Posts

Common Medical Conditions That Are Asymptomatic

/in , , , /by

Signs and Symptoms are technical terms to describe the extent of disease in a patient. A sign is an effect of the disease that can be observed by another person or elicited through certain manoeuvres while a symptom is an effect that is experienced only by the patient. 

What does being asymptomatic mean?

Being “asymptomatic” is when the patient does have the disease but does not experience any effects of the disease. In this article, we will be discussing 5 diseases where patients are usually asymptomatic in the early stages of the disease but as the disease progresses, it adds an increased burden on the body leading to more pronounced signs and symptoms.

The 5 diseases were selected because while there is no way for patients to know if they have the disease early on due to the lack of symptoms these diseases can be easily detected during health screening with your General Practitioner. Therefore, we hope to highlight the importance of your health screening in allowing your doctor to detect these diseases early and prevent the disease from progressing to a more severe state.

So just before you brush off that health screening appointment because “I feel OK” , have a read to see the benefits or early detection and treatment.

5 Diseases where patients are asymptomatic

Human Immunodeficiency Virus (HIV)

What it is?

HIV infection is a disease in which the virus attacks specific cells (CD4) in the immune system and uses the cells to create more copies of the virus, killing the host cells in the process. In the early stages of HIV, the rate of CD 4 cell production can still cope with the loss from the viral infection, therefore patients are mostly asymptomatic.

Over time as the virus replication picks up pace, the CD 4 cell numbers dwindle and the immune system becomes less effective in responding to environmental insults such as bacterial or fungal infections. Major risk factors for HIV infection include, IV drug use, unprotected casual sex and anal intercourse.

How do you test for it?

Point of Care testing can be done at most clinics in Singapore, this involves taking a sample of blood from a finger prick and placing it into a test kit. Currently, the earliest you can be tested for HIV is 30 days after infection. Early treatment of HIV prevents the virus from replicating and thus prevents the disease from worsening and progressing to Acquired Immunodeficiency Syndrome (AIDS).
HIV Testing Singapore
Anonymous HIV Testing Singapore

Chlamydia

What it is?

Chlamydia is a common bacterial infection in both Men and Women. Infection is usually found in the genital tract but also in the rectum, throat and even eyes. Up to 70% of women and 50% of men are asymptomatic. Left untreated, the bacteria can replicate further to eventually lead to an inflammatory state in the pelvis. This results in severe discomfort and particularly in women the risk of infertility is especially raised if chlamydia is untreated.

How do you test for it?

Chalmydia Rapid testing can be carried out to detect the presence of Chalmydia within 24 hours. A sample is taken from the region, a vaginal swab for women and a urine sample for men, and a Polymerase Chain Reaction is used to detect any chlamydial genetic material. Treatment of chlamydia can be as simple as a single dose of antibiotics if detected at an early stage.
Rapid STD Testing Singapore

Chronic Illnesses

High cholesterol

What it is?

Cholesterol can be thought of in 2 forms, a high density form (HDL) and a low density form (LDL). HDL lowers the total cholesterol in the body while LDL increases it. An increase in cholesterol and triglycerides (both from fatty foods) results in plaques developing within your blood vessels (Atherosclerosis). As the plaques increase in size, blood flow to your vital organs like your heart and brain are compromised thus increases the risk of heart attacks and strokes.

How do you test for it?

A blood test usually done at your health screening enables your doctor to determine the cholesterol levels in your body. Not all elevated cholesterol has to be treated with  medications because changes in diet and lifestyle can also lower cholesterol in some cases. 

Hypertension

What it is?

Hypertension is when your blood pressure is persistently elevated, the normal blood pressure should be below 140 systolic and 90 diastolic. There are myriad of causes for elevated blood pressure including, high salt intake, stress or kidney disease.

However, many people have Essential hypertension, which is when the blood pressure is found to be elevated for no particular cause. Even though the cause may not be determined in most cases of hypertension, patients with an elevated blood pressure have a higher risk of strokes. This is because, the increased pressure in the blood adds additional strain to the blood vessels, eventually, the blood vessels become weaker and are more likely to break, resulting in a stroke.

How do you test for it?

The diagnosis of hypertension in an asymptomatic patient involves a Blood Pressure diary where the patient measures her blood pressure at the start and end of the day for 2 weeks. A persistently elevated blood pressure may prompt the doctor to start treatment, however there are also non-pharmacological means of lowering blood pressure.

Diabetes

What it is?

Diabetes, in particular Type 2 Diabetes, is a condition where the body is unable to regulate carbohydrate metabolism. This results in wide spread effects on the patient because sugar derived from carbohydrate metabolism is essential to many cellular activities in the body. Although patients are mostly asymptomatic in the early stages of the disease, patients can eventually have a variety of pathologies as the disease progresses such as loss of sensation in the hands and feet, poor wound healing, reduced immunity and even blindness.

How do you test for it?

Testing for diabetes also involves a blood test to measure the sugar levels in a fasting state to gauge the current level of sugar metabolism in your body and the Haemoglobin A1c (HbA1c) which is a gauge of the long term extent of sugar metabolism in your body. Depending on the extent of your disease, treatment of diabetes can range of lifestyle modification to injectable medications.

Having a disease in its early stages sometimes means that you still feel “fine” and not experience any symptoms. However, if left untreated, these diseases can progress and lead to severe complications in your health. Getting checked regularly is essential for detecting disease in the asymptomatic phase and treating it early. This prevents the disease from progressing to a more severe state and allows us to lead better, healthier lives. Speak to your doctor today!

Make An Appointment
Find A Doctor

Other Asymptomatic Medical Conditions:

Also on this site: Wart Removal Singapore, STD Check Singapore

Can I get an STD from a hand job?

/in , /by

This is a very common question that I get from patients who come to see me. Some are worried about contracting STDs when giving or receiving hand jobs or masturbation from another person. Generally speaking, there is very little risk of contracting STDs from a hand job.

