Sexually transmitted diseases (STDs): types, symptoms and treatments

Here’s what you need to know about the most common STDs, how to treat them, and how to have safer sex.

We all know a bit about the existence of sexually transmitted diseases (STDs) and sexually transmitted infections (STIs). But due to a lack of sex education in schools and in general, many of us aren’t able to spot the most common symptoms.

An STD is generally passed from one person to another through sexual contact, specifically, unprotected vaginal, anal or oral sex.

Here’s what you need to know about the most common STDs, how to treat them, and how to have safer sex.

How common are STDs and STIs?
STDs are actually really common, and according to a Terence Higgins Trust 2020 report, one person in the UK is diagnosed with an STI every 70 seconds.

According to Sarah Welsh, a gynaecology doctor and co-founder of vegan condom brand HANX, ‘the most recent stats from the government showed that in 2018, there were just under half a million diagnoses of sexually transmitted infections made in England, which was a 5 per cent increase since 2017. These were all new STI diagnoses, of which 53 per cent were in men, and 47 per cent in women.’

One person in the UK is diagnosed with an STI every 70 seconds.

Welsh says the rate of STI diagnoses are highest in young heterosexuals aged 15-24 years old, black ethnic minorities, and gay, bisexual and other men who have sex with men (MSM), and people residing in the most deprived areas in England.

But it’s not just millennials affected by STIs. 'Older people still need to be vigilant,’ says Dr Deborah Lee, Dr Fox Online Pharmacy.‘Numbers of infections in men and women aged between 45 and 64, increased between 2014-2018, by 18 per cent and 4 per cent respectively.’

For transgender women, there is a high prevalence (0-49.6 per cent) of HIV according to a 2020 review of 25 medical studies. Lee explains there was a lower prevalence in transgender men (0-8.3 per cent), and that transgender women were also at high risk of syphilis, chlamydia, and gonorrhoea.

How serious are STDs?
Lee refers to STDs as serious infections. ‘They can have miserable long term consequences such as infertility, pelvic pain, painful sex, and ectopic pregnancy,’ she says.

‘Some STIs may be fatal, HIV is incurable, and hepatitis C causes liver cancer. Some STIs are also harmful in pregnancy, for example, syphilis.’

Most common STDs
Of the STIs diagnosed in England in 2018, the most common were chlamydia (49 per cent), genital warts (13 per cent), gonorrhoea (13 per cent) and genital herpes (8 per cent), explains Welsh.

STD symptoms to look out for
While every STD has slightly different symptoms, there are common signs to look out for that may indicate you have an STD.

In women and vulva-having people
Abnormal vaginal discharge. Such as ‘any increase in discharge, change in colour or consistency, or smell,’ Lee says.
Abnormal bleeding. ‘Bleeding after sex, in between periods, break-through bleeding on contraception, very heavy periods.’
Lower abdominal/pelvic pain.
Pain passing urine. Burning/stinging, needing to pee more often, smelly urine.
Painful sex.
Sores, spots, or lumps in the genital area.
Feeling itchy in the genital area.
Vaginal soreness.
In men and penis-having people
Discharge from the penis. ‘Any colour, clear, cloudy, purulent, sometimes greenish,’ Lee explains.
Pain when you pee/peeing more often.
Painful sex. Including ‘pain on erection or ejaculation,’ she says.
Sores, spots, or lumps in the genital area.
Feeling sore or itchy in the genital area
Chlamydia
As the most common STD in the UK, in 2018, 218,095 people were diagnosed with chlamydia in England (which was 6 per cent increase from 2017), Welsh explains. ‘It’s important to remember that these numbers only include people diagnosed with chlamydia, and it’s an infection that people often don’t know they have. About 70 per cent of infected females and 50 per cent of males will not have any obvious signs or symptoms or they may be so mild they are not noticed.’

As chlamydia often has no symptoms, it’s important to have regular STI check-ups if you’re having unprotected sex. ‘Other symptoms for chlamydia include pain when passing urine, unusual discharge from the vagina or penis, abnormal bleeding after sex or between periods for women, pain in the testes for men, and pain during sex,’ Welsh explains.

Chlamydia treatment
Chlamydia is easy to treat with antibiotics, and most people (over 95 per cent) will be cured after taking their antibiotics correctly, she says.

Abbas Kanani, pharmacist at Chemist Click says, ‘The first line treatment for chlamydia is doxycycline 100mg, 1 tablet to be taken twice daily for 7 days. Azithromycin 500mg 2 tablets to be taken as a one off dose used to be the recommended treatment, but due to antibiotic resistance it is now a second line treatment reserved for those who are unable to take doxycycline, and it is now taken over three days (2 tablets on the first day, followed by one tablet on the second and third day).’

