STI Screening

STI Clinic Limerick

At Roxboro Medical Center we offer a full STI (sexually transmitted infection) screening service at our STI Clinic Limerick. We realise that tsexually transmitted infections is a sensitive subject and some people might find it difficult to talk about.  At Roxboro Medical Centre you can be assured of the utmost privacy and confidentiality in all aspects of healthcare.  It is worth noting that most people find the setting of a GP’s surgery to be a more comfortable experience to discuss this aspect of their sexual health than a publicly funded clinic.

As some STI’s, Sexually Transmitted Infections can have no symptoms or might not develop for a long time it would be important to have a screen if you are sexually active. We would recommend regular STI screening especially if you are having unprotected sexual contact with new partners.

 

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Overview

What is an STI (Sexually transmitted infection)?

An STI (sexually transmitted Infection) is a disease that is passed on through sexual contact with a person who is infected.  Most Sexually transmitted infections come from unprotected intercourse from Vaginal, Anal and Oral Sex.  Some STI’s can be passed by skin-to-skin contact.

What is an STI screen?

A Sexually Transmitted Infection (STI) screen at Roxboro Medical Centre involves a consultation on your sexual health with our doctors in Limerick who will take a sexual history, which will include any symptoms/concerns you might have. A full sexual history would include previous STI’s, the type of sex you are having, e.g. vaginal, anal or oral and the number of partners including gender.

After a history, an examination can be performed, to look for any abnormal skin lesions/rashes or abnormal discharge.  Please note a male or female doctor can be specified.

Depending on the initial history and assessment the doctor will order tests.  These tests can include urine, swabs or blood tests.  A follow up review either by phone or appointment will be made to discuss your results and treatment will be offered depending on what STI (sexually transmitted Infection) is found.  Tests to ensure cure following treatment may be necessary and can be discussed at the time.

Overview of STI’s (sexually transmitted Infection’s)

Chlamydia

Chlamydia is a common STI.  It is a bacterium that can affect both men and women.  If left untreated it can cause infertility in Women.  It can be spread through vaginal, anal and oral sex.  It can be spread by the use of unwashed sex toys and can also be passed from mother to infant during vaginal delivery.

Chlamydia can affect the Cervix (entrance to the womb), Urethra (tube you pass urine through), Rectum (back passage), Pharynx  (back of the throat) and eyes.

Chlamydia can cause no symptoms in over half of males and 7 out of 10 females, which make it important to screen for.

Males can complain of urethral discharge, pain or discomfort on urinating, testicular swelling and pain.  Bowel symptoms can include loose stool, mucus discharge or bleeding per rectum.  Females can complain of vaginal discharge, pain on urinating, bleeding after intercourse and bleeding between periods.  The infection can spread to the upper genital tract resulting in a pelvic inflammatory infection, infertility and abdominal pain.  Chlamydia can cause a condition called reactive arthritis, which is a triad of urethral discharge, conjunctivitis (inflammation/discharge of the eyes) and arthritis (inflammation of joints).  The arthritis associated with chlamydial infection is more common in men.

Testing for chlamydia can be a urine sample in men and swabs in women.  Occasionally swabs of the back passage and throat are needed.

Chlamydia can be treated with antibiotics and your doctor will go through this with you if and when needed.
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Gonorrhoea

Gonorrhoea is a STI caused by a bacterium.  It is known colloquially as “the clap”.  It is increasing in numbers among young people in Ireland.  Like Chlamydia it can affect the urethra, cervix, rectum, pharynx and occasionally the eyes.  It too can lead to infertility in women.

You can contract Gonorrhoea through unprotected vaginal, anal and oral sex.  It can be acquired through the use of unwashed sex toys and from mother to infant during vaginal delivery.  Symptoms occur in 9 out of 10 men and 3 out of 10 women.

Males can complain of a discharge from the tip of the penis, swelling and or pain in the testes, pain or discomfort on urinating.  Bowel symptoms can include loose stool and mucus discharge or bleeding from the back passage.  Women can have a vaginal discharge, pain with urinating, pain with intercourse, heavy periods or bleeding between periods and abdominal pain.

If left untreated in females it can cause pelvic inflammatory disease, which can lead to infertility and a higher risk of ectopic pregnancy (implantation of embryo in the tubes as opposed to the womb).   In males it can lead to infections of the testes and prostate gland, which can lead to severe pain and infertility.  In rare cases it can cause arthritis, endocarditis (infection in the heart), skin rashes and meningitis (infection of the spinal cord).

