Lots of us will have problems with sex from time to time. Don't be afraid to ask for help if you have any concerns about sex or relationships.
Sexually transmitted infections are one of the main causes of sexual ill-health. STIs can be passed from person to person during sex. You can use condoms to protect you and your partners from picking up or passing on an STI.
Sometimes sex can be difficult or painful. The causes and reasons can be varied. The good news is that help and support is available.
Loss of desire
A loss or lack of sex drive can affect women at certain times in their lives, and can be caused by both physical and psychological factors. These include tiredness, depression, certain medications and hormone disorders.
Pain during sex
The menopause can make sex more painful, as oestrogen levels fall and the vagina feels dry. But strong discomfort could also be a result of vaginismus, where muscles around the vagina spasm and contract, making intercourse extremely painful or impossible.
Unusual vaginal discharge is commonly a result of bacterial vaginosis. We don’t know much about the causes of it, but it’s thought to be down to an imbalance in the bacteria in your vagina. It’s not an STI, but symptoms can be noticed after sexual intercourse. For the majority of women, it will not be serious.
Sexual Assault Help
Sexual violence is a crime, no matter who commits it or where or when it happens. Don’t be afraid to get help. St Mary’s Sexual Assault Centre in Manchester offers help and support for women, men and children who have experienced rape or sexual assault, recently or in the past. You don’t need to make a report to the Police to use the services at St Mary’s.
Problems with orgasm
Many women don’t need to have an orgasm to enjoy sex, but if not having one is a problem, there could be many different reasons for it. These may be physical or psychological, because of pain, lack of stimulation, fear and worries, or even a lack of knowledge about sex. Or it could be a result of underlying relationship problems, mood disorders or previous sexual trauma.
Female genital mutilation (FGM)
If you have experienced female genital mutilation, you may find sex painful and difficult. You might have a reduced sexual desire and a lack of pleasurable sensations, or want to avoid intimacy all together. There is no medical reason for FGM.
Trichomoniasis (also called trichomonas or TV) is a sexually transmitted infection caused by tiny parasites in both men and women. The infection is found in the vagina of women, and in the urethra of both men and women. Symptoms can be very had to spot, with 50% of those infected showing no signs at all. It causes soreness and swelling around the genitals, and can be painful to urinate. It’s easily passed from one person to another by sexual contact.
Erectile dysfunction (impotence)
If you can’t get or keep an erection, you may be suffering from erectile dysfunction. Reasons for this can be both physical and psychological, and most men will experience it at some point in their lives. Poor health, alcohol and worries about work or money are big factors.
Loss of sex drive
Another common problem to affect men is a loss of sex drive, or lack of libido. This can be down to any number of factors, including physical – such as poor health or the side effects of medication - and psychological – like relationship issues, stress and anxiety.
Sexual Assault Help
Sexual violence is a crime, no matter who commits it or where or when it happens. Don’t be afraid to get help. St Mary’s Sexual Assault Centre in Manchester offers help and support for women, men and children who have experienced rape or sexual assault, recently or in the past.
Premature ejaculation is where a man reaches climax and ejaculates (comes) sooner than he wants. It can happen to everyone, but becomes a problem if it bothers you or your partner. Anxiety, stress or relationship issues can be some of the reasons behind it.
Non-specific urethritis (NSU) - or non-gonococcal urethritis (NGU) as it is sometimes known – is the name given to the inflammation of the urethra (the tube that carries urine from your bladder) when the causes of the redness and soreness are not known, and a gonorrhoea infection has been ruled out. It’s fairly common, and usually treated by antibiotics.
It is important to go to a sexual and reproductive health clinic for a check-up if you have symptoms of infection. The earlier an infection is diagnosed the easier it will be to treat.
You don’t need to have symptoms to get screened for STIs. If you change your partner, or have condomless sex with someone new, it is a good idea to get a routine screen. You can order self-sampling kits online if you don’t need to go to a clinic.
Sexual and reproductive health services are free and confidential and for women and men of all ages.