Gonorrhoea
Since 2009, gonorrhoea has re-emerged as a major public health concerns as diagnoses have risen by 249 per cent overall. ‘This is likely due to high risk behaviour changes, such as having sex without using a condom, and people having more new and casual partners,’ Welsh says. Kanani says these stats are particularly worrying given that drug resistance to gonorrhoea is increasing.

Around 10 per cent of people with gonorrhoea do not have any symptoms, but common symptoms include a thick green or yellow discharge from the vagina or penis, pain when passing urine and, in women, abnormal bleeding between periods, Welsh explains.

Gonorrhoea treatment
Gonorrhoea is usually treated with a short course of antibiotics. But Welsh explains that medical professionals have been concerned over recent years due to a strain of the disease called “super-gonorrhoea” - this is resistant to many of the antibiotics usually used to treat it.

Syphilis
Since 2009, syphilis diagnoses have risen by 165 per cent, Welsh says.

There are three stages of syphilis known as the primary, secondary and tertiary stages. During the primary stage, the most common symptom to look out for is a painless lump about the size of a 5p which could show up around the vagina, penis, anus, mouth or nipple. This lump can then become an ulcer and disappear after six weeks, often fooling people into thinking the issue has resolved.

Genital warts
‘The number of cases of first time genital warts diagnosis has declined by 56 per cent in females, and by 46 per cent by males, most probably attributable to high coverage surrounding the National HPV Immunisation Programme,’ explains Kanani.

If you have genital warts, you’re likely to find one or more painless growths or lumps around your vagina, penis or anus. 'They can cause itching or bleeding from you’re the area and sometimes affect your normal flow of urine,’ explains Welsh.

Genital warts treatment
Treatment for genital warts varies depending on what the warts are like, and this will be assessed by a medical professional. ‘Treatments include creams or liquids that you apply to the warts a few times a week for several weeks, surgery where a professional can cut, burn or laser the warts, and freezing the warts by a professional, usually every week for 4 weeks. These treatments can take a while to work and sometimes need to be repeated if they don’t work. It’s also worth noting that genital warts is caused by a virus and there is no cure, but it’s possible for your body to clear the virus over time,’ Welsh adds.
Human papilloma virus (HPV)
HPV is usually spread through skin-to-skin contact and can affect the vagina, cervix, anus, mouth and throat and result in genital warts and some types of cancer.

Most people won’t experience any symptoms and some people’s bodies will clear the virus naturally. However, more than 30 types of the virus cause genital warts and the most common are HPV types 6 and 11.

HPV can be detected through cervical screening smear tests, which women and vagina-having people between 24 and 65 should attend every three years.

HPV immunisation has led to a steep drop in the first-ever cases of genital warts, explains Kanani. ‘Between 2017-18, in the 15-17 year age group, there was a 56% reduction in genital warts in girls and a 46% reduction in heterosexual boys.’
Genital herpes
Genital herpes are caused by the herpes simplex virus (HSV) type 2. Welsh warns that the infection ‘appears as blisters that burst to leave red, open sores around your genitals, anus, thighs or bottom. These blisters can cause tingling, burning or itching around the area, as well as pain when passing urine. Women may experience abnormal vaginal discharge.’

Genital herpes is also not curable, but there are treatments that can help.

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Genital herpes treatment
Welsh says you may be prescribed anti-viral medication to stop the symptoms getting any worse and pain relief cream. ‘The first episode of genital herpes tends to be the worse, and recurrent outbreaks are usually much milder and clear on their own. Some people might never have more outbreaks, or they may get fewer and fewer over the years,’ she says.

Human immunodeficiency virus (HIV)
Lee explains that numbers of new diagnoses of HIV have fallen by 28 per cent from 6,271 in 2015 to 4,484 in 2018. ‘This is the lowest number of new cases diagnosed over a year, since 2000. This because of new prevention measures which have included increased HIV testing, Treatment as Prevention (TasP) and Pre-exposure Prophylaxis (PrEP).’

Symptoms during the primary infection stage of HIV may include a short, flu-like illness that occurs within six weeks of the infection. However some people experience no symptoms at all.

Six to 12 weeks after the infection, blood tests are able to detect the virus due to the high volume of white blood cells the body creates to fight the virus.

Vaginal thrush
Although not technically an STI, vaginal thrush is a very common fungal infection. Welsh explains that common symptoms include itching and soreness around the entrance of the vagina and the labia, vaginal discharge which does not smell and can be thick and white (cottage cheese like), stinging when you pass urine, pain during sex, and red, swollen or cracked skin around the vagina.

Vaginal thrush treatment
‘Treatment includes a cream to rub around the affected area, a single antifungal tablet that is taken as