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A Teen's Worst Nightmare Sexually transmitted diseases are infectious diseases that can be spread by sexual contact. Some can also be transmitted by non-sexual ways, but these make up a minority of the total number of cases. An estimated ten to twelve million Americans have sexually transmitted diseases (1,). Sexually transmitted diseases in the United States affect sexes, all races, and every economic stature. STD's come from different sources. Some are epidemic like gonorrhea, infections of the urethra, genital herpes, and genital warts. As the chart displays this type of information some diseases are caused by a bacterium such as Chlamydeous, and others are from protozoan or yeast. Many of these infections are transmitted largely by sexual contact with an infected person. The practice of anal and oral sex also leads to cases of anal and oral infections (4). Gonorrhea, syphilis, and chlamydeous infections can also be transmitted from a pregnant woman to her infant, either in the uterus or during birth. Sexually transmitted diseases are very hard to control. Some public officials attribute the increase in many of these diseases to increasing sexual activity. Others say the replacement of the condom with birth control pills and diaphragms might also increase the risk of STD's (4). "Many STD's are transmitted more efficiently from men to women than the reverse, perhaps because the vagina serves as a reservoir that prolongs exposure to infectious secretion (1,)". The physical examination of patients with STD or at risk is a simple procedure. All patients require inspection of the entire skin surface. At a minimum they carefully inspect all skin surfaces that are uncovered or exposed during genital examination. This includes the face, head, hands, lower arms, lower trunk, pubic area, thighs, mouth and throat. Also checked in men are the genitals and the pubic and inguinal regions, the penis, urethra, urethral bulb, and thescrotum are checked for tenderness and other abnormalities (4).