STD Awareness: Which STDs Are Resistant to Antibiotics?

pillsYou’ve probably heard of MRSA, which is pronounced “mersa” and stands for methicillin-resistant Staphylococcus aureus — a strain of bacteria that is resistant to methicillin, as well as pretty much every other antibiotic out there. MRSA is an example of evolution by natural selection — what didn’t kill its ancestors made them stronger, spawning a drug-resistant strain.


There are drug-resistant strains of gonorrhea, trichomoniasis, and syphilis.


Evolution is the force behind life’s diversity. Normally, diversity is a good thing — but when it comes to microbes that cause diseases like gonorrhea, trichomoniasis, and syphilis, these organisms’ ability to evolve new defenses against our antimicrobial drugs isn’t good for us.

STDs have plagued us for millennia, but it wasn’t until the 20th century that we finally developed antibiotics, which gave us a powerful tool against many of our most formidable sexually transmitted foes. Suddenly, scourges like gonorrhea and syphilis could be quickly and easily treated with a dose of penicillin.

Problem solved, right? Nope. Enter evolution by natural selection. Continue reading

STD Awareness: Drug-Resistant Trichomoniasis

Two trophozoites of Trichomonas vaginalis, the causative agent of trichomoniasis. Image from the CDC’s Parasite Image Library.

Trichomonas vaginalis organisms, which cause trichomoniasis. Image: Parasite Image Library, CDC

You’ve probably heard of MRSA, which is a strain of Staphylococcus aureus that evolved resistance to all kinds of antibiotics. You also might have heard of other “superbugs,” like Clostridium difficile, aka “C. diff,” or the emerging strains of bacteria that cause antibiotic-resistant gonorrhea. However, other infectious diseases are slowly evolving drug resistance too, but they’re not grabbing headlines. One such disease is trichomoniasis.


We are only starting to learn about drug-resistant trich — and what it means for those who have it.


Trichomonas vaginalis is the single-celled parasite that causes trichomoniasis, or trich (pronounced “trick”). Symptoms can include vaginal discharge (which might have a bad odor), penile burning or discharge, spotting, and itching or swelling in the genital area — but around 70 percent of trich infections are asymptomatic.

Despite its appearance on our list of 10 STDs you’ve probably never heard of, trich is actually the most common curable sexually transmitted disease out there — around 3.7 million Americans are currently infected with trich. When you consider that trich rarely has symptoms, its ubiquity might not even seem all that surprising — there are millions of infections, right under our noses, but mostly unknown and not being aggressively screened for. STD testing doesn’t always include screening for trich, especially in males, who usually don’t have symptoms and can transmit it to others unknowingly. This might not be so bad if trich didn’t cause complications with pregnancy or make it easier to be infected with HIV. Continue reading

STD Awareness: Intestinal Parasites

Editor’s Note: If you’re wondering if there is a sexually transmitted disease (STD) that causes maggots, please see our new article, “Is There an STD That Causes Maggots?”

This colorized scanning electron micrograph shows Giardia lamblia reproducing asexually. Image: Stan Erlandsen, CDC’s Public Health Image Library.

This colorized scanning electron micrograph shows Giardia lamblia reproducing asexually. Image: Stan Erlandsen, CDC’s Public Health Image Library

Most sexually transmitted diseases are caused by bacteria or viruses, but some are caused by organisms that are classified as completely different lifeforms. Trichomoniasis, for example, is caused by a protozoan organism; protozoa occupy their own kingdom, separate from plants, animals, and bacteria. Intestinal parasites are often protozoan organisms, but can also include parasitic worms (which are members of the animal kingdom). They are spread through contact with fecal matter — and as such, they can be transmitted sexually as well as nonsexually. Intestinal parasites are usually transmitted by fecal contamination of food or water, and are most common in areas with insufficient sewage treatment and untreated water in the wilderness. Some pathogens, however, have low infectious doses, making their sexual transmission more likely.


What has eight flagella and can live in your intestines?


Oral contact with the anus, also called anilingus or rimming, is the primary means of the sexual transmission of these pathogens. Putting fingers or hands in your mouth after they have had contact with the anus is also risky. Other modes of transmission include oral sex, as genitals can be contaminated with feces, as well as sharing sex toys and other equipment. For these reasons, it is very important to use dental dams or latex gloves during contact with the anus; to clean the anus before engaging in rimming; to clean or use condoms on shared sex toys; and to use condoms or dental dams during oral sex. Continue reading

STD Awareness: Trichomoniasis

Editor’s note: To find out if trichomoniasis can go away on its own, please see our April 2016 post Will STDs Go Away on Their Own?

