What is balanitis?

Balanitis is an inflammation of the foreskin or head of the penis. Balanitis is a common condition that mostly affects those who are uncircumcised. Although it can be painful, it is not a serious condition. It is usually relieved using topical medication.

What causes balanitis?

• The main cause of balanitis is poor hygiene. Poor hygiene can lead to an overgrowth of bacteria and yeast, which can cause an infection. The foreskin of the penis is an ideal place for bacteria and yeast to grow.

• Irritation caused by personal products such as:  
• Scented soap to clean the penis
• Bar soap that dries out the skin
• Scented lotions or sprays on the penis

• Medication you are taking may cause balanitis as a side effect, such as:
• Laxatives, sleeping pills, painkillers and antibiotics
• Less common causes of balanitis are:
• Reactive arthritis
• Uncontrolled diabetes
• Sexually transmitted infections, such as herpes and gonorrhea 

• Redness, irritation and soreness of the head of the penis or under the foreskin
• Itching or burning in the affected area
• A white or yellowish thick, clumpy secretion from under the foreskin
• Painful skin on the penis
• Swelling can put pressure on the urethra, causing painful urination 

Balanitis can be diagnosed by a visual exam of the genital area.

• If you have a yeast infection, you may be advised to use an antifungal cream such as clotrimazole. Apply the cream to the affected area two to three times daily for 10 days. Your health care provider may also recommend a prescribed antifungal treatment, in a cream or pill form.
• If you have a bacterial skin infection, you may be advised to use an antibiotic cream and to keep the area clean and dry.
• Avoid using irritants such as perfumed soap, lotion, or powder as these products may further irritate the foreskin.

• Early diagnosis and treatment is the best way to reduce your chances of developing complications including:
  • Scarring in the penis opening
  • Painful foreskin retraction
  • Inadequate blood supply to the penis
  • Allergic dermatitis (allergic skin reaction)

• Good hygiene
• Avoiding using irritants such as perfumed soap, lotion, or powder to prevent further irritation of the foreskin
• Completely drying the penis after you shower

Chlamydia is a sexually transmitted infection (STI) caused by a bacteria called Chlamydia trachomatis. It is the most common bacterial STI.

Most people do not experience any symptoms. This means you can transmit the infection without knowing you have it. Testing is the only way you will know if you have chlamydia. If symptoms do occur, they usually appear two to six weeks after becoming infected.

• A change in vaginal discharge

• Burning with urination
• Lower abdominal pain
• Pain during intercourse
• Bleeding after sex or other abnormal vaginal bleeding
• Rectal pain or discharge
• Watery or milky discharge from the penis
• Burning or itching around the tip of the penis
• Pain or swelling in the testes

How do I get tested?

• A urine test can detect an infection in the genital area.
• A health care provider may collect a swab from the cervix, urethra, throat or rectum.

• Chlamydia can be easily treated and cured with antibiotics.
• Do not have sex for seven days after treatment.
• Your partner(s) needs to receive treatment and wait seven days before having sex again.
• You can be re-infected after treatment. 

• Pelvic inflammatory disease (PID) – an infection in the fallopian tubes, uterus and ovaries
• Infertility (unable to get pregnant)
• Ectopic pregnancy (tubal pregnancy) Babies born to mothers who are infected with chlamydia could have severe eye infections or infant pneumonia
• Infection of the testes

What is epididymitis?

It may be caused by a variety of bacteria, some of which may be sexually transmitted.

What are the symptoms?

One or all of the following symptoms may occur:

• Gradual feeling of pain or tenderness in one testicle
• Swelling, redness or a lump in the affected testicle
• Fever
• Urethral discharge (discharge from the penis)
• Blood in the semen

How is it treated?

Epididymitis is treated with antibiotics. It is important to finish all the medication. To ensure that the medication is working and your symptoms are improving, you should return to the clinic at the time requested by your health provider. Do not have any sexual activity during treatment.

Can I give epididymitis to other people?

The bacteria that causes epididymitis can be transmitted through sexual activities. You can pass the infection to your partner(s) even when there are no symptoms.

Encourage your partner(s) to be tested before resuming any sexual activity.

Are there complications?

