Gonorrhoea

('Clap', 'Drip', 'Jack', 'A Dose')

Gonorrhoea is one of the most common STIs. The germ which causes gonorrhoea cannot survive outside the human body. It is almost always transmitted by direct sexual contact, and is most unlikely to be caught from lavatory seats, towels or other objects. Untreated gonorrhoea can produce inflammation in many places throughout the body, which can lead to sterility and occasionally arthritis. If a mother has gonorrhoea at the time her baby is being born, the child's eyes may be infected.

Symptoms in Males

In men the signs of gonorrhoea usually appear between two and ten days after infection has occurred, although sometimes it may take longer. The first signs are:

• A slight, clear, thick discharge (drip) from the penis. If treatment is delayed the discharge will increase in quantity and become thick, yellow and pus-like, with an unpleasant smell.
• There may be a burning sensation or irritation when urinating.

Occasionally the signs are so slight a man may not notice them.

Symptoms in Females

Very often, women who have caught gonorrhoea do not have any noticeable signs and don't know they are infected. If there is a discharge from the vagina (front passage), it may be so slight that it passes unnoticed. If treatment is delayed, gonorrhoea may pass up through the uterus (womb) into the (Fallopian) tubes and cause internal infection which can result in infertility. The first sign of this is pain in the lower abdomen (belly). Any unusual discharge should be checked immediately by a doctor or sexual health nurse.

For Both Men and Women - 

Gonorrhoea (as well as syphilis and herpes) can be caught through contact of sex organs with the mouth (fellatio and cunnilingus) or rectum (back passage) as well as through penis-vagina intercourse. Where the mouth is involved it may result in a sore throat. An infection in the rectum may cause a slight discharge.

Treatment

If any of the symptoms described appear a few days after sexual contact, it is wise to see a doctor or Family Planning clinic immediately. Diagnosis of gonorrhoea can only be made by special tests carried out by a medical practitioner. DO NOT TRY SELF-TREATMENT OR CONSULT AN UNQUALIFIED PERSON. The symptoms may disappear or lessen with or without treatment, but the person may still have gonorrhoea and can still infect others.

The treatment is painless and quick, and if it is commenced early the cure is complete.

If you think you have gonorrhoea it would be unfair for you to have sexual contact with anyone until you have had proper treatment and your doctor tells you it is safe to do so. Otherwise you may pass the disease on. It can be very distressing and embarrassing if you infect another person.

See additonal information at the bottom of the page for the Gonorrhoea Pamphlet.

Syphilis - ('Pox')

Syphilis, though not as common as some of the other STIs, is a very serious disease if left untreated. The germs which cause syphilis can enter the body through even tiny breaks in the skin or the linings of the body cavities. It is almost always acquired by sexual contact.

Symptoms: First Stage (Primary Syphilis)

The first sign of syphilis is an ulcer called a chancre (pronounced 'shanker') at the place where the germ enters the body (usually on the sex organs, mouth or rectum depending on the type of sexual contact you have had). This ulcer - which is often not painful or itchy - usually appears about three weeks after the infection has been acquired, but may occur between ten days to ten weeks. It can vary in size from what appears to be a very small chafe to that of a five cent piece or larger. There is usually only one sore but may be two or three. The glands in the groin may also become swollen and feel rubbery, though normally painless.

Even without treatment the sore will disappear of its own accord within days or weeks, so it is important to go for a check up to get tested properly. The earlier syphilis is detected the easier it is to cure.

Symptoms in Males: the ulcer is usually easy to see when it appears on or near the penis. But if the sore is very small it may pass unnoticed. It can also occur, though more rarely, on the other parts of the body such as lips, fingers or chest.
Symptoms in Females: the sore may be hidden in the vagina or surrounding areas, or may occur elsewhere on the body. A woman may not know that she has the sore since usually it is not painful.

