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Sexually transmitted disease

From Wikipedia, the free encyclopedia

Sexually transmitted diseases (STD), also referred to as sexually transmitted infections (STI)
and venereal diseases (VD), are illnesses that have a significant probability of transmission
between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex.
While in the past, these illnesses have mostly been referred to as STDs or VD, in recent years the
term sexually transmitted infections (STIs) has been preferred, as it has a broader range of meaning; a person
may be infected, and may potentially infect others, without having a disease. Some STIs can also be
transmitted via the use of IV drug needles after its use by an infected person, as well as
through childbirth or breastfeeding. Sexually transmitted infections have been well known for hundreds of
years, and venereology is the branch of medicine that studies these diseases.

Classification

Until the 1990s, STIs were commonly known as venereal diseases, the word venereal being derived from the
Latin word venereus, and meaning relating to sexual intercourse or desire, ultimately derived from Venus,
the Roman goddess of love.[1] Social disease was a phrase used as a euphemism.

Sexually transmitted infection is a broader term than sexually transmitted disease.[2] An infection is a
colonization by a parasitic species, which may not cause any adverse effects. In a disease, the infection leads
to impaired or abnormal function. In either case, the condition may not exhibit signs or symptoms. Increased
understanding of infections like HPV, which infects most sexually active individuals but cause disease in only a
few has led to increased use of the term STI. Public health officials originally introduced the term sexually
transmitted infection, which clinicians are increasingly using alongside the term sexually transmitted disease in
order to distinguish it from the former.[3]

STD may refer only to infections that are causing diseases, or it may be used more loosely as a synonym for
STI. Most of the time, people do not know that they are infected with an STI until they are tested or start
showing symptoms of disease.

Moreover, the term sexually transmissible disease is sometimes used since it is less restrictive in consideration
of other factors or means of transmission. For instance, meningitis is transmissible by means of sexual contact
but is not labeled as an STI because sexual contact is not the primary vector for the pathogens that cause
meningitis. This discrepancy is addressed by the probability of infection by means other than sexual contact. In
general, an STI is an infection that has a negligible probability of transmission by means other than sexual
contact, but has a realistic means of transmission by sexual contact (more sophisticated means—blood
transfusion, sharing of hypodermic needles—are not taken into account). Thus, one may presume that, if a
person is infected with an STI, e.g., chlamydia, gonorrhea, genital herpes, it was transmitted to him/her by
means of sexual contact.

The diseases on this list are most commonly transmitted solely by sexual activity. Many infectious diseases,
including the common cold, influenza,pneumonia, and most others that are transmitted person-to-person can
also be transmitted during sexual contact, if one person is infected, due to the close contact involved. However,
even though these diseases may be transmitted during sex, they are not considered STIs.

Cause
Bacterial

 Chancroid (Haemophilus ducreyi)

 Chlamydia (Chlamydia trachomatis)

 Gonorrhea (Neisseria gonorrhoeae), colloquially known as "the clap"

 Granuloma inguinale or (Klebsiella granulomatis)

 Syphilis (Treponema pallidum)


Fungal

 Candidiasis (yeast infection)


Viral

 Viral hepatitis (Hepatitis B virus)—saliva, venereal fluids.


(Note: Hepatitis A and Hepatitis E are transmitted via the fecal-oral route; Hepatitis C is rarely sexually
transmittable,[4] and the route of transmission of Hepatitis D (only if infected with B) is uncertain, but may
include sexual transmission.[5][6][7])

 Herpes simplex (Herpes simplex virus 1, 2) skin and mucosal, transmissible with or without visible blisters

 HIV (Human Immunodeficiency Virus)—venereal fluids, semen, breast milk, blood

 HPV (Human Papillomavirus)—skin and mucosal contact. 'High risk' types of HPV cause almost
all cervical cancers, as well as some anal, penile, and vulvar cancer. Some other types of HPV
cause genital warts.

 Molluscum contagiosum (molluscum contagiosum virus MCV)—close contact


Parasites

 Crab louse, colloquially known as "crabs" or "pubic lice" (Pthirus pubis)

 Scabies (Sarcoptes scabiei)


Protozoal
 Trichomoniasis (Trichomonas vaginalis), colloquially known as "trich"
Transmission probabilities
The risks and transmission probabilities of sexually transmitted diseases are summarized by act in the table
below.[8][9][10][11][12][13][14] [15] [16] [17] [18] [19] [20]

Odds of transmission per unprotected sexual act with an infected person

Known risks Possible or unknown risks

 Throat chlamydia [18]


 Throat gonorrhea [18] (25–30%)
 Herpes (rare)
 Human papillomavirus (HPV) [20]
 Hepatitis B (low risk)[13]
 Syphilis [18] (1%)[11]
Performing oral sex on a man  HIV (very low risk; 0.01%)[9]
With anal to oral practices:  Hepatitis C (unknown)

