STIs

Hi Readers! 

This week, we will expand our knowledge on Sexually Transmitted Infections (STIs).

If you are worried that you have an STI, go for a check-up at a sexual health clinic as soon as you can. Do not have sex, including oral sex until you have had a check-up. 

Some clinics offer home testing kits for some STIs.

STI symptoms:

  • Unusual discharge from the vagina, penis or anus
  • Pain when urinating
  • Lumps or skin growths around the genitals or anus 
  • A rash
  • Unusual vaginal bleeding
  • Itchy genitals or anus
  • Blisters and sores around the genitals or anus

Chlamydia

Chlamydia is one of the most common STI in the UK. It gets passed on through unprotected sex (sex without a condom) and is particularly common in sexually active teenagers and young adults. If you are under the age of 25 and are sexually active, it is highly recommended you get tested for chlamydia every year or when you change sexual partners.

Symptoms:

  • Pain when urinating
  • Unusual discharge from the vagina, penis or anus
  • For women, pain in the tummy, bleeding after sex and bleeding in between menstruation
  • For men, pain and swelling in the testicles

You can get chlamydia through:

  • Unprotected vaginal, anal or oral sex
  • Sharing sex toys that are not washed or covered with a new condom each time they are used
  • Your genitals coming into contact with your partner’s genitals – this means you can get chlamydia from someone even if there is no penetration, orgasm or ejaculation
  • Infected semen or vaginal fluid getting into your eye
  • It can be passed on by a pregnant woman to her baby. 

Chlamydia cannot be passed on through casual contact such as kissing, hugging or sharing baths, towels, swimming pools and toilets.

Treatment: 

  • Chlamydia is treated with a course of antibiotics. 

Gonorrhoea

The bacteria that cause gonorrhoea are mainly found in discharge from the penis and in vaginal fluid. This STI is easily passed on through unprotected vaginal, oral or anal sex, sharing sex toys that have not been washed or covered with a new condom each time they’re used. 

The bacteria can infect the entrance to the womb (cervix), the tube that passes urine (urethra), the rectum and, less commonly, the throat or eyes. 

The infection can be passed on from a pregnant woman to her baby. If you are pregnant and may have gonorrhoea, itIis important to get tested and treated before your baby is born because without treatment, gonorrhoea can cause permanent blindness in a newborn baby.

Gonorrhoea cannot spread by kissing, hugging, swimming pools, toilets, sharing a bath, towels, cups, plates or cutlery. The bacteria cannot survive outside the human body for long. 

Symptoms:

  • Thick green or yellow discharge from vagina, penis, pain when peeing and in women, bleeding between menstruation. However, around 1 in 10 infected men and almost half of infected women do not experience any symptoms (NHS).

Treating Gonorrhoea

  • Usually treated with a course of antibiotics.
  • You should avoid having sex until you have been told you no longer have the infection.
  • Previous, successful treatment for gonorrhoea does not make you immune to catching it again.

Trichomoniasis

Trichomoniasis is a STI caused by a tiny parasite called Trichomonas vaginalis (TV). In women, this parasite mainly infects the vagina and the urethra. In men, the infection mostly affects the urethra, but the head of the penis or prostate gland can become infected in some cases.

The parasite is usually spread by having sex without using a condom. You can also contract trichomoniasis by sharing sex toys if they were not washed or covered by a condom. You do not have to have multiple sexual partners to catch trichomoniasis.

You cannot get or pass on trichomoniasis through kissing, hugging, sharing cups, plates, cutlery or toilet seats.

Symptoms:

Symptoms usually develop within a month of infection, but approximately half of the people will not develop any symptoms (but they can still pass the infection). Trichomoniasis can be difficult to diagnose as it has similar symptoms to many STIs.

  • Trichomoniasis in women:
    • 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, swelling and itching around the vagina – sometimes the inner thighs also become itchy.
    • Pain or discomfort when passing urine or having sex.
  • Trichomoniasis in men:
    • Pain when passing urine or during ejaculation
    • Needing to pee more frequently than usual
    • Thin, white discharge from the penis
    • Soreness, swelling and redness around the head of the penis or foreskin

The best way to prevent trichomoniasis is to have safe sex, which means using a condom when having sex, covering any sex toys with a condom and washing your toys after every use.

Treatment:

  • This parasite is unlikely to go away without treatment. It can be effectively treated with antibiotics. It is important to avoid having sex while on treatment. Wait until the infection clears up before resuming your sexual activities. 