If untreated, epididymitis can lead to:

• Abscess in the scrotum
• Chronic epididymitis
• Infertility (the inability to produce sperm)

• Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus (HSV).
• There are two main types of Herpes Simplex Viruses, HSV 1 and HSV 2.  Either type may cause blisters or sores on the mouth or genitals.
• There is no cure for genital herpes and often people will have recurring outbreaks.
• During these outbreaks the infected person will have sores and symptoms for a while, then the virus will go into a dormant stage and the person will have no symptoms again until the next outbreak.
• It is still possible to transmit the virus during the dormant stages when a person has no symptoms.

• Genital herpes is spread through skin-to-skin contact, usually during oral, vaginal or anal sex.
• Even people who don’t have any visible sores or blisters may still unknowingly pass the virus to their sexual partner(s).

• If symptoms of a primary outbreak occur, they will usually develop between six and 21 days after skin-to skin contact with an infected partner.

• Many people do not notice a primary outbreak, making it unclear as to when they were infected.

Primary outbreak symptoms

• Small blisters in the vagina or on the vulva or cervix; on or around the penis or testicles; on or around the anus; or on the thighs or buttocks
• Pain during urination
• Fever and aches in the joints and muscles
• General feeling of ill health

Recurrent outbreaks

The number of outbreaks and the amount of time between outbreaks varies from person to person. Some people may have them frequently and others may have them only rarely. Usually occurs in same area as the primary outbreak. Itching or tingling at site of infection may occur. Less severe and shorter in duration.

• A swab of a sore or blister may be taken.
• In certain circumstances, and when available, a blood test may be done to test for genital herpes.

• There is no cure for herpes, but effective treatments for outbreaks do exist. To be effective these treatments must be started immediately after symptoms appear. 
• Antiviral medications are available and can be taken to speed the healing of blisters or sores and shorten the duration of pain and discomfort.
• Suppressive therapy (daily antiviral medication) is an option for those who have frequently recurring outbreaks.

Emotional effects of genital herpes

For many people, a herpes diagnosis can cause a strong emotional response.  People may feel anger, embarrassment, worry or guilt. Often, people will feel depression, fear, rejection or isolation. These are very common reactions and will not last forever. It is important to talk about these feelings with someone you trust, such as a health professional, a supportive person in your life or your partner. Many other people have felt the same way.

Rarely, people with genital herpes may spread the virus to other parts of their own body with their hands. Transmission to the eye can be very serious. It is important to wash and dry your hands thoroughly after touching sores or blisters in order to prevent spreading the infection.

If you become pregnant, it is important that you tell your health care provider if you or your partner have genital herpes.

Human papillomavirus (HPV) is an extremely common virus with over 100 strains or types. HPV is the most common sexually transmitted and blood borne infection (STBBI) in Canada. Up to 75 per cent of people will come in contact with this virus during their life. Many people are able to clear the infection within two years.

HPV is transmitted by skin-to skin contact, often through sexual contact.

There are usually no symptoms and people do not know they have HPV. If symptoms develop, it may take two to three months, or even years, for them to appear.

HPV can cause warts in the genital area. They can look like common skin warts, and usually appear as soft or hard skin bumps. The warts often have a cauliflower-like appearance and may range in colour from pink, flesh-colour, white, brown or grey. They can be raised or flat, single or multiple.

There is currently no routine diagnostic test for HPV in Canada. A health care practitioner can examine your skin for genital warts.

Treatments are available to remove warts and may reduce the risk of transmission to sexual partners. Several treatments may be required before all the warts are gone.  Treatments used may vary depending on the number and location of the warts.

Some common treatments available include:

• Cryotherapy, a procedure which freezes the warts with liquid nitrogen
• Topical medications (e.g. Podophyllin) applied directly to the warts.
• Home treatments are available by prescription (e.g. Aldara, Vyloma, Condyline)
• Laser treatment or minor surgery, which are often used to treat the cervix or other internal warts.

Over-the-counter wart treatments should never be used in the genital area.

