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Health Library - Sexual Health

Anytime Doctor has published this health library as a resource to provide an accurate and modern view on Sexually Transmitted Infections (STIs) / Sexually transmitted Diseases (STDs).

We have intentionally not provided details for the symptoms of HIV. The symptoms of HIV are very similar to infections such as tonsillitis, chest infections, common colds etc. If you have these symptoms it is much more likely you have one of these infections than HIV. Anxiety is powerful emotion. If you are worried, the best thing to do is to get the required tests done through Anytime Doctor or within the NHS.


General Information on STDs/STIs

Why are STDs/STIs increasing so rapidly?

We are currently in the grip of an UK epidemic of STDs, new cases of herpes, chlamydia, syphilis, HIV and gonorrhoea are at record levels.

There were 621,300 diagnoses of STDs in 2006, up 70% percent on 1997, of which 376,508 were new infections (Health Protection Agency). NHS GUM clinics cannot cope, there were over 1.8million attendances at NHS GUM clinics in 2006 an increase of 350 percent from 1997 (400,000 attendances).

The Government's Independent Advisory Group on Sexual Health and HIV is calling for urgent action to tackle this epidemic.

A number of reasons have been put forward as to why STDs are increasing so rapidly:

1Age of first intercourse is decreasing. A 30 year old woman has now potentially been sexually active for 15 years.
2The proportion of men and women who have concurrent relationships (having more than one sexual partner) has increased.
3The proportion of the population who reported two or more partners in the past year and who did not use condoms consistently has increased since 1990 from 13.6% to 15.4% for men and from 7.1% to 10% for women.
4The proportion of men in the United Kingdom who have ever had a homosexual partner in the last five years increased between 1990 and 2000. Unsafe sex in homosexual men has increased, particularly in London.
5Populations are now more mobile nationally and internationally. Certain groups (tourists and professionals business travellers) are at risk. They are separated from their families and social restraints and are more likely to have sexual contact outside a stable relationship.

Common Symptoms for STDs/STIs

The following symptoms could indicate a STD. However, some infections, while still spreadable, may have no symptoms:
ʼn  an unusual vaginal discharge in women

ʼn  a discharge from the urethra (the tube that runs from the bladder to the tip of the penis) in men

ʼn  bleeding after intercourse or between periods in women

ʼn  sores, blisters, warts, rashes, irritation or itching near the genitals or anus

ʼn  pain on passing urine, or needing to pass urine more often

ʼn  pain during sex

ʼn  pelvic or lower abdominal pain


Safer Sex

Anyone who is having sex can pick up a STD. Whether you are young or old, straight or gay, do it once in a while or all night every night, unprotected sex will put you at risk of getting a STD so it makes sense to make your sex safer.

Safer sex is any sex that does not allow an infected person's blood, semen, pre-ejaculatory fluid (precum) or fluid from the vagina to get inside the other person's body.

Use a condom every time you have sex. Only condoms provide 'all-in-one' protection against unintended pregnancy and most STDs, including HIV.

It seems obvious, but the more sexual partners you have the more chance you have of getting an STD - so be careful who you sleep with.

Just because you've been with someone for a while, don't stop using a condom until you've both had a check-up. Some of the most common STDs have no noticeable symptoms. Don't forget to use another form of contraception to avoid unplanned pregnancies.

Always carry condoms with you when you go out, not just when you are going to a party or a club. Sex isn't something you always plan in advance.

For more information on sexual health (including HIV), call the Sexual Health Line free (from the UK) on 0800 567 123, textphone (for people with hearing impairments) 0800 521 361.

 

Specific Information on common STDs/STIs


Bacterial Vaginosis
Chlamydia
Genital herpes
Genital Herpes in pregnancy
Genital warts
Gonorrhoea
HIV & AIDS
Non-specific urethritis (NSU)
Pelvic inflammatory disease – PID
Syphilis
Trichomonas
Ureaplasma & Mycoplasma
Viral Hepatitis - Type A
Viral Hepatitis - Type B
Viral Hepatitis - Type C

Pelvic inflammatory disease - PID

What is Pelvic inflammatory disease - PID?
Pelvic inflammatory disease is an infection of the uterus and/or fallopian tubes. Possible complications include: infertility, persistent pelvic pain, and an increased chance of ectopic pregnancy. Treatment is with antibiotics. The earlier treatment is started, the less chance of complications. Sexual partners should also be treated.

