It’s like every other part of your body. Your genitalia - sex organs - can also catch an infection.
Anyone who has sex - whether vaginal, anal or oral intercourse or simply genital contact with an infected partner - can catch what is known as a sexually transmitted infection (STI). All STIs require medical attention and the best way to avoid most is by using a condom. So read on to find out how to avoid infections, get tested and get treated.
What are genitalia - the sex organs?
A man’s genitalia are the urethra, penis, testicles, scrotum, anus, rectum.
For women, the genitalia are the urethra, vulva, vagina, cervix, anus, rectum.
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Signs and symptoms
Many STIs do not have any noticeable signs and symptoms. Some may have symptoms that pass but the infection remains and can still be passed on. For this reason, it’s a good idea for everyone who’s been sexually active to have a check up.
Some symptoms that may indicate you have an STI:
- An unusual discharge - vaginal, urethral or anal
- An unusual or unpleasant smell
- Blisters or sores
- Pain or a burning sensation when passing urine
- Lumps
- Itching
- Pain or discomfort during sex
- Unexpected vaginal bleeding either after sex or between periods
Where can I go for help?
If you have any symptoms, believe you may have been in contact with someone who has an STI, or simply want a check up, there are several places you can go for help and advice. As some services only test for selected infections, be sure you know what you are being tested for.
GUM - genitourinary medicine - or sexual health clinics deal specifically with STIs and may be part of a hospital or based separately in their own premises. Sometimes they offer a drop-in service, where you do not need an appointment but others are by appointment only.
At Caledonia Youth, we can test for chlamydia at our Edinburgh and Falkirk clinics and can also refer you to other services if required. Many GPs and family doctors, health clinics and family planning clinics also offer infection testing.
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The number for local clinics can be found in the telephone directory, or try contacting one of the organisations listed at Publications and Links
Tests and treatment
Tests start with urine samples or swabs. Some results can be given on the same day, while others can take up to two weeks.
For some STIs the treatment requires you, and the person or people you have had sex with, to take antibiotics, which will clear the infection completely. This does not mean you are protected against catching the infection again in the future if you have sex with someone who is infected.
Certain infections can’t be cured, although treatment to prevent or relieve symptoms can be given in some cases.
How to avoid STIs
The most effective way of not putting your health at risk and reducing your chance of catching an STI, is to steer clear of risky behaviour and always enjoy safe sex no matter what your sexual persuasion. Limiting the number of sexual partners and using condoms during intercourse greatly reduces the chance of becoming infected.
How to avoid STIs:
- Enjoy safer sex by always using a condom, femedom or a dam correctly whenever you have vaginal, anal and oral sex
- If you think you may have been infected, contact your local sexual health clinic immediately and ask for a test
- If you have an STI it is important to tell your sex partner or partners so that they can be tested and treated quickly
- If you change your partner, seek a test before you have sex with anyone else
- While you wait for your test or results, you shouldn’t have sexual contact with anyone
- If you have the infection, wait until you have been treated and are no longer infectious before you have further sexual contact
- With genital herpes, avoid sex when you or your partner have blisters or ulcers, or can feel blisters developing - herpes is still contagious even when no blisters or ulcers are actually present
- Avoid using drugs that are injected with a syringe - do not share syringes or needles with others
Both men and women should share the responsibility for good sexual health. It makes sense to take precautions. After all, prevention is better than cure or, worse case scenario, no cure.
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Find out more about these different STIs:
Although some other infections such as thrush, scabies or cystitis may be transmitted sexually, they aren't classed as STIs.
Chlamydia
Up to one in ten sexually active young people has chlamydia, by far the most commonly diagnosed STI. This is one STI that can spread rapidly because most sufferers show no symptoms, leaving them completely unaware that they are infected and passing it on. Yet it can cause infertility in both men and women and dangerous pelvic inflammatory disease (PID) in females. PID can scar the fallopian tubes, which blocks them and prevents fertilisation from taking place.
Many being tested positive are in a stable, long-term relationship and while they may not have had a lot of partners, they admit that they haven’t always used a condom - one of the best means of preventing the spread of STIs. Popping the contraceptive pill may help prevent unplanned pregnancy, but it provides no barrier against potentially STIs.
Signs and symptoms
For those who do experience symptoms, it could be an abnormal discharge from the vagina or penis or pain while urinating. But even these signs can be quite mild and easily missed. Untreated infections can also result in painful or uncomfortable intercourse. Who wants that?
Tests and treatment
It’s such a simple, painless, urine test. If you've had anal or oral sex, a swab will be taken from the rectum or throat. The treatment can be just as simple – a course of antibiotics either as a single dose or a longer course for up to two weeks.