Testing for Gonorrhoea includes urine tests and swabs depending on symptoms.  In males it usually involves a urine test and occasionally a swab from the penis.  In females it involves a vaginal swab.  Sometimes swabs are taken from the rectum and throat.

Gonorrhoea can be treated with antibiotics; this may need to be given by injection into the buttocks.
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Genital Herpes

Genital Herpes is caused by a virus called herpes simplex virus (HSV).  There are 2 types of  HSV. Type 1 and Type 2.

Type 1 has been found to cause genital herpes but is more associated with oral herpes or cold sores.  Type 2 is commonly associated with genital herpes.  HSV causes blisters or ulcers.  When they occur on the face they are called cold sores but when they occur on the genitals they are called genital or ano-genital herpes.

Many people with the herpes virus do not exhibit any symptoms when they first get it and so do not know they have it.  If you do get symptoms your first outbreak will usually be the most severe.

Herpes Simplex Virus presents with small blisters around the genital area, which burst and leave red sores or ulcers.  These will crust over and heal over time.  These lesions can be painful, and you can have swollen glands, pain on urinating and flu like symptoms.

HSV is transmitted through skin-to-skin contact, kissing, vaginal, anal and oral sex.  It can be transmitted through the use of unwashed sex toys and from mother to infant during vaginal delivery.

You can reduce your chances of getting genital herpes by using a condom while having vaginal, anal or oral sex.  Avoiding sexual contact during times that your partner has blisters or sores or has tingling or itch suggesting the start of an outbreak.  You cannot get HSV from towels, toilet seats, swimming pools, cutlery or cups.  The virus dies quickly off skin.

Following the initial outbreak, the virus lies dormant in nerve cells, which can reactivate and cause a recurrence.  This is more likely to occur in patients that have type 2 HSV.

Testing for HSV involves swabbing a sore or ulcer during an outbreak.  Blood tests for HSV are not routinely done.

There is no cure for HSV but antiviral medication can be used to treat outbreaks and can be used to prevent recurrences in some instances.
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Genital Warts

Genital warts are “warts” in and around the genitals.  A virus called the Human papilloma virus causes them.  There are many forms of HPV but the most common type that cause genital warts are HPV 6 and 11.  HPV has been associated with different forms of cancer notably cervical in women and anal, throat and penile in men, but the type that cause genital warts do not lead to cancer.

Genital warts are generally pink and project out from the skin.  Most are painless without any symptoms.  They are a STI transmitted by skin-to-skin contact.  This is usually skin to genital skin and doesn’t need to involve penetration.  It is common for sexually active people to come into contact with HPV but most will not develop genital warts.

Genital warts may go away by themselves but can also be treated by creams and freezing called cryotherapy.   There is now a vaccine that can protect against the main forms of HPV that cause genital warts and the main ones that cause HPV related cancers.
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HIV (human immunodeficiency virus)

HIV is a virus that damages your immune system and weakens your ability to fight infections.  If left untreated HIV can lead to a severely weakened immune system, which is called AIDS (acquired immune deficiency syndrome).  While HIV can be transmitted from 1 person to another AIDS cannot be.

HIV is found in bodily fluids of an infected person such as semen, blood, vaginal and anal fluids. It can also be present in breast milk.  It is not in saliva, urine or sweat.  The most common way of contracting the virus as a STI is through unprotected vaginal or anal sex.  Many people that contract HIV never know they have it for years but eventually they become more prone to infections and illnesses.  Others can get a flu-like illness on contracting the virus.

HIV testing can be done with a simple blood test.. It is important to note that it may take 3-6 months following exposure before a test may come back positive, therefore a follow up blood test may be needed.

HIV cannot be cured but can be managed with Antiviral drugs.  The treatment stops HIV reproducing in the body and when taken properly can allow most people to live a long and healthy life.
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Hepatitis

Hepatitis is inflammation of the liver.  There are different causes of hepatitis including “viruses”, drugs and autoimmune conditions. The main viruses involved in hepatitis are hepatitis, A, B, C.

These can be checked for with a Blood test.

Hepatitis A

Hepatitis A is passed through faecal (poo) oral route.  That is ingestion of something that has been contaminated by faeces from an infected person.  It can be passed through ingesting food or water that has been contaminated by an infected person.  This can happen if you travel to an area with an outbreak or a country with poor sanitary conditions.  It would be a common travel medicine vaccine.

