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Online Doctor | Services | Health Library - STD/STI

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
Genital herpes
Genital Herpes in pregnancy
Genital warts
Non-specific urethritis (NSU)
Pelvic inflammatory disease – PID
Ureaplasma & Mycoplasma
Viral Hepatitis - Type A
Viral Hepatitis - Type B
Viral Hepatitis - Type C

Genital herpes

What is genital herpes?
Herpes infection is caused by the Herpes Simplex Virus (HSV). There are two types of HSV:

Type 1 can be found around the lips and is then known as a cold sore, but also commonly occurs in the eye and genital and anal area.
Type 2 is usually found around the genital or anal areas.

Both types can occur in either place and it is very common. In the UK, approximately 1 out of every 7 people has active genital herpes. Remember, genital herpes is exactly the same as cold sores just in a different spot!

The first time you are infected is called the primary infection. This may, or may not, cause symptoms. Once you are infected, the virus stays with you for life. For most of the time the virus remains inactive (dormant) in a nearby nerve causing no problems. In some people the virus 'activates' from time to time, and travels down the nerve to the nearby skin. This causes recurrent genital herpes if the primary infection was in the genitals, or recurring cold sores if the primary infection was around the mouth.

What are the symptoms?
The first time someone gets genital herpes they may be very unwell. The sores usually start as blisters and then as they heal will form scabs. They are often red and painful but with proper treatment, will improve quickly. Untreated, a first episode will last up to 3 weeks and may be associated with headache, and difficulty passing urine. However, the severity is extremely variable and in some people the symptoms are very mild - about half the people with HSV don't know they have it. Future episodes are usually less severe.

Many people can predict an episode, by the presence of early symptoms. These range from an itch or irritation to a sharp pain. They may last from a few hours to days before the sores appear.

It is also normal to be very upset at the time of a first episode of genital herpes.

How does someone get infected?
The herpes virus is transmitted by close skin-to-skin contact with someone who has the infection. This usually occurs during vaginal, anal or oral sex.

If you have sex with someone with obvious herpes sores then you can easily become infected with the virus. However the herpes virus is not always obvious and many people are unaware they are infected with HSV. Surprisingly, despite the lack of sores the virus can still be active. This is how most people get infected.

How long does it take for symptoms to develop?
The first episode usually takes 2 to 20 days to occur after the initial contact, but occasionally symptoms may not occur until months or even years later.

How often does herpes recur?
Recurrent outbreaks occur in most, but not all people. They can even happen years after the first outbreak.

Why do outbreaks occur?
Outbreaks occur when the virus inside the nerve cell is reactivated. The herpes virus lives in the nerve cell and has the ability to switch "on" or "off". When the virus is "switched-off" or is dormant there is usually no sign of infection. For some people, the virus will "switch-on" when they are premenstrual, tired, stressed, sunburnt, or consumes excessive alcohol or other drugs. This will result in an outbreak. Obviously, we can avoid some stress but we do live in the real world! Advice from a counsellor on making healthy lifestyle changes can be of help. Recurrences may occur from once a month to once every few years and tend to be less frequent with time.

How can the chances of transmitting HSV infection to a sexual partner be minimised?
From the time symptoms are experienced the virus can be transmitted by having close skin-to-skin contact with the affected area. During this time it is advisable to avoid sexual intercourse. In between these episodes there is still a small chance that the virus will be active, despite the lack of sores or symptoms. This is called "viral shedding" and occurs (on average) about 3/100 days. Always using condoms reduces the risk of contracting HSV from people who have viral shedding even when they do not have symptoms. However, if you are in a long-term stable relationship then using condoms is something to be discussed.

Condoms should always be used with new or casual partners this also provides protection from other sexually transmissible infections.

Is there any treatment for herpes?
For people having a first episode of herpes or who have frequent or more severe recurrent outbreaks there are antiviral tablets called acyclovir (Zovirax), Valaciclovir (Valtrex), and famciclovir (Famvir).

They can be taken for five days or longer if necessary. The will improve healing and reduce the risk of complications. All three drugs are well tolerated and safe but they do not "cure" herpes.

Pain relief and ice packs can be used to sooth area. Drink lots of water and if you have difficulty passing urine you should contact a health service.

The herpes virus has a bad reputation! Whilst it is a nuisance and cannot be cured, it can be controlled. The good news: you won't die from it and it does not cause cancer.

Good information and knowledge is the first step to avoiding or controlling the virus.