Complications brought about by long-term infection can be much more difficult to deal with. Early diagnosis and treatment will reduce the risk of complications, so possible symptoms should be investigated as soon as possible.
Remember even when there are symptoms of chlamydia, these can be mild or easy to miss. So if there is any chance at all of infection, it’s always best for you and your partner or partners to get things checked out immediately. Even though you feel perfectly healthy, if you are sexually active you may still need to be tested periodically.
If you suspect you may have chlamydia, you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.
Genital Herpes
Genital herpes is a contagious STI caused by a virus. It infects the skin and mucous membranes of the genitals and around the rectum and is passed on by physical and sexual contact. A cold sore can also infect the genitals through oral sex.
The virus attacks the cells in the outer layer of skin where blisters will form. It is transported through the bloodstream down to the nerve roots where the virus lies dormant. If the skin is then damaged in the area around the nerve where the virus lies, or if the immune system is weakened by something like a heavy cold or fatigue, the virus will be reactivated and appear again as herpes.
Signs and symptoms
Genital herpes will appear four to seven days after infection. The first sign is an uncomfortable prickly and piercing sensation, followed by small blisters that appear on the skin between a few hours and up to two days later.
Herpes appears as redness and small watery blisters on the genitals and may be accompanied by pain, itching and burning. The blisters will burst and turn into small ulcers, which will heal after two to three weeks without scarring.
Some people will have very weak symptoms or none at all, while others will experience fever, muscular pains and headaches along with a burning and itching pain in the genitals and around the rectum. There can be considerable discomfort when passing urine. Recurrent outbreaks will generally be milder than the first.
The virus is still contagious and can be passed on even if there are no blisters or ulcers present.
Pregnant woman with genital herpes should consult their doctor. Babies can be infected with herpes at birth because they can pick up the virus from the birth canal or vulva. This risk does not apply to a Caesarean section.
Tests and treatments
In most cases, a description of the condition and the appearance of the blisters will be enough to make a diagnosis, although confirmation is usually done by analysis of the watery fluid in a blister. After the first attack, further attacks can be milder and more difficult to diagnose.
Medicines used to fight the herpes virus include antiviral creams for affected areas and antiviral medication in oral form. Medication is usually necessary and it is important to start treatment when the first signs of herpes appear. Early treatment will shorten the outbreak to a few days.
If you suspect you may have genital herpes, you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.
Genital Warts
Genital warts are an STI caused by the human papilloma virus (HPV) and most common in younger people. They can be flat with stalks or cauliflower-like and most often seen on the genitals or the area around the rectum.
Some types are more resistant to treatment than others, and some are associated with the early stages of cancer in the genitals.
Signs and symptoms
Genital warts do not appear until two to four weeks after infection and sometimes even months pass before they become visible. Although they don’t usually hurt, they can be itchy. They vary in appearance from completely flat to rough cauliflower-like warts. They can appear on their own or in groups.
In males, genital warts often appear on the penis or underneath the foreskin. They can also be situated in the urethra, in most cases at the very end of it, and the area around the rectum.
In females, genital warts appear on the lips of the vulva, in the vagina, or by the urethra. Genital warts can also appear in and around the rectum.
Genital warts can be so flat that they become invisible to the naked eye, but they usually make themselves felt through an itchy and burning sensation. 'Invisible' genital warts can be detected by a doctor as described below.
Tests and treatment
An examination by a doctor can detect 'invisible' genital warts by swabbing the skin with acetic acid, which will show the warts as white patches on the skin. They can be treated by dabbing them with the cell poison podophyllotoxin, but it is important that both partners are treated.
While treatment may last for months, make sure you follow it through as they are relatively easy to treat when they are small and few. Anyone who has previously been infected with genital warts runs the risk that they will return now and again for the rest of their life - sometimes there is only one outbreak
Some cases may be referred to a specialist in skin and STIs who will remove the warts under local anaesthesia using surgery, freezing or laser treatment.
If you suspect you may have genital warts, you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.
Gonorrhoea
Gonorrhoea is an STI caused by the bacteria Neisseria gonorrhoeae, most frequently affecting young people aged 15 to 25-year-olds.
While mainly passed on through sexual contact, mothers infected with gonorrhoea can also transfer the disease to their children during delivery. If untreated, the children may develop a serious inflammation of the eyes, which can result in blindness.
Signs and symptoms
While many people don’t show any symptoms, the primary sign is painful urination. For men, discharge is also seen from the urethra - the tube that passes urine from the body. Discharge is slimy and small at first but quickly develops into a more substantial yellowish substance if left untreated. In women an increasing amount of discharge from the vagina can also be a symptom.
