After you have been infected with the genital wart virus it usually takes between 1 and 3 months for warts to appear on your genitals.

You or your partner may notice pinkish/white small lumps or larger cauliflower-shaped lumps on the genital area. Warts can appear around the vulva, the penis, the scrotum or the anus.

They may occur singly or in groups. They may itch, but are usually painless. Often there are no other symptoms, and the warts may be difficult to see. In women genital warts can develop inside the vagina and on the cervix.

If a woman has warts on her cervix, this may cause slight bleeding or, very rarely, an unusual coloured vaginal discharge.

Not everyone who comes into contact with the virus will develop warts.

Genital warts are spread through skin-to-skin contact. If you have sex or genital contact with someone who has genital warts you may develop them too.

They can be passed on during vaginal or anal sex. (It is possible for warts to spread to the area around the anus without having anal sex.)

A doctor or nurse can usually tell whether you have genital warts just by looking. If warts are suspected but not obvious, the doctor may apply a weak vinegar-like solution to the outside of the genital area. This turns any warts white.

To check for any hidden warts, the doctor may carry out an internal examination of the vagina or anus.

As genital warts are caused by a virus and not a bacteria, antibiotics will not get rid of them.

A common treatment is a brown liquid (podophyllin) which is painted on to the wart(s) and must be washed off 4 hours later (or sooner, if the area is irritated). The clinic may prescribe podophylotoxin for use at home. Another common treatment is freezing the warts or laser treatment. Often more than one kind of treatment is necessary before the warts are gone.

These treatments may be uncomfortable, but they should not be painful. If your treatment hurts, tell the doctor. You should get individual advice about having sex during treatment from your doctor, nurse or health adviser.

Never try to treat genital warts by yourself. Always seek medical advice.

If you’re pregnant, or trying to become pregnant, it is important that you tell your doctor, as podophyllin treatment could harm the developing baby and another treatment will be used.

It is important to return regularly for treatment until your genital warts have gone so that the doctor or nurse can check progress and make any necessary changes in your treatment. Sometimes treatment can take a long time. The majority of people whose genital warts initially disappear will get a recurrence.

Symptoms of infection may show up at anytime between 1 and 14 days after exposure. It is possible to be infected with gonorrhoea and have no symptoms. Men are far more likely to notice symptoms than women.

Women

• a change in vaginal discharge. This may increase, change to a yellow or greenish colour and develop a strong smell
• a pain or burning sensation when passing urine
• irritation and/or discharge from the anus

If left untreated gonorrhoea can lead to pelvic inflammatory disease (PID). This is inflammation of the fallopian tubes which can cause fever, lower abdominal pain and backache. Sex may be uncomfortable. PID can cause a woman to become infertile or have an ectopic pregnancy. A separate factsheet on PID is available.

If you’re pregnant and you have gonorrhoea when your baby is born, you could pass the infection on. Also your baby could be born with a gonoccocal eye infection. This must be treated with antibiotics as it can cause blindness. But it is better for you to be treated before the birth.

Men

• a yellow or white discharge from the penis
• irritation and/or discharge from the anus
• inflammation of the testicles and prostate gland

Gonorrhoea can cause inflammation of the testicles and the prostate gland, which causes pain. Without treatment a narrowing of the urethra or abscesses can develop.

Once gonorrhoea has been successfully treated, it will not come back unless you become reinfected.

Remember, after treatment, using condoms during sex can reduce your risk of getting or passing on sexually transmitted infections.

Gonorrhoea can be transmitted by:

• by penetrative sex (when the penis enters the vagina, mouth, or anus)

and less often by:

• rimming (where a person uses their mouth and tongue to stimulate another person’s anus)
• inserting your fingers into an infected vagina, anus or mouth and then putting them into your own without washing your hands in between

• an examination of your genital area is carried out by a doctor or a nurse
• samples are taken, using a cotton-wool or spongy swab, from any places which may be infected - the cervix, urethra, anus or throat
• women are given an internal pelvic examination
• a sample of urine may be taken

None of these tests are painful, but may sometimes be uncomfortable. If you have had anal sex, it is important to tell the doctor so that a swab can be taken from your rectum. Also tell the doctor if you have had oral sex.

Samples taken during the examination are looked at under a microscope to check for gonorrhoea infection. In some clinics, the result is available immediately.

A second sample is sent to a laboratory for testing, the result of which is available usually within one week.

Treatment is easy and essential. You will be given an antibiotic in tablet, liquid or injection form. If you are allergic to any antibiotics, or if there is any possibility that you may be pregnant, it is important that you tell your doctor. It is important to complete your course of treatment.

