Symptoms of sexually transmitted infections

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Common symptoms of sexually transmitted infections

Here you can find Open House’s rapid review of STIs and their most common symptoms. It is an overview, not an indepth analysis.

  • HIV and AIDS
  • Gonorrhea, chlamydia and Mycoplasma genitalium
  • Ureaplasmas, Mycoplasma hominis and trichomonas
  • Syphilis and herpes
  • Hepatitis A, B or C
  • Papillomavirus (HPV) and warts
HIV and AIDS

HIV and AIDS

Acute infection: This phase usually lasts between 2 to 3 months. In the majority of cases the person goes through this phase without even realising it but there may be flu-like symptoms (fever, unwellness, sore throat, shivers, joint pain, swollen lymph glands or skin rashes).

Asymptomatic infection: This follows the acute phase and it is impossible to detect someone in this stage of HIV just by appearances because they are completely well and look healthy. This may go on for some 10 years.

AIDS infection: HIV does not produce any direct illness but rather it causes the host an immunodeficiency and therefore they are susceptible to infections. These may be serious and are often the cause of death in people with AIDS. Tumours such as Kaposi’s sarcoma may occur.

If you’re concerned about any of these symptoms, we can help you:

  1. Come and see us – you can chat to our doctor and we can do instant HIV tests if need be. Please call us on 914294959.
  2. Read about HIV tests by clicking here
  3. Click here to make use of our interactive contact form to hear his thoughts on your symptoms
Gonorrhea, chlamydia and Mycoplasma genitalium

Gonorrhea, chlamydia and Mycoplasma genitalium

Many people infected with chlamydia, gonorrhea or  Mycoplasma genitalium show now symptoms, but the most common ones are as follows:

In men: stinging when you pee, burning itching or penile discharge

(we also these symptoms in men due to Ureaplasma or trichomonas infections – see the next section below)

In women: stinging or painful urination, altered vaginal secretions, pain in sex

In both sexes: sore throat, tonsillitis, pus in the throat, rectal secretions, burning or rectal pain, abnormal feelings on defecating.

  • Data from Open House reveals that some 60% chlamydia infections in men (in the urethra) are asymptomatic and similarly in around 15% of  gonorrhea infections.
  • In the cervix and throat about 90% of infections will be silent.
  • The only way to be 100% sure of not having chlamydia or gonorrhea is to get tested.

If you’re concerned about any of these symptoms, we can help you:

  1. Come and see us – you can chat to our doctor and we can do tests if need be. Please call us on 914294959.
  2. Read about chlamydia and gonorrhea tests by clicking here
  3. Click here to make use of our interactive contact form to hear his thoughts on your symptoms
Ureaplasmas, Mycoplasma hominis and trichomonas
Ureaplasmas, Mycoplasma hominis, trichomonas
Most people  with these three infections are just a chronic carriers and ydon’t pose any kind of threat to their health, but sometimes they do produce symptoms that need testing and treatment. They are only transmissible in vaginal sex:

In men: stinging, burning, itching when urinating or penile discharge

(we also see these same symptoms in cases of gonorrhea, chlamydia and Mycoplasma genitalium – please see the previous section)

In women: vulval or vaginal burning, altered vaginal secretions with a change in smell.

If you’re concerned about any of these symptoms, we can help you:

  1. Come and see us – you can chat to our doctor and we can do tests if need be. Please call us on 914294959.
  2. Read about relevant tests by clicking here
  3. Use our interactive symptoms contact form get our medical director’s opinion about your symptoms by clicking here
Syphilis and herpes
Syphilis and herpes
Primary syphiis and herpes are two sexually transmitted infections (STIs) that produce ulcers. Primary syphilis then developes into secondary syphilis which is a generalised infection without ulcers. The way the patient developed ulcers gives us clues to the diagnosis:

Primary syphilis:  incubation period of some weeks. Normally a solitary ulcer (in the mouth or on the genitals), usually painless, may be small or big, less common in heterosexuales than between men, regional lymph glands may swell up. It clears up in a few weeks (but has actually moved on to secondary syphilis).