Symptoms: Second Stage (Secondary Syphilis)

A rash will appear, sometimes quite suddenly, about six weeks after infection, on the body and the face, arms and often on the palms of the hands and soles of the feet. The type and extent of the rash will vary from person to person and even vary on different parts of the body on the same person. It may be so mild as to pass unnoticed and often disappears quite quickly.

There may also be mouth ulcers, a sore throat, headache and fever.

During this stage diagnosis can be made by a blood test.

A person in the first or second stage of syphilis is very infectious, because the chancre, rash and mouth sores all carry high doses of the syphilis germs.

Symptoms: Late Stage (Tertiary Syphilis)

The second stage disappears even without treatment and for many years then there may be no external signs of the disease. For the first two years there is a potential risk of infecting sexual partners, but not after that. For anything from five to 15 years there may be no sores, rashes or other obvious physical symptoms and the person feels and looks well. However, the germs are still multiplying within the body and may then attack any part, causing serious illness and sometimes death. Syphilis in this stage can attack the tissues of the heart, brain and the nervous system resulting in irreparable damage.

Syphilis can still be easily diagnosed by a blood test at any time throughout this stage. Treatment at this stage will prevent any further disability but whatever parts of the body have already been damaged may remain damaged.

In Pregnancy

A pregnant woman with untreated syphilis can pass the germs through her bloodstream to her unborn baby, causing the child to be born with syphilis. Every woman should have a blood test for syphilis during her pregnancy - ask your doctor about this as soon as you know you are pregnant. Effective treatment of the mother during pregnancy will prevent the baby being born with syphilis.

Treatment

Diagnosis of syphilis usually requires a special blood test, which will show the presence of the disease from between three to eight weeks after contact. Longer treatment is required for syphilis than for gonorrhoea, but it can be cured completely if treatment is commenced early. Even in the late stage the infection can still be cured, although any damage already done cannot be repaired.

After treatment, follow-up tests are essential for between one and two years to make sure the cure is complete.

There exists a high risk passing it to a partner if you have sexual contact before the doctor says that it is safe to do so.

See additional information at the bottom of the page for CDC - Syphilis Information.

Genital Herpes

Genital herpes is an increasingly common viral infection usually transmitted by sexual contact, which can affect the sex organs, the anus and the areas around them.

With the first attack of Herpes, blisters can be very painful and widespread. Treatment is available to limit the severity of this attack if you contact the doctor early. In subsequent attacks it can appear as an itchy or painful patch but more characteristically as a group of tiny blisters (like the "cold sores" on the lips) which break, weep, dry and then usually heal in ten days.

The virus is contagious while there is any visible form of it on the surface. At these times the only way to be sure not to pass it on is to avoid sexual contact. If both partners have genital herpes they cannot catch it from each other again.

Proper diagnosis of genital herpes is important, and is most easily made when the area is blistering or moist. There are various treatments available to reduce the severity of an attack and frequency of recurrences, but as yet there is no medication that will eliminate the virus from the body.

See additional information at the bottom of the page for Genital Herpes
Or: CDC - Genital Herpes Information

Chlamydia

The silent STI. Often, Chlamydia sufferers do not realise they have the disease. It's estimated that 60- 80% of women and 10% of men with Chlamydia have no symptoms. As a result, they may not seek treatment until serious complications such as infertility occur.

Genital infections caused by Chlamydia can result in a variety of medical problems.

In males, Chlamydia is the leading cause of Non-Gonococcal Urethritis (NGU). When symptoms are present, they include painful urination and a watery discharge from the penis.

In women, the consequences of Chlamydia are much more severe. It often starts as an infection of the cervix. If untreated, it can spread through the uterus to the fallopian tubes and eventually cause infertility and an increased danger of ectopic pregnancy.

Women may suffer itching and burning in the genitals, vaginal discharge, dull pelvic pain and bleeding between menstrual periods. If you have these symptoms see a doctor at once.

Chlamydia is also believed to be a major cause of pelvic inflammatory disease (PID), an inflammation of the entire female reproductive system.

