All you need to know about embarrassing little nasties

15 Could I have an STI without symptoms?

YES — many sexually transmitted infections (STIs) have no symptoms, warns Dr Mark Lawton, a consultant in sexual health based in Liverpool.

‘For example, it’s estimated that 50 per cent of men and 80 per cent of women who have chlamydia — by far the most common sexually transmitted infection — have no symptoms.

‘So if you’ve had unprotected sex with a new partner, it’s a good idea to go to a sexual health clinic for a check-up. There’s no need for a referral.’

To find a local clinic, go to the n HS choices website; some clinics are walk-in, at others you can make an appointment.

16 I’m post-menopausal, how have I got an STI?

‘You can catch an STI at any age — it doesn’t matter if you’re male, female or post-menopausal,’ says Dr Lawton, the spokesperson for the British association for Sexual Health and HIV.

‘In fact, menopause can increase the risk due to vaginal dryness and the increased risk of small tears, making it easier for the warts and herpes viruses to get into the system.’

The latest data from Public Health england shows the age group with the fastest- rising STI rate ( albeit with numbers still much smaller than younger generations) is the over-65s.

‘a lot of older people simply don’t think it will happen to them and are absolutely mortified when they are diagnosed with an STI,’ says Dr Lawton.

‘Many are widowed or divorced and dating again and have never worn a condom in their life and don’t even think to use them — which is a mistake.

‘The women know they aren’t going to get pregnant, so they think there’s nothing to worry about.

‘Many men say they didn’t think they needed to use contraception because “she wasn’t that kind of girl” — when the truth is, how can anyone tell just by looking?

‘If you have an STI, you need to tell your current partner. You may also need to speak to anyone else you’ve had sexual contact with. How far back you go depends on the infection and whether the infection has symptoms — the sexual health clinic will help advise.’

17 Is thrush an STI?

‘THRUSH is a very common infection and is not classed as sexually transmitted,’ says consultant in sexual health Dr Lawton. ‘It can often occur when something upsets the natural balance of the vagina, such as a course of antibiotics, perfumed bubble bath or lubricant.’

Men can also get thrush. If one of you gets it, there’s no need for your partner to be treated, too.

18 Should Ibe worried about...?

‘VAGINAL discharge is normal,’ says gynaecologist Tania adib. ‘This is the vagina behaving as it should do. These mucous secretions are cleaning it and keeping it in a healthy state. The mucus should be clear or white.’

The amount produced depends on the point of your menstrual cycle (you produce more when ovulating, for instance).

However, if you experience changes — such as itching, or it becomes thick — see your GP or gynaecologist. accompanying pain or other symptoms, such as blistering, need to be checked out. They could indicate a sexually transmitted infection.’

19 Is herpes curable?

GENITAL herpes is caused by the herpes simplex virus — the same virus that causes cold sores — and anyone who’s sexually active can get it and pass it on.

Symptoms include small blisters that burst to leave red, open sores; pain during urination, tingling, burning or itching; and, in women, discharge that’s not ‘normal’ for you.

Herpes simplex is most likely to be passed on just before, during or straight after an episode.

‘However, in some people, the body can shed the virus without there being any signs or symptoms of genital herpes,’ says consultant in sexual health Dr Lawton. ‘also, you may not have symptoms at the time of exposure — blisters can take months or years to appear. Some people will get exposed to it and not catch it.’

The herpes simplex virus will stay in your body for life. But that doesn’t mean you will continue to have episodes. ‘By the age of 30, 50 per cent of the population has the herpes virus — either type one (which causes cold sores around the mouth but can occur in the genitals) or type two (which usually causes an episode in the genital area) — and this rises to 75 per cent by the age of 50,’ says Dr Lawton. ‘It’s normal to have the virus in your body. It’s ultimately a cold sore in a different place. Yet there is a huge amount of stigma attached to it.’

Your chances of it recurring are low if you’re healthy, he adds. ‘risk factors include being tired and run down. But symptoms of recurrent episodes are usually milder than the first and clear up more quickly (in about a week).’

