In recent years, there has been a large increase in the number of sexually transmitted infections (STIs) in the UK. The number of people diagnosed with chlamydia, the most common STI, tripled between 1995 and 2005.
Symptoms
The following symptoms could indicate that you have an STI:
* an unusual discharge from the vagina, penis or anus
* bleeding after sex or between periods
* sores, blisters, warts, rashes, irritation or itching near the genitals or anus
* pain on passing urine, or needing to pass urine more often
* pain during sex
* pelvic or lower abdominal pain
* infection in the rectum or throat
You may have an STI but have no symptoms. It's important to be tested if you think you may be at risk of an STI. If untreated, STIs like gonorrhoea and chlamydia may lead to pelvic inflammatory disease in women, which can damage the fallopian tubes and cause pain, ectopic pregnancies and infertility. Men can also experience complications, such as inflammation in the testicles or prostate gland, and painful erections.
Causes
Most STIs are caused by micro-organisms such as bacteria (eg chlamydia, gonorrhoea) or viruses (eg genital herpes, genital warts, HIV, hepatitis B). These infections can be passed from one person to another during intimate physical contact. Sexual intercourse, non-penetrative genital contact, sex toys shared between partners and oral sex can all transmit an infection.
Diagnosis
If you think you may have an STI you can see your GP, visit a genitourinary medicine (GUM) or sexual health clinic.
You can make your own appointment at a GUM or sexual health clinic. All visits are confidential and you don't have to give your real name. Details are not sent to your GP without your consent.
Tests often include a physical examination, which for women may be an internal examination. Swabs (to get cells or traces of infection), blood and urine samples may also be taken.
Commonly Occurred STIs
This list covers some common STIs, but there are around 25 in total. If you have one infection, you may be more likely to catch another, more serious, one.
Chlamydia
Chlamydia is the most common STI and it is thought to affect approximately one in 100 sexually active people under the age of 25. The bacteria infect the cervix, urethra, rectum, throat and eyes. Symptoms usually occur one to three weeks after infection.
Up to eight in 10 women with the infection have only mild symptoms or none at all. In women, symptoms include lower abdominal pain, bleeding after sex, bleeding between periods, unusual vaginal discharge or pain when passing urine. Symptoms in men include, discharge from the penis and pain on passing urine. Approximately half of all men with the infection have symptoms.
If you have a rectal infection you may have discharge, pain, inflammation and sometimes bleeding from the anus. If untreated in women, chlamydia can cause pelvic inflammatory disease which can affect your fertility. Men can develop testicle pain and Reiter's syndrome (arthritis).
Chlamydia can be treated with antibiotics.
Genital herpes
Genital herpes is caused by the herpes simplex virus (HSV). The first (primary) episode usually causes painful ulcers or sores in or around the anus or genital area. You may also have pain on passing urine and a stinging or tingling in the anus or genital area. You may feel generally unwell. A number of people don't have any symptoms or have sores that are not painful.
Some people may have repeat attacks of herpes. These don't tend to be as severe as the first attack.
Cooling the area with ice or cold water or bathing in a salt bath can relieve symptoms. Using a topical anaesthetic, such as lidocaine gel or applying petroleum jelly (eg Vaseline), can be soothing. Treatment with an antiviral drug (eg acyclovir) reduces the severity and duration of symptoms in both the first and repeated outbreaks of infection.
Non-specific urethritis
A number of things may cause non-specific urethritis such as STIs (eg gonorrhoea), another bacterial infection, injury to the urethra or a urinary infection.
Non-specific urethritis occurs in men and is the inflammation of the urethra (the tube that goes from the bladder through the penis). Symptoms include discharge, itching at the end of the penis, pain on passing urine and an increase in urine.
Non-specific urethritis can be treated with antibiotics if it is caused by bacteria.