Besides being transmitted by intimate, sexual contact, Chlamydia can be passed from a woman to her child during birth resulting in a range of potentially painful symptoms in the new born baby.

How can it be stopped?
Use of condoms by men and diaphragms by women can help limit the spread of Chlamydia. Once it is identified, Chlamydia can be cured quickly and painlessly with antibiotics. However, if it has already caused the woman to become infertile this cannot be reversed. All sexual partners should be notified so they can seek medical attention.

 See additional information at the bottom of the page for the Chlamydia Pamphlet.

What is PID

PID stands for Pelvic Inflammatory Disease. It is a major cause of infertility in women. It can also cause chronic pelvic pain and increases the risk of ectopic pregnancy.

The two most common causes of PID are Chlamydia Trachomatis and Neisseria Gonorrhoea. Both of these organisms are not usually found in the human genital tract. They are usually transmitted from one partner to another during sexual intercourse. They are not passed on by kissing, heavy petting or toilet seats. In women, either of these infections may spread upwards from the cervix (the opening to the uterus or womb) to the internal organs, the uterus, fallopian tubes and ovaries, resulting in PID.

Symptoms: 

The symptoms of PID vary. A woman may have no symptoms at all. If you are unsure about whether you have contracted an infection, go to your Doctor and ask for a checkup.

Symptoms of lower genital infection are tingling or burning when passing urine and abnormal discharge. If the infection progresses to PID, symptoms again may vary to lower abdominal pain and tenderness, deep pain on sexual intercourse, menstrual disturbances & fever.

Treatment:

After you have sought medical advice and diagnosis has been made, it can be quickly treated by antibiotics in the form of tablets or capsules. Only in severe cases is PID treated in hospital.

Prevention:

There are ways of preventing PID. Protect yourself by:

1. Using condoms
   (a diaphragm is also a reasonably effective means of protecting the cervix)
2. Limit your partners
3. Communicate with your partner
4. Regular checkups

See additional information at the bottom of the page for Chlamydia and PID.

HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome)

AIDS is a condition caused by a virus (HIV) which attacks and breaks down your body's immune system. Normally your immune system defends your body against infections and diseases. Once it has been broken down by the virus you can get sick and die from diseases which normally wouldn't affect you.

The two most common ways to contract HIV are:

1. Unsafe Sex:
   Sexual intercourse is unsafe if semen, blood or vaginal fluids pass from an infected person to their sex partner. The only safe way to stop the exchange of fluids during penetrative sex is to use a condom.
2. Sharing needles and syringes.

When someone uses a needle or syringe to inject drugs, small particles of blood are left behind in the needle. If this blood contains the virus, then the next person to use that needle will inject themselves with infected blood.

There have been cases of infections resulting from the use of unclean needles and equipment in tattooing procedures and it is important that, if undergoing such a procedure, the practitioner is using clean, sterile equipment and new needles for each client.

HIV can also be contracted through blood transfusions however, with more rigorous screening procedures this is becoming a far more rare occurrence in Western countries.

Five points to stay safe:

1. Know the facts about HIV/AIDS.
2. Make a decision, now, about your sexual behaviour.
3. Don't be embarrassed to ask someone else about their sexual behaviour; they'll want to ask you.
4. Use a condom when you want to have sex.
5. Don't share needles.

At the moment there is no known cure for AIDS and no vaccine to stop you catching the virus (HIV). Not everyone who gets the virus gets sick and dies. Medical treatments are now widely used however treatment usually continues for the remainder of the patient’s life.

Scientists have developed a blood test which can tell whether or not anyone has been infected with HIV.

For more information on HIV and AIDS see: http://www.ntahc.org.au
Or: CDC - HIV Information

Other Infections

NGU 

(Non-Gonococcal Urethritis or 'strain') is an infection which can be transmitted by sexual contact. In men it produces signs like those for gonorrhoea - discharge and burning during urination. Women do not have NGU as such but may have one of several infections which can be passed on to a man resulting in him developing NGU. A correct diagnosis can only be made by a medical practitioner. The NGU discharge may or may not clear up by itself, but it may cause some ill-health in later life if left untreated. It can be treated quite easily, but may recur, often as a result of inadequate treatment of the patient or partner. During treatment it is advisable not to drink alcohol or have sex.

