The STI Clinic News > General Sexual Health
# Thursday, 16 November 2017
Posted: Thursday, 16 November 2017 | Categories: General Sexual Health | Women's Sexual Health

Trichomonas and Prostate Cancer: Link Questioned by New Study

Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. It affects both women and men and because it can be symptomless, or present with symptoms similar to other STIs, it can be difficult to diagnose.

The good news is that trichomonas is relatively rare in the UK; in a study from the end of last year it was found that only 6,000 cases are reported per annum. The bad news is that this fairly innocuous STI is a risk factor for other serious diseases – although not, as previously thought, prostate cancer.

Back in 2006, a study found that that men infected with the T. vaginalis parasite had a 40% greater chance of developing prostate cancer. In 2012, another researcher claimed to have discovered the "molecular mechanism" causing the association between the two conditions.

For men around the world this was concerning news, trichomonas being a common STI in many countries, and not always easily detected. However, doubt has been cast upon these findings by more recent research, which has challenged the idea that trichomonas could lead to prostate cancer.

A study from last year looked specifically at African American men, amongst whom the prevalence of trichomonas and the risk of developing prostate cancer is higher than average. Ultimately, researchers found no strong evidence to suggest a causal link between trichomonas and prostate cancer in these men.

It’s not clear yet what has caused these contradictory results, but one theory is that the T. vaginalis parasite increases inflammation, and encourages the growth of both benign and cancerous cells. Trichomonas, therefore, may not actively cause the development of prostate cancer, but may contribute to more aggressive forms of it.

In other words, men who are particularly at risk of prostate cancer (whether because of age, lifestyle or family history) may do well to stay cautious about STIs such as trichomonas; however, there’s no need to be overly concerned if you receive a diagnosis. Trichomonas is one of the easier STIs to treat. Typically you take an antibiotic called metronidazole for five to seven days.

What is more concerning is that trichomonas is known to increase the risk of HIV transmission and acquisition in women. The T. vaginalis parasite is thought to increase vaginal shedding in women with HIV, which makes them more infectious.

Going forward, the safest thing to do is to continue to practise safe sex, to familiarise yourself with the symptoms of STIs and to get tested if you think you might be at risk of infection.

Trichomonas, STIs & Safe Sex

The symptoms of trichomonas are similar to chlamydia and gonorrhoea. It is thought that about half of all people infected do not suffer any symptoms, but those who do might experience the following:

  • Abnormal discharge from the penis (thin, white) or vagina (thick, thin, or frothy, yellow or green, unpleasant smell)
  • Pain when urinating
  • Soreness and swelling around the vagina or the head of the penis
  • Men may need to urinate more frequently, and women may experience pain during sex

If you are with a partner who is showing any of these symptoms, you should refrain from sex until they have been tested. If you develop these symptoms you should get tested for trichomonas as soon as possible. Click here to visit our clinic and order a home test kit.

Other STI symptoms to watch out for include:

  • Blisters, bumps or sores around the genitals or anus
  • Itching, tingling or burning around the genitals or anus
  • In women, bleeding between periods or after sex
  • In women, pain in the abdomen

To avoid contracting these kinds of unpleasant symptoms, you should always use condoms for penetrative sex if you aren’t sure your partner is free from STIs. You should also be aware that oral sex can transmit STIs; to stay safe when you aren’t sure about your partner’s STI status, use condoms or dental dams during oral sex.

Avoid sharing sex toys that haven’t been washed between uses, and be aware that condoms can’t provide full protection against diseases like genital herpes or warts, as these are spread by skin-to-skin contact.

If you’ve had unprotected sex recently, or if you have sex with multiple or casual partners frequently, it is a good idea to get tested.

 
Posted: Thursday, 16 November 2017 | Categories: General Sexual Health

UK STI Rates: Some Positive News

In recent years, the UK headlines have been hit with news of gonorrhoea strains that cannot be treated with antibiotics, rising rates of STIs, and the return of sexually transmitted diseases we assumed were long dead. Confronted with this, it would be easy to feel like Britain’s sexual health is a lost cause. According to clinical pharmacist Laura Waters, however, it’s not all doom and gloom.

In a recent opinion piece, Waters put these alarming headlines into context, explaining that high STI rates and increasing diagnoses are not necessarily an indication that our sexual health practices are becoming worse. The first point made by Waters is that total STI cases in 2016 actually decreased by 4% from the previous year. Within specific groups, we also saw falling rates of first-episode genital warts (down 8%) and gonorrhoea (down 12%).

