Introduction

Sexually transmitted infections (STIs) can affect anyone.

They are passed on through unprotected sex in the vagina, anus or mouth or by genital skin contact and the best way to protect yourself and your partner(s) is to use a condom each time you have sex.

Many people don’t notice symptoms when they have an STI but if left untreated, they can affect your health. If you have any of the symptoms listed below, get tested, so if treatment is required you will receive it as soon as possible.

Possible signs of an STI

  • pain when you pass urine (pee)
  • pain during sex
  • discharge from the penis or vagina which is not normal for you
  • itching, burning or tingling around the genitals
  • blisters, sores, spots or lumps around the genitals or anus
  • pain low down in your tummy
  • irregular bleeding between your periods or after sex
  • pain in your testicles

These symptoms don’t necessarily mean you have an STI, but it’s worth getting seen and having a chat with a clinician.

If you do not have any symptoms, the tests are very simple either a urine sample or a vaginal swab (which you take yourself) is required to test for Chlamydia and Gonorrhoea. A blood sample is taken to test for infections such as HIV, Hepatitis B/C and Syphilis

If you have symptoms an examination may be required.

Have safer sex

Always use condoms to help protect yourself from STIs. Condoms are available, free, from a number of outlets across Tayside, click here to find out where to find them. Always make sure you buy condoms that have the CE mark or BSI kite mark on the packet. This means they’ve been tested to high safety standards. Condoms that don’t have the CE mark or BSI kite mark won’t meet these standards, so don’t use them. For more information on condom types and where to find free condoms, click here.

List of STIs

Chlamydia is the most common bacterial sexually transmitted infection.
It’s passed on from one person to another through unprotected sex (sex with a broken condom or without a condom) and is particularly common in sexually active young people aged 16-25.

Symptoms
Most people with Chlamydia don’t notice any symptoms and don’t know they have it.

If you do develop symptoms, you may experience:

  • pain when urinating/peeing
  • unusual discharge from the vagina, penis or rectum (back passage)
  • pain in the tummy, bleeding from the vagina during or after sex, and bleeding between periods
  • pain and swelling in the testicles

Testing
Testing for chlamydia is done with a urine test or a swab test (usually self taken). You don’t always need a physical examination by a nurse or doctor.

Anyone can get a free and confidential Chlamydia test at a GP or sexual & reproductive health clinic.

Treatment
Chlamydia can be treated easily with antibiotics. You may be given some tablets to take all on one day, or a longer course of capsules to take for a week.

Prevention
Anyone who is sexually active can catch Chlamydia. You’re most at risk if you have a new sexual partner or don’t use a barrier method of contraception, such as a condom, when having sex.

Herpes simplex virus (HSV) can infect the skin and cause painful blisters on the genitals and surrounding areas.

As genital herpes can be passed to others through close sexual contact, it’s often referred to as a sexually transmitted infection (STI).

Symptoms
Symptoms include itching, blisters and painful ulcers around your genital skin or anus

Testing
Genital herpes can be diagnosed more easily and accurately when the infection is still active, so you should seek medical attention as soon as you develop symptoms. A swab is taken from an area of ulceration to test for herpes simplex virus (HSV) and you may also be tested for other STIs.

Treatment
Although there’s no cure for genital herpes, the symptoms can usually be well controlled using antiviral medicines.

However, it’s important to prevent the spread of genital herpes by avoiding sex until symptoms have cleared up and continuing to use a condom afterwards.

Prevention

Use a condom. By protecting yourself during all types of sex (vaginal, anal and oral), you reduce the risk of becoming infected with herpes and passing it on.

Be aware. Herpes never leaves the body so even if you don’t have any visible blisters or ulcers, you may still be infected.

Talk to your partner. Before embarking on a sexual relationship, talk to your partner about their sexual history, about the benefits of regular testing, signs to look out for and the need to use condoms for every type of sexual contact.

Genital Warts is caused by the human papilloma virus (HPV)

Symptoms

  • Produces lumps on the genital skin, in the vagina or anus

Testing
A doctor or nurse can usually diagnose warts visually, by looking at them.

