New research from Spain and Austria published in the Journal of Leukocyte Biology, suggests that women are more susceptible to infection during ovulation that at any other time during the reproductive cycle.

The presence of high levels of estradiol before ovulation reduces immune system effectiveness and can lead to the growth and promotion of infection. The Spanish and Austrian researchers who conducted the study said that women’s immune systems appear to drop when they are ovulating.

Miguel Relloso, Ph.D., a researcher involved in the work from the Laboratorio de Inmunobiologia Molecular at the Hospital Gregorio Marañon and Complutense University in Madrid, Spain, said:
“ With the help of this study, we can explain why during ovulation women have a great risk of being infected with sexual transmitted diseases such as HIV or HPV.”

Using mice, the team predicted that this monthly dip in immune function could be a necessary adaptation to allow sperm to survive inside the female long enough to fertilize an egg.

“This adaption which allows male sperm to survive long enough to fertilize an egg, may also open the door to other types of infection”, said John Werry, the deputy editor of the Journal of Luekocyte Biology, which published the results of the study.

When women ovulate, their immune system functioning decreases in order to prevent the body from killing sperm and then, allowing for fertilization of an egg. Unfortunately, the reduction in immune system function also increases the woman’s susceptibility to infection from viruses, bacteria and fungi. For this reason, researchers emphasize the importance of practicing safe sex, particularly while a female is ovulating.

Unprotected sex at any point may increase the risk of receiving a positive STD test. Furthermore, it’s important to pay special attention to personal hygiene, such as hand washing, when you’re ovulating.

If you have any questions relating to sexually transmitted diseases, contact us.

Did you know people who can better communicate and understand another person’s emotions are more likely to have a satisfying sex life?

When we say self-esteem (or self-respect) we are referring to a lot of things. To understand how to increase well-being you first have to understand the purpose of our self-respect.

Simply, self-esteem means liking yourself. In other words, you have a good opinion of yourself. Our self-respect is a belief in one’s self-worth. People who have a clear and positive sense of their self are better able to communicate to others what they want and what they need. Because they feel confident, they can also “give and take” in an adequate way. Self-respect is also an important issue for sexuality because it affects both what we do and how we feel.

For more information about sexuality, contact with us.

According to research, personal attributes such as self-esteem and autonomy also play a role in sexual pleasure and health.

“Sexual health includes sexual well-being, and sexual enjoyment is an important part (of that)” said study researcher Adena Galinsky, of Johns Hopkins Bloomberg School of Public Health.

The vicious or virtuous cycle

One of the main benefits of having sex is that sex makes you feel happy: Sexual health and happiness go hand-in-hand. A 2004 study published in the economics journal The American Economic Review asked 900 American women how various daily activities made them feel and found that “intimate relations” topped the charts for happiness. (The morning commute was the most unpleasant daily ritual.) A 2004 study of 16,000 Americans, published by the National Bureau of Economic Research, found that people who are happy tend to be the ones getting the most action. The study estimated that boosting between-the-sheets time from once a month to once a week was the happiness equivalent of getting $50,000 raise.

Our self-respect and sexual health are very interconnected. Sex has a considerable impact on self-esteem. And also self-esteem has a significant impact on sex.

One could say that there is a virtuous circle between self-esteem and sex, if you practice sex you will feel happier and then your morale is higher. And then, you will have a healthy sexual life! Similarly, the opposite can also be true.

The key to good self-respect is positive affirmation

How you can improve my self-esteem?

There have been many books written about self-esteem and how to improve it. Here are three ideas on how to increase your self-respect and better enjoy sex with your partner.

• Know that you’re a unique and special person. Begin thinking positive thoughts about yourself.
• Exercise! Excercise might be the last thing you want to do after a long day at work, but just 20 to 30 minutes spent breaking a sweat can rid your body of stress and recharge you for the night. Exercise makes people have a more positive attitude.
• Work on accepting yourself. If you want to improve your self-respect, one important step is to get to know your own values and act on them.

Most of us would be dismayed if we were diagnosed with a Sexually Transmitted Disease (STD). To get this knowledge we will have discovered or experienced a problem ‘down there’ and plucked up courage to visit our GP or local GUM clinic.

In the UK, GUM clinics take appointments direct and do not need referrals from a GP. You can take a friend, can go to a clinic anywhere in the UK, drop-in or book an appointment. You will need to check for the opening times of the services on offer.