 Hepatitis A
 Shigella
 Pinworms [19]

 Herpes  Throat gonorrhea [18]


Performing oral sex on a woman
 Human papillomavirus (HPV) [20]  Throat chlamydia [18]

 Chlamydia
 Gonorrhea [18]
Receiving oral sex—man  Non-gonococcal urethritis  Human papillomavirus (HPV)
 Herpes
 Syphilis [18] (1%)[11]

 Human papillomavirus (HPV)


 Vaginal thrush [18]
Receiving oral sex—woman  Herpes
 Bacterial Vaginosis [18]
 Gonorrhea [18]

 Chlamydia (30–50%)[13]
Vaginal sex—man  Hepatitis C
 Crabs
 Scabies
 Gonorrhea (22%)[16]
 Hepatitis B
 Herpes (0.07% for HSV-2)[15]
 HIV (0.05%)[9][15]
 HPV (high: around 40-50%)[12]
 Non-gonococcal urethritis
 Syphilis
 Trichomoniasis

 Chlamydia (30–50%)[13]
 Crabs
 Scabies
 Gonorrhea (47%)[17]
 Hepatitis B (50–70%)
Vaginal sex—woman  Hepatitis C
 Herpes
 HIV (0.1%)[9]
 HPV (high;[13] around 40-50%)[12]
 Syphilis
 Trichomoniasis

 Chlamydia
 Crabs
 Scabies (40%)
 Gonorrhea
 Hepatitis B
Anal sex—insertive  Hepatitis C
 Herpes
 HIV (0.62%)[10]
 HPV
 Non-gonococcal urethritis
 Syphilis (14%)[11]

 Chlamydia
Anal sex—receptive  Crabs  Hepatitis C
 Scabies
 Gonorrhea
 Hepatitis B
 Herpes
 HIV (1.7%)[10]
 HPV
 Syphilis (1.4%) [11]

 Amebiasis
 Cryptosporidiosis (1%)
 Giardiasis
Anilingus  HPV (1%)
 Hepatitis A (1%)
 Shigellosis (1%)
 Pinworms [19]

Pathophysiology

Many STIs are (more easily) transmitted through the mucous membranes of the penis, vulva, rectum, urinary
tract and (less often—depending on type of infection) the mouth, throat, respiratory tract and eyes.[21] The
visible membrane covering the head of the penis is a mucous membrane, though it produces no mucus (similar
to the lips of the mouth). Mucous membranes differ fromskin in that they allow certain pathogens into the
body.[22] The amount of contact with infective sources which causes infection varies with each pathogen but in
all cases a disease may result from even light contact from fluid carriers like venereal fluids onto a mucous
membrane.

This is one reason that the probability of transmitting many infections is far higher from sex than by more
casual means of transmission, such as non-sexual contact—touching, hugging, shaking hands—but it is not the
only reason. Although mucous membranes exist in the mouth as in the genitals, many STIs seem to be easier
to transmit through oral sex than through deep kissing. According to a safe sex chart, many infections that are
easily transmitted from the mouth to the genitals or from the genitals to the mouth are much harder to transmit
from one mouth to another.[23] With HIV, genital fluids happen to contain much more of
the pathogen than saliva. Some infections labeled as STIs can be transmitted by direct skin contact. Herpes
simplex and HPVare both examples. KSHV, on the other hand, may be transmitted by deep-kissing but also
when saliva is used as a sexual lubricant.

Depending on the STI, a person may still be able to spread the infection if no signs of disease are present. For
example, a person is much more likely to spread herpes infection when blisters are present than when they are
absent. However, a person can spread HIV infection at any time, even if he/she has not developed symptoms
of AIDS.
All sexual behaviors that involve contact with the bodily fluids of another person should be considered to
contain some risk of transmission of sexually transmitted diseases. Most attention has focused on
controlling HIV, which causes AIDS, but each STI presents a different situation.

As may be noted from the name, sexually transmitted diseases are transmitted from one person to another by
certain sexual activities rather than being actually caused by those sexual
activities.Bacteria, fungi, protozoa or viruses are still the causative agents. It is not possible to catch any
sexually transmitted disease from a sexual activity with a person who is not carrying a disease; conversely, a
person who has an STI got it from contact (sexual or otherwise) with someone who had it, or his/her bodily
fluids. Some STIs such as HIV can be transmitted from mother to child either during pregnancy or
breastfeeding.

Although the likelihood of transmitting various diseases by various sexual activities varies a great deal, in
general, all sexual activities between two (or more) people should be considered as being a two-way route for
the transmission of STIs, i.e., "giving" or "receiving" are both risky although receiving carries a higher risk.

Healthcare professionals suggest safer sex, such as the use of condoms, as the most reliable way of
decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex should by
no means be considered an absolute safeguard. The transfer of and exposure to bodily fluids, such as blood
transfusions and other blood products, sharing injection needles, needle-stick injuries (when medical staff are
inadvertently jabbed or pricked with needles during medical procedures), sharing tattoo needles, and childbirth
are other avenues of transmission. These different means put certain groups, such as medical workers,
and haemophiliacs and drug users, particularly at risk.