They will:

  • ask you about your symptoms and sexual partners
  • look closely at the lumps around your genitals and anus
  • possibly need to look inside your vagina, anus or urethra (where pee comes out) depending where your warts are

Treatment
Treatment for genital warts needs to be prescribed by a doctor or nurse
The type of treatment you’ll be offered depends on what your warts are like. The doctor or nurse will discuss this with you. Most individuals receive either a cream or liquid to apply at home which successfully clears the warts and with time the virus from their body.

Do

  • tell the doctor or nurse if you’re pregnant or thinking of becoming pregnant, as some treatments won’t be suitable
  • avoid perfumed soaps or bubble baths during treatment as these can irritate the skin
  • ask the doctor or nurse if your cream treatment will affect condoms, diaphragms or caps

Don’t

  • use wart treatment from a pharmacy – these are not made for genital warts
  • smoke – many treatments for genital warts work better if you don’t smoke

It is important that you get the HPV vaccination in school 

Gonorrhoea is a bacterial sexually transmitted infection (STI). About 50% of women and 10% of men don’t experience any symptoms and are unaware they’re infected.

Symptoms

  • green or yellow discharge from the penis or vagina,
  • pain passing urine,
  • irregular bleeding
  • pain in the testicles

Testing
Gonorrhoea can be easily diagnosed by testing a sample of discharge, taking a swab from the vagina or a urine sample. Throat and rectal swabs can also be taken to test those sites.

It’s important to get tested as soon as possible, because gonorrhoea can lead to more serious long-term health problems if it’s not treated, including pelvic inflammatory disease (PID) in women, or infertility.

Treatment
Gonorrhoea is usually treated with a single antibiotic injection and a single antibiotic tablet. With effective treatment, most of your symptoms should improve within a few days.

It’s usually recommended that you attend a follow-up appointment after treatment, so another test can be carried out to see if you’re clear of infection.

You should avoid having sex until you’ve been given the all-clear

Pelvic inflammatory disease (PID) is the name given to inflammation of the womb, fallopian tubes or ovaries. In about a quarter of women it is caused by a sexually transmitted infection (STI) such as chlamydia or gonorrhoea.

Symptoms of PID can vary from very mild to severe – sometimes requiring treatment in hospital.

PID is a common condition, although it’s not clear how many women are affected in the UK. It mostly affects sexually active women aged 15 to 24.

Symptoms
PID often doesn’t cause any obvious symptoms.

Most have mild symptoms that may include one or more of the following:

  • pain around the pelvis or lower abdomen (tummy)
  • discomfort or pain during sex that’s felt deep inside the pelvis
  • bleeding between periods and after sex

A few women become very ill with:

  • severe lower abdominal pain
  • a high temperature (fever)
  • nausea and vomiting

Testing
It’s important to visit your GP or a sexual health clinic if you experience any of the above symptoms.

If you have severe pain, you should seek urgent medical attention from your GP or local A&E department. Delaying treatment for PID or having repeated episodes of PID can increase your risk of serious and long-term complications (see below).

There’s no simple test to diagnose PID. You will be examined and swabs will be taken from your vagina and cervix (neck of the womb), to check for infection including STIs but negative tests don’t rule out PID.

Treatment
If diagnosed at an early stage, PID can be treated with a course of antibiotics, which usually lasts for 14 days. You’ll be given a mixture of antibiotics to cover the most likely infections. It’s important to complete the whole course and avoid having sexual intercourse during this time to help ensure the infection clears.

Your recent sexual partners also need to be tested and treated to stop the infection recurring or being spread to others.

Prevention

Use a condom when you have sex.

Some methods of cleaning the vagina, like douching, or using some soaps, can disrupt the balance of bacteria in your vagina.

Getting tested for STIs and treating an STI as early as possible can lower your chances of getting PID.

Scabies is caused by tiny parasitic mites which burrow into the skin and lay eggs. Scabies mites are smaller than a pinhead. The mites that cause scabies can be found in the genital area but also on other areas of skin including between the fingers of the hands and on the wrists and elbows.

