmarried and often engages in promiscuous sex. 3 years ago I suffered from trichomoniasis. It turned out that a few days after sexual intercourse with an unfamiliar woman, he had slight discharge from the urethra for 3-4 weeks. Deciding that it was trichomoniasis again, he began to take the medications that were prescribed to him for this disease, and continued to lead his previous lifestyle: sports, sex, drinking. In the venereology department, the patient was diagnosed with gonorrhea.”

Sometimes a person who has had sexual contact with someone known to have gonorrhea does not show any signs of the disease. This doesn't mean he didn't get infected. You definitely need to do your research. The so-called asymptomatic course of gonorrhea is dangerous both for the patient and for those who come into contact with him. It is of particular importance during pregnancy, since infection of the child is possible. 50-70% of women with gonorrhea do not experience any discomfort. Others may experience purulent or mucopurulent vaginal discharge, frequent urge and pain when urinating. Late seeking medical help with asymptomatic gonorrhea leads to the disease spreading from the cervix to the uterine mucosa, fallopian tubes, and ovaries. There is a risk of ectopic pregnancy, infertility, complications during childbirth/

Often, complications of gonorrhea occur almost unnoticed in women. Only some people have pain in the lower abdomen, bleeding from the vagina, elevated temperature, headache, general poor health. If a patient with gonorrhea is pregnant, then she has a high risk of miscarriage, fetal death and postpartum infection.

A very unpleasant complication of gonorrhea in women is inflammation of the large vestibular glands (bartholinitis), which usually begins 2-3 weeks after infection. Gonococci, penetrating the gland duct, cause inflammation, and a painful cord or nodule appears in the groin: when pressed, pus can be released. If the mouth of the gland is closed, pus, accumulating in the excretory duct, stretches it. Then a painful, mobile tumor the size of a cherry to large egg. The woman feels pain in the external genital area, it is difficult for her to walk and sit. When other microorganisms join the gonococcus, the temperature rises to 38-39 °C. The tumor bursts, pus pours out of it, the pain disappears, the temperature drops, but after a while, if no treatment is carried out, pus accumulates again, redness of the skin, soreness, swelling appear, and everything starts all over again. Often patients with such complications have to undergo surgery. During sexual intercourse through the mouth, gonorrhea of ​​the oral cavity and pharynx occurs. Its signs are redness and sore throat, sometimes severe, with high fever. For the most part, gonorrhea of ​​the genital organs also occurs at the same time.

If there is discharge from the rectum and discomfort in this area, you should also consult a doctor and get examined. Anal gonorrhea is possible not only in homosexual and bisexual men, but also in women, after sexual intercourse through the anus or as a result of infected vaginal discharge."

Gonorrhea is especially dangerous for children. Only a few become infected through shared beds due to poor hygiene. In most cases, they are “rewarded with a bad disease” by older family members or friends at home, forcing them to cohabitate.

The initial manifestation of gonorrhea in a newborn is usually eye disease. A few days after birth, the baby's eyes become red and yellow or green discharge begins to appear. You should immediately consult a doctor and begin treatment to prevent damage to the cornea and all eye tissues, leading to blindness. Children often pay for the mistakes of adults or become their victims.

Infection caused by immunodeficiency viruses (HIV infection). Another name is AIDS(acquired immunodeficiency syndrome). It has become epidemic in the world in recent years and is caused by human immunodeficiency viruses found in the saliva and mucous secretions of patients. This is an infectious disease that develops when a pathogen enters the bloodstream and is most often transmitted through sexual contact. HIV infection is also observed when intravenous injections medications during blood transfusion and its preparations due to unsterile instruments, especially needles.

Pathogens of AIDS destroyed by boiling, ether, acetone, ethanol (20%), sodium hypochloride (0.2%). This disease was first identified in homosexuals and drug addicts. It was even called at first “the disease of homosexuals.” Mostly men were affected (9 out of 10). Subsequently, it also became widespread among people who have promiscuous sex. Transmission of the virus from mother to child during pregnancy and childbirth has been proven.

Symptoms and course. First, the temperature rises to 38-40 °C at any time of the day, profuse sweating appears, and sharply decreases physical activity. At the same time, loose stools, weight loss, shortness of breath, inflammatory changes facial skin, hair loss, enlargement lymph nodes. This may continue for several years. Then patients develop various concomitant infections, which are rarely found in people with normal immunity. They can affect the skin, lymph nodes, eyes, various parts of the gastrointestinal tract, lungs, and central nervous system. In this case, various rashes appear on the skin (spotted, nodular, vesicular, etc.), often accompanied by itching. Severe course These diseases are caused by extremely limited defenses of the body. Most often, patients with AIDS develop bilateral, persistent pneumonia. Oral candidiasis often occurs, which, as it spreads, leads to the appearance of ulcers of the esophagus and lungs. Blistering rashes appear on the mucous membrane of the mouth, genitals and perineum. Many people are affected by the central nervous system and eyes (chorioretinitis). Diarrhea is often observed, which is quite severe, with frequent watery stools (up to 15 liters per day). In most patients, immediately after recovery from one infectious disease, another begins, or a combination of various infections occurs.

Approximately 40% of AIDS patients develop malignant tumors. They are often diagnosed at a late stage or after the death of the patient. About 1/3 have Kaposi's sarcoma, which often affects not only the skin, but also the lymph nodes, mucous membranes and internal organs.

Quite often, those infected with the virus for several years, except for enlarged cervical, axillary or occipital lymph nodes, have no other symptoms of the disease with a further classic picture.

Human immunodeficiency viruses, like war, affect people of the most active age.

Candidiasis. Inflammation caused by yeast-like fungi Candida. Candidiasis (“thrush”) is one of the most common infections, especially in women. >

Increased skin moisture (when wearing nylon tights) contributes to the occurrence of candidal inflammation of the vagina; disturbance of carbohydrate metabolism; the use of antibiotics or other chemotherapy drugs, including drugs prescribed for trichomoniasis, which eliminate other microorganisms that are natural antagonists of fungi; hormone use (taking steroids and birth control pills); diseases that weaken the body's immune system; infection from a sick man.

Symptoms and course. A third of sick women become infected with candidiasis during sexual intercourse. They develop cheesy discharge from the genital tract, itching, and painful sensations that increase with urination and sexual intercourse. The vestibule of the vagina becomes dark red, and the redness may spread to adjacent areas of the skin, in particular around the anus.

In men, usually the head of the penis and the skin covering it become red, covered with a white coating, sometimes sores appear on them, and patients are bothered by itching and burning. It happens that inflammation of the urethra begins with mucous discharge from it and the presence of flakes in the urine.

Molluscum contagiosum. Spreads through close contact, including sexual contact. Children become infected when they are breastfed by a sick mother and through household items. Up to 3 months after infection, small nodules the size of a pinhead to a pea with a depression in the center appear on the skin of patients. In children, rashes are most often located on the skin of the hands, face, and neck; in adults - on the skin of the torso and genitals, inner thighs, pubis and abdomen. These nodules are painful.

Treatment - see chap. Skin diseases, section 5, Molluscum contagiosum.

Pubic lice. Lice are spread not only through sexual contact, but also through underwear. Pubic louse lives in pubic hair, armpits, beards, mustaches, eyebrows and eyelashes. It does not affect the scalp, which distinguishes it from the head louse. On the affected areas of the hairline, mainly the perineum, thighs, and anus, small hemorrhages, bluish spots, signs of inflammation, and scratching appear. In the future, small nodules, blisters, and pustules may form. Patients are bothered by constant itching. Lice can be seen at the roots of the hair, small nits are found on the hair.

Treatment - see chap. Skin diseases, section 11, Irritation from lice bites.

Mycoplasmosis. Inflammation of the urethra and genital organs is quite often caused by mycoplasmas and ureaplasmas (pathogens belonging to the same family of bacteria). Can cause miscarriages, stillbirths in women, premature birth. In men, they are able to attach to sperm and thereby prevent fertilization. The more active a person’s sex life is, the more likely they are to become infected.

Symptoms and course. It takes 10-15 days from the moment of infection to the appearance of symptoms. Men experience mucopurulent discharge, itching, and discomfort in the area of ​​the urethra, the lips of which are slightly swollen and inflamed. Sometimes sexual disorders are added. The most common complications in men are inflammation of the prostate gland and epididymis. There is constant pain, slight swelling and redness of the scrotum. The temperature usually does not rise. Often patients do not feel anything and unwittingly infect their sexual partners! ditch

In women, mycoplasmas affect the urethra, vagina, cervix and uterine cavity, and the inner lining of the uterine tubes. Patients complain of mucous, translucent discharge, itching in the labia and vagina. These bacteria can cause inflammation of the inner lining of the uterus, which leads to weak attachment of the fertilized egg and poor development of the embryo. At any level of the reproductive tract, they can have a detrimental effect on reproductive function. Mycoplasmas are often found in childless women.

