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Genital warts are fleshy growths that can appear on and around the area of the genitals or anus. They result from infection by a virus known as the human papillomavirus (HPV), of which there are many strains.

Genital warts do not usually cause pain and are not associated with a serious threat to an individual’s health. However, they can look unsightly and can be a source of psychological distress.

The Transmission of Genital Warts

Genital warts are passed on during vaginal or anal sex and through the sharing of sex toys. However, an individual who has not had penetrative sex can be infected by HPV as HPV can be spread through skin-to-skin contact. HPV is likely to be passed on when genital warts are present. However, it is possible for an individual to pass on the virus before genital warts have appeared on the skin.

The genital warts incubation period can last as long as a year, meaning that an individual can be infected by the virus yet will not show symptoms for up to a year later.

The Prevalence of Genital Warts

Genital warts are most commonly seen in males aged between 20 to 24 and females aged between 16 and 19. The prevalence of genital warts is high. In England alone, genital warts are the second most common sexually transmitted infection. Between 2004 and 2008, in excess of 79,000 new genital warts cases were diagnosed in England.

The Diagnosis of Genital Warts

Individuals who may have developed genital warts must visit their local genito-urinary medicine (GUM) clinic. While a family doctor is able to diagnose the condition, professionals at a GUM clinic will be able to administer treatments for genital warts.

Genital warts are easily diagnosed. During a check-up, a doctor or nurse will use a magnifying lens to examine the warts found on the skin.

The Treatment of Genital Warts

The treatment for genital warts includes topical treatment, which takes the form of either a lotion or cream that is applied onto the affected area, and physical ablation, in which the infected tissue is destroyed using lasers. The effectiveness of treatment varies between individuals. Treatment is more effective in individuals who do not smoke in comparison to those who do.

Topical treatments have a tendency to work effectively on softer warts while physical ablation has a tendency to work effectively on harder warts. A combination of both topical treatment and physical ablation may be used. Neither treatment removes warts instantly, with treatment often taking several months to eliminate warts.

Preventing Genital Warts

Genital warts can be prevented by using male and female condoms. Condoms must be worn every time an individual has vaginal, oral or anal sex. Condoms do not offer complete protection from genital warts, however, as it is possible for the skin surrounding the genital area to become infected.

The Gardasil vaccine offers protection against the most common strains of the human papillomavirus that have been proven to cause genital warts. The vaccine is thought to be 99% effective at preventing the development of genital warts. However, an individual’s immunity to the strains of the virus that the vaccine protects against will begin to fall after six years and the vaccine is not considered a substitute for condom use.

To learn about Freedom Health’s genital warts treatment click here

Several things motivate me to write this blog, one of them being my great altruistic nature, another being my grave concern for the sexual health of Great Britain. People are engaging in so many and so varied a smorgasbord of sexual activities that this Doctor is fraught with utter despair. I am a very logical person so I have taken a very logical approach to this blog; I am also a very truthful person so I have taken a very honest approach (no holds barred!) Rooted in more than twenty years of hard experience in the field of HIV medicine and sexual health I feel more than qualified to delve into this subject as deep as the average orifice can take.

Now let’s face the facts, when do you have sex? Not every night, not very other night – as a matter of fact the only time you are ever truly concerned with sex is when the encounter is very important. Therefore I have based my advice on four basic categories, categories which, I believe the reasons (if the truth be told) we are compelled to have sex. They are; seduction, motive (I need this job, raise or part) destitution and desperation.

I don’t take to heart what type of sex you are having; it is the way you decide to have it that concerns me. The complications and implications of the way people choose to satisfy themselves are often life- altering and sometimes sadly life threatening. Unsafe destitution sex for example is not going to make you richer but might take you out of the dos house and put you into hospital!

Since the dawn of time (when Adam met Eve or Steve) lurgies have learnt to invade our most private parts. While syphilis has stood the test of time, herpes horrified the sixties, gonorrhoea has never gone away and since the eighties AIDS has annihilated millions we are still having sex. With teenage pregnancy rates higher than anywhere else in Europe and Chlamydia prevalence soaring it is incredibly clear that the messages out there are falling on deaf ears. Our social constructs and moral guidelines seem to be incapable of allowing good honest safe sex from being just that.