Herpes: incubation period of just a few days. The primary infection (the first time you catch the virus) normally consists of several ulcers which burn or sting and with pain in that region, the ulcers are superficial and round. They clear up after a few days but there may be further outbreaks in the future.

Secondary syphilis:  after primary syphilis the infection starts to spread around the body and produces and general skin rash, usually accompanied by unwellness, fever etc.

If you’re concerned about any of these symptoms, we can help you:

  1. Come and see us – you can chat to our doctor and we can do tests if need be. Please call us on 914294959.
  2. Read about our syphilis tests by clicking here
  3. Use our interactive symptoms contact form get our medical director’s opinion about your symptoms by clicking here
Hepatitis A, B or C
The hepatitis viruses
Symptoms of hepatitis may be very subtle (tiredness, flu-like symptoms) or they may be full-blown (jaundice, pale stools, dark urine, fever). Sometimes there is some aspect of the patient’s history that helps reach a diagnosis.

Hepatitis A:  normally seen between men where one has licked the anus of an infected man. This infection almost always produces jaundice.

Hepatitis B: if you are Spanish and born after 1982 you’re almost certainly been vaccinated and are therefore protected. US, Canadian and Australian citizens are all vaccinated whereas citizens from the UK and Ireland are not usually vaccinated. In half of hepatitis B infections the person is unaware and if there symptoms they tend to be subtle (fever, unwellness).

Hepatitis C:  we don’t usually see hepatitis C in sex, except if infected blood has entered the blood stream. Sharing cocaine dosers is also a route of transmission. Symptoms are subtle.

If you’re concerned about any of these symptoms, we can help you:

  1. Come and see us – you can chat to our doctor and we can do tests if need be. Please call us on 914294959.
  2. Read about our hepatitis tests by clicking here
  3. Use our interactive symptoms contact form get our medical director’s opinion about your symptoms by clicking here
Papillomavirus (HPV) and warts
HPV and warts:
There are two kinds of papillomavirus, the strains that produce warts and those that are related to cancer. They are competely different and having warts has nothing to do with developing cancer.
Normally it is easy to identify a wart because:
  • it grows
  • it is the same colour as the skin or pigmented
  • it has a “cauliflower-like” surface

But sometimes making the diagnosis is not so easy and our clinical judgement as experts in the field could help you. There are also tests that help to distinguish between warts and other lesions.

If you’re concerned about any of these symptoms, we can help you:

  1. Come and see us – you can chat to our doctor and we can do tests if need be. Please call us on 914294959.
  2. Use our interactive symptoms contact form get our medical director’s opinion about your symptoms by clicking here


Symptoms you may be experiencing

Here is a rough giude to symptoms we see every day in the clinic and which infections we consider relevant.

  • Flu-like symptoms or
  • Stinging when you pee
  • Peeing more often than normal
  • Discharge from the penis
  • Genital pain in men or testicular pain
  • Difficulty peeing in a man
  • Lumps, bumps and genital sores (in men and women)
  • Redness or irritation of the head of the penis or foreskin
  • Changes in vaginal secretions
  • Vaginal itch or rednesss
  • Mouth and aphthtous ulcers
  • Sore throat
  • Skin rashes
  • Anorectal symptoms
Flu-like symptoms or

Flu-like symptoms or general unwellness:

Many of our patients at Open House come to see us because they believe they may be going through HIV seroconversion.
We try to differentiate bewteen three states: seronversion symptoms, flu-like symptoms due to flu or colds, and unwellness due to stress.

It is usually quite difficult to distinguish between these states just by symptoms, but at Open House we have good clinical judgement.
Our experience tells us that an STI is rarely the cause of these symptoms.

Which STIs do we think about?:

  • HIV
  • Syphilis

Factors the doctor will take into account:

We may be concerned about an STI if:

  • there have been unprotected penetrations, especially anal sex
  • if there was sex between men (where we most see syphilis)
  • if there is nasal mucus (we don’t see this symptom in HIV)

What alternative diagnoses spring to mind?

