If you have a uterus or know someone who does, you may have heard of PCOS, endometriosis – or both! But what are they, and are they any different? Let’s break it down.
PCOS
PCOS stands for Polycystic Ovarian Syndrome. Despite the name, it’s a condition that has less to do with actual cysts and everything to do with hormones – insulin and androgens in particular. The cause of PCOS is still unknown, but it’s thought that raised levels of insulin in the body cause the ovaries to function differently resulting in the release of more androgens. Genetic factors play a big role in this condition so if you have an immediate family member who has PCOS, there’s a 50% chance that you will develop it too.
The two main players in this condition are Insulin and Androgens and so many symptoms of this condition are more or less severe depending on the levels of these two types of hormones.
Insulin:
Insulin is an important hormone that allows the cells in our body to use glucose from the foods we eat as energy. However, around 85% of women who have PCOS have insulin resistance which means their cells don’t respond normally to the available insulin which results in unstable glucose levels in their blood. When this happens, our bodies react by producing more insulin to try and regulate our glucose levels. This boost of insulin increases the production of androgens in the ovaries.
Insulin resistance can be caused by a variety of factors such as lifestyle and genetics and puts you more at risk of developing diabetes.
Androgens:
Androgens are hormones that are present in all people and high levels of these hormones cause symptoms such as increased body and facial hair growth, scalp hair loss, and acne. Higher levels of androgens in the body can contribute to changes in the menstrual cycle, causing symptoms such as irregular periods and irregular ovulation. These symptoms can reduce your fertility.
Other symptoms include mood changes, weight gain, irregular periods, and periods disappearing altogether.
Endometriosis
Endometriosis is a long-term condition that gradually gets worse where cells that are similar to the endometrial cells that line the uterus are found in other parts of the body. They usually occur in the pelvis and affect a person’s reproductive organs.
During a period, endometrial cells along the lining of the uterus thicken, break down, and bleed. When cells do this outside of the uterus, they stick to other organs causing adhesions, scarring, and excruciating pain. Fatigue, nausea, and bloating are also other issues that can come with this condition.
Similar to PCOS, researchers are still unclear of the cause of endo. However, we have been able to identify some factors with family history being the main one. Long and heavy periods lasting more than five days, low body weight, and alcohol use are other factors thought to play a role in causing endometriosis.
Both endo and PCOS can make it difficult to fall pregnant depending on how severe the conditions are. They both need long-term symptom management often involving several different health specialists such as gynaecologists, dieticians, endocrinologists, and a psychologist.
Last year marked 40 years since the first HIV diagnosis and the start of the HIV pandemic. Much has changed in this time: HIV is now a manageable, chronic illness, and people with HIV have the same life expectancy as those without HIV. There are highly effective and tolerable daily medications which manage the virus, and preventatives that can be taken to decrease the chance of HIV acquisition.
Below we’ll outline some of the key terms in management and prevention of HIV that have led Australia to having a 48% decrease in HIV notifications since 2010.
HIV and AIDS
Human Immonodeficiency Virus (HIV) is a virus that affects the immune system of the body. Over time, if HIV is not managed, you can develop severe immune deficiency – meaning your body can no longer defend itself against illnesses. This late stage of HIV infection is called AIDS – Acquired Immunodeficiency Syndrome. Like many STIs and Blood Borne Viruses, HIV can be spread through bodily fluids such as blood, semen, vaginal fluid and breast milk. You can prevent HIV infection by:
Using condoms, dental dams and water-based lubricants during sex
Using sterile equipment (that is not shared) for any injecting, tattooing or piercing practices
TasP – Treatment as Prevention
There is ZERO risk of sexual transmission from someone on HIV treatment with an undetectable viral load.
Once someone starts on HIV treatment – known as Anti-Retroviral Treatment (ART) – it can take 3 – 6 months for the amount of virus in their blood to be undetectable when tested.
Once a person’s virus is undetectable or they are virally suppressed they cannot pass HIV onto to anyone else.
There is now long-acting injectables available for HIV treatment, meaning rather than a pill(s) a day, people can opt for one injection every two months.
