Introduction Description: Varicose veins are dilated, elongated, and tortuous superficial veins with incompetent or congenitally absent valves. Although these may occur anywhere in the body, they are most common in the legs, where gravity produces reverse flow. Varicose veins are five times more common in women than in men. Prevalence: 20% of adults; one of two people older than 50 years. Predominant Age: Middle age and…

Introduction Description: An infection of the urinary tract causes urethritis, cystitis (including trigonitis), or pyelonephritis. Urinary tract infections (UTIs) are much more common in women because of their shortened urethral length and exposure of the urinary tract to trauma and pathogens during sexual activity. Prevalence: Observed in 3%–8% of patients (second most common type of infection in the body; accounts for 8.3 million visits per year),…

Introduction Description: Urinary incontinence is a sign, symptom, and disease all at the same time. Urge incontinence is the involuntary loss of urine accompanied by a sense of urgency or impending loss and is associated with increased bladder activity. Prevalence: Urge incontinence accounts for 35% of patients with incontinence. Predominant Age: Mid-reproductive age and older. Urge incontinence becomes more common during the 40s and beyond and…

Introduction Description: Urinary incontinence is a sign, symptom, and disease all at the same time. Stress incontinence is almost exclusively limited to women and is the passive loss of urine in response to increased intraabdominal pressure, such as that caused by coughing, laughing, or sneezing, in the absence of bladder contraction. The volume of urine lost is generally proportional to the amount of pressure involved. Prevalence:…

Introduction Description: Urinary incontinence is a sign, symptom, and disease all at the same time. Bypass incontinence is continuous incontinence that occurs when normal continence mechanism is bypassed, as with fistulae. Symptoms may be intermittent or continuous, making the establishment of a diagnosis difficult in some patients. Overflow incontinence is the continuous or intermittent insensible loss of small volumes of urine, resulting from an overfilled or…

Introduction Description: Ulcerative colitis is an inflammatory bowel disease that is characterized by inflammation limited to the mucosa of the large bowel and is primarily found in the descending colon and rectum (although the entire colon may be involved). The disease is also characterized by intermittent bouts of symptoms interspersed by periods of quiescence. Prevalence: About 1 million people in the United States are affected. The…

Introduction Description: Toxic shock syndrome (TSS) is caused by toxins produced by an often-asymptomatic infection with Staphylococcus aureus defined by sudden onset of shock, organ failure, and frequently death. Although most commonly associated with prolonged tampon use, approximately 50% of TSS cases are now associated with other conditions. Prevalence: Observed in fewer than 1/100,000 women aged 15–44 years (last active surveillance was conducted in 1987—there are…

Introduction Description: Thrombophlebitis is an inflammatory condition of the veins with secondary thrombosis. This may occur in two forms: aseptic or suppurative (septic). The vessels may be either superficial or deep. Risk factors may be present, or the onset may be idiopathic. Risk varies with the location and cause. Prevalence: Two million cases per year in the United States; 10% of nosocomial infections, intravascular (venous or…

Introduction Description: Infection by the anaerobic flagellate protozoan Trichomonas vaginalis is most often acquired by sexual contact with an infected person. Prevalence: Approximately 3.7 million cases per year in the United States (2.1% of women); accounts for 25% of “vaginal infections.” The most common nonviral sexually transmitted infection (STI). Predominant Age: 15–50 years, but it may occur at any age. One study found a peak rate…

Introduction Description: Since antiquity, syphilis has been the prototypic venereal disease. This disease presents with an easily overlooked first stage and, if left untreated, can slowly progress to a disabling disease noted for central nervous system, cardiac, and musculoskeletal involvement. Prevalence: Increasing; in 2019, 129,813 cases of all stages of syphilis, were reported, including 38,992 cases of primary and secondary (P&S) syphilis reported in the United…

