Possible VD in women

VD, Gonorrhoea, Clap, Whites, Strain, NSU, Syphilis, Sores; these are terms for venereal disease. VD is not for home treatment and if VD is suspected, you must see a doctor. These conditions require antibiotic treatment after accurate diagnosis and all sexual contacts must be traced and treated to prevent spreading.

Do not attempt to use antibiotics that you have left at home for these serious infections. You do not know the potency, the dose or the duration of treatment required, and we are not going to tell you. Tragedies from inadequate home treatment include sterility, heart infection, death from ectopic pregnancy and needless infection of other people.

There are two main forms of venereal disease, gonorrhoea and syphilis, and of the two gonorrhea is considerably more common than syphilis. In women, infection with either disease is often hard to detect since it is ‘inside’ rather than ‘outside’. There may be no symptoms whatsoever, and yet the disease can be active and the woman infective to sexual partners. Gonorrhoea initially can cause a vaginal discharge, but this may not be noticed until the infection has moved to involve the Fallopian tubes, the joints or the bloodstream. Gonorrhoea can be painful, as well as dangerous.

The male partner with gonorrhoea will have a discharge from the penis or pain on urinating. In a man the same symptoms can be caused by NSU (non- specific urethritis), a venereal disease which is probably caused by a germ more like a virus than a bacterium. A woman may become infected with NSU and can pass it on to other sexual partners, but frequently will have no symptoms. In a man NSU can produce serious complications of joint swelling and arthritis, so it is an important disease and any women who has been in contact with a man who has NSU must be treated.

Syphilis is a dangerous disease but fortunately becoming less common. It starts with a small sore (chancre) on the genitalia which appears ten to ninety days after infection. A man may notice the sore on the penis but in a woman it may pass unnoticed as it may be inside the vagina. A skin rash and general malaise (secondary syphilis) occur several weeks after the sore has first appeared and indicate that the infection has become generalised. The tertiary stage occurs years later. This is the bad stage in which people may die or go insane.

Crab lice, trichomonas infections, genital warts and several other conditions may be spread by sexual exposure, but can also be transmitted by other routes. Only gonorrhoea and syphilis are invariably transmitted by sexual contact. When recent experience includes oral or anal sex, either gonorrhoea or syphilis may be found infecting the mouth or rectum.

Home Treatment

This is purely a matter of prevention. Faithfulness to one partner, who is also faithful, is the only certain way of avoiding these infections. Inspection of the penis during the foreplay for sores or for any thick white discharge is useful for the uncertain situation. A condom (sheath) is a reasonably effective barrier to infection, although it does not afford total protection. If there is infection, suspicion of infection or if you have had intercouse with anyone you are not sure about, then you must see a doctor.

What the Doctor Will Do

If you think you may have VD it is essential to see a doctor, but whom should you choose ? Many patients have reservations about seeing their own GP for VD. Some GPs may not want to treat VD without the full diagnostic facilities available in a hospital clinic, although some are expert at its treatment. Our advice is to go to the Venereology Department at a district hospital which may sometimes be called the ‘Special Clinic’ or ‘Department of Genito- Urinary Medicine’. Information about these clinics may be found locally in newspapers, or the clinic phone number may be listed in the telephone book under ‘Venereology’. If in doubt, ring the local district hospital and ask for the clinic phone number. Patients are seen at these clinics in complete confidence and may present themselves for advice and treatment without first seeing their GP.

A history will be taken of the sexual contacts in the few months prior to the appointment. A vaginal examination will be performed and swabs taken from the mouth of the womb, the urethra and sometimes from the anus. A blood test will routinely be taken to detect possible syphilis. Treatment may be tablets, an injection or, for non- venereal vaginal infections, pessaries or creams.

If VD is found, the clinic will ask the patient to get in touch with all the known contacts so that they can be examined and treated. When the patient is unable to do this, specially trained nurses or social workers carry out this contact tracing. It is only by such tracing that spread of the disease can be checked and those people who may have the disease without symptoms found and treated.