Sex is easy to find, have and indulge in. If the internet were a cook book it would be full of recipes that would boggle the mind. The ingredients and artificial additives are easy to come by, as are most utensils. With the advent of smart phone apps such as GRINDR and BLENDR one is literally free to indulge in any form of sexual expression that might titillate the taste buds. If only the results of these exploits where as fine as a creamy cupcake, a pleasant pot of home cooked jam or a traditional Sunday roast with trimmings. Instead of seeking instant carnal delight to satisfy one’s sexual hunger perhaps turning the page and staying in to bake some bread will solve the problem.

Hepatitis A is a highly contagious disease. It’s caused by the hepatitis A virus (HAV). While hepatitis A is often a relatively mild disease, it can manifest very severe symptoms in some individuals. Rarely, a serious case of Hepatitis A results in liver failure and death. With care, the patients own immune system should be able to fight off the disease. Once the virus has been overcome, the illness recedes and doesn’t usually come back.

The incubation period for the hepatitis A virus is about four weeks, During this time, you may have the virus and be infectious even though you feel perfectly well; symptoms don’t manifest until the virus has built up sufficient numbers to trigger an immune response. Patients with hepatitis A typically become jaundiced. They lose their appetites and develop symptoms similar to an upset stomach: nausea, vomiting and loose stools. The patient will generally experience aches and pains similar to a flu attack.

The hepatitis A virus is shed from the lining of an infected person’s intestines and comes out in their stool. If an uninfected person then comes into contact with this waste, they may also be infected. The virus must be transferred to the new patient’s mouth in order to infect them. It can therefore be spread by an infected person who doesn’t wash their hands properly after using the bathroom; through contaminated water; or on food that has been contaminated. This can happen if the person preparing the food has traces of the virus on their hands; it can also occur if HAV is present in waste used to fertilise vegetables. Fruits or vegetables washed in contaminated water can be a source of infection.

HAV can also be spread through unsafe sexual contact; statistically, men who have sex with men may be especially vulnerable but anyone can potentially contract hepatitis A in this manner. Practicing safer sex can reduce the risk, although it doesn’t eradicate it entirely.

As the virus is spread through infected people’s stool, good hygiene is a major weapon in preventing the transmission of HAV. Wash your hands thoroughly with soap and hot water after every visit to the bathroom; use alcohol wipes or hand sanitizer if you don’t have access to these. If you are in a location that may have inadequate water purification, you should avoid eating fresh fruit or salads. All your water should be purified and boiled. Don’t drink unpackaged fruit juices, as these may be mixed with contaminated water or made from contaminated fruit. Even ice in drinks can be a possible source of infection with the virus, if made using contaminated water.

The virus can live on surfaces that have been contaminated by contact with unpurified water or through being touched by someone who has the virus on their skin. Cleaning surfaces with hot water and soap, disinfectant or sterilising fluid can reduce the chance of infection. This is especially important if food is to be prepared on a surface.

By following such common-sense precautions, it’s possible to arrest the spread of the hepatitis A virus.

Hepatitis the name of a medical condition caused by a virus. All forms of hepatitis are characterised by swelling of the liver. There are different disease progressions and levels of severity, depending on the specific virus responsible. There are five main kinds of hepatitis, designated hepatitis A, B, C, D, and E.

Hepatitis A is spread via stool from an infected person. You can catch it by eating food or drinking water contaminated with the hepatitis A virus (HAV). HAV can also be spread through unsafe sex practices. Like all forms of hepatitis, infection with HAV can lead to inflammation of the liver. Hepatitis A is not a chronic disease — the body’s immune response can destroy the virus all together. Except in very rare cases, all hepatitis A patients make a complete recovery.

Hepatitis B is caused by the hepatitis B virus (HBV). It is spread through contact with an infected person’s body fluids, such as blood or semen. HBV is a sexually transmitted disease (STD), which can be passed on through unsafe sex. You can also contract hepatitis B through a bite from an infected person, being pieced or tattooed with unsterilised equipment or by getting infected fluids in a cut or an abrasion. Intravenous drug users may contract the disease by sharing needles. Blood products are now screened for the virus but it is technically possible to contract hepatitis B from an infected blood transfusion. A mother who is infected may pass HBV to her baby during birth or through breast milk. Some people are able to overcome the infection completely; others fall victim to a chronic or lifelong infection. Hepatitis B can damage the liver and may lead to cancer. It is much more serious than hepatitis A.

