How To Treat Different STIs And STDs

STIs And STDs

Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are passed by skin-to-skin contact, or contact with infected bodily fluids from the vagina or penis. They are extremely common, however because they can be asymptomatic, many people may be unaware that they are infected. If you are concerned that you may have contracted an STD or STI we advise that you consider taking an at home test, even if you are not experiencing any symptoms.

What Is The Difference Between An STI and an STD?

Having an STI means that an individual has an infection, which has not yet developed into a disease. So, if someone is infected by HPV (Human Papilloma Virus) and carries the virus, they have an STI. If that HPV goes on to develop into cervical cancer, then the patient has an STD. An infection is often the first step of a disease and occurs when bacteria, viruses or microbes enter the body and start multiplying.

For further information visit: www.stdcheck.com

Chlamydia

Chlamydia is one of the most common sexually transmitted infections in the UK. In the majority of cases, it is passed on from one person to another through unprotected sex (sex without a condom). However, it can also be spread through contact with infected sexual fluids. Most men and women do not have any symptoms, but in men you may have pain when you pass urine or a discharge. In women symptoms may be bleeding between periods or after sexual intercourse.

Chlamydia can usually be treated easily with antibiotics. You may be given some tablets to take all on one day (Azithromycin), or a longer course of capsules to take for a week (Doxycycline). If Chlamydia is treated early, it’s unlikely to cause any long-term problems. However, without proper treatment the infection can spread to other parts of the body. The more times you have chlamydia the more likely you are to get complications. If left untreated in women, Chlamydia can impact fertility.

Gonorrhoea And 'Super Gonorrhoea'

Gonorrhoea is the second most common STD in the UK, after Chlamydia. Super Gonorrhoea is a multidrug-resistant strain of the disease, which means no known form of antibiotic can treat it. Men and women with gonorrhea often don't show symptoms. Some people may not experience anything at all, others will see symptoms between one and 14 days after they've been infected. Once the symptoms begin, the disease has already started causing damage.

In women, symptoms include frequent, painful urination, coloured, foul-smelling discharge and pain on intercourse. If left untreated, it can lead to, pelvic inflammatory disease and an increased chance of ectopic pregnancy, which could lead to lifelong infertility. For men, it can cause tender, swollen testicles and epididymitis, which can also lead to infertility. Gonorrhea can live in the genitals, anus and throat. To be safe, barrier protection should be used for all genital contact, be that vaginal, oral or anal.

As well as person-to-person contact, gonorrhoea can also be passed by sharing vibrators or other sex toys that haven't been washed or covered with a new condom each time they're used. Once a patient is diagnosed, and a course of treatment has been identified by their GP, all medication must be finished and they should also abstain from sex until a second ‘test of cure’ has come back negative. This will eliminate the risk of passing it along to another partner.

Long-term implications are that gonorrhea can spread to your blood and joints. It can also lead to an increased risk of HIV. Other risks include arthritis, heart problems and serious eye infections in babies born to mothers with gonorrhea.

Condoms are the best way to prevent gonorrhea and other sexually transmitted infections. If you or your partner are experiencing any of the symptoms, you should stop having sex and schedule an appointment with your doctor or through our online STI service as quickly as possible. Genital infections can present as skin rashes and arthritis without, causing any genital symptoms at all.

Genital Warts

Genital warts affect men and women and are small fleshy growths that appear around the genitals or anus. They are extremely common and can be treated with creams and solutions available on prescription. Genital warts can also be frozen. You cannot use over the counter wart creams, as these are only for treating warts on the hands or verrucas.

Genital warts are caused by the human papillomavirus (HPV) and generally are painless, they do not cause infertility and are not a serious threat to your health. There are 30 different types of HPV and 90% of genital warts are caused by two strains of the virus: type 6 and 11. Genital warts are mainly spread during vaginal or anal sex. They also spread by sharing sex toys and by close skin to skin contact. You can catch them without penetrative sex.

Condoms may not prevent infection, and it can take months or years for them to develop. So if you are in a relationship and develop genital warts, it does not mean that your partner has had recent sex with other people. You may only get genital warts once, or they may return weeks, months or years later. It is not possible to conclude whether this is due to the original or a new HPV infection. If you have genital warts, you should not have vaginal, anal or oral sex until the infection has cleared up, in order to prevent the virus being passed on to others.

Genital Herpes

Genital herpes is a common infection caused by the herpes simplex virus (HSV). It causes painful blisters around the genitals and surrounding areas. It can be controlled, but not cured, with the use of antiviral medication.

Many people will not have any visible signs or symptoms and others will get symptoms within 4-5 days of coming into contact with the virus. In other people the virus may be in the body for several weeks, months or possibly years before any signs/symptoms appear.