Complications:

Complications of trichomoniasis are rare, although some women with the infection may be at an increased risk of further problems. If you are infected with trichomoniasis while pregnant, the infection may cause your baby to be born prematurely or have low birth weight.

Genital warts

Genital warts are a common STI passed on by vaginal and anal sex, sharing toys and rarely by oral sex. You can get genital warts from skin-to-skin contact, including vaginal and anal sex, sharing sex toys and oral sex, though this is less common. 

Symptoms:

  • 1 or more painless growths or lumps around your vagina, penis or anus. 
  • Itching or bleeding from your genitals or anus
  • A change to your normal flow of urination.
  • A sexual partner who has genital warts, even if you do not have symptoms

Treatment for genital warts:

  • The treatment needs to be prescribed by a doctor. 
  • The type of treatment will depend on what the wart looks like and where they are.
  • Treatment can be cream or liquid, surgery or freezing.

If you notice these warts, consult your GP and/or sexual clinic as soon as you can.

If you have genital warts and are pregnant, tell your GP or midwife. Genital warts during pregnancy can grow and multiply, might appear for the first time, or come back after a long time of not being there. They can still be treated safely (but some treatment should be avoided); they may be removed if they’re very big to avoid problems during birth. These may be passed to the baby during birth, but it is rare.

Genital herpes

Genital herpes is a STI passed on through vaginal, anal and oral sex. 

You can get genital herpes from skin-to-skin contact with an infected area (including vaginal, anal and oral sex), even when there are no visible sores or blisters, if a cold sore touches your genitals, by transferring the infection on fingers from someone else to your genitals or by sharing sex toys with someone who has herpes. It is therefore recommended that you do not have oral sex if you have cold sore.

Symptoms:

  • Small blisters around your genitals, anus, thighs or bottom
  • Tingling, burning or itching around your genitals 
  • Pain when you urinate
  • In women, vaginal discharge 

You should speak to your GP or go to a sexual health clinic if you see blisters, even if you haven’t had sex in a while, as blisters take months or years to appear. 

Treatment:

  • There is no cure, symptoms will clear up by themselves, but the blisters can come back (outbreak or recurrence). You may be prescribed antiviral medicine (including as a cream) to stop the symptoms from getting worse.

Always keep the areas of the outbreak clean to prevent infection.

Genital herpes can be more serious for people living with HIV. If you are living with HIV, and have genital herpes, you will be referred to a GUM clinic. 

Women with herpes before pregnancy can usually expect to have a healthy baby and a vaginal delivery. If you have genital herpes during pregnancy, there is a risk your baby could develop a serious illness called neonatal herpes.

Pubic lice

Public lice, sometimes called crabs, are tiny insects that live on coarse human body hair, such as public hair. They may also be found in underarm and leg air, hair on the chest, abdomen and back, facial hair, such as beards and moustaches, eyelashes and eyebrows (occasionally). Unlike head lice, pubic lice don’t live in scalp hair. It is spread through close bodily contact, most commonly sexual contact. 

Symptoms:

  • Itching in the affected areas, especially at night
  • Inflammation and irritation caused by scratching
  • Black powder in your underwear
  • Blue spots or small spots of blood on your skin, such as your thighs or lower abdomen (caused by lice bites)

Treatment:

Can be treated at home with insecticide cream, lotion or shampoo

Complications:

  • Sometimes a pubic lice infestation can lead to minor complications, such as skin or eye problems.
  • Can lead to skin infection
  • Eye infection, like conjunctivitis, eye inflammation
  • Mild fever, feeling tired

It is important to seek medical attention if you have severe skin irritation or sore eyes

Scabies

Scabies is very common and anyone can get it. It should be treated quickly to stop the spreading.

One of the first symptoms is itching, especially at night.

Scabies is very infectious, but can take up to 8 weeks for the rash to appear.

During your treatment, you should not have sex or come into close contact with anyone.

Scabies can spread easily. 

Complications:

  • Scratching can cause infections
  • Scabies can make conditions like eczema and psoriasis worse.

Syphilis

Syphilis is a bacterial infection that’s usually caught by close contact or having sex with someone who is infected.

It is very important to get tested and treated as soon as possible. Syphilis can be cured with a course of antibiotics. That being said, you can get syphilis more than once.