Hepatitis C is spread in the same way to hepatitis B, through contact with infected body fluids. It also causes swelling of the liver and can lead to long-term damage. Most patients infected with hepatitis C will carry the infection for the rest of their lives. It is a dangerous virus, capable of causing cirrhosis (scarring) of the liver and liver cancer.

Hepatitis D can only be contracted alongside hepatitis B or if you are already infected with the hepatitis B virus. The HBV infection doesn’t have to be active; the presence of the virus is all that’s required. It is spread in a similar way to hepatitis B. Hepatitis D has the highest mortality rate of all forms of hepatitis, with 20% (one fifth) of all cases resulting in death.

Hepatitis E is spread in a similar way to hepatitis B, through means such as contaminated food or water. Hepatitis E is rare in regions of the world with adequate sanitation.

Click here to learn more about our hepatitis services

Dr Alex writes:

There is a lot of confusion about oral sex and the risk of picking up and passing on STI’s including HIV and Hepatitis B. Most patients are very unsure about the risk and many feel that as long as they have protected vaginal or anal sex then they are having safer sex. Most are not aware of the risk of oral sex. Some underestimate the risk and others over estimate it.

Most public health campaigns give blanket advice about oral sex but to really understand oral sex you have to break it down into who is doing what to who!

So what are the real risks and to who?

Receiving and giving oral sex does put you at risk of picking up or passing on chlamydia, gonorrhoea and syphilis. So whatever you do – give or receive- these three infections are a risk.

But things get a bit more complicated when it comes to Hepatitis B and HIV.

The risk of picking up either of these two infections by receiving oral sex from someone (man or woman) is just minimal, probably as close to no risk as you can get! This is because HIV and Hep B viruses are normally only present in saliva in very low levels that are not sufficient to cause infection. The only risk would be from bleeding wounds or gums or lips of the person performing oral sex, which may transfer blood onto the mucous membranes of the person receiving the oral, or into any cuts or sores they may have.

When it comes to giving oral sex the situation is different:

-          If you give oral sex to a man this does pose some small risk of picking up HIV or Hep B, especially if you get semen into a cut, sore, ulcer or area of inflammation somewhere in your mouth or throat. The normal linings of the mouth and throat are very resistant to viral infections such as HIV, so infection is unlikely if they are healthy with no cuts or areas of inflammation. The risk of picking up HIV from giving oral to a man who definitely has HIV and who ejaculates in your mouth is thought to be about 1 in 5,000.

-          If you give oral sex to a woman there is again minimal risk of picking up HIV or Hep B. This is because it is harder to get vaginal secretions or blood into your mouth where if there were cuts, sores, ulcers or areas of inflammation the viruses could enter the body.

 Oral sex and STIs including HIV is a complicated issue. I hope this makes it a bit clearer. In an ideal world condoms would be used for oral sex – but many men don’t accept this and in doing so the risk.

Chlamydia is a sexually transmitted infection that affects nearly 1 in 20 sexually active women in the UK, making it one of the most common STIs in the country.

Around seventy-five per cent of women and half of all men with chlamydia do not display any symptoms. In those cases where symptoms are present – which can involve an unusual discharge or burning sensation while urinating – they are often so mild that the person with the infection does not realise anything is wrong. For this reason chlamydia is often known as the ‘silent’ disease.

If left untreated, the chlamydia infection will eventually spread to the reproductive organs and once there it can cause permanent damage. In some cases the chlamydia bacteria will lead to inflammation of the pelvis, damaging the Fallopian tubes that transport eggs from the ovaries to the womb, causing them to become blocked and stop working. Pelvic inflammatory disease can lead to a fever and in rare cases can even be life threatening.

Although it is not impossible a for a woman with blocked Fallopian tubes to become pregnant, there is a greatly increased chance of the foetus developing the tubes rather than in the womb. This condition, known as an ectopic pregnancy, can lead to a life-threatening condition as the tube may eventually burst causing serious internal bleeding.

Chlamydia has also been linked to miscarriage and premature birth. In some instances, the infection can be passed from mother to baby, either during the birth or before, which can cause the child to be born with conjunctivitis and pneumonia.

Although Chlamydia can be treated and cured with a simple course of antibiotics – even if you are pregnant or breastfeeding – the fact that many of those with the infection do not realise that they have it means many women become infertile unnecessarily. The same bacteria that is responsible for causing chlamydia is also a leading cause of preventable blindness in many parts of the world.

