- Hi, I'm Dr. Natasha Bhuyan.
I'm a family physician at One Medical,
and today I'll be answering the Internet's questions
about sexually transmitted infections.
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Can STIs be transmitted through kissing?
Generally, no.
It's very, very low risk to transmit STIs through kissing.
There are some very rare instances where you can.
So things like syphilis or herpes that
causes cold sores and even HPV,
there's rare instances that it could
be transmitted through kissing.
But I tell people it's a super
low risk activity and to kiss away.
What is the difference between STDs and STIs?
STI stands for sexually transmitted infection
and STD stands for sexually transmitted disease.
Back in the old days,
we used to call STIs sexually transmitted diseases,
but we found they're not actually long term diseases.
Most of the time, they're infections
that we can easily take care of.
Is somebody does get an STI that
turns into a longer term disease like HIV,
then we can refer to it as an STD,
but for the most part we refer to STIs as STIs these days.
Can STIs kill you?
Unfortunately, there are some STIs that if you get,
in the long run they can kill you.
For example, HPV is an STI that can cause cancer.
And cancer of the anus, of the cervix, of the mouth,
all of those things are things that
can ultimately end up killing you.
Hiv is also another sexually transmitted infection
that if untreated could also kill you.
Why do STIs exist?
This is a very existential questions.
Really, around our bodies there are tons and tons
of microbes and bacteria and it exists all around the world.
And some of those bacteria are good and some are bad,
some of the viruses are good and some are bad.
And we find that for some of the bad ones,
they can end up causing havoc on our bodies
and so we just need to get them treated.
But it's pretty normal to get STIs.
They're really just infections
that exist in the world anyway.
Do STIs hurt?
There are some STIs that can cause pain,
and there are some STIs
that will cause no symptoms at all.
For example, chlamydia and gonorrhea
can cause pain when you urinate,
but chlamydia and gonorrhea can also no symptoms at all.
And so if you are worried about having an STI,
it's great to see a doctor to get tested.
And really, even if you're not worried about having an STI,
if you're someone who's sexually active,
you should get regularly tested
and screened for STIs anyway.
Can STIs cause UTIs?
No.
The bacteria that causes UTIs
is different than the ones that cause STIs.
But they can present in the same way.
For example, if you have burning when you pee,
that could be caused by chlamydia or gonorrhea
or it could be caused by a UTI bacteria like E. coli.
The mechanism is a little bit different.
STIs cause inflammation in our urethral track
where pee comes out of.
Where UTIs are actually causing an infection in the urine.
But the symptoms ultimately be the same
so it's important to make sure
you're able to differentiate them.
Why is chlamydia so common?
Chlamydia's so common because it's so easy
to pass from one person to another.
We see it in both males and females.
It tends to end up being in females quite frequently
because our urethral track is a little bit shorter
and so it's easier for the chlamydia to just crawl
up our urethral track.
How does gonorrhea affect the body?
Gonorrhea can affect our body in lots of different ways.
In some people, they might not feel any symptoms at all.
In other people, they might feel burning when they pee,
they might have discharge from their pee hole
in both males and females
or they might even get itching in the pelvic region.
Will an std test show herpes?
No.
The general STI panels do not test for herpes.
The herpes blood test is very controversial
and it's actually not very helpful.
A herpes blood test could give you a false positive
or a herpes blood test might show
you've got antibodies to herpes
but we don't know how long ago that you had the infection.
We really discourage people
from getting a blood test for herpes.
However, if you have a lesion on your genitals,
you should get that swabbed.
And we can swab that for herpes and test it out.
Generally, herpes lesions are quite painful.
If you have a painless lesion on your genitals,
you should get that tested too.
Painless lesions on the genitals could
also be a different STI like syphilis.
People can have herpes and not realize they have it,
but the reality is when people get herpes,
they will get painful lesions.
Will an STI test show HPV?
No.
Again, a general STI panel
tests for gonorrhea and chlamydia, HIV and syphilis.
The way that we're able to test for HPV
is when you get a pap smear,
we can look at those cells and we can see the HPV
DNA on those cells and that's how we diagnose HPV.
Will STIs show up in a pap smear?
You've gotta ask you healthcare professional
to add STIs testing to your pap smear.
It's possible to run gonorrhea
and chlamydia in a pap smear and test for that,
but we specifically have to order it.
So we want you to feel comfortable to tell your healthcare
provider to add it on those STIs when you get a pap.
Blood tests lie HIV and syphilis though,
those do not come up in a pap smear.
You'll have to get a separate lab to get those tested.
How do STIs affect fertility?
It's very important to get tested and treated.
If STIs go untreated,
they can actually impact your fertility
and they can make you infertile.
This doesn't happen commonly,
but gonorrhea and chlamydia can get into your system
and cause a condition called PID,
pelvic inflammatory disease.
What happens then is they'll scar the fallopian tube.
That's the tube that is in between
your ovaries and your uterus.
And when they scar the fallopian tube,
it makes it harder for an egg to pass through.
And it can affect your fertility.
It's similar in men who are cisgendered.
So men who have testicles
can get an inflammation of this
thing called an epididymidis,
which is a tube behind the testicles,
and if they have untreated gonorrhea or chlamydia,
that can become scarred as week.
How do STIs enter the body?
STIs enter the body a couple of different ways.
They can enter through fluid transmissions.
So STIs can be in semen or vaginal secretions or blood.
This is why we tell people use a condom when you have sex
because it reduces the risk of transmission of STIs.
STIs can also be passed with skin to skin contact.
So something like heroes is passed
with skin to skin contact.
And condoms do reduce the risk of this,
but your skin can still touch
and you can still get herpes even if you're using a condom.
Which STIs can be treated with antibiotics?
The bacterial STIs can be treated with antibiotics.
So that's gonorrhea, chlamydia and syphilis.
There's another STIs called trichomoniasis.
It's this little parasite that has a tail
and that can also be treated with an antibiotic.
Which STIs have no cure?
The STIs that have no cure tend
to be the ones that are viral based.
Like hiv, although there's lots
of treatments to manage that condition.
Hepatitis, same thing.
Lots of treatments to help manage that condition.
Herpes is another viral STI that doesn't have a cure,
but there are medications to keep recurrence at bay.
So if you are worried about having an STI,
you should see a healthcare professional
'cause we can help figure out
if we've got a cure for it,
or if we've got something that can help manage it.
Will STIs show up in a blood test?
The STIs that show up in a blood test
are HIV and syphilis most frequently.
The ones that come up in a swab
can be gonorrhea and chlamydia as well as herpes.
And you can also test gonorrhea
and chlamydia through a urine test.
So there's lots of different ways to test different STIs.
STIs are really common.
They affect millions of Americans and lots of young people.
We want to normalize sex in our culture
and be able to feel empowered and take care of our bodies.
If you're worried about having an STI
and you wanna get regularly screened,
please see a primary care provider.
We are more than happy to help you.
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