As such, when you get symptoms it doesn't necessarily mean you've only just come into contact with the virus. Signs and symptoms of recurrent outbreaks are usually milder then the first outbreak and clear up more quickly. There is often an early warning tingling sensation and you may get flu like illness before an outbreak. The blisters and sores are usually fewer, smaller, less painful and heal more quickly. They normally appear in the same part of the body as in previous outbreaks but in some people they may appear nearby.

Symptoms include: feeling generally unwell with flu-like symptoms such as, fever, tiredness, headache, swollen glands, aches and pains in the lower back and down the legs or in the groin. This will be followed by stinging, tingling or itching in the genital or oral area. Small fluid-filled blisters anywhere in the genital or anal area, on the buttocks and tops of the thighs. These burst within a day or two leaving small red sores which can be painful. Pain when passing urine can be caused by the urine coming into contact with the sores.

It is not essential to have treatment as genital herpes will clear up by itself. However, prompt treatment at the start of an outbreak can be a great help reducing the time the outbreak lasts, help the healing process and can reduce the risk of you passing the virus on to someone else. It is strongly advised that you do not have any sexual intercourse, including vaginal, anal or oral sex, if you know an outbreak is coming, while you have signs and symptoms, and for a week after the symptoms have gone. This is to help prevent you passing the infection on to someone else. Having sex while you have blisters or sores can also delay the healing process.

Genital herpes can cause problems during pregnancy. These complications can be more serious depending on whether you already have genital herpes, or develop it for the first time while pregnant.  Treatment is mainly by creams and solutions available only on prescription. It is possible to have more than one STD at a time, so you can get tested and treated for other STI's.

Trichomoniasis

Trichomonas vaginalis is a sexually transmitted infection (STI). It is sometimes referred to as trichomonas or trichomoniasis, or shortened to TV. Trichomonas vaginalis is a tiny parasite which causes infection. In women the infection can be found in the vagina and the urethra (tube where urine comes out). In men it can be found in the urethra. The infection is easily passed from one person to another through sexual contact. Anyone who is sexually active can get it and pass it on. You don’t need to have lots of sexual partners.

Symptoms in women include: abnormal vaginal discharge that may be thick, thin or frothy and yellow-green in colour, producing more discharge than normal, which may also have an unpleasant fishy smell, soreness, inflammation (swelling) and itching around the vagina – sometimes the inner thighs also become itchy pain or discomfort when passing urine or having sex.

Symptoms in men include: pain during urination or ejaculation, needing to urinate more frequently than usual, thin white discharge from the penis, soreness, swelling and redness around the head of the penis (balanitis) or foreskin (balanoposthitis). Trichomonas is unlikely to go away without treatment, however, for some people, it may cure itself. If you delay seeking treatment you risk passing the infection on to someone else.

It is strongly advised that you do not have any sexual intercourse, including vaginal, anal or oral sex until you and a partner have both finished the treatment and any follow-up treatment. This is to help prevent you from being reinfected or passing the infection on to someone else.

Treatment

Different kinds of STDs that can be treated, include:

 •Chlamydia
 •Gonorrhoea
 •Mycoplasma genitalium
 •Ureaplasma
 •Trichomonas vaginalis
 •Gardnerella vaginalis
 •Herpes Simplex

Tests are carried out by the UK’s largest independent pathology clinic, and patients are advised via email of their results. The Oxford Online Pharmacy at home STD test service also includes the option of home blood tests for HIV, Syphilis and Hepatitis B&C. There are also separate MSM (men who have sex with men) tests covering HIV, Syphilis and Hepatitis B&C, Chlamydia, Gonorrhoea, Mycoplasma genitalium, Ureaplasma, Trichomonas vaginalis, Gardnerella vaginalis and Herpes Simplex I/II.

If you test positive for HIV, Syphilis and Hepatitis B&C, it is recommended that you contact your GP or a GUM (genitourinary medicine) clinic, who will carry out a retest and provide specific treatment. For other STIs, our GMC registered doctor can help. If you test positive, you can take a free online consultation and, if you are approved our doctor will provide a private prescription for a specific treatment, this will be issued at a cost of £25.00. If a treatment is not appropriate, and you are unsuccessful, your payment will be refunded.

In addition, if you already have a private or NHS prescription you can order your medication online and send your prescription to us. We will then dispense the prescribed medication, straight to your home.

If you test positive, you should not 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.

All STIs and STDs should be treated as soon as possible, as long-term health problems may occur. Retesting is also recommended to ensure treatment has been effective.

Q&A

Links For Sexual Advice

https://www.nhs.uk/Service-Search/Sexual-health-services/LocationSearch/1847

https://www.fpa.org.uk/sites/default/files/genital-herpes-information-and-advice.pdf

Authored by Stuart Gale, on 13 September 2018. Reviewed by Robert Bradshaw, on 14 December 2018.