Sexually Transmitted Infections or STI - also known as Sexually Transmitted Diseases or STD

Sexually Transmitted Infections (STI's) or Diseases (STD's), whichever you prefer! 

One person in five has a sexually transmitted disease or STD right now in the UK. Amazing though this may sound, consider this: one person in three will get one at some point in their sex life.

There are more than 30 STD's, and millions of people are infected, many without knowing it. Many cases of STD do not have any symptoms, unless you happen to be the susceptible type, in which case you are not only likely to pass it on, but you're also you are going to come down with a nasty case of seeping, suppurating genitals. The other key things you need to know: having had it once doesn't stop you getting it again - whatever "it" happens to be; not even condoms protect you from everything; and there is no such thing as completely safe sex - even kissing can pass on the herpes virus.

However, don't be too depressed. It's not all bad news, and forewarned really is forearmed. Women are the ones who are most at risk when you think about STD's as a whole, because they can be rendered infertile or develop serious complications when they catch and STD - and remember, the man they catch it from might not be showing any symptoms. Frankness and honesty are essential, not optional, when it comes to talking to your partner about STD's. Only when you both know what's going on can you both take the right action. So talk to your partner about your sexual history before you get down and dirty: it will be a lot more difficult if you wait till after the act! 

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Penile cancer
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Sexually transmitted diseases
Peyronie's disease: bent penis

There are some important things you need to think about before you have sex with a new partner. For example, how do you know they're telling you the truth if they say they haven't got any STD's? How do they know, for example, that they are not carrying chlamydia but showing no symptoms? Can you really be sure that there aren't any HIV viruses lurking in their system? They may not even know about this themselves if they had spontaneous unprotected sex with an infected person they just met and liked - even just the one time.

HPV - Human Papilloma Virus

According to Em & Lo's book, 1 woman in 4 has this virus. And even more surprisingly, more than 3 out of 4 sexually active people will get an HPV infection at some point in their lives. Yet HPV isn't particularly well known, because most infected people show no symptoms, and the virus doesn't show up in STD testing in many cases. So what does HPV do? Mostly, in sexually transmitted cases, two things: it causes either genital warts or cancerous changes in the cells of a woman's cervix (and, rarely, in the anus, vulva or penis).

The most difficult thing about HPV is that the time between your picking up the infection and a wart developing is totally unpredictable, so you may never know who you got it from. What's more, you may never know who you're passing it on to, either, because when you have the infection you will go through phases where the virus is active and phases where it is completely inactive, depending on the vagaries of your own immune system. And wearing a condom won't necessarily protect you against HPV infection, at least not if the virus is sitting around on the skin of your scrotum or the edge of your partner's vulva: this also means you don't need to have penetrative sex for it to spread to your partner.

If you do develop a wart, then it's worth getting it treated - they can look awful, and although they may go away of their own accord, you can't be sure of this. Treatment will also reduce the risk of your passing on the infection to someone else. They generally are quite visible - see the illustration - and occur mostly on the penis, scrotum or vulva. However, since some other diseases can look rather wart-like, you need to see a doctor to get a definite diagnosis. The bad news is that if you are keen on oral sex, they may actually develop around your mouth or throat - in which case, I suppose, people may be able to guess what you've really been up to. Fortunately it isn't hard to remove a wart.

Since it's so hard to identify who has and who hasn't got HPV, you might wonder what you can do to minimize the risk of getting infected. The first thing is not to mess around with someone who obviously has genital warts. The next is that wearing a condom, despite the discouraging words above, does at least protect some of the skin that's likely to be exposed during sex. The third thing you can do is tell your partner if you've ever had warts on your privates. Hmm.....it may be hard to get that fact into a casual conversation, and since HPV is so prevalent you might not even think it's necessary, but telling your partner at least gives them the choice of whether to have sex with you or not.

The more potent strains of HPV cause abnormal or pre-cancerous cells to develop in the cervix. Happily, though, these changes develop very slowly, so an annual smear test eliminates the risk of a woman getting cervical cancer without knowing about it. And the good news is that a large proportion of pre-cancerous cells will spontaneously revert to normal or die out long before they become a serious problem. The even better news is that treatment for pre-cancerous cellular changes is effective when it's detected early. 

Herpes

1 in 10 UK residents is infected with herpes, but the majority don't show any symptoms. For the unfortunate ones, the first sign of an infection is a slight burning or tingling sensation on the skin where the virus made contact. Then, usually between 2 and 20 days later, the herpes blisters begin to develop - small blisters which burst, ulcerate and seep fluid, in that order. They then dry up and turn scabby, and everything returns to normal in about three weeks. From then on, depending on how strong your immune system is, there may or may not be further outbreaks, accompanied by some or all of fever, swollen glands and general pain in the infected area. Even if you do have further outbreaks they will most likely die out eventually, though this may take several years; you'll carry the virus for life, though, so potentially it can always return.