In a GUM clinic, a sensitive and understanding physician will perform examinations and take samples to determine diagnosis and so provide the correct treatment. As with most medical conditions, when an early diagnosis is made, the swifter is your recovery.

In an STD Clinic, Contact Tracing can add a new level of emotional discomfort. Your physician will ask if the clinic can contact your previous sexual partner, or partners, in order to call them forward for treatment. It was from a sexual partner that your infection was passed on to you, so they too are in need of treatment or counselling.

Logical and sensible that this request is, contact tracing is a difficult task. Yet if successful, some STDs such as Gonorrhoea and Chlamydia could be eradicated. In a recent report ‘Improving Sexual Health Services in Scotland: Integration and Innovation’ it was noted that Contacting Tracing ‘was weak’. Most successful Contact Tracing that the report found was from NH Boards that had good data gathering systems and a Sexual Health Advisor or specialist trained professional. This person would be able to speak with a patient and advise on the need to trace the contacts ands the best approach. Contacts would be made anonymously and both patients and contacts are able to use fictional names linked only in the clinic computer to unique and confidential patient numbers.

The difficulties cannot be minimised. A 100% success rate is not possible. The name of the sexual partner may not be known, or false and the address similarly obscure. There is the possibility of an affair or involvement of a relative, there may be several partners over a short interval, or the partner was a sex worker. Few patients will be prepared to divulge much of this information.

In some instances, a patient may themselves be prepared to assist the clinic and contact the partner directly. However, the contact may be placed in an awkward position and not visit the clinic. One route, if the patient is sure of the source of infection, is to supply medication for the partner via the patient. It may not be the best solution but it could be better than ignoring the infected person, or the subsequent and continuing risk. Using the Internet is another approach. Contacts could choose ‘screen names’ similar to those used on social network websites and undertake a web based consultation. Anonymity is maintained and clinic, patient and society get a better chance of protection.

At SDD we offer a service, where if you have been diagnosed with an STD we can do a telephone consultation with any of your partners that might be infected , and issue them with medication to treat the condition without them having to come in. This servciuce is only available if we have seen and diagnosed the infected patient, and we will only do this if the partner requests this service

Syphilis is one of the most instantly recognised Sexually Transmitted Disease (STD), yet during the last years of the previous century, the recorded annual incidence of syphilis in Genitourinary Medicine (GUM) clinics within the UK was low, around 300 cases in 1997. During the first decade of the 21st Century, the numbers unexpectedly climbed to more than ten-fold by 2007. Alerted and alarmed by the rapid rate of increase of cases, the highest for fifty years, studies were initiated for syphilis alone, and highlighted for notification in wider STD programmes.

The studies identified disease clusters that were located in specific areas and among identifiable group behaviours. Infected groups were linked to internet chat rooms and social websites, other groups were associated with sex between male partners, use of ecstasy and GHB, female sex workers and ignorance of infection spreading via oral sex. HIV cases are also linked to syphilis to a much larger extent than non-HIV patients.

The rise in the incidence of syphilis was not a general phenomenon throughout the UK.

Syphilis is a highly contagious bacterial infection that is easily spread through sexual activity with an infected partner. During the first stage the infection is noticeable: flu-like symptoms and painless, open sore ( chancre) on the genitals and sometimes the mouth. These symptoms occur in either sex during the first 9 to 90 days. Later, these symptoms disappear and might be followed by an itchy rash, most commonly on the soles of the feet and the palms of the hands. A sufferer can believe the original infection has been beaten, however they remain infectious

During these first two stages, infection is easily treated, usually through a course of penicillin injections. It is vital that treatment is sought as the second stage can last many years before moving to the last stage of syphilis infection ( tertiary) affects the brain and can potentially  lead to blindness and death.

For more information, contact us in Samedaydoctor Canary Wharf.

It is also possible for a  pregnant mother to pass the disease on to her unborn baby who can be born with multiple catastrophic conditions such as blindness and brain damage, but fortunately today all blood tests for prospective mothers in the UK are routinely checked for syphilis.

Prevention

As with all STDs, condoms also provide the best protection against syphilis, whether engaged in vaginal or anal sex. Our younger population are more aware of this than the more experienced among us, but may be unaware of infection passing via oral contact.