Condoms can help prevent the spread of HPV, but they do not provide full protection. An HPV vaccine is also available to protect against the most common strains of HPV. This vaccine is being given to students in grade 7 in Ontario schools and
persons assigned male at birth 9 to 26 years old (who meet high risk eligibility criteria), who are immunocompromised or immunocompetent HIV infected. In some circumstances, this vaccine may also be prescribed for adults who did not receive the vaccine in school. Discuss with your health care provider if this vaccine is appropriate for you.

Some types of HPV can cause cancer of the cervix, as well as other rare cancers of the penis, vulva, anus or throat. HPV types that cause genital warts are unlikely to cause cancer.

Gonorrhea is a sexually transmitted infection (STI) caused by a bacteria called Neisseria gonorrhea. It is the second most common bacterial STI.

Gonorrhea is transmitted through unprotected vaginal, anal and/or oral sex with an infected partner. You can pass it on without even knowing that you are infected.

Many people do not experience symptoms of gonorrhea. If symptoms do occur, they usually appear two to seven days after exposure.

• Thick yellowish vaginal, penile and/or rectal discharge
• Burning with urination
• Lower abdominal pain
• Vaginal pain and/or bleeding during intercourse
• Abnormal vaginal bleeding
• Rectal pain and/or discharge
• Sore throat
• Burning and/or itching around tip or inside of the penis or around the anus
• Pain and/or swelling in the testes

A swab may be taken from the cervix, urethra, throat and/or rectum. A urine test may also be done. Testing is the only way you will know if you have gonorrhea.

Gonorrhea can be easily treated and cured with antibiotics. In some parts of Canada and the rest of them world, gonorrhea may be resistant to some antibiotics. Please let your health care provider know if you and/or your partner(s) have been travelling. Do not have sexual contact during treatment and for seven days after treatment.

Make sure that your partner(s) are treated before resuming any sexual activity. You can be re-infected after treatment.

Possible complications:

• Pelvic inflammatory disease (PID), which is an infection in the fallopian tubes, uterus and ovaries
• Infertility (inability to get pregnant)
• Ectopic pregnancy (tubal pregnancy)
• Babies born who are infected with gonorrhea could have severe eye infections or infant pneumonia
• Infection of the testes
• Rarely causes infertility

People infected with hep A can have a variety of symptoms. Some people do not get sick at all but they can still spread the infection to others. Often people with hep A develop the following symptoms 15 to 50 days after exposure to the virus:

• Fatigue (feeling tired)
• Jaundice (yellowing of the skin and whites of the eyes)
• Dark urine, pale stools
• Abdominal pain, nausea, vomiting, poor appetite
• Diarrhea
• Fever

Symptoms are often mild, typically lasting one to two weeks. In severe cases, the symptoms can last several months. For pregnant women, hep A is more serious and can be fatal, particularly for women in their third trimester.

There is currently an approved vaccine for hep A. Once vaccinated you are immune for life. If you have already had the virus, your body has developed a natural immunity. 

The hep A virus is spread from person to person through contact with infected feces (stool). People can carry the virus without showing any symptoms, then spread it to other people, foods or surfaces. Most commonly, the virus spreads through:

• Sexual contact with an infected person (oral – anal contact)
• Sharing needles and drug paraphernalia
• A contaminated food handler
• Hands that are not washed properly after using the restroom or helping someone use the restroom
• Contamination during harvest, manufacturing and processing of food
• Persons travelling to countries where hep A is common

Food sources of hep A include:

• Contaminated water
• Raw or undercooked shellfish
• Raw fruits and vegetables

A blood test is used to diagnose hep A.  This blood test can reveal if an individual currently has hep A, has had hep A in the past (resolved) or has previously received the vaccine.  

What is the treatment for hepatitis A?

There is no medication to treat hepatitis A. Most people are sick for about 1 to 2 weeks and then recover, while others may develop more serious illness. It is important to see your healthcare provider if you think you might be sick with hepatitis A. After recovering from the illness, a person is considered immune and protected against hepatitis A in the future.

How do I protect myself from hepatitis A?