Genital warts. In other words, venereal warts appear on the genitals, as well as the vagina, cervix, urethra and contribute to deformation of the genitals and birth canal. Can lead to cervical cancer in women. It has been established that malignant lesions are in direct connection with early onset sexual life and a large number of sexual partners and that the sexual behavior of men and women plays an important role in the development of the tumor. About half a million women are diagnosed with cervical cancer every year; shchin. Lately, more and more of them are young in age.

Symptoms and course. Venereal warts appear 1-2 months after infection. At first these are tiny specks, then they grow in size and finally turn into warty growths pink color, resembling cauliflower in appearance. They can occur on the head and shaft of the penis, and in the urethra, accompanied by discharge or bleeding from the urethra, burning during urination, as well as on the external genitalia of women, in the vagina, cervix, in the anus (in particular in persons with anogenital sexual relations, for example, homosexuals).

Both sexual partners need to be treated at once so that one of them, having been cured, does not become infected again from the other. Principles of treatment - see chap. Skin diseases, section 5, Warts.

Syphilis.

Most serious illness(until AIDS appeared). The causative agent - treponema pallidum, or pale spirochete - was discovered in 1905. “Pale” - because it is almost not stained with the usual aniline dyes used for this purpose in microbiology. Treponema pallidum has a spiral shape, resembling a long, thin corkscrew. It is extremely insidious: under unfavorable conditions it becomes covered with a dense shell and becomes impenetrable to medicinal substances. In this form it can remain in the body for a long time, until at a favorable moment it “comes to life” again, causing the progression of a disease that was considered cured. Spiral-shaped treponemas reproduce by division every 30-33 hours, “frozen” ones do not divide. In the initial stages of syphilis, the body contains almost exclusively spiral-shaped ones; in late and latent syphilis, there are more and more capsulated ones. Penicillin, used in the treatment of syphilis, acts only on spiral forms of treponema, so the effectiveness of the drugs is maximum in the first months of the disease,

For the life of treponemes, a warm, moist - “living” biological environment is necessary. Therefore, infection occurs almost exclusively through sexual contact. It is transmitted through household means mainly to young children, whose parents, having contagious manifestations on the oral mucosa, try food from the child’s spoon, sometimes even chew it for him, lick the pacifier, etc. Treponema pallidum persists, for example, on wet underwear for many hours and even several days. Drying or exposure to disinfectants quickly deprives it of mobility.

The optimal conditions for its life activity are human body temperature (37 °C). When heated to 55 °C, microorganisms die after 15 minutes, when boiled - immediately. Low temperatures, on the contrary, promote their survival. At -4-6 °C they last for about 3 days, at -18 °C for about a year. Mobile treponemes remain in the tissues of the deceased for quite a long time, within 2 days.

Treponema pallidum can be contained in the blood of people, even those in the incubation period. If such blood is transfused to a healthy person for some reason, infection will occur and so-called “transfusion” syphilis will occur. That's why donor blood Be sure to test for syphilis and preserve it for 4 days, which guarantees the death of bacteria. If by chance, in emergency situation, in a direct transfusion, blood is taken from a patient with syphilis, then the person who received it is given preventive treatment. A 0.5% solution of caustic alkali, as well as acid solutions, have a detrimental effect on Treponema pallidum. Urine with a pronounced acidic reaction, as well as some food products - sour milk, kvass, vinegar and even lemonade can destroy the pathogen. He dies immediately soap suds, and therefore washing your hands with soap reliably protects against infection.

Penetration of the causative agent of syphilis into the human body occurs through wounds on the skin and mucous membranes that are barely visible or completely invisible to the naked eye. It is even believed that it can pass through intact integument. If a pregnant woman has syphilis, the child becomes infected in utero. The likelihood of this is greatest if she has an early stage of syphilis, less often - a late stage. Then even an untreated woman can give birth to a completely healthy child.

Symptoms and course. Syphilis is a very long-term disease. A rash on the skin and mucous membranes gives way to periods when there are no external signs and the diagnosis can be made only after a blood test for specific serological reactions. Such hidden periods can drag on for a long time, especially during late stages, when, in the process of long-term coexistence, the human body and Treponema pallidum adapt to each other, achieving a certain “equilibrium”.

Manifestations of the disease do not appear immediately, but after 3-5 weeks. The time preceding them is called incubation: bacteria spread through the flow of lymph and blood throughout the body and multiply quickly. When there are enough of them and the first signs of the disease appear, the stage of primary syphilis begins. Its external symptoms are erosion or ulcer (hard chancre) at the site of infection entering the body and enlargement of nearby lymph nodes, which disappear without treatment after a few weeks. 6-7 weeks after this, a rash appears that spreads throughout the body. This means that the disease has entered the secondary stage. During her rash of different nature appear and, having existed for some time, disappear. Tertiary period Syphilis occurs after 5-10 years: nodes and tubercles appear on the skin.

Primary syphilis. Hard chancre (ulcers), one or more, are most often located on the genitals, in places where microtraumas usually occur during sexual intercourse. In men it is the head, foreskin, less often - the shaft of the penis; sometimes the rash may be located inside the urethra. In homosexuals, they are found in the circumference of the anus, in the depths of the folds of skin that form it, or on the mucous membrane of the rectum. In women, they usually appear on the labia minora and majora, at the entrance to the vagina, on the perineum, less commonly -on the neck uterus. In the latter case, the ulcer can only be seen during a gynecological examination on a chair using mirrors. Chancres can practically appear anywhere: on the lips, in the corner of the mouth, on the chest, in the lower abdomen, on the pubis, in the groin, on the tonsils - | nah, in the latter case it resembles a sore throat, in which the throat hardly hurts and the temperature does not rise. Some patients develop thickening and swelling with severe redness, even bluishness of the skin; in women - in the area of ​​the labia majora, in men - in the foreskin. With the addition of a “secondary”, i.e. additional infection, complications develop. In men, this is most often inflammation and swelling of the foreskin (phimosis), where pus usually accumulates and you can sometimes feel a lump at the site of an existing chancre. If, during the period of increasing swelling of the foreskin, it is moved back and the head of the penis is opened, then the reverse movement is not always successful and the head ends up pinched by the sealed ring. It swells and if not released, it may become dead. Occasionally, such necrosis (Gangrene) is complicated by ulcers of the foreskin or located on the head of the penis.

About a week after the appearance of chancre, nearby lymph nodes (most often in the groin) painlessly enlarge, reaching size; peas, plums or even a chicken egg. At the end of the primary period, other groups of lymph nodes also increase.

Secondary syphilis. It begins with the appearance of a profuse rash throughout the body, which is often preceded by a deterioration in health, and the temperature may rise slightly. The chancre or its remains, as well as enlarged lymph nodes, are still preserved by this time. The rash usually appears as small pink spots that evenly cover the skin, do not rise above the surface of the skin, do not itch or peel. This kind of spotty rash is called syphilitic roseola. Since they do not itch, people who are inattentive to themselves can easily overlook it. Even doctors can make a mistake if they have no reason to suspect a patient has syphilis, and diagnose measles, rubella, scarlet fever, which are now often found in adults. In addition to roseola, there is a papular rash, consisting of nodules the size of a match head to a pea, bright pink, with a bluish, brownish tint. Much less common are pustular or pustular rashes similar to common acne, or chicken pox rash. Like other syphilitic rashes, pustules do not hurt.

The same patient may have spots, nodules, and pustules. The rashes last from several days to several weeks, and then disappear without treatment, only to be replaced by new ones after a more or less long time, opening a period of secondary recurrent syphilis. New rashes, as a rule, do not cover the entire skin, but are located in separate areas; they are larger, paler (sometimes barely noticeable) and tend to cluster together to form rings, arcs and other shapes. The rash can still be macular, nodular or pustular, but with each new appearance the number of rashes becomes smaller and the size of each of them larger. For the secondary relapse period, nodules on the external genitalia, in the perineal area, near the anus, and under the armpits are typical. They enlarge, their surface becomes wet, forming abrasions, the weeping growths merge with each other, resembling cauliflower in appearance. Such growths, accompanied by a fetid odor, are little painful, but can interfere with walking. Patients with secondary syphilis have so-called “syphilitic tonsillitis”, which differs from regular topic that when the tonsils become red or whitish spots appear on them, the throat does not hurt and the body temperature does not rise. Whitish flat formations of oval or bizarre shapes appear on the mucous membrane of the neck and lips. On the tongue there are bright red areas of oval or scalloped outlines, in which there are no papillae of the tongue. There may be cracks in the corners of the mouth - so-called syphilitic jams. Brownish-red nodules sometimes appear on the forehead - the “crown of Venus”. Purulent crusts may appear around the mouth, simulating ordinary pyoderma. A rash on the palms and soles is very common. If any rashes appear in these areas, you should definitely check with a venereologist, although skin changes here may also be of a different origin (for example, fungal).

