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

24th December 2018/in Herpes, HPV (Human Papilloma Virus), Skin, STD & HIV /by Miri Yeo

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!

Syphilis Symptoms & Treatment (Painless STD Sores and Rashes)

17th December 2018/in STD & HIV, Syphilis /by Miri Yeo

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!

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

16th December 2018/in General Health, STD & HIV /by Miri Yeo

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).

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.

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!

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Why Do I Have Abnormal Vaginal Discharge?

14th December 2018/in Women's Health /by Miri Yeo

Let’s talk a little about normal vaginal discharge first.

The vagina is a muscular passage which leads from the vaginal opening to the cervix, which is the entrance to the womb. There are naturally occurring “good” lactobacillus and other bacteria which are part of the normal vaginal flora. The walls of the vagina have glands which produce secretions for the cleansing of the vaginal canal. Normal vaginal discharge is a result of these secretions. It is usually clear or whitish and largely odourless and may change slightly throughout your menstrual cycle.

via GIPHY

How to identify abnormal vaginal discharge and what you should be worried about?

However, when you notice a major change from your usual vaginal discharge, this abnormal vaginal discharge may indicate that something is wrong.
Signs that your vaginal discharge may be abnormal include different coloured discharge – greenish, yellowish, greyish or even brownish discharge, the presence of a bad vaginal odour, changes in discharge consistency such as thicker, clumpy discharge or large amounts of watery discharge.
If this discharge is accompanied by abdominal pain, fever, or spotting/bleeding after sexual intercourse or bleeding when your period is not due yet, then these are all alarming features that should Fprompt you to consult a doctor.
Abnormal vaginal discharge is one of the most common female health problems and it should not be something you feel you have to suffer in silence about. Most ladies will experience this at some point in their life and while it can be an extremely distressing and uncomfortable problem, it is very treatable.

You probably have a vaginal infection.

The top cause of abnormal vaginal discharge is a vaginal infection, also known as vaginitis. Other rare causes of abnormal vaginal discharge include cervical abnormalities such as cervical cancer.
The next question, then, would be what sort of infections you have to worry about if you are experiencing abnormal vaginal discharge. These can broadly be divided into Sexually Transmitted Infections (STIs) and non-Sexually Transmitted Infections (STIs).
The most common causes of abnormal vaginal discharge are non-sexually transmitted infections- Bacterial Vaginosis and yeast infections. These all occur when there is disruption to the delicate balance of your healthy vaginal flora and can be triggered by a multitude of factors.
However, if you have had unprotected sexual intercourse, particularly if you are unsure of your partner’s infection status (whether this be a casual partner or a long-term partner), then your abnormal vaginal discharge may very well be due to a Sexually Transmitted Disease (STD) such as Chlamydia, Gonorrhoea, Trichomonas, and various types of Mycoplasma and Ureaplasma bacteria.
Regardless of the underlying cause of your abnormal vaginal discharge, proper evaluation is crucial as it allows you to receive the appropriate treatment, which is important not just in relieving your discomfort but also in preventing more serious, long-term complications (like Pelvic Inflammatory Disease) that can occur with certain infections.

Why does the abnormal vaginal discharge keep coming back?

This is a very common question and recurrent abnormal vaginal discharge can be an extremely frustrating and distressing issue.
Recurrent yeast infections and bacterial vaginosis tend to be responsible for the above phenomenon and can be triggered by a variety of factors which upset the balance of your vaginal flora.

1) Hormonal Fluctuations

For some ladies, they may find that the hormonal fluctuations during their peri-menstrual period (before or after menses), may cause them to be prone to recurrent yeast infections.
Pregnancy

2) Weakened Immune System

If you have diabetes or are undergoing any other sort of medical treatment that affects your immunity, you may be more prone to recurrent yeast infections.

3) Sexual Lifestyle

Sexual intercourse can trigger off bacterial vaginosis – in fact, the number of sexual partners which one has had is actually a risk factor for bacterial vaginosis, with every new partner that a lady has increased the risk of Bacterial Vaginosis infections.
Other habits like using spermicide may also kill off the good lactobacilli in the vagina and lead to increased susceptibility to infection

4) Medications

Being on the combined oral contraceptive pill does increase your risk of recurrent yeast infections
Antibiotic usage (for instance, taking something for a bacterial throat infection) can also (ironically) upset the delicate balance down there

5) Hygiene Habits

Use of vaginal douche washes or feminine washes with harsh chemicals can disrupt your natural vaginal balance and lead to increased yeast and BV infections
Tight underwear, pantyliners or menstrual pads which trap humidity and moisture may also place you at increased risk for a yeast infection

As can be seen, not all triggers may be entirely avoidable but good habits- like avoiding feminine douche washes, wearing breathable cotton underwear, minimising antibiotic use unless medically indicated, and using condoms- do play a part in helping you maintain a healthy vagina.
If you keep having abnormal vaginal discharge that comes back with a vengeance after the initial episode, do speak to your doctor about additional treatment that may be suitable for you.

