Dr. Daniel Yankov: Chlamydia leads to sterility if neglected

Dr. Daniel Yankov: Chlamydia leads to sterility if neglected
Dr. Daniel Yankov: Chlamydia leads to sterility if neglected

In this interview with Dr. Yankov, we emphasize what is characteristic of the most common sexually transmitted diseases, but we will also pay attention to the post-covid complaints of patients.

Dr. Yankov, what are the most common skin-venereal diseases?

- I will start with one of the most common diseases of this group in men. It is about balanitis. This is a disease that occurs with inflammation of the genitals. I hasten to clarify right away that balanitis in men is not necessarily sexually transmitted. It can also be caused by various bacteria and fungi that a person can get in other ways.

I, for example, have repeatedly detected diabetes mellitus in men with a severe form of balanitis on the genitals. In a sense, I suspected, and subsequently proved correct, that these patients were hyperglycemic. What is interesting in this case is that they do not know that they have developed diabetes. Accordingly, when examining the blood sugar level, it is found that they have diabetes, as a result of which they develop severe forms of fungus. They, in turn, manifest themselves in the form of various balanitis.

In this regard, there is another disease of this group, again in men, which is worth mentioning, although it is less common. It is about sclerosis of the penis. Also a very interesting disease, which occurs with a violation of the integrity of the foreskin on the penis, as a result of which it begins to lose its elasticity. In the beginning, the disease can be treated with different types of creams. If it starts to progress a lot, it is also necessary to cut out part of the cuticle. So, this is another male-specific disease in this area.

What is the most common STD in both sexes?

- Perhaps the most common of the sexually transmitted diseases is chlamydia. For example, the so-called chlamydia-trachomatis is a causative agent that occurs quite often. It is primarily sexually transmitted. In order to check the carrier of this agent, various tests are applied. For example, the immunoglobulin in the body is measured. It is important to note that both partners must be treated at the same time. Several courses of treatment are carried out over several months. The treatment is really long, but good results are achieved.

How does this disease manifest itself? What is the clinical picture?

- Chlamydia acts as an intracellular microorganism, i.e., inside the cell. Usually the complaints are more discreet: slight burning, slight irritation; some light urethral discharge in the man and correspondingly light vaginal discharge in the woman. The disease is proven by blood serum tests to look for immunoglobulins. Sometimes, if the disease continues for a long time, it can lead to sterility in both men and women.

I want to note that chlamydia infection can be asymptomatic, that is, there are no complaints. And it's found randomly. The patient heard about this disease and decided to get tested. Then it can be detected and diagnosed. Or the dermatovenerologist refers him to establish the diagnosis. But many times, as I mentioned, the patient does not have any complaints, that is, he is only an asymptomatic carrier, and the disease at the same time can spread and, accordingly, damage various organs.

Could you also list the less common STDs, if any?

- There are less common diseases in this area. For example, gonorrhea (popular among people as triper). With him, the manifestations are much more intense and abundant: such as discharge of purulent discharge and severe pain - occurs spontaneously or during urination. This disease can also be detected and diagnosed by carrying the gonococci. Treatment is carried out accordingly. The injection form of treatment gives the fastest result, but therapy can also be carried out with tablets.

And are there sexually transmitted diseases that can lead to severe complications, if, of course, they are not diagnosed and treated in time? Including. and malignant?

- No, STDs cannot turn malignant. But, as I already mentioned, it can lead to sterility. Which is pretty serious. They can even cause an abscess in the lower parts of the abdominal cavity

Such a severe condition can cause the gonorrhea we just talked about. It can lead to an abscess in the excretory system - of the bladder, of the kidneys, of the ovaries. It depends on how far the infection has progressed, how long it has been present in the body, what the immunity is like, whether he will react with any complaint or only with carriage. These are already serious consequences for the patient.


The truth is that gonorrhea still exists now, as it once did. It's not that common anymore, but it's not that rare either. The reason is that patients began to self-medicate. I mean this: every second patient with gonorrhea has been treated with something. And whether he somewhat extinguished the disease or just masked it, the consequences are for the patient. For this reason, the feeling is created that this disease does not occur so often. Patients drink antibiotics, and horribly, hoping to get the situation under control. But all over the world, antibiotics are prescribed only with a doctor's prescription, while here everyone can buy whatever antibiotic they want.

There are patients who took 5-6 types of antibiotics before coming to me. But after taking 5-6 types of antibiotics, the body has become resistant, resistant, and then it will be much more difficult to catch the infection. And it will be much more difficult to influence.

