A to Z of Sexual Health

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Bacterial Vaginosis is a condition that occurs when there is a change in the natural bacterial balance in the vagina. It is the most common cause of abnormal vaginal discharge in women of childbearing age. Women with BV have either less of the normal vaginal bacteria or an overgrowth of other types of bacteria in the vagina.

Around half of women with BV will not have any signs or symptoms at all, or may not be aware of them. If you do not have any symptoms, then there is no need to get tested. More definite symptoms include, an increase in vaginal discharge – it may become thin and watery or change to a white/grey colour and develop a strong, fishy smell, especially after sexual intercourse. Symptoms are not usually associated with itching or irritation.

Treatment of BV is oral antibiotics or use of an antibiotic vaginal gel.

Balanitis is inflammation of the head of the penis. The foreskin is often affected too. The condition is common, and can occur at any age. Balanitis is usually caused by a candida (yeast) infection, but it can also result from a bacterial infection or from an allergy or irritation.

Balanitis symptoms include red skin around the head of the penis, swelling, irritation and soreness of the head of the penis. Thick, lumpy discharge under the foreskin. Ulcers or a rash around the penis. An unpleasant odour. A tight foreskin and pain when passing urine.

Depending on the type of Balanitis (yeast, bacterial, or irritation), as to what form of treatment is suitable. Yeast infection will require antifungal cream or tablets. Bacterial infections will be treated with antibiotics. Allergic reaction or irritation as the cause of Balanitis may be treated with either antifungal or antibiotic medication, with or without a steroid cream.

Bartholin Cyst is a condition whereby the Bartholin glands, which are a pair of pea-sized glands found just inside the opening of the vagina, become blocked and full of mucus. This then becomes a cyst. If the cyst becomes infected it is then known as an abscess, and can be very painful.

Most cysts do not cause any symptoms, and are usually found during routine smear test examinations. However, if an abscess develops, it is usually red, very painful and tender to the touch.

No treatment is required if the cyst is small and not causing any symptoms. However, if the cyst becomes an abscess, antibiotics may be needed to clear the infection.

Chlamydia is the most commonly diagnosed STI . It is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. There are usually no symptoms at all in both men and women and can often go undiagnosed.

The majority of both women and men have no symptoms of Chlamydia at all, and those that do are so minor, they go unnoticed. Women can sometimes complain of cystitis, a change in vaginal discharge, or mild lower abdominal pain. Men may experience a urethral discharge from the penis, also a mild inflammation or irritation at the end of the penis.

The most common treatment for Chlamydia is a course of antibiotics that, if taken as instructed, is at least 95% effective. Chlamydia is very easily passed on through sexual contact, therefore if you are diagnosed, anyone within the last 6 months who you have had sex with may also be infected. It is important that they are also tested, regardless of whether they have any symptoms or not.

Genital Herpes is an infection of the genitals that is caused by the herpes simplex virus (HSV). The herpes simplex virus can also affect the skin on the face, causing cold sores to develop, usually around the mouth area.

Most people with the Herpes Simplex Virus do not experience any symptoms when they are first infected, and as a result, do not know they have the condition. However, people who do experience symptoms when they are first infected will usually experience the following within 4-7 days after being exposed to the virus ?Painful red blisters which burst to leave ulcers on external genital area, rectum, thighs and buttocks. A vaginal discharge in women. Pain when passing urine. A fever and generally feeling unwell. Recurrent symptoms of HSV which occur time to time once the virus is present include ?A tingling or burning sensation around the genitals before the blisters appear (this can signal the onset of a recurrent infection). Painful red blisters which leave ulcers on your genital area, rectum, thighs and buttocks. Blisters and ulcers on the cervix in women.

Treatment for HSV will depend on whether you have the infection for the first time, or whether you are experiencing a recurrent infection. Your G.P will usually refer you to receive treatment from a Genito-Urinary Medicine (GUM) Specialist at your local GUM clinic.

Genital warts are an infection of the skin of the genital and anal area, and the mucous membranes (lining) of the vagina, cervix and rectum. They are caused by the human papilloma virus (HPV). They can be spread during vaginal or anal sex, and by sharing sex toys. However, you do not need to have penetrative sex to pass it on. The virus is spread by skin-to-skin contact. You cannot get genital warts from kissing, hugging, sharing baths or towels, using swimming pools, or toilet seats.

In women they can be found on the vulva, cervix and upper thighs, in the vagina and on or the inside of the anus. In men they can be found on the penis, scrotum, urethera, upper thighs, and on or inside the anus. The warts can be flat or smooth small bumps, or quite large, pink, cauliflower-like lumps on their own or in the groups. You may not notice having genital warts as they can be so tiny and difficult to see.

