The majority of the information on this page can be applied universally, and is not country specific. However, certain sections, such as 'Where to go for help', 'Treatment' and 'Testing' may be specific to the UK.

Gonorrhoea

Gonorrhoea is a bacterial infection. It is sexually transmitted and can infect the cervix, urethra, rectum, anus and throat.

Signs and symptoms

Symptoms of infection may show up at anytime between 1 and 14 days after exposure. It is possible to be infected with gonorrhoea and have no symptoms. Men are far more likely to notice symptoms than women.

Women

Symptoms of gonorrhoea can include:

• a change in vaginal discharge. This may increase, change to a yellow or greenish colour and develop a strong smell
• a pain or burning sensation when passing urine
• irritation and/or discharge from the anus.

Men

Symptoms may include:

• a yellow or white discharge from the penis
• irritation and/or discharge from the anus
• inflammation of the testicles and prostate gland.

How gonorrhoea is passed on

• by penetrative sex (when the penis enters the vagina, mouth, or anus)

and less often by:

• rimming (where a person uses their mouth and tongue to stimulate another person's anus)
• inserting your fingers into an infected vagina, anus or mouth and then putting them into your own without washing your hands in between.

Where to go for help

• Your local NHS sexual health (GUM) clinic.

In the UK, you can find details of your nearest NHS sexual health clinic in the phone book under genito-urinary medicine (GUM), sexually transmitted diseases (STD) or venereal diseases (VD). Or phone your local hospital and ask for the 'special' or GUM clinic. Our help and advice page links to websites which can tell you where to find your nearest clinic.

You will get free, confidential advice and treatment. You can go to any clinic anywhere in the country - you don't have to go to a local one - and you don't have to be referred by your GP. (Non-NHS sexual health clinics may not always offer the full range of services which are available at NHS sexual health clinics.)

• Your own GP.
• If you are in the UK, go to www.playingsafely.co.uk to find details of STI clinics.
• If you are in the USA, go to http://herpes-coldsores.com/support/std_clinic_us.htm, from this site you can also find details of STD clinics in Australia, New Zealand, Puerto Rico and India.

The tests for gonorrhoea

• An examination of your genital area is carried out by a doctor or a nurse.
• Samples are taken, using a cotton-wool or spongy swab, from any places which may be infected - the cervix, urethra, anus or throat.
• Women are given an internal pelvic examination.
• A sample of urine may be taken.

None of these tests are painful, but may sometimes be uncomfortable.

If you have had anal sex, it is important to tell the doctor so that a swab can be taken from your rectum. Also tell the doctor if you have had oral sex.

You can have a test as soon as you think you might have been in contact with gonnorhoea.

Diagnosis and treatment

Samples taken during the examination are looked at under a microscope to check for gonorrhoea infection. In some clinics, the result is available immediately. A second sample is sent to a laboratory for testing, the result of which is available usually within one week. Treatment is easy and essential. You will be given an antibiotic in tablet, liquid or injection form.

If you are allergic to any antibiotics, or if there is any possibility that you may be pregnant, it is important that you tell your doctor. It is important to complete your course of treatment.

If you are told you have gonorrhoea, you may be asked to see a health adviser who will explain the infection to you and answer your questions. The health adviser will also ask you about your sexual partner(s), so that they can get a check-up and treatment if necessary.

You should not have penetrative sex until you have returned to the clinic and been given the all-clear by the doctor. The doctor or health adviser will tell you about which sexual activities are safe.

Follow-up

Once you have completed your course of treatment for gonorrhoea, you should return to the clinic or GP for a check-up.

Some types of gonorrhoea are resistant to certain antibiotics, especially if you acquired the disease abroad. Further tests will be done to make sure that the infection has cleared. If it has not, you will be prescribed a different antibiotic.

Complications

Women

If left untreated gonorrhoea can lead to pelvic inflammatory disease (PID). This is inflammation of the fallopian tubes which can cause fever, lower abdominal pain and backache. Sex may be uncomfortable. PID can cause a woman to become infertile or have an ectopic pregnancy. A separate factsheet on PID is available.

If you're pregnant and you have gonorrhoea when your baby is born, you could pass the infection on. Also your baby could be born with a gonoccocal eye infection. This must be treated with antibiotics as it can cause blindness. But it is better for you to be treated before the birth.

Men

Gonorrhoea can cause inflammation of the testicles and the prostate gland, which causes pain. Without treatment a narrowing of the urethra or abscesses can develop.

Once gonorrhoea has been successfully treated, it will not come back unless you become reinfected.

Remember, after treatment, using condoms during sex can reduce your risk of getting or passing on sexually transmitted infections.

Chlamydia

Chlamydia is the most common treatable bacterial sexually transmitted infection. It can cause serious problems later in life if it is not treated (see 'Complications' section). Chlamydia infects the cervix in women. The urethra, rectum and eyes can be infected in both sexes. Occasionally chlamydia lives in other parts of the body, including the throat, lungs and liver.