Symptoms
You might notice:

  • intense itching in the affected areas, which may only be noticed at night, or which becomes worse in bed at night or after a hot bath or shower
  • an itchy red rash or tiny spots. Sometimes diagnosis can be difficult because the rash can look like other itchy conditions, such as eczema
  • inflammation or raw, broken skin in the affected areas – usually caused by scratching

It can take up to six weeks after coming into contact with scabies before signs and symptoms appear.

Treatment
Scabies is not usually a serious condition, but it does need to be treated.
A pharmacist will recommend a cream or lotion that you apply over your whole body. It’s important to read the instructions carefully.

Everyone in the household needs to be treated at the same time – even if they don’t have symptoms.

Anyone you’ve had sexual contact with in the past 6 weeks should also be treated.

Do

  • Wash all bedding and clothing in the house on the first day of treatment

Don’t

  • have sex or close physical contact until you’ve completed the full course of treatment
  • share bedding, clothing or towels with someone with scabies

Testing
Diagnosed visually.

Prevention

Scabies is prevented by avoiding direct skin-to-skin contact with an infected person or with items such as clothing or bedding used by an infected person.

Pubic lice are tiny parasitic insects that live on coarse human body hair, such as pubic hair.

As well as being found in pubic hair, the lice are also sometimes found in:

  • underarm and leg hair
  • hair on the chest, abdomen and back
  • facial hair, such as beards and moustaches
  • eyelashes and eyebrows (very occasionally)

Unlike head lice, pubic lice don’t live in scalp hair.

Pubic lice are spread through close bodily contact, most commonly sexual contact.

Symptoms
After getting pubic lice, it can take several weeks before any symptoms appear. Symptoms are the same for men and women and include:

  • itching in the affected areas which may only be noticed at night, or which becomes worse in bed at night or after a hot bath or shower
  • inflammation and irritation caused by scratching
  • black powdery mites droppings in your underwear
  • blue spots or small spots of blood on your skin, such as on your thighs or lower abdomen (caused by lice bites)

Itching is the most common symptom of pubic lice and is an allergic reaction to their saliva. The itching is usually worse at night, when the lice are most active.

Testing
Visually. Adult pubic lice are very small (2mm long) and aren’t easy to see they are a yellow-grey or dusky in red colour

Treatment
Pubic lice can be treated at home with insecticide cream, lotion or shampoo. Your GP or pharmacist can advise you about which treatment to use and how to use it. It’s important to follow this advice.

Do

  • wash all bedding and clothing in the house on the first day of treatment

Don’t

  • have sex or close physical contact until you’ve completed the full course of treatment

Syphilis is caused by a bacteria Treponema Pallidum and can present with a variety of symptoms.

The symptoms of syphilis aren’t always obvious and may eventually disappear, but you’ll usually stay infected unless you get treated.

Some people with syphilis have no symptoms.

Symptoms

Symptoms can include:

  • small, painless sores or ulcers that typically appear on the penis, vagina, or around the anus, but can occur in other places such as the mouth
  • a blotchy red rash that often affects the palms of the hands or soles of the feet
  • tiredness, headaches, joint pains, a high temperature (fever), and swollen glands in your neck, groin or armpits

Testing
The test for syphilis usually involves a blood test and removing a sample of fluid from any sores using a swab (similar to a cotton bud).

You should get tested as soon as possible if you’re worried you could have syphilis

Treatment
Syphilis is usually treated with an injection of antibiotics. Most people will only need one dose, although three injections given at weekly intervals may be recommended if you’ve had syphilis for a long time, a course of antibiotics tablets if you can’t have the injection – this will usually last two or four weeks, depending on how long you’ve had syphilis.

You should avoid any kind of sexual activity or close sexual contact with another person until at least two weeks after your treatment finishes.

Trichomoniasis is a sexually transmitted infection (STI) caused by a tiny parasite called Trichomonas vaginalis (TV).

Symptoms

Symptoms of trichomoniasis such as vaginal discharge or pain passing urine usually develop within a month of infection, although up to half of all infected men and women have no symptoms.

