As we know, sexually transmitted infections (STIs) or diseases (STDs) are not a common topic of conversation, especially in Ireland. In fact, STIs and STDs are commonly associated with shame and embarrassment. In addition, there are many misconceptions about STIs due to a lack of education and widespread misinformation. During Sexual Health Awareness Month, we want to try to squash the stigma that surrounds sexual health and STIs by sharing reliable, useful information to help you recognise symptoms of infection and reduce the risk of infection. We’ll also take a look at treatments for different STIs and how STI testing works. Let’s get started!
The Difference Between STIs and STDs
Before we dive right into different kinds of sexually transmitted infections and their symptoms, we need to dispel one myth – STIs and STDs are not the same things. Although the terms are used interchangeably, they’re actually different. Infection occurs when a virus or bacteria enters the body and begins to multiply.
Sexually transmitted viruses and bacteria can be spread via skin-to-skin contact with a person who has an infection. They can also be spread by an exchange of bodily fluids, such as semen, vaginal secretions or blood. STIs are generally asymptomatic meaning you may not experience any symptoms. However, as the infection progresses and your cells become damaged, symptoms will begin to appear. When symptoms appear, we refer to the infection as a sexually transmitted disease. Therefore, sexually transmitted diseases start off initially as sexually transmitted infections!
What Are the Most Common Infections and How Will I Know if I Have an STI?
Currently, in Ireland, chlamydia is the most commonly notified STI. However, gonorrhoea, syphilis, and genital herpes are also common. According to the Health Protection Surveillance Centre, the number of certain STIs, including HIV, has increased significantly in comparison to the same period last year (2021). While this increase is likely the result of Covid-19 restrictions easing and our social lives returning to (almost) normal, it is still important to stay on top of your sexual health to reduce the risk of infection. Let’s take a closer look at some of the most common STIs and how to recognise them.
As mentioned, chlamydia is the most commonly reported STI in Ireland, especially amongst those aged 35 and under. This infection can survive in the genitals, mouth and anus. Therefore, you can get it by having vaginal, anal or oral sex with someone who is infected. Most people who have chlamydia do not experience symptoms. In fact, up to 70% of women and 50% of men are asymptomatic!
If you do experience symptoms, you may experience pain when urinating or pain in the tummy or pelvis. Women may experience pain during sex, bleeding after sex, unusual vaginal discharge, and bleeding between periods. Men may experience cloudy, watery or white discharge from the tip of the penis, pain in the testicles, and a burning/itching sensation in the urethra. Chlamydia can also cause conjunctivitis.
Untreated, chlamydia can cause serious health problems, especially for women. For instance, it can cause pelvic inflammatory disease and fertility problems, as well as fallopian tube damage which can increase the risk of ectopic pregnancy. Similarly, it can cause inflammation and infection of the prostate and testes in men. This can also affect fertility.
Luckily, chlamydia is usually easily treated with antibiotics and you can start treatment once an STI test has confirmed your diagnosis. If you experience any symptoms of chlamydia, you should visit a sexual health/ GUM clinic or your GP as soon as possible. The earlier you start treatment, the better! Many people may not even know they have chlamydia. Therefore, it’s important to get regularly tested to help prevent the unintentional spread of infection and so that you can get treatment as soon as possible if needed.
Gonorrhoea is a sexually transmitted bacterial infection that can be spread via vaginal, anal or oral sex with a partner who is infected. Just like chlamydia, many people do not experience gonorrhoea symptoms and may not even know that they have it. 1 in 10 men and almost half of women do not experience any symptoms! Therefore, it’s important to get tested every time you have sex with a new partner and you should ask them to get tested too!
Typical gonorrhoea symptoms include thick green or yellow discharge from the vagina or penis and pain when urinating. Women may also experience bleeding between periods. Untreated, gonorrhoea can cause infection in the testes, prostate, penis, and urethra in men. In women, this STI can cause infection in the womb, fallopian tubes and vagina. This means that it can affect fertility for both men and women.
Gonorrhoea can be treated with an antibiotic injection. You should see your GP or visit a sexual health/ GUM clinic if you experience any gonorrhoea symptoms or an STI test has shown that you have gonorrhoea.
Syphilis is an STD mainly spread via vaginal, anal and oral sex. This STD causes small sores (ulcers) to form in the mouth, throat, vagina, anus or external genitalia, such as the penis and vulva. Syphilis is passed on when a partner comes into direct contact with one of these sores during sex.
Primary infection (the first time you get this infection) occurs within 2-3 weeks of first exposure to this infection and can cause small, painless sores/ulcers on the penis, vagina, vulva, mouth, anus, buttocks, hands or lips. Syphilitic sores are usually painless so you may not even know you have them.
Secondary infection can develop within a month from initial exposure if the primary infection has not been treated. Symptoms may be milf and unnoticeable, and they can come and go or change over time. Some of the most common symptoms include:
- A rash on the soles of the feet and palms of the hands – this is not usually itchy and can spread over your body.
- White patches in your mouth.
- Flu-like symptoms e.g. headaches, high temperature, fatigue.
- Swollen glands.
- White or grey wart-like growths on the penis, vulva or anus.
Tertiary infection may occur years after the primary infection and can cause serious complications of the nervous system, heart and blood vessels.
So, whilst syphilis does cause recognisable symptoms, it can take 3 weeks or more for these symptoms to appear after you have been infected. These symptoms may even ease over time but unfortunately, the infection is still in your body and can be transmitted to partners. Therefore, it is important to get tested after unprotected sex with a new partner or if you experience any of the above symptoms.
