Sexually transmitted diseases

Sexually transmitted diseases

1. Anatomy

   • Uterus
   • Cervix
   • Vagina
   • Female external genitalia
   • Adnexia

2. Menstrual cycle

   • Both FSH and LH secretion by the anterior pituitary increases, with FSH increase being slightly greater than LH
   • -LH stimulates the granulosa cells and theca cells to be converted to luteal cells → Corpus luteum -Progesterone: Stimulate the uterine endometrium to become secretory and produce a source of nutrient for the developing blastocyst. Stimulate the cervical mucus to become thick: prevent entry of sperm and bacteria Causes basal body temperature to rise slightly.
   • If no implantation occurs, the low levels of FSH and LH causes the corpus luteum to degenerate Degeneration → decrease release of estrogen and progesterone  Decreased stimulation of the endometrial cells by these two hormones
   • Ovulation : Day 14 / LH surge

3. Ulcerative

   • Painful
     • Herpes simplex
       • Mainly type 2
       • Complications: neonatal transmission, enhanced HIV transmission, psychosocial issues
       • Microscopy - Tzanck smear and PCR
         • Cowdry bodies
       • Treatment : acyclovir, valacyclovir, and famciclovir
     • Chancroid
       • Haemophilus ducreyi
       • soft chancres
       • Tender suppurative inguinal lymphadenopathy - unilateral
       • Rx: Azithromycin
   • Painless
     • Syphilis
       • Trepenoma Pallidum
       • Congenital : deafness + hutchinson's teeth and mulberry molar
       • Treatment : Benzathine penicillin
       • STAGES
         • Primary : chancre
           • Secondary : Rash at the palms and the soles + condyloma lata
             • Tertiary : Gumma and neurosyphilis and cardiovascular syphilis
     • LGV
       • Granuloma inguanale

4. Discharge

   • Normal vaginal discharge : white, odorless, clear and watery
     • Normal flora in the vagina : Lactobacillus and candida albicans
   • Causes of abnormal discharge

5. Complications

   • Bacterial vaginosis
   • Vaginal dryness
   • PID
   • Scarring of the tubes and infertility in females
   • Urethritis, prostatitis and orchitis in males
   • Cervical cancer

6. Risk factors

   • Multiple sex partners
   • Unprotected sex
   • Homosexuality
   • Sex for drugs and money

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