21 Thrush treatment hasn’t worked. What can I do now?

FIRST, you need to ascertain it is thrush, says consultant in sexual health Dr Lawton. ‘Women often confuse the symptoms of thrush with another common condition, bacterial vaginosis, which has similar symptoms, but also often a strong odour. It’s best to see your GP or go to a sexual health clinic, as it can be hard to tell between the two.’

Bacterial vaginosis is commonly caused by using perfumed products, which upsets the natural balance of bacteria.

Like thrush, it’s not an STI. But STIs can also cause similar symptoms to both, so if you’re in any doubt, visit your local sexual health clinic (you can self-refer, see the NHS Choices website for your nearest clinic) or see your GP to get tested.

Women going through the menopause often suffer ‘thrush-like’ symptoms, adds TV doctor Dr Dawn Harper. ‘These ladies sometimes wrongly think they have thrush, but it might be a lack of oestrogen causing dryness, stinging and burning.’

Some women find their monthly cycle is a trigger, says Dr Lawton, due to changes in hormone levels. When it comes to treatment, it’s really up to individual preference. ‘Some women prefer the pessary and cream option, as it’s very soothing. I tend to prescribe the antifungal tablet fluconazole,’ he adds.

22 I’ve not been unfaithful—so how have I got an infection?

‘ SOME infections, such as chlamydia, often have no symptoms and can be there for years before they are picked up — so don’t automatically assume your partner has been unfaithful,’ says consultant in sexual health Dr Lawton.

‘However, if you have had sex only with your partner since you were last tested — or only ever had sex with them — then it suggests you caught it from your current partner, and that’s a conversation you’re going to have to have with them, as uncomfortable as it may be.’

either way, you will need treatment to prevent the disease causing long-term damage.

23 What’s causing this red, intensely itchy rash?

Men may worry a rash like this in the genital area is an STI. ‘This is commonly asked by men after warm weather and almost always turns out to be “jock itch” (or tinea cruris), a fungal infection,’ says consultant in sexual health Dr Lawton. ‘It affects the crease of the groin, causing the area to appear red and sore, and the skin to peel and itch.’

Treatment is an antifungal cream such as Canesten bought over the counter — but see your GP or go to a sexual health clinic if it doesn’t settle down or keeps recurring, says Dr Lawton.

Tighter briefs may be better, as they stop skin rubbing against skin. ‘eczema and psoriasis can also cause red rashes in the groin area,’ he says.

24 I’ve got a lump —is it warts?

IT’S not necessarily genital warts, says consultant in sexual health Dr Lawton. ‘It could be any number of things. Many of us have tiny bumps on the penis or labia that are just glands. If the gland gets blocked, you can end up with a white lump under the skin and ingrown hair.’

It could also be molluscum contagiosum — these small, smooth, pink round bumps are caused by a virus that can be spread in the area by shaving and/or can be sexually transmitted. It usually resolves spontaneously within two years, but can also be treated medically.

a genital wart is a fleshy growth that can take up to two years to show up after you have been exposed to the virus, says Dr Lawton. ‘If you’ve been with your partner a year and they suddenly have an outbreak, don’t assume they’ve been unfaithful.’

genital warts are usually frozen off with liquid nitrogen or treated with a cream, normally at a sexual health clinic. unlike many viruses, the wart virus will work its way out of your system eventually — typically after one or two years.

‘Women often say they have a big “lump” down there,’ adds gynaecologist Tina adib. ‘These are usually Bartholin’s cysts. There are two glands at the entrance of the vagina that secrete fluid.

‘ Sometimes, this duct can become blocked and a cyst will form — about two in 100 women will develop one. This may not be painful initially, however it can become infected.

‘My recommendation would be to go to your GP and ask for a referral to a gynaecologist who will be able to treat the cyst by draining it.’

All the information given here should be taken in a general context — always consult your own GP with any health worries