Recent epidemiological studies have investigated the networks that are defined by sexual relationships
between individuals, and discovered that the properties of sexual networks are crucial to the spread of sexually
transmitted diseases. In particular, assortative mixing between people with large numbers of sexual partners
seems to be an important factor.

It is possible to be an asymptomatic carrier of sexually transmitted diseases. In particular, sexually transmitted


diseases in women often cause the serious condition of pelvic inflammatory disease.

Prevention

Main article: Safe sex

Prevention is key in addressing incurable STIs, such as HIV and herpes. Sexual health clinics promote the use
of condoms and provide outreach for at-risk communities.

The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which
can lead to transfer with an infected partner. Not all sexual activities involve
contact: cybersex, phonesex or masturbation from a distance are methods of avoiding contact. Proper use
ofcondoms reduces contact and risk. Although a condom is effective in limiting exposure, some disease
transmission may occur even with a condom.[24]

Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a
partner engaged in contact with someone else. Many infections are not detectable immediately after exposure,
so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain
STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical
procedures.

Many diseases that establish permanent infections can so occupy the immune system that other diseases
become more easily transmitted. The innate immune system led by defensins against HIV can prevent
transmission of HIV when viral counts are very low, but if busy with other viruses or overwhelmed, HIV can
establish itself. Certain viral STI's also greatly increase the risk of death for HIV infected patients.

Vaccines
Vaccines are available that protect against some viral STIs, such as Hepatitis A, Hepatitis B, and some types
of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection.

Condoms
Condoms and female condoms only provide protection when used properly as a barrier, and only to and from
the area that it covers. Uncovered areas are still susceptible to many STDs. In the case of HIV, sexual
transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin,
thus properly shielding the insertive penis with a properly worn condom from the vagina or anus effectively
stops HIV transmission. An infected fluid to broken skin borne direct transmission of HIV would not be
considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided
simply by not engaging in sexual contact when having open bleeding wounds. Other STIs, even viral infections,
can be prevented with the use of latex, polyurethane or polyisoprene condoms as a barrier. Some
microorganisms and viruses are small enough to pass through the pores in natural skin condoms, but are still
too large to pass through latex or synthetic condoms.

Proper usage entails:

 Not putting the condom on too tight at the end, and leaving 1.5 cm (3/4 inch) room at the tip for ejaculation.
Putting the condom on snug can and often does lead to failure.

 Wearing a condom too loose can defeat the barrier.

 Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not.
 Avoiding condoms made of substances other than latex, polyisoprene or polyurethane that do not protect
against HIV.

 Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes
into them.

 Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used
to penetrate.

Not following the first five guidelines above perpetuates the common misconception that condoms are not
tested or designed properly.[citation needed]

In order to best protect oneself and the partner from STIs, the old condom and its contents should be assumed
to be infectious. Therefore the old condom must be properly disposed of. A new condom should be used for
each act of intercourse, as multiple usage increases the chance of breakage, defeating the effectiveness as a
barrier.

Nonoxynol-9
Researchers had hoped that nonoxynol-9, a vaginal microbicide would help decrease STI risk. Trials, however,
have found it ineffective[25] and it may put women at a higher risk of HIV infection.[26]

Diagnosis

STI tests may test for a single infection, or consist of a number of individual tests for any of a wide range of
STIs, including tests for syphilis, trichomonas, gonorrhea, chlamydia, herpes, hepatitisand HIV tests. No
procedure tests for all infectious agents.

STI tests may be used for a number of reasons:

 as a diagnostic test to determine the cause of symptoms or illness

 as a screening test to detect asymptomatic or presymptomatic infections

 as a check that prospective sexual partners are free of disease before they engage in sex without safer
sex precautions (for example, when starting a long term mutually monogamous sexual relationship, in fluid
bonding, or for procreation).

 as a check prior to or during pregnancy, to prevent harm to the baby

 as a check after birth, to check that the baby has not caught an STI from the mother

 to prevent the use of infected donated blood or organs

 as part of the process of contact tracing from a known infected individual

 as part of mass epidemiological surveillance


Not all STIs are symptomatic, and symptoms may not appear immediately after infection. In some instances a
disease can be carried with no symptoms, which leaves a greater risk of passing the disease on to others.
Depending on the disease, some untreated STIs can lead to infertility, chronic pain or even death.[27] Early
identification and treatment results in less chance to spread disease, and for some conditions may improve the
outcomes of treatment.

There is often a window period after initial infection during which an STI test will be negative. During this period
the infection may be transmissible. The duration of this period varies depending on the infection and the test.

