Sexually Transmitted Infections (STI’s)

What is it?

Mycoplasma Genitalium (MGen or MG) is a curable sexually transmitted infection (STI). It is a type of bacterium or germ which can infect

• the water passage (urethritis)
• the neck of the womb (cervicitis)
• the womb and fallopian tubes (pelvic inflammatory disease)
• less commonly it can be found in the rectum

Most people who carry the infection do not experience any problems, and many get rid of the infection without any treatment.

What are the symptoms?

Symptoms you might notice

• Pain in the lower abdomen (tummy), particularly during sex, in women/transmen
• Vaginal bleeding after sex
• Pain or burning in the penis when passing urine
• Discharge from the penis

Other infections may also cause these symptoms, your doctor or nurse will advise you if you need testing for MGen.

How do you test for it?

Most people who carry the infection do not develop any problems and naturally clear the infection without any treatment.

Therefore it is not recommended to test and treat all clients attending the Sexual Health clinic for MGen. This could lead to antibiotic resistance and make the infection hard to treat.

Your doctor or nurse will advise you if you need testing for MGen based on your symptoms.

If you do need a test, either a swab will be taken from inside the vagina (taken by the doctor/nurse, or by you), or a urine sample will be taken.

What is the treatment?

What is it?

HIV is a virus that damages the body’s immune system; this makes it difficult to fight off infections and diseases.

Although there is currently no cure for HIV, effective treatment is available.

How is it passed on?

The virus is passed on through exchanging bodily fluids (such as semen, vaginal fluid, blood or breast milk)

The most common ways HIV is passed on are:

• Having vaginal or anal sex without a condom.
• Sharing needles or injecting equipment
• From mother to child during pregnancy, birth or breastfeeding. This can be prevented with medication.

You can’t get HIV from sharing toilet seats, towels, cups, plates, cutlery, food or shaking hands and kissing.

What are the symptoms?

Most people who are infected with HIV experience a short, flu-like illness that happens two to six weeks after infection.

Not everyone experiences early symptoms. Longer-term symptoms can include weight loss, skin rashes, swollen glands, diarrhoea and infections.

HIV can affect anyone and people with HIV can look and feel healthy for years so the only way to know whether you have HIV is to get tested.

How do you test for it?

A blood test is the most common way to test for HIV. The blood test is not a fasting blood test, so please eat and drink as normal prior to your appointment

It can take 45 days for HIV to show up on a blood test. If you test whilst you are still within this “window period” you may need to repeat your test once you are outside the window period. If you experience any concerning symptoms, please contact LSH so we can offer an assessment as soon as possible.

Some pharmacies in Luton also offer testing, please see our HIV testing page for more info.

What is the treatment?

If you test positive for HIV, we will discuss the options for treatment with you. It is recommended that people with HIV start treatment as soon as possible.

When HIV is managed well, by taking medication correctly every day you are able to prevent the HIV damaging your immune system. This enables most people with the virus to live a long and healthy life as long as the infection is found and treated early.

Luton Sexual Health provides free treatment and care for people living with HIV in a relaxed, non-judgmental environment.

What is it?

Syphilis is a bacterial infection that can be treated with antibiotics.

However if syphilis is not treated it can affect our health over many years, causing damage to important organs such as the heart and brain.

How is it passed on?

Syphilis can be passed on by:

• Vaginal, anal or oral sex
• Direct skin contact with someone who has a rash or sores caused by syphilis
• Pregnant women can pass the infection onto their unborn baby

What are the symptoms?