What causes pelvic inflammatory disease?
Pelvic inflammatory disease (PID) is an infection of the uterus (womb) and fallopian tubes. The bacteria which cause the infection usually travel into the uterus from the vagina or cervix.

- PID is usually caused by a sexually transmitted infection (the bacteria are passed on when you have sex). A bacterium called chlamydia is the most common cause. Gonorrhoea can also cause PID. A mixture of chlamydia plus gonorrhoea sometimes occurs.
- A variety of other bacteria that may live in the vagina sometimes cause PID. These may not be passed on by sexual contact.
It is not always possible to identify a specific bacterial cause and diagnosis will be made on symptoms.

What are the symptoms of pelvic inflammatory disease?
Pain in the lower abdomen (pelvic area) is the most common symptom. It can range from mild to severe.

Other symptoms that may also occur include:

- periods that are heavier than usual
- bleeding between periods
- bleeding after having sex
- Pain during sex
- Abnormal vaginal discharge
- Fever
- Low back pain

Symptoms sometimes develop quickly. You can become quite unwell over a few days. Sometimes symptoms are mild and develop slowly. For example, you may just have a mild abdominal pain which may 'grumble on' for weeks or months.

In some cases no symptoms develop and you do not know that you are infected. However, you are still at risk of complications even if you have no symptoms.

What are the possible complications of pelvic inflammatory disease?
In most cases complications do not develop if PID is diagnosed and treated early. Possible complications include one or more of the following.

- Difficulty becoming pregnant (infertility). PID can cause scarring or damage to the fallopian tubes. This can occur whether or not the PID caused symptoms.
- An increased chance of ectopic pregnancy (a pregnancy that develops in a fallopian tube and can cause serious problems). Again, this is due to damage to the fallopian tube by the infection. If you have had PID and become pregnant, you have about a 1 in 10 chance that the pregnancy will be ectopic.
- Chronic (persistent) pain develops in about 1 in 5 cases. This often includes pain during sex.
- Some complications of pregnancy such as miscarriage, premature birth, and stillbirth are higher in pregnant women with untreated PID.
- Reiter's syndrome: arthritis and eye inflammation. It is an uncommon complication. It is thought to be due to the immune system 'over-reacting' to the pelvic infection.
You are less likely to develop complications if you begin treatment within 2-3 days of symptoms starting. This may be possible if symptoms develop quickly. However, some women with PID have mild symptoms, or no symptoms at all. The infection may progress for quite some time before it is diagnosed or treated.

What is the treatment of pelvic inflammatory disease?
The usual treatment is a course of antibiotics for at least 2 weeks. Two, or even three, antibiotics are commonly prescribed. This is to cover the range of possible bacteria that can cause PID. It is important to take the full course of treatment.

Tell your doctor if you are (or may be) pregnant. This may affect the choice of antibiotic.

You should not have sex until both you and your sexual partner have finished treatment.

Does my partner need to be treated?
Yes. Also, any other sexual partner within the past 6 months should also be tested for infection. (If you have not had sex within the last 6 months then your latest sexual partner, however long ago the relationship was, should be tested and treated.) A course of antibiotics is usually advised whether or not infection is found on testing. This is because:

Most PID is caused by chlamydia. It is often passed on during sex.

Men often have no symptoms with chlamydia, but can still pass on the infection.

If your sexual partner is infected and not treated, chlamydia may be passed back to you again after you are treated.

Can pelvic inflammatory disease be prevented?
Wearing a condom during sex helps to protect you from sexually transmitted infections. The risk of infection increases with the number of changes of sexual partner.

Will it happen again?
About 1 in 5 women who have PID have a further episode.

This may happen if:

- Your sexual partner was not treated. You are then likely to get the infection back again.
- You did not take the antibiotics properly, or for long enough. The infection may not clear completely, and may flare up again later.
- You change your sexual partner and do not practice safer sex.
- Some women are more prone to infection once their uterus or fallopian tubes have been damaged by a previous episode of PID.
- If you become pregnant
- If you have ever had PID, then see a doctor as soon as you think that you may be pregnant. An early ultrasound scan is usually advised if you become pregnant. This checks that the pregnancy is in the uterus and not 'ectopic' in a fallopian tube.

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