Sometimes small (the size of a little fingernail) rounded light spots, surrounded by darker areas of skin, form on the back and sides of the neck. “Necklace of Venus” does not peel off and does not hurt. There is syphilitic baldness (alopecia) in the form of either uniform hair thinning (up to pronounced) or small numerous patches. It resembles moth-eaten fur. Eyebrows and eyelashes often also fall out. All these unpleasant phenomena occur 6 or more months after infection. An experienced venereologist only needs a quick glance at the patient to diagnose him with syphilis based on these signs. Treatment quickly leads to restoration of hair growth. In weakened patients, as well as in patients who abuse alcohol, there are often multiple ulcers scattered throughout the skin, covered with layered crusts (the so-called “malignant” syphilis). If the patient is not treated, then a few years after infection he may enter the tertiary period.

Sixth stage of syphilis. Single large nodules appear on the skin, up to walnut or even a chicken egg (gumma) and smaller ones (tubercles), usually located in groups. The gumma gradually grows, the skin becomes bluish-red, then a viscous liquid begins to secrete from its center and a long-term non-healing ulcer with a characteristic yellowish bottom of a “greasy” appearance is formed. Gummous ulcers are characterized by a long existence, lasting for many months and even years. Scars, after they have healed, remain for life, and from their typical star-shaped appearance one can understand after a long time that this person had syphilis. Tubercles and gummas are most often located on the skin of the anterior surface of the legs, in the area of ​​the shoulder blades, forearms, etc. One of frequent places tertiary lesions - mucous membrane of the soft and hard palate. Ulcerations here can reach the bone and destroy bone tissue, soft palate, wrinkle with scars, or form holes leading from the oral cavity to the nasal cavity, causing the voice to acquire a typical nasal quality. If gummas are located on the face, they can destroy the bones of the nose, and it “falls through.”

At all stages of syphilis, internal organs and the nervous system can be affected. In the first years of the disease, some patients develop syphilitic hepatitis (liver damage) and manifestations of “latent” meningitis. With treatment they go away quickly. Much less often, after 5 or more years, thickening or gumma, similar to those that appear on the skin, sometimes form in these organs.

The aorta and heart are most often affected." A syphilitic aortic aneurysm is formed; in some part of this vital vessel, its diameter sharply expands, and a sac with very thinned walls (aneurysm) is formed. Rupture of the aneurysm leads to instant death. The pathological process can also “slide” from the aorta to the mouth of the coronary vessels that supply the heart muscle, and then attacks of angina occur, which are not relieved by the means usually used for this. In some cases, syphilis causes myocardial infarction. Already on early stages diseases can develop: syphilitic meningitis, meningoencephalitis, a sharp increase in intracranial pressure, strokes with complete or partial paralysis, etc. These severe phenomena are very rare and, fortunately, respond well to treatment.

Late lesions (tabes dorsalis^ progressive paralysis). They occur if a person has not been treated or was treated poorly. With tabes dorsalis, treponema pallidum affects the spinal cord. Patients suffer from attacks of acute excruciating pain. Leather from|.;| loses sensitivity so much that they may not feel the burn and pay attention only to the damage to the skin. The walk changes, becomes “ducky”, there is first difficulty urinating, and then urinary and fecal incontinence. The defeat of vision is especially difficult, 4g | body nerves, leading to blindness in a short time. Rough-S formations of large joints, especially flax joints, may develop. Changes in the size of pa and the shape of the pupils and their reactions are detected, as well as a decrease or complete disappearance of tendon reflexes, which are caused by a blow of a hammer on the tendon of the i knee (patellar reflex) and above the heel! (Achilles reflex). ;

Progressive paralysis usually developing after 15-20 years. This is irreversible brain damage. A person’s behavior changes sharply: ability to work decreases, mood fluctuates, the ability to self-criticize decreases, either irritability, explosiveness, or, conversely, unreasonable cheerfulness and carelessness appear. The patient sleeps poorly, often has a headache, his hands tremble, and his facial muscles twitch. After some time, he becomes tactless, rude, lustful, and displays a tendency to cynical abuse and gluttony. His mental abilities are fading, he loses memory, especially for recent events, the ability to count correctly during simple arithmetic operations “in the head”, when writing he misses or repeats letters and syllables, his handwriting becomes uneven, sloppy, his speech is slow, monotonous, as if “ stumbling." If treatment is not carried out, he completely loses interest in the world around him, soon refuses to leave his bed, and with symptoms of general paralysis, death occurs. Sometimes with progressive paralysis, delusions of grandeur occur, sudden attacks of excitement, aggression that are dangerous to others.

Congenital syphilis. A child can become infected in the mother's womb. Sometimes he is stillborn at 5-6 months of pregnancy or is born prematurely alive. A full-term baby may be born with clinical manifestations of the disease or with hidden infection. Manifestations of congenital syphilis usually do not occur immediately after birth, but during the first 3 months of life. However, from the very beginning, certain features are noticeable in the appearance and behavior of a sick child, who in “classical” cases looks like a “little old man.” This is a dystrophic person with a large head and an emaciated body, pale, sallow skin. He is restless, screams for no apparent reason, develops poorly, and gains little weight, despite the absence of gastrointestinal disorders. In the first days or weeks of life, blisters (syphilitic pemphigus) surrounded by a purple rim may appear on his palms and soles. Their contents are initially transparent, then become purulent and bloody, then the covers of the blisters shrink into crusts. Around the mouth and forehead, the skin thickens in places, becomes shiny, purple, and cracks when the child cries or sucks, leaving scars located radially in the corners of the mouth. Spots or nodules often appear on the torso, buttocks, and limbs. In places of friction and natural folds, they sometimes become wet and ulcerate. In the first weeks of life, the so-called “syphilitic runny nose” occurs; the nasal passages narrow sharply, breathing becomes difficult, and sucking is almost impossible if the baby’s nose is not thoroughly cleared before each feeding. In more severe cases, ulcers may form - not only on the nasal mucosa, but also on the cartilage and bone of the nasal septum. At the same time, it is destroyed, and the shape of the nose changes (“saddle”, “blunt”, “goat” nose).

Damage to internal organs begins in utero. The liver is enlarged and dense, and cirrhosis may subsequently develop. The spleen is also usually enlarged and thickened. Severe pneumonia is possible, and then the child dies either before birth or shortly after it. Less commonly, the kidneys and other organs are affected.

With congenital syphilis, the bones are changed. The arm or leg lies motionless, as if paralyzed, since the slightest movement causes displacement of the deformed bones, causing acute pain. At the site of their separation, all the signs of a fracture are revealed: swelling, pain, etc. These fractures received a special name after the name of the author who described them: pseudoparalysis (or false paralysis) of Parrot. Serious changes can also occur in the central nervous system. The “unreasonable” cry of a child, regardless of food intake, is one of the symptoms of syphilitic meningitis. Attacks of convulsions may occur, usually passing without a trace, but sometimes leaving behind strabismus and semi-paralysis of the limbs, signs of cerebral edema (hydrocephalus), leading to increased intracranial pressure and an increase in the volume of the skull.

Nowadays, a child with congenital syphilis is most often born at term, with normal weight and without visible manifestations of the disease. Upon examination, one can only detect an enlarged liver and spleen, bone changes (osteochondritis) and positive blood reactions to syphilis. Sometimes the latter are the only sign of a congenital disease, which is then called congenital latent syphilis. The disease can be first detected at an older age - after 2 years (late congenital syphilis). During this period, damage to the eyes is possible, quickly leading to blindness, damage to the ear, accompanied by sudden and irreversible deafness, and a change in shape upper teeth(incisors). The special structure of the shins (“saber-shaped shins”) is characteristic.

Getting infected with syphilis is scary. But it’s even worse to infect your own child with it. Therefore, it is necessary, first of all, to reduce the very probability of this to a minimum. Often husbands, when their wife is “in a position,” allow themselves random, dubious relationships, without realizing the full extent of their responsibility for the fate of the child. It happens that women themselves become infected with syphilis during extramarital affairs and, when deciding to become mothers, do not realize it. There is no need to risk the health of your unborn child. If any rashes appear on the body, any changes in the skin and mucous membranes on the genitals, in the mouth, you should contact a dermatovenerologist, regardless of the results of blood tests during pregnancy.