Trichomonas vaginalis, normally pear-shaped, flattens itself out after attaching to vaginal epithelial cells, maximizing surface area between parasite and host. The purple rod-shaped organisms are bacteria. Image courtesy of Antonio Pereira-Neves and Marlene Benchimol, Santa Ursula University, Rio de Janeiro, Brazil

Trichomonas vaginalis, normally pear-shaped, flattens itself out after attaching to vaginal cells, maximizing surface area between parasite and host. The purple organisms are bacteria. Image: Antonio Pereira-Neves and Marlene Benchimol, Santa Ursula University, Rio de Janeiro, Brazil

Most sexually transmitted diseases are caused by viruses or bacteria. STDs caused by viruses include herpes and genital warts, and the viruses that cause them aren’t even technically living organisms — they are pieces of genetic information that are able to infect a host cell. STDs caused by bacteria include gonorrhea and syphilis; bacteria are microscopic, single-celled organisms with relatively simple cell structures.

But some STDs are caused by other types of living organisms. Protozoan organisms are microscopic and unicellular, like bacteria; unlike bacteria, their cell structures more closely resemble that of the so-called “higher” life forms such as animals and plants. While protozoa are considered to be “animal-like,” they are not animals at all — they are single-celled organisms that reproduce asexually. When certain types of protozoans get into your body, they can cause infections — such as trichomoniasis, the most common curable STD among young females (as well as more females over 40 than previously thought). It is estimated that 7.4 million new cases of trichomoniasis occur annually in the United States; worldwide, there are about 170 million cases each year.

Trichomoniasis, colloquially known as trich, is spread by vaginal or anal intercourse, direct vulva-to-vulva contact, and other activities that involve passing secretions from one partner to another (e.g., sharing sex toys or mutual masturbation). Sexually active people can reduce the risk of contracting trichomoniasis by using latex barriers, such as condoms. Continue reading

STD Awareness: Bacterial Vaginosis and Chancroid

Editor’s Note: Please see our post of November 2, 2015 to learn if bacterial vaginosis (BV) can cause sores, and to get the scoop on whether or not it’s actually an STD.

Sexually transmitted diseases can be caused by viruses, bacteria, protozoans, and even animals. Bacterial vaginosis and chancroid are both infections caused by bacteria, which means that they can be treated with antibiotics. While bacterial vaginosis only affects people with vaginas, chancroid disproportionately affects people with penises. You can seek diagnosis and treatment for bacterial vaginosis and chancroid at a Planned Parenthood health center, as well as health clinics, private health-care providers, and health departments.

Bacterial vaginosis is caused by an imbalance of bacteria species in the vagina. Image: renjith krishnan / FreeDigitalPhotos.net

Bacterial vaginosis is caused by an imbalance of bacteria species in the vagina. Image: renjith krishnan / FreeDigitalPhotos.net

Bacterial Vaginosis
Bacterial vaginosis seems to be most commonly caused by the bacteria species Gardnerella vaginalis. Scientists aren’t quite sure how this infection is caused, but risk seems to correlate with a change in sexual partners, having multiple sexual partners, douching, or using an intrauterine device; it can also occur in females who have never been sexually active. It is more common in pregnant women. There is no counterpart to this infection in males, although G. vaginalis can be found in their urethras; this raises the possibility that bacterial vaginosis can be sexually transmitted, in which case it could be directly transmitted between two females or indirectly transmitted from one female to another via a male.

Bacterial vaginosis seems to result from an imbalance in the vaginal flora (“flora” is a somewhat fanciful term for the bacteria that live in your body; under normal circumstances they are harmless and even beneficial). Vaginas usually are habitat to a population of bacteria called Lactobacillus, which produce hydrogen peroxide as a byproduct. When the number of Lactobacillus declines, G. vaginalis is able to move in on Lactobacillus’ old territory. The decrease in Lactobacillus and increase in G. vaginalis leads to a rise in the vagina’s pH. The new vaginal environment is less acidic and more alkaline; a vaginal pH of more than 4.5 is one criterion for the diagnosis of bacterial vaginosis. Another symptom includes a vaginal discharge that may smell somewhat fishy. There might also be genital itching or pain during urination. It is also possible not to have symptoms. Continue reading