Category Archives: Sexual Health

Many common sexually transmitted diseases (STDs) share the same or very similar symptoms. These include:

• Abnormal discharge
• Painful and/or frequent urination
• Pain during sexual intercourse
• Itching, irritation or pain in the genital area
• Small lumps or sores in the genital area

Of course, many common STDs also don’t cause any symptoms at all! For example, for chlamydia, only an estimated 10% of infected males show symptoms and 5-30% of infected females (1). This is why routine testing is very important to detect, treat, and prevent the spread of STDs. Our easy-to-use at-home sample collection kits make STD testing even simpler. If you are concerned about a recent potential exposure, take an STD test today.

Abnormal discharge:
Chlamydia, gonorrhea, and trichomoniasis can all cause abnormal discharge from the vagina in females and penis in males. This is typically a yellowish discharge in females and a white, cloudy or watery discharge in males. Sometimes the discharge can have a slightly green tinge and also have an unpleasant smell.

Non-STD health issues can also cause abnormal discharges, including urinary tract infections and yeast infections (2). Taking a simple STD test is an easy way to rule out a potential STD.

Painful and/or frequent urination:
Chlamydia, gonorrhea, trichomoniasis, and herpes are all associated with pain while urinating (dysuria). But once again, many non-STD health issues can also cause dysuria, including urinary tract infections, yeast infections, urethritis, certain prostate conditions, bladder and kidney stones, and certain medications (3).

Frequent urination is another common symptom of STDs, but can also be caused by kidney disease, urinary tract infection, pregnancy, prostate problems, and diabetes among other things (4).

Pain during sexual intercourse:
Chlamydia, gonorrhea, trichomoniasis, and herpes can also cause pain during sexual intercourse. Non-STD health issues in females that can also cause painful sex include vaginismus, vaginal infections, endometriosis, menopause, pelvic inflammatory disease (which can itself be a complication of an STD) (5). In males, other causes of painful sex include Peyronie’s disease, a tight foreskin, or prostatitis (6).

Itching, irritation, or pain in the genital area
Chlamydia, trichomoniasis, and herpes can cause discomfort in the genital area, particularly in females. This may be just mild irritation or severe itching and pain. Other causes of irritation include yeast infection and bacterial vaginosis in females, jock itch in males, and allergies in both genders. Sweating, tight clothing, and certain substances (e.g. soap) can also contribute to itchy genitals (7).

Small lumps or sores in the genital area
Syphilis, herpes, and human papillomavirus (HPV) are all associated with skin lumps and sores in and around the genitals.

For syphilis, a skin lesion known as a chancre occurs during primary infection. It can be a single painless chancre, or multiple painful and tender chancres (8).

Genital herpes can cause a patch of small red or white bumps, which are often painful. These pus-filled sores eventually burst to leave an ulcer-like sore on the skin (9).

HPV can cause warts in the genital area. These can be flat lesions, small cauliflower-like bumps, or tiny stem-like protrusions (10).

References:
1. Farley TA, Cohen DA, & Elkins W (2003). Asymptomatic sexually transmitted diseases: the case for screening. Prev Med, 36 (4), 502-509.
2. Barad DH (2020). Vaginal Discharge. Merck Manual Consumer Version.
3. Michels TC, Sands JE (2015). Dysuria: Evaluation and Differential Diagnosis in Adults. Am Fam Physician. 92 (9), 778-788.
4. Maddukuri G (2021). Excessive or Frequent Urination. Merck Manual Consumer Version.
5. Why Does it Hurt When I Have Sex? American Society for Reproductive Medicine.
6. Why does sex hurt? NHS. Reviewed May 2021.
7. 8 reasons your groin itches and how to get relief. American Academy of Dermatology Association.
8. Kent ME & Romanelli F (2008). Reexamining syphilis: an update on epidemiology, clinical manifestations, and management. Ann Pharmacother, 42 (2), 226-236.
9. Genital Herpes – CDC Fact Sheet (Detailed). CDC. Reviewed July 2021.
10. Genital HPV Infection – Fact Sheet. CDC. Reviewed January 2021.

Consistent and correct use of male latex condoms does dramatically reduce the risk of transmitting STDs. However, condoms do not eliminate the risk of STD transmission.

How are STDs transmitted?
STDs, such as chlamydia, gonorrhea, and HIV, are usually transmitted through contact between infected secretions from the vagina or urethra and mucosal surfaces of the anus, vagina, urethra, or cervix. Syphilis, genital warts (herpes), and human papillomavirus (HPV) typically cause ulcers or sores in the genital area, and transmission can occur when the ulcer/sore comes into contact with a mucosal surface.

How do condoms reduce transmission?
Latex condoms effectively prevent the contact between infected secretions and mucosal surfaces of a sexual partner. However, condoms are not 100% effective, particularly if they are used incorrectly. In addition, they can be less effective at preventing the transmission of STDs that cause genital sores (e.g. syphilis), especially if the condom does not cover the sore.