Treatment will only be offered if warts are visible. Various methods include applying cream or liquid onto the warts, freezing the warts (cryotherapy), heat (electrocautery), using local anaesthetic, laser treatment and surgery.

Gonorrhoea is a sexually transmitted infection (STI) caused by a bacteria. It used to be known as the clap. The bacteria is found mainly in the semen of infected men and vaginal fluids of infected women, so is easily passed between people through sexual contact.

Women experience symptoms including a strong, unpleasant smelling thick discharge from the vagina which may appear green or yellow in colour, pain or tenderness in the lower abdominal area including a burning sensation when urinating, frequent need to urinate, irritation or discharge from the anus, and bleeding between periods or heavier periods. Men experience symptoms that include a thick white, yellow or green-coloured discharge from the tip of the penis, pain of the testicles, pain or burning sensation when urinating, frequent need to urinate, and irritation or discharge from the anus.

Gonorrhoea is treated with a single dose of antibiotics, usually Ceftriaxone, Cefiximine or Spectinomycin. The antibiotics are either given orally or by injection.

HIV – The Human Immunodeficiency Virus is a sexually transmitted virus that attacks the body immune system. A healthy immune system provides a natural defence against disease and infection.

HIV infects special cells, called CD4 cells, that are found in the blood and are responsible for fighting infection. After becoming infected, the CD4 cells are destroyed by HIV. Although the body will attempt to produce more CD4 cells, their numbers will eventually decline and the immune system will stop working. This leaves a person who is infected with HIV with a high risk of developing a serious infection or disease, such as cancer.

There is no cure for HIV and no vaccine to stop you from becoming infected. However, since the 1990s, treatments have been developed that enable most people with HIV to stay well and live relatively normal lives. HIV is a special type of virus known as a retrovirus. Retroviruses spread by breaking down the DNA in our cells and then reassembling it to make copies of themselves. Retroviruses are challenging to treat as they can rapidly mutate (alter) into new strains of virus.

Acquired Immune Deficiency Syndrome is a term that is used to describe the latter stages of HIV, when the immune system has stopped working and the person develops a life-threatening condition, such as pneumonia (infection of the lungs).

The term AIDS was first used by doctors when the exact nature of the HIV virus was not fully understood. However, the term is no longer widely used because it is too general to describe the many different conditions that can affect somebody with HIV. Specialists now prefer to use the terms advanced or late-stage HIV infection.

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NON-SPECIFIC URETHRITISWHAT IS IT: Non-specific Urethritis is inflammation of the urethra, usually due to infection. The term on-specific?relates to the fact that the cause of the urethritis has not yet been identified, but it is known that gonorrhoea is not responsible.

SYMPTOMS: NSU symptoms in men include ?A white, or cloudy, discharge from the tip of the penis. A burning or painful sensation when you urinate. Irritated or sore tip of the penis. A frequent need to urinate. NSU symptoms in women are unnoticeable unless the infection spreads to other parts of the female reproductive system, such as the womb or the fallopian tubes. If this happens the women may develop pelvic inflammatory disease (PID). PID is a serious condition that can cause persistent pain and infertility.

TREATMENT: Treatment for NSU usually involves antibiotics. Non-specific urethritis should be regarded as an STI and all precautions for spreading the disease should therefore be adhered to.

PUBIC LICEWHAT IS IT: Pubic Lice aka crabs?are tiny parasitic insects that live most commonly in pubic hair, although can be found on the eyelashes, eyebrows, or beards or moustaches. They are insects that suck blood but dont usually live on other animals. Sexual contact is the most common cause of infestation, but can also be caught by close contact, eg, hugging or kissing or sharing clothing, bedding or towels.

SYMPTOMS: The most common symptoms of pubic lice is itching and a red pimply rash. You may see the lice which are about 2mm long, or their white tiny eggs. You may also be able to see louse droppings which are dark brown or a black power on your skin or in your underwear.

TREATMENT: You can treat pubic lice with a simple insecticidal lotion or cream which can be bought over the counter at a Pharmacy. Always check correct instructions on use if in doubt ask your Pharmacist or Doctor. Also, it would be advisable to wash all towels, underwear and bedding on a 50degress wash to eliminate re-infestation.

SCABIESWHAT IS IT: Scabies are tiny mites which burrow into warm folds of skin such as, between fingers, around buttock or breast creases, and under arms. They cause extreme itching and discomfort. They are spread through close physical contact but also can be caught by secondary contact with clothes and bed linen.

