Sexual Health
In the UK, the number of people with sexually transmitted infections (STIs) is rising, and teenage pregnancy rates remain high. A recent report by the Health Protection Agency suggests that STIs have been rising in number consistently since the 1990s, with the highest increases in recent years being seen in the 16-24 age group. The most commonly diagnosed infection is Chlamydia, which over 100,000 people in the UK experienced in 2005. In addition, there is a low perception of risk in relation to sexually transmitted diseases for many people, but this is not necessarily the case. It’s very important to be educated about sexual health and contraception, and to know what the risks are and how to minimise them.
Sexually Transmitted Infections
Most STIs can be treated, and treatment is most effective when started as soon as possible. For this reason, if you suspect that you have the symptoms of an STI, it’s important to contact your doctor or another point of contact who can confirm it – see below for more information about who you can contact. If you don’t treat the infection, it can get worse over time and may permanently damage your health or fertility, as well as the health of others if you pass it on. Some infections, such as herpes and HIV, cannot currently be cured, but there are medicines available that can minimise their symptoms.
What are the most common Sexually Transmitted Infections?
The most common STIs are Chlamydia, Gonorrhoea, Genital Herpes, and Genital Warts. There are more details of each of these infections below.
Other STIs include Syphilis, HIV, and Trichomoniasis.
All of these infections are easily passed from person to person through sexual contact. You cannot catch an STI from hugging, sharing baths or towels, swimming pools, toilet seats, or sharing cutlery or plates.
1. Chlamydia
Clamydia is a bacterial infection that is found in the semen and vaginal fluids of men and women who have the infection.
It’s estimated that around 1 in 10 people under the age of 25 are infected. The National Chlamydia Screening Programme in the UK advises that if you are 24 or under and sexually active, you should have a test every year and every time you have a new sexual partner.
Symptoms: Around three-quarters of people who have the infection don’t have any symptoms, or don’t notice them. Of those who do notice the symptoms, they usually become apparent some weeks or months after the infection was passed on. The symptoms of a Chlamydia infection can include:
- Pain when urinating
- Pain and/or bleeding when you have sex (women)
- Unusual vaginal discharge
- Bleeding between periods, or heavier bleeding on your period
- Painful swelling of the testicles
2. Gonorrhoea
Like Chlamydia, Gonorrhoea is a bacterial infection that can affect both men and women. Some people who have the infection will experience only mild symptoms, or no symptoms at all, which means they are likely to pass on the infection without knowing. Symptoms: The symptoms of a Gonorrhoea infection can include:
- Pain when urinating
- Pain or tenderness in the lower abdomen (women) or testicles (men)
- An unusual discharge from the vagina or the penis
3. Genital Herpes
Genital herpes is a viral infection (herpes simplex), rather than a bacterial infection. It can be passed on through sexual contact with a person who is having an outbreak of genital herpes at the time, or by contact with a herpes simplex sore. Some people will not experience symptoms, or they will be very mild; it usually takes several days after contact with the virus for any symptoms to become apparent, although in some people it can take much longer.
Symptoms: The symptoms of a Genital Herpes episode can include:
- Small blisters in the anal or genital area, which burst to leave small red sores which can be painful
- Pain when urinating
- Stinging, tingling, or itching in the genital area
- General feelings of malaise; flu-like symptoms
4. Genital Warts
Genital warts are also caused by a viral infection (human papilloma virus). Many people with the virus will not have visible warts, making it difficult to determine if you are carrying the virus and will pass it on to sexual partners. The warts can be internal or external, in the genital or anal areas. It can take anything from a few weeks to several months after contact with the virus for symptoms to show.
Symptoms: Genital warts are usually painless, but can sometimes itch or cause bleeding.
Prevention against STIs
There are many easy ways to minimise your risk of catching a sexually transmitted infection.
- Use a condom, male or female, and use it correctly. If you are not sure how to, see the advice on the FPA website (www.fpa.org.uk).
- For oral sex, cover the genitals with a condom or a latex square (‘dental dam’).
- Avoid sharing sex toys.
Testing for STIs
If you think you may have an STI, it’s very important to have a test to make sure, so that you can quickly obtain the correct treatment and advice.
You may be reluctant to go for a test because you will expect it to be embarrassing, however there are clinics all over the UK that can offer free and confidential tests and advice without judging your sexual behaviour. All tests are optional and will only be undertaken with your permission.
You will find details of your local clinic in the telephone directory, under “sexual health”, “genitourinary medicine (GUM)” or “sexually transmitted infections (STI)”.
In addition Dr Thom is a healthcare commission approved private clinic who offer home testing services for STIs. Click Here to visit.