Congenital syphilis was widespread in the past: at the beginning of the 20th century, children accounted for up to 1/4 of patients with syphilis. Currently, cases of congenital syphilis are rare - almost exclusively in children whose mothers were not registered with the antenatal clinic. If the disease is detected on time, with full treatment in the first 25 weeks of pregnancy, the child is born healthy. At a later date, he may have certain signs of infection.

Some women who have had syphilis in the past are afraid to have children. If treatment was carried out before pregnancy, and serological reactions became negative, fears are unnecessary, but it is still necessary to carry out preventive treatment during pregnancy, which prevents the possibility of infection developing in the child.

Trnchomonnaz. This widespread disease is fatally accompanied by various misunderstandings. Let's start with the name - for some reason, patients (and sometimes even medical workers) call it "fungus", although the pathogen that causes the disease has nothing to do with fungi - it is Trichomonas, a simple microorganism. Secondly, they believe that trichomoniasis can be contracted in a bathhouse, swimming pool, when washing with unboiled water, etc. In fact, it has long been convincingly proven that infection with Trichomonas vaginalis occurs during sexual intercourse. The only exceptions are little girls who become infected from a sick mother at birth or in the family when sanitary and hygienic rules for caring for them are violated. And finally, the third misconception is that trichomoniasis is a trivial disease that can be easily cured or even go away on its own - without treatment.

Symptoms and course. Infection occurs in 2/3 of cases during extramarital sex. In women, the first sign is copious liquid, often foamy yellowish color leucorrhoea, often with an unpleasant odor. Some, for example, in old age, have discharge after sexual intercourse mixed with blood. Corrosive whites contribute to the occurrence of pain in the genital and vaginal areas and cause a feeling of itching and burning. Pain may appear in the lower abdomen, in the lumbar region, during urination, during sexual intercourse, so severe that sexual intercourse becomes impossible. In some cases, painful superficial ulcers are observed on the labia. It happens that the infection spreads to the cervix, causing erosion and inflammation. Women begin to experience pain when urinating and a burning sensation after it. With further progression of the process it is possible acute inflammation mucous membrane of the uterus: pain appears in the lower abdomen, leucorrhoea intensifies, often mixed with blood, disturbances menstrual cycle. When Trichomonas penetrate the uterine appendages, damage to the tubes and testicles occurs, which can lead to infertility.

Often trichomoniasis is asymptomatic, unnoticed by patients. During pregnancy, after childbirth or abortion, a cold, excessive sexual activity or drinking alcohol, a latent form of trichomoniasis can become acute. That is why a gynecologist can often hear at an appointment: “I infected by gynecologists during an abortion (birth). Before that I was healthy, then I started having itching and discharge.”

The mysterious case when trichomoniasis is found in virgins can usually be clarified during a confidential conversation with the patient: “Irina K, 17 years old, categorically denied sexual intercourse and upon examination turned out to be a virgin. Only after having several conversations with her face to face and gaining her trust, it was possible to establish that Irina, trying to maintain physical chastity, had one-time incomplete sexual intercourseintercourse, allowing only contact of the external genitalia with his partner, who, as it later turned out, was sick with trichomoniasis*.

In men, the disease begins with itching, tickling, burning, and sometimes pain when urinating. Discharge appears from the urethra, which can be transparent or grayish-white, very rarely foamy. Sometimes they take on the appearance of a large transparent spherical drop, as if rolling out of the external opening of the urethra, the lips of which are swollen and inflamed. At hidden form Trichomonas urethritis patients complain of inconsistent scanty discharge from the urethra, and then only in the morning in the form of a drop (French venereologists called it “good morning”). Unpleasant sensations when urinating intensify after consuming alcoholic beverages and spicy foods. The discomfort may spread to the head of the penis, scrotum, perineum, rectum, and lumbar region. Often such patients are treated for a long time and unsuccessfully by neurologists for radiculitis.

Trichomoniasis in men can cause complications: the head of the penis turns red, the foreskin swells, then wounds, abrasions, and sometimes ulcers form on the penis. With phimosis, the penis, increasing in size, takes on the shape of a pear and becomes painful. Due to the swelling, exposure of its head becomes impossible. Trichomonas epididymitis is possible, which occurs in 7-15% of patients. Some of them have fever, pain in the scrotum and testicle. A complication of trichomoniasis is inflammation of the prostate gland - prostatitis. At the same time, the man himself may not feel anything for years, not suspect that he is sick, but infect women during sexual intercourse. Sometimes patients with prostatitis experience a feeling of heaviness and dull pressure in the anus, itching in it and in the urethra, pain in the perineum. Vision and orgasm are often weakened, and premature ejaculation occurs. With trichomonas inflammation of the bladder, patients are forced to urinate every 15-30 minutes. Urination is accompanied by sharp pain and the release of a few drops of blood.

Children, as a rule, become infected with trichomoniasis from adults through sexual contact. About 32% of them have inflammation of the urethra - urethritis, which may cause painful urination. In girls, swelling and redness of the labia minora and majora and the hymen, itching and burning of the external genitalia, yellow purulent discharge drains from the vagina.

“Galya, 13 years old, was raped a year ago by a man with gonorrhea. Then the girl venereal diseases was not found. Six months later, she began her first menstruation and was followed by purulent vaginal discharge, which she was afraid to tell her mother about, fearing a repeat examination by a gynecologist. Only after another six months did her mother notice traces of purulent discharge on her underwear. The girl was found to have both gonorrhea and trichomoniasis, which “dormant” until the onset of the menstrual cycle.”

Symptoms and course. The first signs of the disease usually appear 1-2 weeks after contact with the patient. Men usually complain of ulcerative-purulent, translucent or watery discharge from the urethra, itching or pain when urinating. The lips of the urethra are slightly reddened, swollen, and often stuck together. In some cases, there are no signs of the disease, although a person is infected and through sexual contact) is able to infect his partner.

Over time, the itching in the urethra decreases or disappears completely, the discharge becomes insignificant and is usually observed only in the morning before the “first” urine. However, this does not mean that the disease has passed; from acute it has become chronic with the spread of infection along the urethra.

Lesions of the prostate gland occur quite often. Unpleasant sensations appear in the perineum, rectum, nagging pain in the lower back. Discharge from the urethra is slight, mucous or watery, usually in the morning. Another common complication of chlamydia in men is inflammation of the epididymis. It often starts suddenly. The temperature rises, the scrotum becomes swollen, its skin is hot, red and tense, and the epididymis enlarges. Sometimes the pain spreads to the inguinal canal. In patients, sperm formation may be impaired and infertility may develop. A serious complication is Reiter's syndrome. With this disease, in addition to the urethra, the mucous membrane of the eyes and joints (usually the knees and ankles) are affected. Sometimes the illness lasts several months.

Nulliparous women with chlamydia should not use intrauterine contraceptive devices (coils), since their use contributes to the complication of the inflammatory process of the appendages. It is better to avoid inserting the IUD into those who have had inflammation of the fallopian tubes. The cause of exacerbations of chlamydia in women may be sexual partners who, not knowing that they are sick, endlessly “gift” them with this infection.

Cytomegalovirus infection. Transmitted sexually. The causative agent, cytomegalovirus, is found in saliva, urine, blood, breast milk, vaginal and cervical discharge, as well as in extremely large quantities in semen. Most often found in the genital tract of women with promiscuity.

Cytomegalovirus infection in adults is widespread and usually asymptomatic, with minor damage to the lungs and liver, usually without jaundice, resembling a very mild form of hepatitis. Infected people can shed the virus in their saliva (up to 4 weeks) and urine (up to 2 years).

Children become infected in utero from their mother. One in a thousand newborns has serious complications which can lead either to the death of the fetus in the uterus or cause congenital deformities.

Scabies. A contagious disease that is transmitted through close contact with a sick person, in most cases through sexual contact or when sleeping in the same bed. A connection has been established between the increase in the incidence of scabies and sexually transmitted diseases in the sexually active age group of 16-29 years.

Symptoms As the name itself suggests, the patient’s skin itches, especially in the evening and at night. Scabies are visible on the hands - wavy whitish or gray, slightly raised lines. Often their end ends in a transparent bubble. In addition to the passages, small, blister-like nodules appear at the site of bites of young ticks and males, which become covered with bloody crusts as a result of scratching. Constant scratching, which damages the skin, allows germs to enter it and cause suppuration.

scabies rash, in addition to the hands (especially between the fingers), it is located on the palms, on the chest (near the nipples, especially in women), stomach, buttocks, penis in men, under the knees.

Treatment - see chap. Skin diseases, section 5, Scabies.