Pubic lice
Pubic lice mainly live in pubic hair, but they can infect other body hair, eyebrows and eyelashes. They lay eggs (nits) that stick to the hairs. Itching and inflammation is a common symptom, you may also notice black powdery spots from the lice in your underwear. Lice are usually passed via sexual or intimate contact with somebody, but can live on bed sheets or clothes and occasionally be passed this way.
Treatment is with lotions or shampoos, which may have to be reapplied after seven days. Lice can live in bedding and clothing so these should be washed at a high temperature (50°C) to kill the lice preventing re-infection.
Trichomoniasis
Trichomoniasis is caused by the Trichomonas vaginalis parasite. It infects the penis, bladder and the vagina. Women usually have itching and soreness in and around the vagina and an unusual discharge which may be yellow, smelly or frothy.
Men may have inflammation of the foreskin and discharge from the penis. Men and women may experience pain when passing urine. Up to one in two people don't have any symptoms.
Trichomoniasis can be treated with antibiotics.
Genital warts
Genital warts are caused by certain strains of the human papilloma virus (HPV). They are fleshy growths found on or around the genitals and anus. Sometimes they can be found on fingers and in the mouth or throat. The warts are usually painless but can itch and may bleed or become inflamed.
Warts can be treated by applying a chemical solution or using liquid nitrogen (cryotherapy). Surgery or laser treatment may also be used. Repeat treatments may be needed to get rid of the warts. You shouldn't use treatments designed for removing warts on other parts of the body (such as feet and hands), as they are too harsh for the genital area.
Gonorrhoea
Gonorrhoea is a bacterial STI that infects the urethra, cervix, rectum, mouth and throat. Around half of all women with gonorrhoea won't have any symptoms. Women may notice an increase in vaginal discharge and pain on passing urine if they are infected. Lower abdominal pain and bleeding between periods or heavier periods may also occur.
Men tend to have a white, yellow or green discharge from the urethra and pain on passing urine. One to two in every 10 men have no symptoms. Non-genital infections often have no symptoms. Rectal infection may cause discharge, pain or discomfort and itching. The throat and eyes can also be affected.
Gonorrhoea can lead to pelvic inflammatory disease in women if it's not treated. This can cause infertility and long-term pelvic pain. Men can develop painful erections and infections in the testicles and prostate gland, which may cause infertility. Skin problems and inflammation of joints may also occur. On rare occasions gonorrhoea can cause inflammation of the heart, a type of liver disease and meningitis. Ask your nurse or doctor to explain this risk to you. Gonorrhoea can be treated with antibiotics, in tablet form or as an injection.
Syphilis
Syphilis is a bacterial infection. The first sign of syphilis is a raised lump or lesion usually found on or near the genitals or anus which may then form a painless sore. This can take one to 12 weeks to develop, and may be followed by a general feeling of being unwell with symptoms such as fever, headache and tiredness. You may notice white patches on your tongue or on the roof of your mouth.
These symptoms may gradually clear up but it's important to treat syphilis as soon as possible. Over time it can cause major health problems, such as damage to organs, bones and the nervous system.
Today, very few people get syphilis. However, recent outbreaks have occurred causing a 15-fold increase in the number of infections. Early syphilis can be cured with antibiotics, in tablet form or as an injection. Later syphilis can also be treated.
HIV/AIDS
The human immunodeficiency virus (HIV) attacks the immune system. Please see Related topics.
Hepatitis B
The hepatitis B virus (HBV) is highly infectious and causes hepatitis B. Please see Related topics.
Prevention
Simple measures can reduce the risk of catching an infection. Safer sex methods include using condoms for vaginal, anal and oral intercourse and when sharing sex toys. This can help prevent the spread of HIV and reduce the risk of many STIs. Reducing the number of partners also reduces overall risk.
Previous partners who may be at risk should be contacted to prevent further spread of infection. Clinics can send anonymous notifications on your behalf if you are willing to provide details.
People who are at increased risk of catching an STI, such as those who change sexual partners frequently, should consider having a check-up at the GUM clinic every few months. Once diagnosed with an STI, you should wait until the doctor gives you the 'all clear' before you resume sexual relations."