In men chlamydia can infect the tubes that carry urine from the bladder out of the penis or even to the prostate gland. It can also affect fertility by causing the testicles and tubes that transport sperm to swell up, preventing sperm from being released. A rare complication, more often seen in men than women, is inflammation of the joints, known as Reiter’s syndrome.

You can be tested for chlamydia by providing your doctor with a urine sample.
If you are diagnosed with the infection you will not know how long you have had the infection for or who you caught it from. This can be extremely difficult to come to terms with and it may help for you to talk through the issues with staff at your local healthcare centre. If you delay seeking treatment you run the risk of the infection causing more serious problems.

Another issue linked to the lack of symptoms is that, unless both partners are treated at the same time, there is a strong possibility that one partner will simply reinfect the other.

Freedom Health offer Chlamydia Testing and Treatment

Gonorrhoea is UK’s second-most common sexually transmitted infection (STI). Luckily it is easily curable, but if left untreated can lead to serious health problems including infertility, pelvic inflammatory disease and even meningitis. Therefore it is important to visit a doctor or local sexual health clinic to request an STI check-up if you are showing symptoms or think you may have been exposed to infection. The doctor or nurse will usually use a swab to test for gonorrhoea in women, while men generally provide a urine sample.

If you test positive, don’t panic: gonorrhoea treatment is straightforward. Gonorrhoea will not go away without treatment, so it is important to be treated promptly to prevent any complications and to avoid passing the infection on to any sexual partners.
Gonorrhoea is treated by a single dose of antibiotics, usually ceftriaxone or azithromycin, administered either orally or by injection. Until recently a third antibiotic, cefixme, was commonly used to cure gonorrhoea, but due to growing resistance to the drug by bacteria which cause the infection it is no longer considered sufficiently effective.

You should refrain from all sexual contact with any partners for a week after being treated for gonorrhoea. All sexual partners who may have been exposed to the infection should seek treatment, otherwise they could pass the infection back to you. Treatment will often be offered prior to testing if infection seems particularly likely. Treatment is around 95 per cent effective so you will not usually need a follow-up inspection to get the all-clear unless symptoms persist.

You should notice an improvement in your symptoms fairly quickly after treatment, with discharge, painful urination and rectal discomfort improving within a couple of days. For women, vaginal bleeding should improve by the next period.

While gonorrhoea can currently be easily cured, it is worth bearing in mind that the organism that causes the infection has evolved to be resistant to a number of antibiotics – including penicillin – that had previously treated it effectively. As such, the Health Protection Agency last year warned of “a very real threat of untreatable gonorrhoea in the future”. As with all STIs, prevention is better than cure. The best way to avoid contracting gonorrhoea is to practise safe sex and use a condom whenever you have sex with a new partner.

Many people mistakenly believe syphilis is a thing of the past, a sexually transmitted disease widespread until the medical advancements made in the 20th century practically swept it from the face of the Earth. However, this is not the case. In fact, in many countries infection rates have increased over the last decade.

What has caused the increase in syphilis infection in recent years? A general lack of awareness coupled with a failure to forcefully promote the importance of protected sex has certainly aided the disease to spread. Perhaps a general complacency grew in the wake of the drastic reduction in syphilis cases that followed the advent of penicillin in the 1940s.

Sexual health campaigns and school sex education classes have focussed more on highlighting the dangers of contracting sexually transmitted diseases like gonorrhoea, Chlamydia and HIV, but everyone should also be alert to the threat of contracting syphilis through unprotected sex.

How is syphilis spread and who is at risk? The infection is caused by the germ Treponema Pallidum and can be spread by sharing needles, kissing and having oral, vaginal or anal sexual contact. It can also be passed as congenital syphilis from mother to baby during the pregnancy or birth.

Anyone in a sexual relationship with an infected partner, engaging in unprotected sex, leading a risky and promiscuous sex life or sharing needles are more likely to contract syphilis and other sexually transmitted diseases.

Syphilis has three main stages, each with different symptoms. In the primary stage, the infected person may develop an open oral, vaginal or anal sore. If medical advice is not sought the painless sore will eventually heal itself. However, this means the disease goes undiagnosed.

The secondary stage is equally problematic, as the symptoms are very similar to flu and often dismissed as such. The disease can then lay dormant until entering the tertiary stage, during which the heart and brain can be damaged, leading to serious illness or death.