Signs and symptoms

Women

Symptoms of infection may show up at anytime. Often this is between 1 to 3 weeks after exposure. However, symptoms may not emerge until a long way down the line. The majority of women who are infected with chlamydia will have no symptoms at all. Possible symptoms are:

• a slight increase in vaginal discharge - caused by the cervix becoming inflamed
• a need to pass urine more often/pain on passing urine
• lower abdominal pain
• pain during sex
• irregular menstrual bleeding
• a painful swelling and irritation in the eyes (if they are infected).

Men

Symptoms of infection may show up at anytime. Often this is between 1 to 3 weeks after exposure. However, symptoms may not emerge until a long way down the line. Men are more likely to notice symptoms than women. However, they too may have no symptoms. Likely symptoms are:

• a discharge from the penis which may be white/cloudy and watery and stain underwear
• pain and/or a burning sensation when passing urine
• a painful swelling and irritation in the eyes (if they are infected) Chlamydia in the rectum rarely causes symptoms.

How chlamydia is passed on

Chlamydia can be transmitted by:

• having sex with someone who is infected
• a mother to her baby at birth
• occasionally, by transferring the infection on fingers from the genitals to the eyes.

Where to go for help

• Your local NHS sexual health (GUM) clinic.

You can find details of your nearest NHS sexual health clinic in the phone book under genito-urinary medicine (GUM), sexually transmitted diseases (STD) or venereal diseases (VD). Or phone your local hospital and ask for the 'special' or GUM clinic. Our help and advice page links to websites which can tell you where to find your nearest clinic.

You will get free, confidential advice and treatment. You can go to any clinic anywhere in the country - you don't have to go to a local one - and you don't have to be referred by your GP. (Non-NHS sexual health clinics may not always offer the full range of services which are available at NHS sexual health clinics.)

• Your own GP.
• If you are in the UK, go to www.playingsafely.co.uk to find details of STD clinics.
• If you are in the USA, go to http://herpes-coldsores.com/support/std_clinic_us.htm, from this site you can also find details of STD clinics in Australia, New Zealand, Puerto Rico and India.

The tests for chlamydia

• An examination of your genital area is carried out by a doctor or a nurse.
• Samples are taken, using a cotton-wool or spongy swab, from any place which may be infected.
• Women are usually given an internal pelvic examination.
• Men are given an external examination of their testicles (balls) to check that these are healthy.
• A sample of urine is usually taken.

None of these tests should be painful, but may sometimes be uncomfortable.

Chlamydia will show up on the tests a few days after you have been in contact with it, often before you have any symptoms.

Diagnosis and treatment

Samples taken during the examination are sent to a laboratory for testing, and the result is available usually within one week.

The treatment for chlamydia is simple and effective once it has been diagnosed. You will be given antibiotic tablets.

If you are allergic to any antibiotics or if there is any possibility that you may be pregnant, it is important that you tell your doctor. This will affect which antibiotics you are prescribed.

It is important that you finish any course of treatment for chlamydia . If treatment is interrupted, it may be necessary to start again from the beginning.

If you have chlamydia, a health adviser will explain the infection to you and answer your questions. The health adviser will also ask you about your sexual partner(s), so that they can get a check-up and treatment if necessary.

You should not have penetrative sex (when the penis enters the vagina, mouth or anus) until you have returned to the clinic and been given the all-clear by the doctor.

Follow-up

It is important to return for a check-up once you have completed the treatment to make sure you are well and have no other infection.

Complications

Women

• If untreated, chlamydia can lead to pelvic inflammatory disease (PID). This is an inflammation of the fallopian tubes (the tubes along which an egg passes to get to the womb). PID can lead to problems with fertility. Many cases of infertility can be traced back to infection with chlamydia.
• If a woman has chlamydia when she is pregnant she risks having an ectopic pregnancy (pregnancy outside the womb) or a premature birth. The infection can be passed on to the baby, giving it an eye or lung infection. Chlamydia can be safely treated during pregnancy.
• Chlamydia can also lead to chronic (long-term) pelvic pain.

Men

Complications caused by chlamydia in men are uncommon. But it may lead to painful inflammation of the testicles, which can cause infertility.

Men and women

• Reiters syndrome is a result of chlamydia. It causes inflammation of the eyes and joints and sometimes a rash on the soles of the feet and genitals.
• Appendicitis (inflammation of the appendix) can also be caused by chlamydia.

Remember, after treatment, using condoms during sex can reduce your risk of getting or passing on sexually transmitted infections.

Syphilis

Syphilis is not a common infection in the UK but it is more common in some other countries. It is a bacterial infection. It is usually sexually transmitted, but may also be passed from an infected mother to her unborn child.