Remember that you are not alone – abnormal vaginal discharge is common – and treatable!
Don’t let your discomfort about the topic keep you from treatment.

Take Care!

What is Rapid Chlamydia & Gonorrhea PCR STD Testing?

30th October 2018/in Chlamydia, Gonorrhoea, STD & HIV /by Miri Yeo

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:

An Overview of Gonorrhoea Symptoms

17th April 2018/in Gonorrhoea, STD & HIV /by Miri Yeo

Gonorrhoea symptoms in Men & Women can include discharge, painful urination and itch. Some people who are infected may not display any signs or symptoms.

What is the Cause of Gonorrhea?

Gonorrhoea is one of the most common Sexually Transmitted Infection (STI) in women. It can cause infections in the vagina, rectum, and throat.
Gonorrhoea is known to be easily transmittable via both penetrative and oral sex. It can infect the reproductive system and less commonly, the throat or eyes. A maternal to child transmission is also possible here.
Similar to Gonorrhoea, Chlamydia is a common sexually transmitted disease caused by bacteria called Chlamydia trachomatis. Gonorrhoea is caused by the bacterium Neisseria gonorrhoeae.

In women, gonorrhoea affects the cervix and its functions 90% of the time.

via GIPHY

What are the risk factors for contracting Gonorrhea?

Multiple sexual partners
New sexual partner
Unprotected sex
Men that have sex with Men (MSM)
A sexual partner who has an STI
Having concurrent STI

What are the Gonorrhoea Symptoms:

Gonorrhoea can be a silent infection in most of the population. Often time, women and men with Gonorrhea will not display any signs and symptoms.
Gonorrhoea Symptoms & Chlamydia Symptoms can be overlaping.

The Symptoms of gonorrhoea can differ between men and women.

via GIPHY

Gonorrhoea Symptoms in women:

Abnormal vaginal discharge – thin, purulent, yellow or green
Vaginal odour (from discharge)
Pain while passing urine
Unusual pain in the cervix or lower abdomen during sex
Lower abdominal pain without precipitating factor
Vaginal Itch
It may rarely present as abnormal vaginal bleeding (in between period cycles or after sex)

Gonorrhoea Symptoms in Men

Penile discharge – colour may vary from white, yellow, green, or occasionally blood-tinged
Pain when passing urine
Pain in the testicles – rare

Read more about what are the other causes of penile infection & foreskin infection
Depending on the nature of the sexual activity and the severity of the infection, both men and women may experience pain, itchiness or discharge from the anus. They may also have pain, swelling, irritation, or discharge from the eye or both eyes (otherwise diagnosed as conjunctivitis).

How to Treat Gonorrhoea?

As with most bacterial infections, gonorrhoea is treated with antibiotics. The first choice is a wide spectrum antibiotic. It is, however, proving to be getting more resistant to antibiotics.
Gonorrhoea is also challenging to treat because most people who have this STI also have concurrent sexually transmitted illnesses like chlamydia.

via GIPHY
Also, like with any other sexually transmitted illness, treatment must be extended to all partners, and once treatment is completed, routine testing is highly recommended in view of relapse due to the increasing resistant nature of the gonorrhoea bacteria.
Abstinence is recommended during treatment.

What are the Complications of Gonorrhoea

Rarely, untreated gonorrhoea can spread throughout the body giving rise to skin pustules, infection of the joints (fingers, ankles, knees, and toes), brain or heart valves.

Complications of Gonorrhea in Men

More commonly, in men, infections of the epididymis, prostate and urethra are noted. Gonorrhoea can cause subfertility in some patients.

Complications of Gonorrhea in Women

In women, similar to other sexually transmitted diseases, untreated gonorrhoea may cause pelvic inflammatory disease (via an ascending infection involving the uterus, fallopian tubes, and ovaries) in up to 20% of patients. With inflammation, scarring and/or multiple infections, issues of subfertility and extra-uterine pregnancy will arise.
More annoyingly is the chronic, relapsing pelvic pain. This pain is characteristically stubborn and may require multiple analgesic medications in some women.
Read more about Herpes: Everything You Need to Know!

How is Gonorrhea Test Performed?