The virus is usually spread through contact between active herpes sores and the head of the penis, the inside of the lips, the urethra, the mouth, the vagina or the rectum. You might think this means that all you have to do is avoid anyone with a visible seeping sore, but sadly, you'd be wrong, though it's a good start. The first problem is that herpes sores aren't always visible - they can develop on the cervix, the thighs, between the cheeks of someone's bottom, and so on. So unless you're going to play hide and seek before you get down and dirty, you can't be sure there isn't a herpes sore lurking somewhere on your partner's body. The second problem is that there are periods where an infected person gives off the virus even if they don't have any active sores - the virus appears to creep through the skin and can infect a partner without either of you knowing anything about it. 

In theory there are two types of herpes - oral and genital - but the distinction doesn't mean much in practice. So don't bank on kissing someone with oral herpes and not getting genital herpes yourself, or going down on someone with genital herpes and not getting it. You can have a blood test that will reveal if you have the herpes virus in your system. If you have, there's an antiviral drug called Zovirax which may well help to speed your recovery and lessen the frequency and seriousness of the outbreaks when they do happen. As a responsible sexual player, you'll never want to have sex when you have an active outbreak, even with a condom. Why? Simply because condoms don't offer much protection against this virus's ability to spread. 

Stress is a key factor in how often viral outbreaks develop, and how serious they are when they do, so you may want to consider some stress-reducing relaxation therapy and a good diet with lots of supplements (that's vitamins and minerals, in case you don't know)

Get much more information here: Herpes.org.uk

HIV and AIDS

Apparently 1 in every 250 American adults is infected with the HIV virus. In New York, 1 adult in 30 is infected. The problem with HIV is that it's not curable, and it causes AIDS, and that makes people die. Sure, drugs have increased the lifespan of people with AIDS, but it can be a bad experience, and you'll die eventually. After infection with HIV the initial symptoms are usually mild - fever, aches and pains, swollen glands. As time goes by, the HIV virus destroys the body's ability to fight other infections and much worse problems develop: TB, cancer, yeast infections - the list is long and nasty. 

The HIV virus that is responsible for this carnage can spread in many ways, but if you think bodily fluids you won't go far wrong. Blood, semen, vaginal fluid and breast milk can all contain the virus, and coming into contact with these fluids during sex involving the vagina, anus, rectum or urethra, or through any cut or tear in the skin or mouth, or by sharing infected needles, can result in you becoming infected. 

There's only one sure fire way of knowing if you carry the virus - and that's to get tested. And of course, you can't tell if the person you're about to have unprotected sex with has it either. And what do you know of their sexual history? So, use a condom each and every time you have sex with a partner whose sexual history you don't know. Don't just believe what they tell you - your life is at stake. If you're in any doubt, mutual masturbation is a good option - provided you don't get semen or vaginal juices on any cuts or wounds on your skin. Dry humping with your clothes on (frottage) may be the safest sex of all, though it may not do a lot for your laundry bill.

Hepatitis

What with the number of variations of hepatitis floating around, you might well be confused. But the ones mostly passed on by sex are Hep A and Hep B. Let's take them in turn.

Hepatitis A is passed on by the transmission of fecal matter or blood from an infected person to an uninfected person: the most likely non-sexual source of infection being unwashed, just-used-the-toilet hands which are now preparing food. In a sexual context, analingus or accidentally ingesting your partner's shit (even just a tiny bit) are the most likely sources of infection. (Analingus means having your mouth in contact with someone else's anus. As they say, shit happens.)

When you've picked up Hepatitis A, between two and seven weeks later you're likely to experience flu-like symptoms, pain in your gut, dark colored urine, and jaundice. There's no medical cure, but you will recover naturally, given time, and then you're immune for life. Even so, having contracted Hep A myself, I'd recommend that you avoid the possibility of catching it, and get yourself along to your doctor for a combined immunization which protects you against both Hep A and Hep B.

Hepatitis B is linked to sexual activity. Estimates of its prevalence in the population range from 1 in 250 in the US to 1 in 1000 in the UK. Whatever the facts, it's common, and it can cause serious liver problems or death. 

A large proportion of infected adults never show any symptoms, but those who do will develop flu-like fever, dark urine, jaundice, abdominal pain, hives, light-colored shit, arthritis, and joint pain. These symptoms develop between six and twelve weeks after exposure to the virus. In most cases the symptoms get better; in a few unfortunate individuals, they get worse, affecting in particular the liver. This can be serious, leading to liver failure. The good news: about 9 out of every 10 infected people recover completely and do not become carriers. The bad news: as with many other sexual diseases, a proportion of the men and women who get infected become carriers for life, and they can pass it on even if they don't show any symptoms themselves. 

The main transmission routes are unprotected sex - oral, anal or vaginal - and of course the same routes as HIV transmission: sharing needles or exchanging bodily fluids. The best cure is prevention - using condoms, practicing safe sex, and so on.

Gonorrhoea (aka the clap)

Gonorrhoea is the most common and oldest STD, and it's not going away: in fact, it's getting much more common with each succeeding year. It can affect your urethra, genitals, rectum, eyes, mouth and throat, leading to pelvic inflammatory disease, ectopic pregnancy, menstrual problems, eye infections, arthritis, inflammation and infection. It's especially unpleasant if you happen to be a woman - and pregnant. And the catch is that 8 out of 10 women who contract gonorrhea have no symptoms, at least initially. Men don't escape unscathed, however, because gonorrhea can cause prostatitis, sterility, inflammation of the inner bits of the testicles and scarring of the penile urethra. There are more effects, but you get the picture. And guess what? While 1 man in 10 infected with gonorrhea won't show any symptoms, he can still pass it on.