Shapkrond(soft chancre, venereal ulcer). Isolated cases of this disease noted in our country are associated with the importation of infection from abroad. The main route of infection is sexual. The causative agent is streptobacilli, which is easily detected by microscopic examination of exudate from ulcers. Chancre pus at room temperature remains infectious for up to 8 days. Incubation period chancroid in men is often 2-3 days, in in rare cases reaches 2-3 weeks. In women, this period is longer: up to 2-3 weeks. It is characterized by the appearance of peculiar suppurating ulcers with a soft base, prone to inoculation on the genitals.

3-4 weeks after the formation of ulcers, their bottom begins to clear of pus, granulations appear, and after 1-2 months the process ends with scarring. There is no immunity after chancroid. The disease can be complicated by damage to the lymphatic system, as well as the development of phimosis and paraphimosis. Chancroid should be differentiated from hard chancroid, herpes simplex and other diseases.

PRINCIPLES OF TREATMENT OF VENEREAL DISEASES

Treatment of diseases that are sexually transmitted is carried out after a diagnosis has been established and confirmed by laboratory tests: The arsenal of medications is quite extensive, but currently the main ones are antimicrobial drugs: antibiotics and sulfonamides.

To treat syphilis, drugs of the penicillin group are most often used, which are administered intramuscularly or endolymphatically. Single, daily and course doses are selected by the doctor individually depending on the stage of the disease, age, weight of the patient, and concomitant diseases. The duration of treatment is from several days to 1-2 months. For warranty purposes full recovery After the end of therapy, patients undergo long-term (up to 5 years) clinical and laboratory follow-up. The final conclusion about the cure of syphilis is made by specialists only after this period: patients are then not prohibited from starting a family and having children.

Each specific medication has its own indications and contraindications. The most serious complications of antibiotic treatment are anaphylactic shock. Other complications that must be kept in mind are toxicoderma, dizziness, fainting, thrombophlebitis, toxic-allergic conditions. In such cases, antihistamines are prescribed. In case of intolerance to penicillin, erythromycin or tetracycline drugs (tetracycline, olitetrin, doxycycline) are used. Side effects from erythromycin are rare (nausea, vomiting, diarrhea, and with long-term use- jaundice). Tetracycline should not be prescribed to pregnant women, and when treating it in the summer, prolonged exposure to radiation should be avoided sun rays due to the possible manifestation of photosensitizing effects.

Bismuth preparations are used in late stages of syphilis; they are administered simultaneously with antibiotics. Side effects are rare, they are usually limited to the appearance of the so-called. bismuth border - narrow strip gray along the dental edge of the gum, as well as bismuth cells in the urine - degenerated renal epithelium.

Iodine, without affecting Treponema pallidum, is only an auxiliary agent that promotes the resorption of infiltrates and is prescribed in between courses of treatment, as well as for night pain in joints and bones. A 3-5% solution of potassium iodide is taken orally, 1 tablespoon three times a day after meals, preferably with milk, soda or mineral water. In some cases, iodine preparations cause side effects - damage to the mucous membranes and skin (conjunctivitis, runny nose, swelling of the tongue, larynx, bronchitis), gastrointestinal disorders, as well as toxicoderma, often in the form of acne.

Although antisyphilitic drug therapy has a high effect, it is advisable to combine it with stimulants. This primarily applies to late forms of the disease, to patients with concomitant pathology, including alcoholism. Methods of nonspecific therapy include: pyrotherapy, ultraviolet irradiation, injections of biogenic stimulants (extracts of aloe, placenta, vitreous, splenin), immunomodulators (levamisole, diu-ficin, methyluracil, pyrokean, etc.), vitamins, especially C and group B.

In most cases, external therapy is not advisable; it is used only in isolated cases. Local treatment comes down mainly to the hygienic maintenance of the affected areas. If the patient has large ulcerative, multiple chancre with significant infiltrates, warm baths, lotions with solutions of benzyl penicillin in demixide, applications of Acemin ointments, yellow mercury, and heparin are prescribed. To speed up the regression of weeping papules on the genitals and near the anus, powders of calomel mixed with talcum powder, or ointments with antibiotics are recommended. In the presence of rashes in the oral cavity (papular-ulcerative tonsillitis) - rinse with solutions of rivanol, 2% boric acid or grimicidin (1 ml per glass of water). Treatment of pregnant women and children, as well as recipients (people who have received blood transfusions from a patient with syphilis) and preventive treatment (in order to prevent infection of persons who have had sexual or close household contact with a patient with syphilis) have their own subtleties.

Treatment of patients with gonorrhea and other diseases with predominant damage to the urinary tract (chlamydia, trichomoniasis, ureoplasmosis) are carried out by venereologists and gynecologists. Methods depend on the cause inflammatory process, its stage, localization, type of infection and tolerance medicines. Various antibiotics are used (penicillin, tetracycline, erythromycin, cephalosparins, etc.), sulfonamides (sulfadimizine, sulfaxin, biseptol, etc.), imidazole drugs (Trichopol, fazizhin, tinidazole), antifungal agents.

After completion of treatment, medical supervision is required for up to several months with periodic laboratory examinations. Final recovery is established after provocations are carried out - with means and substances that aggravate the process. Duration of treatment: if the process is acute - several days, chronic - weeks.

Prevention. The surest remedy against sexually transmitted diseases, and especially AIDS, is marital fidelity. After all, the only relationship with one partner that can be considered truly safe is monogamy, understood as fidelity to one companion for the rest of your life. However, in real life this represents a rare exception. And the main threat to health comes from relationships with unfamiliar partners.

If you notice that your underwear is stained with something unknown or you have discharge from the genitals (sometimes with itching, pain or burning), frequent and painful urination, pain during sexual intercourse, consult a doctor.

This should also be done if spots, nodules, ulcers, blisters, etc. appear on the body, head, mucous membranes, hair loss, or changes in skin color. All this

signs of sexually transmitted diseases. Over time, they may weaken without treatment. However, an apparent improvement in no way means that the disease has passed; the right time for effective treatment is missed. To prevent this from happening, you must adhere to the following rule: if you suspect that an infection has occurred or after sexual intercourse with an unfamiliar partner, even if there are no signs of infection, you should immediately contact a venereologist. Typically, the study helps detect syphilis, venereal warts, genital herpes, gonorrhea of ​​the rectum and pharynx, but an asymptomatic infection is very difficult to diagnose. This may require repeat tests, sometimes in the hospital. All this, of course, is unpleasant, but it seems like a trifle next to the truly unpleasant consequences when time is lost.

So, if any suspicions arise, “it is necessary, firstly, to consult a doctor (and not try to get treatment on your own or from friends); secondly, to consult a doctor without delay (do not wait until everything goes away on its own); thirdly, contact a specialist doctor if possible (so as not to waste a lot of time establishing a diagnosis); fourthly, do not take antibiotics until the nature of the disease is determined (as this complicates diagnosis and contributes to the development of resistance in microorganisms, worsening the possibility of cure). ).

What if there are no symptoms of the disease yet, but accidental sexual intercourse occurred and individual preventive measures were not taken? Do I need to be examined, when and where is the best place to do it? Mandatory - either at the regional dermatovenerological dispensary, or at anonymous service points. A one-time analysis is not enough, since the latent period of sexually transmitted diseases can range from 2-3 days to several months. The first examination can be done in the absence of any manifestations of the disease after 10-14 days. At this time, gonococci and trichomonas can be detected in smears, and information about syphilis infection can also be obtained. The study should be repeated 2 months after suspicious contact, when the Wassermann reaction becomes positive for infection with syphilis. If there is reason to be afraid of contracting AIDS, then it is advisable to conduct a blood test no earlier than 3-6 months after possible infection. Other sexually transmitted diseases (herpes, genital warts, a contagious mollusk and t l.) are detected only in the presence of symptoms of the disease.

“People don't need to become monks. We just need to not do anything stupid,” writes one Swedish specialist. For example, do not enter into fleeting sexual contact with a stranger when leaving home, or do not sleep with someone who is ready for this after the first drink. These people, whether men or women, are usually not doing this for the first time.

Most reliable means protection against all sexually transmitted diseases - a condom. It reduces the risk of infection tenfold, but, unfortunately, does not provide a 100% guarantee for promiscuous sex life. For example, when kissing, the mucous membrane of the mouth can be damaged, and through this damage, the pathogens of AIDS and other sexually transmitted diseases found in the patient’s saliva are introduced.

What if there was an accidental relationship without a condom?