Diagnosis may also be delayed by reluctance of the infected person to seek a medical professional. One report
indicated that afflicted people turn to the Internet rather than to a medical professional for information on STIs
to a higher degree than for other sexual problems.[28]

Management

High-risk exposure such as that which occurs in rape cases may be treated prophylactically using antibiotic
combinations such as azithromycin, cefixime, and metronidazole.

An option for treating partners of patients (index cases) diagnosed with chlamydia or gonorrhea is patient-
delivered partner therapy, which is the clinical practice of treating the sex partners of index cases by providing
prescriptions or medications to the patient to take to his/her partner without the health care provider first
examining the partner.[29]

Epidemiology

Age-standardized, disability-adjusted life years for STDs (excluding HIV) per 100,000 inhabitants in 2004.[30]

no data 360–420
< 60 420–480
60–120 480–540
120–180 540–600
180–240 600–1000
240–300 > 1000
300–360

STD incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can
rapidly render patients with many STDs noninfectious and cure most. In many cultures, changing sexual morals
and oral contraceptive use have eliminated traditional sexual restraints, especially for women, and both
physicians and patients have difficulty dealing openly and candidly with sexual issues. Additionally,
development and spread of drug-resistant bacteria (e.g., penicillin-resistant gonococci) makes some STDs
harder to cure. The effect of travel is most dramatically illustrated by the rapid spread of the AIDS virus (HIV-1)
from Africa to Europe and the Americas in the late 1970s.[31]

In 1996, the World Health Organization estimated that more than 1 million people were being infected daily.
About 60% of these infections occur in young people <25 years of age, and of these 30% are <20 years.
Between the ages of 14 and 19, STIs occur more frequently in girls than boys by a ratio of nearly 2:1; this
equalizes by age 20. An estimated 340 million new cases of syphilis, gonorrhea, chlamydia and trichomoniasis
occurred throughout the world in 1999.[32]

Commonly reported prevalences of STIs among sexually active adolescent girls both with and without lower
genital tract symptoms include chlamydia(10–25%), gonorrhea (3–18%), syphilis (0–3%), Trichomonas
vaginalis (8–16%), and herpes simplex virus (2–12%).[citation needed] Among adolescent boys with no symptoms of
urethritis, isolation rates include chlamydia (9–11%) and gonorrhea (2–3%).[citation needed] At least one in four U.S.
teenage girls has a sexually transmitted disease,[33] a CDC study found.[34] Among girls who admitted ever
having sex, the rate was 40%.[35]

AIDS is the single largest cause of mortality in present-day Sub-Saharan Africa.[36] The majority
of HIV infections are acquired through unprotected sexual relations between partners, one of whom has HIV.
Approximately 1.1 million persons are living with HIV/AIDS in the United States,[37] and AIDS remains the
leading cause of death among African American women between ages 25 and 34.[38] Hepatitis B is also classed
as a sexually transmitted disease because it can be passed on sexually. [39] The disease is found globally, with
the highest rates in Asia and Africa and lower rates in the Americas and Europe.[40] Worldwide, an estimated
two billion people have been infected with the hepatitis B virus.[41]

History

The first well-recorded European outbreak of what is now known as syphilis occurred in 1494 when it broke out
among French troops besiegingNaples.[42] From this centre, the disease swept across Europe, killing more than
five million people.[43] As Jared Diamond describes it, "[W]hen syphilis was first definitely recorded in Europe in
1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people's faces,
and led to death within a few months," rendering it far more fatal than it is today. Diamond concludes,"[B]y
1546, the disease had evolved into the disease with the symptoms so well known to us today."[44]

Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and
treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases
was founded in 1746 at London Lock Hospital.[45] Treatment was not always voluntary: in the second half of the
19th century, the Contagious Diseases Act was used to arrest suspected prostitutes. In 1924, a number states
concluded theBrussels Agreement, whereby states agreed to provide free or low-cost medical treatment at
ports for merchant seamen with venereal diseases.

The first effective treatment for a sexually transmitted disease was salvarsan, a treatment for syphilis. With the
discovery of antibiotics, a large number of sexually transmitted diseases became easily curable, and this,
combined with effective public health campaigns against STDs, led to a public perception during the 1960s and
1970s that they have ceased to be a serious medical threat.

During this period, the importance of contact tracing in treating STIs was recognized. By tracing the sexual
partners of infected individuals, testing them for infection, treating the infected and tracing their contacts in turn,
STI clinics could be very effective at suppressing infections in the general population.