SYMPTOMS: Symptoms of scabies include intense itching especially at night or after a hot shower or bath. You may also experience a rash which looks red and blotchy, this is caused by the scabies burrowing into the skin.

TREATMENT: You can buy insecticidal creams from the Pharmacist to clear the scabies and also cream to ease the itching and discomfort for your skin rash.

SEXUALLY TRANSMITTED INFECTIONSSexually transmitted infections (STIs) are passed on through intimate sexual contact. STIs include chlamydia, syphilis and gonorrhoea. They can be passed on during vaginal, anal and oral sexual intercourse, as well as through genital contact with an infected partner.

In the UK, STIs have been rising continually since the 1990s. Between 2004 and 2005, the Health Protection Agency (HPA) reported a 3% increase in the number of diagnosed STIs, with a total of 790,387 cases. The biggest increase was in the number of confirmed diagnoses of syphilis, which rose by a massive 23%, to a total of 2,807 cases. There were also increases in positive diagnoses of chlamydia, genital warts and herpes.

To some extent, the increase in the number of diagnosed cases of STIs is due to a greater awareness of the problem, more reliable diagnostic techniques, and an increase in the number of sexual health and GUM clinics carrying out tests. However, by far the highest increase in STIs has been among 16-24 year olds, which is a worrying trend.

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SYPHILISWHAT IS IT: Syphilis is a bacterial infection that is typically passed through sexual contact. However, it can be passed on by intravenous drug use (injecting drugs directly into the vein), blood transfusions and from an infected mother to her unborn child. The latter is known as congenital syphilis. Syphilis cannot be caught through casual contact, such as toilet seats or sharing cutlery.

The condition can be particularly dangerous because it lies dormant (after some initial symptoms) for many years and can recur, causing serious damage to the: Heart, Nervous system, Eyes, Brain, and almost every other part of the body.

Symptoms of syphilis begin with one or more painless, but highly infectious, sores on the skin known as chancres. If somebody else comes into close contact with these chancres, which typically happens during sexual contact, then they can also catch the condition. This stage of the condition is known as primary syphilis.

Secondary symptoms develop two to 10 weeks after the appearance of the chancre. Symptoms include a skin rash, sore throat, tiredness, a headache.

This stage of the condition is known as secondary syphilis. The symptoms then disappear, even without treatment. However, syphilis may return many years later, and the infection can cause serious damage to the body, including organ damage and death. This last, most deadly, stage of the condition is known as late or tertiary syphilis. Syphilis can be successfully treated with antibiotics.

Syphilis used to be relatively common in the UK until the end of the Second World War. Then the widespread availability of antibiotics meant that the condition became quite rare. However, in recent years, the number of people syphilis has increased. There were 2,766 reported cases in the UK during 2006. Syphilis is more common in men than women, and rates are highest among gay men. Catching syphilis increases your chances of catching HIV. Also, HIV will alter the typical course of syphilis, increasing the chances of it progressing to tertiary syphilis. For more information go to Click Here

THRUSH WHAT IS IT: Vaginal thrush is a yeast infection caused by the candida species of fungus. Many women are affected by vaginal thrush at some point in their lives, and for some women it recurs regularly. Thrush is a harmless condition but can cause irritation and swelling of the vagina and vulva.

SYMPTOMS: Vaginal thrush symptoms include vulval itching, soreness and irritation, vaginal discharge, pain and discomfort during sexual intercourse and during urination. Vaginal discharge is common and it is often white and 鈥渃heese-like鈥? but may be watery. The discharge is usually odourless.

TREATMENT: Treatment usually involves a short course of antifungal medication which can be taken orally or by inserting them into the vagina. Topical creams may be used to also ease irritation of the vulva.

TRICHOMONAS VAGINALIS WHAT IS IT: Trichomonas Vaginalis is a common infection which can affect both men and women, caused by a germ known as trichomonas vaginalis. The infection affects women in the vagina and urethra and in men in the urethra. There are usually no symptoms so it is usually diagnosed by a G.P.

SYMPTOMS: Symptoms are rare but some women may experience soreness, inflammation and itching around the vagina, change in vaginal discharge, pain when passing urine, discomfort during sexual intercourse, or pain in the lower abdomen. Men鈥檚 symptoms are also rare but may include, pain after urinating or ejaculation, thin white discharge from the penis, and discomfort during sexual intercourse.

TREATMENT: Trichomonas Vaginalis is usually treated with antibiotics. The antibiotics used to treat this condition may affect women taking the contraceptive pill so your G.P will be able to advise on what contraceptive precautions you will need to take.