U = U – Undetectable Equals Untransmissible
The U=U Consensus statement was endorsed by Living Positive Victoria which outlined:
A person living with HIV who is on treatment and has an undetectable viral load cannot sexually transmit HIV.
Based on research from studies around the world including HIV Prevention Trial Network (HPTN 052), Opposites Attract, the Swiss Statementand the PARTNER study sero-discordant couples in heterosexual and same-sex relationships did not transmit the virus to their partners if the HIV positive partner had a undetectable viral load.
The official cut-off point for an undetectable viral load as defined by the WHO ranges from <50 copies/ml in high income countries to <1,000 copies/ml in low to middle-income countries.
In Australia an undetectable viral load is defined as under <200 copies/ml, which is also the measurement for viral suppression.
PEP – Post Exposure Prophylaxis
PEP (Post-Exposure Prophylaxis) is a month-long course of anti-HIV (ART) drugs that may prevent HIV infection after a possible exposure
The sooner someone starts PEP the better. It is most effective when started within 24 hours, but it must be started within 72 hours after a possible exposure to HIV.
It takes a few days for HIV to become established in the body following exposure. PEP drugs given in this time may help the body’s immune system to stop the virus from replicating (multiplying) in the infected cells of the body. The cells that may originally have become infected would then die naturally within a short period of time without producing more copies of HIV.
Studies estimate that PEP reduces HIV transmission by 81%.
PrEP – Pre-Exposure Prophylaxis
The use of HIV medication by people at risk of HIV to prevent HIV infection before a possible exposure
By taking PrEP, people who are HIV-negative (meaning they do not have HIV) can reduce the risk of getting HIV by 99%
PrEP is a combination of two medications, tenofovir plus emtricitabine, that comes in a single tablet. PrEP works by preventing HIV from replicating in the body. After contact with the virus, the tenofovir and emtricitabine block the enzyme needed by the virus to replicate.
PrEP can be taken daily, periodically or on-demand
PrEP is only effective in preventing HIV and does not provide any protection against other STIs.
These advances have only been made possible through community-led action, advocacy and activism, peer to peer services, education and support, harm reduction strategies and scientific and medical breakthroughs. It is important to recognise the lives lost to HIV/AIDS and the unbelievable struggles the LGBTQ+ community faced in accessing care; we honour those generations and thank them for their work.
If you’re sexually active, make sure you book in at least one STI test this year. Most STI tests are quick and painless – either a urine test, blood test or swab – and can be done at any GP or sexual health clinic. Remember, the most common STI symptom is no symptoms at all – so your future self will thank you!
Also, if you have a cervix, check that you’re up to date on your cervical screening tests. Cervical screening tests are the best way to detect cervical cancer. You can ask for a self-collected test too, if you don’t want your GP to perform the swab. CSTs are recommended every 5 years.
2. Stock up
The start of the year is a great time to do a stocktake of your sexual and reproductive health tools. Check the use-by dates on your condoms, dental dams, lubes and period products like tampons and disposable pads – and replace whatever has expired! Expired condoms and dams can start to degrade, leaving you at risk of STIs and unplanned pregnancies; expired lubes can change in chemical composition meaning they won’t work as well, and can even cause irritation and infections. Expired cotton tampons and pads, especially if they are stored in moist bathrooms can be a breeding ground for bacteria and mould.
3. Try something new
Lean into the ‘new year, new you’ mantra and explore some sexual and reproductive health products you’ve never tried! This could mean new sex toys, new period products (moon cups or period panties, anyone?) or new contraception options. Like anything else, you won’t know what suits you best until you’ve tried!
4. Educate yourself
Make 2023 the year of learning about all things sexual and reproductive health. From learning about your body and anatomy, learning about fun and pleasurable sex, or the history of the LGBTQIA+ or abortion rights movements, there’s lots of interesting, empowering and inspiring stories out there. Check out our list of recommended books, movies, TV shows and podcasts in our annual zine!