It is rarely thought of as a STI but in recent times it has been increasing in the MSM (men who have sex with men) population. It can be picked up through sexual contact involving mouth to anus, or through swallowing something that has been infected by faeces.

Initially hepatitis A can be mistaken for flu-like symptoms and in children they might have no symptoms at all.  The time taken from infection to development of symptoms in those that develop them is usually 2-6 weeks.  They include Fevers, Fatigue, Muscle aches, loss of appetite, sick feeling in the stomach, jaundice (yellow skin and eyes), diarrhoea and abdominal discomfort.  The illness usually lasts up to 2 months but some may last 6 months.  Longstanding liver damage is rare.  Good hygiene, in particular hand washing, is the cornerstone of prevention.  Using barriers for example, condoms if engaging in anal play.

Hepatitis A is preventable by vaccination.
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Hepatitis B

Hepatitis B is a virus that is very infectious and is considered 100 times more infectious than HIV.  It is a major cause of long standing liver disease such as cirrhosis and cancer of the liver.

Hepatitis B is spread through unprotected sexual contact, vaginal, oral and anal.  You can pick it up by sharing needles and anything with contaminated blood.  It can be passed from mother to infant during pregnancy and delivery.

Most people with hepatitis B don’t get symptoms; so getting tested can be the only way to know if you have it.  Some people get flu-like symptoms including fatigue, fevers, headaches, loss of appetite, nausea and vomiting, diarrhoea, muscle pains and jaundice.  Some people will naturally clear the virus themselves, but for many the infection will remain and without treatment the virus can lead to long-term damage to their liver.  If you are diagnosed with hepatitis B you will need to see a specialist who may prescribe treatment.

Hepatitis B is preventable by vaccination and by practicing safe sex, never sharing needles and avoiding contact with blood containing items.
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Hepatitis C

Hepatitis C is a virus that is spread mainly by blood-to-blood transmission, associated with intravenous drug use, poorly sterilized medical equipment, needle-stick injuries and transfusions.  It is much harder to contract through sex than Hepatitis A or B, but is becoming more common among MSM.

About 1 in 4 people will clear the infection themselves without any treatment. Most people don’t get any symptoms when they first get the disease.  Those who do may feel, feverish, tired, have a reduced appetite or feel nauseated, get abdominal pains and can develop jaundice.  Most people will however carry the virus for years or even for the rest of their lives.  Without treatment it can lead to severe liver problems likes cirrhosis or liver cancer.

Like Hepatitis A and B it can be tested for by a blood test.

There is no vaccine for hepatitis C so prevention includes practicing safe sex and not sharing needles.  It can be treated with anti-viral mediations under the care of a specialist doctor.
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Syphilis

Syphilis is a STI caused by a bacterium, which is not very common in Ireland, but the numbers are growing especially among MSM.

It enters the body by close skin-skin contact with an infected sore.  It can be contracted through unprotected, oral, vaginal and anal sex.  Symptoms typically include small painless sores or ulcers (called a chancre) that typically appear on the penis, vagina, around the anus and sometimes in the mouth or lips.  The sore will appear on the part of the body where the infection was transmitted.  The sore will disappear within 2 to 6 weeks and if the condition is not treated, syphilis can move into different phases of the illness that can spread to parts of the body such as the brain, heart, eyes or nerves.  This can cause serious and potentially life threatening problems.

Syphilis is usually diagnosed through a blood test.  Getting tested is the only reliable way of knowing if you have syphilis or not.

It is treated and cured with antibiotics, usually injections.
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Trichomonas Vaginalis (TV)

TV is a STI caused by a small parasite that can infect the vagina and cervix in women and the urethra and foreskin in men.  It is spread by having unprotected sex or through the use of unwashed sex toys.  It is not thought to be passed on through anal or oral sex.

TV in women can cause abnormal vaginal discharge, which can be unpleasant and odorous.  It can cause soreness, swelling and itch around the vagina and pain or discomfort on passing in urine.  In men TV can cause pain with urinating or during ejaculation.  It can cause discharge from the penis and more a frequent need to pass urine.  It can cause soreness, swelling and redness around the head of the penis / foreskin.

Swabs and urine samples can detect TV and can be treated by a course of antibiotics.
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https://www.sexualwellbeing.ie/sexual-health/sexually-transmitted-infections/types-of-stis/

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