Introduction Description: Phthirus pubis (pubic or crab lice) and Sarcoptes scabiei (scabies or itch mite) are parasitic insects that may be transferred through sexual activity or contact with contaminated clothing or bedding. Prevalence: Three million cases per year in the United States. Predominant Age: Reproductive age. Etiology and Pathogenesis Causes: Parasitic insects P. pubis (pubic or crab lice) and S. scabiei (scabies or itch mite). P.…

Introduction Description: Molluscum contagiosum is a papillary lesion caused by viral infection (poxvirus) that is spread by skin-to-skin contact, first described in 1817. Prevalence: 2/100,000; 1 of 40–60 patients with gonorrhea; approximately 1% of all skin disorders in the United States. Predominant Age: Early reproductive age. Genetics: No genetic pattern. The virus shares one-half of the genes found in variola and vaccinia viruses. Etiology and Pathogenesis…

Introduction Description: Lymphogranuloma venereum (LVG) is a potentially destructive infection caused by a number of serotypes (L-1, L-2, L-3) of Chlamydia trachomatis. Although uncommon in the United States, this infection causes significant morbidity. Prevalence: Uncommon; <100 cases per year in the United States; endemic in parts of Africa, India, Southeast Asia, South America, and the Caribbean. Predominant Age: Younger reproductive age. Genetics: LVG is 20 times…

Introduction Description: Infection by one or more subtypes (of the more than 100 known) of human papillomaviruses (HPVs) causes epithelial proliferations at cutaneous and mucosal surfaces. Some serotypes are associated with warty growths on the hands, feet, and other locations (including genital warts). Some high-risk serotypes are found in more than 99% of cervical cancers. Prevalence: Considered to be the most common sexually transmitted infection (STI)…

Introduction Description: Infection by the human immunodeficiency virus (HIV) preferentially involves the immune system and leads to progressive deterioration in immune function. Infection produces a spectrum of disease that progresses from a clinically latent, asymptomatic state to acquired immune deficiency syndrome (AIDS) as a late manifestation. The speed of this progression varies. In untreated patients, the time between infection and the development of AIDS ranges from…

Introduction Description: Infection by the herpes simplex virus (HSV) results in recurrent symptoms that range from uncomfortable to disabling. There is a particular risk to neonates when herpes infection occurs during pregnancy. Prevalence: Most common cause of genital ulcers. 45–50 million recurrent cases; 1.6 million new cases per year; one in four women have been infected. Roughly 12%–21% of individuals 14–49 years. Predominant Age: 15–30 years…

Introduction Description: Granuloma inguinale (also called Donovanosis) is relatively common in the tropics, India, Papua New Guinea, South Africa, and Caribbean areas but accounts for fewer than 100 cases per year in the United States. This infection is caused by the intracellular gram-negative bacterium Klebsiella granulomatis (formerly known as Calymmatobacterium granulomatis ). Prevalence: Uncommon; 100 cases per year in the United States; up to 25% of…

Introduction Description: Infection with Neisseria gonorrhoeae, a gram-negative intracellular diplococcus, remains common. Prevalence: In 2019 a total of 616,392 cases of gonorrhea were reported in the United States, and the national gonorrhea rate increased to 152.6 cases per 100,000 women. Before COVID-19, it was the second most commonly reported communicable disease. Predominant Age: 15–30 years (85%); highest prevalence at ages 15–19 years. Genetics: No genetic pattern.…

Introduction Description: Condylomata acuminata are raised, warty lesions caused by infection by the human papillomavirus (HPV, singular: condyloma acuminatum). Prevalence: Most common sexually transmitted infection (STI), 500,000 cases per year. Women account for two-thirds of cases. HPV is responsible for >20,500 virus-related cancers in women each year. At least 75% of sexually active adults in the United States have been infected. Predominant Age: 16–33 years; peak…

Introduction Description: The most common bacterial sexually transmitted infection (STI) is that caused by Chlamydia trachomatis. More common than Neisseria gonorrhoeae by 3-fold, infections caused by C. trachomatis can be the source of significant complications and infertility. Prevalence: 20% of pregnant patients and 30% of sexually active adolescent women. Up to 40% of all sexually active women have antibodies, suggesting prior infection. In 2019 a total…