In most cases, usually for men, a urine sample will be required for the test. However, for female patients, ideally, the doctor will need to take a sample from the cervix ( neck of the womb).
For this, patients will lie down on the examination couch with knees bent and a small plastic instrument called a speculum will be used to open the vagina, then a soft brush will be used to collect a sample from the cervix. This procedure is very quick and painless, with only some minimal
discomfort.
Depending on sexual history, gonorrhoea swab may also be taken from the throat and rectum, in both men and women.

Any preparation needed before the test?

Vaginal douching and rectal douches, as well as creams, should be avoided 1 day before the test.
For the urine test, it is best to not urinate at least 2 hours before the sample is taken.

How long will the results take?

The test is usually performed together with chlamydia screening and results will be ready by the NEXT DAY. This allows treatment to be given as soon as possible when needed.
We can provide Rapid Chlamydia and Gonorrhea STD Testing. STD Test result will be available the following day.
If you are interested in getting a Rapid STD Testing or treatment for gonorrhoea, please visit our clinics and speak to our male and female doctors.
That’s All Folks!

Genital Warts: The Cauliflower-Like Lumps on the Genitals

17th April 2018/in HPV (Human Papilloma Virus), STD & HIV /by Miri Yeo

Genital warts are white or flesh-coloured, smooth, small bumps that can appear anywhere in the general area of the genitals. They can also grow larger and appear as fleshy, cauliflower-like lumps on the genitals. Neither of which are more dangerous than the other, it is merely a characteristic and the stage that the illness was noticed.
Genital warts is an STD symptom caused by the Human Papilloma Virus (HPV).

HPV can cause multiple illnesses in the body as there are multiple strains of the virus attributing to different diseases in humans. Out of the hundreds of known strains of HPV, about 30 strains of the virus cause diseases of the genital area. These include warts, or in more sinister cases, cancer of the anus, cervix, vagina, and penis. Read: Causes of Vaginal Lumps & Bumps & Perianal Warts (Peri-Anal Warts)

Most of the other strains have no known effect on humans.

How do I get infected by the Human Papilloma Virus (HPV)?

Human Papilloma Virus (HPV) is a contagious disease that is transmitted through genital skin contact or through direct contact with genital fluids of a person already infected with HPV.
For transmissible illness such as these, using barrier methods of protection for sexual intercourse such as condoms should be emphasised. However, condoms are not very effective against transmitting HPV just because the HPV virus does not require penetrative sex to transmit the virus.

It can also be transmitted from a mother to an unborn child if the mother has an active HPV infection during the course of the pregnancy.

How do I know I am infected with HPV? How can it be detected?

A majority of people infected with HPV do not realise they even have the virus as it does not present with any symptoms.

Some people will notice bumps or warts around the genital area, otherwise known as genital warts. These usually occur one to three months after initial infection with HPV.

The most sinister manifestation of the HPV disease is cervical cancer affecting women in their 30s or 40s. The simplest way to detect cervical cancer is by identifying if an individual is an active risk of getting the disease and doing regular PAP smears. MOH guidelines are also apparent on the timing and interval for PAP smears for women in the reproductive age group. Sometimes a biopsy of unhealthy cervical looking tissue may be needed.

For men-who-have-sex-with-men (MSM), it is recommended that they do an anal PAP smear to investigate for HPV.

We also provide Rapid HPV Testing (next day result) in all our clinics in Singapore.

How can HPV & Genital Warts be treated?

In most cases, the HPV infection is self-limiting therefore no treatment is deemed necessary.

Unless an individual has issues with antibodies or a weak immune system in general, the body should be able to contain and eradicate the virus from the body in due time.
If an individual has an impaired immune system or a weak immune response, a lingering infection or a co-infection with another sexually transmitted illness can occur.

In cases of genital warts, the treatment options are largely dependent on the severity of the infection. The most common treatment options include creams and paint-on ointments. These induce a state of cell death so warts around the genital will eventually wither and fall off the skin.

Some patients may be offered cryotherapy where the wart is frozen then removed. The wart is frozen prior to that so that there will be no transmission of the wart after.
Apart from the above surgical options for wart removal also exist. This is where a surgeon uses electrocautery or a scalpel and surgically excise warts. See: Genital Warts Removal

Unfortunately, the majority of genital warts or other warts can recur very frequently and is rather common to have warts recur post removal. Sometimes, repeated treatments are required for complete remission, but patients should be aware of the recurrence rates in such an infection.

HPV and Cervical cancer

Some HPV viruses are known as high-risk viruses. This is particularly true in virus strains 16 and 18. This is because it induces changes in the cells in the cervix of a woman and causes cervical if not detected early.

It is in this light that it is recommended that all sexually active women are advised to go for regular PAP smear tests, screen for HPV infections and visit your doctor for HPV vaccination in Singapore.

