Reproductive tract infections in women

Abstract

Reproductive tract infections (RTIs) are of significant public health concern. The bulk of their long-term morbidity disproportionately affects women. Consequently, research and public health efforts have focused on trying to minimize the burden of these infections in women. In this chapter, we focus on two agents that cause RTIs: Neisseria gonorrhoeae, a curable bacterial infection, and herpes simplex virus (HSV), a viral pathogen for which no cure exists. We have chosen these pathogens to highlight intriguing differences in epidemiology, clinical manifestations, and immunological responses noted between men and women. We begin by summarizing what we know about these infections in women and any existing differences between the sexes. Potential mechanisms that may explain the sex-based differences observed for these and other RTIs are evaluated. Such mechanisms consist of both behavioral (gender) and biological (sex) factors. Consideration of the role of mucosal immune responses, sex hormones, and the vaginal microbiome in mediating sex-based differences are suggested.