Of course, a sweeping improvement of sexual health education for all ages and promotion of using condoms as a preventive measure would be an effective global strategy, but mounting such campaigns successfully in less developed countries can be difficult.

Found early syphilis can be simply treated with penicillin. However, without the necessary knowledge, infected people may not recognise the warning signs. Syphilis in modern times remains a grave concern and a challenge, requiring worldwide raised awareness of its symptoms and how to prevent it spreading. Freedom Health offer comprehensive Syphilis Treatment and Syphilis Testing.

Known as the “The Middle-age Spread”, STIs in the over 50s has become a topic garnering increasing attention in both the medical community and the press. In the last decade, cases of Chlamydia in those aged 45-64 have risen by three quarters. While almost a fifth of the same age group admitted to having unprotected sex in the last five years with someone other than their long-term partner. But why is an age range with typically low rates of STIs seeing a rise?

One reason lies in divorce. While the overall divorce rate has begun to decline, it is actually increasing in those of retirement age. On reaching retirement many older couples are finding their increased amounts of free time actually detrimental to their marriage. Quite literally, they’re realising they don’t like each enough to spend the whole day together. Indeed, this rise in over 50s divorce has even created some cultural attention, being labelled “silver separations”. Instead of staying in, the aging population are travelling widely, experimenting with new cultural experiences, and more importantly, embarking on casual relationships. In that sense, the rise of STI rates isn’t too surprising; over 50s are having more casual sex now than ever.

Ironically, the wealth of safe-sex advertising aimed at today’s youth is also having a diverse effect on the over 50s. Returning to the world of casual sex, none of the advice or guidance provided by the government is targeted at the older ages. This means that they are finding themselves unaware of many of the modern problems with STIs and how easy the solutions can be. Without the reminder, it’s unlikely to be something on their mind when embarking on their new life. Only now are we beginning to see a growth in over 50s aimed sexual health advertising, but it still too little too late to stem the rise of STIs.

Another factor is likely the lower use of condoms in the over 50s, thanks to the prevalence of erectile dysfunction in men of older age. If an over 50 finds it hard to maintain an erection, the wearing of a condom will likely make it much worse as it restricts the blood flow to the penis. And whilst prescription drugs and other remedies are available to help with erectile dysfunction, its influence will still lead to reduced condom usage and therefore higher rates of STIs.

Often referred to as the ‘silent disease’ because many people who contract it don’t experience any symptoms, Chlamydia is the most common sexually transmitted infection (STI) in the UK.

Untreated, the disease can lead to infertility and other complications in both men and women. Even if you don’t experience any symptoms yourself, you can still pass on the disease to your partner so regular screening is important if you are sexually active or have multiple partners. All sexually active women up to the age of 25 should be screened annually for Chlamydia.

Chlamydia is passed on through unprotected sex and can easily be passed back and forth. Symptoms usually start one to three weeks after getting the infection, but they may take longer to develop. However, around 50% of men and 70% of women with Chlamydia don’t experience any symptoms at all.

In women, the symptoms include an increased or unusual amount of discharge from the vagina. This is caused by an inflamed cervix. You may feel the need to urinate more frequently or experience pain when passing urine.

You may experience pain, and even bleeding, during or after sex. Your periods may become irregular or particularly heavy and you may also experience pain in the lower abdomen or the pelvis area.

If left untreated, the infection can spread to your womb and cause Pelvic Inflammatory Disease (PID) which is a major cause of infertility, ectopic pregnancy and miscarriage.

Men with Chlamydia may notice a milky discharge from their penis, which may stain your underwear.

You may experience a burning sensation or pain when passing urine, and your testicles could become swollen and painful.

If left untreated, you are at risk from complications such as inflamed or swollen testicles, reactive arthritis and infertility.

Very rarely the infection can affect other areas of the body including the rectum (anus), eyes or throat.

If you are infected in the rectum, you may experience a discharge or bleeding and may feel discomfort. Chlamydia infection in the throat is unlikely to give you any symptoms but if your eyes are infected, they can become irritated and weepy (conjunctivitis).

If you suspect you have symptoms of Chlamydia, it is important to get tested as soon as possible to ensure you don’t pass it on or develop complications. Testing for Chlamydia is very simple and can even be done at home using a confidential test kit. The usual treatment is a short course of antibiotics.