by Dr Alison Palmer of Femma
An STI (also known as a sexually transmitted disease) is any infection which is passed on during sexual activity. This can include oral, vaginal and anal sex. Some STIs, such as HIV and Hepatitis B, can also be spread via blood exposure eg. sharing needles during injecting drug use, unregulated tattooing or blood transfusion in some overseas countries. If you have an STI you may have no symptoms at all. Or you may have one or more of the following symptoms: Vaginal discharge, pain or burning when passing urine, vulval itch, bumps, lumps or blisters, pelvic pain, irregular vaginal bleeding, infertility or symptoms of a blood viral infection such as fever, rash, weight loss (systemic symptoms).
Male partners can experience discharge from the penis and pain with urination. They can also have bumps, lumps or sores on their penis or systemic symptoms.
Some important points to remember here:
STIs are common and preventable and even if you have no symptoms, you may be infected with an STI and it may be adversely affecting your health without you realising. Even if you have no symptoms, if you have an STI you or your partner can easily pass it on to others. Condoms are the most effective way to prevent catching or spreading STIs and most STIs are treatable if detected early
Chlamydia is a common STI that can affect the cervix, fallopian tubes, anus, urethra & throat. Most people who have chlamydia have no symptoms, but it can cause burning when passing urine, vaginal discharge, pelvic pain and irregular vaginal bleeding. If left untreated it can cause pelvic inflammatory disease and infertility. Chlamydia can be diagnosed via a urine test or cervical swab. It is easily treatable with a short course of antibiotics. The use of condoms prevents this infection.
Like Hepatitis B, HIV (human immunodeficiency virus) is spread via unprotected sex, sharing needles or from mother to baby during pregnancy. HIV has a high prevalence in many third world countries around the world. Initial symptoms of infection can include a flu-like illness and rash. In later stages, if left untreated, HIV can deteriorate to AIDS (adult immunodeficiency syndrome), causing serious infections and cancer. HIV is diagnosed via a blood test There is no vaccination currently available to prevent the spread of HIV.Transmission of HIV is prevented by condom use. There is no cure for HIV, but there are modern antiviral medications that can manage HIV effectively and prevent the transition to AIDS (these medications need to be taken lifelong). There are also medications that can prevent HIV transmission (PrEP) and prevent HIV infection after exposure (PEP).
Hepatitis B is a viral infection that can be transmitted during sex without a condom, from mother to unborn baby and via needle sharing and other unsafe blood exposure. It mainly affects the liver and can cause chronic liver disease and in some cases, liver cancer. Infection with hepatitis B can often cause no symptoms, but in some people it causes abdominal pain, fevers and a flu-like illness. Hepatitis B can be prevented by immunisation. It is diagnosed via a blood test. In people with hepatitis B, specialised anti-viral medication is required in many cases to prevent progression to chronic liver disease.
Herpes Simplex Infection
The herpes simplex virus (HSV) can get into the body through tiny abrasions (cuts) in the genitals, mouth and lips or anus. It is spread via skin to skin contact, including sexual activity & kissing. Condoms will not prevent the spread of HSV in many cases. Many people who have HSV have no symptoms. Symptoms may include painful ulcers or blisters, painful swelling of the vulva causing difficulties urinating and flu-like symptoms. HSV infections can cause recurrent symptoms . It can also be spread during labour to the unborn baby. It is diagnosed via a swab taken by a healthcare professional from an ulcer or sore area. HSV is treated with anti-viral medication during the first episode. Some people will require further treatment for recurrences and/or regular medication to suppress recurrent episodes.
Gonorrhoea is caused by the bacterium, Neisseria gonorrhoeae, which can cause an infection of the urethra, cervix, anus and throat.. It can cause no symptoms, or you can experience vaginal discharge, pain with urination, irregular bleeding or pelvic pain . Left untreated, gonorrhoea can cause chronic pelvic inflammatory disease and infertility. It is diagnosed via urine test or cervical swab and is treated with an antibiotic injection as well as a course of oral antibiotics. The use of condoms prevents this infection.
HPV and Genital Warts
Genital warts are growths or bumps in the genital area, and are caused by some types of human papillomavirus (HPV). The majority of sexually active people will be exposed to HPV infections during their lifetime. Most HPV infections clear up without treatment. Most people with HPV do not develop warts. Some types of HPV are responsible for cervical cancer, however this is uncommon and is not caused by the HPV types that cause genital warts. HPV is spread by skin to skin contact. It is diagnosed via examination by your healthcare professional or by a cervical screening test. There are several effective treatments for genital warts including creams, cryotherapy and laser treatments. Some HPV types are prevented by the HPV vaccine. Condoms will not always prevent spread. Regular cervical screening tests are important for diagnosing the type of HPV that can cause cervical cancer.
Syphilis is a bacterial infection caused by direct sexual contact and has become more common in recent years. Symptoms can vary, but include : no symptoms, fevers, skin lesions, rashes and painless genital ulcers. If left untreated it can cause serious health consequences such as heart disease and cognitive decline due to brain inflammation. Syphilis infection during pregnancy can cause severe health problems for the unborn baby. It is diagnosed via a blood test and sometimes via a biopsy of a skin lesion. Syphilis is treatable with antibiotic injections. Syphilis infection can be prevented by condom use.
Mycoplasma genitalium is an infection transmitted via unprotected sex. Most people with this infection have no symptoms. Symptoms can include vaginal discharge, pelvic pain and pain with urination. It is diagnosed via a vaginal swab or urine sample and is treated with antibiotics. Left untreated it can lead to pelvic inflammatory disease and infertility.
Trichomonas infection is spread by having sex without a condom. It can present with vaginal discharge, unpleasant vaginal odour and vulval itch/burning. It is diagnosed by vaginal swab. Trichomonas infection is treated with a course of antibiotics. If untreated during pregnancy, it can affect unborn babies.