Anatomy & Physiology

1. Anatomy & Physiology Human Reproductive System: Sexually Transmitted Diseases

2. Sexually Transmitted Diseases (STD’s) • AKA – Venereal Diseases (VD’s) • Spread through sexual contact • US has highest rates of infection among developed countries • > 12 million new cases of STD’s in the US each year • ¼ of new cases occur among adolescents

8. Chlamydia Pathogen: Chlamydia trachomatis – bacterium exhibits virus-like dependence on host cells Prevalence: Most common STD in US - infects 4-5 million people annually (~2.8 million women) - 20 % – 30% of women infected with gonorrhea also have chlamydia Transmission: vaginal, anal, or oral sex Incubation: 1 week Symptoms: urethritis; painful, frequent urination; thick penile discharge; vaginal discharge; abdominal, rectal, and/or testicular pain; painful intercourse; irregular menses; 80% of women suffer no symptoms Consequences: Men – arthritis, urogenital tract infection Women – PID…sterility (If ≤ 25 y.o. get tested annually.) Infants – conjunctivits, respiratory tract infections Diagnosis: cell culture Treatment: antibiotics (tetracycline)

9. Penile discharge Vaginal discharge on surface of cervix

10. Genital Warts Pathogen: human papillomavirus (HPV) - a group of ~ 60 viruses Prevalence: Most common STV - 1 million Americans develop genital warts each year - > 50% of sexually active people have HPV sometime Transmission: genital contact, oral sex Incubation: weeks to months Symptoms: most people carry virus w/o symptoms; usually appear as a small bump or groups of bumps in the genital area; can occur in throat Consequences: linked to several types of cancer – vulva, vagina, penis, anus, head and neck (80% of invasive cervical cancers) Diagnosis: visual inspection, Pap smear Treatment: 90% of cases clear up within two years; cryotherapy, laser surgery

11. Vaginal warts Penile warts

12. Gonorrhea (AKA – the clap) Pathogen:Neisseriagonorrhoeae, bacterium Prevalence: est. 700,000 new cases each year - most common among teenagers & young adults Transmission: mucus membranes (anus, eyes, mouth, genitals, throat) Incubation: 1 – 14 days Symptoms: Men – burning sensation while urinating; white, yellow, green discharge; painful/swollen testicles; few are asymptomatic Women – most are asymptomatic; burning sensation while urinating; increased discharge; bleeding between periods Consequences: Men – epididymitis…infertility Women – Pelvic Inflammatory Disease (PID): symptoms include abdominal pain and fever…chronic pelvic pain; increases risk of ectopic pregnancy Diagnosis: microscopic examination of sample Treatment: antibiotics (penicillin, tetracycline)

13. Penile discharge Vaginal discharge

14. Herpes Pathogen: herpes simplex viruses Type I & Type II (HSV-1, HSV-2) HSV-1 commonly causes mouth sores (fever blisters) HSV-2 causes genital herpes Prevalence: 16.2% of Americans 14-49 have HSV-2 (1 in 6) Transmission: genital contact or oral-genital contact Incubation: 2 weeks Symptoms: painful, blister-like lesions Consequences: linked to cervical cancer; congenital herpes infections can cause severe malformations of fetus Diagnosis: visual inspection; blood test for HSV-1 & HSV-2 antibodies Treatment: antiviral drugs (e.g. acyclovir), antiviral ointments, daily suppressive therapy…ultimately there is no cure.

16. Syphilis Pathogen:Treponemapallidum, bacterium (the great immitator) Prevalence: ~ 6% of Americans, recently common among gay men Transmission: vaginal, anal, or oral sex Incubation: 10-90 days (avg. 21 days) Symptoms: Primary syphilis results in a chancre (painless, firm, round sore) that heals in 3-6 weeks. Develop on penis, within vagina & rectum. Consequences: Left untreated, after several weeks, Secondary syphilis rashes appear on the body (typically palms and soles of feet); fever; joint pain…resolves in 3-12 weeks. Then the bacterium enters the latent period which could last for decades. Tertiary syphilis is characterized by gummas (destructive lesions of the CNS, blood vessels, bones, skin) which lead to difficulty coordinating movements, paralysis, numbness, gradual blindness, and dementia Diagnosis: microscopic analysis of chancre fluid; blood test for syphilis antibodies Treatment: antibiotic - penicillin

17. Primary syphilis: chancres

18. Secondary syphilis: Rashes on palms of hands and soles of feet

19. Trichomoniasis Pathogen:Trichomonasvaginalis, parasitic protozoan Prevalence: 5 million new cases per year Transmission: vaginal sex Incubation: 5 - 28 days Symptoms: Men – most are asymptomatic; burning while urinating, mild discharge Women – frothy, yellow-green discharge w/ strong odor; itching Consequences: Pregnant women could have premature babies or babies with low birth weight Diagnosis: visual examination for small, red ulcerations on vaginal wall or cervix; microscopic examination for both men and women Treatment: metronidazole or tinidazole

22. AIDS (Acquired Immunodeficiency Syndrome) Pathogen:HIV (Human Immunodeficiency Virus) Prevalence: > 1 million Americans living with HIV Transmission: vaginal, anal, or oral sex (sharing needles*) Incubation: a few months to more than 10 years Symptoms: Initial infection is occasionally accompanied by a minor cold; asymptomatic Consequences: AIDS – virus destroys helper T-cells, depressing cell-mediated immunity; body can no longer fight off infections; occasional dementia…5th leading killer among Americans aged 25-44 Diagnosis: blood test for Anti-HIV antibodies (appear 2 weeks – 6 months after infection) Treatment: antiviral medication to suppress the virus… ultimately, there is no cure.

25. References: Marieb, Elaine. Human Anatomy & Physiology, 6th ed. San Francisco: Pearson Benjamin Cummings, 2004. pp. 818-819, 1096-1097. CDC.gov. 2011. United States Centers for Disease Control. 18 May 2011 <www.cdc.gov>