A man should wash his hands, urinate, then thoroughly wash the penis, scrotum, thighs and perineum with warm water and soap, dry them with a towel and wipe with cotton wool soaked in a disinfectant solution. In the urethra
the channel needs to be injected with 6-8 drops of gibitan or cidipol (gibitan and cidipol are available in special bottles with tips), while lightly massaging the external opening of the urethra. After this, you should try not to urinate for 2-3 hours. It is recommended to change your underwear.

A woman should also wash her hands, urinate, wash warm water genitals, thighs and perineum with soap, dry them with a napkin or towel and wipe thoroughly with a swab soaked in a solution of gibitan. Then you should douche the vagina with a solution of gibitan, 150-200 ml (glass). Treatment should be carried out no later than 2 hours after sexual intercourse.

If you are unable to resist risky adventures, at least try to protect yourself from their harmful consequences.

In our enlightened age, there is hardly a person who does not know about syphilis or AIDS. The most advanced even have information about cytomegalovirus and gardnerellosis. However, in particularly intimate situations, for some reason we forget about the basic rules of safe sex, and the first symptoms of “indecent” diseases cause us real horror.

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To avoid getting into a sticky situation, you must use a condom. Often, home-grown Casanovas do not want to interrupt their passion for such base matters as removing the packaging from item No. 2 and putting on this item. But no matter how romantic the situation is, no matter how impatient the gentleman is - think about the consequences! If the hero-lover is disgusted by the pulling of the “elastic band,” then perhaps he will find the procedure of taking a smear from the urethra for bacteriological examination more “pleasant”? In this case, a wire pin wrapped in cotton wool is inserted into the urethra (yes, exactly there!) and quickly scrolled. As they say, no comments!

Get ready for analysis!

The list of sexually transmitted diseases was not formed immediately. At first, doctors talked only about syphilis and gonorrhea. But as time went on, the list expanded, and a group of diseases was even identified under the “code” name STDs (sexually transmitted diseases), which includes more than 20 diseases (in particular, AIDS, hepatitis B, and even pediculosis pubis - lice). According to the law, only dermatovenerologists have the right to treat sexually transmitted diseases, although patients usually first go to a gynecologist or urologist.

The doctor will definitely send the patient for tests. Modern diagnostic methods are able to identify an insidious pathogen, no matter how it disguises itself. Another thing is that in order to pass all the necessary tests, you will have to run around to various laboratories.

• Bacteriological research (seeding, cultural method). The material obtained from the urethra or cervix is ​​sown on a nutrient medium. If after a few days microbial colonies appear on its surface, the diagnosis is beyond doubt. After this, they move on to the second stage: each colony is treated with an antibiotic. The antibiotic that kills bacteria the fastest is recommended for treatment (the analysis states that bacteria are sensitive to this particular drug).

• Microscopic examination. The smear is smeared on glass, stained with special dyes and carefully examined under a microscope. As a rule, no more than 40% of infections are diagnosed: for example, chlamydia and mycoplasma are difficult to detect even with multiple magnification, and viruses are only visible under an electron microscope.

• Immunological methods. They are based on the unique ability of antibodies to tightly bind foreign microbial proteins (antigens) and neutralize them. Blood taken from a patient is treated with a set of proteins - antigens of the pathogen, which “fish out” antibodies that suit them (like a key to a lock). After special processing these complexes turn yellow. If no antibodies are detected, the solution remains colorless. The presence of a sufficient amount of antibodies in the blood is a sure sign of infection.

• DNA diagnostics. The smear is treated with a protein solution. These proteins repeatedly copy the DNA molecules of the pathogen (if they are there), then special reagents make it possible to detect these copies.

No to super thin condoms!

The main enemy of infections is a condom, but for amateurs non-standard solutions it breaks easily. The superthin condoms that are popular today are often permeable to the protozoan Trichomonas vaginalis. These microorganisms produce enzymes that dissolve cell membranes, as a result of which the “infection” firmly digs into the vaginal mucosa. Moreover, these enzymes are so omnivorous that they can even dissolve the latex of condoms!

Gonorrhea

It is extremely easy to purchase - even with a single contact, the probability of infection is almost one hundred percent!

How to suspect. It is difficult not to notice gonorrhea, since the disease is accompanied by copious purulent discharge, burning sensation when urinating, chills, and fever. Another point that you need to pay attention to: the causative agent of gonorrhea, gonococcus, easily penetrates the mucous membranes, so oral sex is fraught with inflammation of the pharyngeal wall (pharyngitis).

What complications. In men, inflammation of the testicles leads to infertility. In women, gonorrhea can be asymptomatic, causing chronic inflammation of the fallopian tubes. Another problem that can be expected from gonorrhea is inflammation of the joints.

How to detect. Gonococci have a peculiar shape, so the disease is quite easily diagnosed during microscopic examination. Cultures are used to definitively confirm the diagnosis and select an antibiotic.

Syphilis

Unlike other infections, this disease (in running forms) is fatal, so timely treatment is vital!

How to suspect. At the site where Treponema pallidum (the causative agent of syphilis) is introduced, a nodule appears on the penis in men (labia in women), which eventually turns into an ulcer. It does not bleed or hurt, and after a month and a half it disappears safely - to the great joy of the owner. In fact, there is nothing to rejoice at: the disease has simply moved into the next stage. Very soon a rash appears that spreads over the torso, palms and feet. However, it also does not cause much trouble and quickly disappears. At this stage, the disease is still curable: it is very important to catch it before the next round begins to unfold - the third stage of syphilis.

What complications. Irreversible changes occur in the nervous and cardiovascular systems. The disease destroys bones and affects the brain and spinal cord. As a result, one of the most common complications of syphilis develops - paralysis.

How to detect. The most well-known method is the Wasserman reaction (WR), which allows the detection of antibodies to treponema. Attention! For unknown reasons, during pregnancy the Wasserman reaction can be positive (after childbirth it again gives negative result).

Chlamydia, mycoplasmosis, ureaplasmosis

How to suspect. In most cases, the infection is asymptomatic. Men experience some discomfort when urinating; in the morning, the external opening of the urethra may be stuck together due to discharge; traces of discharge are also found on underwear. The infection forces women to go to the toilet more often than usual, and urination is accompanied by a burning sensation. There may be minor pain in the lower abdomen and slight discharge. All this is usually attributed to cystitis and people start drinking cranberry juice(of course, without much effect).

What complications. Chlamydia is one of the common reasons chronic inflammatory processes and infertility in women. In men, the disease is complicated by Reiter's syndrome, in which chlamydia actively multiplies in the genitals, joints and eye tissues, causing acute inflammatory processes.

How to detect. A quick answer is provided by DNA diagnostics, which makes it possible to detect chlamydia both in the initial stages of the disease and in its chronic forms. And to work out the right tactics treatment is allowed by culture (required with antibiotic sensitivity testing).

Trichomoniasis

This disease is as common as it is unique, since Trichomonas is a natural container in which pathogens of other diseases can “travel freely”: gonococci, chlamydia, mycoplasma. During treatment, Trichomonas are destroyed, and free-rider infections get a happy opportunity to leave their refuge - and the next round of the disease develops.

How to suspect. In the morning, men feel the need to visit the toilet and experience slight discharge from the urethra. But in general, trichomonas do not bother the stronger sex much - they are waiting for the right moment to get on the vaginal mucosa. Women notice the disease immediately: is it possible to ignore symptoms such as foamy discharge, constant burning and itching? Sometimes the infection is asymptomatic, but when the body’s defenses fail (for example, after the flu or stress), Trichomonas are sharply activated

What complications. In women, Trichomonas readily multiply in the bladder, adding cystitis to their suffering. In men, the favorite habitat of trichomonas is the prostate gland, so trichomoniasis and chronic prostatitis usually go together.

How to detect. Sowing Trichomonas on a nutrient medium allows you to get an accurate answer about the presence of infection - however, after a few days.

Genital herpes

The culprit of this disease is the herpes simplex virus, which is activated when immunity is reduced. Sores on the lips seem to be a harmless phenomenon, but when they get on the mucous membranes of the genitals, herpes becomes dangerous.

How to suspect. During an exacerbation, bubbles or ulcers filled with liquid appear on the genitals (exactly the same as on the lips). These ulcers are painful, take a long time to heal and may be accompanied by fever. During an exacerbation, genital herpes is so contagious that any sexual contact at this time is excluded. Unfortunately, even successful treatment does not always prevent relapse.

What complications. The virus can enter the nervous system and infect the meninges, causing meningitis. Severe forms infections usually develop against the background of immunodeficiency. There is evidence that one type of herpes simplex virus increases the risk of developing cervical cancer.

How to detect. Material obtained from the vagina or urethra is applied to a culture of cells in which the virus multiplies especially readily. If the disease is in the active phase, the virus “eats” the cells very quickly, literally in a day or two.

papillomavirus

This virus is the subject of close attention of oncologists, since recent studies indicate that under certain conditions it provokes the growth of malignant tumors.