Even though it is low risk, it is still not zero risk. Let me share with you some points about hand jobs and STDs.

You getting the hand job VS when you’re giving the hand job

Generally hand jobs have very low risk of transmission of STDs. However, if you give the hand job, you are at lower risk of getting an STD as compared to when receiving one. Why is that? STDs tend to affect genitals more than our hands. So if you are at the receiving end, it is your genitals that are at risk. If you are giving the hand job, it is less likely for you to get STDs unless you touch your own genitals after giving the hand job.

Type of STDs that might be transmitted through a hand job

Not all STDs are transmissible via handjobs. It is usually the ones that are passed on through skin to skin contact that are transmissible.

These include: 

  • Herpes Simplex Virus (HSV) Type 1 and 2. This usually causes painful sores or vesicles around the lips or genital areas. There is no cure for the virus but you can take antiviral medication when the symptoms appear to reduce the duration and severity of the symptoms.
  • Human Papilloma Virus (HPV): This virus usually causes genital warts. Warts are flesh coloured growths on the skin. There is also no treatment to treat the virus but there are different types of treatment available to remove the warts when they appear.
  • Molluscum Contagiosum: This is causes by a virus that lives on the skin. It can also be spread via skin to skin contact. It appears as small firm bumps on the skin which are generally harmless and painless. They usually go away on its own or you can get it removed by a doctor through freezing or laser removal.

How can you prevent it? What is considered “safe sex”?

As how we advise for all STDs, abstinence is best. 

Avoid multiple partners. Keeping to one partner minimizes the risk of STDs.

Avoid high risk exposure from sex workers or those who work in massage parlours. These workers have high exposure to several people a day so you will be at higher risk.

Condoms: Condoms may provide some protection. However do take note that areas not covered by the condom is still at risk of STDs.

Get tested to be sure!

If you’re ever in doubt, or unsure of your risks and or symptoms, do seek medical advice. The doctor will be able to advise if you need to get tested or get treated.

Make An Appointment
Find A Doctor

Also on Dtapclinic.com: HIV Test Singapore, STD Test Singapore, Anonymous HIV Testing

Trichomoniasis in Men and Women – Sexually Transmitted Infection

/in , /by

What is Trichomoniasis?

Trichomoniasis (also known as “trich”)  is a very common sexually transmitted infection caused by a parasite (a single-celled protozoan organism) called Trichomonas vaginalis. The US Centers for Diseases Control (CDC) estimates that about 3.7million people in the US have this infection.
Both men and women can be infected with trichomoniasis, although it is more common amongst women.

Only 1/3 of infected individuals actually develop symptoms and asymptomatic individuals can still transmit the infection to their sexual partners.

How is Trichomoniasis Transmitted?

Trichomoniasis is transmitted through sexual intercourse. The parasite commonly resides in the urethra in men (the urine tract), and the lower genital tract (including the urethra, vaginal canal and cervix) in women. Transmission occurs with genital to genital sexual contact. Sex toys may potentially be a mode of transmission if shared. The transmission does not occur through oral intercourse.
DidYouKnow:
Chlamydia, Gonorrhea, and Trichomoniasis are all common sexually transmitted diseases (STDs) that can cause infections in the genitals, rectum and throat. These diseases are easily spread by having vaginal, anal, or oral sex with someone who is infected with the disease. See: Gonorrhea Symptoms 

What are the Symptoms of Trichomoniasis?

In men, the symptoms of trichomoniasis may include:

  • Discomfort, itching or an irritation along the urine tract
  • Dysuria (pain) or discomfort when passing urine
  • Penile discharge
  • Discomfort or pain during or after ejaculation

In women, the symptoms of trichomoniasis may include:

Again, it is crucial to remember that less than half of infected individuals develop symptoms. As with many other STDs, feeling well does not rule out the possibility of trichomoniasis.

Learn More about Other STDs & Other STD Symptoms

What are the Possible Complications of Trichomoniasis?

Trichomoniasis infection in women has been shown to increase the risk of acquiring as well as transmitting HIV to partners.
In pregnancy, trichomoniasis increases the risk of preterm labour in pregnancy (going into early labour before the baby is due) and of the infant being of low birth weight.

How is Trichomoniasis Diagnosed?

In women, trichomoniasis can be diagnosed with a vaginal swab test or a urine test. In men, testing can be done with a urine sample, semen sample or urethral swab. Trichomoniasis is more easily diagnosed in women than in men. See: STD Screening
Test methods that involve nucleic acid amplification testing (NAAT) are highly accurate, while other methods like a culture (waiting for the parasite to grow on a culture medium) may potentially yield false negatives.

How is Trichomoniasis Treated?

Trichomoniasis is treated with oral antibiotics – either metronidazole or tinidazole. Both sexual partners should be treated so as to minimise the risk of the infection recurring.

How Can I Reduce My Risk of Getting Trichomoniasis?

Observing safe sexual practices can help reduce your risk of trichomoniasis – this includes the proper and regular use of condoms, reducing your number of sexual partners as well as ensuring both you and your partner get tested regularly for STDs, regardless of whether you have symptoms or not.
If you would like to find out more about Trichomoniasis Testing and Treatment, come down to any of our clinics for a consultation.
Also see: std test singapore

Mycoplasma Genitalium (MG) – STD Screening, Testing & Treatment

/in /by

Mycoplasma Genitalium (MG) is a type of bacteria that can be sexually transmitted: what it is and why you should be concerned.

  • Women tend to experience vaginal itching, burning on urination, pain during intercourse & etc.
  • Men, on the other hand, may experience urethral discharge, burning on urination, pain or swelling of the testicles & etc.

 

Mycoplasma Genitalium (MG): What It Is & Why You Should Be Concerned.

What is Mycoplasma Genitalium (MG)?