5. Advocate!
Sexual and reproductive rights around the world have been under attack – supporting these causes protects not only your health rights, but those of people all over the world. You can donate to somewhere like the International Planned Parenthood Federation, who fight for sexual and reproductive rights worldwide, or the Guttmacher Institute, a global research and policy advocacy group for sexual and reproductive health. Closer to home, you can support organisations like Share the Dignity, who distribute period products to those doing it tough. You can even encourage the health workers in your life to support sexual and reproductive health rights; ask your GP to train to provide medication abortions to their patients!
Five Red Flags in Bed and How to Manage Them
Here at 1800 My Options, we aim to promote healthy and supportive relationships which make you feel safe and fulfilled, and that includes in the bedroom. Read on for some red flags which should prompt at least a discussion with your partner(s) about why their behaviour isn’t okay, and advice on how to approach the chat.
1. Body-shaming behaviour.
Any partner who ridicules, judges or has opinions on how to “optimise” your body are exhibiting body-shaming behaviour. Commentary about weight, cellulite, stretch marks, acne or the appearance of genitalia or breasts only makes a person feel more self-conscious and less accepted in a relationship, in turn decreasing their enjoyment of sex. All bodies are unique and beautiful: for reference, up to 90% of women have cellulite,1 and all labia and breasts are unique to their owner (see the Labia Library) or the Normal Breast Gallery to view photographs of normal, varying anatomy). Similarly, shaming about noises you make, bodily fluids, or even sexual fantasies you have is problematic. Sit your partner down to communicate how their judgment reduces key factors like trust and openness in the relationship– and if they don’t adjust, there is simply no excuse. All bodies are good bodies, and your natural one deserves respect.
2. Pressuring you or disrespecting your boundaries.
Open communication about what you enjoy, including firm boundaries about what you don’t, can not only help a partner to learn what you like, but also ensures you feel safe with them. If a sexual or romantic partner tries to coerce you into something you don’t feel ready for or don’t like to do, or tries to pressure you to have sex when you don’t want to, that is a form of abuse. Each person’s autonomy and consent is paramount, and attempts to change your mind or act against your will are unacceptable. In such a scenario, feel empowered to say no and leave the situation if safe to do so. If you do not feel safe to do so, call 000 or Victoria’s Sexual Assault Crisis Line on 1800 806 292.
3. They’re keen to receive but reticent to give.
Whilst receiving pleasure important, all partners deserve to feel satisfied, so providing pleasure to others is also important. Studies demonstrate a major orgasm gap between men and women, with one study demonstrating that 91% of men and 39% of women usually experienced orgasm during sex with a partner.2 Cultural focus on men’s sexual appetite and pleasure contributes heavily – there is evidence that women in heterosexual relationships value their partner’s orgasm more than their own.3 In one study including cohorts of women of different sexual orientations, lesbian women reported they usually or always orgasmed 86% of the time, compared with 66% of bisexual women, and 65% of heterosexual women.4
As a society we can challenge these biases by acknowledging female sexuality more openly, and personally women can more directly communicate their needs to their partner. Emphasis on the importance of female orgasm, open communication about desires, good sexual self-esteem and incorporating other types of sex aside from vaginal intercourse are known positive influences on increasing the female orgasm.
4. A lack of education about safe sex, or refusal to learn.
A major part of good sexual health is regular screening for STIs (according to your number of partners, frequency of change of partners, and communities). Discussing STIs you have and being proactive in protecting oneself is very important in keeping our communities sexually safe. However, if a partner is resistant to this discussion, refusing to use condoms or other barriers you’d like to use, or not inclined to undergo STI testing despite your appropriate request, it is very reasonable to not proceed with having a sexual relationship with this person. Being sexually responsible includes openness about STIs, consent and other topics. If a person is not mature enough to communicate about this without being awkward, dismissive or critical, then they are probably not mature enough to be having sex.
5. They tell you they’ve had better.
Maybe it was a throwaway comment, or maybe they did it to intentionally criticise you. However, this sentiment isn’t expressing support or helping to make you feel good. The approach for expressing feedback should always be positive and include helpful suggestions; it should not be mocking or derogatory. Feel free to not try any harder.