Syphilis can develop in three stages:

• Primary syphilis
• Secondary syphilis
• Tertiary syphilis

Many people do not have any symptoms in the early stages. If you do get symptoms, you might notice the following:

Primary syphilis

• One or more (usually) painless sores on the genital area, in the mouth, around the anus or on other areas of the body, depending on the area of the body exposed to the infection
• The sores are very infectious and may take two to six weeks to heal

Secondary syphilis

If syphilis remains untreated, the second stage usually occurs some weeks later. The symptoms you might notice are:

• A painless rash that is not usually itchy. It can spread all over the body and is often seen on the palms of the hands and soles of the feet
• Flat, warty looking growths on the vulva and around the anus. These are often mistaken for genital warts
• A flu-like illness, tiredness and loss of appetite, with swollen glands and a sore throat (this can last for weeks or months)
• Headaches, neck stiffness and changes in hearing or vision. If these occur you should contact a doctor immediately for assessment
• White patches on the tongue or roof of the mouth
• Patchy hair loss

Tertiary syphilis

When syphilis is not treated for many years it can develop into tertiary syphilis.

This is when the infection causes very serious damage to the heart, skin or bones, brain and nervous system. At this stage syphilis can be life-threatening.

How do you test for it?

A blood test is used to test for syphilis. The blood test is not a fasting blood test, so please eat and drink as normal prior to your appointment.

If you have sores or an ulcer a swab may also be tested if you attend our clinic.

It can take 3 months for Syphilis to show up on a blood test. If you test whilst you are still within this “window period” you may need to repeat your tests once you are outside the window period. If you experience any concerning symptoms, please contact LSH so we can offer an assessment as soon as possible.

What is the treatment?

Syphilis can be cured by a course of penicillin injections, or by taking antibiotics tablets.

Once treated, Syphilis antibodies will remain in your blood. This means if you have ever been diagnosed with Syphilis, you will need to test in clinic in future rather than through a home testing kit, so we can determine if it is a new infection or just evidence of the past treated infection.

What is it?

Scabies are tiny insects that burrow under the skin

Scabies can live on any part of our body but tend to prefer:

• The genital area and buttocks
• Between the fingers and toes
• Wrists
• Inside of elbow and knee joints
• Underarms

How is it passed on?

What are the symptoms?

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

You might notice:

• Intense itching in the affected areas, often at night or after a hot bath or shower
• An itchy red rash or tiny spots. This can look similar to other skin conditions such as eczema

Sore or broken skin which is usually caused by scratching

How do you test for it?

There is no routine test available. Scabies is diagnosed in clinic by the doctor or nurse looking at your skin.

What is the treatment?

Scabies is treated by using a special cream, lotion or shampoo over the whole body.

You will need to wash your clothing, bedding and towels in a washing machine on a very hot cycle (50°C or higher) to kill the bugs and avoid re-infection.

The itching may continue for a few days following treatment.

Make sure your sexual partners and close contacts in your household are treated at the same time. This should be done even if they don’t have any signs or symptoms.

What is it?

Pubic lice are tiny, crab-like insects that live on body hair.

This includes

• Pubic hair
• Underarm hair
• Body hair
• Beards
• Eyebrows or eyelashes

They do not live on the hair on the head.

The pubic lice are a yellow-grey colour and approximately 2mm long. They travel around the body by crawling from hair to hair laying eggs as they go. The eggs appear as brownish dots that are fixed to the body hair.

How is it passed on?

Pubic lice are passed on by close body contact, including vaginal, anal and oral sex. They cannot jump or fly.

Pubic lice can sometimes be spread by sharing clothing, bedding and towels. Although this is less common as lice can only survive off of the body for around 24-48 hours.

What are the symptoms?

It can take several weeks after coming into contact with pubic lice before signs and symptoms appear.

You might notice:

• Itching and irritation in the affected areas
• Black powdery droppings from the lice in your underwear and bedding
• Tiny insects on body hair

How do you test for it?

There is no routine test available. Pubic lice are diagnosed in clinic by the doctor or nurse looking at your skin.

What is the treatment?

Pubic lice are treated by using a special cream, lotion or shampoo over the whole body.

You will need to wash your clothing, bedding and towels in a washing machine on a very hot cycle (50°C or higher) to kill the lice and avoid re-infection.