Symptoms:

  • Small, painless sores and ulcers that typically appear on the penis, vagina, or around the anus, but can occur in other places (i.e.: the mouth)
  • A blotchy red rash that often affects the palms of the hands or soles of the feet.
  • Small skin growths (similar to genital warts) that may develop on the vulva in women or around the anus for both men and women
  • White patches in the mouth
  • Tiredness, headaches, joint pains, high temperature and swollen glands in your neck, groin, or armpits.

If left untreated, syphilis can spread to the brain or other parts of the body and cause serious long-term problems.

Treatment:

  • Injection of antibiotics.

Syphilis in pregnancy:

If a woman is infected while pregnant, it can be very dangerous for her baby if not treated. Infection in pregnancy can cause miscarriage, stillbirth or serious infection in the baby.

Screening for syphilis during pregnancy is offered to all pregnant women so the infection can be detected and treated before it causes any complications.

Preventing STIs

  • Use a male or female condom every time you have vaginal or anal sex
  • Use a condom to cover the penis during oral sex
  • Using a dam (a piece of thin, soft plastic or latex ) to cover the female genitals during oral sex or when rubbing female genitals together. (Cool trick: you can cut a condom to create a dam! Cut the tip on the condom, then cut it lengthwise. You will see that it looks like a rectangle. It is ready to use. Keep good hygiene with this. Do not start flipping it over.)
  • Not sharing sex toys. And if you do share them, use a condom (one for each person) to cover them or wash them after each person who uses them.

I hope this article has help you better understand STIs and why it is important to keep good hygiene and use protection!

Be kind to one another!

Julia, Sexologist

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Contraception

Hi Readers!

Did you know that without the use of contraception, 85 women in every 100 will get pregnant in 1 year. (UCL)

Contraception is a choice and a right. You need to choose the method that works best for you. We will go over multiple contraception choices in the article, but I highly suggest you speak to your doctor before making that choice, ensuring that the method you choose is appropriate for your body based on your medical history. 

You also need to remember that while most of these contraception methods help prevent pregnancy, they do not protect against STIs! Please be mindful of this. It is also suggested that you use these contraceptives in combination with the condom. 

Implant

Fewer than 1% of women will get pregnant in one year. (UCL)

The implant is a small piece of plastic that is put under the skin of the arm. It contains the hormone progestogen, which hormone is very similar to the oestrogen your body produces. It lasts for up to 3 years, but can be taken out at any time

Benefits:

  • It’s extremely good at preventing pregnancy
  • Very convenient; it doesn’t interrupt sex
  • Menstruation can be lighter and less frequent
  • It helps to make menstruation less painful
  • It can help you deal with pre-menstrual symptoms (PMS)
  • Often suitable for people who can’t take oestrogen

Risks:

  • A small injection of local anaesthetic is needed to put it under the skin
  • Irregular bleeding can be a nuisance (1 in 5 women) (UCL)
  • Some women get side effects like mood changes and changes in sex drive
  • No protection against STIs

IUS

Fewer than 1% of women will get pregnant in one year. (UCL)

The hormonal coil (IUS) is made of plastic and releases a small amount of progestogen. It is inserted into the womb by a doctor or nurse and lasts up to 5 years. The IUS can be a great help for heavy or painful periods. 

Benefits:

  • Lasts up to 5 years 
  • No need to remember pills or patches
  • It doesn’t interrupt sex
  • It is extremely good at preventing pregnancy
  • Menstruation is usually lighter and less painful
  • It is a low level of a very safe hormone
  • Often suitable for people who can’t take oestrogen
  • It’s usually quick and easy to take out
  • Can help with pre-menstrual symptoms (PMS)

Risks:

  • The procedure can be painful
  • Some have irregular bleeding
  • The IUS can come out (1 in 20)
  • STI check needed before putting it in
  • No protection against STIs
  • Can cause mood changes, skin problems or breast tenderness

Rare risks:

  • Can go through the wall of the womb when it’s put in (fewer than 1 in 1000)
  • Pregnancy outside the womb (ectopic pregnancy) – possible but very rare

Copper Coil (IUD)

Fewer than 1 in 100 women will get pregnant in one year.