You may have heard of sexually transmitted infections (STIs) like Chlamydia or Syphilis or the feared HIV. But Mycoplasma genitalium (M.gen) may be unfamiliar to most of you, even if you are fairly conscientious in looking after your own sexual health. This is partly because of difficulty in testing for the infection. Up until recently; testing for M.gen was not available in Singapore.
Furthermore, a good proportion of people infected with M.gen may feel completely fine but are still able to spread the infection. So if you’ve done a full STI screen and think you are completely safe because it came back clear, think again- there might just be something else you need to be concerned about.
Mycoplasma genitalium is a tiny, slow-growing bacterium which was first identified in the 1980s. Testing for M.gen has traditionally been very difficult because of the nature of the bacteria. The M.gen bacterium also does not have a cell wall, which means certain classes of antibiotics which are commonly used are unfortunately ineffective against the bacteria. This, coupled with recent increasing antibiotic resistance, makes treatment of M.gen potentially challenging as well.
It is only in more recent years that it is now being recognised as a significant and increasingly more common STI which can cause symptoms in both males and females with potentially more serious consequences.
To put things in perspective as to exactly how prevalent M.gen is, the Centers for Diseases Control (CDC) data indicates that it is more common than Gonorrhea, coming in a close second to Chlamydia.

How is Mycoplasma Genitalium Transmitted?

Mycoplasma genitalium infects the cells in the genital and urinary tracts and can be transmitted through sexual contact including vaginal intercourse, anal intercourse and oral intercourse.

What are the symptoms of Mycoplasma Genitalium?

M.gen can affect both males and females. Both males and females may often be asymptomatic/feel completely well, but can continue to spread the infection to their sexual partners. M.gen is thus a silent but dangerous STI.
In males who do develop symptoms, it can cause urethritis, which manifests dysuria (painful or uncomfortable urination), which may be associated with penile discharge. These symptoms are non-specific and similar to urethritis caused by other STDs like Chlamydia. As of now, M.gen is not yet well linked to more serious symptoms like pain or swelling of the testicles or epididymis (a gland near the testicles), but it is important to remember that data on M.gen is still lacking right now. Learn more about STD Risk From Receptive Anal Sex in Men

10 Causes Of Penile Pain – Ouch! Pain In The Penis

In females, it can cause cervicitis, inflammation of the cervix, resulting in abnormal vaginal discharge, painful intercourse, or bleeding after intercourse (post-coital bleeding) or spotting when one is not having one’s menses (intermenstrual bleeding). If the infection spreads to deeper organs like the uterus and fallopian tubes or ovaries, a condition known as pelvic inflammatory disease (PID) with potentially devastating long-term complications like infertility, one may also experience pelvic pain.

Common STD Symtopms in Women

Anal intercourse can result in M.gen in the rectum and anal canal, but this is generally asymptomatic in another word, does not display symptoms.

Can Mycoplasma Genitalium cause serious infections?

M.gen may very well be one of the next major STIs that the world needs to worry about. While there is a paucity of existing data, emerging research links M.gen to more serious infections with long term health consequences.
There is data to suggest that M.gen can cause Pelvic Inflammatory Disease (PID) in females- the bacterium was detected in women suffering from PID more frequently. Women with tubal factor infertility (infertility due to scarring of the fallopian tubes) were also found to have antibodies to M.gen, suggesting the bacterium could again be responsible or linked to increased risk of infertility. Learn more about Women’s Fertility Screening 
Some studies have also shown that in pregnant women, M.gen is associated with increased risk of pre-term delivery.
It is still uncertain as to whether M.gen can cause infertility in males, but it is important to note that there have been cases where M.gen was detected in men with epididymitis (inflammation of the epididymis).
All in all, we currently still lack robust data about M.gen and the consequences of infection, but overall data does suggest that there may be more to worry about than previously thought.

How is Mycoplasma Genitalium diagnosed?

M.gen was classically known to be notoriously difficult to diagnose because of difficulty in getting the bacterium to grow in laboratory conditions. Testing is done by nucleic acid amplification testing (NAAT) and is not as widely available as testing for other more well-known STIs is.
Until recently, testing for M.gen was not available in Singapore. But you will be glad to know that at DTAP clinic, we now offer testing for M.genitalium.
For males, testing is done using a urine sample. A high vaginal or endocervical swab is performed in females.
If you are a male who is troubled by persistent or recurrent symptoms of urethritis despite antibiotic treatment, and your urine STI screen is persistently “clear” of infection, this is a diagnostic test you should consider.
M.gen is an established cause of urethritis in males. If you may have potentially been exposed to M.gen from a sexual partner, you may also wish to consider getting tested, particularly in light of the above potential complications.
Diagnosis of M.gen is particularly important because of potential antibiotic resistance amongst various M.gen strains. This means that treatment of M.gen may not be so straightforward.

We provide Comprehensive STD screening for Men & Women in all our clinics.

 

Can Mycoplasma genitalium infection be treated?

M.gen is inherently resistant to some classes of antibiotics and there are concerns about increasing antibiotic resistance. It is therefore important that you are treated properly with the correct antibiotic and for an appropriate duration – this makes testing and treatment more crucial than ever.
As always, safe sexual practices including using barrier protection, reducing your number of sexual partners and knowing your partners’ infection status remains crucial in keeping yourself safe and healthy.
If you would like to find out more about Mycoplasma Genitalium testing and treatment, come down to any of our clinics for a consultation.

Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. Is HPV Vaccine Necessary for Males?
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. 11 Causes of Penile Itching & Pubic Itch
  5. HPV Infection & HPV Vaccination for Men who have sex with Men
  6. STD Risk for Receptive Unprotected Anal Sex in Men
  7. Is HPV Vaccine Necessary for Males?
  8. Low HIV Risk Doesn’t Mean No HIV Risk
  9. HIV PrEP for Travel – How You Need to Know
  10. An Overview on STD from an STD Doctor
  11. Everything You Need to Know about Herpes Simplex Virus
  12. How Do I Treat Oral Herpes (Cold Sores)
  13. Syphilis Symptoms – Painless Sore & Ulcers
  14. HIV Symptoms – What You Need to Know
  15. Sex During Period (Sex & Menstruation) What To Know
  16. 10 Common HIV Related to Opportunistic Infections

 

Perianal Warts (Peri-Anal Warts) & Anal Warts Removal

/in , /by

Perianal Warts (aka Peri-Anal Warts, Condyloma Acuminata) are flesh coloured, cauliflower-like growths in and around the anus that is caused by HPV (Human Papilloma Virus).

