STD General Info
As long as you are having sex, you are at risk of STDs. Unless of course you are in a mutually monogamous relationship. Condoms offer some protection but only abstinence is 100% safe.
Here is a list of some of the common STDs and their symptoms. Please remember that STDs do not produce symptoms all the time. In other words you might have and STD even if you feel 100% completely well. The only way to know for sure is to see a medical professional well trained in STDs and so a STD screening.
Types of STDs
1. *Genital warts/Human papilloma virus (HPV)
3. *Chlamydia/Lymphogranuloma venereum
4. Mycoplasma genitaliae
5. Ureaplasma urealyticum
6. Trichomonas vaginalis
7. Bacterial vaginosis/Gardnerella
8. *Hepatitis A/B/C
11. *Herpes simplex type I/II
12. Molluscum contagiosm
13. Crab lice
16. Granuloma inguinale
17. Tinea cruris
18. Gardnerella vaginalis
1. Penile discharges
2. Vaginal discharges
3. Pain during urination
4. Lymph nodes
5. Misc. Lumps and bumps
6. Pain when having sex/Vaginitis
7. Itch in the genital area
8. Genital sores (painful/painless)
This is the commonest STD in Singapore. Unfortunately, 40% to 60% of people do not show any symptoms. Even when symptoms do appear, they are often mild and disappear quickly.
The common symptoms are pain passing urine, discharge from the penis or vagina.
The symptoms can occur as early as 2 days after exposure but in some people it might take months to show symptoms. In 10% of people there are no symptoms at all.
The common symptoms are pain passing urine and a discharge from the penis or vagina.
It very commonly causes no symptoms at all.
The common symptoms are mild discomfort passing urine or a mild discharge.
It very commonly causes no symptoms at all.
The common symptoms usually occur about 3 to 4 weeks after exposure. They are fever, sore throat, rash and swollen lymph nodes.
It can infect a person for years without showing any symptoms. Sometimes the symptoms are so mild they go unnoticed. For people who do get symptoms, the first time is the worst.
The common symptoms are painful blisters that burst to form painful ulcers. This is usually preceded by a flu-like illness, itching, tingling and pain in the genital area. The first episode is usually very painful and can last up to 3 weeks without treatment.
Hepatitis A, B and C
Some people never develop any symptoms. Or the symptoms are so mild that they go unnoticed.
The common symptoms are nausea, loss of appetite, fever, itching, yellowing of the skin or eyes. Smokers sometimes lose their urge to smoke.
Its symptoms can be so mild that they go unnoticed.
The first sign occurs between 9 to 90 days after exposure. It is a painless ulcer where the Syphilis entered the body. It can be on the penis, vagina, rectum, tongue or lips. The ulcer disappears without any treatment which gives patients a false sense of security.
Years later it will surface again as a rash all over the body and fever. If at the time it is still not treated it will affect the brain and major blood vessels of the body causing severe illnesses.
It commonly appears as discrete pearly round lesions on the skin. They are completely painless but might be itchy.
It commonly appears as skin colored cauliflower like lumps on the skin.
Scabies and Lice
It commonly causes a lot of itching especially at night. Under good lighting and magnification you can actually catch the Scabies which look like translucent tiny insects.
Note: Please remember that you can catch an STD and show no symptoms. If you feel you are at risk, go for STD screening.
Many STDs can infect you and yet show no symptoms. Or they may stay in your body for months to years before they show any symptoms. You cannot determine that your partner has no STDs just because he or she also has no symptoms. If you have been infected with an STD and show no symptoms you can still pass it on to your partner. Condoms reduce the risk of catching STDs but it is not 100% safe.
As long as you are having sex and you are not in a mutually monogamous relationship, there is a chance you have an STD.
It is advisable to go for a thorough STD screening regularly. STDs that are diagnosed early can be easily cured. Also, you reduce the risk of passing it on to your partner.
If not picked up and treated, STDs can lead to permanent damage of your genital organs and affect your fertility. Some STDs like Syphilis, HIV and Hepatitis can damage other organs in your body leading to major illnesses and even death.
STD testing can be very complicated as there are many tests available for different STDs. Some tests are also time sensitive. Please make sure that you consult a Medical Professional with adequate knowledge and experience in testing for STDs.
Your STD screen should include tests for the following:
The most accurate test for this STD is a PCR test on your urine or urethral/vaginal swab. Blood tests are cheap but completely inaccurate.
The most accurate test is a PCR test on your urine or urethral/vaginal swab. If you engage in oral sex you might also need a swab of your throat to test for this STD. If you engage in anal sex you might also need a swab of your rectum to test for Gonorrhea.
NSU (Non-Specific Urethritis)
This consists of tests for Ureaplasma, Mycoplasma and Trichomonas. These tests can be conducted on your urine or a urethral/vaginal swab.
HIV tests are very time specific. There are different tests available including HIV RNA PCR, P24 Antigen/Antibody test, HIV Rapid Antibody tests, ELISA Antibody test. Let your Doctor know when your exposure was and he will advice you accordingly.