The itching may continue for a few days following treatment

Your sexual partner should be treated at the same time even if they don’t have any signs and symptoms.

You do not need to shave off pubic or other body hair.

What is it?

Hepatitis C is virus carried in the blood that can affect the liver.

It is often possible to cure the infection and most people with it will have a normal life expectancy.

However if left untreated over many years, it can sometimes cause serious and potentially life-threatening damage to the liver or liver cancer.

How is it passed on?

The most common way to catch hepatitis C is by sharing needles, filters and contaminated spoons when injecting drugs.

Other ways the virus is passed on include:

• Sharing notes for snorting drugs
• From a pregnant women to her unborn baby
• Unprotected sex, although this is rare. Sexual transmission is more common when having anal sex, including fisting and the use of sex toys

What are the symptoms?

Many people who are infected with hepatitis C don’t have any symptoms for many years.

Some people may notice the following symptoms after the initial infection of hepatitis:

• Feeling sick and vomiting
• Mild flu-like symptoms
• Loss of appetite
• Fever
• Yellowing of the skin and eyes (jaundice)

Some people with Hepatitis C remain well throughout their lives and develop no problems with their liver.

However, for some people it can become a long-term illness (chronic Hepatitis C infection). People who have chronic hepatitis C infection may develop liver damage, which can become very serious as it can cause scarring of the liver, liver failure and liver cancer.

How do you test for it?

Hepatitis C is diagnosed by a blood test.

It can take 3 months for Hepatitis to show up on a blood test. If you test whilst you are still within this “window period” you may need to repeat your tests once you are outside the window period. If you experience any concerning symptoms, please contact LSH so we can offer an assessment as soon as possible.

What is the treatment?

You will be referred to a liver specialist (hepatologist) for further assessment and treatment. Early testing and diagnosis allows you to be treated as quickly as possible.

What is it?

Hepatitis C is virus carried in the blood that can affect the liver.

It is often possible to cure the infection and most people with it will have a normal life expectancy.

However if left untreated over many years, it can sometimes cause serious and potentially life-threatening damage to the liver or liver cancer.

How is it passed on?

The most common way to catch hepatitis C is by sharing needles, filters and contaminated spoons when injecting drugs.

Other ways the virus is passed on include:

• Sharing notes for snorting drugs
• From a pregnant women to her unborn baby
• Unprotected sex, although this is rare. Sexual transmission is more common when having anal sex, including fisting and the use of sex toys

What are the symptoms?

Many people who are infected with hepatitis C don’t have any symptoms for many years.

Some people may notice the following symptoms after the initial infection of hepatitis:

• Feeling sick and vomiting
• Mild flu-like symptoms
• Loss of appetite
• Fever
• Yellowing of the skin and eyes (jaundice)

Some people with Hepatitis C remain well throughout their lives and develop no problems with their liver.

However, for some people it can become a long-term illness (chronic Hepatitis C infection). People who have chronic hepatitis C infection may develop liver damage, which can become very serious as it can cause scarring of the liver, liver failure and liver cancer.

How do you test for it?

Hepatitis C is diagnosed by a blood test.

It can take 3 months for Hepatitis to show up on a blood test. If you test whilst you are still within this “window period” you may need to repeat your tests once you are outside the window period. If you experience any concerning symptoms, please contact LSH so we can offer an assessment as soon as possible.

What is the treatment?

You will be referred to a liver specialist (hepatologist) for further assessment and treatment. Early testing and diagnosis allows you to be treated as quickly as possible.

What is it?

NSU (Non-specific urethritis) occurs only in the penis. It is inflammation of the urethra, the tube that carries urine out of the body.

How is it passed on?

There are many causes of NSU. It can be caused STIs (e.g. Chlamydia) or sensitivity to chemicals such as spermicide, soap or latex. Sometimes it can be caused by bacteria which can be passed through sex, but that we cannot test for. This is why it is important that partners are treated too.