The following tips will help protect you and your family from hep A:

• Talk to your doctor about getting a hepatitis A vaccination
• Wash your hands after using the restroom and changing diapers, and before preparing or eating food
• When travelling, especially to developing countries:
  • Only drink commercially bottled water or boiled water
  • Avoid ice cubes in drinks
  • Eat only freshly cooked food
  • Avoid non-peelable raw fruit or vegatables
• Cook food to a safe internal temperature using a digital thermometer
• If you think you have been exposed to hep A, see your physician immediately. Vaccination can prevent the onset of symptoms if given within two weeks of exposure
• If you’ve been exposed to hep A, or any other gastrointestinal illness, do not prepare food for other people

How do I practice safer sex?

• Use an internal or external condom, every time you have oral, vaginal and/or anal sex
• Use water-based or silicone-based lubricants
• If you share sex toys, cover the toy with a condom and clean after each use
• Get tested for sexually transmitted infections (STIs) regularly 

Download fact sheet - Hepatitis A - Practising safer sex and safer drug use (PDF)

• Use new equipment every time you use, including pipes, needles, syringes and all other supplies (like cookers, filters and water)
• Never share equipment with anyone, including your sex partner(s)
• Access Needle and Syringe Programs or Supervised Consumption Services for new equipment and harm reduction services

What is Hepatitis B?

• Hepatitis B (hep B) is a virus that affects the liver. Someone can live with hepatitis B for a long time (20-30 years) before they develop any symptoms, feel sick, or see any sign of liver damage. Without testing, treatment or follow-up from a provider, the liver can become scarred and cause people to become ill.
• Hepatitis B can be very common in certain parts of the world, such as sub-Saharan Africa, East Asia, parts of Central and South America.

 What are the symptoms?

Most people have no signs or symptoms of hepatitis B.  People who have hep B may have some or all of the following symptoms:

• Fatigue (feeling tired)
• Jaundice (yellowing of the skin and whites of the eyes)
• Dark urine, pale stools
• Abdominal pain, nausea, vomiting, poor appetite

Hepatitis B is passed through blood, semen (pre-ejaculate), vaginal fluids, rectal fluids and saliva from someone who has the virus.  The main ways that hep B is passed between people are:

• Anal or vaginal sex, oral sex, sharing sex toys
• Maternal transmission (during pregnancy or childbirth)
• Sharing needles/syringes or other equipment used to inject drugs (such as cookers, filters, etc) or equipment to snort or smoke drugs such as stems, bills/straws, etc
• Tattoos, body piercing/modifications, acupuncture, manicures or pedicures where non-sterile equipment is used
• Sharing personal hygiene articles such as razors, toothbrushes or nail clippers
• Medical/surgical procedures where infection prevention and control practices are inadequate

 Hepatitis B cannot be passed through:

 Shaking hands

• Hugs or kisses
• Coughs or sneezes
• Food or water
• Sharing eating utensils
• Breastfeeding

Hepatitis B is diagnosed with a blood test.  This blood test can reveal if an individual currently has hepatitis B, has had hepatitis B in the past (resolved) or has previously received the vaccine.  Most tests are accurate within four weeks of exposure but some people may take as long as 3 to 6 months to test positive. You may be encouraged to return for repeat testing.

What happens if I have a positive hepatitis B result? Your body may clear the virus on its own without treatment within the first 6 months: the majority of adults are able to clear the virus and develop lifelong immunity.  However, the majority of infants and children who contract hepatitis B will develop chronic hepatitis B. 

• There is no cure for hepatitis B but there are treatment options that can help prevent further damage to your liver.
• To reduce the risk of passing the hepatitis B virus on to your baby, you doctor will ensure that your baby receives an immune globulin injection and hepatitis B vaccine at birth
• Your healthcare provider or public health nurse will provide you with resources, counselling, support, and information to help guide your care, including linking you to community services and/or social workers.
• Your healthcare provider or a public health nurse will help you notify household contacts, sexual and/or drug-equipment sharing partners to encourage them to be tested for hepatitis B, assess their immune status and/or provide vaccine protection to those who are not immune.  They can get free hepatitis B vaccination through Ottawa Public Health.

