For a lot of Americans, this topic can be very uncomfortable. It can bring back the awkward recollections of high school or memories of traumatic events. STIs, otherwise known as sexually transmitted infections, were renamed by the World Health Organization in 1999. These infections used to be called STDs (sexually transmitted diseases) or known by the older term venereal disease (VD). STIs have plagued humanity since antiquity with clay tablets from Mesopotamia or papyrus from ancient Egypt documenting these diseases. The World Health Organization estimates more than one million STIs are acquired daily around the world. They also estimate 374 million new infections each year are due to one of four curable STIs including chlamydia, gonorrhea, syphilis, and trichomoniasis.

Most Common STIs

There are many STIs in the world, but some are more common than others. Below is a list of STIs that tend to be more common in the United States.

• Human papillomavirus (HPV) generally doesn’t cause any symptoms though it’s estimated 80% of sexually active people in the United States (US) are infected with it. HPV can cause warts, and it can also lead to cervical or oropharyngeal cancer. It’s even been linked to other cancers of the reproductive organs and anus.
• Chlamydia (caused by the bacteria Chlamydia trachomatis) is the most common curable STI in the US according to the Center for Disease Control (CDC). Symptoms can include pain in the reproductive organs and pelvic region, painful urination, and frequency of urination. Purulent discharge and odor is possible for women. Men may experience pain with bowel movements if the rectum or prostate is affected. A fever is possible if the infection is severe enough.
• Gonorrhea (caused by Neisseria gonorrhoeae) is the second most common sexually transmitted disease in the US. It is similar in symptoms to chlamydia though the discharge may be yellow, green, or white. Additionally, for women, the genital area is generally itchy.
• Genital herpes (caused by herpes simplex virus 1(HSV-1)) or herpes simplex virus 2 (HSV-2) is estimated to affect 50 million people in the US. The initial infection can cause typical sick symptoms including fever, fatigue, itchiness, and skin lesions in the affected area. Thereafter, tingling, itchiness, and lesions/rash can reoccur with less intensity and with a shorter duration than the initial infection.
• Human Immunodeficiency Virus (HIV) is caused by the human immunodeficiency virus. It can initially show up with no symptoms, or flu-like symptoms that can last for weeks. These symptoms can include fever, malaise, joint and/or muscle pain, etc. This virus directly attacks the immune system, compromising its ability to fight off infections over time. The immune system becomes so compromised over time, on average eleven years after onset, that Acquired Immunodeficiency Syndrome (AIDS) develops. This leaves the body susceptible to other common infections.
• Syphilis (caused by the spirochete Treponema pallidum) in the United States is more common. There are three different stages of syphilis. The primary stage includes developing a painless skin lesion called a chancre which heals after 3-8 weeks. The secondary stage can present as a rash on the skin or mucus membranes; feet and hands can also be involved. The tertiary stage can start months to years later and is serious. It can involve the cardiac system, nervous system, etc.
• Trichomoniasis (caused by protozoa Trichomonas vaginalis) can be asymptomatic in men or cause testicular or rectal pain, or urinary symptoms. Women can experience foul-smelling discharge, pruritus, dyspareunia, dysuria, and vaginal spotting.
• Mycoplasma genitalium is another sexually transmitted disease and is the second most common cause of inflammation/irritation of the lower urinary tract or cervix in women. It is closely associated with HIV infections.

How to Prevent STIs

Overall, in the United States, cases of STIs are increasing each year. The following recommendations can help you maintain a healthy sex life.

Practice Safer Sex: Abstinence is the best way to prevent STIs if you are not in a serious, committed relationship. If you are sexually active with multiple partners, consider reducing the number of sexual partners. The more partners you have, the higher your risk of contracting an STI. Consider practicing mutual monogamy with your partner where the two of you agree to only have sex with each other. Additionally, using a condom for any type of sexual contact is highly effective at reducing your risk of STIs. There are also topical microbicides which can be applied to the vagina or rectum that may help prevent infections.

See your Doctor Regularly: Getting regular checkups, at least yearly, can help prevent/catch STIs early. This is important even if you practice monogamy, as some STIs are more difficult to diagnose than others and many with STIs can go symptom-free for years without knowing they are putting their partner(s) at risk. Women and men should get regular genital exams from their doctors. If you are at a higher risk of STI infection for any reason, ask your doctor for STI testing. Those under the age of 25, who have multiple partners, are partners of the same sex, have a history of drug use or weakened immune system, history of an STI, and/or inconsistent use of condoms are at an increased risk of contracting an STI.

