STDs

Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 

This is definitely a topic I don't want to think or write about, but because there will be some unfaithful spouses and innocent victims, it's important to address.  Readers should already be pretty well aware of risk factors and methods of prevention.  This article will cover identification and treatment.

Chlamydia and gonorrhea.  These diseases are caused by different bacteria, but they are discussed together because they sometimes appear together and because there will be no lab work to differentiate them.

In women, STDs are difficult to diagnose.  An STD must be considered in any woman with pain above the pubic bone, a low-grade fever, and offensive vaginal discharge.  Women may experience slight pain when urinating.  If the woman is pregnant and untreated, the baby's eyes can become infected, resulting in blindness.  However, many individuals will have no symptoms or only minimal symptoms.  Symptoms may not develop for weeks or months.  Sterility may result. 

Men may experience pain or difficulty when urinating.  Pus may drip from the penis and there may be painful swelling of the testicles.  Weeks or months later, one or both knees, ankles, or wrists may swell painfully.  Symptoms usually begin two days to three weeks after sexual contact.  Untreated, sterility may result. 


Women with an offensive vaginal discharge but no risk factors are more likely to have vaginal thrush or trichomonas.  These infections are treated with a single dose of tinidazole or a five-day course of metronidazole.

Treatment options for chlamydia include:

• Azithromycin, 1 gram, single dose;
• Doxycycline, 100 mg, twice per day, 7 days;
• Erythromycin, 500 mg, 4 times per day, 7 days;
• Levofloxacin, 500 mg, once per day, 7 days.(1)

Treatment options for gonorrhea are more limited, and gonorrhea strains are developing resistance.  The most commonly used antibiotics are intramuscular injections of cefixime.  Azithromycin is used in addition to those, in a 1 gram single dose, and may be effective on its own.(2)

Syphilis.  There are three stages to syphilis, three opportunities for identification.

• Primary syphilis presents with a painless penile ulcer, called a chancre, that looks like a pimple, a blister, or an open sore that appears a few weeks after sexual contact.  It's full of bacteria that are easily passed to another person.  In women, this chancre generally occurs on the cervix or vaginal wall and is usually unnoticed.  Both sexes may present with an enlarged lymph node in the groin.  This chancre lasts a few days to a few weeks and then disappears. 
• Secondary syphilis appears a few months later, often as a rash all over the body that may be painless or painful.  It can look like small, pus-filled spots, or ring-shaped welts, like hives.  It lasts a few weeks and then disappears.  
• Tertiary syphilis appears years later.  It affects the heart and brain primarily and will eventually kill the patient if untreated.  

Syphilis is best treated with intramuscular penicillin injections, an option unlikely to be available in a long-term collapse.  The Centers for Disease Control suggest azithromycin in a single two-gram dose for primary and secondary syphilis.  Doxycycline (100 mg, twice per day, 14 days) and tetracycline (500 mg, 4 times per day, 14 days) are other options, but not for pregnant women.(3)

If the infection was contracted more than one year previously, the standard treatment protocol is 1.2 million units of penicillin in each buttock, once per week, for three weeks.  Again, that may be difficult to come by.(4)  An alternative proposed in Where There Is No Doctor is tetracycline, 500 mg, 4 times per day, for 30 days.  Pregnant or breastfeeding women can take erythromycin in the same dosage as tetracycline.(5)

These are the most common STDs.  There are others, but they're difficult to diagnose without a laboratory and training.  Like with everything in medicine, threat avoidance is best.  

For further reading:
Survival and Austere Medicine, 3rd Edition, pp 138-40.
(1)  https://www.cdc.gov/std/tg2015/chlamydia.htm
(2)  https://www.cdc.gov/std/tg2015/gonorrhea.htm
(3)  https://www.cdc.gov/std/tg2015/syphilis.htm
(4)  https://www.cdc.gov/std/tg2015/gonorrhea.htm
(5)  Where There Is No Doctor, p 238.