In perhaps the best news, diagnoses of HIV amongst men who have sex with men (MSM) fell by 23% between 2015 and 2016; this group also saw a significant decline in gonorrhoea diagnoses. The clinics which reported the sharpest decline in HIV diagnoses were also the ones in which testing for HIV had seen an increase. As Waters explains, HIV-negative MSM are likely to be driving this increase in testing, and increased screening seems to be having the doubly beneficial effect of catching gonorrhoea in its early stages and facilitating swift treatment.

While some STI rates have stayed relatively stable or even declined in recent years, it is true that we have seen a sudden increase in syphilis for MSM. Some have speculated that this is related to improved HIV treatment and campaigns such as "Can’t Pass It On" which publicise the fact that HIV-positive men receiving proper treatment have an undetectable viral load and cannot pass the virus on during sex. Though breaking down the stigma around HIV is crucial, it’s believed that these campaigns could have the effect of reducing condom use in MSM, thus making them vulnerable to other STIs such as syphilis.

Perhaps the most dispiriting revelation in Waters’ article is that there is a significant public funding gap when it comes to sexual health issues. In 2012, the Health and Social Care Act was introduced; this means that sexual health is now commissioned by local authorities and not the NHS. With huge reductions in public health spending, sexual health services have been seriously impacted.

And yet, there is still cause to stay hopeful. The roll-out of the HPV vaccination to schoolgirls has led to a significant drop in genital warts for this age group. Currently, the NHS and Public Health England are trialling HPV vaccinations for MSM under 45, which will hopefully lead to a decline in cases of genital warts for this category as well.

Moving forward, the best thing to do is push education around sexual health issues, for people of all ages. Second to that, regular testing should be encouraged amongst the most at-risk groups: MSM, the under-25s, and those of black African descent.

Safe Sex & STI Testing

One of the key STI facts that should be circulated is that sexually transmitted infections aren’t solely transmitted through penetrative sex. They can be passed on during oral sex, when sharing sex toys, and even simply by having skin-to-skin contact.

To stay safe, you should always use condoms and dental dams for oral sex with someone whose STI status is unclear. You should always wash sex toys between uses or cover them with a fresh condom. You should also refrain from sexual contact if you spot any STI symptoms.

STI symptoms can include:

  • pain when urinating
  • unusual discharge from the penis or vagina
  • in men, pain in the testicles
  • in women, pain in the pelvis or abdomen
  • in women, irregular bleeding (e.g. after sex or between periods)
  • fleshy growths around the genitals or anus
  • painful blisters around the genitals or anus
  • a painless blister on the genitals or mouth

To get tested for STIs, visit an NHS centre such as a sexual health clinic, or order home test kits from The STI Clinic. Click here to learn about our Quad Blood Test, which screens for HIV, syphilis, hepatitis B and hepatitis C.

 
# Thursday, 26 January 2017
Posted: Thursday, 26 January 2017 | Categories: General Sexual Health

STI Rates Up in Older People

In the UK, most people tend to associate sexually transmitted infections with irresponsible teenagers and drunken students. But while the statistics certainly support this stereotype to some degree (in this 2016 Public Health England report, 16 to 24-year-olds were found to be most at risk for chlamydia, genital herpes and genital warts), it’s worth bearing in mind that STIs affect every age category. In fact, when it comes to gonorrhoea and syphilis, men over the age of 25 seem to be most at risk.

In perhaps the most surprising news of all, sexually transmitted infections are actually on the rise amongst the oldest age categories. In the last decade, STI diagnoses in people aged between 50 and 70 have risen by a third. To get more specific with the numbers, 2010 saw sexual health clinics recording 11,366 new infections in this age group; by 2014 that number had risen to 15,726.

It’s hard to pin down exactly why we’re currently seeing this trend, but there are a few factors to consider.

Safe Sex Campaigns

The first thing to think about is the fact that safe sex campaigns tend to be targeted towards young people. As a result, the average 18-year-old may well know more about the STI symptoms and where to get tested than the average 62-year-old. In fact, in a study by the Office for National Statistics carried out between 2008 and 2009, it was found that only 19% of men aged 50-69 could correctly answer a series of questions about chlamydia symptoms (as opposed to 37% of men aged 30-34).

Consider too that a lot of sexual education material can be found online, and the fact that youngsters tend to be more proficient with computers and the internet than their parents and grandparents.