How Do I Know I Have Perianal Warts?

One of the first occurrences where people note this is new bleeding from the rectum, especially after wiping with toilet paper. Of course, there are many other causes of rectal bleeding, the most common being piles and the most deadly being some form of rectal cancer.
The other way people notice this is when their partner sees it and tells them about it. One would be able to feel the growth with your fingers and also see them with a mirror.

These perianal warts are painless and itchless.

How Can I Catch Perianal Warts?

These cauliflower-like perianal warts are caused by the virus HPV. This is spread through unprotected anal intercourse with a partner who has HPV.
Most often, HPV is symptomless and you can catch HPV from your partner even if he seems completely well.

If I Have Perianal Warts Can I Pass It To My Partner?

Yes the virus which causes perianal warts – HPV, can be passed on to your partner during unprotected anal intercourse.
In the situation, you do not have noticeable perianal warts but your partner develops penile warts after anal intercourse with you, you should also have yourself check for perianal warts and HPV.
Also, you can learn more about symptoms of other STD one can contract from Anal sex

How Do I Check For Perianal Warts?

During a physical examination, what you will tend to notice is “cauliflower-like” growths around the anus. These are usually flesh coloured or a slightly lighter or darker shade.
Other growths that may appear around the anus would be skin tags which can mimic perianal warts to the untrained eye, or even on rare occasions, ulcers which may be red flags of non-benign growths.
The best advice we can offer is to see our doctors to determine whether you truly have Perianal Warts or another condition. We may then take a sample of the growth and send it to the laboratory for confirmation.
All our clinics in Singapore provide Rapid HPV Testing (Next Day Results)
You can learn more about

How is Perianal Warts Treated?

We have covered in this article “How to Get Rid of Genital Warts” some of the commonly used treatments for Perianal warts. We will summarize them here again for your perusal.
The 3 main modalities we use are Creams and lotions, Freezing the wart or “Laser” electrocautery of the wart.

1. Creams and Lotions

Aldara Cream (Imiquimod) is effective for Perianal Warts. The cream is applied 3-4x a week nightly and left for 8 hours overnight. This warts treatment process is repeated for about 6 weeks to get full eradication of the wart. If too much of the cream is applied, some may experience redness and burning of the area as well.
Of course, there is also a small percentage who do not see full resolution and may need other treatments. If too much cream is applied it can cause redness and even blistering of the surrounding skin.

2. Freezing

With a special device that controls the release of liquid nitrogen, we can also freeze the wart. Most people see a resolution after 2-3 freezing treatments over a month. This process is usually painless and no anaesthesia is needed prior.

3. “Laser” Electrocautery

This is usually done in 1 sitting and is enough to eradicate the wart. However, this process often stings and would require some form of anaesthetic to numb the pain prior.

How Can I Protect Myself From Perianal Warts?

One of the best ways to protect yourself is to use a condom if you are intending to have anal sex. This however only confers a rough 30% protection against HPV infection.
There are more than 100 strains of HPV viruses out there, 4 of them are the main high-risk ones causing cervical cancer, anal cancer, throat cancer and penile cancer.
There are new vaccinations available which protect you against these 4 high-risk strains and 5 other low-risk strains which are wart causing. You can read more about Gardasil 9 (HPV vaccination).
Recently the FDA (food drug administration of the USA) announced that Gardasil 9 should be expanded to include Men and Women from 27-45 years of age, thereby providing greater protection against HPV and the risks of those above-mentioned cancers or warts.
You can speak to our doctors to find out more about this HPV vaccination.

Are There Any Other Diseases Associated with Perianal Warts?

Yes as described above there are risks of getting anal cancer, throat cancer, cervical cancer (women) and penile cancer from HPV.

Are There Other STDs Associated with Perianal Warts?

Perianal warts are known to be associated with Rectal Gonorrhoea, HIV, Syphilis and Hepatitis B
If you are interested in HPV Treatment or Anal Warts Removal and Rapid STD Screening for other HPV Strain & other STDs, you can visit any of our clinics.
You can call us or email us for an appointment at hello@dtapclinic.com.sg.
Take Care!

For more information on other STDS.

  1. An Overview of STD by an STD Doctor
  2. Is HPV Vaccine Necessary for Males?
  3. Mycoplasma Genitalium Testing & Treatment
  4. 11 Causes of Penile Itching & Pubic Itch
  5. Sexual Health Advice for Travellers 
  6. HIV & STD in the Singapore Commercial Sex Scene
  7. What is HIV / AIDS Signs and Symptoms
  8. Ouch! 10 Causes of Penile Pain (Pain in the Penis)
  9. 7 FAQs on HIV PrEP (Pre Exposure Prophylaxis)
  10. HPV Infection & HPV Vaccination For Men Who Have Sex With Men
  11. A Guide to HIV Prevention Pills – (HIV PEP & HIV PrEP)
  12. Do I Have HIV Rash? Or Are They From Other STD-Related Rashes
  13. What Are The Causes of Abnormal Penile Discharge
  14. HIV Window Period – Timelines For Accurate HIV Testing
  15. Herpes Simplex Virus – Everything You Need to Know
  16. The Causes of Genital Blister, Genital Ulcer & Genital Sore

 

Genital Blisters, Genital Warts and Genital Ulcers – Causes & Treatments

/in , , , /by

Genital blisters, genital warts, genital ulcers – more common than you think but invariably exceedingly distressing for the person suffering from them. Today we talk a little about the various causes for the above genital skin conditions.
Genital lumps, bumps and sores can be an alarming phenomenon for anyone. One day you notice a tiny little bump, or perhaps several bumps.
Now you’re not sure when they appeared – was your skin normal last week, or did you just never notice the bumps for a good duration? Or perhaps you notice what you thought was a little pimple or an ingrown hair follicle which happens from time to time because you shave. But now it’s burst, leaving a painful raw ulcer.