Medical Prevention: Have a conversation with your doctor about STIs to better educate yourself on how to reduce your risk of developing infections. There are preventative measures on the market including HPV vaccination and safer sex options. You can also talk to your doctor about specific interventions which may be right for you. Be sure to have a long chat with your doctor about the pros and cons of any medical intervention to make sure the choice you make is best for you and your health.

Natural Ways to Support Your Immune System

If you suspect you have an infection, have a conversation with your doctor right away. Prescription medications are the most researched and supported option to cure or manage STIs. Though if you are at a higher risk for STIs, supporting your body’s natural immune system may be helpful. Below are a few standard recommendations to help support your body’s defense against any infection.

Vitamins and Minerals: It’s important to have a well-balanced diet for overall health. Specific vitamins that can help support the immune system include B vitamins, vitamin C, vitamin D, and zinc among others. You can get these through nutrient-dense foods or by taking a multivitamin or specific supplement. Ask your doctor for what might be best for you.

Drink Adequate Amounts of Water: It’s also a good practice to drink enough water. Water is what helps produce blood and lymph which moves immune cells around the body. It helps move nutrients through the body better.

Eat Fermented Foods: Probiotics have been linked to immune system health. A good microbiome can help you process nutrients better as well as potentially help stave off "bad" bacteria. You can get these by eating kimchi, sauerkraut, keifer, sourdough bread, pickles, etc. Probiotic supplements can also be purchased and used if eating fermented foods isn’t for you.

Add Immune Boosting Foods and Seasonings: Garlic (Allium sativum) has been found to support increased production of virus-killing immune cells, and it can help lower stress which supports a stronger immune system. Green tea (Camellia sinensis) is loaded with antioxidants and is an anti-inflammatory. It may also help support a healthy immune system. Beta-carotene-rich foods like carrots, spinach, kale, apricots, sweet potato, squash, and cantaloupe are good to add to your diet. Beta-carotene converts to vitamin A which also supports immune health. Specific seasonings such as turmeric, ginger, basil, thyme, etc., may also support a healthy immune system.

What to Do if You Suspect You Have an STI

Finally, if you are sexually active and suspect you have a sexually transmitted infection, you should see a doctor right away. For men and women, long-term infections can cause fertility problems. Remember, many STIs are treatable or very manageable with medical interventions.

Pelvic Inflammatory Disease (PID) is specific to women and can develop from sexually transmitted diseases, and it can affect future fertility. If you experience a fever and abdominal or pelvic pain, changes in your menstrual cycle or discharge, pain with urination or intercourse, etc, you should see a doctor right away. If men experience testicular pain, rectal pain, pain with bowel movements, pain with intercourse, or urinary changes, contact your doctor right away. As always, have a chat with your doctor before adding any supplements or committing any lifestyle changes that will affect your health. If you are looking to support your health naturally, Dr. Blandford offers a 15 minute Discovery Visit where you can find out if naturopathic health support is right for you!

Resources:

1. Center for Disease Control. N.D. "How You Can Prevent Sexually Transmitted Diseases." Revised Feb. 22, 2023. https://www.cdc.gov/std/prevention/default.htm
2. Garcia, Michael Ray, Stephen W. Leslie, Anton A. Wray. 2023. "Sexually Transmitted Infections." https://www.ncbi.nlm.nih.gov/books/NBK560808/
3. Gruber, Franjo et al. 2015. "History of Venereal Diseases from Antiquity to the Renaissance." Acta dermatovenerologica Croatica: ADC; 23(1): 1-11.
4. Isbill, Jonathan et al. 2020. "Opportunities for Health Promotion: Highlighting Herbs and Spices to Improve Immune Support and Well-being." Integrative Medicine (Encinitas, Calif.); 19(5): 30-42.
5. Obiero J, Ogongo P, Mwethera PG, Wiysonge CS. 2021. "Topical Microbicides for Preventing Sexually Transmitted Infections." Cochrane Database of Systematic Reviews; 3: Art. No. CD007961. DOI: 10.1002/14651858.CD007961.
6. Van Gerwen, O.T., Muzny, C.A. & Marrazzo, J.M. 2022. "Sexually Transmitted Infections and Female Reproductive Health." Nat Microbiol; 7: 1116–1126. https://doi.org/10.1038/s41564-022-01177-x
7. Ward, Tammy. 2020. "You Are What You Eat: Choose Foods that Boost Immunity and Fight Infection." UC Health. https://www.uchealth.com/en/media-room/covid-19/boost-immunity-with-food
8. World Health Organization. 2023. "Sexually Transmitted Infections (STIs)" https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

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