Untreated, Syphilis Can Cause Serious and Potentially Life-Threatening Health Conditions
You can treat syphilis with antibiotics but the duration of treatment will depend on the stage of your infection. In untreated, syphilis can cause serious and potentially life-threatening health conditions so early detection and treatment are very important. Untreated (tertiary) syphilis can cause:
- Heart problems: angina, aortic aneurysm, heart failure
- Brain problems: seizures, memory problems, personality changes, dementia
- Nerve problems: pins and needles, joint pain, gradual damage to joints
Syphilis can also cause problems with the skin, bones, testicles, liver and other organs.
Genital herpes is an STI caused by the herpes simplex virus (HSV). This STI is extremely contagious and can be spread by skin-to-skin contact e.g. kissing, vaginal and anal sex (genital contact), and oral sex (mouth-to-genital contact). It can also be passed on by sharing sex toys with a person who has been infected.
There are two different types of HSV, both can cause genital herpes. HSV Type is the most common cause of genital herpes due to the transmission from cold sores during oral sex. Although less common, HSV Type 2 is more likely to be associated with recurrent infections.
The first time you are infected with HSV is known as the “primary infection”. Many people will not experience any symptoms and so, they may not even know that they have it. We call this a “subclinical infection”. On the other hand, others may feel generally unwell and experience more severe symptoms than during subsequent episodes.
If you are concerned you may have this infection, you should visit your GP or sexual health/GUM clinic for an in-person assessment and confirmation of diagnosis. It is also important to screen for other STIs at this time, as they often co-exist. Here, you can find more information on HSE STI test services.
Unfortunately, There Is Currently No Cure for Genital Herpes but Symptoms Are Manageable
After the primary infection,(the first time you have the infection) the virus lies dormant in the nerve cells of the skin. It can then reactivate at any time, causing recurrent episodes that trigger symptoms, such as blisters/sores on the buttocks, thighs, anus, mouth, and genitals. Women can develop sores in or on the vaginal area, external genitalia and cervix. Men can develop sores on the urethra, penis and scrotum. This is a lifelong infection.
For most people, outbreaks become less frequent and less severe as time goes on. We can help you manage symptoms with antiviral medication and anaesthetic gel to ease pain and discomfort.
How Can I Reduce The Risk of Getting an STI?
Prevention is always better than cure, this is especially true when it comes to STIs and STDs. There are some simple ways that you can reduce the risk of getting an STI.
1. Use Barrier Methods of Contraception
Firstly, you can use barrier methods of contraception, such as male and female condoms, and dental dams. Barrier methods reduce skin-to-skin contact and prevent the exchange of bodily fluids, such as semen and vaginal secretions. This can help lower your risk of infection.
Many people will not know they have an STI, as they will not have symptoms. You should use barrier protection during all sexual encounters. Remember, you can acquire STIs from all types of sex and intimate contact.
It is worth noting that barrier methods, such as condoms, will only cover the skin of the penis and so, they will not provide complete protection. However, they do reduce the risk of transmission. This is particularly relevant to the HPV infection that causes genital warts and genital herpes/cold sores as this virus lives on the skin.
2. Avoid Sexual Contact if There is Any Sign of Infection
If you or your partner have any sign of infection e.g. sores or blisters on the genitals, discharge or bleeding, you should avoid any form of sex until you/your partner has been tested and treated. If you or your partner has genital herpes, you should not have intimate contact until the sores/blisters have completely healed.
Genital herpes can be passed on even if you don’t have any visible sores or blisters. Therefore, you should use condoms during every sexual encounter if you know you or your partner is a carrier of this infection. It is worth noting that barrier methods, such as condoms, will only cover the skin of the penis and so, they will not provide complete protection. However, they do reduce the risk of transmission.
3. Avoid Sharing Sex Toys
As we mentioned above, you can pass STIs on via sex toys. Therefore, we don’t recommend sharing sex toys. If you do, you should always make sure the toys are cleaned thoroughly between uses. You can also apply a condom to the toy for each use.
4. Get Vaccinated
There are vaccinations available for some STIs, such as hepatitis B. Some types of human papillomavirus (HPV) can cause genital warts, genital herpes and some types of cancers. Getting vaccinated against HPV can help reduce the spread of the HPV infection and reduce the risk of these conditions.
5. Regular Testing
As you now know, many people will not experience any symptoms of common STIs and they might not even know that they have them. This means that it is very important to get regularly tested. Early detection and treatment can help reduce the unintentional spread of STIs and it means you can get treatment early on if needed. The earlier STIs are treated the better!
Visiting a sexual health clinic can be a little nerve-wracking, especially if you haven’t gone before. But there is no need to feel embarrassed or ashamed! Healthcare professionals who work in sexual health/ GUM clinics will not judge you or pass comment. They will simply offer treatment and support. STIs are very common and many people will have an infection at some point in their lives!
Alternatively, you can check on your sexual health from the comfort of your own home. Webdoctor.ie STI Home Test Kits make this super easy and simple. You can order a test kit online and we will deliver the kit directly to your door. Don’t worry, we use discreet packaging for your privacy. Once your test kit arrives, you can follow the instructions to take a sample. Then, you can return the test kit to our accredited laboratory partner. When your results are available, we’ll send them to you via your secure online Patient Portal. There, you can check them at your convenience.
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