There are 2 tests for this STD. They are called VDRL (Venereal Disease Research Lab) and TPHA (Treponema Pallidum Haemagglutination). It is advisable that you have both tests done.
Hepatitis A, B and C
Hepatitis A, B and C are detected through blood tests. You do not need to test for these if you have been vaccinated and previous blood tests have confirmed that you have the antibodies.
Herpes 1 and 2
They can be detected through blood tests.
Certain strains of this STD can be detected through a Cervical Swab for women.
Certain strains can be detected through an anal swab for people who engage in anal sex.
Most other strains of HPV cannot be tested for. Your Doctor will examine your genital area thoroughly for warts. The presence of warts indicate an infection with this STD.
Your Doctor will examine your genital area thoroughly for pearly round umbilicated lesions that are an indication of an infection.
Scabies and Lice
Your Doctor will examine your genital area thoroughly for knits and crabs.
Note: Please remember when you collect your urine for STD tests you need to collect the first catch of urine. This is different from regular urine tests when you need to collect the mid-stream. Check with your Doctor if you are unsure.
STD Screening for MSM (Men who have Sex with Men)
MSM stands for Men who have Sex with Men. There are many other terms used to describe MSM such as Gay Men and Homosexual Men. These are unhelpful labels which might not apply to you. If you are a man and ever have had sex with another man then there are specific STD concerns that apply to you.
The fact is MSM are at a higher risk for HIV and other STDs such as Syphilis, Gonorrhea, Herpes and Warts. There could be several reasons for this. First, the anal canal is not designed for sex. There is a greater chance of tearing and bleeding of the anal canal during sex. This increases the chance of catching HIV and other STDs. Secondly, because many safe sex campaigns are targeted at MSM, this can lead to ‘safe sex burnout’. This results in MSM not taking the usual precautions and protection during sex.
STD and HIV screening in MSM must be conducted in a rational, scientific and non-judgemental fashion. Also, it takes unique experience, skill, techniques and testing procedures to properly screen for STD and HIV in MSM. Our Doctors are specially trained to provide all these services to you in an absolutely discrete setting.
STD and HIV screening is recommended to be conducted at least once a year for MSM. In fact, for MSM of higher risk, screening every 3 to 6 months is recommended. Aside from the regular HIV and STD screening, MSM must take extra careful note of the following:
HIV Screening for MSM
Statistically MSM are at a significantly higher risk of HIV. HIV testing is recommended every 3 to 6 months. The Doctor will recommend different HIV tests depending on the time of exposure.
HIV PEP (Post Exposure Prophylaxis) is a course of medicines that if taken within 72 hours of exposure to HIV has up to a 90% chance of preventing HIV infection. If you have had unprotected anal sex and think you are at risk of HIV, speak to our doctors immediately about HIV PEP.
HIV PREP (Pre-Exposure Prophylaxis) is a course of medicines taken before exposure to HIV that has up to a 90% chance of preventing HIV infection. If you think you might be in a situation that you might be exposed to HIV, speak to your Doctor about HIV PREP. These situations are usually events or parties that involve the use of recreational substances.
It is a serious disease that can lead to blood vessel and brain damage. The initial symptom is a painless ulcer that can be in the anus and therefore not easily seen. Early detection can lead to a complete and early cure.
Aside from screening from the penis, MSM who have receptive oral or anal sex should also test for this STD from the Throat an Anus/Rectum.
It is the most common STD in Singapore. Aside from screening from the Penis, MSM who have anal sex should also test for this STD from the Anus/Rectum.
It is a common STD and an essential part of STD screening.
Hepatitis A, B and C
The prevalence of Hepatitis A, B and C among MSM is high. Vaccination is a very cost effective way to prevent such infections. If you already have been vaccinated, speak to your Doctor about doing a serologic test to ensure the antibodies are enough.
They are very common in MSM who have receptive anal sex. It is caused by the HPV virus. There is no blood or urine test for this. Doctor will have a check on your peri-anal area carefully for the presence of warts.
HPV and Anal Cancer
Certain strains of HPV will not cause warts but might increase the risk of Anal Cancer. This is more so in MSM who also suffer from HIV. Speak to your Doctor about doing an anal swab fro cancer causing HPV and anal cancer.
Singapore might be a conservative society and the 377A penal code might still be in force. But please do not let this worry you. Our Doctors are well trained, respectful and discrete. We are here to help you. Please feel free to discuss any of your problems with us.
The questions are used to determine your at-risk status for sexually transmitted diseases (STDs),
- I have had “sex” without using a condom. YES/NO
- I have had “oral sex” without using a barrier. YES/NO
- I have had sexual contact with someone who has had sex with another person other than myself. YES/NO
- I am in a relationship and neither my partner or myself had been tested for STD. YES/NO
If you have answered “YES” to any of the questions, you may be at risk for STDs.
About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.