In the 1980s, first genital herpes and then AIDS emerged into the public consciousness as sexually transmitted
diseases that could not be cured by modern medicine. AIDS in particular has a long asymptomatic period—
during which time HIV (the human immunodeficiency virus, which causes AIDS) can replicate and the disease
can be transmitted to others—followed by a symptomatic period, which leads rapidly to death unless treated.
HIV/AIDS entered the United States in about 1969 likely through a single infected immigrant from
Haiti.[46] Recognition that AIDS threatened a global pandemicled to public information campaigns and the
development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as
possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps
to contain infection.

http://en.wikipedia.org/wiki/Sexually_transmitted_disease
Penyakit Menular Seksual
Aug 15, 200920 Commentsby lusa

Penyakit menular seksual merupakan penyakit yang ditakuti oleh setiap orang. Angka
kejadianpenyakit ini termasuk tinggi di Indonesia. Kelompok resiko yang rentan terinfeksi tentunya
adalah seseorang yang sering “jajan” alias punya kebiasaan perilaku yang tidak sehat. Penyakit
menular seksual yang nantinya kita bahas disini antara lain :
1. Herpes
2. Gonorea
3. Sifilis
4. Chlamidia

Herpes
Pengertian herpes adalah infeksi akut pada genetalia dengan gejala khas berupa vesikel.
Etiologi
Disebabkan oleh virus herpes simpleks tipe II. Cara penularan melalui hubungan kelamin, tanpa melalui
hubungan kelamin seperti : melalui alat-alat tidur, pakaian, handuk,dll atau
sewaktuproses persalinan/partus pervaginam pada ibu hamil dengan infeksi herpes pada
alat kelaminluar.
Perbedaan HSV tipe I dengan tipe II

HSV tipe I HSV tipe II

Kulit dan mukosa di luar Kulit dan mukosa daerah genetalia dan
Predileksi
perianal

Kultur pada chorioallatoic Membentuk bercak kecil Membentuk pock besar dan tebal
membran (CAM) dari telur
ayam