What complications. The virus causes the formation of condylomas (warts): in men - on the penis, in women - on the labia and the inner surface of the vagina.

What makes it more difficult?. With a decrease in immunity, as well as pregnancy, condylomas, growing, can turn into a malignant tumor.

How to detect. It is enough to do a biopsy: take a small piece of the wart and examine it under a microscope.

Let's consider characteristic features the most common STDs.

Chlamydia

This is a very common disease that very often occurs without any symptoms. Chlamydia does not manifest itself in any way in 46% of sick men and 67% of women. Typically, the first signs of infection appear 1-4 weeks after infection. Sick women begin to notice the appearance of pathological discharge from the vagina, sometimes of a purulent nature, pain in the lower abdomen. In men, chlamydia has typical signs inflammation of the urethra (). Pain and pain when going to the toilet, discharge from the penis.

A person becomes contagious approximately from the 3rd day after exposure to microorganisms, but the likelihood of transmitting the pathogen is low.

Gonorrhea

Gonococcal infection or gonorrhea is the second most common STD among other STDs. Symptoms of this venereological disease appear quite quickly after infection. Approximately 2-10 days after infection. The main signs of gonorrhea in women are: yellowish or greenish discharge from the genital tract.

Pain during urination and its frequency, pain of varying degrees of intensity in the lower abdomen. In men, symptoms are not significantly different. But in most of them the disease is less acute, and in about 20% of cases there is an asymptomatic course.

Regardless of how long it takes for this disease to manifest itself in men or women, theoretically a person is contagious even during the incubation period. Therefore, prevention is necessary - the use of latex or polyurethane condoms.

Genital herpes

The causative agent of genital herpes has a recurrent course, since the pathogen persists after infection for life. Incubation period this venereal disease usually lasts 2-10 days. Relapses occur when the body experiences stress and when the immune system is weakened. The harbingers of herpes are itching and small red rashes on the skin of the genitals.

Subsequently, they are replaced by bubbles, first with transparent contents, and then with cloudy contents. Somewhat later, the blister opens and leaves behind an ulcer with a crust.

In severe cases multiple rashes have a draining nature, which causes severe pain to a person.

Infectiousness during the incubation period data venereal disease scanty. The risk of transmission of the virus becomes maximum during periods of pronounced clinical picture.

Mycoplasmosis and ureaplasmosis

These are similar diseases that have almost the same pathogens. Ureaplasmas used to belong to the group of mycoplasmas. But later they were allocated to separate group due to its ability to break down urea.

The incubation period for these infections is 3-5 weeks. It is almost impossible to distinguish between mycoplasmosis and ureplasmosis without appropriate tests.

During the period of pronounced clinical picture, symptoms of urethritis and inflammation of the vagina are observed. And when the process spreads further - inflammation of the uterus and appendages, kidney damage.

Syphilis

The incubation period of one of the most famous sexually transmitted infections, syphilis, in both men and women is approximately 3-4 weeks. The first manifestations of the disease are small pink or reddish rashes. Next, the rash gives way to an ulcer with dense edges, called a chancre. This happens in a period from a week to 3 months, which depends on protective forces body and resistance against infection. There are frequent cases of the affected area spreading to the palms, plantar side of the feet, neck and even face.

Later, in the third stage, dense tubercles are formed, which in the future will ulcerate and scar. Infectiousness during the incubation period is low. Moreover, the probability of infection from a sick person during a single sexual contact is about 30%.

Trichomoniasis

The incubation period of this venereological disease is 1-4 weeks; in women the disease occurs much more often than in men. Trichomoniasis has symptoms typical of an STD: redness of the genitals, severe itching, discharge from the vaginal canal that has bad smell and yellow color.

In men, the disease has signs of inflammation of the urethra. And when involved in pathological process prostate gland - symptoms of prostatitis. You can become infected not only from a patient with an acute form of trichomoniasis, but also from a carrier of the infection.

Sexually transmitted diseases: diagnosis before symptoms appear

Diagnostics venereal diseases during the incubation period is difficult, since few tests will be positive. Classic detection methods, such as culture, as well as serological methods, with a large share the probabilities will be negative. Since the amount of pathogen in the body is not enough to detect them. But the polymerase chain reaction (PCR) method is a way out.

Since its principle is based on multiple doubling of a certain fragment of DNA or RNA. Any biological material in which the pathogen is expected to be found is suitable for PCR analysis. Additional method Real-time PCR allows you to determine the exact number of microorganisms.

Preventive treatment of sexually transmitted diseases

If after sexual intercourse there is great uncertainty about its safety, what should you do? Venereal disease can be prevented if preventive or preventive treatment is carried out during the incubation period. The complexity of this method of prevention lies in the fact that there is no universal method of treating all STDs. Every pathology requires individual approach and prescribing a specific set of medications.

How to treat during the incubation period with an unknown, but probable?

Complexes of several drugs are used. Broad-spectrum antibiotics are prescribed, and immunomodulatory agents are additionally used.

If a specific type of pathogen is suspected, it is possible to select the most successful group of drugs. Local preventive therapy is also effective. Use of antibacterial or anti-inflammatory ointments, irrigation products. As well as instillation (administration of drugs into bladder, urethra), etc. But before starting preventive treatment, it is worth thinking about the feasibility and safety.

It is worth remembering that many drugs, especially antibiotics, are toxic. At frequent use drug resistance is developing and their further use will be ineffective.

If you suspect a venereological disease, contact a competent venereologist.

The term “venereological disease” refers to an infectious disease that is transmitted during sexual intercourse. It is worth saying that such diseases have been known to mankind for a long time. Today, of course, they are not so common, and effective methods of therapy exist. Unfortunately, many patients prefer to ignore the symptoms of the disease and seek help when complications develop.

That is why it is worth familiarizing yourself with the available information. How and where can you get an infection? What do the symptoms of sexually transmitted diseases look like in men and women? Where can I get tested? What does the treatment regimen look like? How to protect yourself from sexually transmitted infections? Many readers are looking for answers to these questions.

Venereal diseases in men and women

Sexually transmitted diseases are considered quite common, with 50% of those infected being young people under 24 years of age. The risk group primarily includes men and women with promiscuous sexual intercourse, especially if condoms are not used during contact.

Symptoms of sexually transmitted diseases in men and women, of course, depend on the type of pathogen. The incubation period can last from several weeks to several months and even years. During this period, a person becomes a spreader of infection, without even suspecting that he has his own problem.

Despite the diversity, several main symptoms can be identified that are present to one degree or another with any sexually transmitted infection. Venereal disease is usually accompanied by an increase in body temperature. Patients complain of discomfort in the genital area, sometimes there is a burning sensation and pain. TO general symptoms may include inflammation of the lymph nodes (most often their enlargement is observed in the groin area). Many patients complain of an increased urge to urinate, and the process itself is often accompanied by pain.

Many diseases are accompanied by external signs, such as rash, redness and swelling of the genitals. Often men experience mucous or purulent discharge from the urethra. Venereal diseases in women are accompanied by vaginal discharge of an uncharacteristic color, often with an unpleasant odor.

If you notice any of the signs, you should consult a doctor. Self-treatment is very dangerous, because first you need to determine the nature of the pathogen and the stage of development of the disease. In the absence of adequate therapy, sexually transmitted diseases quite often develop into chronic form, which entails very unpleasant consequences (prostatitis, infertility). Heal chronic illness much more difficult, and even with the right approach, it is not always possible to get rid of the infection and the consequences of its activity.

Gonorrhea: causes and symptoms

Gonorrhea is an infectious disease that is accompanied by inflammation of the genitourinary system. The causative agent is gonococcus, which is most often transmitted during sexual intercourse. Microorganisms infect organs that are lined with columnar epithelium, in particular the urethra and uterus. Much less often, the infection spreads to the mucous membranes of the intestines, pharynx, and conjunctiva of the eyes. If left untreated, pathogens can infect musculoskeletal system, in particular joints.

Signs of sexually transmitted diseases are quite characteristic. There is swelling of the mucous membranes of the genitals. Many patients complain of pain in the lower abdomen and pain during urination. People are constantly bothered by discomfort, burning and itching. Discharge appears from the vagina and urethra - often it contains impurities of pus and has a very unpleasant odor.

Syphilis: features of the clinical picture

At one time, syphilis was terrible disease, which invariably led to a rather painful death. Today, this disease is easily diagnosed and quite successfully treated. The causative agent is a pallidum spirochete, which is spread sexually. The incubation period lasts about 3-4 weeks.

