The effects of STDs differ by gender

GLOBALLY, the numbers of sexually transmitted diseases (STDs) have been trending upwards for both men and women, which make them a public health concern. But while both sexes are affected by STDs, obstetrician-gynaecologist Dr Robyn Khemlani said that they pose a greater risk for women than men in many ways partly because women disproportionately endure the long-term consequences of STDS.

“STDs are an important global health priority because of their devastating impact on women and infants and their interrelationships with HIV/AIDS. Women with certain STDs are at an increased the risk of getting and transmitting HIV. Also, STDs can cause long-term health problems, particularly in women and infants,” Dr Khemlani explained.

She pointed out that STDs, which may be passed from person to person in blood, semen or vaginal and other bodily fluids, are generally acquired through sexual contact and are caused by bacteria, viruses or parasites.

“These STDs carry a lot of risks, including pelvic inflammatory disease, chronic pelvic pain, infertility, tubal or ectopic pregnancy, certain cancers such as HPV-associated cervical and rectal cancers, and perinatal or congenital infections in infants born to infected mothers,” Dr Khemlani outlined.

If left untreated, STDs such as gonorrhoea, syphilis, chlamydia and human papillomavirus can lead to devastating and sometimes long-term complications. These complications include eye inflammation and blindness, arthritis and bone deformities, as well as brain damage.

Dr Khemlani said that emerging data suggests that men and women differ in terms of their biological risks for STD acquisition, the clinical manifestation of infection when present, and their behavioural likelihood of both acquiring and transmitting STDs. Some of these ways include:

Circumcision in men appears to reduce the risk of acquiring STIs

“There is evidence that male circumcision can help reduce a man’s risk of acquiring infections such as HIV. Male circumcision may also help prevent transmission of genital HPV and genital herpes,” Dr Khemlani shared.

Men are often silent carriers of HPV

Men are less likely to know that they have HPV; however, it is the leading cause of cervical cancer in women and is the most common STD contracted by women. “Sexually transmitted infections are more devastating to women. In the case of HPV, for example, most men do not develop any serious problems, though HPV is very common in men. On the other hand, it is the main cause of cervical cancer in women,” Dr Khemlani said.

A woman’s anatomy makes her vulnerable to contracting STDs

Women, particularly adolescent women, are especially vulnerable to STIs due to differences in anatomy. “The lining of the vagina is thinner and more delicate than the skin on a penis, so it’s easier for bacteria and viruses to penetrate. There is also a larger exposed mucosal surface area, [and] hormonal effects, changes in the protective female genital tract microflora, and the intermittent presence of ectopy, especially in adolescence, all play a role in making women more prone to STIs,” Dr Khemlani said, noting that the vagina is a good environment for bacteria to grow.

Women sometimes don’t present symptoms

Women typically see their doctors more often than men; however, women especially those in committed relationships, don’t often use the opportunity to test for STDs. “Women should use time with their doctor as an opportunity to ask for an STD test,” Dr Khemlani advised.

Women can pass STDs to their unborn children

“Pregnant women with STIs may miscarry or may pass on their STDs or STIs to their babies. STIs can also cause low birth weight and premature babies. Babies with infected mothers develop complications such as pneumonia, eye infections, and brain damage if they infected,” Dr Khemlani advised.

Women often confuse symptoms

“Women are more likely to confuse symptoms of a STD for something else. For example, they often think that the burning or itching sensation is related to a yeast infection, which they sometimes get over-the-counter drugs for,” Dr Khemlani said.

 Men rarely experience long-term complications

Men are more likely to notice and get treatment for their STDs; however, outside of this, men still rarely bear long-term complications of STDs. On the contrary, untreated STDs in women can cause serious health complications such as pelvic inflammatory disease and infertility.

Men usually notice unusual symptoms like discharge

Women have discharge all the time and so unless it looks different, for example, if it appears greenish or yellow or presents a foul odour, a woman is not likely to suspect that she has a STD, especially if she does not present with other noticeable symptoms.

 Women may not see symptoms as easily as men

“STDs like genital ulcers (like from herpes or syphilis) can occur in the vagina and may not be easily visible, while men may be more likely to notice sores on their penis,” Dr Khemlani said.