Bacterial Vaginosis (BV) a condition caused by overgrowth of bacteria that normally live in the vagina. It is not a sexually transmitted infection therefore treatment of partners does not tend to help. Symptoms It is common to have no symptoms but, if present, they may include a watery, grey discharge and a fishy odour. Diagnosis BV is diagnosed by examination of a sample of vaginal fluid under a microscope. Causes of BV The exact cause of BV is not known, but it is found more commonly in women who are sexually active. BV may appear shortly after a change of sexual partner, and other sexually transmitted diseases are often found to be present. Treatment Treatment is with antibiotic tablets. BV is only treated when there are obvious symptoms, if you are about to have a medical procedure such as IUCD insertion or a gynaecological procedure, or in some situations during pregnancy.

Candidiasis, or thrush, is caused by an overgrowth of a yeast (a type of fungus) called Candida. It is not caught or transferred by sexual activity. 80% of women will have thrush at some stage of their life, and most women will develop thrush without any identifiable cause. However, antibiotics, pregnancy and some medical conditions such as diabetes, can cause thrush to occur. Symptoms The main symptoms for women are itching and irritation of the vulval skin and vagina. There may be a thick, white vaginal discharge and discomfort with sex and when urinating. Symptoms may be worse the week before menstruation, or made worse by having sex. Men may notice itching, redness, and white discharge on the head of the penis and the foreskin. Diagnosis Diagnosis is made from a combination of symptoms, examination findings and specific cultures for Candida. Treatment Candidiasis may be treated with an antifungal medication, usually in the form of vaginal creams or pessaries. Partners only need to be treated if they have symptoms.

Chlamydia is a very common infection of the mucous membranes (linings) of the male urethra, female cervix and sometimes the eye, rectum or throat. Chlamydia is transmitted by having vaginal, anal or oral sex with an infected partner. A mother may pass the infection on to her baby at birth, causing the baby to develop eye or lung infections. Symptoms Most women will not develop symptoms, but can still pass it on to others. Possible symptoms in women include: lower abdominal pain, abnormal vaginal bleeding, pain when passing urine, or altered vaginal secretions. Men may have a discharge, experience painful urination, penile irritation or testicular pain. About 25% of men have no symptoms, but can still pass it on. In both men and women, the infection can remain for months or years if untreated. Diagnosis Chlamydia testing is done by swab or urine sample. Treatment Chlamydia is treated with antibiotics. Sexual partners should have a sexual health check and treatment for Chlamydia even if they have no symptoms and even if they have a negative test result.

Crabs are very small insects which can infect the genital skin and cause itching. Crabs are not the same as the lice found in the scalp. Crab lice are common and can be transmitted by close bodily contact. Symptoms The main symptom of crabs is itching in the genital area. Sometimes it is possible to see them in the pubic hair. Treatment Pubic lice shampoo can be bought over-the-counter at pharmacies. Sexual partners should also be treated. Bedding and clothing should be machine washed or removed from body contact for 72 hours.

Cystitis is inflammation of the bladder, usually caused by a bacterial infection. Cystitis is not sexually transmitted but sexual activity may trigger cystitis in some women. Symptoms The symptoms of cystitis may include: A burning feeling when passing urine Increased frequency of urination and urgency to pass urine Passing small amounts of urine Strong smelling urine Lower abdominal pain. Diagnosis Diagnosis is made by testing the urine for bacteria. Treatment Cystitis is treated with a course of antibiotics.

Genital herpes is a common infection caused by a virus called herpes simplex. You can get genital herpes by having genital skin contact with someone who has the infection. Most transmission occurs when herpes blisters or sores are not present. This can happen in two ways: People who have recurrent (repeated episodes of) genital herpes can transmit the virus at the time of or between recurrences. Many people exposed to the virus never develop any signs or symptoms of the infection but may transmit the virus to their sexual partner. Symptoms Herpes affects different people in different ways. Following exposure, some individuals will develop symptoms within two to fourteen days. However, most people have mild or no clinical symptoms of herpes. The symptoms of the first episode of genital herpes may include a flu-like illness, swollen glands in the groin, pain and blisters in the genital area and pain on urinating. The entire episode can last from ten days to one month and will generally heal without any long term problems. Subsequent episodes can vary from one or two to twelve or more episodes a year but generally last only a few days. The symptoms are usually minor, consisting of pain or tingling. Diagnosis The best way of confirming a diagnosis is to go to your doctor when blisters or sores are present. A specimen will be taken from one of the sores or blisters and sent to the laboratory. Your doctor may also recommend tests to rule out other sexually transmissible infections. Treatment Try to keep the area clean and dry. Bathing affected areas with a diluted salt solution two or three times a day can provide relief. If the pain is severe, aspirin or paracetamol may be helpful. Antiviral drugs are available that help to manage genital herpes. Pregnancy and the newborn Occasionally, babies will become infected with herpes, but this is rare. It’s important to see your doctor if you have recurrent genital herpes and are thinking of becoming pregnant or are already pregnant, or if you’re pregnant and develop herpes for the first time. For further information, please click on the link to visit the New Zealand Herpes Foundation website.