What are the Causes of Genital Blisters, Genital Warts and Genital Ulcers?

1) What are the Causes of Genital Blisters?

Genital blisters are small, fluid-filled bumps and can occur anywhere over the genital region.

a) Genital Herpes

One of the classic causes of genital blisters is genital Herpes, caused by the Herpes Simplex Virus.
Here’s a video about Herpes

Genital herpes has Several Stages:
Stage 1: Prodrome – the skin appears normal but you may feel an unusual sensation like a tingling or itching. This indicates that the virus is active and heralds an impending outbreak
Stage 2: Redness – you may notice some nonspecific red spots which may be uncomfortable or slightly painful.
Stage 3: Blisters – this is usually when people realise something is not right, Initially, these may resemble tiny pimples. They then grow in size and become fluid-filled and painful.
Stage 4: Ulcers – the blisters burst, leaving shallow, painful ulcers
Stage 5: Scabbing or crusting – a scab or crust forms over the ulcer, which eventually heals
Also, check out What is Oral Herpes & Cold Sore

b) Balanitis

In males, balanitis may sometimes present with tiny blisters. The term “balanitis” is a descriptive term which means inflammation of the head of the penis and foreskin. This usually manifests as skin redness, with some tiny blisters or whitish bumps, as well as possible itching/pain or discomfort.
There can be multiple causes of balanitis. The skin on the penis is no different from skin elsewhere on your body and redness, discomfort and irritation can be caused by many factors:

  • Infections such as fungal skin infections
  • Skin irritation caused by external factors like soaps (irritant or contact dermatitis)
  • Mechanical trauma in the form of excessive friction e.g. masturbation or sexual intercourse with insufficient lubrication
  • Poor hygiene
  • Sensitive skin e.g. in people prone to eczema or dry skin

Depending on the possible underlying trigger or cause, various topical creams may be useful. In some cases, skin swab tests or urine tests may be useful in checking for underlying infections.
Read more about What is a Penile Infection?

2) What are the Causes of Genital Warts?

a) Human Papilloma Virus

This is THE cause of genital warts. Genital warts are skin coloured, fleshy bumps which may occur singly or in clusters around the genital and anal region. They can range from tiny firm bumps to larger, irregular shaped bumps which are classically described as “cauliflower-like” in appearance.
The Human Papilloma Virus (HPV) is a sexually transmitted viral infection. There are many strains of HPV and they are transmitted through sexual contact. Some strains are responsible for genital warts, while other “high risk” strains can lead to an increased risk of cancers such as cervical, oral and anal cancers.
If you have warts, it effectively means you have been infected by at least one strain of HPV. If you are female and you are not already doing your regular PAP smear for cervical cancer, you should do a PAP smear with high risk HPV testing because an individual may have not just one but several strains of HPV. You can read more about PAP smears and cervical cancer screening.
There are various methods available for the treatment of genital warts, ranging from topical medications to freezing or cryosurgery electrosurgery. But one must be prepared that warts can unfortunately recur as the treatment for warts addresses the effects of a HPV infection but does not clear the virus from your body.
The best defence we have against genital warts is the HPV vaccine – Gardasil 9, which provides immunity against certain wart causing strains of HPV.

3) What are the Causes of Genital Ulcers?

When people think of genital ulcers, often the first few causes that spring to mind may be herpes or syphilis. However, genital ulcers can be due to other infections as well as rarer, non-infective causes such as autoimmune diseases.
This is why various tests are useful in differentiating the causes of genital ulcers. The treatment of choice varies drastically depending on what the underlying cause is.
Caused by Sexually transmitted infections (STIs)

  • Herpes Simplex Virus (Common)
  • Syphilis (Common)
  • Chancroid (Rare)
  • LGV (Rare)
  • Donovanosis (Rare)

Non-infective causes

  • Behcet’s (Autoimmune)
  • Crohn’s disease (Autoimmune)
  • Fixed drug eruption (rare causes)
  • Skin Cancer (rare causes)

a) Herpes Simplex Virus

(Painful shallow ulcers and blisters)

As mentioned earlier, both genital blisters and ulcers are different stages of a herpetic flare. A genital skin swab test for the presence of HSV DNA is helpful in confirming HSV as the cause of genital ulcers.

b) Syphilis

(Painless ulcers)

Syphilis can cause ulcers both during its primary and secondary stages.  A chancre, a painless round ulcer, occurs in primary syphilis, while in secondary syphilis, multiple painless ulcers may occur as well. One of the defining traits of a syphilitic ulcer is its painlessness.
These ulcers may be accompanied by other symptoms such as a rash elsewhere on the body.

C) Chancroid

(Multiple painful deep ulcers and swollen groin lymph nodes)
Chancroid is a painful ulcer which is frequently associated with enlarged and painful inguinal (groin) lymph nodes. These are located along your underwear line and may be felt as tender swollen lumps. There are usually several or multiple deep and painful ulcers.
This is caused by a bacterium called Hemophilus ducreyi, which is transmitted through sexual contact. Painful lymph nodes and negative test results for both Herpes and syphilis support this diagnosis. The good news is that antibiotic treatment can clear this up.