  • Colds or flu
  • Other viral infections such as mononucleosis (glandular fever)

Don’t forget that Open House has some of the best tests available for detecting early infections of HIV and syphilis. Click here for more information:

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Stinging when you pee

Stinging when you pee:

Which STIs do we think about?:

  • Chlamydia, gonorrhea, mycoplasmas, ureaplasmas or trichomonas.

Factors the doctor will take into account:

  • A short incubation makes us think about gonorrhea and along one Mycoplasma genitalium.
  • A penile discharghe is highly suggestive of one of these infections.
  • Stinging at the tip of the urethra may be a sign of prostatitis
  • Chlamydia and gonorrhea are transmissible in oral sex whereas the others mentioned above require unprotected penetration.

What alternative diagnosis spring to mind?:

  • Non-specific urethritis (NSU), an inflammation with non-sexually transmitted bacterias
  • Prostatitis
  • Urine infection

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Peeing more often than normal

Peeing more often than normal:

Something is irritating or occupying the bladder to have this symptom.

Which STIs do we think about?:

  • We don’t usually think first about an STI with this symptoms unless it is accompanied by others such as stinging or discharge, in which case the relevant infections would be chlamydia, gonorrhea, mycoplasmas, ureaplasmas or trichomonas.

Factors the doctor will take into account:

  • Stinging or discharge would be highly suggestive of an STI.
  • The need to pee happens during the daytime or also at night could be significant.
  • If it happens only during the daytime we would think of anxiety as the major cause.
  • If there is also difficulty urinating (a weak stream or difficulty to get started) there may be a prostate problem.

What alternative diagnoses spring to mind?

  • Anxiety
  • Prostatitis
  • Urine infection

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Discharge from the penis

Urethral secretions:

This symptoms is highly suggestive of a sexually transmitted infection (STI).

Which STIs do we think about?:

  • Chlamydia, gonorrhea, mycoplasmas, ureaplasmas or trichomonas

Factors the doctor will take into account:

  • A short incubation period would make us think first about gonorrhea and a long one, Mycoplasma genitalium.
  • If the discharge is mostly in the morning we think of chlamydia
  • If it is transparent we think about chlamydia or prostatitis
  • Chlamydia and gonorrhea are transmitted in oral sex, but the others require unprotected penetrations

What alternative diagnoses spring to mind?

  • Non-specific urethritis (inflammation and infection witn non-sexually transmitted bacteria)
  • Prostatitis

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Genital pain in men or testicular pain

Genital pain or testicular pain in men:

Many men come to see us at Open House with pain that is difficult to define (lower abdominal pain, between the scrotum and anus, or in the testicles).

If there are no other symptoms in the urethra or prostate (stinging inside the penis, difficulty urinating, heightened need to pee), these symptoms don’t often have anything to do with a sexually transmitted infection.

Which STIs do we think about?:

  • In about 3% of these cases we will diagnose chlamydia, gonorrhea, mycoplasmas, ureaplasmas or trichomonas but normally the final diagnosis has nothing to do with STIs.

Factors the doctor will take into account:

  • Any urethral discharge would be highly suggestive of an STI.
  • Some 30% of men with prostatitis have painful testicles.
  • The symptoms of generalised pain may be due to mild prostatitis so we would almays ask after other relevant prostate symptoms (pain at the tip of the penis, between the scrotum and anus, unstable bladder producing the need to pee more often)
  • Chlamydia and gonorrhea are transmitted in oral sex but the other infections require unprotected penetration
  • If a phsyical examination reveals painful testicles there may be another kind of bacterial infection happening.

What alternative diagnoses spring to mind?

  • Bacterial prostatitis (caused by innocent bacteria) is the most likely diagnosis.
  • Non-specific pain may be due to anxiety
  • A direct infection of the testicles (orquiditis) or its structures (epididymitis, varicocele etc)

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Difficulty peeing in a man

Difficulty peeing in men:

Here we’re not talking about pain, but rather that it is difficult to start the urine flow, or the stream is weaker than normal or there is dribbling at the end.

These are the typical symptoms we see when there is obstruction of the prostate, but sometimes we see the same thing when there is a massive infection of the urthera due to chlamydia or gonorrhea etc.