Testing
You will be examined, a swab is taken from the vagina or penis. You will be tested for all STIs.

If your doctor or nurse strongly suspects you have trichomoniasis, you may be advised to begin a course of treatment before your results come back. This ensures your infection is treated as soon as possible and reduces the risk of the infection spreading.

Trichomoniasis can be effectively treated with antibiotics. Most men and women are treated with an antibiotic called metronidazole, which is usually taken twice a day for five to seven days.

It’s important to complete the whole course of antibiotics and avoid having sex until the infection clears up, to prevent reinfection.
Your current sexual partner and any other recent partners should also be treated.

Prevention

The best way to prevent Trichomonas is to use condoms during any type of sexual contact. In addition, it may be helpful to:

  • Use a barrier contraceptive method (condoms, female condom, dental dam) during oral sex.
  • Avoid sharing sex toys.
  • Get screened for STIs and talk to your partners about their results.

Hepatitis A is caused by a virus which can be spread by contact with infected poo, This can happen during sex that involves fingering, licking (rimming), anal sex or handling condoms that have been used for anal sex. Food and water can become infected and this is common in countries with poor hygiene.

Symptoms

Symptoms can be mild and can include flu-like symptoms, diarrhoea, sickness and tiredness. Urine may become dark and faeces become pale.

Treatment

There is no specific treatment and most people fight off the virus naturally, returning to full health within a couple of months.

However, it’s still a good idea to see your GP for a blood test if you think you could have hepatitis A, as more serious conditions can have similar symptoms.

Your GP can also advise you about treatments and they may carry out regular blood tests to check how well your liver is working.

Go back to your GP if your symptoms get worse or haven’t started to improve within a couple of months.

Prevention

A vaccine is available for Hepatitis A.  Men who have sex with other men should consider getting vaccinated.

Without the vaccination, risks can be reduced by washing your hands after using the toilet, using condoms and plenty of lubricant for anal sex, using gloves and plenty of lubricant for fisting and a barrier (dental dam or cut-up condom) for rimming.

Shigella is a common disease which can cause diarrhoea.  It is spread by contact with infected poo. This can happen during sex that involves fingering, licking (rimming), anal sex or handling condoms that have been used for anal sex. Food and water can become infected and this is common in countries with poor hygiene.

Symptoms

Symptoms typically start 1–2 days after exposure and include frequent diarrhoea (sometimes bloody), fever, tummy pain, nausea and vomiting.

Treatment

Diarrhoea caused by Shigella usually goes away without antibiotic treatment in 5 to 7 days. People with mild shigellosis may need only fluids and rest. However, antibiotics are useful for severe cases of shigellosis because they can reduce the duration of symptoms. Tell your healthcare provider if you do not get better within a couple of days after starting antibiotics. He or she can do additional tests to learn whether your strain of Shigella is resistant to the antibiotic you are

Prevention

Risks can be reduced by washing your hands after using the toilet, using condoms and plenty of lubricant for anal sex, using gloves and plenty of lubricant for fisting and a barrier (dental dam or cut-up condom) for rimming

LGV – Lymphogranuloma venereum – is a strain of Chlamydia that can have more serious effects if left untreated. It is passed on through unprotected: 

  • Anal sex (both giving and receiving)
  • Oral sex (both giving and receiving)
  • Fisting & being fisted

Symptoms

Most men will experience pain and inflammation inside their anus along with fever and feeling ill However, in the early stage of LGV symptoms may include:

  • A painless sore in your mouth, penis or inside your anus
  • Pain / Discharge when urinating

Treatment

A three-week course of antibiotic tablets will cure LGV in most cases.

Untreated LGV can cause serious damage to your bowel.  It can also increase your risk of catching HIV, syphilis and hepatitis C.

Prevention

Using condoms and plenty of water based lubricant will greatly reduce the risk of getting chlamydia and LGV from anal and oral sex.

Getting Tested

Testing is available in a number of locations across Tayside.  To find a service in your area click below.  There’s no need to be scared or embarrassed!  We’ve heard it all before and anything you tell staff will be kept confidential.