Homosexual men can develop gonorrhoea in the rectum. This varies from being symptom-free to the painful discharge of bloody pus from the rectum.
If you have had oral sex with an infected partner, a throat infection can occur, sometimes along with a fever.
If left untreated, it can develop into an inflammation of the sexual organs in women and testicles in men. A potential long-term problem in women is closure of the Fallopian tubes increasing the risk of sterility and ectopic pregnancy.
In very rare cases, gonorrhoea can spread to the whole body through the veins, resulting in painful joints, rashes, high temperature, and shivering. In extreme cases, cerebrospinal meningitis and inflammation of the heart might develop.
Tests and treatment
A smear is taken from the urethra, the neck of the uterus, the throat or the rectum – depending on whether you have had vaginal, oral or anal sex - to see if gonorrhoea is present.
If the test is positive, treatment is a course of antibiotics. If you suspect you are infected, it is extremely important that both you and your partner or partners are tested.
If you suspect you may have gonorrhoea, you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.
Hepatitis
In the UK, hepatitis usually occurs through unprotected sex, the sharing of contaminated needles by drugs users, accidental injury with a contaminated needle - if needles used for tattooing, body piercing or acupuncture are contaminated - and sharing razors or even toothbrushes.
This is a virus usually transmitted through contact with infected blood or body fluids. Only a tiny amount of blood is needed to transmit the virus because it's so infectious. The virus may also be present in saliva, vaginal secretions, breast milk and other bodily fluids.
While you can catch both hepatitis B and hepatitis C from sexual contact, it's very uncommon to catch hepatitis C. That’s because hepatitis B is much more infectious and, in fact, is up to 100 times more infectious than HIV!
You can reduce your risk by:
- Always wearing a condom properly when having sex with an infected person
- Never share needles or syringes
- Never share personal items from someone infected with hepatitis such as razors or toothbrushes
- Always wear gloves when coming into direct contact with blood and other body fluids
- Protect your eyes, mouth and nose from contact with blood and other body fluids
Signs and symptoms
Symptoms vary with roughly one-third of cases having none - this is called a silent infection, meaning there is no jaundice or yellow appearance of the skin and membranes. In another third of cases, mild symptoms can be similar to those of flu with weakness, aches and pains, headache, fever, loss of appetite, diarrhoea, jaundice, nausea and vomiting.
In the final third, the infection can cause severe illness that last many months with abdominal pain, diarrhoea and jaundice, as well as flu-like symptoms.
Jaundice occurs in hepatitis infections because the liver becomes unable to remove a substance called bilirubin from the blood. This is a pigment that builds up in the body, causing the skin and whites of the eyes to turn yellow. Rarely, rapid liver failure develops, which may need a life-saving liver transplant.
In as many as one in five cases, the infection then goes into a chronic phase, where people may be apparently healthy with no symptoms but carrying and shedding the virus (known as healthy carriers).
Tests and treatments
While the majority of people with hepatitis don't need specific treatment other than rest, it is important that the infection is monitored to check whether chronic disease develops. The person is also given advice about the risk of passing on the infection.
You may need more specific drug treatment if the infection lasts more than six months, to reduce the risk of permanent liver damage (cirrhosis) and liver cancer. Your GP will refer you to a specialist in either liver disease or general digestive diseases.
If you suspect you may have hepatitis you should see your GP without delay. All diagnosis and treatment is free and confidential.
HIV and AIDS
HIV means 'human immunodeficiency virus'. In 8 out of 10 cases, HIV is transmitted during sex between a man and a woman or between two men. The virus is passed on when infected blood, semen, or vaginal fluids from one partner enters the body of the other partner through the very thin skin of their sex organs, mouth or anus, or through sores or cuts on their mouth, hands or body.
It attacks some of the cells vital to a healthy immune system, including the white blood cells. At the start of HIV infection you can either have a short, flu-like illness that occurs one to six weeks after infection, or a so-called 'dumb' infection with no symptoms at all. Even if you don’t have any symptoms you can still infect other people.
Six to 12 weeks after infection, the white blood cells have produced so many antibodies against HIV that they can be measured in the blood. If you have HIV antibodies in your blood, you are HIV-positive (HIV+). Although an infected person will feel well for a long time, the infection is still active inside the body.
The number of white blood cells will slowly be reduced and, after a number of years when the immune system has been weakened, the infected person will start showing symptoms of AIDS –‘acquired immune deficiency syndrome'. Without treatment, it takes an average of nine years for AIDS to develop after initial infection with the HIV virus.