Which STIs do we think about?:

  • Chlamydia, gonorrhea, mycoplasmas, ureaplasmas or trichomonas but normally these are symptoms urelated to sexually transmitted infections (STIs).

Factors the doctor will take into account:

  • If there is also a urethral discharge this is highly suggestive of an STI
  • It is most probably a prostate problem so we would ask the patient about other symptoms of prostatitis such as stinging at the tip of the penis, testicular pain, pain between the scrotum and anus (the perineum), an unstable bladder making the patient want to pee all the time but never emptying properly.
  • Chlamydia and gonorrhea are transmissible in oral sex whereas the other infections we see in unprocted penetrations.

What alternative diagnoses spring to mind?

  • Bacteria prostatitis (due to innocent bacteria) is the most likely diagnosis (in about 90% of these cases). It is a diagnosis that will require agressive treatment with both antibiotics and antiinflammatories.

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Lumps, bumps and genital sores (in men and women)

Lumps, bumps and genital sores:

Lumps, bumps and sores (ulcers) may be due to a sexually transmitted infection (STI).

Which STIs do we think about?:

  • Syphilis
  • Herpes
  • Warts due to papillomavirus

Factors the doctor will take into account:

  • Incubation: herpes has a short incubation of just a few days whereas that of syphilis is several weeks
  • Both herpes and syphilis may start initially with a lump (a raised lesion or a blister) which will later ulcerate
  • Syphilis doesn’t usually hurt whereas this is typical of herpes
  • Warts are not ulcers, they are elevated structures and often have a “cauliflower-like” surface. They also grow over time.

What alternative diagnoses spring to mind?

  • Lumps: Moluscum, infected hairs, cysts, skin tags and other benign skin lesions
  • Ulcers: trauma, mechanical irritation

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Redness or irritation of the head of the penis or foreskin

Red or irritated head of the penis or foreskin:

The overwhelming majority of these infections are due to a fungal infection (thrush), These fungal infections are usually part of your own skin flora that has managed to escape control of your protective bacterial flora and are not sexually transmitted.

Which STIs do we think about?:

  • We almost never see an STI causing this symptom

Factors the doctor will twe ake into account:

  • If urethral discharge is present this is highly suggestive of an STI. The secretions can irritate the skin of the head of the penis
  • Very occasionally we see atypical syphilis infections producing redness
  • There may be an underlying factor to have a fungal infection (recent antibiotics, high blood glucose etc)
  • Itchiness is typical of a fungal infection
  • Whether there has been unprotected sex or not

What alternative diagnoses spring to mind?

  • Our first thought would be a fungal infection but there may be allergic reactions or eccemas that are not due to microorganisms.

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Changes in vaginal secretions

Changes in vaginal secretions:

There may be many reasons to experience changes in secretion that may not have anything to do with a sexually transmitted infection but it is symptom which is common in these infections and requires investigation.

Which STIs do we think about?:

  • Chlamydia, gonorrhea and Mycoplasma genitalium – abundant and liquid secrections
  • Trichomonas and Gardenerella – more watery secretions with a noticeable change in smell
  • Ureaplasma, Mycoplasma hominis – vaginal itch also present
  • Candida – white semisolid secretions

Factors the doctor will take into account:

  • Changes in secretions with vaginal and/or vulval itching are not usually due to a sexually transmitted infection (STI)
  • Pelvic or abdominal pain, or deep pain during sex is highly suggestive of an STI.

What alternative diagnoses spring to mind?

  • Fungal infection or hormonal imbalances would be a major cause of these symptoms at Open House.

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Vaginal itch or rednesss

Vaginal or vulval itching and redness:

Symptoms that normally happen in the vagina or vulva are not usually associated with a sexually transmitted infection (STI). Any changes in the vaginal secretion may help us reach a diagnosis.

Which STIs do we think about?:

  • Chlamydia, gonorrhea and Mycoplasma genitalium – abundant and liquid secrections
  • Trichomonas and Gardenerella – more watery secretions with a noticeable change in smell
  • Ureaplasma, Mycoplasma hominis – vaginal itch also present
  • Candida – white semisolid secretions

Factors the doctor will take into account:

  • Changes in secretions with vaginal and/or vulval itching are not usually due to a sexually transmitted infection (STI)
  • Pelvic or abdominal pain, or deep pain during sex is highly suggestive of an STI.