Divorce rates

Another factor in rising STI rates amongst older people is divorce. As shown by another Office for National Statistics study, the average age at which people are getting divorced has risen in the UK in recent years – in 2013, the average age for a man to get divorced was 45. But how does that relate to STI rates?

Well, following a divorce, it’s common for newly single people to begin dating and enjoying casual sex. But after many years of marriage, divorced men and women who may be used to having unprotected sex may find it difficult to readjust and start taking precautions again.

Women in the 50 - 70 age bracket may also be more careless when it comes to sex if they have been through the menopause. When the risk of pregnancy is taken out of the equation, it can be tempting to forgo condoms – despite the threat of STIs.

Overcoming the Stigma

When it comes to sex, older people may also feel more reluctance in talking to their doctor, or getting advice about doing things safely. They may even feel embarrassed walking into a pharmacy to buy condoms, particularly if they have not done so in a long while.

The important thing to remember is that the consequences of unprotected sex can be far worse than the slight embarrassment of getting advice from your GP or pharmacist. This is also the case when it comes to getting tested and treated properly.

If you have engaged in unprotected sex and you aren’t sure that your sexual partner or partners were STI-free, you should get tested. You can do this for free by visiting an NHS clinic, or by ordering a home test kit through a private service like The STI Clinic (click here to learn more about our Full STI Screen).

It’s also important to get an STI test if you are experiencing any of the following symptoms:

  • pain or a burning sensation when urinating
  • unusual discharge from the penis or vagina
  • fleshy growths around the genitals or anus
  • sore red blisters around the genitals or anus
  • in women, irregular bleeding, heavy periods, pain in the abdomen or pain during sex
  • in men, pain or tenderness in the testicles

Be aware that this is not an exhaustive list of STI symptoms, and that many infections are initially symptomless, so if you think you may have been exposed to something, you should get tested regardless.

 
# Saturday, 05 November 2016
Posted: Saturday, 05 November 2016 | Categories: General Sexual Health

In the popular imagination, syphilis is a disease that belongs to another time: an age before modern medicine, plumbing and hygiene practices. But according to the latest reports, this "old-fashioned" STI is actually experiencing a comeback.

Earlier this year, the European Centre for Disease Prevention and Control released new data showing that syphilis diagnoses have been steadily increasing across Europe since 2010. As reported here, the ECDC found that gay and bisexual men contract syphilis most frequently; in fact, 63% of all diagnosed cases of syphilis occurred in men who have sex with men (MSM). Perhaps most surprising, though, is that the largest percentage increases in diagnoses year on year were seen in those aged 45 or over.

This increase in syphilis diagnoses can be seen not only across Europe as a whole, but in the UK as well. This year’s STI study from Public Health England reported a 20% increase in syphilis diagnoses from 2014 to 2015 – and an increase of a startling 76% from 2012.

Potential Causes for the Increase in Syphilis Diagnoses

One of the key causes for the increase in syphilis diagnoses may be that many people consider it to be a largely extinct disease. For this reason, they may not be familiar with the symptoms and how it is spread. This may be particularly the case for older people (i.e. the at-risk over-45 age category). Most sex education is targeted towards young people, meaning that older people may be missing out on key information.

As for men who have sex with men, it is thought that better screening programs have contributed to more diagnoses – which puts a positive spin upon these startling numbers. However, many doctors also believe that more and more men in the MSM group are having condomless sex. This may be attributed to the decline of the AIDS crisis, and the sophisticated developments in modern HIV treatment. Bacterial STIs such as syphilis are also on the rise in HIV-positive men who have sex with men (this is because HIV makes you more susceptible to other sexually transmitted infections).

Lastly, although syphilis usually causes symptoms, it can be entirely symptomless in some people. This means that you may be infected and not be aware of it.

Syphilis: Symptoms & Transmission

Syphilis can be contracted through sexual contact with someone who has been infected. In its early stages, the disease is known as "primary syphilis" and causes a small, painless sore or ulcer to develop, usually on the vagina, penis or anus. Because you usually only get one sore and it isn’t painful, it can be easy to ignore this symptom. Another sign that you might have contracted syphilis is swollen glands in the neck, armpits or groin.

Primary syphilis usually passes within a few weeks. However, when left untreated it can develop into secondary syphilis. The symptoms of this stage include:

  • A blotchy red rash
  • Skin growths on the vulva or anus
  • White patches inside the mouth
  • Flu-like symptoms
  • Swollen glands
  • Hair loss

In the first two years after contracting syphilis, it is possible to pass on the infection to other people. This usually happens during sex when coming into contact with an infected sore – for this reason, it’s important to practise safe sex (by using condoms and dental dams) when having sex with someone who may be infected.