HPV and PAP Smear

Pap smear is a relatively painless test that can be quickly done. It involves inserting a speculum into the vagina of the patient to allow for inspection then a tool is inserted to obtain scraping. The patient should go back to resume activities of daily living with no hindrance once after the procedure completed by our female doctor.
These scrapings and obtained cells are then examined under a microscope to look for abnormal cells.

We also provide Rapid HPV Testing & Pap Smear in all our clinics in Singapore.

HPV and HPV Vaccination

Human Papilloma Virus (HPV) is a group of virus that can cause:

Vaginal Cancers
Vulvar Cancers
Anal Cancers
Penile Cancers
Oropharyngeal Cancers (cancers of the throat and tongue)
Genital warts or Papillomas

HPV vaccination is used to protect against HPV-related diseases and cancers.
To complete the HPV vaccination, 3 doses of injections will be given. The recommended HPV vaccine schedules are:
First dose: During your doctor visit.
Second dose: 1 – 2 months after the first dose
Third dose: 4-5 months after the second dose

Get More protection with New 9-valent HPV vaccine (Gardasil 9)

There are over a hundred strains of HPV and they are each given a designated number e.g. HPV 6 or HPV 16 or HPV52.
HPV strains that cause warts will NOT cause cancers and HPV strains that cause Cancer will NOT cause warts.

Compared to the older Gardasil, the new GARDASIL 9 offers a wider range of protection against HPV strains.
Both Gardasil and Gardasil 9 give you protection against the cancer-causing HPV 16 and 18 and the wart-causing HPV 6 and 11.
Gardasil 9 protects additional 5 other high-risk types: 31, 33, 45, 52 and 58.
Together these types cause about 90% of cervical cancers.

Another HPV vaccine Cervarix, on the other hand, protects only against the commonest cancer-causing HPV 16 and 18. There is no wart protection with Cervarix.
If you are interested in getting the HPV testing & PAP smear, genital warts treatment or HPV vaccine, please visit our STD clinics and speak to our male and female doctors.
If you or your partner are experiencing any possible signs or symptoms of infection, or have had any potential risk exposures, please see our STD doctors today.
Take Care. Be Safe!

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Posts

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

1) What are the Causes of Genital Blisters?

a) Genital Herpes

b) Balanitis

2) What are the Causes of Genital Warts?

a) Human Papilloma Virus

3) What are the Causes of Genital Ulcers?

a) Herpes Simplex Virus

(Painful shallow ulcers and blisters)

b) Syphilis

(Painless ulcers)

C) Chancroid

Lymphogranuloma venereum (LGV)

Small ulcer, swollen groin lymph nodes, possible rectal pain

Donovanosis

Shallow beefy looking ulcers

Other rare causes:

Autoimmune or inflammatory causes, skin cancers, drug reactions

All in All

An Overview on STD from an STD Doctor

What is syphilis?

Syphilis – Still a Real and Relevant Infection Today

What are the symptoms and different stages of syphilis?

Primary Syphilis Symptoms

a.) Syphilis Symptoms: Chancres

Secondary syphilis

b.) Syphilis Symptoms: Rashes

c.) Snail track ulcers

d.) Condylomata Lata

e.) Nonspecific symptoms

Tertiary syphilis

What Does a Syphilis Test Do

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

What Treatment is Available for Syphilis?

Other Interesting Reads:

An Overview of STD – From an STD Doctor

What Causes Cold Sores?

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Herpes Simplex Viruses (Type 1)

What is the Treatment for Cold Sores?

Other Interesting Reads:

An Overview of STD – From an STD Doctor

Let’s talk a little about normal vaginal discharge first.

How to identify abnormal vaginal discharge and what you should be worried about?

You probably have a vaginal infection.

Why does the abnormal vaginal discharge keep coming back?

1) Hormonal Fluctuations

2) Weakened Immune System

3) Sexual Lifestyle

4) Medications

5) Hygiene Habits

Other Interesting Reads:

An Overview on STD from an STD Doctor

What is the Cause of Gonorrhea?

In women, gonorrhoea affects the cervix and its functions 90% of the time.

What are the risk factors for contracting Gonorrhea?

What are the Gonorrhoea Symptoms:

Gonorrhoea Symptoms in women:

Gonorrhoea Symptoms in Men

How to Treat Gonorrhoea?

What are the Complications of Gonorrhoea

Complications of Gonorrhea in Men

Complications of Gonorrhea in Women

How is Gonorrhea Test Performed?

Any preparation needed before the test?

How long will the results take?

Other Interesting Reads:

An Overview of STD – From an STD Doctor