Everything your doctor wants you to know about sexually transmitted infections

Here's what you should know if you've got issues down below.

Getty Images

Sexually transmitted diseases are both surprisingly common and widely misunderstood. But it's important that we're given the lowdown to dispel some myths. So join me on a journey down below, into the world of itchy bugs and suspicious rashes.

Simple facts about STDS

STDs are common. Abstinence, followed by the use of barrier methods (condoms and female condoms) reduce the risk. Herpes and genital warts may spread regardless, so special care must be taken. Oral contraceptives, injections, implants and coils do not protect against disease.

STDs may have no symptoms, or may have periods of being symptomless, so people may not be aware they have them. Which means being safe is better than sorry. Blame is dangerous due to the sometimes subtle nature of symptoms, and most of the social stigma for disease is unwarranted, and more harmful than disease itself.

Risk is increased with multiple partners and in the gay or bisexual communities (possibly due to the increased risk of bleeding found in anal sex creating a vector for disease spread.) Multiple partners increase risk as simply because the chance of coming into sexual contact with someone who's infected is obviously also increased. 

It's important to remember that STDs are not to be blamed on any group; it's the action of individuals and their own responsibility. Some diseases have serious complications, so seeking medical advice is essential if you are unsure or feel you have been exposed. Earlier help, especially in the case of HIV, is essential.

So here's what's what:

Chlamydia (The Clam, Clam chowder, gooey stuff)

Getty Images

Chlamydia is a common and often asymptomatic bacterial infection spread though unprotected sexual contact, genital or anal. It's more common in those under 24, but is also making a resurgence in the middle aged. Symptoms in men include a creamy discharge and pain, and in women discharge, irregular or post sex bleeding and cervical pain (which is felt in the tummy.). Tests include swabs and treatment is often as simple as antibiotics and painkillers.

Although the bug itself is irritating, it's the complications that we worry about. Untreated or progressive Chlamydia can lead to infertility in women, so early treatment is important. Pelvic inflammatory disease, (infection of the pelvic organs) is one potential repercussion, as well as an increased risk of ectopic pregnancy (outside of the womb), which can be dangerous. 

Genital Warts (Percy)

Getty Images

Warts are lumpy, irregular growths which may bleed if picked, and grow back if pulled off.  Genital warts, like any warts on the body, arise from the Human Papilloma Virus (HPV). This virus is extremely diverse and common, with over 100 types. It's most common in under 24s, but almost all sexually active adults will have been exposed to it - the chances are that if you've had sex, you have been at risk.  New genital warts can have come from a partner without visual warts, so placing blame is hard, especially as some may never have symptoms and that condoms are not fully effective.

The virus may spread even without visual warts. Men develop warts on the penile shaft, head of the penis and surrounding areas, while women develop warts on the vulva and surrounding areas. Anal infection is also possible. Women can develop discharge, itching and pain on going to the toilet. Treatment is with creams, freezing, heat or microsurgery, and self treatment is most definitely not recommended.

You might be aware that some forms of the virus (HPV16, 18 most commonly) increase the risk of cervical cancer by inducing changes in cervical tissue, but vaccinations are now available to prevent the spread of these. The forms of HPV that cause visable warts, however, rarely increase risk of cancer, but may be alongside forms that do. Due to the high prevalence of the virus and difficulty in preventing it, cervical screening is undertaken in all women over the age of 25 to reduce risk and isolate any virus induced changes early. 

Gonorrhoea (The Clap, the drip, morning drip, dose)

Getty Images

Gonorrhoea is a disease on the rise. It is rapidly developing resistance to antibiotics, and soon may not be treatable. It is once again a disease most commonly found in the young, under the age of 24. It is spread through oral, vaginal or anal sex, and symptoms are characteristic: a green/yellow painful discharge from the vagina, penis or anus, with pain on going to the toilet. You might also feel generally unwell, with tummy pain. 

Gonorrhoea causes an increased risk of early labour, miscarriage and irregular bleeding, as well as risk of infertility and ectopic pregnancy.

At the moment, treatment is with antibiotics, but you're reminded that it's very important to finish your course, as more resistant forms will develop if any of the disease is left inside you. Doctors are already seeing this happen, so every effort must be made.

Herpes (fever blisters, gift that keeps on giving)

Getty Images

Herpes has a bark worse than its bite; it's quite common and does not deserve its stigma.  Caused by the Herpes Simplex Virus in its various forms, it can exist orally or on genitals. Different forms of the virus tend to favour different areas, with HSV1  causing oral blisters and HSV2  causing sores down below. 

