It would be reasonable to assume that most people ripping open a condom packet are not thinking about their long term fertility. But in fact, their wise decision to use ‘barrier protection’ not only provides contraception for the here and now, but it can also support successful conception for when the time is right.
With the prevalence of sexually transmitted infections (STIs) like chlamydia and gonorrhoea rising every year in Australia, and with many infections being asymptomatic, it’s sometimes easy to dismiss the importance of taking diligent prevention and screening measures. Thankfully, the majority of Australia’s most common STIs are easily treatable and unlikely to cause long term consequences. However in a small proportion of cases, long-term damage from these ‘bed bugs’ can cause future fertility issues.
What Should You Know About Chlamydia?
When someone says ‘I have chlamydia’, it means they are hosting the bacteria chlamydia trachomatis in their genital tract. For those with a uterus, the hottest spot for these pesky bacteria to gather is the cervix. For those with a penis, it is the urethra -— or ‘pee hole’. The throat, eyes and anus may also be infected.
3 in 4 people with a uterus who have contracted the infection will not show any symptoms. For those with a penis, 1 in 2 people will not experience symptoms. For the minority that do show symptoms, the most common complaints involve a new or changed penile or vaginal discharge and pain in the genital area.
There is a 30 to 50 percent chance that chlamydia will be passed on through sexual activity if one of the partners is carrying the infection.
What Should You Know About Gonorrhoea?
Gonorrhoea is another very common STI in Australia, caused by the bacteria Neisseria gonorrhoea and sometimes nicknamed ‘the clap’. This bacteria tends to hang out around the urethra, cervix, anus, throat or eyes.
Like its big sister chlamydia, gonorrhoea often causes no symptoms. Symptomatic infections can cause abnormal vaginal or penile discharge, genital pain, anal discharge, a sore, dry throat or irregular menstrual bleeding in someone with a uterus.
If you think you may be at risk of having caught either of these infections, visit your local GP for a quick test.
What Should You Do If a STI Progresses?
In untreated cases, most chlamydia infections will self-resolve in two years. But gonorrhoea infections are far more persistent. In people with a uterus, 1 in 10 chlamydia infections and up to 1 in 5 gonorrhoea infections will travel up the genital tract, leading to pelvic inflammatory disease (PID). PID is an umbrella term used to describe the acute infection of the upper genital tract (the uterus, ovaries and fallopian tubes). Regardless of the cause of PID, the involved infection can cause widespread inflammation, scarring and damage of the inside of this important organ.
Most people with PID may not experience symptoms and therefore do not seek treatment before inflammation and scarring of the genital tract have occurred. People with symptoms often complain of two or more weeks of lower abdominal pain, sometimes with abnormal bleeding, vaginal discharge or the sense of needing to urinate more frequently.
If the inflammation occurs in the fallopian tubes, any future egg that has been released through ovulation may have trouble traversing the scarred and damaged tubes, which is an essential component of the successful fertilisation and implantation phase of pregnancy. In these cases, the person is at an increased risk of experiencing an ectopic pregnancy. This is when the embryo implants outside of the uterus (usually in one of the fallopian tubes), leading to an unviable pregnancy, and putting the health of the person who is pregnant at risk as it tries to grow in an area that it shouldn’t.
Even if the fertilised egg is able to travel to the uterus for implantation, scarring and inflammation from infection may impact the successful implantation and development of an embryo into the uterine cavity.
Thankfully, PID can be cured by a course of antibiotics. It is important to remember though, that antibiotics will not reverse any damage that has already been done. So it is important to get diagnosed and begin treatment as soon as possible.
The best way to avoid STI related complications is to avoid acquiring the infection in the first place. Using condoms and asking sexual partners if they have been screened is the easiest first step. If you think you may have been exposed to an STI, visit your local GP for a quick and easy test. It’s important to remember that the most common STIs are often asymptomatic — so don’t wait for your body to tell you about it!
So let’s take a moment to appreciate the humble condom. For such a simple invention, it is really doing a lot — contraception, infection prevention and future conception protection.
If this article has raised any concerns, please consult your GP or a medical professional.
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