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Sexually Transmitted Diseases: Causes, Types, Symptoms, Treatment, Diagnosis

Sexually transmitted diseases (STDs)

Introduction

Sexually transmitted diseases (STDs) are also known as sexually transmitted infections(STIs)  or the  venereal diseases. The latin word venereal means sexual love and is derived from the word Venus; the goddess of love.  Sexually transmitted diseases are due to  infections spread by sexual activity, especially vaginal intercourse, anal sex and oral sex. STIs often do not initially cause symptoms, which results in a high risk of passing the infection on to others.

ICD-10 Codes for Sexually Transmitted Diseases (STDs) in Women:

For women, the relevant ICD-10 codes for various STDs include:

  • A50.0: Congenital syphilis, early congenital (for syphilis transmitted from mother to infant)
  • A51.0: Primary syphilis
  • A51.1: Secondary syphilis
  • A51.2: Early latent syphilis
  • A51.3: Late latent syphilis
  • A51.4: Syphilis, unspecified
  • A52.0: Neurosyphilis
  • A54.0: Gonococcal infection of the pharynx (if applicable to women with oral gonorrhea)
  • A54.1: Gonococcal infection of the cervix
  • A54.2: Gonococcal infection of the female genital tract (includes cervix, uterus, and other parts)
  • A54.3: Gonococcal infection of the rectum (if applicable to women with rectal gonorrhea)
  • A54.9: Gonococcal infection, unspecified
  • A55: Chlamydial infection of the cervix
  • A56.0: Chlamydial infection of the female genital tract
  • A56.1: Chlamydial infection of the urethra
  • A56.9: Chlamydial infection, unspecified
  • B00.1: Herpes simplex virus infection of the eye (if affecting the eye)
  • B00.9: Herpes simplex virus infection, unspecified
  • B02.9: Zoster (shingles), unspecified (not typically an STD but can be relevant if there is a viral infection)
  • B37.3: Candidiasis of the vagina and vulva (vaginal yeast infection)
  • B37.4: Candidiasis of the vulva and vagina with vaginitis (vaginal yeast infection with inflammation)

CPT Codes for Diagnosis and Treatment of STDs in Women:

Diagnostic and treatment procedures might include:

  1. 99201 – 99215: Office or other outpatient visits (for consultations, evaluations, or follow-up related to STDs)
  2. 87270: Smear, cervical or vaginal (for detecting infections such as HPV or other pathogens)
  3. 87491: Chlamydia trachomatis test (nucleic acid probe or other methods)
  4. 87591: Gonorrhea test (nucleic acid probe or other methods)
  5. 87798: Testing for sexually transmitted infections (e.g., HPV, herpes simplex virus)
  6. 88305: Pathology examination, including biopsy (if needed for diagnosing infections or related conditions)

STD

Dr. Dimple Doshi at Vardaan Hospital; believes prevention is better than cure, and thus apart from the precise treatment guidelines; preventive measures are an essential part of our consultations with the patients who have either had it or want to know more about it.

  1. Bacterial STIs include chlamydia, gonorrhea, and syphilis.

  2. Viral STIs include genital herpes, HIV/AIDS, and genital warts.; hepatitis A B or C
  3. Parasitic STIs include trichomoniasis
  1. Trichomaniasis
  2. Chlamydial infection
  3. Gonorrhea
  4. Syphilis
  5. HPV
  6. HIV
  7. Hepatitis A
  8. Hepatitis B
  9. Hepatitis C
  10. Herpes
  11. Genital warts

Anyone who is sexually active carries a risk of contracting sexually transmitted infections. The factors which increase the risk include:  

  • Having unprotected sex. Not wearing a condom or an improper and inconsistent use of condoms can also increase your risk.
  • Having  multiple partners. The more people you have sexual contact with, the greater your risk. if your partner is having multiple partners; your risk of getting STIs increases more even though you are steady with one partner. .
  • Having a history of STIs. Having one STI makes it much easier for another STI to flourish in the body..
  • Anyone forced to have sexual intercourse or sexual activity. Dealing with rape or assault can be difficult, but it’s important to see a doctor as soon as possible so that you can receive screening, treatment and emotional support.
  • Misuse of alcohol or use of recreational drugs. Substance misuse can inhibit your judgment, making you more willing to participate in risky behaviors.
  • Injecting drugs. Needle sharing spreads many serious infections, including HIV, hepatitis B and hepatitis C.
  • Tattooing: Prefer going to standard tattoo parlors where only disposables are used. If these aseptic precautions are not followed it increases the risk of getting sexually transmitted diseases manifold.  
  • Pain and burning in urine along with white vaginal discharge
  • Urgency of urine with burning
  • Lower abdominal pain
  • Vaginal itching
  • Growth or warts on vagina
  • Vaginal discharge which may be quite irritating and foul smelling
  • Fever
  • Ulcers on the private parts
  • Eruptions on private parts which are assoicated with extreme burning and pain with itching
  • Inability to conceive
  •  

Early detection and treatment is important to reduce the spread of disease and its late complications.