Condoms will not protect against well against rashes outside of the latex barrier, and the disease can spread even when there's no visible rash during a 'shedding phase'. It cannot be cured, but it can be managed well.

 The characteristic painful, blistering rash is only seen during times when the virus 'flares', so people with herpes may not always have symptoms. Sometimes the virus is so mild that people may never know they have it, with just a single spot being the only sign; easily dismissed as an ingrown hair or shaving rash. 

Patients may have only a few flares in their entire lives, or may experience a few a year when they're run down. Aside from being unsightly, these rashes are not dangerous unless you have a weak immune system (i.e advanced HIV or under chemotherapy or steroid use.) Fertility is not affected by herpes.

Simply put, herpes does not mean someone can be judged. Due to the high prevalence of the virus, and often minimal or no symptoms, anyone can have it and get it with one partner on their first time having sex. 

Pubic Lice (Crotch crickets, Crotch Critters, Crabs)

Getty Images

Pubic lice are simply lice found in pubic hair. There are three recognisable stages: Nits are the eggs, and are brown when full and white when hatched. They are found attached to hairs. Nymphs are the young, and lice are the adult forms. They will cause itching, and can be diagnosed by sight. 'Black powder' (debris and louse leavings) can often be seen on underwear. Treatment is by creams, combing, washing exposed bed sheets and clothing and careful examination post treatment to ensure there are no stragglers.

Syphillis (Pox, great imitator, bad blood)

Getty Images

Syphillis is caused by the bug Treponema Pallidum,  and is more present in the young. It is spread by oral, vaginal and anal sex. Symptoms follow a well documented course. Primary infection is a 'chancre', or a painless, rubbery, self-healing ulcer. 

Secondary infection can occur up to 8 weeks later, and is characterised by a rash on the trunk (the body's torso), soles of hands and feet. Patients may have a fever, joint aching, lymph node swelling, mouth ulcers and hair loss. Tertiary infection can occur many years later, causing large granulomas (areas of inflammation and bug growth), brain and heart symptoms, as well as increased risk of miscarriage and stillbirth. Treatment is by antibiotics and best done early before permanent damage is done.

HIV (High Five, The Virus, Redcard, Slim, Z3, The Big)

Getty Images

HIV is often misunderstood. Human Immunodeficiency Virus has multiple forms, and causes a weak immune system by attacking signalling cells in the body. AIDS, or Acquired Immunodeficiency Syndrome, is a progression of severe immunodefiency, where usually harmless bugs become a real threat.

Due to advances in medication, most HIV sufferers will never progress to AIDS, and if well controlled, will have a very low chance of spreading the virus. HIV is no longer the 'death sentence ' it once was, and people can live long and healthy lives. 

The virus is transmitted in bodily fluids, but tends to be more risky in larger quantities of blood and semen. Transmission can occur through oral (although it's rare), vaginal and anal sex. The risk is highest in anal sex. Needle sharing in drug use increases risk, but risk from blood transfusion is very low due to the screening of all donations. Needle stick injuries in healthcare do carry some risk. 

Transmission through kissing, unless blood is present in the mouth, is very rare.  Transmission can occur from mother to child. There is increased risk in homosexual and bisexual communities due to the increased risk of bleeding during anal sex. The anal area is often less lubricated and is highly vascular, so bleeding and exposure to blood is more likely.

The virus can present itself as a common illness, much like a flu, to begin with; joint aching, fever and a diffuse rash over the trunk may be present. This is Primary HIV infection.  However, this isn't the case for all infections.  The HIV disease often moves slow, and may not damage the body's immune system enough to cause symptoms. Different strains progress at different rates, but the average latency time is around 10 years.

Once the infection hits a certain point, either with the sufferer experiencing a very low immune count or the presence of certain infections, AIDS  is present. These diseases include some pnuemonias, tuberculosis and some candida (thrush) infections.

Management of HIV is through a combination of highly effective anti-viral medications. The use of multiple dugs reduces the risk of drug resistance. These drugs are so effective that the 'viral load' (i.e the amount of HIV in the blood) can become so low that the bug cannot be transmitted. If you feel you have been exposed, the use of active anti-virals within the first three days of exposure may prevent the disease from taking hold entirely.  Again, it's important to use medication as directed, as there is growing evidence that resistant forms are developing.


Any opinions above are the author's alone. Guidance is based on the best available evidence at the time of writing. Online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice.

Follow Ben on Twitter or Facebook.

Like this? Come and check us out on Snapchat Discover

Advertisement - Continue Reading Below
More From Health