A Anyone can Attend
Anyone can access sexual health services at the Claude Nicol Clinic regardless of age, ethnic group, gender, sexuality, disability or religion. Your information is made anonymous with a number so that your details do not leave the clinic when we send tests. Your GUM medical records are different to your GP and hospital notes and will remain confidential unless you ask us to pass information on.
B Bacterial Vaginosis (‘BV')
This is caused by overgrowth ‘unfriendly' bacteria in the vagina and leads to a thin, watery, grey discharge with an unpleasant smell in women. It can be caused by washing with any type of soap or detergent, smoking and hormonal changes. It is not a sexually transmitted infection (STI) but is more common in women who are sexually active. It can be easily tested for in the GUM clinic and treated with antibiotics.
One in ten sexually active young people has Chlamydia which is caused by a bacteria which passes on through semen and vaginal fluids. You don't need to have lots of sexual partners to get it. It can live in the cervix (neck of the womb), the urethra (urine tube), the rectum (back passage) and the throat. It can cause painful inflammation of the testicles or rectum in men or serious inflammation of the womb in women effecting fertility so it is really important to have it treated with antibiotics (PID see later). 70-80% of men and women will have NO symptoms and may not know they have Chlamydia without having a test.
D Dams and Condoms
Barrier methods are the only reliable way for men and women to reduce the risk of picking up STIs during sex. Even if a woman is using a coil or hormonal contraception, she can still pick up and pass on STIs. Partners should respect a request to use barrier methods, and if you have concerns about how to use condoms or dams you can ask at the GUM clinic.
E coming Early...
If you think you need a sexual health check-up you should try to get an appointment as soon as possible. Leaving it till later might mean any problem just gets worse and you may pass an infection on to partners.
F Family Planning
The GUM clinic can offer Family Planning advice and provides a special service for young people (under 18) who are mature enough to make decisions about their sexual health. Advice can be given on methods including the contraceptive pill, implants and coils, condoms and the cap (diaphragm). Counselling when there is a risk of unplanned pregnancy can also be given. Women who notice their periods are becoming irregular, who miss a period, who have bleeding in between periods or low abdominal pain should consider whether they might be pregnant. These symptoms can be related to STIs and a proper check up can be done at the GUM clinic.
Gonorrhoea is a common STI which may cause a yellow or green discharge from the penis or the vagina. It may also cause pain on passing urine in men, low abdominal pain and bleeding between periods. Men and women can become infected if they come into contact with infected semen or vaginal discharge, or discharge from the throat or rectum. In 10% of men and 50% of women there may be no obvious symptoms. In women Gonorrhoea can cause PID and problems with fertility and in men it can cause painful infection in the testicles and prostate gland. More rarely it can spread to cause rashes, joint pains and even meningitis.
Many people are not aware of the real facts about HIV (Human Immunodeficiency Virus). The virus can be passed on by men and women through sexual contact and by both heterosexual and homosexual sex. There is even a risk of passing on the infection through oral sex, pre-ejaculate fluid (pre-cum) and breast milk. Another important way infection is passed on is by drug users sharing injecting needles. Many people have no idea they are carrying the virus and only find out when they have a blood test. The number of people in Brighton and Hove with HIV infection is increasing.
HIV IS NOT AIDS (Acquired Immunodeficiency Syndrome) but HIV can eventually weaken the immune system leading to the development of illnesses which indicate AIDS. Nowadays there is good treatment for HIV if its picked up early so having the test and knowing your status is really important. The test can be done at the GUM clinic if you want it and involves a simple blood sample. The results will be back within 3 weeks. The best way to protect yourself from HIV if you are having sex is to ALWAYS use barrier protection and think about get tested with your partner. Having an STI can make you more susceptible to catching HIV infection.
I Itching and Scratching?