Serologi Antibodi terhadap HSV tipe Antibodi terhadap HSV tipe II


I

Sifat lain Tidak bersifat onkogeni Bersifat onkogeni

Epidemiologi
Herpes simpleks virus tipe II ditemukan pada wanita pelacur 10x lebih tinggi daripada wanitanormal.
Sedangkan HSV tipe I sering dijumpai pada kelompok dengan sosioekonomi rendah.
Patogenesis
Infeksi herpes genitalis dapat sebagai infeksi primer maupun sebagai infeksi rekuren.
 Infeksi primer – Infeksi primer terjadi bila virus dari luar masuk ke dalam tubuh penderita, DNA
dari tubuh penderita melakukan penggabungan dan mengadakan multiplikasi. Pada saat
itu,tubuh hospes belum memiliki antibodi yang spesifik hingga menimbulkan lesi lebih luas. Selanjutnya
virus menjalar melalui serabut syaraf sensorik menuju ganglion sakralis (syaraf regional) dan berdiam
disana.
 Infeksi rekuren – Infeksi rekuren terjadi pada suatu waktu bila ada faktor tertentu (trigger
factor) sehingga virus mengalami reaktivitas dan multiplikasi kembali.
Gambaran Klinis (Tanda dan Gejala)
 Timbul erupsi bintik kemerahan, disertai rasa panas dan gatal pada kulit region genitalis.
 Terkadang disertai demam, seperti influenza, setelah 2-3 hari bintik kemerahan berubah menjadi
vesikel disertai nyeri.
 5-7 hari, vesikel pecah dan keluar cairan jernih sehingga timbul keropeng.
 Kadang dapat kambuh lagi.
Komplikasi
 Gangguan mobilitas, vaginitis, urethritis, sistitis dan fisura ani herpetika terjadi bila mengenai
region genetalia.
 Abortus
 Anomali kongenital
 Infeksi pada neonatus (konjungtifitis/ keratis, ensefalitis, vesikulitis kutis, ikterus, dan anomali
konvulsi).
Penanganan
 Lakukan pemeriksaan serologi (STS).
 Atasi nyeri dan demam dengan parasetamol 3 x 500 mg.
 Bersihkan lesi dengan larutan antiseptic dan kompres dengan air hangat.
 Keringkan dan oleskan acyclovir 5% topikal setelah nyeri berkurang.
 Berikan acyclovir tablet 200 mg tiap 4 jam.
 Rawat inap bila terjadi demam tinggi, nyeri hebat, retensi urin, konvulsi, neurosis, reaksi neurologik
lokal, ketuban pecah dini maupun partus prematurus.
 Berikan pengobatan pada pasangan berupa acyclovir oral selama 7 hari.
 Bila terpaksa partus pervaginam, hindari transmisi ke bayi atau penolong.
Gonorhea
Pengertian, adalah penyakit kelamin yang bisa terjadi pada pria maupun wanita.Disebut
jugapenyakit kencing nanah atau GO.
Penyebab
Penyebabnya adalah kuman Neisseria Gonorrhoea, disebut juga gonokokus, berbentuk diplokokus.
Kuman ini menyerang selaput lendir dari :
 Vagina, saluran kencing dan daerah rahim/ leher rahim.
 Saluran tuba fallopi.
 Anus dan rektum.
 Kelopak mata.
 Tenggorokan.
Tanda Dan Gejala
Penularan melalui oral, anal dan vaginal seks. Hampir 90% penderita GO tidak memperlihatkan keluhan
dan gejala. Tanda pada penderita GO baik lelaki dan perempuan, bisa tanpa keluhan dangejala.
Lelaki
 Keluar cairan putih kekuning-kuningan melalui penis.
 Terasa panas dan nyeri pada waktu kencing.
 Sering buang air kecil.
 Terjadi pembengkakan pada pelir (testis).
Perempuan
 Pengeluaran cairan vagina tidak seperti biasa.
 Panas dan nyeri saat kencing.
 Keluhan dan gejala terkadang belum tampak meskipun sudah menular ke saluran tuba fallopi.
Bila gejala sudah meluas ke arah PID (Pelvic Inflamatory Disease) maka sering timbul :
 Nyeri perut bagian bawah.
 Nyeri pinggang bagian bawah.
 Nyeri sewaktu hubungan seksual.
 Perdarahan melalui vagina diantara waktu siklus haid.
 Mual-mual.
 Terdapat infeksi rektum atau anus.
Bila GO tidak diobati maka ± 1% dari lelaki dan wanita, akan terjadi DGI atau Dessiminated Gonorrhoe
Infection. Tanda dan gejalanya berupa demam, bercak di kulit, persendian bengkakdan nyeri,
peradangan pada dinding rongga jantung, peradangan selaput pembungkus otak serta meningitis.
Komplikasi
Komplikasi dapat timbul pada bayi, lelaki maupun perempuan dewasa.
1. Lelaki – prostatitis (radang kelenjar prostat), adanya jaringan parut pada saluran kencing (urethra),
mandul/ infertil, peradangan epididimis,
2. Perempuan – PID, infertil, gangguan menstruasi kronis, peradangan selaput lendir
rahimsetelah melahirkan (post partum endometriosis), abortus, cistitis (peradangan kandung kencing),
peradangan disertai pus.
Pencegahan
 Menghindari seks bebas (free sex).
 Monogami.
 Penggunaan kondom saat vaginal, oral maupun anal seks.
Penanganan
1. Pada masa kehamilan, berikan antibiotika seperti : a) Ampisilin 2 gram IV dosis awal, lanjutkan
dengan 3 x 1 gram per oral selama 7 hari. b) Ampisilin + Sulbaktan 2,25 gram oral dosis tunggal. c)
Spektinomisin 2 gram IM dosis tunggal. d) Seftriakson 500 mg IM dosis tunggal.
2. Masa nifas, berikan antibiotika seperti : a) Xiprofloksasin 1 gram dosis tunggal. b) Trimethroprim +
Sulfamethoksazol (160 mg + 800 mg) 5 kaplet dosis tunggal.
3. Oftalmia neonatorum (konjungtivitis) : a) Garamisin tetes mata 3 x 2 tetes. b) Antibiotika – Ampisilin
50 mg/ kgBB IM selama 7 hari; Amoksisilin + asam klamtanat 50 mg/ kgBB IM selama 7 hari; Seftriakson
50 mg/ kgBB IM dosis tunggal.
4. Lakukan konseling tentang metode barier dalam melakukan hubungan seksual.
5. Berikan pengobatan yang sama pada pasangannya.
6. Buat jadual kunjungan ulang dan pastikan pasangan & pasien akan menyelesaikan pengobatanhingga
tuntas.
Sifilis
Pengertian
Adalah penyakit yang disebabkan oleh Treponema Pallidum, bersifat kronik dan sistematik. Nama lain
adalah Lues venereal atau raja singa.
Penyebab
Penyebabnya adalah Treponema Pallidum, termasuk ordo Spirochaecrales, familia Spirochaetaceae dan
genus Treponema. Bentuk spiral teratur, panjang 6-15 µm, lebar 0,15 µm, terdiri atas 8-24 lekukan.
Pembiakan secara pembelahan melintang, pada stadium aktif terjadi setiap 30 jam.
Klasifikasi
Sifilis terbagi menjadi sifilis congenital dan sifilis akuista.
1. Sifilis Kongenital, terbagi atas : a) Dini (sebelum 2 tahun); b) Lanjut (sesudah 2 tahun); Stigmata
2. Sifilis Akuista, terbagi : a) Klinik; b) Epidemiologik
Menurut caranya sifilis dibagi menjadi tiga stadium yaitu : Stadium I (SI); Stadium II (SII); Stadium III
(SIII)
Secara epidemiologik, WHO membagi menjadi :
 Stadium dini menular ( dalam waktu 2 tahun sejak infeksi), terdiri dari SI, SII, stadium rekuren dan
stadium laten dini.
 Stadium lanjut tak menular (setelah 2 tahun sejak infeksi), terdiri atas stadium laten lanjut dan SIII.
Komplikasi
 Pada kehamilan: a) Kurang dari 16 minggu : kematian janin (sifilis fetalis). b) Stadium lanjut
:prematur, gangguan pertumbuhan intra uterin, cacat berat (pnemonia, sirosis hepatika, splenomegali,
pankreas kongenital, kelainan kulit dan osteokondritis).
Tanda dan gejala
 Lesi (berupa ulkus, soliter, dasar bersih, batas halus, bentuk bulat/longitudinal).
 Tanpa nyeri tekan.
Penanganan
1. Menerapkan prinsip pencegahan infeksi pada persalinan.
2. Menerapkan prinsip pencegahan infeksi pada penggunaan instrumen.
3. Pemberian antibiotika, misal : Benzalin pensilin 4,8 juta unit IM setiap minggu dengan 4x pemberian;
Dofsisiklin 200 mg oral dosis awal, dilanjutkan 2×100 mg oral hingga 20 hari; Sefriakson 500 mg IM
selama 10 hari.
4. Sebelum pemberian terapi pada bayi dengan dugaan/ terbukti menderita sifilis kongenital, maka
dilakukan pemeriksaan cairan serebrospinalis dan uji serologik tiap bulan sampai negatif. Berikan
antibiotik : Benzalin pensilin 200.000 IU/ kgBB per minggu hingga 4x pemberian; Sefriakson 50 mg/ kg
BB dosis tunggal (per hari 10 hari).
5. Lakukan konseling preventif, pengobatan tuntas dan asuhan mandiri.
6. Memastikan pengobatan lengkap dan kontrol terjadwal.
7. Pantau lesi kronik atau gejala neurologik yang menyertai.
Chlamydia
Pengertian
Adalah infeksi yang disebabkan oleh kuman Chlamydia trachomatis dan dapat diobati.
Penyebab
Kuman Chlamydia trachomatis.
Penularan
Kuman ini menyerang sel pada selaput lendir : a) Uretra, vagina, serviks dan endometrium. b)
Saluran tuba fallopi. c) Anus dan rektum. d) Kelopak mata. e) Tenggorokan (insiden jarang).
Chlamydia paling sering menyerang pada usia muda dan remaja. Penularannya dapat melalui :hubungan
seksual secara oral, anal maupun oral seks; hubungan seksual dengan tangan, sehinggacairan mani
terpercik ke mata; dari ibu ke bayi sewaktu proses persalinan.
Tanda dan gejala
Sekitar 75 % perempuan dan 50% laki-laki yang tertular Chalmydia tidak menunjukkan tanda dan gejala.
Keluhan dan gejala biasanya timbul sekitar 3 minggu setelah tertular kuman chlamydia.
Adapun tanda dan gejalanya adalah :
1. Menderita proktitis (radang rektum), urethritis (radang saluran kencing) dan konjungtivitis (radang
selaput putih mata).
2. Pada wanita : keluar cairan dari vagina; perasaan panas dan nyeri sewaktu buang air kecil
3. Bila sudah menyebar ke tuba fallopi, akan timbul : nyeri perut bagian bawah; nyeri sewaktucoitus;
timbul perdarahan pervaginam diantara siklus haid; demam dan mual-mual
4. Pada pria : keluar cairan kuning seperti pus dari penis; nyeri dan rasa terbakar sewaktu
kencing; nyeri dan bengkak pada testis
Komplikasi

