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For more detailed medical information on STI's and related conditions visit the Association of Genito Urinary Medicine (AGUM) site
What are the tiny spots on the head of my penis?
How common are genital warts?
There are over 100 types of viruses that cause warts. They are known as human papilloma viruses (HPV). Only about one third of these can infect the genital area. Current evidence suggests that over 50% of sexually active adults have been infected with one or more HPV type. The vast majority of these infections are not spotted and do not pose a long-term threat to sexual health. Will genital warts stay until you have the right medication?Studies suggest that in the majority of cases human papilloma virus (HPV) infection will clear from the body. We don’t know if the immune system eliminates the virus or just suppresses it. There is a wide variation in how individuals experience their infection in terms of how likely the warts are to return. For some people recurrences are frequent and can go on for years. Others experience it as a one-off infection. Little is known as to why this should be so. Without treatment genital warts may disappear, stay the same, or grow larger in size or number. Treatment is usually given for cosmetic reasons because of their unsightly appearance. There is a whole range of treatment options with variable results though one does not favour another in preventing recurrences. How long can the genital wart virus lie dormant?It is generally accepted that the time taken from infection to visible warts appearing is anything from one month to several years. Do genital warts cause cancer?
There are
over 100,000 cases of genital warts treated each year in GUM
clinics of England & Wales. Cervical cancer is rare, less than 2,000 cases per
year. Most genital warts are caused by types 6, 9, 11 and are of no consequence. Types 16,
18, 33 have been associated with cancer but then only if present for a long time and
coupled with other factors ie. smoking. Only a minority of women with these specific virus
types will go on to develop cancer of the cervix. If they do then it generally progresses
at an extremely slow rate. It is therefore felt unnecessary to perform smear tests more
frequently than every 3 to 5 years. A woman with a wart on her cervix usually is
recommended to have a colposcopy performed to
closer look at it and possibly take a biopsy, to more fully assess the situation. Is it possible to have genital warts without ever having sexual intercourse?Non-sexual spread of genital warts due to the human papilloma virus (HPV) has been documented though it is felt to be rare. It may be possible to pass on the virus to the genital area from warts on the fingers but this is unlikely to happen often. Infants born to women with genital warts during pregnancy very rarely develop laryngeal (throat) warts. Pregnancy can often trigger warts to grow in size and number and can be treated. There is no justification to perform a caesarean section delivery as a result of their presence Genital HPV infections are transmitted almost exclusively through sexual contact. Infection is rarely found in people who have not had sexual intercourse. The more sexual partners a person has had, the more likely they are of acquiring the infection. It is thought that up to 90% of longer-term partners of people with HPV will themselves become infected. There is no evidence to suggest that condom use provides an effective barrier to transmission of HPV. Is thrush a sexually transmitted infection?
It is estimated that 3 out of 4 women will experience a thrush infection of the genital area caused by the yeast, candida albicans. Over half of these will experience a recurrence. 5% of women will suffer thrush for prolonged periods of time. Its presence is considered normal in the vagina and gut. Pregnancy, oral contraceptives, diabetes and antibiotics have all been implicated in playing a role in provoking a flare up of candida. Sexual transmission can occur but this does not play a major role in the spread of the condition. Improved lubrication during sex can help with the use of products such as senselle, KY jelly. Sufferers commonly report how tight, restrictive, poorly ventilated clothing and nylon underwear encourages thrush. Some also find that chlorinated swimming pools, feminine hygiene sprays, vaginal douches and perfumed toilet paper provoke an attack. Itching is usual and a discharge may be present. This is often described as ‘cottage-cheese-like’ in character though it can vary from watery to thick in consistency. Soreness, burning, irritation, painful sex, and stinging urine are often experienced. It is not usually associated with a particular smell. Symptoms are often most marked the week leading up to a menstrual bleed. Male partners of women with thrush can experience a rash, redness of the penis, itching and a burning sensation minutes or hours after unprotected sexual intercourse. These frequently disappear especially after a shower. Treatment should be applied if they persist. Can thrush be cleared up quickly?A variety of highly effective treatments for thrush are available in the form of creams, vaginal pessaries and oral tablets. Only a small number of cases prove resistant to treatment. I have an unusual discharge from my vagina. What could it be?The three major categories of abnormal discharge are an increase amount, abnormal odour, or abnormal colour, often yellow. The reporting of such symptoms is not always an accurate indication of infection as there are several causes of a vaginal discharge. Where an infection is present, an increased amount of discharge is more likely to be due to bacterial vaginosis or trichomoniasis as opposed to gonorrhoea, chlamydia or thrush. It is always best to seek medical advice should an unusual discharge appear and/or persist. Why should my vagina have a horrible scent even after a shower?An unusual