Gonorrhea and chlamydia are two of the most common sexually transmissable diseases (STDs) in both women and men. Both gonorrhea and chlamydia can cause serious health problems if they are not treated. These problems may include pelvic infection. If a pelvic infection is not treated, it can damage the fallopian tubes and make ectopic pregnancy more likely. A woman who has had a severe infection may not be able to become pregnant. She may also have problems during pregnancy after birth that pose risks to herself and her baby.

What Is Gonorrhea?
Gonorrhea infects about 1 million people each year in the United States. In the last 20 years, the rate has declined. It is still high, though, in some groups. For example, it may be increasing in teenagers.

In both women and men, gonorrhea can occur without symptoms. As many as half of all women who get this disease have no symptoms in the early stages. Men are more likely to have symptoms, but they too may not show symptoms in the early stages. If your partner has symptoms you should avoid having sex.

The most common site of infection in women is the cervix (opening of the uterus). Untreated, gonorrhea can spread upward into the uterus and fallopian tubes. The rectum can also become infected, either through anal sex or from spread of the infection from a woman's vagina. The urethra (the opening through which urine is passed) is also a common site of infection. Gonorrhea can also infect the mouth and throat of a person who has oral sex with an infected partner.

What is Chlamydia?
Chlamydia infects about 3-5 million women and men each year. It is one of the most common STDs in the United States. Chlamydia usually infects a woman's cervix.

Like gonorrhea, chlamydia that is not treated can spread into the uterus and fallopian tubes. It can also spread to the urethra causing urethritis. The rectum, throat, and even the lining of the eye can also become infected. In both women and me, chlamydia may occur without causing symptoms.

Symptoms of Gonorrhea and Chlamydia
Many women and men with gonorrhea or chlamydia have few or no symptoms when they are first infected When they do occur, symptoms may appear anywhere form 2 days to 3 weeks after contact with an infected partner. The most common symptoms in women include:

A yellowish vaginal discharge
Painful or frequent urination
Burning or itching in the vaginal area
Burning or itching in the vaginal area
Pain in the pelvis or abdomen during sex
Abnormal vaginal bleeding

The most common symptoms in men include:

Discharge from the penis
Pain and burning during urination

In both women and men, a gonorrhea infection in the rectum can cause discharge, itching around the anus, and pain during bowel movements. A woman or man whose throat is infected may also have a sore throat.

None of the symptoms in either sex is a sure sign of gonorrhea or chlamydia. Any of them though, should prompt you to see your doctor.

Risk Factors
Like other STDs, both gonorrhea and chlamydia are passed on my sexual contact. The risk of getting these infections is high if you have sex-vaginal, anal, or oral- with someone who is infected.

Anyone who has sex can get these diseases. But the risk is higher in young women and those who:

Have more than one sexual partner
Have sex with some one who has or has had more than one partner
Began sexual activity at an early age
Have other types of STDs, either now or in the past
Have gonorrhea before
Use illegal drugs

Problems during pregnancy
Both gonorrhea and chlamydia can cause problems for a pregnant woman and her baby, both during pregnancy and after birth. Both gonorrhea and chlamydia increase the risks of preterm birth (birth before 37 weeks) and premature rupture of membranes (in which the sac that surrounds the fetus breaks before labor begins). A newborn can also become seriously ill if he or she gets gonorrhea from the mother. Gonorrhea can also result in a miscarriage.

Chlamydia can be passed from a pregnant woman to her fetus before birth. The baby of an infected mother has a 40% chance of developing an infection of the lining of the eye (conjunctivitis). This is the most common problem in babies born to infected mothers. Although it can be easily treated, other problems in the newborn can be more serious. About 10-20% of babies of infected mothers develop pneumonia, which can require special care in the hospital.

Gonorrhea can also be passed to the fetus before birth. A baby born to a woman with gonorrhea may develop an eye infection that can lead to blindness. For this reason, babies are treated with eye medication soon after birth, whether or not the mother has gonorrhea.

