There are several different organisms that cause STDs; the two most common encountered in the UK, Chlamydia and Gonorrhea, will be described below.

Chlamydia

Chlamydia is caused by bacteria called Chlamydia trachomatus. It is the most common STD in the UK, with 5-10% of the population being affected, mostly between 20 – 30 years old.

Chlamydia commonly does not manifest with symptoms, however symptoms in women may include:

• Discharge from the vagina.
• Urethritis – inflammation of urethra (outlet of urine) leading to pain on urination.
• Cervicitis – inflammation of the cervix that may cause bleeding in between the periods, or pain and/or bleeding during sexual intercourse..
• Reiter’s Syndorme – this is a triad of symptoms including urethritis, arthritis (pain and inflammation in the joints) and conjunctivitis (pain, redness and inflammation of the eye).
• Pelvic inflammatory disease (also see PID) – this is the most important complication of Chlamydia infection. This where the infection extends into the pelvis potentially causing tubal damage, leading to subfertility. Hence Chlamydia infection can be very serious as it can be silently causing infertility without the patient realizing, as she has no covert symptoms. Mr. Ismail advises all his patients to have regular sexual health check-up to avoid such unwanted complications. PID can also lead to chronic pain in the pelvis that can also be avoided if the infection is caught early and treated effectively.

Symptoms are also rare in men although may include discharge from the penis (white, cloudy or watery), pain on urination, painful swelling of the testicles and Reiter’s Syndrome.

Gonorrhea

Gonorrhea is a bacterial infection caused by N. Gonorrhea. Like Chlamydia, Gonorrhea usually does not manifest with symptoms but it does more so than Chlamydia, particularly in men.

Symptoms in women may include:

• Discharge from the vagina.
• Urethritis – inflammation of urethra (outlet of urine) leading to pain on urination.
• Cervicitis – inflammation of the cervix that may cause bleeding in between the periods, or pain and/or bleeding during sexual intercourse.
• Pelvic inflammatory disease (also see PID) – this is the most important complication of Chlamydia infection. This where the infection extends into the pelvis potentially causing tubal damage, leading to subfertility. Hence Chlamydia infection can be very serious as it can be silently causing infertility without the patient realizing, as she has no covert symptoms. Mr. Ismail advises all his patients to have regular sexual health check-up to avoid such unwanted complications. PID can also lead to chronic pain in the pelvis that can also be avoided if the infection is caught early and treated effectively.
• Septic arthritis – this occurs when the Gonorrhea bug travels in the blood (bacteraemia) to a single joint in the body. The joint acutely becomes hot, red, swollen and painful and the patient complains that they cannot mobilize their joint. They may also present with fever. The joint that is most commonly affected is the knee. This is a medical emergency and needs to be treated urgently in hospital as it may lead to permanent damage of the joint.

In men, Gonorrhea presents with symptoms more commonly than it does in women. These include discharge from the penis and pain on urination. Men can also be affected by septic arthritis however this is rare.

How are Chlamydia and Gonorrhea STDs diagnosed?

As the different sexually transmitted diseases may have similar symptoms it is important to accurately identify them. They are diagnosed by a simple swab from the genital region, the vagina or penis, to obtain a sample of the discharge. This is then sent to the laboratory to be examined. With certain STDs, Mr. Ismail can diagnose the infection there and then in the clinic under the microscope.

How can they be treated?

Both Chlamydia and Gonorrhea infection can be successfully treated with antibiotics prescribed by Mr. Ismail, especially if found early. If the infection has lead to PID then supplementary treatment is used (see PID).

How can I prevent having an STD in the first place?

It is important to recognize that STDs are infections that you can avoid getting as long as you practice “safe sex”. This means always wearing protection in the form of condoms or always ensuring both you and your partner have been checked and cleared of any STD. It is vital to emphasise the use of condoms even if you are on another form of contraception (e.g. the pill, the Mirena Coil, the patch etc) as the condom in this instance is not for the purpose of contraception but to protect you from contracting an infection. Mr. Ismail advises all his patients to practice safe sex and to have frequent checkups, as even though it is easy to treat the infections, this is only the case when it is in its early stages. In view that the infections commonly do not have symptoms, one can understand how the infection progresses without a person realizing they are passing it on to another. Evidently, the advanced stages of infection have more serious symptoms and more complicated forms of treatment which could well have been easily avoided.