• Decrease or eliminate alcohol, drug and/or tobacco use
• Get vaccinated for Hepatitis A
• Talk to your healthcare provider/pharmacist before starting new medications or natural remedies 

• Use an internal or external condom, every time you have vaginal and/or anal sex

• Use water-based or silicone-based lubricants

• If you share sex toys, cover the toy with a condom and clean after each use

• Get tested for Sexually Transmitted Infections (STIs) regularly

• Use new equipment every time you inject, including needles, syringes and all other supplies (like cookers, filters and water)

• Never share equipment with anyone, including your sex partner(s)

• Access Needle and Syringe Programs or Supervised Consumption Services for new equipment and harm reduction services

Hepatitis C (hep C) is a virus that affects the liver. Someone can live with hepatitis C for a long time (20-30 years) before they start to develop any symptoms, feel sick, or see any sign of liver damage. Without testing, treatment or follow-up from a provider, the liver can become scarred and cause people to become ill. Hepatitis C can be very common in certain parts of the world, such as Central, East and South Asia, Australasia and Oceania, Eastern Europe, sub Saharan Africa, North Africa and the Middle East.

 What are the symptoms?

Most people have no signs or symptoms of hepatitis C. People who have hepatitis C may have some or all of the following symptoms:

• Fatigue (feeling tired)
• Jaundice (yellowing of the skin and whites of the eyes)
• Dark urine, pale stools
• Abdominal pain, nausea, vomiting, poor appetite

Hepatitis C is passed through blood-to blood-contact with someone who has the virus.

The main ways that hepatitis C is passed between people are:

• Sharing needles/syringes or other equipment used to inject drugs, such as cookers, filters, stems, bills/straws, etc
• Having received blood and/or blood products, or immunoglobulin before 1992
• Tattoos, body piercing/modifications, acupuncture, manicures or pedicures where non-sterile equipment is used
• Sharing personal hygiene items such as razors, toothbrushes or nail clippers
• Maternal transmission (during pregnancy or childbirth)
• Condomless sex where there is a higher risk of blood transmission, such as anal sex, rough sex, party and play, menses, etc

Hepatitis C is diagnosed with a two-step blood test: an antibody and an RNA test. Within 6 months after becoming infected, almost everyone has antibodies in their blood that can be measured by the hepatitis C antibody test. If antibodies are found, an RNA test is ordered to determine if you currently have the hepatitis C virus. Hep C antibodies will remain positive in the blood for life, even after somebody has cleared the virus. Even if someone clears the virus (on their own or with treatment), they can get hepatitis C again.

Hepatitis C is a treatable infection.  About one in four (25%) people clear hepatitis C without treatment, but most people need treatment to cure hepatitis C. If your RNA test is positive, you will be referred to a hepatitis specialist. Treatment is usually 3 months long and decided with your specialist.  

• Decrease or eliminate alcohol, drug and/or tobacco use
• Get vaccinated against Hepatitis A and Hepatitis B
• Talk to your healthcare provider/pharmacist before starting new medications or natural remedies 

• Use an internal or external condom, every time you have vaginal and/or anal sex
• Use water-based or silicone-based lubricants
• If you share sex toys, cover the toy with a condom and clean after each use
• Get tested for Sexually Transmitted Infections (STIs) regularly

• Use a new needle/syringe and other drug equipment every time you use drugs
• Never share equipment with anyone, including your sex partner(s)
• Access safe injection sites for new equipment and care

• Skin-to-skin contact
• Wet towels, gym equipment and tanning beds
• Sexual contact
• It can be spread to other parts of the body when you scratch the bumps and then touch another body part

• Molluscum causes small, smooth, pearly white or flesh-colored hard bumps with a pitted or dimpled centre.
• You can have one or a group of bumps anywhere on the body.
• In sexually active people, these bumps may be found on the genitals, inner thighs, or abdomen.
• The bumps can last from 6 months to 2 years. Once the bumps are gone so is the virus.
• If scratched, the bumps can become infected with bacteria and may be tender or red.

The bumps will usually go away on their own in 6 to 12 months. Very rarely, bumps will stay up to 2 years. Molluscum can be treated by freezing with liquid nitrogen or applying a prescription cream.

A health care professional diagnoses molluscum after examining the skin.

What is mucopurulent cervicitis (MPC)?