Because of the risks posed to both mother and baby by these infections, tests for gonorrhea and chlamydia are offered to pregnant women who are at risk for these diseases. Some states require that all pregnant women be tested for certain STDs. There is less risk to the baby when the mother is treated for gonorrhea and chlamydia during pregnancy.

Diagnosis
If you have any of the risk factors described here, or you think you have been exposed to someone with these infections, contact your doctor to get tested. Lab tests can be done to find out whether you have gonorrhea or chlamydia.

Treatment
Gonorrhea and chlamydia can be treated at the same time. Antibiotics that act against both can be taken by mouth. Treatment may last for up to 7 days.

Genital Herpes
Genital herpes is an infection caused by a virus that produces sores and blisters around the external sex organs. In most cases it is passed on through direct contact with secretions from the active sores of a person infected with the virus, often during sexual activity. Some people have only one outbreak; others have repeated bouts. Herpes can be annoying, uncomfortable, and upsetting emotionally, Herpes is nothing new-reports of outbreaks reach as far back as ancient Rome-but the incidents seems to be on the rise. As many as 30 million Americans currently have genital herpes, and about 500,000 new cases occur each year. Scientists are working to find a cure as well as to develop a vaccine to prevent the disease. As the first step toward coping with genital herpes and controlling its spread, it's important to understand the true nature of the disease.

What causes herpes?
Herpes is an infection caused by a virus of the same name. It is one of a group of viruses that causes chickenpox, cold sores, and mononucleosis. Two closely related virus strains, called Herpes Simplex Virus 1 and 2, could affect the mouth and the genitals. Herpes Simplex Virus type 1 usually infects the lips, mouth, or nasal membranes. The sores (know as cold sores or fever blisters) caused by it often occur in both children and adults without having any relationship to sexual activity. Some studies have suggested that sores caused by the type 1 strain generally tend to be less severe than those caused by the type 2 strains. Type 1 can, however, also infect the genitals, and it does cause up to one-third of genital herpes infections. Most often however, genital herpes is caused by Herpes Simplex Virus type 2.

Infection occurs when the herpes virus passes through a break in the skin or penetrates the moist membranes of the penis, vagina, urinary opening, cervix, or anus. Once it invades the skin, the virus starts infecting healthy cells. Sores, blisters, and swelling are cause by the body's natural defense system as white blood cells react to the infected cells.

Though these sores (often called lesions) heal in a few days to a few weeks, some of the virus travels to nerve cells near the spine, where the virus remains inactive until some event triggers a new bout. This event may be a lapse in the body's defenses because of infection, stress, fatigue, or other, unknown reasons. The viruses leave their resting place and travel along the nerves, back to the spot where they first entered the body, causing new blisters to pop up.

About 90% of people with herpes have recurrent infections. How often these outbreaks occur varies greatly from person to person. Some people have only one or two outbreaks a year, while others have as many as five to eight. Symptoms also vary with each person. Some people may have painful attacks with many sores, while others have only mild symptoms. Fortunately, most recurrent infections are milder than the first, and sores usually heal faster.

Who gets herpes and how?
Virtually anyone, no matter what age, race, or sex, can become infected with herpes. Because the virus is probably transmitted most frequently through sexual contact, it often occurs in young, sexually active people who have more than one partner.

During an active infection, herpes sores and blisters contain live viruses that can be spread to another place on the body or to another person. Therefore when sores touch the skin of another person, that person can become infected. Besides the sex organs, genital herpes can affect the tongue, lining of the mouth, eyes, gums, lips, fingers, and other parts of the body. During oral sex, herpes can be passed from a cold sore around the mouth to the partner's genitals or from the genitals to the mouth.

Though the herpes virus can survive hours away from the human body, there is no proof the disease can be picked up from toilet seats, hot tubs, or other objects. In general, simple methods of disinfections, such as washing with detergent or bleach and water, is enough to inactivate the virus on objects.