References
Luebberding, S., Krueger, N. & Sadick, N.S. Cellulite: An Evidence-Based Review. Am J Clin Dermatol. 2015; 16, 243–256. https://doi.org/10.1007/s40257-015-0129-5
Wade LD, Kremer EC, Brown J. The incidental orgasm: the presence of clitoral knowledge and the absence of orgasm for women. Women Health. 2005;42(1):117-38. doi: 10.1300/J013v42n01_07. PMID: 16418125.
Kontula O, Miettinen A. Determinants of female sexual orgasms. Socioaffect Neurosci Psychol. 2016 Oct 25;6:31624. doi: 10.3402/snp.v6.31624. PMID: 27799078; PMCID: PMC5087699.
Frederick DA, John HKS, Garcia JR, Lloyd EA. Differences in Orgasm Frequency Among Gay, Lesbian, Bisexual, and Heterosexual Men and Women in a U.S. National Sample. Arch Sex Behav. 2018 Jan;47(1):273-288. doi: 10.1007/s10508-017-0939-z. Epub 2017 Feb 17. PMID: 28213723.
Why do people use contraception?
Contraception is used for many reasons, from preventing unwanted pregnancy, to managing menstrual cycles and various health conditions.
Different people may choose to use different methods depending on their circumstances, so it is important not to make assumptions on why someone might choose to use contraception, or to judge them for the type of contraception method they choose to use.
First of all, what is contraception?
Contraception refers to the intentional use of artificial methods, various devices, medication, or surgeries to prevent unwanted pregnancy. Some contraceptive barrier methods, such as condoms, are used to prevent sexually transmitted infections (STIs).
In Australia, there are many contraception methods available:
Long Acting Reversible Contraception methods, such as contraceptive implants and hormonal IUDs
Short Acting Contraception methods, such as the contraceptive injection, vaginal ring, and oral pills
Barrier methods such as internal condoms, external condoms and diaphragms
Permanent methods such as vasectomy and tubal ligation
You can have a read of their correct use and effectiveness in a previous blog post we wrote, at this link.
So, what are the main reasons people use contraception?
Most commonly, contraception is known for preventing unplanned pregnancies.
Different contraception methods work in different ways, and have different efficacy rates. For example, Long Acting Reversible Contraception methods like the IUD and implant are over 99% effective at preventing pregnancy, while emergency contraception pills are around 85% effective.
Our previous blog post discusses various contraception methods and their effectiveness in preventing pregnancy.
Contraception can also help you space your children.
People may choose to plan their families, by having more control of the spacing in between childbirths. These may be for health reasons, lifestyle choices, for financial reasons or otherwise.
Hormonal contraception can be great for managing periods and associated issues.
People may choose to use hormonal contraception options to manage period pain, cramps, bloating, breast soreness, menstrual migraines and the symptoms of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Hormonal contraception may also be used to regulate their menstrual cycles or skip their periods when convenient.
Common hormonal contraception options include the pill, implant and hormonal IUD (eg the Mirena or Kyleena in Australia).
Hormonal contraception can also be useful in managing other health conditions. For example, acne, iron deficiency, polycystic ovary syndrome, endometriosis, cysts, bone thinning, and unwanted hair growth.
A combination of the above!
It is important to note, that most contraception methods do NOT provide protection against STIs, so the use of barrier methods as well as getting regular STI tests are key in ensuring STI prevention. Barrier methods like condoms can be useful in promoting safer sex and preventing STIs. These can be used for oral, vaginal, and anal sex.
It’s always a good idea to discuss your contraception options with your GP or sexual health nurse. You can also contact us at 1800 My Options to find a service near you – call 1800 696 784 (weekdays, 9am – 5pm).
The Better Health Channel has a very useful factsheet on various Contraception Choices.
You can also view our videoexplaining the various contraception options available in Victoria.
If you have periods, you probably want to minimise bloodstains and mess.
Whether they’re single use, multi-use, external or internal – there’s more period products out there than ever before, with all sorts of fun, eco-friendly, fancy-packaging options to choose from! Have a read through some of the pros and cons of period products available in Victoria, and see if there’s something new that catches your eye.
Disposable pads
How they work: Pads are long strips of absorbent material that are stuck to the inside of your underwear crotch. Most disposable pads have a plastic lining. They come in lots of different shapes and sizes – eg with wings, extra long night pads, and heavy flow.