If you are told you have gonorrhoea, you may be asked to see a health adviser who will explain the infection to you and answer your questions. The health adviser will also ask you about your sexual partner(s), so that they can get a check-up and treatment if necessary.

You should not have penetrative sex until you have returned to the clinic and been given the all-clear by the doctor. The doctor or health adviser will tell you about which sexual activities are safe.

Once you have completed your course of treatment for gonorrhoea, you should return to the clinic or GP for a check-up.

Some types of gonorrhoea are resistant to certain antibiotics, especially if you acquired the disease abroad. Further tests will be done to make sure that the infection has cleared. If it has not, you will be prescribed a different antibiotic.

People may have no symptoms at all, but they can still pass on the hepatitis virus to others. Symptoms may include:

• a short, mild, flu-like illness
• nausea and vomiting
• diarrhoea
• loss of appetite
• weight loss
• jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces)
• itchy skin.

Some people may need to be admitted to hospital.

The hepatitis A virus (HAV) is a common infection in many parts of the world. It is possible to become infected through eating or drinking contaminated food or water. The hepatitis virus is found in faeces.

It can be passed on if even a tiny amount of faeces from a person with hepatitis A comes into contact with another person’s mouth.

This means the virus can also be passed on sexually through practices such as rimming. Personal hygiene, with careful hand washing, can minimise the risk of the virus being passed on.

Your GP or doctor at an NHS sexual health (GUM) clinic can diagnose hepatitis A by carrying out blood tests. You will be asked questions to try to discover the source of the infection.

What does a positive result mean?

It could show:

Past infection. This means that you have been in contact with the hepatitis A virus and your body has cleared it. You now have a natural protection against future infection with the hepatitis A virus.

Current infection. By the time most people have developed symptoms of hepatitis A they will be less infectious to others, but in the weeks before this there will have been a risk of passing on the infection. Your doctor will ask you questions to find out if others have been at risk of hepatitis A. Those who have been in contact with the virus and have become infected may be given an injection to reduce the severity of the symptoms.

Most of the symptoms of hepatitis A settle after a few weeks, although some people can feel tired for a number of months after infection. There is little likelihood of chronic liver damage and no chronic carrier state (where a person remains chronically infected).

What does a negative test result mean?

This result means that you have never been in contact with hepatitis A and have no natural protection against it.

If you are thought to be at risk of hepatitis A infection, the doctor may advise you to be immunised.

Infection with hepatitis A is usually mild, but occasionally causes severe inflammation of the liver, requiring admission to hospital.

If you are infected with hepatitis A, you should limit the amount of alcohol you drink. The doctor may also offer you dietary advice.

Your doctor will advise you about any precautions necessary to ensure that you avoid infecting others with the virus.

For hepatitis A you are given a single injection in the arm which gives you protection for a year. A second booster injection at 6 to 12 months gives you protection for up to 10 years. Most hepatitis A immunisations are given to people who are travelling to parts of the world with a high incidence of hepatitis A.

These injections are available from your GP.

You can also get immunised to prevent hepatitis A developing, if you have recently come into contact with it.

Immunisation is also recommended for those whose sexual practices are likely to put them at risk.

People may have no symptoms at all, but they can still pass on the virus to others. Symptoms may include:

• a short, mild, flu-like illness
• nausea and vomiting
• diarrhoea
• loss of appetite
• weight loss
• jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces)
• itchy skin.

Some people may need to be admitted to hospital.

Most adults infected with the hepatitis B virus fully recover and develop life-long immunity. Between 2% and 10% of individuals infected as adults will become chronic carriers, which means they will be infectious to others and can develop chronic liver damage. Infected children, especially new-born babies, are much more likely to become chronic carriers.

If a person continues to be infected over a number of years with the hepatitis B virus, they could develop the following complications:

• chronic hepatitis
• liver cirrhosis
• liver cancer

The hepatitis B virus (HBV) is very common worldwide. It is very infectious.

The virus can be spread in the following ways:

• by unprotected (without a condom) penetrative sex (when the penis enters the anus, vagina or mouth) with someone who is infected. Also by sex which draws blood with someone who is infected
• by sharing contaminated needles or other drug-injecting equipment
• by using non-sterilised equipment for tattooing, acupuncture or body piercing
• from an infected mother to her baby, mainly during delivery. Immunisation of the baby at birth prevents the transmission of hepatitis B
• through a blood transfusion in a country where blood is not tested for the hepatitis B virus. All blood for transfusion in the UK is tested.

Your GP or doctor at an NHS sexual health (GUM) clinic can diagnose hepatitis B by carrying out blood tests. You will be asked questions to try to discover the source of the infection.

What does a positive result mean?

