Sexually Transmitted Infections

Syphilis is a bacterial infection that in the early stages causes a painless, but highly infectious, sore on your genitals or around the mouth. The sore can last up to six weeks before disappearing.

Symptoms of Syphilis

During the primary stage of infection, you may not necessarily have any symptoms. Some people have none at all.

You may get small, painless sores or ulcers that usually appear on the penis, vagina, or around the anus. These can also occur in other places such as the mouth. You may get a blotchy red rash that often affects the palms of the hands or soles of the feet

Some people experience small skin growths (similar to genital warts) that may develop on the vulva in women or around the anus in both men and women.

Secondary symptoms such as a rash, flu-like illness or patchy hair loss may then develop. These may disappear within a few weeks, after which you’ll have a symptom-free phase.

The late or tertiary stage of syphilis usually occurs after many years, and can cause serious conditions such as heart problems, paralysis and blindness.

Causes of Syphilis

Syphilis is mainly spread through close contact with an infected sore.

This usually happens during vaginal, anal or oral sex, or by sharing sex toys with someone who’s infected. Anyone who’s sexually active is potentially at risk.

Pregnant women with syphilis can also pass the infection to their unborn baby. Read more about Syphilis in pregnancy below.

It may be possible to catch syphilis if you’re an injecting drug user and you share needles with somebody who’s infected, or through blood transfusions (this is very rare in the UK as all blood donations are tested for syphilis).

Syphilis can’t be spread by using the same toilet, clothing, cutlery or bathroom as an infected person.

Testing for Syphilis

The symptoms of syphilis can be difficult to recognise. A simple blood test can usually be used to diagnose syphilis at any stage.

Treatment for Syphilis

The condition can be treated with antibiotics, usually penicillin injections. When syphilis is treated properly, the later stages can be prevented.

Preventing Syphilis

Using the male condom or Femidom (the female condom) reduces the risk, but only if the condom covers the sores or rash. Avoid touching the sores or the rash.

Gonorrhoea is a bacterial STI easily passed on during sex. About 50% of women and 10% of men don’t experience any symptoms and are unaware they’re infected.

Signs and Symptoms of Gonorrhoea

In women, gonorrhoea can cause pain or a burning sensation when urinating, a vaginal discharge (often watery, yellow or green), pain in the lower abdomen during or after sex, and bleeding during or after sex or between periods, sometimes causing heavy periods.

In men, gonorrhoea can cause pain or a burning sensation when urinating, a white, yellow or green discharge from the tip of the penis, and pain or tenderness in the testicles.

It’s also possible to have a gonorrhoea infection in your rectum, throat or eyes.

Testing for Gonorrhoea

Gonorrhoea is diagnosed using a urine test or by taking a swab of the affected area. The infection is easily treated with antibiotics, but can lead to serious long-term health problems if left untreated, including infertility.

Using the male condom or Femidom (female condom) reduces the risk of picking up or passing on Gonorrhoea, but doesn’t eliminate it entirely.  It can also be passed on via oral sex, so using flavoured condoms or dental dams can help reduce the risk.

Treatment for Gonorrhoea

Treatment usually consists of an antibiotic injection followed by an antibiotic tablet. You can sometimes have 2 tablets instead if you prefer. You should start to feel a reduction in symptoms within a few days but it can take up to 2 weeks for pelvic or groin pain to completely disappear. You will usually go back to your clinic 2 weeks later for further tests which will ensure your body has cleared the infection.

Preventing Gonorrhoea

You should avoid having sex until you have been cleared of infection. Gonorrhoea is very easily transmitted via sexual contact, so your sexual partners should all be tested too. Clinics offer a partner notification service where they contact people you feel may have been at risk, and advise them to come and test. Your name will not be mentioned. so your own confidentiality will be maintained.

Pubic lice are very small, crab-like insects which live in pubic hair, underarm hair, hairy legs and chests and sometimes in the eyebrows or facial hair- but not in hair of the head.