What reduces the effectiveness of a condom?
There are many mistakes in using condoms that are actually more common than you might realize. These include using:

• An expired condom, which increases the risk of breakage during sex
• Teeth to open the condom pack. This can damage the condom and increase the risk of breakage.
• A condom that is too tight. The semen needs somewhere to go!
• A condom with air left at the tip. This can cause it to burst during sex.
• A partially unrolled condom. It needs to be fully unrolled to fit properly and prevent slipping off during sex.
• An oil-based lubricant. These can weaken the latex. Stick to water-based lubrication to increase comfort and reduce the risk of condom tearing during sex.

Tips for using condoms correctly
These are the dos and don’ts for condom use as recommended by the CDC (1):

• DO use a condom every time you have sex.
• DO put on a condom before having sex.
• DO read the package and check the expiration date.
• DO make sure there are no tears or defects.
• DO store condoms in a cool, dry place.
• DO use latex or polyurethane condoms.
• DO use a water-based or silicone-based lubricant to prevent breakage.

• DON’T store condoms in your wallet as heat and friction can damage them.
• DON’T use nonoxynol-9 (a spermicide), as this can cause irritation.
• DON’T use oil-based products like baby oil, lotion, petroleum jelly, or cooking oil because they will cause the condom to break.
• DON’T use more than one condom at a time.
• DON’T reuse a condom.

Do I still need to get tested even if I always use condoms?
Yes. Condoms unfortunately do not eliminate the risk of STD transmission. So if you think you have been exposed to an STD and/or you are experiencing potential STD symptoms, get an STD test to keep yourself and your sexual partners safe and healthy.

Routine STD screening is still recommended for sexually active individuals, particularly with multiple sexual partners, even if condoms are consistently used.

References:
1. External (sometimes called Male) Condom Use. CDC. June 21, 2021.

Sexually transmitted diseases (STDs) can also be known as sexually transmitted infections (STIs). They are infections that are usually spread from person to person during vaginal, anal, and oral sex. Many STDs are quite common but do not cause any symptoms, particularly in the early stages. However, despite being asymptomatic, infected individuals can still transmit the STD to any sexual partners. In addition, if the STD is left untreated, serious health complications can occur.

Have you been potentially exposed to an STD?
STDs can spread through vaginal, anal, or oral sex, and sometimes transmission can occur even with the correct use of a condom.

Are you experiencing potential symptoms of an STD?
These can include:

• Sore or bumps in the genital area
• Abnormal discharge from the penis or vagina
• Painful and/or frequent urination
• Itching, pain, and/or irritation in the penis, vagina, vulva, or anus
• Flu-like symptoms

Of course, these symptoms can also be caused by something that is not an STD (e.g. a yeast infection) and many people with an STD do not actually experience any symptoms. The only way to be sure that you don’t have an STD is to get tested.

Testing is simple and easy.
Just a urine sample or finger-prick blood sample is all that is required. We offer STD testing from a sample collected in the privacy of your own home. The sample is then shipped to our fully accredited laboratory for very accurate testing using approved and validated testing procedures. Your results are quickly available in your secure online account.

Testing is important.
Many STDs can cause serious health complications if they are left untreated. For example, untreated chlamydia and gonorrhea infections in females can lead to pelvic inflammatory disease (PID), and PID-associated infertility, and chronic pelvic pain. Complications in males include epididymitis and prostatitis (1).

Some STD infections during pregnancy are particularly dangerous. For example, syphilis during pregnancy is associated with miscarriage, stillbirth, or infant death shortly after delivery in up to 40% of cases. Congenital syphilis occurs when an infected pregnant woman passes syphilis to her baby during pregnancy. For infected infants, treatment must begin immediately to prevent developmental delays, seizures, and other fatal complications (2).

In addition, if you have an STD (even if asymptomatic), it can increase the risk of contracting another STD, which may be more serious. For example, trichomoniasis infections are associated with a two to three-fold increased risk of HIV (3).

CDC recommendations for STD testing include (4):

• Annual screening for chlamydia and gonorrhea in females 25 years and younger
• Screening for chlamydia and gonorrhea during each pregnancy
• Routine screening for chlamydia in men who have sex with men and high-prevalence settings
• Annual screening for gonorrhea in males 25 years and younger
• Screening for trichomoniasis in females with abnormal vaginal discharge
• HIV testing at least once for everyone 13 – 64 years, with annual screening in higher-risk populations and screening during each pregnancy
• Anybody potentially exposed to HIV should be tested immediately and again at six weeks, three months, and six months post-exposure
• Hepatitis B testing in individuals born in countries with high prevalence, as well as during pregnancy and in high-risk populations
• Hepatitis C testing at least once and during each pregnancy (except in populations where the prevalence of HCV is less than 0.1%), as well as routine testing in high-risk populations
• Syphilis testing in anyone showing suggestive signs of syphilis, as well as during pregnancy and in high-risk populations

References:
1. Farley TA, Cohen DA, & Elkins W (2003). Asymptomatic sexually transmitted diseases: the case for screening. Prev Med, 36 (4), 502-509.
2. 2015 STD Treatment Guidelines Syphilis. CDC 2015, June 4.
3. Trichomoniasis Fact Sheet. CDC Feb 2020.
4. Workowski KA & Bolan GA (2015) Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep, 64 (RR-03), 1-137.