AIDS sets in when the HIV virus has killed so many white blood cells that the immune system is no longer able to recognise and react to attacks from everyday infections. HIV may also attack the nervous system.
Signs and symptoms
- Fatigue
- Inexplicable weight loss
- Repeated bronchial and skin infections that do not react to normal treatment
- Fever
- Diarrhoea
- Small, deep ulcers often preceded by small blisters
- Night sweats
- Outbreak of previous infections that have remained dormant such as herpes, shingles and other conditions
- Opportunistic infections - serious infections by micro-organisms normally prevented by the immune system, which could lead to related illnesses such as cancer or dementia
- The disease can become so serious that the infected patient dies
Tests and treatment
If you have been exposed to infection, you should contact your GP as soon as possible for advice, testing and treatment. In most cases, the GP will advise that you are tested approximately three months after the possible time of infection - a test that checks both antibodies and the HIV virus itself. In some instances of early HIV infection, the treatment is started at this very early stage.
While new and more efficient treatments to fight HIV are being developed all the time, unfortunately HIV is a very efficient virus that can mutate and create new variants resistant to the medicines. To reduce the risk of developing resistance to the medication and fight the virus from several directions, you will be offered a treatment that includes several types of medication.
For help and advice contact AIDS and HIV support groups.
Pubic Lice
Pubic lice, also called ‘crabs’, are parasitic insects found in the genital area. They are usually spread through sexual contact. Rarely, they can be spread through contact with an infested person's bed linens, towels or clothes. A common misbelief is that infestation can be spread by sitting on a toilet seat. This is unlikely, since lice cannot live long away from a warm human body.
Although generally found in the genital area on pubic hair; they may occasionally be found on other coarse body hair on the legs, armpit, eyebrows and eyelashes. Lice found on the head are not pubic lice; they are head lice.
Signs and symptoms
- Itching in the genital area
- Visible nits - lice eggs on pubic or other body hair
- Black powdery droppings from the lice in underwear
A lice infestation is diagnosed by looking closely through pubic hair for nits, nymphs, or adults. If crawling lice are not seen, finding nits – lice eggs - confirms that a person is infested and should be treated. If you are unsure about infestation or if treatment is not successful, see a health care provider for a diagnosis.
Tests and treatment
A lice-killing shampoo is recommended to treat the STI. Medication is generally very effective.
If you suspect you may have pubic lice, you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.
Syphilis
Syphilis is a bacterial STI that is typically passed through sexual contact, although 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, known as congenital syphilis. It can’t be caught through casual contact, such as toilet seats or sharing cutlery.
The condition can be particularly dangerous because it lies dormant for many years - after some initial symptoms - and can recur, causing serious damage to the heart, nervous system, eyes and brain and almost every other part of the body.
Signs and symptoms
Symptoms 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, typically during sexual contact, then they can catch the condition. Secondary symptoms, which develop two to ten weeks after the appearance of the chancre, include a skin rash, sore throat, tiredness and headaches.
Although symptoms then disappear, even without treatment, 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 is known as late or tertiary syphilis.
Syphilis is more common in men than women, and rates are highest among gay men. Catching syphilis increases your chances of catching HIV.
Tests and treatment
A swab is used to take a sample of the fluid from a sore and tested for the presence of the bacteria. A blood test can also detect the infection.
Syphilis can be successfully treated with antibiotics. Sexual partners should be informed, and sexual contact avoided until all sores have healed and the infection has gone.
If you suspect you may have syphilis you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.
Trichomonas
Trichomonas infection is an STI. Although not normally serious, symptoms can be unpleasant.
It can infect the vagina and urethra in women, and the urethra and sometimes the prostate gland in men.
Signs and symptoms
While no symptoms occur in up to half of infected women, some can experience a vaginal discharge, usually greeny-yellow in colour and it may also be 'frothy' with an unpleasant or fishy smell. Your vagina and vulva may be itchy and uncomfortable and the irritation may extend into the groin. Sex may be painful and it could be sore when you pass urine.
As with women no symptoms occur in up to half of infected men, while others can experience discharge from the penis and pain when you pass urine - you may pass urine frequently due to irritation inside the penis.
Tests and treatments
It is important to get the correct diagnosis as the same symptoms can be caused by a number of different infections. A doctor or nurse may take a swab from the vagina or penis for testing. A sample of urine from men may also show the infection.
A course of antibiotics usually clears the infection and you and your sex partner or partners should be treated at the same time. You should not have sex until you have finished treatment, and symptoms have gone.
If you suspect you may have Trichomonas you should see your GP or local genito-urinary medicine (GUM) clinic without delay. All diagnosis and treatment is free and confidential.