Lymphogranuloma venereum (LGV)

Small ulcer, swollen groin lymph nodes, possible rectal pain

Lymphogranuloma venereum (LGV) is an uncommon cause of genital ulcers. It is caused by the bacterium called Chlamydia trachomatis (serovars L1-3). This Chlamydia is different from the “subtype” of Chlamydia trachomat is that causes the common STD you are thinking about. A Rapid Chlamydia & Gonorrhoea PCR test will be about to detect the infection.
The ulcer it causes tends to be small and often goes unnoticed. The lymph node swelling is dramatic and painful and may even discharge pus.
If this was acquired through anal intercourse, inflammation of the anal and rectal canal (known as “proctitis”) can occur, causing rectal pain, bleeding and discharge and diarrhoea.

Donovanosis

Shallow beefy looking ulcers

This is again a rare cause of genital ulcers in the developed world. It is caused by a bacterium called Klebsiella granulomatis and causes shallow ulcers which may bleed easily. This is usually diagnosed with a punch biopsy, which is when a sample of skin tissue is removed for evaluation in the lab.

Other rare causes:

Autoimmune or inflammatory causes, skin cancers, drug reactions

“Autoimmune” diseases occur when your body’s immune system has a tendency to attack itself and one of the many manifestations can be genital ulcers. These are rare and treatment is by a specialist doctor. These ulcers will go away only with good control of the underlying disease.
Sometimes, a bad reaction to a certain medication may cause a persistent, painful ulcer.
Very rarely, genital ulcers may be due to cancer.

All in All

The good news is that most of the above mentioned causes for genital blisters, warts and ulcers can be treated. But an even better step would be to protect yourself from even developing these – safe sexual practices (using barrier protection, doing your regular sexual health screening, and getting the HPV vaccine) are your best bet against these.
Take Care!

  1. HPV Infection & HPV Vaccination for Men who have sex with Men
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. How Late Can a Period Be (Delayed Menstrual Cycle)
  4. What are the Causes of Abnormal Penile Discharge?
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know About Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related to Opportunistic Infections

What are the Sign​s & Symptoms of HIV / AIDS

/in , /by

Human Immunodeficiency Virus (HIV) is a virus that can be spread through sexual contact, contaminated needles, blood transfusions, and other infected body fluids. It targets the immune system, specifically CD4 cells, and if left undiagnosed and untreated, can overwhelm the immune system and cause life-threatening complications.
HIV symptoms can appear at different times for different people, and some may not recall having any symptoms at all until diagnosis (which can be many years after the initial infection).

What are the Different Stages of HIV Infection?

HIV infection occurs in three main stages:

  1. Acute HIV Infection,
  2. Chronic HIV Infection (Clinical Latency Stage),
  3. and Late-Stage HIV or AIDS (Acquired Immunodeficiency Syndrome).

HIV symptoms may vary depending on the individual and the stage of infection, and some people may not have any HIV symptoms at all.

1) Acute HIV Infection

Within the first 2-4 weeks after initial infection, the virus replicates very quickly and HIV viral load will reach a high level. People may experience flu-like symptoms, which they may describe as ‘the worst flu ever’.
This is known as Acute Retroviral Syndrome or ARS. These acute HIV symptoms may occur in about 70-80% of people.
Acute Retroviral Syndrome ARS / HIV Symptoms may include:

  • Fever
  • Night sweats
  • Swollen glands
  • Sore throat
  • Body rash
  • Fatigue
  • Body aches
  • Headache
  • Nausea and vomiting
  • Diarrhea

Acute HIV symptoms can last between several days to several weeks, until the body can develop HIV antibodies to fight the virus. This is also the stage of the greatest infectious risk to others as the HIV viral load is very high. However, do remember that these symptoms are seen in other common conditions as well, and you shouldn’t assume you have HIV just because you experienced them.
If you are concerned about any symptoms or potential exposure, it is best to see a doctor to have them evaluated and consider HIV testing.

Different HIV tests are able to detect the infection at different times

The earliest you may be able to detect the virus is with HIV DNA/RNA PCR testing, which can be accurate from 10-12 days post-exposure. Other more common tests would be the 4th Generation HIV p24 Antigen/Antibody test, which is considered conclusive from 28 days post-exposure.
If you have had a potentially risky exposure within the last 72 hours, you can consider a course of medication called HIV Post-Exposure Prophylaxis (HIV PEP). This works to prevent the virus from replicating and taking hold in the body, and can reduce risk of transmission by more than 90%. It is only effective if started within 72 hours.

2) Chronic HIV Infection

After the early stage of acute HIV infection, the disease enters into a clinical latency stage, where the virus is developing in the body, but no symptoms are seen. During this time, the virus is still active but will replicate slowly inside the cells – it can still be transmitted to others, but the risks of transmission are lower than during the acute phase.
If you have been diagnosed with HIV and are on HIV antiretroviral treatment (HAART), the virus is often kept under control and you may experience a symptom-free period that can last decades. If the virus can be suppressed to undetectable viral load levels, we would deem the risk of transmission extremely low. This stage of HIV infection can last for 5-10 years.
If you have HIV but are not on treatment, then it will eventually progress to late stage infection, known as AIDS.

3) AIDS (Acquired Immunodeficiency Syndrome)

Late Stage HIV / AIDS (Acquired Immunodeficiency Syndrome)
If you have HIV but are not on antiretroviral treatment, it will eventually weaken your immune system and progress to AIDS, or Acquired Immunodeficiency Syndrome.
Symptoms or signs of late stage HIV / AIDS may include:

  • Rapid weight loss
  • Recurring fever
  • Profuse night sweats
  • Extreme tiredness
  • Swollen glands
  • Persistent diarrhea
  • Mouth or genital sores and ulcers
  • Fungal infections, especially oral thrush
  • Shortness of breath, lung infections (e.g. PCP)
  • Memory loss, limb weakness and other neurological disorders
  • Mucous membrane and skin rashes and lesions (patches of reddish-purplish lesions may be characteristic of Kaposi sarcoma)

Many of these signs and symptoms in AIDS are due to Opportunistic Infections (OI’s), which are organisms that usually only cause infections in people with a weak immune system. People with normal functioning immune systems will typically be able to fight these types of infections off, or suppress them so they do not manifest with significant symptoms.
Common types of OI’s include candidiasis (thrush), pneumocystis carinii pneumonia (PCP), tuberculosis (TB), and salmonella colitis infection, among many others.
In someone who is diagnosed with late-stage HIV and whose CD4 cell count is found to be very low, doctors will usually start on certain medications such as antifungals or antibiotics to prevent these OI’s; they will be kept on these medications as prophylaxis, while they are taking their regular HIV medications, until their CD4 count is high enough (indicating their immune system is strong enough to fight off these infections by itself).
Even if you experience the previously mentioned symptoms, it is impossible to confirm HIV infection unless you get tested. If you are concerned about a possible exposure, please visit our clinics for a consultation and evaluation.
Take Care!

