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Thursday, Oct. 15, 2009

Trick Question: What Are the Symptoms of Common STIs?

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What are the symptoms of gonorrhea, syphilis and Chlamydia? What are the risks of giving oral to a man and receiving oral from a man?

When I lead workshops on safer sex, I often ask participants to name the most common sign of a sexually transmitted infection (STI). While they usually come up with a long (and sometimes wild) litany of pox, pus and pains, this is actually a trick question, because the majority of people who have STIs either exhibit no symptoms or have symptoms after they’re initially infected that appear to go away on their own. The important take-away message is that just because you or your partner(s) don’t have any outward signs of STIs does not mean that you’re STI-free. For gonorrhea, syphilis and Chlamydia, the only way to know for sure is to get tested. Free or low-cost STI testing sites in Milwaukee include the Brady East STD Clinic, Planned Parenthood and the Milwaukee Health Department.

That said, each of these three STIs can have physical symptoms. The symptoms of gonorrhea and Chlamydia are very similar, and, for both, more men than women will exhibit symptoms. Gonorrhea and Chlamydia can infect the vagina, penis, rectum or throat (meaning that they can be transmitted through oral, vaginal or anal sex), so pain or inflammation in any of these areas can be a symptom of infection, as can discharge from the penis, vagina or rectum; painful urination; and pain during sex. (Side note: These STIs can also infect the eye, so watch your aim when giving facials.) For the most comprehensive list of symptoms, check out the American Social Health Association Web site. Gonorrhea and Chlamydia are both very common, so if you are sexually active and not in a mutually monogamous relationship, it’s worth getting tested regularly, even if you have no symptoms. And, of course, using condoms or latex dams will help prevent transmission of these STIs.

Not too long ago, public health professionals thought that syphilis was on its way to being eradicated in the United States. Alas, it’s made a resurgence over the past couple of years, especially among men who have sex with men. In fact, I interviewed a while ago for a job with the title of “syphilis elimination coordinator,” which I almost took just for the awesome business cards I would have gotten. Syphilis has four distinct stages, and each stage has its own symptoms. The first stage involves a single, painless sore at the site of infection, which will go away by itself. The second stage involves several different types of rashes that can appear at various locations on the body (such as the hands or neck) as well as on the genitals. This also goes away on its own. If a person does not notice or worry about the initial sore, he or she may not realize the rashes that come later are actually symptoms of an STI. Syphilis can have serious complications in its later stages, so more and more health professionals are beginning to recommend routine testing for syphilis among men who have sex with men. Like gonorrhea and Chlamydia, syphilis can be transmitted through oral, anal and vaginal sex.

So, how risky is performing or receiving oral sex on a penis? Chlamydia is actually not likely to be transmitted through oral sex, although it is possible. Gonorrhea is transmitted through contact with infected body fluids, e.g. semen, or through contact with the inside of the mouth of an infected person. Syphilis is transmitted through skin-to-skin contact with the sores or rashes that are caused by the disease, which can appear on the penis or (though less common) the mouth and lips. So, both those receiving oral sex and those giving oral sex can be at risk. Using an unlubricated or flavored condom on the penis during oral sex can reduce risk for both partners, although it’s important to note that protection only extends to the areas that are covered by the condom—if there are sores or rashes caused by syphilis on the scrotum, for example, the disease can still be transmitted. 

Want Laura to answer your questions in SEXpress? Send them to laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.

Laura Anne Stuart has a master’s degree in public health and has worked as a sexuality educator for more than a decade. She owns the Tool Shed, an erotic boutique on Milwaukee’s East Side.

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