How long they last: Pads should usually be changed every 4 hours, or as soon as they feel too wet.
Pros: Easy to find and relatively cheap. Great for if you’ve just started menstruating, find inserting products in your vagina difficult or don’t feel comfortable using inserted products for cultural reasons. They have almost no risk of Toxic Shock Syndrome. They can also be great for heavy flows, overnight use and are easy to clean up – just pop them in the bin.
Cons: Pads can sometimes shift out of place if you’re moving around, and you can’t wear them over some types of underwear (eg thongs) or doing certain activities (eg swimming). Some types can irritate the vagina. Depending on your flow, you might need to change your pads sooner than every 4 hours to avoid any odour. Like tampons, because they are disposable, they can have a negative environmental impact (with lots of plastic packaging and pads ending up in landfill).
Cost range: $3-5 for a pack of 10-20 pads
Where to get them: Supermarkets, pharmacies, convenience stores, online.
Cloth pads
How they work: These work just like disposable pads, in that they are made of an absorbent material and sit inside your underwear crotch. Unlike disposable pads, they don’t have a sticky side but usually have wings that snap into place. Some cloth pads have a removable absorbent insert. Most cloth pads can be washed just in the washing machine and dried, (though some brands also recommend soaking and stain-treating).
How long they last: Like disposable pads, these pads will need to be changed every 3-4 hours, or when they start feeling wet. But, you can wash and reuse cloth pads for years!
Pros: A lot softer and more comfortable compared to rustle-y plastic pads. Some people also say they smell a bit less, as the fabric allows for more breathing, less moisture and therefore less bacteria build-up. They’re also great for the environment, as they will last a long time. And finally, there’s lots of cute fabric patterns to choose from.
Cons: A bit annoying to carry around (you will need a water-proof pouch) and wash. They can be a lot more expensive up-front too, compared to disposable pads, but over a long time, this cost can even out. Like disposable pads, you also can’t go swimming in these.
Cost range: Varies a lot, depending on the maker – but averaging around $10-15 per pad.
Where to get them: Environmental stores, some supermarkets, online.
Tampons
How they work: These are little cotton plugs that you put in your vagina to soak up blood. They have a little string on the end to make removing them easier. Sometimes they come with plastic applicators that help to insert them, which work like a syringe. You can get tampons with various absorbency ratings. In an entire lifetime, if you use only tampons, you might go through over 11,400 tampons!
How long they last: Tampons should generally be changed every 4-6 hours. Never keep a tampon in for over 8 hours to avoid the risk of Toxic Shock Syndrome. Tampons need to be disposed of in a sanitary bin or regular bin (don’t flush them down the toilet!).
Pros: Super easy to find, relatively cheap, convenient, small to carry around. They’re also great if you need to be active; you can swim with them in! Also, feel very cool knowing they were originally invented to stop bleeding from gunshot wounds.
Cons: Inserting them can be a bit uncomfortable, with some trial and error to find which ones suit you best. They can sometimes dry out the vagina or cause irritation. There is also the small risk of Toxic Shock Syndrome, a very rare complication of some bacterial infections (but handwashing, regular tampon changes and using a pad at night will lower your chance of developing TSS). Additionally, as tampons are disposable, they can have a negative environmental impact – with millions of tampons and packaging ending up in landfill each year.
Cost range: Usually around $5 for a 20 pack.
Where to get them: Supermarkets, pharmacies, convenience stores, online.
Sponges
How they work: Sponges work like tampons – they are inserted into the vagina to absorb blood. There are lots of different types of sponges, made from different materials – from natural sea sponges to synthetic sponges. Some sponges are designed to be reusable, while others should be disposed of after use. Some also come with pre-lubrication, or else you can soften it with some water before insertion. Reusable sponges can usually just be washed with a mild soap under warm water.
How long they last: Like tampons or cups, sponges need to be changed every few hours. Don’t leave them in longer than 8 hours. Reusable sponges can last up to 6 months.
Pros: Being very soft, sponges are often said to be more comfortable as they can adjust to the shape of your body. Reusable sponges are also great for the planet, and sponges made from natural materials are renewable and biodegradable. They’re also great for use during intense activity or sex.