It could show:

Past infection. This means that you have been in contact with HBV and your body has rejected it. You now have a natural protection against the virus.

Carrier. This means that you carry HBV and can pass it on to others. You are at risk of chronic liver disease and may be referred to a specialist centre for further assessment.

A positive result can be confirmed by further tests and referral to a specialist. To find out how much hepatitis B may be affecting the liver, and what may be the best treatment for this, a small sample of liver tissue may need to be taken (a liver biopsy).

What does a negative result mean?

This result means you have never been in contact with HBV and have no natural protection against it.

If there is a chance you have been recently exposed to the virus, your doctor may advise you to have a repeat test and be immunised against hepatitis B.

Many people do not require treatment, as the inflammation of the liver may not be severe. If you need treatment for liver inflammation, you will be referred to a specialist centre for a full assessment.

If you are diagnosed as having an active infection with hepatitis B, you will be advised to have regular blood tests and physical check-ups. All carriers should expect to be referred to specialist services.

If you are infected with hepatitis B, you should limit the amount of alcohol you drink. The doctor may also advise you to avoid fatty foods and follow a low-salt diet.

If you have hepatitis B, you should use a condom for penetrative sex to prevent passing on the virus.

Your partner should also be immunised against hepatitis B ( if not already infected).

Your doctor will advise you about any precautions necessary to ensure that you avoid infecting others with the virus, such as not sharing toothbrushes or shaving equipment.

Three injections are given over a period of 3-6 months. A blood test is taken once the course of injections is completed to check that they have worked. Immunity should last for at least 5 years.

The injections are available at your local NHS sexual health (GUM) clinic, or from your GP.

People may have no symptoms at all, but they can still pass on the virus to others. Symptoms, though not common, may include:

• a short, mild, flu-like illness
• nausea and vomiting
• diarrhoea
• loss of appetite
• weight loss
• jaundice (yellow skin and whites of eyes, darker yellow urine and pale faeces)
• itchy skin

Some people may need to be admitted to hospital.

Current evidence suggests that only about 20% of individuals who have been infected with the hepatitis C virus appear to clear the virus from the blood, whilst about 80% will remain infected and can pass on the virus to others. If a person continues to be infected over a number of years with the hepatitis C virus, they could develop the following complications:

• chronic hepatitis
• liver cirrhosis
• liver cancer

The hepatitis C virus (HCV) can be spread in the following ways:

• by sharing contaminated needles or other drug-injecting equipment. If you have ever shared drug-injecting equipment, you may want to be tested for hepatitis C
• by using non-sterilised equipment for tattooing, acupuncture or body piercing
• by unprotected (without a condom) penetrative sex (when the penis enters the anus or vagina) with someone who is infected. Also by sex which draws blood with someone who is infected. This is not a common way of becoming infected with hepatitis C
• on rare occasions, from an infected mother to her baby, mainly during delivery. The risk may be greater if the mother is also infected with HIV
• through a blood transfusion in a country where blood is not tested for the hepatitis C virus. All blood for transfusion in the UK is tested

Tests for the hepatitis C virus (HCV) have only been available since 1989.

Your GP or doctor at your local NHS sexual health (GUM) clinic can diagnose hepatitis C by carrying out blood tests. You will be asked questions to try to discover the source of the infection.

If you are diagnosed as having an active infection with hepatitis C, you will be advised to have regular blood tests and physical check-ups. All carriers should expect to be referred to specialist services.

If you are infected with hepatitis C, you should limit the amount of alcohol you drink. The doctor may also advise you to avoid fatty foods and follow a low-salt diet.

Transmission of the hepatitis C virus by penetrative sex does occur, although it is not common. If you are infected it is advisable to use a condom for penetrative sex to ensure that you do not pass on the virus to your partner(s).

Your doctor will advise you about any precautions necessary to ensure that you avoid infecting others with the virus, such as not sharing toothbrushes or shaving equipment.

NSU may be experienced months or even in some cases years into a relationship. The symptoms of NSU may include:

• pain or a burning sensation when passing urine
• a white/cloudy fluid from the tip of the penis. This may be more noticeable first thing in the morning
• feeling that you need to pass urine frequently

Often there may be no symptoms, but this does not mean that you cannot pass the infection on to your partner(s).

NSU may recur. A recurrence may be triggered by excessive friction during sex or masturbation, or by excessive alcohol consumption. Serious complications are rare. If they do occur you may experience:

• inflammation of the testicles
• reduced fertility
• Reiters syndrome - which causes inflammation of the eyes, joints and urethra, and sometimes sores on the penis or soles of the feet

NSU is almost always caused through sexual infection. Very rarely it can result from an allergic reaction, such as to bubble baths or washing powders or other chemicals.