Mucopurulent cervicitis (MPC) is an inflammation of the cervix that may be caused by a variety of bacteria and/or viruses which may be sexually transmitted.  Symptoms may take 1 to 6 weeks to develop after exposure.

How is MPC transmitted?

Most bacteria and/or viruses that cause MPC can be transmitted during oral or vaginal sex.

What are the symptoms?

Most people do not experience symptoms. If symptoms occur, they can be:

• Increased vaginal discharge
• Painful intercourse
• Bleeding between periods or after intercourse
• Long or heavier periods

How is MPC treated?

MPC is treated with antibiotics. Do not have any sexual contact during treatment and for 7 days after treatment. Encourage your partner(s) to be tested before resuming any sexual activity. You can be re-infected after treatment.

Possible complications:

If left untreated it may cause:

• Pelvic inflammatory disease (PID) (an infection in the fallopian tubes, uterus and ovaries)
• Infertility (inability to get pregnant)
• Ectopic pregnancy (tubal pregnancy)

What is non-gonococcal urethritis (NGU)?

Non-gonococcal urethritis (NGU) is an inflammation of the male urethra (the tube that carries urine from the bladder out of the body) with or without urethral discharge. NGU can be caused by a variety of bacteria, including chlamydia but not by gonorrhea. Less common causes are viruses. 

How is it transmitted?

Most bacteria and/or viruses that cause NGU can be transmitted during oral, vaginal and anal sexual contact.

What are the symptoms?

Many people do not experience symptoms. If symptoms occur, they can be:

• Discharge from the penis
• Itching, irritation and redness around the tip of the penis
• Burning with urination

How is NGU treated?

• NGU is treated and cured with antibiotics.
• It is important to abstain from any sexual contact during treatment and for 7 days after treatment.
• Encourage your partner(s) to be tested before any sexual activity.

Possible complications

If untreated, the bacteria causing NGU may lead to epididymitis (an infection of the tubes that store sperm from the testes) and prostatitis (infection of the prostate).

Pelvic Inflammatory disease (PID) is an inflammation of the uterus, fallopian tubes, ovaries and/or surrounding tissues.

It may be caused by a variety of bacteria and/or viruses, including sexually transmitted infections (STIs).

Many people do not experience symptoms of PID. If symptoms occur, they can be:

• Lower abdominal pain or cramping
• Increased or abnormal vaginal discharge
• Pain during sex
• Bleeding between periods or after sex
• Heavier periods
• Chills and/or fever

• PID is treated with antibiotics. It is important to finish all the medication and tell the clinic if you vomit within one hour of taking it.
• To ensure that the medication is working and your symptoms are improving, you must return to clinic within three to seven days.
• Do not have sex while you are on treatment.
• Encourage your partner(s) to get tested.

Bacteria and/or viruses that cause PID can be sexually transmitted. You can pass the infection to your partner even when there are no symptoms.

If untreated, PID can lead to:

• Chronic pelvic pain (ongoing lower abdominal pain)
• Infertility (inability to get pregnant)
• Ectopic (tubal pregnancy)

Pubic Lice

Pubic lice, also known as crabs, are parasites that attach to body hair, often in the pubic area.  They can also be found in chest, armpit and facial hair, eyebrows and eyelashes. The lice are the size of a pencil dot and are greyish brown in color, making it difficult to see with the naked eye. Lice will lay their eggs at the base of the hair; these nits (eggs) are white or tan in color. Symptoms may appear two to six weeks after infestation.

The following symptoms can be present:

• Severe itching that can be worse at night
• Skin irritation, redness, and inflammation
• Small blue spots can appear where the lice have bitten
• Visible eggs or lice

Scabies

Scabies are mites that infest the skin; they are invisible to the naked eye. Female scabies will lay eggs under the surface of the skin. Symptoms may appear two to six weeks after infestation.

The following symptoms can be present:

• Severe itching, especially at night
• Skin irritation, redness and inflammation that usually appear between fingers and toes, wrist, underarm and the genital area.

How are pubic lice/scabies infestations diagnosed?

Infestations are diagnosed by a doctor or a nurse practitioner after examining the skin and hearing about the symptoms you are experiencing.

How is pubic lice/scabies treated?