Cons: Sponges can be a bit messy to deal with when removing and replacing (though some sponges are designed with little loops for easier removal and less chances of breaking pieces apart). They can also take a bit of care to make sure they’re clean and ready for re-use. Like tampons, there is the very slight risk of Toxic Shock Syndrome. Disposable sponges are a lot more expensive per use than tampons, and they can be a lot harder to find.
Cost range: Depends on the material and whether they’re reusable/disposable. Disposable sponges can cost a few dollars each, while reusable sea sponges can cost $20-30 each.
Where to get them: Online, some pharmacies.
Cups
How they work: Menstrual cups are small, flexible, bell-shaped devices that are inserted into the vagina to collect blood. They are usually made from rubber or silicone. Cups use suction to stay in the vaginal canal. Some cups will have a stem to help you locate the cup for removal. Before and after a cycle, most cups will need to be boiled; during day-to-day use, you can generally clean cups using a mild soap under cold water. Some brands also sell special devices to sterilise your cups.
How long they last: Cups can be worn for 8-12 hours at a time, or until they are full. With appropriate care, they can last up to 10 years!
Pros: They can be safely kept in for a much longer time than tampons or pads, avoiding frequent bathroom trips. There’s lots of variety in menstrual cup shapes and sizes, so you can find what suits you best. Given their long lifespan, they’re also environmentally friendly, and much cheaper in long run compared to disposable products!
Cons: Cups have a bit of a learning curve to them, and it can require some trial and error to find which brand, shape or size suits you best. They can be more expensive up front compared to a pad or tampon (but long-term are definitely more cost effective). They need to be taken out during sex, and for people with an IUD there maybe a small risk of menstrual cups shifting the IUD.
Cost range: Prices generally range from $30 – 60 a cup, depending on the brand.
Where to get them: Pharmacies, some supermarkets, online.
Discs
Image source: Nixit
How they work: Menstrual discs are similar to cups, in that they are small, flexible devices inserted into the vagina to collect blood. However, unlike cups, menstrual discs sit in the vaginal fornix – the widest part of the vagina and the base of the cervix – and rely on gravity, not suction, to stay in place. Discs can be disposable (made of plastic) or reusable (made of silicone or rubber). Like cups, they will need to be boiled before and after each period, and washed in between insertions.
How long they last: Discs can be inserted for up to 12 hours. Some discs are single-use, while others can be reused and will last for months or years.
Pros: Because they’re thinner and more flexible compared to cups, discs can be worn during sex, if you have an IUD inserted (as they don’t use suction), or if you have a tilted uterus or partial prolapse. Reusable discs are also great for the environment.
Cons: Like menstrual cups, there is a bit of a learning curve involved with inserting discs. They are also a bit messier to remove than cups. Discs can also be a bit expensive, especially if they’re single-use.
Cost range: Discs can range from $3 – $100 each, depending on if they’re reusable, what they’re made from and the brand.
Where to get them: Online
Underwear
How they work: These are basically just super absorbent undies, with usually a few layers to wick away moisture, absorb blood and protect your clothes. They can be made from a variety of fibres, including cotton, bamboo, or synthetics. Usually they’re easy to clean – just run them through cold water before doing a cold machine wash. They can take a while to dry, so you’ll need to have more than 1 set per cycle.
How long they last: Change and clean these every 12 hours. If you care for them correctly, period underwear can last for several years.
Pros: Period underwear are an easy to use, and non-invasive option. With lots of different styles, patterns and absorbency options, these could also be great for people just starting out periods, people wanting overnight protection or extra protection at the tail end of a period. The reusable aspect of these makes them a good environmental choice too.
Cons: These need to be washed immediately after wearing, and take a while to dry. There’s also the upfront cost involved, as well as the trial and error as you find the right size, fit and fabrics you like.
Cost range: Anywhere between $10 – $40 a pair.
Where to get them: Pharmacies, online, and lots of supermarkets and underwear brands are now stocking these.
All About Chlamydia
Chlamydia remains the most common bacterial sexually transmissible infection worldwide – so we’ve got LOTS to say about it!