Perempuan Laki-laki Bayi baru lahir


1. PID 1. Prostitis 1. Kebutaan
2. Infertil 2. Timbul jaringan parut pada urethra2. Pneumoni (radang paru)
3. Radang kandung kencing (cyctitis) 3. Infertil 3. Kematian
4. Radang serviks (servisitis) 4. Epididimis

Pencegahan
1) Hindari seks bebas; 2) Monogami; 3) Gunakan kondom saat hubungan seks baik dengan oral, anal
maupun vaginal seks.
Penanganan
1. Doksisiklin per oral 2x sehari selama 7 hari.
2. Asitromisin dengan pemberian dosis tunggal (kontraindikasi untuk ibu hamil, gunakan eritromisin,
amoksilin, azitromisin).
3. Lakukan follow-up pada penderita dengan : a) Apakah obat yang diberikan sudah diminum sesuai
anjuran. b) Pasangan seksual juga harus diperiksa dan diobati. c) Jangan melakukan hubungan seks,
bila pengobatan belum selesai. d) Lakukan periksa ulang 3-4 bulan setelah selesaipengobatan.

http://www.lusa.web.id/penyakit-menular-seksual/
Apakah Penyakit Menular Seksual (PMS)?
6 Apr 2012 Kategori: Kulit & Kelamin Blm ada komentar

Penyakit menular seksual (PMS) adalah infeksi yang ditularkan dari satu orang ke orang lain melalui
hubungan seksual, termasuk seks vaginal, oral maupun anal. Beberapa PMS, seperti kutu kelamin,
bahkan dapat ditularkan hanya dengan kontak tubuh berdekatan.