What alternative diagnoses spring to mind?

  • Feminine hygiene washes or allergic reactions in sex are common causes.

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Mouth and aphthtous ulcers

Sores, ulcers and aphthous ulcers in the mouth:

Mouth ulcers due to syphilis are not easy to distinguish from other sores. Anything wrong in the mouth or throat can also bring on sores or aphthous ulcers, with stress being a common cause.

Which STIs do we think about?:

  • Syphilis
  • Herpes

Factors the doctor will take into account:

  • Skin: herpes primarily affects the skin and not mucosas
  • Pain: syphilis is usually painless, whereas herpes and aphthous ulcers usually are.
  • The rest of the mouth: if another pathology is present in the mouth, for example tonsillitis or a white coated tongue, we would think initially of aphthous ulcers as the cause.
  • In order to have syphilis in your mouth you would have to have given someone oral sex.

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Sore throat

Sore throat:

A sore throat is common folllowing a sexual contact. At Open House some of these cases will be due to chlamydia or gonorrhea. Occasionally we see syphilis as the underlying cause or HIV seroconversion.

Which STIs do we think about?:

  • Chlamydia and gonorrhea may cause pharyngitis or tonsillitis but they are usually asymptomatic throat infections. One in every 8 men who have sex with men who come to Open House will be positive for these infections.
  • Although you will not find it in the medical literature, we do see sore throats due to syphilis, normally secondary syphilis, in other words we don’t see the typical ulcer of primary syphilis when we do the physical examination.
  • In HIV seroconversion there may be sore throat, but it usually happens in context of a full-blown flu-like illness with fever, unwellness etc.
  • Don’t forget that Open House has the most sensitive tests that exist for detecting these infections.

Factors the doctor will take into account:

  • If you have given someone oral sex or if there have been unprotected penetrations (a risk for HIV).

What alternative diagnoses spring to mind?

  • Viral infections causing sore throat
  • Chronic pharyngitis
  • Environmental factors causing irritation or allergies

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Skin rashes

Skin rashes:

The most common sexually transmitted infection that casues skin rashes is syphilis. Occasionally we see rashes as part of HIV serovonc¡version. But many other infections and skin conditions can produce these changes in the skin.

Which STIs do we think about?:

  • Syphilis
  • HIV

Factors the doctor will take into account:

  • To be going through HIV seroconversion there must have been sufficient risk (unprotected penetration) in the last few weeks.
  • The rash that HIV produces usually covers the entire body and is associated with extreme unwellness, fever, flu-like symptoms etc.
  • The rash we see in syphilis is usually accompanied by unwellness, nighttime fever and lesions on the hands.

What alternative diagnoses spring to mind?

  • Viral infections
  • Dermatogical manifestations of fungal infections
  • Reactions to medications
  • Reactions to the environment or allergies

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959

Anorectal symptoms

Anorectal symptoms:

Symptoms we experience may be anal (the external part and just inside) or rectal (deeper).

Which STIs do we think about?:

We see cases of gonorrhea, chylamydia, lymphogranuloma venereum and Mycoplasma genitalium producing rectal symptoms.

Syphilis can produce both rectal and anal symptoms.

Factors the doctor will take into account:

We would be suspicious of a rectal STI if the following symptoms are present:

  • deep pain,
  • secretions or mucus,
  • blood,
  • the need to empty your bowels even though there are no faeces left – this is highly suggestive of an STI such as gonorrhea or chlamydia.
  • rectal penetration or receiving anilingus

What alternative diagnoses spring to mind?

  • Colitis
  • Fissures
  • Fistulas
  • Warts
  • Hemorrhoids
  • Fibromas

Would you like to send us an email and have our medical director’s opinion regarding your symptoms?:

Click here to make use of our interactive contact form to hear his thoughts on your symptoms

Or if you prefer, give us a call to make an appointment on 914294959



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