Finally, there are several home testing kits that can be purchased from pharmacies, enabling you to undertake a test at home. Click here to see the range of self-tests available from Pharmacy2U.
Treatments
Chlamydia and Gonorrhoea can be treated effectively with antibiotics
if tested and diagnosed quickly. Genital Herpes is treated
with an anti-viral medicine from the doctor.
All these treatments can be provided by Pharmacy2U in conjunction
with Dr Thom, a healthcare commission approved private clinic
who offer services for these infections.
Herpes Treatment Service
You can reduce the length and severity of future herpes attacks by taking medication as soon as you feel a herpes attack coming on. Request the medication here.
Chlamydia Treatment Service
If you have already been diagnosed with Chlamydia or you are the partner of someone who has been diagnosed with Chlamydia you can request to have treatment posted to you here.
Genital warts can be treated by your doctor, using either a cream or liquid to apply to the warts, or by other methods including freezing or heating the affected area. There are no treatments for genital warts available from pharmacies – it’s important to understand that creams and paints for other types of warts and verrucae are not suitable for genital warts.
If an STI is not treated, the infection is very unlikely to go away by itself, and can develop to cause other health problems, such as pelvic inflammatory disease (PID) in women, and a painful infection in the testicles in men, both of which can lead to fertility problems.
Other Genital Infections
Thrush (Candidiasis)
Vaginal thrush is caused by an infection with the Candida fungus; this is an organism that is normally present on the skin, which is kept in check by the action of the immune system and also the presence of other harmless organisms. It does not require special testing or referral to a clinic like the STIs above, and can usually be treated quickly and easily.
The main symptoms include a vaginal discharge, which will be white in colour, but should not have an offensive smell; this may be accompanied by irritation, itching, soreness, and redness of the surrounding area, which can cause discomfort during intercourse.
Thrush can be passed between sexual partners, however it’s easily treated using an antifungal medicine which you can purchase without a prescription. For women, either a single-dose oral capsule containing Fluconazole (Canesten Oral Capsule, or Diflucan Capsule) or a vaginal preparation (Canesten Pessary, Canesten Once) will quickly and effectively treat the majority of cases. For men who have penile thrush associated with their partner’s vaginal thrush, the single-dose Fluconazole oral capsule is also effective.
For more details, see our main health information article on vaginal thrush.
To see the range of products available from Pharmacy2U for the treatment of thrush, click here.
Cystitis
Cystitis is a bacterial infection of the urethra (urine passage), and although this is not strictly a genital infection, the symptoms can be mistaken for those of an STI. Cystitis causes a burning pain on passing urine, and a desire to pass urine more often than normal. There will be no unusual vaginal discharge. It does not usually require referral to a doctor or clinic.
Mild cases can be treated using sachets to dissolve in water which make the urine more alkaline, helping to wash away the infection, such as Canesten Oasis and Cymalon, available from pharmacies. If these are not effective, your doctor can prescribe a short course of antibiotics.
For more details, see our main health information article on cystitis.
To see the range of products available from Pharmacy2U for the treatment of cystitis, click here.
Contraception
There are many methods of contraception; the right method for you might be different at different times of your life. Many types of contraception can be less effective if they are not used properly, so it’s important that you know what choices are available to you.
It’s estimated that if 100 sexually active women don’t use any contraception, 80 to 90 of them will become pregnant in a year.
There are a lot of myths about how to avoid pregnancy, and what constitutes a method of contraception. A woman can still get pregnant in all of the following situations:
- If she is on her period
- If it is the first time she has sex
- If she does not have an orgasm
- If the man pulls out before ejaculation
- If she washes out her vagina after sex (this is potentially harmful)
- If she is not fully breastfeeding
Most people will know about condoms, and “the pill”, however there are several other methods of effective contraception that are perhaps less well-known, most of which are listed below – there are many choices, some of which you might not have been aware of.
- Condoms – male and female condoms are available
- Contraceptive pills – ‘combined’ pills or ‘mini’ pills
- Diaphragm (‘cap’) with spermicide
- Contraceptive injections
- Contraceptive implants
- Intrauterine system (IUS) or device (IUD)
- Natural family planning methods
- Male or female sterilisation
Contraception is free for women and men of all ages through the NHS.
For more information and advice about these methods and their relative effectiveness, see the FPA website or talk in confidence with your doctor or practice nurse, pharmacist, or family planning clinic.
Emergency Contraception
If you have had sex without using contraception, or you think your contraception might have failed, there are two methods of emergency contraception that you can use.
- The emergency hormonal pill, which is more effective the earlier it is taken after sex. It must be taken up to three days (72 hours) after sex. It is available from your doctor, or you can ask your local pharmacist, now available without a prescription when appropriate (Levonelle One Step).
