In today’s episode of Dr Nora, I take you through what to expect if you have a common sexually transmitted infection such as chlamydia or gonorrhea.
As a General Practitioner I am presented with an array of health conditions. However, Sexually Transmitted Infections (or STIs) are becoming a more common presentation.
CHLAMYDIA
Approximately 85–90% of people who are infected show no symptoms at all, making it harder for patients to come forward for testing. However, for those who are symptomatic, symptoms for men include, discharge, pain on passing urine and testicular pain to name a few. For women, they may experience vaginal discharge, pelvic pain and irregular bleeding - such as bleeding in between periods or after intercourse.
If chlamydia is not treated, it can lead to a number of complications. For men it may lead to a condition known as epididymo-orchitis, which presents with pain and swelling of the scrotum. For women it can lead to a condition known as pelvic inflammatory disease and later infertility. In both groups, it may cause reactive arthritis - a condition where joints become inflamed and swollen and conjunctivitis. It is therefore very important to get tested.
Your medical practitioner will either ask you to present a first pass urine of the day or may offer to perform a swab or ask you to collect a swab for yourself.
Treatment includes a 7 day course of oral antibiotics, or if compliance may be an issue, your doctor may give you a one day course of strong antibiotics instead.
It is very important that you carefully follow the aftercare instructions once you have been treated. Following treatment, you should not have intercourse for at least 7 days to prevent infection spreading. You should also contact anyone you had relations with over the past 6 months and not engage in any activity with them until they test negative. This helps to prevent re-infection. Your doctor may ask for you to repeat your test after 4 weeks to ensure that the infection has been fully cleared.
GONORRHEA
Gonorrhea (or ‘the clap’) is another bacterial sexually transmitted infection, although its prevalence is not as high as chlamydia, rates are steadily rising. I am seeing a larger number coming through this year compared to last.
It is frequently found in homosexual males but also younger heterosexual couples. The prevalence is increasing, especially in women.
Most women, around 80% who are diagnosed with vaginal gonorrhea, may not experience any symptoms at all. However, men who are diagnosed with urethral gonorrhea tend to present with symptoms (around 85–90%). For men, symptoms include, penile discharge and pain on passing urine. For symptomatic women, they may experience vaginal discharge, pain during intercourse and pelvic pain.
Just like chlamydia, it is important that gonorrhea gets treated as non treatment can lead to complications. For women, pelvic inflammatory disease and later fertility issues may be a problem and for men, again epididymo-orchitis and less commonly prostatitis (inflammation and swelling of the prostate gland).
Diagnosis takes the form of either a first pass urine or a swab either collected by yourself or the doctor and treatment, if positive generally consists of a short course of an oral antibiotic and an intramuscular injection of a strong antibiotic.
It is recommended that you abstain from intercourse for 7 days post treatment and contact trace any partners over the past 2 months. It is vital to have a repeat test of cure after 2 weeks to ensure that the infection has been successfully treated.
Of course, STIs are considered to be easily preventable and this would be through the form of using barrier contraception such as condoms. If you had a previous infection with either STI and you become re-infected, you will still need to receive treatment as you will not be immune.
CHAPTERS
0.07 Introduction
0:46 Chlamydia
1:35 Chlamydia Symptoms
2:55 Diagnosis
3:46 Chlamydia Treatment
5:45 Gonorrhea
6:18 Gonorrhea Symptoms
8:17 Gonorrhea Treatment
10:26 Conclusion
I hope you enjoyed this video and as always if you have any questions or comments please drop me in a line below.
Have you been putting off your cervical smear test? Are you unsure what the fuss is all about?
In today’s episode of Dr Nora, I’ll be answering all your questions and more, from what the test is for, what the procedure is like and my top tips on surviving your test. I’ll also be sharing with you an exciting news update about cervical cancer.
By the end of the video you’ll be clued up and ready to book in your test.
In order to understand this better, let’s go through a little anatomy. The cervix is found at the top of the vagina and forms the entrance of the womb - the organ in females that allows us to carry children. By having a cervical screening test it helps to detect any abnormal cells that may go on to causing cervical cancer.
THE TEST
You may have already heard of the PAP smear - The PAP smear preceded the cervical screening programme. The test consisted of collecting, staining and microscopic examination of the cells from the cervix. If abnormal cells were found they were removed to stop cervical cancer developing. The PAP test relied on cell changes being visible under a microscope and so it was recommended to have this every 2 years.
It was later discovered that HPV causes cervical cancer and the first HPV test was invented 15 years later. And it is this principle that we use today which forms the basis of the cervical screening test. Cells are taken from the cervix in the same way as the traditional PAP smear but instead of looking for cell changes it looks for the types of HPV which can cause cells to change and in come cases cause cervical cancer. HPV is the cause of more than 99% of cervical cancers.
WHAT IS HPV?
HPV, otherwise known as Human Papilloma Virus, is very common, in fact it’s so common that many of us including men, will have it at some point in our lives and not know about it as it has no symptoms. There are a lot of different types of HPV infections - to be precise - there are over 100 of which at least 14 are considered high risk and can cause cancer.
HPV is spread from genital skin to skin contact and it is considered the most common sexually transmitted infection. Most HPV infections will be naturally cleared up by your own immune system within one or two years without causing problems. In rare cases your body may not clear it and so your doctor may refer you onwards for further management.
THE PROCEDURE
In Australia, the cervical screening test is available from the ages of 25 to 74 years old and is open to hetero and homosexual women, transgender and intersex, as anyone who engages in genital skin to skin contact with a person of any gender can be infected with HPV.
The test itself is very quick and should not be painful however it may be uncomfortable.
Your practitioner will offer you a chaperone if wished and you will be asked to remove your garments from the waist downwards and place your legs apart on the couch. A plastic speculum is then inserted into the vagina and a quick sample is taken.
TOP TIPS
Top tips to get you through your smear:
- relax and take some deep breaths. the pelvic floor muscles sense when you’re anxious and tense up making the procedure longer and more uncomfortable.
- make trivial conversation, you’ll be surprised by how much this actually helps because by the time you’ve finished your sentence the procedure is over
- don’t worry about how things look down there. As doctors we’ve seen it all, and trust me when I say that by the time you’re out the door we’ve already forgotten (in the nicest way)
- and finally, don’t put it off.
POSSIBLE RESULTS
- return to screen in 5 years
- repeat the test in 12 months
- refer to specialist
- unsatisfactory test result.
Cervical screening is offered from the ages of 25 to 74 years old in Australia. If you are outside of these age groups and are suffering from symptoms such as abnormal bleeding - for example in between periods, after intercourse or even after menopause it is important to seek the advice from your medical practitioner for further tests.
THE FUTURE
With the new cervical screening and vaccination programme now in full swing in Australia, academics say that over 13 million cases of cervical cancer could be prevented in the next 50 years. If these strategies are implemented worldwide, researchers have estimated that by the end of the century, the level of cervical cancer could be so low that it could be considered as eliminated.
Thanks for watching and if you have any questions please don’t hesitate to leave me a comment in the comments section below or pop by and see me in clinic.
One of my specialties is sexual health. Did you know that only 34% of young people have ever had a sexually transmitted infection (STI) test?
STI rates are increasing in Queensland and you can help reduce this. Testing is simple and easy and could involve a urine test, a swab or a blood test.
It’s important to check for STI’s at least once a year or after each new partner. Treatment is available and depending on the infection it could just mean a course of antibiotics. If left untreated, you’re at risk of spreading it to others but can also lead to long term health effects such as trouble conceiving later in life.
Don’t sit on it, test it!
If you’d like any more information or would like to get tested pop by and see me in clinic.