Chlamydia is the most common STI in the UK, and is especially common amongst the under 25s, affecting around 1 in 10 young people.
It is a bacterial infection, which often doesn’t have any signs or symptoms. Some people call it the silent infection.
But if left untreated, it can be extremely painful and be very serious for your health, spreading to other parts of your body. It can be responsible for strong pains in your testicles and pelvis, and can even affect your fertility.
The majority of men and women do not show any signs of a chlamydia infection. It can also take several weeks after unprotected sex for any symptoms to develop. These include:
- Unusual discharge from your penis, vagina or rectum
- Pain or swelling in your testicles (men)
- Pain in your pelvis/abdomen (women)
- Pain when urinating
- Heavy periods, bleeding between periods, or bleeding after sex
- Antibiotic tablets (single dose or longer course)
- Complete your treatment and wait 7 days before sexual intercourse
- Tell partners to get tested
As the second most common type of STI after chlamydia, genital warts affect a large percentage of the population.
They are small, usually painless bumps or growths that appear on the skin on or around your genitals or anal area. They do not usually pose a serious threat to your health, but are unpleasant to look at.
Genital warts are caused by a viral infection from the human papilloma virus (HPV), which has many different strains. They are spread by skin-to-skin contact.
You can have the virus and not show any signs of infection. For many people, genital warts take months or even years to develop. They can be:
- On their own (small, smooth bumps)
- In small clusters (larger, cauliflower-like lumps)
- In or around your vagina
- Anywhere on your penis or scrotum
- Around or inside your anus
- On your upper thighs
- Usually painless, but can be itchy and inflamed
You can only have treatment if you have visible warts, as antibiotics cannot be used for viral infections. The type of treatments depends on the warts, but could include:
- Creams or lotions
- Freezing or heating
- Removal via surgery or laser treatment
- Avoid any sexual contact until the warts have cleared completely
Genital herpes is one of the most common STIs, caused by the herpes simplex virus (HSV). This is the same virus responsible for cold sores.
It’s highly contagious, passing easily from one person to another even if you don’t have any symptoms. It causes sore, painful blisters on your genitals.
There is no cure for genital herpes, as the virus remains in your body, but treatment can prevent it worsening.
- Small, painful blisters, ulcers or red sores all around your genitals, anus and the tops of your legs.
- Itching, stinging or tingling around your genitals
- Pain when urinating
- Unusual discharge from your vagina
- Generally feeling run down or unwell, with flu-like symptoms
Many people do not show any visible signs of genital herpes.
Genital herpes will clear up by itself, although recurrent infections are possible. Treatment can reduce the length of the outbreak and speed up healing, and include:
- Antiviral drugs to prevent infection worsening
- Keeping the affected area clean
- Soothing and reducing pain with wrapped ice packs and creams
- Vital that you avoid sexual contact for a week after the infection has cleared, to prevent further infections in both you and your partner.
Gonorrhoea is a bacterial infection, sometimes called ‘the clap’. Similar to chlamydia, it is the second most common STI caused by bacteria.
It can affect anyone who is sexually active, and can be passed on easily. The bacteria responsible for gonorrhoea can live in the urethra, uterus, cervix, rectum, throat and eyes.
Gonorrhoea can cause unusual discharge and a burning pain. If left untreated, it can lead to infertility in both men and women.
Many people infected with gonorrhoea don’t show any signs or symptoms – about half of women, and 1 in 10 men. Those symptoms which do occur usually develop within a couple of weeks, but can take months:
- Unusual green, yellow or white discharge from your penis or vagina
- Pain or burning feeling when urinating
- Swelling of your foreskin (men)
- A single antibiotic injection into your buttocks
- One antibiotic tablet
- Tell your partner(s) you are being treated
- Return for a follow-up appointment and test
Wait until you have the all-clear before any sexual activity. You can still contract gonorrhoea again after treatment.
