A sexually transmitted infection (STI) is an infection that is passed on through sexual contact with someone who is infected. There has been a sharp rise in the number of STI’s in Ireland in the past 10 years.
Some patients just want routine sexual health screening regularly as a precaution, for example if they change partners etc. Some patients will engage in high risk sexual behaviour and present to the clinic after that. Some patients self-refer or are referred in by their Doctor because they have genital warts, or some other STI and a recommendation for full sexual health screening will then be made. Sex workers, men who have sex with men, are all much higher risk individuals.
Most patients present to their local GUM clinic or Doctor’s surgery. However we have two Dermato-Venerologists in our clinics so they are happy to offer STI screening and advice and likely diagnosis if necessary. Many STI clinics are state funded so screening is provided free of charge. However we are private clinics so there is a charge.
Many STI’s are asymptomatic and are picked up on routine blood tests or examinations. If a female or male patient suffers from vaginal or anal discharge or smell, lumps or warts they are likely to present to the clinic. Also if a previous or current sexual partner is diagnosed with an STI they will also present. Depending on your sexual history (oral, vaginal, anal sex) you can just have swabs done (mouth, anus, vagina), but more high risk patients should have screening for Hepatitis and HIV and syphilis, plus a full blood count. Some patients will request this anyway. Patients should always wear a condom with new sexual partners and, with new partners, if both of you have already been sexually active, you should both present for STI screening and get a clean bill of health before you stop using condoms. It prevents a lot of trouble and heartache down the line. Remember if you are diagnosed with an STI your partner also must be treated.
Chlamydia is a common bacterial infection that affects men and women. Many men and women will not notice any symptoms. It is diagnosed in men and women by taking a swab from the cervix or the penis. If not treated, it is contagious to other people and can cause infertility in women. It is easily treated with oral antibiotics.
Genital Herpes (HSV). This can be a horrible condition and can not be permanently eradicated because it is a virus. There is no effective vaccination against it. The emotional impact of being diagnosed with Genital Herpes can be severe. It can present in men with blisters around the anus and penis. In women the blisters are usually in the vaginal area, but also around the anus. Attacks can be so bad at first that female patients are unable to pass urine. Subsequent attacks are not as painful but any reduction in your immune system for example menses, pregnancy, and just being run down can trigger an attack. This is contagious and will be passed to another sexual partner during active shedding of the virus during vaginal, anal or oral sex. It can be well controlled with anti-viral medication.
Genital warts (HPV) – These are very common and have already been discussed on a previous page- see under Warts. The HPV vaccine can prevent most genital warts and most causes of cervical cancer.
Gonorrhea – This is also a common STI. It can present as a vaginal discharge in women or urethral discharge in men. Pain passing urine, anal itching, pain passing bowel motions or painful swollen testicles are also presenting symptoms. It is diagnosed by taking a swab from the urethra in men or the Cervix in women. It can be easily treated with antibiotics and cured. Left untreated this can cause infertility.
Hepatitis A, Hepatitis B and Hepatitis C are all diagnosed by taking a blood test. Hepatitis B can be vaccinated against- speak to your local GP. Hepatitis C is common in eastern Europe, Hepatitis A is more common in homosexual men, it can also be vaccinated against. There is no vaccination against Hepatitis C.
HIV (Human Immunodeficiency virus) – this is a very serious STI and can develop into AIDS( Acquired immunodeficiency Virus). However if diagnosed early, while there is no cure yet, it can be very well controlled with drugs. It will be diagnosed on a blood test. Sometimes it is suspected because of an abnormality that shows up on a routine FBC ( full blood count).
Lymphogranuloma Venereum (LGV) – This is a bacterial infection of the lymphatic system. It is caused by any of the 3 types of Chlamydia Trachomatis. LGV usually presents in homosexual men. LGV is treated with antibiotics to cure the infection and prevent ongoing tissue damage.
Pubic lice (crabs) – This is a very common STI and has already been covered under infestations.
Scabies – This is very common and is not always an STI. It has already been covered under infestations.
Shigella(MSM) – Shigella is a bacteria that can causes severe stomach cramps and diarrhoea. The Shigella bug is passed on through infected faeces (poo). This can happen with contaminated food or sexual activity. Men who have sex with men are much higher risk.
Trichomonas Vaginalis – This is an STI caused by a tiny protozoan parasite called Trichomonas vaginalis. Smelly vaginal discharge that can be white, grey, yellow or green will make the Doctor suspect the diagnosis. Frequency or burning on passing urine and vaginal itch are also sometimes present. Left untreated, it can cause severe health problems like pelvic inflammatory disease, infertility, miscarriages etc. It can be treated properly with the appropriate antibiotics.
Syphilis – Syphilis is a bacterial infection( Treponema Pallidum) , and is a sexually transmitted disease. It is diagnosed by a blood test and can be treated with antibiotics. Untreated it can kill the patient. It used to be rare but there has been a massive resurgence in this disease in the past 20 years especially in the homosexual community.
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