Make An Appointment |  Find A Doctor

Other Interesting Reads:

  1. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  2. The HIV Provirus DNA Test can be done 10 days post exposure.
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. An Overview of STD – From an STD Doctor
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. Anonymous HIV Testing – What You Need to Know
  8. Low HIV Risk Doesn’t Mean No HIV Risk
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. What is the Treatment for Cold Sores? What causes Cold Sores?
  13. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes)

Syphilis Symptoms & Treatment (Painless STD Sores and Rashes)

/in , /by

What is syphilis?

Syphilis is a sexually transmitted infection (STD) with many different manifestations and potentially serious complications. It is caused by a bacteria called “Treponema pallidum”.
In the past, before the advent of antibiotics, syphilis was considered a dangerous illness with long-term, devastating consequences which could even affect the brain and nerves.
Thankfully, with the development of penicillin antibiotics and lab tests to detect syphilis infection early, modern medicine is now well equipped to diagnose, treat and cure syphilis well before complications can set in.

Syphilis – Still a Real and Relevant Infection Today

As of recent years though, there has been a rise in syphilis cases amongst both heterosexuals as well as homosexual couples, as reported by the Centers for Diseases Control (CDC), a reminder that syphilis remains a very real infection concern that any sexually active individual should be aware of.
Syphilis is transmitted by direct contact with a syphilis sore, which is a painless ulcer known as a “chancre”. These chancres can occur both in the mouth/oral cavity or in the genital region and the rectum. Sexual contact in the form or oral, vaginal or anal intercourse can all spread syphilis. If a pregnant mother has syphilis, she can also transmit it to her unborn child.

What are the symptoms and different stages of syphilis?

Reading about syphilis can be confusing because it is an infection with different stages and a multitude of varied symptoms.
But to simplify things, there are three stages of syphilis: primary, secondary and tertiary.

Primary Syphilis Symptoms

(usually begins a few weeks up to 3 months from infection)

a.) Syphilis Symptoms: Chancres
  • Painless, round ulcer
  • usually single – occurring at the site where the infection enters the body which is usually in the genital, anal or oral region
  • lasts between 3 – 8 weeks

Note that chancres will heal by themselves and disappearance of the chancre does not mean the infection is gone!

Secondary syphilis

(months or more after initial infection)

b.) Syphilis Symptoms: Rashes
  • Syphilis is known in the medical world as “the Great Mimicker” – so keep in mind that the rash it causes may look very different from what you see in photos!
  • The classic rash is a brownish rash over the palms and soles but syphilis can also cause a rash anywhere over the body
  • May range from very faint rashes to obvious reddish patches
  • Generally not itchy
  • Can occur anytime from when the initial chancre is healing to weeks after
  • May come and go
c.) Snail track ulcers
  • Raw reddish ulcers in the mouth and genital region
d.) Condylomata Lata
  • Raised, greyish patches that occur in moist regions of the body like the groin, armpits
e.) Nonspecific symptoms
  • Fever
  • Enlarged lymph nodes
  • A sore throat

Tertiary syphilis

(occurs decades after initial infection)

  • Tertiary syphilis is now fairly rare as most cases are detected and treated before they progress to this. Symptoms depend on the organs affected by syphilis

NOTES:
Someone with syphilis can also feel entirely well and not have any symptoms- this is known as latent syphilis. If the infection was acquired within the last year, it is considered early latent syphilis, but if it occurred more than a year ago, then it is considered late latent syphilis.
Syphilis can affect the eyes and nerves during any stage of infection. This can result in a variety of symptoms including vision problems, abnormal body movements and even early dementia or memory problems.

What Does a Syphilis Test Do

Who should test for syphilis and what tests are done to diagnose syphilis?

You should test for syphilis…

  • If you have had sexual contact with someone with known syphilis
  • If you have symptoms suspicious for syphilis
  • As part of your regular STD screening if you have an active sex life and have had partners whose infection status you are unsure of

Diagnosis of a syphilis infection is done through a blood test which looks for antibodies to syphilis. Syphilis blood tests can be a little complex and your doctor will be able to explain more to you about the interpretation of results and what to look out for.

What Treatment is Available for Syphilis?

Syphilis infections are treated with penicillin which is administered as an injection. The dosage or number of injections required depends on the stage of the infection.
In unfortunate cases where the infection fails to clear up with initial treatment (which is known as treatment failure), then additional antibiotics may be required for a longer duration of time.
In order to determine if treatment is successful, as well as to monitor for recurrence of the syphilis infection, regular blood tests at intervals of a few months may be required. Until one is clear of syphilis, it is best to abstain from the sexual activity so as to minimise the risk of transmitting the infection to others.
Syphilis remains a problem in the present day, but while it is a potentially serious infection, the good news is that with early diagnosis, the frightening complications that occur with untreated syphilis can very easily be prevented.

Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. What are the Symptoms of HIV Infection and AIDS?
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  12. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

What is the Treatment for Cold Sores? What Causes Cold Sores?