(It also happens to be the infection one of our team wrote their thesis on, so…read on!)
The infection
Chlamydia trachomatis (CT) is the scientific name for chlamydia. This gram negative bacterium enters and infects the epithelial cells, which make up the vagina, cervix, urethra, anus and penis as well as the throat and eyes (although infection in these last 2 are a little rarer).
Transmission
It is commonly transmitted through oral, vaginal and anal penetrative sex. It can also be transmitted through genital-to-genital contact – sometimes known as frottage. Semen (or cum) does not have to be present to cause an infection.
Symptoms
The most common symptom of Chlamydia is having no symptoms! This is known as being asymptomatic. An asymptomatic infection is only revealed by active, regular testing (get an STI test done at least yearly, if not 3-6 monthly).
Symptoms of chlamydia in people with vaginas can vary, but the ones to look out for are bleeding after sex and unusual bleeding, pelvic pain, pain during sex, urinary frequency or urgency as well as painful urination. The big one to watch for is vaginal discharge change – this can be initial change that then clears up, continues or can lead to things like thrush and bacterial vaginosis because the environment of the vagina has been thrown out of whack by the chlamydia.
Complications
If left untreated, infection can result in pelvic inflammatory disease (PID), ectopic pregnancy, chronic pelvic pain and tubal infertility in women and people with uteruses. BUT – not everyone that gets chlamydia will experience these complications. Just getting the infection does not mean your fertility is at risk. Once it’s diagnosed, it can be readily and easily treated!
Treatment
Treatment is relatively straight forward. Most often, if you have an uncomplicated or asymptomatic chlamydia infection, you’ll be offered a once-off dose of an antibiotic. If you’re symptomatic or have the infection in your anus you might be put onto a 7 day course of antibiotics. Your doctor will discuss which treatment will suit you best. Most importantly, after treatment, you should avoid any sexual contact for 7 days. This is to allow the medication to work effectively and prevent re-infection from untreated partners.
Testing
Often you’ll be offered a urine pot which makes it relatively quick and easy – just pee in the cup. You can also self-collect a high vaginal swab instead. This way of testing is actually more sensitive and specific than urine and there’s no pressure to pee on demand! You just insert the swab as high up as a tampon, give it a little swirl around, remove it and then place in the tube. Same goes with the rectal swabs – self-collection is often easier and less uncomfortable in many ways.
Re-test at 3 months to exclude reinfection (as reinfection rates are high!) but don’t re-test for chlamydia too soon! If you test again within 4 weeks you could still come up positive because the test finds Chlamydia DNA even if it’s non-viable (treated and “dead”) Chlamydia DNA.
Talking
It’s important to avoid getting re-infected and to protect yourself and your sexual community. The best way to do this is to let your sexual partners know and ensure they get tested and treated too. Repeat infections in quick succession can cause inflammation and can cause scarring that leads to infertility. It’s ok to get chlamydia multiple times in a lifetime – it’s just important that it gets tested and treated as soon as possible. Talk to your partners about regular testing and use condoms as much as possible.
We hope that Chlamydia 101 has been helpful! Get tested, get treated, get talking.
To find an sexual health service near you, contact 1800 My Options on 1800 696 784, weekdays 9am – 5pm!
Telling your partner(s) you have an STI
Sexually Transmissible Infections (STIs) are a normal part of having sex and yet it can still be a tricky part of relationships.
Openly discussing sexual health is not something we are taught to do, but it’s an important part of caring for ourselves and others. It’s important to break down the unnecessary shame and stigma associated with STIs—this stigma causes increased rates of STI transmission, prevents people from getting treatment, and negatively affects people’s health and sexuality.
If you are able to discuss the situation openly and honestly, this can strengthen relationships and lead to a great foundation for communication around sex and sexual safety. People fear the possibility of rejection but the reality of this is that it rarely happens.
It can be helpful to reassure people that all STIs are treatable, and most are curable. For some STIs, using condoms, dental dams, medications or avoiding sex during outbreaks can limit the risk of STI transmission.