If, however, you're one of those with symptoms you can expect the following within days of infection: discharge from the penis, urethra or vagina, a kind of green or yellowish pus, pain when you pee, and menstrual problems. If these symptoms are left untreated they can quite quickly become much worse.

Fortunately curing gonorrhea is easy: a dose of antibiotics for you and your partner, then a period of abstinence. The best way to avoid getting it is to put your penis in a condom before you put it in your partner.

Chlamydia

This nasty little bug often travels with gonorrhea, so if you get treated for one you may well get treated for the other at the same time - even if you didn't ask! Once again, a large proportion of infected men and women show no symptoms, so both partners have to be treated. Of course, if you've been shagging around, you have to locate and tell your previous partners - though that's true with all STD's. 

Symptoms? For women, they can include vaginal discharge and/or bleeding, painful periods, fever, painful peeing, inflammation, and painful sex. Sounds pretty painful? It can be, since left untreated it can cause sterility. But since many women display no symptoms, it's a sad fact that some of them are going to find out they've got it only when they discover they're infertile. For men: discharge from the penis, painful peeing, swollen balls, and itching. For both sexes: you thought that itchy ass was piles? If you've been indulging in a bit of backdoor action, think again - it might be gonorrhea or chlamydia.

It's transmitted through the usual routes (penetrative sex, exchanging bodily fluids), but in addition it can leap from one to another via skin contact. Watch out, since you won't see it coming! Happily, treatment's easy with antibiotics and prevention is easy with condoms.

Pelvic Inflammatory Disease (PID)

Most people will never have heard of this. It's basically the consequence - for women - of untreated STDs or vaginal infections. To sum it up: your reproductive system stops working, you go sterile, and and you have a lot of pain. The moral of the story? Get tested for STDs if you suspect you have one (or maybe just get tested, period), and if you know you have one, get it treated as soon as possible. Once a woman has it, her man needs to get his system checked as well - always assuming he didn't cause it in the first place, knowingly or unknowingly - because, as you may remember, he may not be showing any symptoms of the STDs he's carrying.

Syphilis

This was a medieval killer, and it comes and goes even now. Currently it's occurring with increasing frequency in the UK, though decreasing in the US. 

When you get syphilis, the first symptom is a painless little ulcer called a chancre which develops between a week and thirteen weeks after you pick up the syphilis bacteria. This will develop at the place where the syphilis bacteria entered your body - penis, vulva, anus, lips, mouth, fingers....yes, it can transmit from skin to skin. Next, you'll develop a rash or discolored skin patches, experience flu-like symptoms, and maybe lose weight or your hair. After a period as long as several years, during which you may or may not develop internal tumors, the syphilis bacteria can cause some really serious problems: in your brain, it causes blindness, neurological problems, madness and deafness; in your heart, it causes heart disease, and so on. Having said that, some lucky syphilis sufferers don't develop these symptoms. But since there's no way of knowing whether you will or you won't, it's probably a good idea to get it treated early on. Being a bacterial infection, antibiotics are prescribed. Condoms can help to prevent its transmission, but remember that the bacteria can be transmitted through skin contact, so the protection that condoms offer is not perfect.

Pubic Lice and Scabies

Lice cling to your pubes (or other bodily hair) and lay their eggs there. Since they suck your blood and make you very itchy, it's hard not to know you have them. You get them from an infected partner - or perhaps from infected bedding - and you get rid of them with an over-the-counter shampoo from the pharmacy. Ask for the one for pubic lice. That might be embarrassing, in which case get a prescription from your doctor. Use it on your partner too. (See below for some more advice.)

As for scabies, it's caused by some little insects which like to burrow into your skin and lay their eggs there. Nice, eh? The giveaways are little track marks, bumps, rashes, itching and red bumps, though the intense itching is a pretty good sign. Get the right medication from your doctor, and use it on yourself and your partner if you're in a regular relationship. After that, you'll want to discuss with each other how you got it. 

Yeast Infections

Yeast infections are caused by the microscopic organism Candida albicans. There are actually men strains of yeast infection, none of them related to the species Saccharomyces cerevisiae, which is used for making wine! When these yeast cells infect human genitals, they can cause both severe irritation and secretion of pus from the vagina or penis. Scaly, itchy red areas indicate a yeast infection, which needs treatment before it is spread from one sexual partner to another.

As you may know if you have followed the development of self-help treatment sites on the internet, you have a choice of hard core prescription medication or milder, gentler, but no less effective traditional yeast infection home remedies which you can use to cure yeast infections of the genitals or, indeed, yeast infections anywhere else on the body. I'd recommend and approach to health which takes advantage of all approaches to self-care if you wish to take a holistic approach to your sexual and general well-being.

Other websites:

Planned parenthood advice on infections

UK based site with useful advice and information