Several STIs can cause itchy symptoms including Genital Warts, Herpes (Herpes Simplex virus), Scabies (a mite infection) and ‘Crabs' (a louse infection). Thrush (Candida) infection Eczema can be found in the genital area as well, so itchy symptoms are not always caused by STIs. Any itchy symptoms in the groin can be checked at the GUM clinic where they can be properly diagnosed and treated.
J Just a Check Up Please!
You don't have to have a problem to attend the GUM clinic. A lot of people who come are just getting a check up and ensuring that they are safe to start a new relationship with no problems. The common STIs can be tested for and if you have not heard from us in 3 weeks, no news is good news.
There are very few infections that can be passed on through kissing. You cannot catch Chlamydia or Gonorrhoea from kissing.
LGV (Lymphogranuloma Venereum) is a type of Chlamydia which is affecting men who have sex with men (MSM). It usually causes pain and discharge from your bum. It is a serious infection and needs to be treated with a longer course of antibiotics than the more common type of Chlamydia. If it is not treated it can cause scarring and long-term problems in the areas affected. It can be passed on sexually to partners and can be avoided by ALWAYS using condoms and using latex gloves for sexual activity like fisting.
M Men who have Sex with Men
Men who have sex with men (gay, homosexual, bisexual, ‘MSM') may be at higher risk of STIs associated with anal sex, and serious infections associated with bodily fluids such as Hepatitis and HIV. The GUM clinic can offer routine check ups including a proctoscopy examination to take swabs from the rectum (back passage). We can also offer vaccination against Hepatitis A and Hepatitis B. Condoms will help protect against infection and our Health Advisers at the clinic can offer advice on minimising the risk of infection, tests and treatments.
N New Partner?
If you are starting a new sexual relationship you need to think about protecting yourself and your new partner from infections. If you have had partners before, or your new partner has had partners before it is a good idea to think about getting a sexual health check-up before having unprotected sex. If any infections are detected you can be treated before passing the infection on. If a relationship is going to be casual the best way to protect yourself if you are going to have sex is to ALWAYS use barrier contraception. Women need to think about the possibility of becoming pregnant as well.
O Oral Sex
Oral sex means stimulating the penis, clitoris, vagina or anus with the mouth and tongue. It is safer than penetrative sex but people often do not realise that there is still a chance of passing on infections like Chlamydia, Gonorrhoea, Herpes, Syphilis, Thrush, Hepatitis A and B and HIV. Condoms and dams can act as a barrier to passing on infections. There are flavoured condoms available for oral sex but you should ALWAYS use a NEW condom if you are going on to have penetrative sex after oral sex.
Pelvic Inflammatory Disease is a condition in which the uterus (womb) and fallopian tubes in a woman become inflamed. This is often associated with an STI,. Important causes of PID are Chlamydia and Gonorrhoea and in some women this can lead to infertility. The more times a woman gets PID, the higher the chance of infertility. If you have PID you should not have ANY sex until you are treated and given the all clear, and any recent partner is checked and treated so that you do not become infected again.
We do our best to see everyone within 30 minutes of their appointment but sometimes that is not possible as the GUM clinic is a very busy service. You need to expect to spend about two hours at the clinic to be seen, have all your tests and get any initial results. You may think this is a long wait, but bear in mind that this is a very important visit for you, your sexual health and the health of partners. You will be treated respectfully, in confidence and treatments are free of charge.
R higher Risks
Certain sexual activities and behaviours are more risky than others and people who practice these can take precautions to take care of their health. This includes those who have frequent new sexual partners, Injecting Drug Users, Commercial Sex Workers, and MSMs. The GUM clinic will give relevant advice to all those who are at increased risk and help to provide information, and barrier methods. Hepatitis vaccination and emergency treatment in the event of a high-risk exposure to HIV infection (PEP) are available here and we will also see people who have been sexually assaulted.
Syphilis is important because untreated it can cause serious health problems (including heart and brain problems). The bacteria that causes it is called Treponema pallidum and is easily passed on by sexual contact including vaginal, anal and oral sex and by skin contact with someone who has a syphilis ulcer (sore) or a syphilis rash. An ulcer could be in the back of the throat, in the back passage, on the penis or in the vagina. It usually does not cause any pain so it is often missed. Syphilis can be treated with antibiotics after confirming it with tests on an ulcer and a blood test. If it is treated early it will not progress to the serious late stage.