• a physical examination of your genital area by a doctor or nurse
• samples are taken, using a cotton-wool or spongy swab, from the penis or urethra
• a sample of urine is taken

None of these tests should be painful, but they may be uncomfortable.

Samples taken during the examination are looked at under a microscope to check for infection. In some clinics, the result is available immediately. A second sample is sent to a laboratory for confirmation of the infection. The result is usually available within one week.

Treatment for NSU is easy. You will be given antibiotic tablets. If you are allergic to any antibiotics, it is important that you tell your doctor.

It is important that you finish any course of treatment. If treatment is interrupted, it may be necessary to start again from the beginning.

Your partner should also attend the clinic for a check-up.

It is important to return for a check-up after you have completed the treatment to ensure that the infection has gone.

You should not have penetrative sex (when the penis enters the vagina, mouth or anus), not even with a condom, until you have returned to the clinic and been given the all-clear by the doctor.

The signs and symptoms of syphilis are the same in both men and women. They can be difficult to recognise and may take up to 3 months to show after having sexual contact with an infected person. Syphilis has several stages. The primary and secondary stages are very infectious.

Primary stage

One or more painless sores appear at the place where the syphilis bacteria entered the body. On average, this will be after 21 days. You may not notice them. These sores can appear anywhere on the body but mainly:

• on the vulva (lips of the vagina), the clitoris and around the opening of the urethra (the water passage)
• on the cervix (neck of the womb) in women and on the penis and foreskin in men
• around the anus and mouth (both sexes)

The sore (or sores) is very infectious and may take from 2 to 6 weeks to heal.

Secondary stage

If the syphilis infection remains untreated the secondary stage usually occurs 3 to 6 weeks after the appearance of sores. The symptoms include:

• a non-itchy rash covering the whole body or appearing in patches
• flat, warty-looking growths on the vulva in women and around the anus in both sexes
• a flu-like illness, a feeling of tiredness and loss of appetite, accompanied by swollen glands (this can last for weeks or months)
• white patches on the tongue or roof of the mouth
• patchy hair loss

When these symptoms are present, syphilis is very infectious and may be sexually transmitted to a partner. Treatment at any time during these first two stages of syphilis will cure the infection.

Latent stage

Latent syphilis refers to the presence of untreated syphilis. You can have no symptoms or signs of the infection, which is diagnosed by a positive blood test. If left untreated, you may develop symptomatic late syphilis. This would usually develop after more than 10 years. It is then that syphilis can affect the heart, and possibly the nervous system.

If treatment for syphilis is given during the latent stage the infection can be cured. However, if there has been heart or nervous-system damage before treatment is started this may be irreversible.

Syhpilis can be transmitted by:

• having sex with someone who has the infection
• a mother to her unborn baby

• a blood sample is taken.
• if you have a sore, a specimen of fluid is taken from this and looked at under a microscope
• your genital area and whole body are examined by the doctor
• samples are taken, using a cotton-wool or spongy swab, from any sores
• women are given an internal examination
• a sample of urine is taken

None of these tests should be painful, but they may be slightly uncomfortable.

Samples taken during the examination are looked at under a microscope to check for infection. Samples are sent to a laboratory for testing. The result is usually available within one week.

If you are told that you have syphilis a health adviser will explain the infection to you and answer any questions you may have. You will also be asked about your sexual partner(s), so that, if necessary, they can get treatment too.

If it is suspected that you have the early infectious stages of syphilis, you should not have oral, vaginal or anal sex. You should also not have any kind of sex involving contact between your partner and any sores or rashes you may have until the treatment is completed. Treatment for syphilis is usually a 2-week course of penicillin injections or, in some cases, antibiotic tablets or capsules.

If you are allergic to any antibiotics, or if there is any possibility that you may be pregnant, it is important that you tell your doctor. It is important that you finish any course of treatment. If treatment is interrupted, it may be necessary to start again from the beginning.

Once you have completed your treatment, you will be asked to attend the clinic at regular intervals for blood tests.

In the UK blood tests for syphilis are given to all pregnant women when they visit an ante-natal clinic. If syphilis is found, treatment can safely be given during pregnancy with no risk to the unborn baby. If a woman has untreated syphilis she may pass the infection to her baby in the womb. In some cases this can lead to miscarriage or stillbirth.

Once syphilis has been successfully treated, it will not come back unless you become reinfected. However your blood test will be positive in any future tests (e.g. for immigration reasons). Make sure you get a certificate from your clinic explaining about your treatment.

Remember, after treatment, using condoms during sex can reduce your risk of getting or passing on sexually transmitted infections.