Signs and symptoms

The signs and symptoms of syphilis are the same in both men and women. They can be difficult to recognise and may take up to 3 months to show after having sexual contact with an infected person. Syphilis has several stages. The primary and secondary stages are very infectious.

Primary stage

One or more painless sores appear at the place where the syphilis bacteria entered the body. On average, this will be after 21 days. You may not notice them.

These sores can appear anywhere on the body but mainly:

• on the vulva (lips of the vagina), the clitoris and around the opening of the urethra (the water passage)
• on the cervix (neck of the womb) in women and on the penis and foreskin in men
• around the anus and mouth (both sexes)

The sore (or sores) is very infectious and may take from 2 to 6 weeks to heal.

Secondary stage

If the syphilis infection remains untreated the secondary stage usually occurs 3 to 6 weeks after the appearance of sores. The symptoms include:

• a non-itchy rash covering the whole body or appearing in patches
• flat, warty-looking growths on the vulva in women and around the anus in both sexes
• a flu-like illness, a feeling of tiredness and loss of appetite, accompanied by swollen glands (this can last for weeks or months)
• white patches on the tongue or roof of the mouth
• patchy hair loss

When these symptoms are present, syphilis is very infectious and may be sexually transmitted to a partner.

Treatment at any time during these first two stages of syphilis will cure the infection.

Latent stage

Latent syphilis refers to the presence of untreated syphilis. You can have no symptoms or signs of the infection, which is diagnosed by a positive blood test. If left untreated, you may develop symptomatic late syphilis. This would usually develop after more than 10 years. It is then that syphilis can affect the heart, and possibly the nervous system.

If treatment for syphilis is given during the latent stage the infection can be cured. However, if there has been heart or nervous-system damage before treatment is started this may be irreversible.

How syphilis is passed on

Syphilis can be transmitted by:

• having sex with someone who has the infection
• a mother to her unborn baby

Where to go for help

• Your local NHS sexual health (GUM) clinic.

You can find details of your nearest NHS sexual health clinic in the phone book under genito-urinary medicine (GUM), sexually transmitted diseases (STD) or venereal diseases (VD). Or phone your local hospital and ask for the 'special' or GUM clinic. Our help and advice page links to websites which can tell you where to find your nearest clinic.

You will get free, confidential advice and treatment. You can go to any clinic anywhere in the country - you don't have to go to a local one - and you don't have to be referred by your GP. (Non-NHS sexual health clinics may not always offer the full range of services which are available at NHS sexual health clinics.)

• Your own GP.
• If you are in the UK, go to www.playingsafely.co.uk to find details of STD clinics.
• If you are in the USA, go to www.unspeakable.com/locator/index.jsp.

The tests for syphilis

At the clinic the following tests will normally be made:

• A blood sample is taken.
• If you have a sore, a specimen of fluid is taken from this and looked at under a microscope.
• Your genital area and whole body are examined by the doctor.
• Samples are taken, using a cotton-wool or spongy swab, from any sores.
• Women are given an internal examination.
• A sample of urine is taken.

None of these tests should be painful, but they may be slightly uncomfortable.

You can have the test as soon as you think you might have been in contact with syphilis.

Diagnosis and treatment

Samples taken during the examination are looked at under a microscope to check for infection. Samples are sent to a laboratory for testing. The result is usually available within one week.

If you are told that you have syphilis a health adviser will explain the infection to you and answer any questions you may have. You will also be asked about your sexual partner(s), so that, if necessary, they can get treatment too.

If it is suspected that you have the early infectious stages of syphilis, you should not have oral, vaginal or anal sex. You should also not have any kind of sex involving contact between your partner and any sores or rashes you may have until the treatment is completed. Treatment for syphilis is usually a 2-week course of penicillin injections or, in some cases, antibiotic tablets or capsules.

If you are allergic to any antibiotics, or if there is any possibility that you may be pregnant, it is important that you tell your doctor. It is important that you finish any course of treatment. If treatment is interrupted, it may be necessary to start again from the beginning.

Once you have completed your treatment, you will be asked to attend the clinic at regular intervals for blood tests.

Pregnancy and syphilis

In the UK blood tests for syphilis are given to all pregnant women when they visit an ante-natal clinic. If syphilis is found, treatment can safely be given during pregnancy with no risk to the unborn baby. If a woman has untreated syphilis she may pass the infection to her baby in the womb. In some cases this can lead to miscarriage or stillbirth.

Once syphilis has been successfully treated, it will not come back unless you become reinfected. However your blood test will be positive in any future tests (e.g. for immigration reasons). Make sure you get a certificate from your clinic explaining about your treatment.

Remember, after treatment, using condoms during sex can reduce your risk of getting or passing on sexually transmitted infections.

AVERT.org has more information about other STDs including statistics and our STD booklet.