- Levonelle is also available from Dr Thom a healthcare commission approved private clinic who specialise in this area. Click Here to visit Dr Thom and follow links for their emergency contraceptive service.
- An IUD (intrauterine device), which must be fitted up to five days after sex, or up to five days after the earliest time you could have released an egg (ovulation).
Where to go for further advice
Family Planning Association (fpa) - website with details and advice about all aspects of sexual health. For confidential advice on the telephone, call them on 0845 310 1334 (Mon-Fri 9am-6pm)
Sexual Health Information Line - call 0800 567 123 for details of GUM or sexual health clinics.
Levonelle – information about the emergency contraceptive pill available from pharmacies.
NHS Direct - advice about all aspects of health, and details of your local clinics and NHS services. Also available by telephone on 0845 4647 (available 24 hours).
More information about sex and contraception for young people can be obtained from Brook on 0800 0185 023, or Sexwise on 0800 28 29 30.
Common Sexual Problems
Erectile Dysfunction (ED, impotence)
Most men, at some point in their lives, suffer with the occasional erection problem often associated with stress, tiredness or drinking too much alcohol. However it is estimated that at least one in ten men suffer with frequent and long-standing erection problems (erectile dysfunction). That means there are well over 2 million men in the UK who suffer with erection problems. The problem becomes more frequent in older men. It is probable that around 20 % of men between 50 and 54 years and 50 % of men between 70 and 74 years have erection problems.
It is estimated that only 10% of men who suffer with frequent and long-standing erection problems actually seek medical assistance. This is remarkable since effective treatments are available for many men that can really help.
Sexual therapy can be of great help for men with erection problems with a predominantly psychological cause. Often medicines are used in association with such therapy.
If a physical cause is the main problem, such as a hormonal imbalance, addressing this can remove the erection problems. In some cases surgery can ensure normal blood flow is restored. Treatment of depression can remove erection problems caused by this.
In many cases, medicines will be prescribed by a patient’s doctor to directly assist the body to create and maintain a good erection. These medicines can either be injected into the penis, such as Caverject (alprostadil); inserted into the eye of the penis, such as Muse (alprostadil); or taken as a tablet by mouth, such as Cialis (tadalafil), Levitra (vardenafil), and Viagra (sildenafil).
Vacuum pumps, such as the Erecaid Classic, Erecaid Esteem, and Rapport Premier devices, are another option to help men with erection problems get a good erection, and can be prescribed on the NHS under certain circumstances, or they are available to purchase from most pharmacies. Click here to see the range of devices available from Pharmacy2U.
Ask your pharmacist or doctor in confidence for more advice about any of these treatments. If you already have a prescription from your doctor, click here for more details about how to send your prescription to Pharmacy2U for dispensing.
Painful intercourse
Vaginismus is a condition where the vaginal muscles go into spasm, causing the vagina to feel tight and often making sexual intercourse impossible. This may be due to a number of reasons including fear and pain of penetration, gynaecological surgery or trauma following childbirth.
Dyspareunia can also inhibit sexual intercourse as it may cause pain and discomfort upon penetration. This is often associated with vaginal dryness or infection.
Treatment involves a discussion with a sexual therapist, and the use of vaginal dilation exercises with different sized plastic dilators (such as the Amielle Comfort dilators), ultimately with the aim of allowing the woman to have normal sexual intercourse without pain or discomfort.
Products to promote sexual wellbeing
There are several products available from Pharmacy2U that can help to promote your sexual wellbeing. Click here to see our current range, which includes the following products:
Stud 100 (also known as Premjact) – a desensitising spray, which contains a local anaesthetic to reduce the sensitivity of the penis, helping to delay ejaculation in cases of over-rapid or premature ejaculation.
Veromax For Men and Veromax For Women - dietary supplements with Jujube Dates, Ginseng, Ginkgo Biloba & Amino Acids, designed to promote healthy blood flow which is beneficial to the sexual health of both partners.
Veromax Instant For Men and Veromax Instant For Women – work in the same way as the Veromax preparations but with a faster action.
Zestra Feminine Arousal Oil - a sensual massage oil that is intimately applied during foreplay like a vaginal lubricant and is scientifically proven to enhance sensation.
Vielle Stimulator and Lubricant - Vielle Lubricant is specially formulated lubricant to aid sexual pleasure, and recommended for use with Vielle Stimulator. Vielle Stimulator is a discreet clitoral arouser designed to enhance sexual satisfaction and make orgasm easier to reach and more fulfilling.
Scentuelle Patch - a special patch designed to help stimulate the libido. Each Scentuelle patch has impregnated with a unique combination of aromas known to affect the sex drive.
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