Lots of us will have problems with sex from time to time. Help and support is available.

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Lots of us will have problems with sex or relationships from time to time. Don't be afraid to ask for help if you have any concerns.

Sexually transmitted infections (STIs) are one of the main causes of sexual ill-health and can be passed from person to person during vaginal, anal or oral sex. Condoms can be used 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, treatment and support is available from your GP, sexual & reproductive health clinic or Talklistenchange (formerly Relate).

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Understanding your sexual health

Female sexual health

It’s not uncommon to experience problems with sex at some stage in your life. There can be many different causes and reasons for this, and about a third of young and middle-aged women, and around half of older women are estimated to be affected by some form of female sexual dysfunction. Support is always available to help deal with these problems.

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Male sexual health

It’s also very common for men to experience sexual problems. Around 1 in 10 men have an issue with sex and performance at some point in their lives. Problems can be short lived or long-term, and can affect any man, whether he is gay, straight, bisexual or transgender. There’s lots of help and advice available for any of these issues.

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Screening for sexually transmitted infections

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.


Sexually transmitted infections can be passed from an infected person to their partner through sexual contact including oral, vaginal and anal sex. Some infections can also be passed on through skin-to-skin contact during sex.

Common infections include chlamydia, genital herpes and genital warts.

You can have a sexually transmitted infection without realising it. This is because some of the infections have no obvious symptoms. It is for this reason that regular screening for STIs (and HIV) is important. The earlier an infection is diagnosed, the easier it will be to treat or manage.

You can go to a sexual and reproductive health clinic if you have symptoms of infection or if something is bothering you. You might not have an infection but the cause of the symptoms needs to be investigated.

If you have had condomless sex with a new partner since the last time you were screened for STIs, consider getting a routine screen.

You can buy low-cost condoms and lube from the PaSH online shop The Condom Shop.

Understanding the symptoms and the treatments

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) damages your immune system and prevents it from fighting off infections. The final stage of the HIV 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:

  • Fever
  • Sore throat
  • Rash
  • 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