Genital warts are caused by infection with human papilloma virus (HPV). Most people who have genital HPV infection do not have any symptoms, but those who do have symptoms develop genital lumps. The types of HPV affecting the genital area are different from those causing warts on the hands or other areas of the body. HPV is transmitted by genital skin contact with an infected sexual partner. Diagnosis The diagnosis is made by the presence of warts on the genital skin. Treatment Genital warts can be removed by freezing, applying medication or burning with electrical heat or laser. Don’t use over-the-counter treatments for warts on sensitive genital skin. Removal of the warts does not mean the virus is removed. It will remain in the skin for months to years, and the warts may recur.

Gonorrhoea is caused by a bacterial infection of the mucous membranes (linings) of the male urethra, female cervix and sometimes the eye, rectum or throat. Gonorrhoea is transmitted by having vaginal, anal or oral sex with someone who has the infection. An infected mother can pass the infection on to her baby at birth. Symptoms Women often do not develop symptoms but can still pass on the infection. Possible symptoms include vaginal discharge, pelvic pain or abnormal bleeding. Men with urethral infection may experience urethral discharge, urethral irritation, or pain on urinating. Infection in the rectum or throat does not usually cause symptoms. Diagnosis Testing for gonorrhoea is done by swabs taken from the cervix in women and from the urethra in men. Treatment Gonorrhoea is treated with antibiotics. Sexual partners should have a sexual health check and treatment even if they have no symptoms and even if they have a negative test result.

Molluscum contagiosum is caused by a virus and is seen as small lumps with waxy, white centres. They are commonly found on the genital area, thighs or lower abdomen. Molluscum contagiosum is spread by close bodily contact, and in adults this is usually sexual contact. Symptoms Molluscum contagiosum is usually painless but can sometimes cause itching. The condition usually resolves within 12 - 18 months. Treatment Molluscum can be removed by freezing or burning or removing the central core of the lesion.

Syphilis is an uncommon disease in New Zealand but one that can be very serious if left untreated. Syphilis is almost always acquired by sexual contact with an infected person. Symptoms Many people do not have any symptoms of infection, but those who do may experience a painless genital ulcer, swellings in the groin, or a body rash. Often these symptoms will resolve and the infection may not cause any further problems. However, if untreated, the infection may remain active for many years and can cause damage to the brain, heart, internal organs, and skin. Diagnosis Diagnosis is by a blood test or tests taken from the genital ulcer or rash. Treatment Treatment is with antibiotics, usually given by injection. Sexual partners should be tested and treated also. Pregnancy A pregnant woman who has syphilis can cause damage to the baby and cause the baby to be born with syphilis. Effective treatment of the mother during the pregnancy will prevent the baby being born with syphilis.

Trichomoniasis is caused by a small parasite called Trichomonas vaginalis. The infection is acquired through sexual contact with an infected person. Symptoms Symptoms usually develop 1-4 weeks after contact, but some women do not have symptoms. In females symptoms include vaginal discharge which is greenish, frothy and watery with an unpleasant smell. The skin around the vagina and vulva can be uncomfortable, hot and swollen with redness and inflammation that can extend onto the upper thighs. Itching or pain when urinating can also occur. In males it can cause a discharge from the penis and discomfort when urinating. However, men usually don’t have symptoms of infection. Diagnosis A swab of vaginal fluid can be sent to a laboratory where the organism can be detected by culture or other methods. Trichomonas in males is very difficult to identify. Male partners of infected females should always be treated. Treatment Trichomoniasis is treated with a course of antibiotic tablets.

Urethritis is the term used to describe an inflamed urethra. If tests for gonorrhoea and Chlamydia are negative, then the urethritis is usually called non-specific urethritis (NSU). Urethritis can occur after unprotected vaginal, anal and oral sex. Symptoms Symptoms of urethritis include discharge, pain passing urine, or just an uncomfortable feeling in the urethra. Diagnosis A swab from the urethra and a urine sample are taken for gonorrhoea and Chlamydia. The test is more accurate if you do not pass urine for at least 2 hours beforehand. Treatment Treatment is with antibiotic tablets. Sexual partners also need assessment and treatment even if your results for Chlamydia and gonorrhoea are negative.