Trichomonas

Is one of the most common sexually transmitted diseases and can affect both women and men. In women, the vagina is inflamed, there is a lot of unpleasant-smelling frothy discharge and sex and urination may be painful. Men may carry the disease and not know about it. Sometimes there is a little pain in the penis and a discharge from it. It is treated with a course of antibiotics.

For more information on Trichomonas see: CDC - Trichomonas Information

Thrush (Candida)

Is a fungus which can be found in men and women, but usually men have no noticeable signs, except perhaps some inflammation of the penis. In women, the sex organs are very itchy and may be red and tender. There is usually a little yellowish-white discharge from the vagina. Thrush often occurs after a course of antibiotics and in people with diabetes. It may be associated with a change of brand of the Pill, or early pregnancy.

Most women have mild thrush, but it needs some upset to the normal balance to cause the fungus to overgrow and become a problem.

Tell your doctor which of these things (if any) is likely to have caused your thrush, and then follow his or her treatment exactly.

See additional information at the bottom of the page for Candida Thrush.

Hepatitis B

Is a viral infection of the liver. The main way it is passed on is by infected blood entering the body by injection or inoculation, or other body fluids entering the body through tiny scratches and abrasions. In about a third of cases it is transmitted by sexual contact. Hepatitis B can be a long and disabling illness with a convalescence lasting months. A small proportion of sufferers develop persistent inflammation of the liver.

The signs of hepatitis B include general feeling of illness, fever, loss of appetite. The skin may turn yellow (this is known as jaundice), but this does not always happen. Anyone who has these signs and/or has been in contact with someone who later developed hepatitis B should have a blood test. They should also refrain from sexual contact until they have been cleared by a doctor. For people whose work or other activity puts them at a high risk of catching hepatitis B, a vaccine is available.

For more information on Hepatitis see: http://www.ntahc.org.au

Bacterial Vaginosis/Gardnerella

This organism is an anaerobe which is normally found in the vagina but can occasionally "take over". It can be associated with sexually spread infections.

Symptoms and Signs: There is a vaginal discharge, not dissimilar to that of Trichomonas, with a most offensive smell. Occasionally it is the smell alone that brings the patient to the doctor. In more severe cases, there will be itching and painful sex.

Bacterial Vaginosis can be treated with vaginal cream or antibiotics.

See additional information at the bottom of the page for Bacterial Vaginosis.

Genital Warts

Flourish in the moist areas of the body, but grow also on dry parts like the penis. They are caused by a virus and may be sexually transmitted. They usually appear two months after contact but may come anytime from one to six months afterwards, starting as tiny red swellings and growing into warts which have a pinkish colour and an irregular surface.

Genital warts can cause complications. Genital wart virus may infect the cervix and increase the woman's risk of developing cervical cancer. A woman who has genital warts or has a partner with warts must have regular Pap smears to check her cervix.

See additional information at the bottom of the page for the Genital Warts pamphlet.
Or: CDC - Genital Warts Information

Pubic Lice ('Crabs') and Scabies ('the itch')

Can both be passed on by close physical contact, including sexual contact and also sharing bed linen or clothing.

Pubic lice live in pubic hair. The main thing you notice is an itch. The crabs are greyish and about the size of a pinhead. The bodies appear brown after a meal of blood. The adults move slowly and lay eggs on the hairs themselves. Creams and lotions are available from the chemist which will kill the crabs. There is no need to shave off the hair. It is important that your partner be treated at the same time, or you could catch them again.

Scabies is caused by a mite which burrows into the skin. It can be treated easily and effectively, but your partner (and all members of the household if they have it) should be treated at the same time, and all bed linen washed.

See additional information below CDC - Scabies Information

See additional information below CDC - Pubic Lice Information