But ironically; people turn to the internet first to know about their problems rather than visiting the doctor.

There is often a window period after initial infection during which an STI test will be negative. During this period, the infection may be transmissible. The duration of this period varies depending on the type of infection and the test.  

The tests which are often used to diagnose sexually transmitted infections are:

  1. CBC and urine routine to confirm any infection
  2. S. VDRL test
  3. S. HIV
  4. S. Hbsag
  5. S. HCV
  6. Vaginal swab test
  7. Pap smear and HPV DNA test

Treatment of the STIs is based on the type of infection. For example:

Chlamydial infection: Simple treatment with antibiotics like azithromycin or doxycycline taken for a week.

Trichomonal infection: Short treatment with metronidazole or tinidazole .It cures 95% infections.  Both the partners should take.

Gonorrhea infection: Treatment with oral antibiotic like azithromycin and IV ceftriaxone for resistant strain.

Syphilis infection: Treatment with antibiotic like benzathine penicillin

Herpes infection: Treatment with antivirals like acyclovir and femcyclovir or valacyclovir

HIV infection: Requires appropriate treatment by an infectious disease specialist

  1. Abstinence: to not have sex is called abstinence and is the most effective way to avoid sexually transmitted infections.
  2. Stay with only one uninfected partner.
  3. Avoid  intercourse  (vaginal, oral or anal )with new partners until you have both been tested for STIs. And if it happens by accident, get tested and consult your gynaecologist immediately.
  4. Get vaccinated. Getting vaccinated early; before sexual exposure helps  best for prevention .Vaccines are available for some infections like HPV; Hepatitis B   and Hepatitis A

But vaccine for one infection does not make you safe against other infections. Having a restrained and disciplined sexual life is always healthy.

The Centers for Disease Control and Prevention (CDC) recommends the HPV vaccine for girls and boys ages 11 and 12.

If not fully vaccinated at ages 11 and 12, the CDC recommends that girls and women through age 26 and boys and men through age 26 receive the vaccine.

The hepatitis B vaccine is usually given to newborns, and the hepatitis A vaccine is recommended for 1-year-olds.

5. Use condoms consistently and correctly. Use a new latex condom  for each sex act, whether oral, vaginal or anal. Never use an oil-based lubricant, such as petroleum jelly, with a latex condom.

Keep in mind that while condoms reduce your risk of exposure to most STIs, they provide less protection for STIs involving exposed genital sores, such as HPV or herpes.

6. Don’t drink alcohol excessively or use drugs. If you’re under the influence, you’re more likely to take sexual risks.

7. Communicate. Before any serious sexual contact, communicate with your partner about safe sex. Be sure you specifically agree on what activities will and won’t be OK.

8. Consider male circumcision. There’s sufficient evidence that male circumcision helps reduce a man’s risk of acquiring HIV from a woman who is infected (heterosexual transmission) by as much as 60%. Male circumcision may also help prevent transmission of genital HPV and genital herpes.

9. Consider pre-exposure prophylaxis (PrEP). The Food and Drug Administration (FDA) has approved the use of the combination drugs Truvada (emtricitabine plus tenofovir disoproxil fumarate ) and   Descovy (emtricitabine plus tenofovir alafenamide ) to reduce the risk of sexually transmitted HIV infection in people who are at very high risk.

Your doctor will prescribe these drugs for HIV prevention only if you don’t already have HIV infection. You will need an HIV test before you start taking PrEP and then every three months as long as you’re taking it. Your doctor will also test your kidney function before prescribing Truvada and continue to test it every six months.

These drugs must be taken every day, exactly as prescribed. If you use Truvada daily, you can lower your risk of getting HIV from sex by more than 90%. Using additional prevention, such as condoms, can lower your risk even more. Continue to practice safe sex to prevent other STIs.