How to be STD-free despite a wild sex life

Hook-ups, open relationships, polyamory, threesomes—sexual exploration and experimentation in India—  are at an all time high, or that’s what most surveys have us believe. But can you determine how safe your partner is if you’ll be mating the first time you meet? Or how safe all your partners’ partners are? It’s tough to be sure. What has gynaecologists and sexologists frowning, though, is the ignorance about sexually transmitted diseases (STDs) and people’s unwillingness to use protection when becoming intimate with strangers. To avoid a case of pleasure turning into future nightmares, familiarise yourself with infections and safety measures.

The big bad fright

All the campaigning about AIDS has ensured that renowned sex expert Dr Mahinder Watsa often gets “panic calls from those who’ve had unprotected sex with a stranger. But only some may get the infection even when having intercourse with an infected partner”. But it’s important to know that HIV, which still has no cure, may take three-four months to show up on tests, and the initial symptoms range from chronic common cough and cold to diarrhea and abdominal infection, which a lay person generally wouldn’t associate with STDs. In some cases even such symptoms are lacking.

Beyond HIV

“Hepatitis B spreads far more easily than HIV, affects you for life, and damages the liver in the long term, leading to liver cirrhosis or cancer,” warns gynaecologist Dr Medha Tankhiwale. The transmission could happen during sex or blood transfusion; vaccines can be given in childhood.

Gonorrhea and syphillis, largely contracted by men, are curable. While the latter starts as painless ulcers on the pubic area, it eventually enters the bloodstream and can cause heart problems. Gonorrhea causes hot, burning urine and can lead to kidney infections; women contracting it feel severe itchiness, lots of discharge and foul smell.

Instances of both have reduced, but “warts and herpes are fairly common”, finds Dr Watsa. Herpes is painful and gets transmitted on contact with active lesions. They generally subside after the initial outbreak and may not cause symptoms after, but the virus stays in the system for life and can flare up when the person’s immunity is low. “If it flares up in pregnant women, it can affect the newborn in many ways, including inhibiting brain development,” says gynaecologist Dr Duru Shah. Warts are curable, but spread very quickly. While warts and herpes are visible infections, “you can’t spot ones behind the foreskin or inside the vaginal tract,” adds Shah, and oral sex with infected partners may cause laryngeal warts.

Worse for women

Certain local infections have graver consequences for women, symptoms for which often include vaginal itching, whitish, greenish or yellowish rather than clear discharge and may also have odour. If untreated, these infections ascend to the uterus, tubes, and even the liver.

“The most common one is chlamydia, and can be cured simply with medication. But if unidentified or neglected, it can lead to infertility in women or ectopic pregnancies,” says Shah.

Other silent STIs include: trichomonial infection that causes greenish or yellow discharge and severe itching, and fungal infections resulting in a curd-like discharge. The latter can be contracted from a diabetic partner, who is not taking his/her medication regularly.

Multiple exposures and spreading of these infections leads to long-term complications for women such as “painful vaginal abscesses and frozen pelvis, where the internal organs get stuck, cause immense pain and require surgical removal of organs," shares Shah.

Repercussions of these infections are less severe in men with symptoms like dysuria, discharge, itching, rashes, testicular swelling, warts and herpes. Finally, some strains of Human Papilomavirus (HPV) can cause cervical cancer in women and warts in men. Vaccines are available and must be taken before the first sexual encounter.