Syphilis - systemic disease with a wavy current. The primary stage of the disease lasts about 6-8 weeks and is accompanied by the formation of a hard chancre at the site of infection penetration through the skin (usually a tubercle or pimple on the genitals). Secondary syphilis develops over years - the infection gradually spreads to other organs, affecting circulatory system, musculoskeletal system. Syphilis is often accompanied by characteristic skin rashes and alopecia. The tertiary stage is characterized by severe damage to the central nervous system, which often leads to death.

Symptoms of chlamydia

Chlamydia is a very common sexually transmitted disease. The photo shows the pathogen, namely chlamydia. This is a group of quite dangerous diseases. Pathological microorganisms primarily affect organs genitourinary system. Urethritis, vulvovaginitis and cystitis are observed. In men this disease often leads to the development of prostatitis. Women suffer from cervicitis, endometritis and erosions, which, of course, is fraught with infertility.

In some cases, the infection spreads to other organ systems. Chlamydial pneumonia may develop. Other complications include bacterial conjunctivitis and encephalopathy. The most dangerous is the generalized form of chlamydia, in which pathogenic microorganisms affects the tissues of the liver, heart, digestive tract and lungs.

Clinical picture of trichomoniasis

The causative agent of trichomoniasis is Trichomonas vaginalis. By the way, these microorganisms exclusively affect the organs of the genitourinary system. In men, the target organs are the testicles, seminal vesicles, urethra and prostate gland. Women suffer from inflammation of the urethra, vagina and cervical canal.

Patients complain of pain, redness and irritation in the genital area. Often there appears abundant foamy discharge with an unpleasant odor of yellow or even green color. There is discomfort during urination and sexual intercourse. Ulcers and erosions may form on the mucous membrane of the genital organs. Some patients develop dermatitis on the skin of the thighs.

Viral venereal diseases

If we are talking about viral diseases, then it is worth mentioning genital herpes, the causative agent of which is the herpes simplex virus (most often type 2). Signs of sexually transmitted diseases in this case are the appearance of a blistering rash on the skin of the penis, scrotum in men, in the anus and external genitalia in women. Often quite painful ulcers form at the site of the rash. By the way, herpes infection, as a rule, becomes more active against the background of decreased activity immune system, and it is completely impossible to cure it.

The next common pathogen is the human papillomavirus, which can also be transmitted during sexual intercourse. There are more than 100 varieties of this virus. In most cases, against the background of its activity, warts (papillomas) of various shapes and sizes appear. They can form on the skin and mucous membranes, and not only in the genital area.

The most dangerous viral disease is the human immunodeficiency virus (HIV). The infection spreads during sexual intercourse, as well as through contact with the blood of an infected person. This virus destroys the human immune system, making the body susceptible to almost any other infections (even common cold may be dangerous). The incubation period lasts on average 10 years. Today, doctors can only offer supportive therapy.

Tests for sexually transmitted diseases and other diagnostic methods

If you notice suspicious symptoms, you should consult a doctor. After a general examination, the patient must be tested for sexually transmitted diseases. There are several main research methods.

The advantages of the technique include speed and low cost. On the other hand, it is not always possible for a laboratory technician to identify all pathogens, so this analysis is used for preliminary diagnosis - additional examinations are needed to make a final diagnosis.

Additionally carried out bacteriological culture samples obtained from a smear. The study takes several days, but it makes it possible to accurately determine the causative agent of the disease, as well as the degree of its sensitivity to certain medications.

Sometimes a blood test is performed, although it is more effective in viral infections. It is worth saying that in some cases false results are possible, since it takes time for the immune system to begin producing antibodies.

Basic principles of treatment

Treatment of sexually transmitted diseases directly depends on the type of disease, the stage of its development and, of course, the nature of the pathogen. If we are talking about bacterial infection, then antibiotics will be effective. For example, for chlamydia, Azithromycin is used. If we are talking about gonorrhea, then Cefixime or some other broad-spectrum antibiotics are used. Syphilis in the first stage also responds well to treatment with antibacterial agents. Of course, as the disease progresses, the infection spreads to other organs, so other drugs are also included in therapy.

As for viral diseases, for example herpes, papillomavirus, it is not possible to completely get rid of them - viral particles remain in the body, from time to time provoking an exacerbation of the disease. During an acute inflammatory process, they are used antiviral drugs(“Acyclovir”) in the form of tablets or gels for external use.

It’s worth saying right away that if the patient has a venereological disease, then both partners should undergo therapy, since there is a high probability reinfection. During treatment, it is recommended to abstain from sexual contact. The state of the immune system is also important. Proper nutrition, frequent walks, physical activity, normal sleep and rest patterns, lack of stress - all this has a positive effect on the body’s protective functions, increasing resistance to infectious agents.

Preventive precautions: how to prevent infection?

As you can see, sexually transmitted infections can be quite dangerous, and therapy takes a lot of time. It is much easier to avoid infection than to then undergo complex treatment. What does prevention of sexually transmitted diseases look like? Unfortunately, there are no specific remedies. But by following certain rules, you can reduce the risk of infection.

As mentioned, people with promiscuous sex life are at risk. In this case, the use of a condom is simply necessary, since today it is the only means of protection against infection (oral contraceptives and other means only prevent fertilization). In the event that sexual contact does occur without the use of protection, it is important to carry out hygiene procedures. For washing, you can use boiled water and soap. Women are recommended to douche, preferably using antiseptics, in particular Miramistin.

Afterwards, you should get tested for sexually transmitted diseases - the sooner the disease is detected, the faster and easier its treatment will be.

An unpleasant surprise after a holiday romance or a romantic adventure with a stranger can be STDs. The topic is quite sensitive, so people are usually in no hurry to go to the doctor. However venereal symptoms which may be absent, can lead to very unpleasant consequences.

Today, more than 20 of them are known. The most common STDs are chlamydia, gonorrhea, syphilis, trichomoniasis, genital herpes, hepatitis, genital warts and, of course, the most dangerous - HIV.

The problem is that women don't always show up. Often they do not even realize that they are infected and continue to transmit the infection to their sexual partners, and sometimes to relatives, through everyday means.

The disease, when it is asymptomatic, does not harm the body less harm than in the presence of severe symptoms. Without timely treatment, it becomes chronic, which is more difficult to diagnose and treat. It can manifest itself as periodic exacerbations when immunity decreases.

So, how do sexually transmitted diseases manifest themselves? Symptoms in women depend on the body and have varying severity. STDs can manifest themselves as follows:

• redness, itching, burning, soreness and swelling of the genitals;
• unusual discharge (abundant, purulent, having an unpleasant odor and strange color, foamy, etc.);
• painful and;
• the appearance of ulcers, rashes, neoplasms on the genitals;
• abdominal pain;
• cycle disorders;
• pain during sex.

Even the presence of one of these symptoms is a reason to consult a doctor. By the way, inflammation of the genitourinary system, caused not by STDs, but by ordinary opportunistic flora, manifests itself in a similar way. It is impossible to distinguish them by symptoms alone, so you need to visit a gynecologist or venereologist.

Treatment can be prescribed only after the pathogen has been identified. Quite often there is a combination of several diseases. Therefore, if symptoms are present, a full diagnosis is usually carried out.

Today, cultures and PCR are used to detect sexually transmitted diseases in women. Symptoms can only indirectly indicate specific pathogens. For example, the presence of ulcers is characteristic of genital herpes and trichomoniasis, and the appearance of a rotten fish smell in the discharge is characteristic of gardnerella.

PCR is highly accurate and can detect even one pathogen DNA in the material. Using cultures, you can determine the number of microorganisms and the drugs to which they are sensitive. The main disadvantage of the method is that the analysis takes a very long time, about a week.

To identify HIV, hepatitis and syphilis, they are usually tested. These are the most dangerous diseases that can even lead to the death of a person without treatment.

Sexually transmitted diseases are especially dangerous for reproductive function in women. Their symptoms go away without treatment, but chronic inflammation remains. Over time, they lead to the formation of adhesions, pathological changes in the mucous membranes, and can periodically worsen, this is especially dangerous during pregnancy, as it can lead to pathologies and even miscarriage.

Quite often it leads to infertility in which pregnancy becomes problematic. Slow inflammation of the ovaries disrupts their functioning, calls into question the possibility of pregnancy and worsens women's health.

However, the most common complication of STDs, especially chlamydia, is blockage of the fallopian tubes. It occurs when there are adhesions in them and in the small pelvis. With this pathology, either fertilization is not possible at all, or an ectopic pregnancy occurs, threatening the woman’s life.

So, sexually transmitted diseases in women, the symptoms of which may be absent, must be treated. Otherwise, they can lead to infertility, chronic inflammation, pelvic pain, even cancer and death.