There’s  A Problem Down There – Part 2
                                                                                                                      April 14, 2021



 Hey Everyone!  I’m Dr. Jasmine Bookert aka Dr. Jazz.  So, this is part two of There’s a Problem Down There. Sexually Transmitted Infections can be serious, and can have long lasting effects. But before we get into the blog let me say that this blog is NOT medical advice. This blog is for educational and informational purposes. If you have medical concerns or need medical advice, please consult your physician for appropriate evaluation and treatment.  So, now back to this post.


Sexually transmitted infections

In this post I will abbreviate sexually transmitted infections as STIs. Now let’s go over three different STIs that may cause a discharge.  Frequently these three STIs do not cause a discharge which is why you may not know you have an infection. Due to the possibility of having an asymptomatic infection, using protection and having regular evaluations for STIs is important. I frequently test for all three in the emergency department.




First up is Trichomoniasis. This STI is caused by Trichomonas Vaginalis, which is a protozoan parasite. Often patients will be asymptomatic.  Infection is more common in women than men.  It is the most common curable STI.  Signs and symptoms can be itching or irritation in the genitals, burning with urination, and vaginal or penile discharge. Trichomoniasis can lead to preterm labor in pregnancy.  Treatment is metronidazole or tinidazole which are taken orally.  To avoid reinfection, all sexual partners need to be treated. It is also important to get tested after treatment to make sure the infection is resolved. 




Next, is Gonorrhea. Most people have at least heard of gonorrhea. It is another common STI that can cause infection in the genitals, rectum, and throat.  If you are sexually active, especially if with multiple partners, or high risk partners, you should get tested yearly at a minimum.  Women are often asymptomatic, but can have pain with urination, vaginal discharge, or irregular vaginal bleeding. Untreated, this can lead to pelvic inflammatory disease (PID) which can cause serious complications. Men may have burning with urination, penile discharge, and pain or swelling in the testicles. There are also specific symptoms if there is an anal or throat infection. Gonorrhea can be transmitted to an infant during delivery which is why it is important to have screenings during pregnancy. Testing can be done with a urine test or by swabbing the area of infection. Treatment includes antibiotics, usually intramuscular ceftriaxone. 




Last, is Chlamydia.  Chlamydia can be spread by vaginal, anal, or oral sex. Occurs in men and women. Symptoms are similar to the other STIs: genital discharge and burning with urination.  If there is an anal infection, a patient may have rectal bleeding, discharge, or pain.  Chlamydia may lead to preterm labor or cause infection in newborns.  Testing is the same as for gonorrhea- urine or swab. PID is a complication with this infection as well, which can affect fertility or cause chronic pelvic pain. Due to increased resistance to azithromycin (one time dose antibiotic for chlamydia), now the most recent recommendation is to use doxycycline, which is taken orally twice daily for 7 days. At one time it was almost standard to treat gonorrhea and chlamydia together, hence the term GC, but now it is recommended to just treat each one independently, unless there is definitive reason to treat both. 


So key things to remember about these three STIs:


1. They are treatable.

2. May or may not have symptoms

3. Should be screened at least yearly if risk warrants

4. There may be co-infections

5. Affect pregnancy

6. Increase risk of contracting HIV





So that is the quick rundown on trichomoniasis, gonorrhea, and chlamydia. The most important take away is to practice safe sex and get tested.  If you want to give some feedback on the blog or if you have suggestions for a new topic to discuss, drop me an email. You can email me at, and follow my social media pages for my podcast on Instagram and Facebook, @thebreakdownwithdrdiagnosis. There you can find the link to my podcast website and subscribe to the podcast. I would love for you to check in with me and my guests regularly to get the breakdown on a new diagnosis every episode. And remember, go check out the telemedicine company, Dr. Diagnosis. Please follow Dr. Diagnosis on Instagram, Facebook, and Twitter, @diagnosemenow. And even if you don’t need to see a provider at Dr. Diagnosis, please check out the website at We have plenty of resources and links about COVID-19, influenza, mental health, and other topics. Until next time, stay safe and keep you and your loved ones healthy. See you soon!