If NSU is not treated it can have long term effects on health, including painful infection in the testicles.

What are the symptoms?

You might experience burning or stinging when you pass urine and/or a discharge coming from your penis.

How do you test for it?

NSU is diagnosed by looking at a sample from the top of the penis under a microscope in clinic.

What is the treatment?

NSU is treated with antibiotics.

If you are treated for NSU, it is important that your partner is also treated before you have sex again, even if they have no symptoms.

What is it?

PID is a condition that causes the womb/uterus, fallopian tubes and ovaries to become inflamed due to a bacterial infection.

How is it passed on?

PID can be caused by many different types of bacteria, including a gonorrhoea or chlamydia infection. Sometimes PID is caused by infections that are not sexually transmitted and the cause remains unknown.

What are the symptoms?

The symptoms of PID are fairly general, meaning that it can be difficult to diagnose. Signs to look out for include:

• Discomfort or pain felt deep inside during vaginal sex
• Pain around the lower abdomen (usually similar to period pain)
• Bleeding in between periods and after sex
• Unusual vaginal discharge
• Pain in the rectum (back passage)
• Fever and vomiting

You don’t have to have all of these symptoms to have PID. Sometimes symptoms are mild.

How do you test for it?

There is no test for PID. The Doctor or Nurse will diagnose PID based on your symptoms and their examination.

What happens if I don’t get treated?

If PID is left untreated, it can lead to more serious complications like problems with fertility or chronic pain.

What is the treatment?

PID is treated using a combination of at least two antibiotics because it often involves several different types of bacteria. The course will last for 14 days.

Your partner will need to be treated before you have sex again, even if your STI check is fine and they have no symptoms.

The Doctor or Nurse will want to see you in clinic to review your symptoms following treatment.

What is it?

Trichomonas vaginalis is a tiny parasite that can be passed on during sex

How is it passed on?

TV is easily passed on by having unprotected vaginal sex or sharing sex toys

What are the symptoms?

Vaginal symptoms include:

• Soreness and itching in and around the vagina
• Discomfort while having sex
• Change in vaginal discharge
• Pain when passing urine or needing to pass urine more often
• An unpleasant smell

Usually TV does not cause any symptoms in the penis, but you may notice:

• Discharge from the penis
• Pain or burning when passing urine
• Irritation of the foreskin (this is unusual)

How do you test for it?

Testing is available after an assessment with a Nurse/Doctor. If you need testing, the Doctor or Nurse will take a swab from the vagina, or a urine sample if you have a penis.

What is the treatment?

TV can be treated with antibiotics.

This treatment is effective for most people but it is important you have a further TV test to make sure that the treatment has worked you have any further sexual contact.

What is it?

Gonorrhoea is a common bacterial sexually transmitted infection

How is it passed on?

Gonorrhoea is easily passed from one person to another during oral, vaginal or anal sex. It can sometimes affect the eye if semen or vaginal fluid comes into contact with the eye

Sex toys can also pass on gonorrhoea if they are not washed or covered by a new condom each time they are used.

You can’t get gonorrhoea from sharing towels, cups, plates, cutlery or toilet seats.

What are the symptoms?

The majority of people with a vagina may not experience any symptoms when they have a gonorrhoea infection, whereas the majority of people with a penis will show symptoms.

How do you test for it?

Gonorrhoea tests can be done on a urine sample or swabs taken from the vagina, anus or throat, depending on the type of sex you have.

If there is a discharge a sample may be taken to look for gonorrhoea under the microscope in clinic.

It can take 2 weeks for Gonorrhoea to show up on tests. If you test whilst you are still within this “window period” you may need to repeat your tests once you are outside the window period. If you experience any concerning symptoms, please contact LSH so we can offer an assessment as soon as possible.

What is the treatment?

Gonorrhoea is treated with antibiotics. This is likely to be in the form of an injection.