The reality is, most people will want to know if they’re at risk of an STI, so they can prevent passing it back and forth with you and/or passing it on to others. They may not have even realised that they had an infection, as most STIs don’t have symptoms. Once they know, they can get tested and treated, and look after their health.
The key bits of information you need to know if you get diagnosed with a bacterial STI like chlamydia, gonorrhoea or syphilis are:
Notify partners both past and current, how far back to go depends on which STI you have and when you were last tested (eg. chlamydia is 6 months and gonorrhoea is 2 months)
Avoid sexual contact until you have been treated
Wait the full 7 days after treatment to resume sexual contact
Wait the full 7 days until after your partner(s) have had the treatment
This is to prevent passing the infection back and forth. Repeat infections can lead to more serious complications and risks to fertility. Ensuring partners are tested and treated is an important way of controlling the spread of infections in the community as a whole.
For herpes there’s some great information and conversation starters from the New Zealand Herpes Foundation under the heading “herpes and relationships” as telling your partner(s) can often be the most difficult part of a herpes diagnosis.
There are websites with examples of conversations and that allow you to send an SMS or email to your partner(s) directly from the site, either personally or anonymously or if you prefer, you can ask your doctor or nurse to help. You don’t even need to provide your name or contact details to use these free and confidential services.
To appropriate from another campaign: it’s a little bit of awkward telling a partner about an STI …for A LOT of peace of mind for your sexual health and relationships going forward!
Top 5 STI myths busted
About 16% of people will report having an STI in their lifetime. That’s one in six people in Australia!
Certain types of STIs have increased in our communities lately, including gonorrhoea (which tripled between 2008 and 2017), and syphilis (which doubled from 2004 to 2017). To keep you as STI-safe as possible, read on as we myth-bust the top five most common misconceptions about STIs with Melbourne doctor, Dr Madeleine.
1. “STIs always show symptoms.”
Symptoms of STIs can include itch, developing a rash or sores on your genitals, unusual discharge and pain passing urine. In people with uteruses, you may experience pain in the lower stomach, and have bleeding after sex or between periods. People with testicles may experience pain in this area.
However, many infections are completely asymptomatic – one study estimated 45% of gonorrhoea cases and 77% of chlamydia cases didn’t present with symptoms! Viruses such as HIV and Hepatitis C often cause infection silently, and can present for the first time years later with life-threatening illness.
As such, it’s important to have STI screening regularly even without symptoms, and to discuss your risk profile with your doctor so you can be tested appropriately. We recommend screening every 6 to 12 months, or more often if you have a new partner or a frequent change in partners.
2. “STIs are only transmitted via penetrative sex.”
STIs can be transmitted with any sexual act! This includes vaginal sex, anal sex, oral sex, and oralanal sex. Sharing toys can also pose a risk. It’s best to protect yourself by using condoms and dental dams whenever you have any type of sex, and keep on top of your own status with regular health checks.
3. “Taking contraception will protect me from STIs.”
Whilst taking some form of contraception is a great idea if you don’t want to become pregnant, it will not protect you from an STI. Ongoing use of condoms or other barrier protection is still essential. And don’t forget that STI protection and contraception are the responsibilities of both partners to think about.
4. “Having an STI means I’m “dirty” or “promiscuous”.”
This is very far from the truth. A person could have sex once and get an STI; alternatively, a person could have multiple partners and remain STI-free by taking appropriate preventative steps. As such, regular screening, abstaining from sex until you’ve been completely treated (such as finishing your course of antibiotics), and making sure any skin sores have completely healed before you have sex again, are very important too.
Also, being aware of language that encourages the stigmatisation of STIs (such as referring to oneself as “clean” from STIs, or implying that STIs only happen to people who have lots of sex with lots of different people), will help us collectively remove the shame associated with STIs, and normalise the need for sexual health care!
5. “Having an STI screen is too expensive for me.”
In Victoria, testing can be bulk-billed or directly-billed – meaning there is no out-of-pocket cost for you to have the test. However, some clinics may charge you to see a GP. If cost is an issue for you, try to find a GP who can bulk-bill you for your appointment or visit a sexual health clinic (as they’re typically free or low cost). You can contact 1800 My Options for STI testing services near you!
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