Symptoms
About 2-10 days after the herpes virus enters your body, you may get flu-like symptoms such as swollen glands, fever chills, muscle aches, fatigue, and nausea. Sores appear as small, fluid-filled blisters on the genitals, buttocks, or other areas. Theses sores are often grouped in clusters. Pain during urination is common, especially among women. Some people infected with herpes, however, have no symptoms at all. Still others don't notice the symptoms or don't realize what they are.

The first bout with genital herpes, known as a primary infection, usually lasts about 3 weeks. During this time the sessions break open and "weep" then gradually shrink and dry up. Rarely are scars left behind.

If lesions recur, your are often warned ahead of time by an itching or tingling feeling near the site where the virus first entered the body. This is called the prodrome. You may fell pain running into your buttocks or knees. A few hours later sores will appear. In recurrent infections there is usually no swelling in the genital area or fever, and sores heal more quickly, usually within a week or two.

If you think you have herpes
See your doctor right away if you have symptoms of genital herpes or if you think you have herpes. Since similar symptoms can be caused by other infections, it takes a physician to make the diagnosis. The sooner herpes is found, the earlier it can be treated, thus reducing the pain of first and future outbreaks.

Although it is rare, it is possible, once you have herpes, to accidentally reinfect yourself in another place on your body. If you touch an active herpes lesion and then rub or scratch another part of your body, you can transfer the virus to a new location. Reinfecting yourself in this way is called autoinoculation. The eyes, mucous membranes of the mouth or genitals, and areas where there are breaks in the skin are the most susceptible. Autoinoculation occurs most often right after a person is first infected with herpes, before he or she understands what it is and what precautions should be taken. Keeping in mind that you have an active sore is important in avoiding reinfection. To avoid autoinculation, wash your hands after coming in contact with the sore. It is best to avoid touching the sore as much as possible. It may help to cover the sore with a clean white bandage, if you can do so comfortably.

Treatment
Though no cure has yet been found for genital herpes, a prescription medicine called Acyclovir is available to help control the course of the disease. This drug, which is available in the form of ointment capsules or intravenous (by vein) medication, prevents the herpes virus from multiplying when used to treat a first infection; Acyclovir will shorten the length of the outbreak and help reduce discomfort.

If you have repeat outbreaks, taking Acyclovir in capsule form can greatly reduce the number of attacks and, in many cases, prevent them completely. To accomplish this, this drug must be taken on a daily basis. The daily dosage prescribed varies from person to person. The decision to use Acyclovir, and for how long, is best made by you and your doctor.

If you do have herpes recurrences, you can help the healing process by keeping the lesions clean and dry. Wash the sores with soap and warm water and dry gently. Use a blow dryer on the low setting to dry sores that are very sensitive or hard to reach. Because nylon and other synthetics hold in heat and moisture, sores may heal faster if you wear loose-fitting clothes, cotton underclothes, and avoid pantyhose.

Take aspirin or acetaminophen to relive pain. If urination causes burning, ask your doctor to prescribe medicine for discomfort. Urinating in a sitz bath may also help you empty your bladder less painfully.

Avoiding recurrence.

No one is sure why some people have recurrences of herpes, or why it reemerges when it does. One trigger seems to be stress-both emotional and physical. Outbreaks may recur when you are under pressure or when your resistance is lowered by cold or flu. You can help keep your resistance up by getting plenty of rest, eating a balanced, healthy diet, and learning to cope with stress.

Evidence that too much sunlight brings on herpes outbreaks (usually type 1) on exposed areas suggests that you should use a sunscreen when outdoors in the summer. If you have outbreaks fairly often, talk to your doctor about prescribing Acyclovir pills to lessen the frequency of outbreaks.

Prevention
A good way to reduce the risk of getting genital herpes is to limit sexual relationships to people you know and trust. When herpes is passed on, it's usually because one partner didn't realize he or she had the infection, wasn’t honest about it, or wasn't careful to abstain from sex during infectious periods.

If you or your partner has oral or genital herpes, avoid sex from the time of prodromal symptoms until a few days after scabs have disappeared. Abstaining from sex doesn't mean you cannot kiss, hug, and cuddle.