The problem is that, after its initial stages, syphilis can progress in the body without causing symptoms. If left to develop untreated, it can lead to tertiary syphilis, which is often associated with neurological diseases such as meningitis, dementia, stroke and blindness. At this point, the damage caused by the disease is difficult to reverse.

Testing For & Treating Syphilis

The good news to take away from the ECDC’s scary report is that, because syphilis is a bacterial infection, it can usually be treated with antibiotics.

It’s also very easy to get tested for syphilis. You can get tested for free at an NHS centre such as a GUM clinic. You can also obtain a home test kit from The STI Clinic. Click here to learn more.

 
# Saturday, 15 October 2016
Posted: Saturday, 15 October 2016 | Categories: General Sexual Health

Pain or a burning sensation when you urinate often indicates a sexually transmitted infection. Chlamydia, gonorrhoea and the herpes virus can all cause pain when urinating (also known as dysuria). However, there are a number of other things that can cause this specific symptom.

Urinary Tract Infections

One common cause of dysuria is a urinary tract infection. This is where bacteria enters the urethra, the tube that passes urine and, in men, seminal fluid out of the body. This can happen during sex or when wiping your bottom after a bowel movement. It is more common in women than in men because women have a shorter urethra that is closer to the anus.

If the infection affects the urethra or bladder it can cause pain when urinating, cloudy or bloody urine, abdominal pain, and the need to urinate frequently. This type of UTI can clear up on its own within a few days, though you can also get a prescription for antibiotics to help the healing along.

The infection is more serious if it affects the kidneys or the tubes connecting the kidneys to the bladder. Symptoms of this include those listed above, as well as pain in the sides and back, a fever, and feeling sick. These symptoms require more urgent medical care, and shouldn’t be left untreated.

Urethral Syndrome

Urethral syndrome is where the urethra becomes inflamed, but not as a result of a bacterial or viral infection. It causes pain in the abdomen and frequent, painful urination.

Urethral syndrome is thought to be caused by a number of different things, including injury to or irritation of the urethra. The urethra can become irritated by:

  • Using scented products around the urethral opening (e.g. soap, perfume or fragranced sanitary towels)
  • Using spermicidal lubricant during sex
  • Drinking too much caffeine
  • Chemotherapy or radiation treatment

Injury to the urethra, meanwhile, can happen as a result of:

  • Sexual intercourse/activity
  • Riding a bike
  • In women, using tampons
  • In women, using a diaphragm or cap as contraception

In some cases, urethral syndrome is caused by constriction in the urethra, which can happen as a result of inflammation, injury or scarring. If this is the cause of your symptoms, then surgery to widen the urethra may be the best course of action.

Adenoviruses

An adenovirus can cause bladder infection and inflammation, leading to dysuria. These viruses can be spread through close personal contact, but they are not classed as sexually transmitted.

Lesser-known STIs

If you are suffering from painful urination but a doctor has ruled out the major STIs, it's still possible that your symptoms have been caused by a sexually transmitted infection. STIs such as mycoplasma aren’t as common or as well-known as chlamydia or gonorrhoea, but they can still cause dysuria. You can order a home test kit for mycoplasma at The STI Clinic.

Protecting Yourself in the Future

If you are frequently experiencing pain when urinating, you should take some steps to protect yourself. This involves:

  • Using condoms during sex to avoid sexually transmitted infections
  • Not sharing sex toys unless they have been washed or covered in a new condom
  • Not using scented bath products around your genitals
  • Wiping from your urethra back to your anus after a bowel movement, to avoid the spread of bacteria
  • Urinating after sexual intercourse to help expel bacteria from the urethra
  • Avoiding wearing tights or jeans that are too close-fitting
  • Avoiding underwear that isn’t made from cotton

It’s also important to get regular STI tests if you think you might be at risk (e.g. if you don’t use condoms or you have multiple sexual partners). STIs can normally be treated easily if they are diagnosed early on. You can get a full urine screening test at The STI Clinic, by ordering one of our home test kits. Click here to find out more.

It’s not always easy to avoid getting an infection, or incurring injury to the urethra, particularly if you are a woman. However, if you stick to the rules above and visit a doctor when symptoms don’t go away on their own, you should be able to avoid any serious health complications.

 
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