Cancer of the testicles is rare but it is the most common cancer that men aged 15-45 get. Men should regularly do a self-check and see a doctor as soon as possible if any changes are noticed. Signs to look out for include: a hard lump on a testicle, swelling or enlargement of a testicle, and pain or discomfort in the scrotum. Testicular cancer is almost always curable if it is found early so it is really worth while learning how to check yourself, and you can ask about this at the GUM clinic. Alternatively a painful lump or swelling might be related to an STI, but it still needs to be checked as soon as possible.
U Ulcers or Sores
An ulcer is an area of skin where the surface has broken. An ulcer in the genital area should NEVER be ignored, as it may be a sign of a serious infection such as Syphilis. Alternatively, an ulcer might indicate Herpes or other infections. Herpes is a viral infection which can be passed to the groin by oral sex if someone has the cold sore virus or by sexual contact if someone has Genital Herpes. It causes painful outbreaks of blisters and sores. Whatever the cause, an ulcer should be looked at so that you can be properly diagnosed and treated before the problem gets worse, or you pass on an infection to a partner.
V Vagina issues
Vaginal discharge and soreness are important symptoms to look out for. A foreign body or a lost tampon could potentially lead to infection in the vagina. Remember to change tampons regularly. Pain during sex (either on penetration, or deep inside) may be a symptom of an STI too. Being on your period at the time of your check-up will not cause any problem with the test results, all that really matters is that you feel comfortable having a check up at this time.
Genital Warts are one of the most common STIs and are caused by a virus that is passed on by sexual contact in the genital area. They are small bumps which occur in the genital area of both men and women. Many people will have been exposed to the virus in their lifetime and some people never see any warts appear, whereas others do. The infection can be passed on even if penetrative sex does not occur. The virus is not the same as the type commonly causing warts on the hands or the type strongly associated with cancer of the cervix (the neck of the womb). Genital warts don't look nice and may become itchy or bleed sometimes but they do not usually cause longer-term problems. The important thing is people who have warts may have other STIs too and so a sexual health check up is essential. The warts themselves can be treated by freezing or with a liquid or cream, which clears them over time.
So what happens at the GUM clinic? After asking questions to find out about any problems you may have we ask about your sexual history which helps us to know if you are at risk of particular infections. Men will have their groin area, penis and testicles examined, a swab test from the urethra (the water passage) and then produce a urine sample. The whole thing is very quick. Women will have their groin area examined and then swabs taken after a speculum is inserted into the vagina. This enables the doctor or nurse see the cervix (neck of the womb) and take good samples to check on Gonorrhoea and Chlamydia. It is similar to the examination done when you have a Smear Test for early cervical cancer changes, but is not the same as a Smear. It may feel uncomfortable, but should not hurt and is over quickly. Examinations and swabs from the mouth and the rectum may be taken if necessary.
Y Yeast Infections
Thrush (Candida) is a yeast infection that is common in women, causing itch, soreness in the vulva area and a change in vaginal discharge. Thrush can develop if you are pregnant, wear tight clothing with no ventilation, are taking antibiotics, have uncontrolled diabetes or use soaps and detergent products to wash with. It can be passed on by sex with someone who has thrush, but is not considered an STI as it can develop without having had sex. Men can get Thrush, causing irritation, itch and redness at the bell end of the penis (glans) and the foreskin, or a discharge like cottage cheese around the foreskin. Thrush can be treated with cream, pessaries or tablets for women and usually with a cream or tablet for men. It is possible to mistake the symptoms of an STI for Thrush, so it should be properly checked and treated.
What happens before you actually sleep with somebody matters and may have a significant impact on your health. Think about your risks, use barrier methods and consider getting a sexual health check up regularly.