After all, there are also responsible people who come to the first complaints. There are also those who self-medicate for a long time, and the consequences, as I have already mentioned, are quite serious and are at the expense of the patient.

What is the most characteristic thing to know about sexually transmitted diseases from the point of view of prevention?

- Regarding sexually transmitted diseases, I advise to consult a specialist for any atypical complaint that appears: such as a rash; as a type of secretion that is released or as a type of entity. For example, condylomas - pointed warts - an extremely common manifestation.

Patients come with hundreds of warts We have discussed this topic with you and the trend has not changed much. The disease remains extremely prevalent. A young, intelligent and responsible person cannot see these warts (they turn from one to two, three, dozens) and say that this is something that will pass by itself. And in the end, the treatment is long and persistent.

Furthermore, the organism has already become infected and the immunity decreases. That's why it becomes extremely difficult, sometimes for months it has to be treated. So, the main recommendation: if you notice something atypical on your skin and body, something you haven't had before, to contact a dermatovenerologist, that is, a specialist in skin and sexually transmitted diseases.

Because a tumor is removed immediately without infecting the surrounding skin. While dozens and hundreds of formations are removed very slowly and with difficulty. And then they relapse again, that is, they appear again, since the body already has a weaker immunity.

Dr. Yankov, what is characteristic of the cases in your practice lately?

- The new thing - since the winter and until now, is the severe hair loss due to the covid-infection. Mostly in women who have had a previous illness. I have many such patients with severe hair loss in my office every day.

Men usually have male pattern baldness, so they hardly came with this kind of complaint. There have been women whose crowns literally show through at the first examination. Especially if the woman has thinner hair. That is, very intense hair loss over a period of one to two months. It usually occurs around the second-third month after relapse.

I would like to point out, however, that there is almost no patient in whom we have not been able to stop hair loss. This is important to know. We apply therapy. It is difficult for me to say how far complete recovery is achieved, but in all patients I have been able to cope with the appropriate therapy. This is the interesting thing from the last months. And other colleagues share about such patients.

And do you have patients who have delayed diagnosis and, accordingly, treatment because of this long pandemic?

- Of course I have. There are those who are afraid to even come for an examination, and this accordingly gives some reflection of their underlying illness. There are also people in bed, at home. I have not refused an examination at home either, because there are people with difficulty moving or those who cannot go out for another reason. Yes, there are patients in whom the underlying disease has progressed due to the fear of contact with other people, but in the end, the consequences are more severe than the disease itself sometimes.

Some have gotten used to the prolonged epidemic, but others cannot. Again, in this connection, I want to say one more thing. There are also diseases that cause phobia, including and in our medical field. For example, venerophobia and acarophobia. Very interesting phobias. Our patients who think they have a venereal disease or scabies, for example.

This is the first time I hear that such phobias also exist…

- I have a patient who has come to me at least 10 times. And I know that she went to see other colleagues many times. She comes to me dozens of times for examination with the worry that she has scabies. After the treatment (because there may not have been scabies at all, but we assume there was the first time) the disease goes away. This is a relatively common disease, sometimes several patients with this diagnosis pass through in just one day.

This disease is cured in 4 days with the right treatment. Regarding these patients I am talking about, they develop a feeling that they are not cured. As with any minimal itch, any simple pimple, this patient thinks it's scabies

This is called acarophobia, that is, fear of mites and in this case - of the cause of scabies. And begins an endless visit to doctors, who in this case can hardly help. In true acarophobia, when there is some scratching and wounding, we treat it together with psychologists or psychiatrists.

What are venerophobia patients afraid of that you also mentioned?

- Another very common phobia is the fear of venereal diseases. It is very common in young boys and men. If, for example, he was once sick with something and it passed, the fear and thought that there might be an infection leads to venerophobia. We are talking about ordinary balanitis, which can also happen in a banal way. It can occur when washing with the wrong soap or gel, for example. Or if he had contact with an unknown partner.

After that, the fear is already increasing and the thought that there may be an infection even when conducting an examination, after applying treatment, even without any complaints, this person after some time develops this phobia. Fear that he has a venereal disease. He begins to imagine that any itching or rash indicates a venereal disease.

Begins going to various laboratories by the patient himself and an uncontrollable desire for research. As well as for treatment by different doctors. There are patients who end up with full psychiatric help when developing venerophobia because the dermatologist has nothing more to help. It's a mental illness now.

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