The Copper Coil (IUD) is made of plastic and copper. It’s put into the womb by a doctor or a nurse and lasts 5 to 10 years. The method is popular as it has no hormones

Benefits:

  • It doesn’t interrupt sex
  • It doesn’t contain hormones
  • No need to remember pills or patches
  • Lasts 5 to 10 years
  • It is usually quick and easy to take out
  • It is extremely good at preventing pregnancy
  • Almost all women can use the IUD (speak to your GP)

Risks:

  • Can make menstruation heavier and more painful
  • Having it fitted can be painful
  • The IUD can come out (1 in 20) 
  • STI check needed before putting it in
  • No protection against STIs

Rare risks:

  • IUD can go through the wall of the womb when it is put in (fewer than 1 in 1000)
  • Pregnancy outside the womb (ectopic pregnancy) – possible but rare

Injection

3 in 100 women can get pregnant in one year when using depo injections.

The injection (or depo) is given as an injection into the buttocks or thigh every three months. It contains a hormone called progestogen. It is long-lasting and convenient, it can stop periods temporarily 

Benefits:

  • It doesn’t interrupt sex
  • It helps to make periods lighter and less painful
  • Most women (7 in 10) have no periods
  • Often suitable for people who can’t take oestrogen
  • It’s extremely good at preventing pregnancy
  • It protects against cancer of the womb

Risks:

  • It’s an injection, which some people dislike
  • May cause irregular bleeding
  • Weight gain is fairly likely (3kg in 2 years)
  • Possible changes in mood and sex drive
  • Not suitable for someone who definitely wants a regular period
  • It can take several months to wear off
  • No protection against STIs

Combined Pill

8 in 100 women can get pregnant in one year while using the combined pill.

The combined pill (“the pill” as most people call it) is taken daily and usually with a week off, once a month, to allow menstruation to happen. It contains 2 hormones, which are similar to women’s own hormones. Easy to start and stop, but can be difficult to remember to take

Benefits:

  • Easy to take; one pill a day
  • It doesn’t interrupt sex
  • The pill is good at preventing pregnancy
  • It helps to make menstruation lighter and less painful
  • Menstruation will usually be very regular
  • Easy to know and to control when menstruation will come
  • The pill can help with acne and spots
  • Some users notice enlargement of their breasts
  • It protects against womb and ovarian cancer
  • Protects against pelvic inflammatory disease

Risks:

  • Can be difficult to remember to take the pill
  • No protection against STIs

Possible side effects:

  • Spotting (bleeding in between periods)
  • Nausea
  • Sore breasts
  • Changes in mood or sex drive
  • Feeling more hungry
  • Blood clots in the legs or lungs (1 in 5,000 women)

Mini Pill 

8 in 100 women can get pregnant using the mini-pills.

The progestogen-only pill (mini-pill) is taken every day without any breaks. It contains a hormone which is very similar to one of the hormones produced by a woman’s body. It needs to be taken at the same time every day.

Benefits:

  • Easy to take; one pill a day, every day
  • It doesn’t interrupt sex
  • It’s good at preventing pregnancy
  • Under the user’s control
  • It’s out of the system quickly once stopped
  • Often suitable for people who can’t take oestrogen
  • It can help with heavy or painful periods
  • It may mean that periods stop (temporarily)
  • Can be used when breastfeeding

Risks:

  • Can be difficult to remember 
  • No protection against STIs

Possible side effects:

  • Irregular bleeding
  • Headaches
  • Sore breasts 
  • Changes in mood
  • Changes in sex drive

Patch

8 in 100 women will get pregnant in one year while using patches.

The patch is a square sticker like a thin plaster. It contains 2 hormones (oestrogen and progestogen) which are very similar to women’s own hormones. The patch is changed once a week

Benefits:

  • Easy to use; change once a week
  • It doesn’t interrupt sex
  • The patch is good at preventing pregnancy
  • It helps make periods lighter and less painful
  • Periods are usually very regular
  • Easy to know and control when a period will come
  • The patch can help with acne
  • Some users notice some enlargement of their breasts
  • It protects against womb & ovarian cancer and pelvic inflammatory disease

Risks:

  • It can be hard to remember when to change
  • No protection against STIs
  • Only available in a light colour making it visible on many women

Possible side effects:

  • Spotting (in between periods)
  • Nausea
  • Sore breasts
  • Changes in mood or sex drive
  • Increased appetite 
  • Blood clots in the legs or lungs (1 in 5,000) 

The Ring

9 in 100 women will get pregnant in a year while using vaginal rings

The vaginal ring is a soft plastic ring put in the vagina. It releases oestrogen and progestogen, which are similar to the women’s own hormones. The ring must be changed every 3 weeks with a week off

Benefits:

