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Effect of STDs On Sexual Function and Sexual Drive

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Sexually transmitted diseases (STDs) are an umbrella term for infections that can be acquired through sexual intercourse. Based on the local epidemiological studies in Singapore, STDs affected 201.6 per 100,000 of the population in 2017.

This leads us to the following questions: 

  • What is the effect of untreated STDs on a person’s sexual function? 
  • Will my sexual drive improve following the treatment of my STDs?
  • Should I be worried if I have STDs?

We will explore the above points in this article.

STDs can have a detrimental effect on a couple’s sexual function.

Effect of STDS on Men’s Sexual Function

STDs can have a detrimental effect on male hormones and can result in prostatitis and sexual dysfunction.

Epididymitis and low testosterone in STDs

Testosterone is an essential male sex hormone that regulates the male libido, sperm production, general energy level, fat and muscle mass distribution, and red blood cell production. Testosterone hormone is produced mainly in the testicles, and the level can fluctuate. Common causes of reduction of testosterone hormone include ageing, diabetes, trauma, thyroid disease, hormonal disorders, tumour, and infection. 

STD Infections can cause inflammation of the testicles (this is known as epididymitis), leading to impairment of the production of testosterone. Common STDs that are associated with low testosterone include HIV, chlamydia, gonorrhoea, and syphilis.

Prostatitis and erectile dysfunction in STDs

The prostate gland is a small chestnut organ located at the neck of the bladder, just in front of the rectum, and at the base of the urethra (the urinary tube that delivers urine). It is an important organ in the male reproductive system and aids in the production of semen to ensure the sperm is viable and able to move. Due to its location, the prostate gland can easily become infected by pathogens such as STDs.

Untreated STDs, such as HIV, gonorrhoea, and chlamydia, can infect the prostate, leading to prostatitis – inflammation of the prostate. When the prostate is inflamed, the surrounding blood circulation to the genitals can be compromised; there will be lesser blood flow to the penis which can result in difficulty in sustaining an erection.

The prostate gland can be infected by STDs, resulting in prostitis or inflammation of the prostate.

Prostatitis and urethritis in STDs

Urethritis is a type of urinary tract infection that affects the urethra. The urethra is the opening tube that allows urine to flow from the bladder to the external body. Due to the proximity to the external environment, it is easily infected by STDs. Chlamydia and gonorrhoea remain two of the most common STDs associated with urethritis. However, there are other bacteria, such as syphilis, trichomonas, mycoplasma spp, ureaplasma spp, candida, etc that may contribute to urethritis symptoms. 

Abnormal urinary symptoms such as painful urination, itching or burning sensation, and discharge over the urethral can occur in untreated urethritis. Untreated STD-related urethritis can be associated with the further spread of the disease to the surrounding reproductive organ, resulting in peri-pelvic infection or abscess, urinary tract scarring, inflammation of the testicles and prostate, etc. These can all lead to penile discomfort, pelvic pain, and inflammation and again affect a person’s sexual function.

Thankfully, most STDs that affect male sexual function are treatable with the correct diagnosis and medications.

Effect of STDs on Women’s Sexual Function

STDs have been known to have a negative role in menstrual cycle and PMS.

Intermittent spotting, irregular period, pelvic inflammation in STDs

Although STD infections do not affect the female hormonal axis, they can be associated with abnormal vaginal discharge and spotting symptoms. One may notice spotting from light to dark brown/red discharge when they are not having their usual period or after intercourse. Less commonly, STDs can be associated with irregular periods or missed periods, though other causes such as pregnancy, PCOS (polycystic ovarian syndrome), or thyroid disorder should be considered as possible differentials as well.

In chronic untreated STD infections, one may develop more severe complications such as inflammation and scarring of the pelvis and reproductive organs, including the uterus, fallopian tubes, and ovaries. In such instances, the ovulation or menstrual cycle can cease to function, leading to clinical presentation of irregular or missed periods.

Common bacterial STDs can be associated with abnormal menstrual cycle or vaginal symptoms. STDs bacteria including chlamydia, HPV, gonorrhoea, trichomonas, and mycoplasma genetalium, are common culprits. Unfortunately, as most symptoms of abnormal vaginal discharge or abnormal menstrual spotting tend to be mild, one may delay seeking medical treatment. If it is a case of an untreated STD, delaying treatment increases the risk of long-term complications such as pelvic inflammatory disease and can affect future fertility. 