• You can treat pubic lice and scabies at home with medicated lotions, creams or shampoos that are available at the drug store without a prescription.
• Ask the pharmacist for assistance and follow all the instructions carefully.
• Seek medical attention if symptoms persist after two treatments.
• All sexual partners, family and other people who have come into close body contact with you will need to be examined and treated.
• Any clothes, bed linen or towels used in the 2-3 weeks prior to having symptoms must be dry-cleaned or washed in hot soapy water. If dry cleaning is not possible, place them in a closed plastic bag and store them away for two weeks.
• Carpets, mattresses and furniture should be vacuumed thoroughly.

Pubic lice and scabies can be transmitted during sexual activity or other skin-to-skin contact. They may also spread by sharing clothing, towels or bedding with someone who is infested. Condoms do not prevent the spread.

What is syphilis?

Syphilis is a sexually transmitted infection (STI) caused by a bacteria called Treponema pallidum. Syphilis infection has four stages with different symptoms at each stage. It is common that a person who has syphilis will not notice any symptoms. If syphilis is not treated, it can lead to serious health problems over time.

How is syphilis transmitted?

• Through direct sexual contact (oral, genital, anal) or close physical contact with a contagious lesion or rash.
• To an unborn baby during pregnancy or delivery.

Primary Stage:

• Painless lesion(s) or sore(s) close to or inside the mouth, genitals (penis or vagina), and/or anus and rectum.  These may or may not be noticeable.
• Swollen lymph nodes.

Secondary Stage:

• A rash on one or more area(s) of the body, including stomach, extremities, palms of the hands, soles of the feet.
• Raised lesions or white patches in the mouth, genitals, or anal regions.
• Swollen lymph nodes.
• Flu-like symptoms (headache, muscle and joint pain, loss of appetite, fever).
• Patchy hair loss.

Early Latent Stage:

• No signs or symptoms, but the infection can still be transmitted to sexual partners

Late Latent Stage:

• After a period of 1-2 years, if syphilis has not been treated it can progress to a late latent stage. During this phase symptoms will not be present. The infection cannot be transmitted, but it can still affect a person’s health. Left untreated, syphilis can damage the heart, liver, brain, bones, or eyes. 

Neurosyphilis:

• Neurosyphilis can occur at any time after the initial infection.
• Symptoms of neurosyphilis can include changes to vision or hearing, severe headache and/or stiff neck, confusion, nausea, or vomiting.
• A neurological examination is performed to assess for neurosyphilis.
• If neurosyphilis is suspected, you will be referred to a specialist.

• A blood test is used to test for syphilis.
• It may take up to 4 weeks for syphilis to be detected in your blood test.  If you’ve been in contact with someone with syphilis you should get tested right away. If needed, repeat the test in 4 weeks.
• Syphilis can also be detected in the fluid from a syphilis lesion or sore.
• Staging of syphilis is based on your symptoms, physical assessment, testing history, and test results. 

What happens if I have a positive test result?

• You will be contacted by a public health nurse who will provide you with resources, counselling, and information.
• Your sexual partner(s) should also be tested and treated for syphilis before you resume sexual activity.
• If you are living with HIV, your healthcare provider will complete a neurological examination on you to rule out possible complications from syphilis.
• If you are diagnosed with syphilis while pregnant, you may be referred to a specialist
• Even though a person is treated for syphilis, part of your test result will remain positive for life. This does not mean you have an active syphilis infection. When seeing a new healthcare provider, it is important to let them know if you have had previous treatment for syphilis. 

How is syphilis treated?

• Syphilis is treated and cured with antibiotics.
• First choice is intra-muscular injections of Penicillin G.
• If you are unable to take Penicillin, an alternative treatment is oral Doxycycline.
• The only treatment option for syphilis in pregnancy is Penicillin G.
• After you have been treated for syphilis, you will need to have follow-up blood tests to ensure treatment success.

• Use an internal or external condom, every time you have sex.
• Use water-based or silicone-based lubricants.
• If you share sex toys, cover the toy with a condom and clean after each use.
• Get tested for STBBIs regularly.

Bacterial Vaginosis (BV)

Yeast Infection