Beberapa PMS memiliki gejala seperti:

 keluar cairan yang tidak biasa dari penis atau vagina

 ruam, lepuhan, benjolan atau koreng (ulkus) di daerah kelamin, atau kadang-kadang di mulut jika Anda
melakukan seks oral

 nyeri di pinggang bawah

 rasa sakit saat buang air kecil.

Namun, PMS seringkali tidak menimbulkan gejala, bahkan ketika infeksinya masih ada. Anda mungkin
tidak tahu jika Anda terinfeksi, apalagi pasangan Anda.

PMS umum
Ada banyak jenis PMS, silakan baca rincian masing-masing jenis PMS di sini. Di Indonesia, klamidia
adalah infeksi umum dan dapat menimbulkan efek jangka panjang terhadap kesehatan dan kesuburan
wanita. HIV adalah infeksi yang jarang, namun di beberapa tempat tertentu seperti lokasi wisata
internasional atau di kalangan pengguna narkoba, prevalensinya bisa tinggi.
Jika Anda curiga telah terinfeksi PMS, jangan tularkan kepada orang lain! Segeralah didiagnosis dan
diobati dengan cepat.

Pemeriksaan dokter
Anda perlu mendapatkan pemeriksaan oleh dokter karena PMS tidak selalu menunjukkan gejala. Alasan
lainnya adalah karena PMS sangat mudah diobati pada tahap awal, tetapi jika dibiarkan untuk waktu
yang lama akan lebih sulit. Lebih buruk lagi, beberapa PMS yang tidak diobati dapat membuat pria dan
wanita tidak subur (sulit mendapatkan anak). Mengetahui bahwa Anda sehat melalui pemeriksaan
berkala juga memungkinkan Anda untuk bebas dari kekhawatiran.

Pemeriksaan PMS dapat dilakukan di klinik dokter umum, dokter spesialis, dan Puskesmas. Mereka
memiliki aturan kerahasiaan, sehingga status kesehatan Anda hanya diketahui oleh Anda dan staf klinik
yang terkait. Namun, beberapa PMS (misalnya HIV/AIDS) perlu dilaporkan ke Kementerian Kesehatan.

Cara pemeriksaan
Dokter akan mempelajari riwayat medis dari Anda , termasuk menanyakan tentang masalah kesehatan
Anda di masa lalu dan kehidupan seks Anda. Dokter seharusnya hanya menanyakan pertanyaan yang
relevan. Namun, jika ada pertanyaan yang benar-benar memalukan bagi Anda, mintalah dokter untuk
melompat ke pertanyaan berikutnya.

Tes untuk PMS meliputi tes darah, tes urin, tes sampel lendir/jaringan mukosa atau pemeriksaan alat
kelamin. Ketika melakukan pemeriksaan alat kelamin, dokter akan melihat dan meraba area genital dan
anus. Dokter akan mencari dan meraba adanya benjolan, ruam, kutil, koreng atau kelembekan. Pada
pria, dokter akan mencari cairan yang keluar dari penis. Jika ada cairan yang keluar, maka akan diambil
sampel cairan atau sel-sel jaringan dengan tongkat kecil berujung kapas. Pada wanita, dokter akan
memasukkan dua jari ke dalam vagina untuk merasakan dinding vagina, saluran leher rahim, rahim dan
tuba untuk memeriksa benjolan atau kelembekan. Dokter juga mungkin memasukkan spekulum pada
vagina wanita. Spekulum adalah instrumen plastik atau logam untuk membuka bibir vagina sehingga
memungkinkan dokter untuk melihat leher rahim. Dokter akan menyeka lubang vagina, leher rahim dan
saluran kencing dengan tongkat kecil berujung wol atau sikat untuk mengambil sampel.

Dokter umumnya menyadari bahwa pemeriksaan ini bisa membuat Anda malu dan tidak nyaman. Jika
Anda merasa tidak nyaman, Anda dapat meminta dokter untuk berhenti. Anda juga dapat meminta dokter
untuk menjelaskan apa yang sedang dia lakukan. Untuk mengurangi rasa malu, Anda bisa memilih
dokter yang berjenis kelamin sama dengan Anda.

Beberapa PMS (seperti HIV, hepatitis dan sifilis) memerlukan sampel darah. Beberapa PMS cukup
dilakukan dengan mengumpulkan sampel urin.

Cara untuk menghindari PMS


Pencegahan PMS dapat dilakukan dengan perilaku seks yang sehat (tidak berganti-ganti pasangan).
Kondom dapat mencegah sebagian besar PMS, tetapi beberapa, seperti herpes dan kutil kelamin, dapat
menyebar melalui kontak dengan kulit yang tidak tertutup oleh kondom. Anda bisa memilih untuk tidak
berhubungan seks sama sekali, tapi tidak semua orang sanggup melakukannya.

http://majalahkesehatan.com/apakah-penyakit-menular-seksual-pms/