Untreated STDs can increase the risk of long-term complications such as pelvic inflammatory disease.

Possible exacerbation of PMS in STDs

Studies have shown that there may be a link between untreated STDs and worsening premenstrual symptoms (PMS). Premenstrual symptoms such as headache, sadness, and longer period of cramps are exacerbated by untreated STDs (such as chlamydia, herpes, HPV) based on a clinical study in Oxford using a period-tracker app for smartphones. 

The hypothesis suggests that with the associated inflammatory phase and falling of progesterone level prior to menses, STDs can worsen further this inflammation, hence, exacerbating PMS symptoms. 

Psychological toll of STDs on sexual function

Aside from the physical complications from STDs, these infections are also associated with negative psychological impacts. The way general society stigmatizes STDs, a person’s upbringing and cultural background may affect a person’s mental outlook against STDs.

Emotional responses such as anger, depression, guilt, shame, and isolation can occur. This can be followed closely with reduced self-worth, low self-esteem, anxiety, and depression when one is dealing with STD conditions. Over time, constant mental stress against STDs can be associated with restlessness and reduced sexual desire or satisfaction.

One may be scared of contracting STDs to the extent of being unable to be aroused sexually. In males, psychogenic erectile dysfunction can occur out of fear of STDs. In females, one can experience sexual dysfunction symptoms such as vaginismus, reduced libido, painful intercourse, etc.

Will my sexual dysfunction to improve following clearance of STD infections?

This will depend on the underlying cause of sexual dysfunction. If the root of the medical condition is due to underlying STD infections, treating or managing the underlying culprit STD infections is likely to improve a person’s overall sexual function. However, bear in mind that most cases of sexual dysfunction can be multi-factorial, and it may benefit to discuss your concerns with your doctor to address any other causes.

Bottom line:

  • STDs can affect a person’s sexual function.
  • In men, STDs can be associated with lower urinary tract abnormal symptoms and progressive inflammation affecting the surrounding reproductive organs such as the prostate and testicles, leading to low testosterone and erectile dysfunction issues.
  • In females, STDs potentially can disrupt the menstrual cycle, worsen premenstrual symptoms, and are known to cause pelvic inflammatory disease, which can eventually lead to infertility.
  • The psychological stress associated with untreated STDs can affect a person’s sexual outlook negatively.
  • Sexual dysfunction secondary to underlying STDs may improve following proper treatment and management of the disease.

 References

  1. Henkel R. Long-term consequences of sexually transmitted infections on men's sexual function: A systematic review. Arab J Urol. 2021 Jul 7;19(3):411-418. 
  2. Gomes AR, Souteiro P, Silva CG, Sousa-Pinto B, Almeida F, Sarmento A, Carvalho D, Freitas P. Prevalence of testosterone deficiency in HIV-infected men under antiretroviral therapy. BMC Infect Dis. 2016 Nov 3;16(1):628.
  3. Alexander Müller et al. Sexual dysfunction in the patient with prostatitis. Curr Opin Urol. 2005 Nov;15(6):404-9.
  4. Ma C, Cai Z, Xiong J, Li H. History of Prostatitis Is an Independent Risk Factor for Erectile Dysfunction: A Cross-Sectional Study. Biomed Res Int. 2020 Oct 17;2020:8964673.
  5.  Young A, Toncar A, Wray AA. Urethritis. [Updated 2022 Dec 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537282/
  6. Al-Farraj DA, Moubayed NM. The association between sociodemographic, hormonal, tubo-ovarian factors and bacterial count in Chlamydia and Mycoplasma infections with infertility. Saudi J Biol Sci. 2019 Jan;26(1):20-23.
  7.  Toth T, Senterfit LB, Ledger WJ. Secondary amenorrhoea associated with Chlamydia trachomatis infection. Br J Vener Dis. 1983 Apr;59(2):105-8.
  8. Jennings LK, Krywko DM. Pelvic Inflammatory Disease. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499959/
  9. Alvergne A, Vlajic Wheeler M, Högqvist Tabor V. Do sexually transmitted infections exacerbate negative premenstrual symptoms? Insights from digital health. Evol Med Public Health. 2018 Jul 3;2018(1):138-150.
  10. Singapore Ministry of Health. Blood-borne and sexually transmitted diseases.
  11. https://www.moh.gov.sg/docs/librariesprovider5/diseases-updates/blood-borne-and-sexually-transmitted-2017a3322a92d7c34c4280013fc8bc83fff7.pdf

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