This treatment is effective for most people but because gonorrhoea is starting to show resistance to some antibiotics it is important you have a further test to make sure that the antibiotics have worked.

What is it?

Chlamydia is one of the most common bacterial STIs in the UK.

How is it passed on?

Chlamydia is easily passed from one person to another during oral, vaginal or anal sex. It can sometimes affect the eye if semen or vaginal fluid comes into contact with the eye.

Sex toys can also pass on chlamydia if they are not washed or covered by a new condom each time they are used.

You can’t get chlamydia from sharing towels, cups, plates, cutlery or toilet seats

What are the symptoms?

80% of women and 50% of men who have Chlamydia will have no symptoms

Symptoms you might notice

• Pain passing urine or having sex
• Unusual discharge from the penis, vagina or rectum
• In women or trans men – stomach pain, bleeding during or after sex, and bleeding in between periods
• Pain and swelling in the testicles

How to test for it?

Chlamydia tests can be done with a urine sample or swabs taken from the vagina, anus or throat, depending on the type of sex you have.

We will recommend the best test for you depending on whether you have any symptoms and what they are.

It can take 2 weeks for Chlamydia to show up on tests. If you test whilst you are still within this “window period” you may need to repeat your tests once you are outside the window period. If you experience any concerning symptoms, please contact LSH so we can offer an assessment as soon as possible.

What is the treatment?

Chlamydia is treated with antibiotics – typically one set of tablets.

It is important that your recent sexual partners are treated and tested, even if they have no symptoms.

What is it?

Genital Herpes is a viral infection affecting the skin.

There are two types of herpes simplex virus:

• Type 1 Virus is usually the cause of “cold sores” affecting the mouth and nose but can also be the cause of genital sores as it is easily passed to the genital area via oral sex.
• Type 2 Virus usually affects the genital and anal areas.

How is it passed on?

It is difficult to avoid coming into contact with the herpes virus. The majority of the population will come into contact with one of the herpes viruses at some time in their lives.

Many people who have herpes will never know they have the infection as they never experience any symptoms.

Herpes is passed from one person to another by

• Skin-to-skin contact during sex if the virus is active on the skin outside the area protected by a condom
• Vaginal, anal and oral sex
• Sharing sex toys without washing them or covering them with a new condom with each use
• If a person with whitlows (herpes on the hand) touches a partner’s vagina, genitals or anal area

You can’t get herpes from sharing towels, cups, plates, cutlery or toilet seats

What are the symptoms?

Initial infection may have no symptoms at all in a number of people. These people can carry the infection for years without ever realising.

If symptoms are present, the following may be recognised:

• Flu-like symptoms (fever, headache, muscle and joint aches)
• Itching and/or tingling (discomfort) in the affected genital area.
• Painful red spots or lumps (often you may see fluid inside the lump)
• Small painful blisters or sores.
• Pain passing urine
• Lymph glands in the groin, neck or armpits may be swollen

How to test for it?

Genital herpes can only be tested usually when sores are present, so if you notice symptoms please contact us as soon as possible. Testing is available after an assessment with a Nurse/Doctor.

The doctor or nurse will take a sample from the blisters. This involves brushing a cotton-tipped swab (like a cotton-bud) over the area affected.

If you have no obvious blisters there is no routine test for herpes.

What is the treatment?

Treatments available aim to relieve the symptoms of the blisters and stop new blisters developing, although symptoms can disappear by themselves.  There is currently no cure for herpes.

Treatment is with antiviral tablets.  Sometimes a local anaesthetic cream may be used to numb the area and relieve discomfort.  Unlike treatments for cold sores, there are currently no over-the-counter remedies available for genital herpes.

