Bacterial Vaginosis (BV) is also known as non specific vaginitis or Gardnerella vaginitis. BV is 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 its whitish discharge, change in vaginal pH (acidity) and microscope examination. 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 if you are pregnant.

Candidiasis, or thrush, is caused by an overgrowth of a yeast (a type of fungus) called Candida albicans. It is not caught or transferred by sexual activity. Candidiasis can be triggered by: • Antibiotics • Diabetes • Pregnancy • Severe infections • Hypersensitivity (allergy) • Dermatitis or ulcers • Scratching • Tight clothing. Most women however, will develop thrush without any identifiable cause. 80% of women will have thrush at some stage of their life. Symptoms The main symptoms are itching and irritation of the mucous membranes (lining) in the vaginal and vulval skin. There may be a thick, white vaginal discharge and discomfort with sex and when urinating. Symptoms may be worse the week before your period or made worse by having sex. Men may notice itching and redness on the head of the penis or in the groin. Diagnosis Patients with vulvitis, vaginitis (inflammation of the vulva or vagina, respectively) or balanitis (redness and itching on the head of the penis) should be examined and have tests done. Treatment Candidiasis may be treated with an antifungal medication. 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 or altered vaginal secretions. Men may have a discharge, experience painful urination, penile irritation or testicular pain which develops 2-4 weeks after having unprotected sex with an infected partner. About 25% of men have no symptoms, but can still pass it on. In both sexes, the infection can go away without treatment, but can also remain for months or even years. Diagnosis Chlamydia testing is done by swab or urine sample. Test results usually take 2-3 days. 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 and cause itching in the genital area. 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 groin. 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. Other people in the household only need to be treated if they have slept in the bed or used the towels or clothing of the person who is infected.

Cystitis is inflammation of the bladder, usually caused by a bacterial infection. Symptoms The symptoms of cystitis may include: A burning feeling when passing urine Increased urgency and frequency to pass urine Passing small amounts of urine Strong smelling urine Lower abdominal pain. Causes of cystitis include: Bacteria (e.g. from the anal area) making their way into the bladder via the urethra Sex may cause cystitis in women Structural abnormalities in the kidneys or bladder. Treatment Taking a course of antibiotics treats cystitis.

Genital herpes is a common infection caused by a virus called herpes simplex. You can get genital herpes by having genital skin contact (vaginal, oral or anal sex) with someone who has the infection. Most transmissions occur 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.

Genital warts are caused by infection with human papilloma virus (HPV) and appear as small lumps in the anal and genital areas. HPV is different from the virus that causes warts on the hands or other areas of the body. HPV is most often sexually transmitted and most sexual partners will develop warts. Those who do not develop obvious warts may still be infected with the virus. Genital warts can occur in pregnancy, even in women who have not had them before. An infected mother can pass the virus to her baby at birth. 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 body and warts may recur later. Do genital warts cause cancer? Genital wart virus (human papilloma virus, HPV) is found in certain cancers, particularly in cervical cancer. HPV virus causes the formation of abnormal cells which may develop into cancer over a long period of time.

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, on clothing or bedding or from one part of the body to another by scratching. Sexual partners will not necessarily become infected. Symptoms Molluscum contagiosum is usually painless but can sometimes cause itching. The condition usually resolves within 12 months. Treatment Molluscum can be removed by freezing or burning or picking out the centre core.

Syphilis is an uncommon disease in New Zealand but one that can be very serious if left untreated. The bacteria enter the body through tiny breaks in the skin or through the linings of the body cavities i.e. vagina, anus, mouth. Syphilis is almost always acquired by sexual contact. This disease is detected by a blood test. Symptoms First Stage The first sign of syphilis is an ulcer (chancre). The ulcer is not painful or itchy. It appears at the place where the germ enters the body, usually on the sex organs but sometimes elsewhere. The ulcer will probably disappear of its own accord within a few weeks but the infection is still active in the body. This early stage is very infectious. Any genital ulcer must be examined by a doctor even if it starts to heal by itself and/or is small and painless. Second Stage A rash will appear about six weeks after infection. It may appear on the body, face, arms and often the palms of the hand and soles of the feet. The rash lasts about 4 to 6 weeks during which time the person is very infectious. Late Stage After the symptoms of the second stage disappear, there are usually no signs of the disease for at least five years and in many people there will be no harmful effects or further signs of the disease at all. In some people the syphilis germs will eventually cause damage to internal organs which may include the heart, brain and the nerves in the spinal cord. After two years the person is no longer infectious to others. Treatment Treatment is with antibiotics, usually given by injection. Sexual partners must be advised to visit their doctor or STI clinic. 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. Worldwide it is one of the most common sexually transmitted diseases (STD’s) but in New Zealand it is uncommon. The infection is most common amongst sexually active females between 16 – 35 years. It is caught during sexual contact with an infected person. Trichomonas can be called ‘Trich” for short (sounds like trike). Symptoms Symptoms usually develop 1-4 weeks after contact. In women symptoms include vaginal discharge which is greenish, frothy and watery with an unpleasant ‘fishy’ smell. The skin around the vagina and vulva is 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. Sometimes it produces an inflammation of the head of the penis (balanitis). Men usually don’t have symptoms and can act as carriers. 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 are always treated. Treatment Antibiotic tablets have about a 90 percent cure rate.

Urethritis is not a diagnosis, it 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. Many people do not realise that Chlamydia and gonorrhoea infection may be present without symptoms but, even in this situation, can still be transmitted to sexual partners. 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. Urethral irritation Sometimes men experience urethral irritation when no inflammation or infection is present. This is usually short-lived and may be due to strong urine, other general illness, allergy (e.g. to spermicide) or topical irritants (e.g. soap).