Public lice are not necessarily sexually transmitted, but are passed on through close body contact.

Signs and symptoms of pubic lice

You may not notice that you have pubic lice, but people usually experience the following symptoms:

  • – Itching in the affected areas.
  • – Irritated skin from the itching.
  • – Sky-blue spots or specks of blood on the skin from where the lice have bitten you.
  • – Black powder in your underwear , caused by lice droppings
  • – Brown eggs on pubic or other boy hair.

The causes and how its passed on

They can be spread by having close body contact with someone who has them and will crawl from hair to hair. They can also be spread through close body contact including vaginal, anal, or oral sex and they may be passed on by sharing towels and bed linen.

Pubic lice cannot transmit HIV or other STI’s.

Condoms and other forms of contraception will not protect you from pubic lice.

If you get them, you can prevent them being passed onto others by:

  • – washing bedding, towels and clothes on a 50 degree wash -which kill the lice and their eggs.
  • – ensure anyone who you have had close contact with is treated. This includes sexual partners from the last 3 months and everyone in your household.

Testing for pubic lice

If you think you may have pubic lice, you will need to visit a GUM, or sexual health clinic, or your local GP surgery.

There is no test for pubic lice but its easy for a health professional to diagnose by examining the areas. They will be looking for the lice and their eggs.

Treatment of pubic lice

Treatment can be done at home using an insecticide cream, lotion or shampoo. This treatment can be a prescription or over the counter at a pharmacy.

In most cases the treatment is applied to the affected areas. Some have to be applied to the whole body and some have to be repeated. You can treat pubic lice if you are pregnant or breastfeeding, but do let your doctor, nurse or pharmacist know.

Avoid having close body contact until you and your partner have completed treatment. This includes any sexual activity.

If left untreated the lice may spread to other parts of the body. Pubic lice will not go away without treatment.

Shaving off pubic hair will not get rid of the lice.

Genital warts are caused by the human Papillomavirus (HPV) and are small fleshy bumps, or skin changes that appear on and around the genital or the anal area. The warts are usually painless and do not pose a serious threat to health.

Genital warts are the second most common sexually transmitted infection in England, after Chlamydia. 

Signs and symptoms of genital warts

Most people who have an HPV infection will not develop any visible warts. If genital warts do appear, it can be several weeks, months or years after you first came into contact with the virus.

If warts do appear, they can either appear on their own, or in clusters of multiple warts that grow together to form a kind of ‘cauliflower’ appearance.  If they are inside the anus or inside the vagina or on the cervix you may not know they are there.

Warts in women

The commonest places for genital warts to develop in women are:

  • – around the vulva (opening of the vagina)
  • – on the cervix ( the neck of the womb)
  • – inside the vagina
  • – around or inside the anus
  • – on the upper thighs

Warts in men

The commonest places for genital warts to develop in men are:

  • – anywhere on the penis
  • – on the scrotum
  • – inside the urethra (tube where urine comes out)
  • – around or inside the anus
  • – on the upper thighs

The causes and how it is passed on

The most common way for HPV to be passed on from person to person is through skin-to-skin contact. This  is usually through sexual activity such as:

  • – Vaginal sex
  • – Anal sex
  • – Sharing sex toys
  • – Non-penetrative genital to genital contact in very rare cases, oral sex.

HPV is not passed on through kissing, hugging or sharing towels, clothing and everyday items such as cutlery or toilet seats.

A condom can help protect against genital warts but the virus may still be passed on by the surrounding genital areas coming into contact.

Testing for genital warts

If you think you have warts, or your partner has them, visit your local sexual health or GUM clinic.

There is no test for genital warts but its easy for a doctor or nurse to diagnose by examining the affected area. In some cases the doctor or nurse may wish to perform a more detailed examination to see if the warts are present inside the vagina or anus. 

Treatment for genital warts

You will only be offered treatment if you have visible warts. Treatment for warts depends on the type of warts you have and  where they are located.