Things you can do to help ease the pain are:

• Gently bathe the area with diluted salt water.
• If passing urine is very painful it can help to pass urine in the shower or in a warm bath.
• Drink plenty of water
• Rest

Herpes can be managed safely during pregnancy, but it is important to discuss with your midwife if you have, or have had, herpes infections.  If you are pregnant when you get symptoms of herpes for the first time it is important to inform your midwife and to attend the clinic to see a doctor as soon as possible.

What is it?

Genital warts are caused by a very common skin virus in the human papillomavirus (HPV) family. It is not one of the HPV types that leads to cancer. The HPV vaccination given in schools and sexual health clinics can protect against genital warts.

How is it passed on?

Genital warts are easily passed from one person to another through skin-to-skin contact in the genital area.

You can’t get genital warts from sharing towels, cups, plates, cutlery or toilet seats

What are the symptoms?

Most people do not show any signs or symptoms (they do not get any warts), and the virus can go away by itself. This means you might not know if you or your partner has the virus.

If you do get warts you might notice fleshy growths, bumps, or skin changes which may appear anywhere in the genital or anal area.

Warts can appear any time from three weeks to many years after first coming into contact with the genital wart virus.

How to test for it?

There is no routine test available. Genital warts are diagnosed in clinic by the doctor or nurse looking at your skin.

What is the treatment?

Standard treatment for genital warts is home treatment with creams or ointment to be applied directly to the warts – several different treatments are available.

Cryotherapy (freeze therapy) is a treatment used for warts and some other skin conditions.

At Luton Sexual Health cryotherapy may be offered or recommended in the following situations:

• It may be used to help show up skin lesions so that it is easier to tell if they are warts or not.
• Warts in some areas, e.g. the urethral (pee tube) opening, can be difficult to apply creams to, so we may use cryotherapy to treat warts in these areas.
• Some of the creams are not safe to use in pregnancy, so if the warts are large and causing problems in pregnancy cryotherapy may be recommended.
• If warts have not responded to any of the creams then repeated cryotherapy (every 1-2 weeks) may be offered.

Side effects and risks of cryotherapy:

Cryotherapy can be uncomfortable for some people – of you are finding it too painful to continue please inform the clinician.

Most people will experience some redness, soreness and swelling for around 48 hours after cryotherapy treatment – this is expected.

Skin lesions may blister, turn dark, shrivel, shrink and scab after cryotherapy.  If the skin becomes broken please bathe the area in salt water and contact the clinic for advice if it does not heal within 7 days.

Scarring and loss of pigment in the skin can occur after cryotherapy.  This can cause pale or darker patches to appear on the skin which in some cases may be permanent.

If scarring occurs on the foreskin it may cause difficulty in pulling the foreskin back – if this occurs please contact the clinic to discuss.

Genital warts can reappear after successful treatment, so further treatments may be required.

Warning – Do not use wart treatments that you can buy at a chemist or pharmacy. They will not work and can cause considerable discomfort to the skin in the genital area. Genital skin is very sensitive.

What is it?

Epididymo-orchitis is the inflammation of the epididymis and testicles. It is caused by spread of bacterial infection.

How is it passed on?

Infections that cause epididymo-orchitis, such as gonorrhoea and chlamydia, are passed from one person to another during unprotected sex. This includes vaginal, anal and oral sex.

A urine infection can also cause epididymo-orchitis, although this is not sexually transmitted.

What are the symptoms?

Testicular pain and scrotal swelling are the most common symptoms of epididymo-orchitis. Some people might also notice a discharge (liquid) from the tip of the penis, experience pain when passing urine, and occasionally a fever might be present.

How to test for it?

Epididymo-orchitis is usually diagnosed by a physical examination of the testicles at a sexual health clinic. In some circumstances, a testicular ultrasound might also help. All patients are also offered a test for gonorrhoea and chlamydia.

What is the treatment?

Treatment is with oral antibiotics, usually for two weeks. It is usual to have a follow up after two weeks to check that the symptoms have improved.

It is very important that your partner also gets tested before you have sex again, to prevent possible re-infection.