/in , /by

What exactly is a cold sore?
You have probably heard of cold sores or even have had one at some point in your life. But perhaps you’re not entirely sure of what it is caused by and what else you may need to be concerned about.
A cold sore is a small, painful, fluid-filled blister that most commonly occurs near the mouth or on the face, although it may infrequently appear elsewhere on the body. Cold sores tend to occur in clusters.  The appearance of a cold sore is sometimes preceded by an unusual tingling or itching sensation over the same area.
The blisters then form and eventually burst, leaving shallow ulcers/open sores which scab over, forming a crusty lesion. They may come and go, with each flare lasting up to a few weeks.

What Causes Cold Sores?


Cold sores are caused by the Herpes Simplex Virus
There are two types of Herpes Simplex Viruses (HSV) – Type 1 and Type 2.
Cold sores are caused by the Herpes Simplex Virus (Type 1), and genital sores are caused by the Herpes Simplex Virus (Type 2).

genital-herpes

Herpes Simplex Viruses (Type 1)

HSV-1 usually causes cold sores, while HSV-2 tends to be responsible for genital sores. HSV-1 is extremely common in the general population, with the World Health Organisation (WHO) estimating 3.7 billion people under the age of 50 have HSV-1 globally.
Herpes Simplex Viruses (HSV) is transmitted through body secretions.
HSV-1 can be transmitted through saliva via kissing, or sharing of utensils (oral-to-oral transmission), but oral-to-genital secretion can also occur through oral intercourse. This means that someone with cold sores can transmit HSV-1 to their partner’s genitals, resulting in genital sores. An STD Screening can screen for both herpes simplex viruses.
Individuals with HSV are most contagious when they have cold sores, but can still be infectious even when they have no sores or blisters.
Here’s a video about Herpes

Unfortunately, HSV infections are lifelong – meaning there is no cure for HSV and once infected a person carries the virus for life.
This is the reason why cold sores can flare up from time to time. There are certain triggers that can set off an outbreak of cold sores- for instance, environmental factors such as sunlight and cold temperatures, or anything which weakens your immune system, such as an illness, or medications which suppress your immunity.

cause-of-cold-sore

What is the Treatment for Cold Sores?

Antivirals can help clear up and keep cold sores away.
While there is no cure for HSV, the good news is that anti-viral medications (treatment for cold sores) are extremely effective in suppressing the virus and can be used to treat an outbreak of cold sores, and even prevent or minimise future outbreaks.
Some people may not be significantly bothered by their cold sores, which flare up only occasionally and go away by themselves. However, if you are troubled by your symptoms and worried about transmission of the virus to people around you during a flare, anti-virals such as acyclovir or valacyclovir are available as both oral tablets and topical creams.
Sometimes, just the topical cream (treatment for cold sores) may be enough to address your cold sores but if they fail to respond or if your flare is particularly bad, your doctor may prescribe a short course of tablets on top of the cream.
If you are someone who experiences frequent and painful outbreaks of cold sores, or if you are concerned about transmitting the virus to your loved ones, then suppressive anti-viral therapy may be a good option for you. This is when you take the anti-viral medication on a daily basis in order to achieve continued suppression of the virus just like HIV treatment. This not only stops flares from occurring but also reduces your infectivity and the risk of transmitting HSV to others.
Now that you know a little more about, the cause of and, the treatment for cold sores, hopefully, this has helped you realise that you do not need to live with intermittent painful outbreaks. There are treatment options available in our clinics, so if this is an issue which has been troubling you, then it’s time to make that a thing of the past.
Take Care!

Make An Appointment |  Find A Doctor

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. What are the Symptoms of HIV Infection and AIDS?
  3. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  4. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  5. What are the Causes of Abnormal Penile Discharge?
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. 10 Common HIV-related Opportunistic Infections
  9. What is HPV Vaccination (Gardasil 9)
  10. 10 Causes of abnormal Vaginal Lumps and Bumps
  11. An Overview of Gonorrhoea
  12. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  13. How Do I Get an Anonymous HIV Testing?
  14. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

 

What is Rapid Chlamydia & Gonorrhea PCR STD Testing?

/in , , /by

Chlamydia and gonorrhoea are 2 common Sexually Transmitted Infections (STIs) which can infections in various parts of the body such as penis, vaginal, anus, throat and eyes.
Most commonly you will experience discharges from the penis/ vaginal or discomfort when passing urine.
However, the majority of men may not have any symptoms and for women, 50% may also not have symptoms.
The infection will stay in the body for a few weeks after the symptoms have been treated.
In rare instances, Gonorrhoea and Chlamydia can continue to cause damage to the body, specifically the urethra and testicles. Pain may also spread to the rectum. An overview of Gonorrhoea

At Dr Tan and Partners, we recognize that symptoms like abnormal vaginal discharges, penile discharge or discharge from the rectum can cause quite a bit of worry.
Thus, we have introduced a Rapid STD testing (next day results) that can detect these 2 infections within a day.
Which means that you can get the necessary treatment quickly as well.
All it requires is a urine sample or swab from the vaginal/ throat/ anal

This Rapid STD Testing detects for the presence of the DNA of the 2 organisms, making the test very sensitive

If you think you may have symptoms suggestive of chlamydia or gonorrhoea infection or if you think you may have been exposed and you are interested in an STD Screening, please visit a doctor for further evaluation.

Take Care!

Other Reads:

  1. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. HPV Infection & HPV Vaccination for Men who have sex with Men
  4. STD Risk for Receptive Unprotected Anal Sex in Men
  5. Low HIV Risk Doesn’t Mean No HIV Risk
  6. HIV PrEP for Travel – How You Need to Know
  7. An Overview on STD from an STD Doctor
  8. Everything You Need to Know about Herpes Simplex Virus
  9. How Do I Treat Oral Herpes (Cold Sores)
  10. Syphilis Symptoms – Painless Sore & Ulcers
  11. HIV Symptoms – What You Need to Know
  12. 10 Common HIV related Opportunistic Infections