The Human Immunodeficiency Virus (HIV) is a viral STI that damages your immune system and prevents it from fighting off infections. The final stage of the HIV virus is known more commonly as AIDS (Acquired Immune Deficiency Syndrome).
HIV is transmitted via several ways, most commonly through blood and semen, because of unprotected sex or the sharing of needles. It affects BOTH men and women of ALL sexual orientations.
Prevention is key. HIV cannot be cured once you have it and the virus will remain in your body for life. However, it can be treated and controlled. Most people will not go on to contract AIDS with early diagnosis and treatment.
Although there are no obvious signs of symptoms, around 80% of people will experience a short illness soon after contracting the virus. This includes around two weeks of:
- Sore throat
- Other flu-like symptoms
After that, you can go years without any symptoms, whilst the virus is multiplying and causing damage to your immune system.
Early diagnosis and treatment is vital to prevent serious damage to your body. This includes:
- Regular blood tests to monitor the infection and your immune system
- A combination of antiretroviral drugs
- Emergency ‘PEP’ medication if you have been exposed to HIV within 72 hours and are at high risk of contracting the virus.
Syphilis is an STI caused by bacteria, and although not as common as Chlamydia or Gonorrhoea, it is on the rise in the UK. It’s highly contagious, and passed by any form of sexual contact.
There are three different stages of syphilis: primary, secondary and tertiary. The third stage is rare in the UK, but if syphilis is left untreated, it can cause serious health problems.
Anyone who is sexually active can get syphilis. If caught earlier enough, it can usually be cured with antibiotics. You can catch syphilis again, even if you have previously been treated.
The symptoms of syphilis are usually mild and not very obvious. You may not notice them, or think they are something else, and they will eventually disappear. But you will remain infected unless you get treatment.
- Stage 1: a small, painless sore or ulcer (called a chancre) where the infection entered the body
- This is usually on the vagina, penis or anus
- Stage 2: A non-itchy painless rash
- Flat looking growths, that look like genital warts on the vulva or anus
- White patches in the mouth
- Flu-like illness
- A single antibiotic injection (usually penicillin)
- Or a course of antibiotics in tablet form
- Avoid any sexual activity for at least two weeks after treatment
Pubic lice are tiny, parasitic insects that live in any kind of body hair, including underarm, leg, chest, back, facial and pubic hair.
They are often referred to as crabs because of the way they look. They are about 2mm long, and feed on the human body to survive.
Pubic lice are passed by any kind of sexual or body contact, as well as by sharing towels or bed linen. They cannot jump or fly.
It can take a few weeks for symptoms to show up after getting pubic lice, but they include:
- Itching or irritation in any affected areas
- Black powder (droppings) in your underwear
- Tiny brown dots (eggs) on your hair
- Small blue spots or specks of blood on your skin (lice bites)
Pubic lice are easy to diagnose, and your GP will usually recommend applying:
- Insecticide lotion, cream or shampoo
- This can be applied by yourself at home
- It is usually repeated after a few days to ensure eggs are killed too
Scabies is caused by tiny mites which feed on your skin, burrowing into the top layer to lay eggs. These hatch after a few days, and the new mites rise to the surface of your skin.
Scabies mites like warm places to burrow, including the genital area, around the buttocks, underneath breasts, between fingers and underneath fingernails. They can also hide under straps, rings and bracelets.
The mites cause severe itching and a skin rash. They are very contagious and are spread through close skin-to-skin contact or sexual activity. They can live away from the body for up to 72 hours, so could also be passed by the sharing of towels or clothes.
- Intense itching where mites burrow, usually worse at night, or after a bath or shower
- A skin rash, or tiny red sore spots (which can affect the whole body)
- Crusty sores or inflamed skin if you have been scratching
- Tiny silver-coloured lines, where mites have burrowed
- A cream or lotion on the affected areas to kill the mites
- Wash all bed linen, towels and nightwear at a high temperature (or isolate in a bag for 72 hours)
- Avoid sexual activity or close body contact until all symptoms have subsided