  • Easy to use; one ring lasts 3 weeks
  • It doesn’t interrupt sex
  • The ring is good at preventing pregnancy
  • It helps to make periods lighter and less painful
  • Periods will usually be very regular
  • Easy to know and to control when a period will come
  • The ring can help acne
  • Some users notice some enlargement of their breasts
  • It protects against womb & ovarian cancer and pelvic inflammatory disease

Risks:

  • Need to remember to change it once a month
  • No protection against STIs

Possible side effect

  • Spotting 
  • Nausea
  • Sore breasts
  • Change in mood or sex drive
  • Feeling more hungry
  • Blood clots in the legs or lungs (1 in 5,000)

Condoms

15 in 100 women will get pregnant in one year when using a condom during sexual activity

There are two different types of condoms, male condoms that are worn on the penis and female condoms which are placed inside the vagina. Condoms are made from very thin latex, synthetic nitrile, polyisoprene or polyurethane and can be used for vaginal, oral and anal sex. For men, the size and fit of condoms are important so that they are comfortable and don’t break or slip off. That being said, condoms are very stretchy and can expand.

Benefits:

  • Easy to obtain; clinics provide them for free
  • Available without the need to see a doctor, nurse or healthcare professional 
  • Protect against STIs
  • Gives men and women control over whether and when to have a baby
  • They may it easier to clean up after sex

Risks:

  • Condoms can interrupt sex
  • Condoms may reduce pleasure for either or both parties
  • It can be difficult to ask men to wear condoms
  • Some men worry about condoms and erections
  • Condoms need some skill; knowing how to stop condoms breaking or slipping off

Diaphragm

16 in 100 women will get pregnant in one year while using the diaphragm.

Diaphragms and cervical caps are cups made of silicone. It is put at the top of the vagina, to cover the cervix (neck of the womb). It’s used with spermicide (a cream that kills sperm). It is necessary to check if it’s in the right place before sex

Benefits:

  • Most women can use a diaphragm or cap
  • They are hormone-free
  • They can be put in up to 3 hours before sex
  • They offer some protection against STIs
  • Can have sex more than once with a diaphragm or cap in place (with extra spermicide) 
  • Skin to skin contact

Risks:

  • Diaphragms and caps are less effective than other methods
  • Technique needs a bit of practice
  • Need to be put in before intercourse
  • They need to be left in for 6 hours after sex
  • The spermicide can be messy
  • Some spermicides can increase the risk of HIV transmission 

Fertility Awareness 

25 in 100 women will get pregnant in one year using natural methods.

Fertility Awareness (natural family planning) is a way of predicting ovulation to work out when pregnancy is more likely. This method involves recording signs of fertility such as body temperature, thickness of fluid in the vagina and calculating fertility from menstrual cycle dates. Fertility awareness can be very effective (with daily monitoring).

Benefits:

  • Non-hormonal method
  • There are no side effects
  • The method involves learning how the body works
  • Skin to skin contact
  • Acceptable in most religions and cultures
  • Can be useful when trying to become pregnant

Risks:

  • It can be tricky to learn and takes a few months to monitor patterns
  • May have a higher risk of pregnancy
  • Daily monitoring is needed (temperature, thickness of fluid in the vagina)
  • Illness, stress or travel can make it hard to interpret signs
  • Unprotected sex must be avoided on the most fertile days
  • No protection from STIs
  • To work best, it should be thought by a qualified fertility awareness teacher, nurse, GP

Withdrawal 

27 in 100 women will get pregnant in one year when using the withdrawal method.

The withdrawal method (pulling out) is when a man pulls out before he ejaculates.

Benefits:

  • No need to see a doctor, nurse or healthcare professional 
  • Free 
  • No hormones
  • Acceptable for women whose religion or culture forbids other methods

Risks:

  • Requires extreme self control and body awareness of the man
  • It’s not a very reliable way of preventing pregnancy
  • There can be small deposits of sperm before orgasm (ejaculation)
  • Some people find withdrawal unsatisfying for sexual pleasure
  • Difficult to do it every time

Now that I have peaked your curiosity in this subject, I strongly recommend you read on the different methods in more detail on public health websites (NHS, etc.) to learn more about side effects, how they work, etc. You should also consult your GP as some methods may not be the right fit for you depending on your medical history.

If you would like to make an appointment to discuss your decision making process and the side effects of these methods please email me at depetrillojulia@gmail.com

Be kind to one another!

Julia, Sexologist

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