odour, often described as a ‘fishy’ smell is often associated with bacterial vaginosis. It can appear worse after unprotected sexual intercourse. Many women believe the odour is owing to poor hygiene, are embarrassed about the symptoms and therefore do not report this. Trichomoniasis caused by the germ trichomonas vaginalis is the next likely cause. This often has a frothy discharge. Gonorrhoea and chlamydia are not usually reported as having a strong smelling discharge. I have a discharge from my penis. What is it?A penile discharge is often due to gonorrhoea, chlamydia or non-specific urethritis (NSU). In the case of NSU, chlamydia is often found to be the cause but there are dozens of other causes, not all of them sexually related. A medical practitioner should investigate a discharge. In the UK attendance at a GUM clinic is recommended. What are these sore like things on my vagina?Sores or ulcers in the genital area are commonly due to the herpes simplex virus (HSV). Less common causes are the venereal diseases of syphilis and chancroid. It is crucial that medical advice is sought early. In the case of HSV, the condition can become quite severe and early treatment may ease the situation drastically. What are the little bugs living in my pubic hair?Pubic lice or ‘crabs’ are a sexually transmitted infestation. Because they depend on human blood for survival, they will rarely leave the body unless there is close personal contact with another person. Off the body they will survive less than 24 hours. Sensitivity to the effect of the louse bites can take as little as 5 days but their presence may not be noticed for weeks. Treatment that kills off both the lice and their eggs is required to rid the body of them. Sexual partners may also require treatment. How easy is it to get chlamydia?Chlamydia is thought to be highly infectious. There is up to a 70% chance of getting it with a single episode of unprotected sexual intercourse with an infected person. However because symptoms are commonly absent or very vague, it is unlikely that it will be known about. How long does it take for a chlamydia infection to show up?It usually takes one to three weeks for men to show symptoms of infection. It may not be possible to detect chlamydia if a test is performed less than 72 hours after exposure. Without treatment with an appropriate antibiotic it is unlikely that the body will clear itself of the infection. It is therefore possible to test positive for chlamydia from an exposure years earlier. As a consequence it is a leading cause of pelvic inflammatory disease and associated fertility difficulties. Can you get any sexual infection if you used a condom?To be effective, condoms must be applied prior to genital contact, must remain intact, and most important must be used consistently and correctly. Most sexual infections including HIV can be prevented by the correct use of latex or polyurethane condoms. Genital warts however are not easily prevented from being passed on to a sexual partner even if condoms are used. Condom failure in terms of breakage can be related to poor storage facilities and the use of oil-based lubricants. However it is more likely due to incorrect use. How risky is oral sex?For many years it has been known that unprotected oral sex carries a risk, albeit relatively small, of HIV transmission. Recent work in the USA and in the UK has suggested that this risk may contribute to 3-8% of HIV infections among men who have sex with men. We also know that other sexually transmitted infections (STIs), such as syphilis, can be transmitted through oral sex more readily than HIV; for example, in a recent outbreak of syphilis in gay men in north west England, oral sex was a significant mode of transmission. Unlike HIV, syphilis can be cured if diagnosed and treated early, but it can have serious consequences if left untreated, so it is better to prevent it than to have to treat it. Oral sex is also known to transmit STIs like gonorrhoea and herpes simplex. (For more details visit the Public Health Laboratory Service site) How will I know if I caught anything from unprotected sex last night?Don’t rely on looking for symptoms of infection. Many conditions can be present without a person realising. Generally speaking the earlier you seek help the easier it is to sort the situation out. Worry about picking up an infection and all the consequences of this can be very stressful. It’s better to seek professional help for a full screen for infections and the opportunity to talk through the related issues. GUM clinics in the UK are the ideal place to do this. Can a blood test detect all sexually transmitted diseases?No. GUM clinics in the UK routinely do a blood test for syphilis. Depending on the circumstances blood can also be tested for HIV, Hepatitis B and C. Many sexual infections would not show up in a blood test. Swabs and possibly urine tests may be offered to investigate the presence of some infections like chlamydia and gonorrhoea. I am afraid to go to my doctor and get checked. Can I treat myself?It depends on what the problem is. Very few medications to treat sexual infections are available from a chemist. Even for example if pubic lice or scabies is self-treated it may be important to exclude the presence of any other conditions. Remember that some infections can be present and doing damage to a persons sexual health without them even realising that they exist. What's the cost of having tests and treatments at a GUM clinic?In the UK there is absolutely no charge at GUM clinics. It may be possible to reimburse travel expenses to them too. Where can I get up to date figures of STI's in the UK?The Public Health Laboratory Service is responsible for collecting statistics on the diagnoses made when individuals attend UK GUM clinics. Their website is regularly updated and has links to other sites which record the picture in other countries.
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