There are two main types of treatment:

  • – applying a cream, lotion or chemical to the warts
  • – destroying the tissue of the warts by freezing, heating or removing them.

More detailed information regarding treatment can be found here.

You should tell the doctor if you are pregnant  or if their is a risk of pregnancy as this may affect the treatment that they offer you.

It is recommended that you avoid having sex until your warts have fully healed. This is to prevent you passing on the HPV virus to others but also allows you to recover more quickly.

How to avoid infection

Using condoms male or female (femidom) every time you have vaginal or anal sex is the most effective way to avoid genital warts.

The protection offered by condoms is not 100%. As HPV is spread through skin-to-skin contact, it is possible for the skin around your genital area not covered by a condom to become infected.  

If you have oral sex, cover the penis with a condom. A dental dam, can be used to cover the anal area or female genitals.

If sharing sex toys, wash them or cover them with a condom before anyone else uses them.

In the UK, HPV vaccines are offered to all girls in school aged 12-13 years (year 8). There are over 100 strains of the virus but the vaccination protects against two strains which cause the majority of genital warts (type 6 and type 11).

Chlamydia is one of the most common STI’s in the UK and is easily passed on during unprotected sex (sex without a condom).

Most people don’t experience any symptoms, so they are unaware they’re infected. It is particularly common in sexually active teenagers and young adults, and it’s recommended that if you are under 25 and sexually active, you test for chlamydia every year or when you change sexual partner.

Signs and Symptoms

In women, chlamydia can cause pain or a burning sensation when urinating, a vaginal discharge, pain in the lower abdomen during or after sex, and bleeding during or after sex or between periods. It can also cause heavy periods.

In men, chlamydia can cause pain or a burning sensation when urinating, a white, cloudy or watery discharge from the tip of the penis, and pain or tenderness in the testicles.

It’s also possible to have a chlamydia infection in your rectum, throat or eyes.

Causes of Chlamydia

Chlamydia is a bacterial infection which is passed on by unprotected sex or the exchange of infected genital fluids.

You can get chlamydia through:

Unprotected vaginal, anal or oral sex

Sharing sex toys that aren’t washed or covered with a new condom each time they’re used

Your genitals coming into contact with your partner’s genitals – this means you can get chlamydia from someone even if there is no penetration, orgasm or ejaculation

Infected semen or vaginal fluid getting into your eye

It can also be passed by a pregnant woman to her baby – read about the complications of chlamydia for more information about this.

Testing for Chlamydia

Chlamydia can’t be passed on through casual contact, such as kissing and hugging, or from sharing baths, towels, swimming pools, toilet seats or cutlery.

If left untreated, chlamydia can lead to serious long-term health problems if left untreated, including infertility.

Testing for chlamydia involves a urine test or by taking a swab of the affected area. Chlamydia is easily treated with antibiotics.

Using the male condom or a Femidom (the female condom) reduces the risk of picking up or passing on Chlamydia.

Treatment for Chlamydia

Chlamydia can usually be treated easily with antibiotics. You may be given some tablets to take all on one day, or a longer course of capsules to take for a week.

You shouldn’t have sex until you and your current sexual partner have finished your treatment. If you had the one-day course of treatment, you should avoid having sex for a week afterwards.

It’s important that your current sexual partner and any other sexual partners you’ve had during the last six months are also tested and treated to help stop the spread of the infection.

Sexual health or GUM clinics can help you contact your sexual partners. Either you or the clinic can speak to them, or they can be sent a note advising them to get tested. The note won’t have your name on it, so your confidentiality will be protected.

Preventing Chlamydia

Anyone who is sexually active can catch chlamydia. You can prevent the spread by using a condom every time you have vaginal or anal sex, and also using a condom during oral sex. You should also cover the female genitals during oral sex using a dental dam, which is a square of latex or plastic.

If you share sex toys, you should wash them thoroughly between uses, and especially if you have multiple sexual partners or a new sexual partner.