The usual risk factors for STD are : number of partners, age (young are at a greater risk), alcohol owing to relaxing inhibition and discrimination, drugs that can remove the ability to control personal situations, injecting drugs with contaminated needles.. Sex with partners outside of the UK may also carry a greater risk as management and control of syphilis varies between countries.

The reported studies indicate that you should now be more  aware of internet chat rooms and the associated risks. Also check out if your area caries a heightened risk. Data is readily accessible on the web.

If you suspect that you have caught any STD visit your doctor or GUM clinic. Remember, with syphilis the symptoms change but you remain infected and a risk to others and yourself.

An infected person remains infectious for some time after treatment has finished. Sex is not to be entertained until the doctor gives the all clear.

It has become apparent that having lots of friends on Facebook, Twitter and MySpace could lead to an increased sex life!

Reports have shown that the number of women looking for casual sex encounters online has doubled over the last five years – but does this mean that the number of STI’s contracted as a direct result of online dating has increased?

In short, YES. Popular social networking sites like Facebook and Twitter have been blamed for the rise in cases of sexually transmitted diseases like Chlamydia, Herpes and Syphilis are on the rise as members opt for unprotected sex with the partners they meet over the Internet.

Dramatically, official figures shows a four-fold increase in UK for the potentially-lethal cases of Syphilis.

“There has been a four-fold increase in the number of syphilis cases detected. More and more young women are being affected,” says Prof. Peter Kelly, Director, Tees Public Health.

In a survey, Prof. Kelly also found out that most of the people who report with such diseases had met partners through the networking sites. Therefore, it appears that online dating is making it easier for people to meet up for ‘casual love’. This ‘casual love’ extends to their casual attitude in not wearing condoms.

A spokesperson from one of the social networking sites said that users should take “precautions” and be on their guard while meeting with anyone they encountered online. That includes being properly screened on a regular basis to avoid spreading sexually transmitted diseases.

People over 60 are now the fastest-growing group contracting sexually transmitted diseases, according to government statistics. Since 2002, syphilis has tripled in the over-65s in the UK, and HIV has increased by 60%

What are the reasons for this?

Greater life expectancy and improved health mean that a phase of life never previously seen now exists: an extended middle age: fit, competent and interested in sex.

Internet dating sites and social media has made finding someone to suit this new, more assertive state easier. There are some that are specifically designed to target people in the second half of their life.

New relationships are said to increase enthusiasm and a positive mental attitude. “It’s much better when you live alone and have ‘visits’,” says nanachrissy – from a 50+ dating site.

“When I was married, I think sex was spoiled by underlying resentments and suppressed anger. Now there are no strings and sex is the best ever. Also I have no hangups about my body, because I don’t really care what he thinks (although he is very kind!).”

Furthermore, Menopause, according to author and activist Gloria Steinem, gives women a new drive and confidence. “What we lose in those menopausal years is everything we needed to support another person,” she argues. “What we keep is everything we need to support ourselves.”

Despite this evidence, people over 50 still, like any young sexually active male or female need to go for regular screenings. Unfortunately age has no effect on sexually transmitted diseases and they are just as harmful (if not more so) in older individuals whose immune systems aren’t as strong. Regular checks will eliminate the risk of spreading diseases and promoting illness.

Michael Fassbender has recently starred in a film highlighting the psychological turmoil of a sex addict.

Caspar Walsh states his view on sex addiction: ‘Despite the evidence of an epidemic of sex related diseases, societal problems, marriage breakdowns and family dysfunction, we prefer to take the stiff upper-lip approach; to keep calm and carry on’. He suggests that in this day and age people tend to be ignorant towards sex addiction and anything related.

The film graphically highlights the routine of a sex addict and how it affects his wellbeing. Scenes involving prostitutes, porn, gay sexual activity and heterosexual sex highlight the topic in a new light and shows just how much sex/sex related activity some people actually have.

Clearly, films portraying this subject matter help to highlight the importance of being tested for sexually transmitted diseases and the importance of sexual health clinics.

In his role, Fassbender clearly portrays that sex addicts are unable to face up to their addiction by leading an otherwise normal existence.

It shows how the condition affects not only his emotional state of mind, but problems at work, with his family, relationships and anger issues.

Furthermore, it highlights how issues occurring as a result of sex addiction adds an untold burden to the NHS, police and social service budgets all dealing with its knock-on effects – crime and societal breakdown.

At samedaydoctor we are happy to see pateints concerned about the above issues and can refer you for appropriate counselling if needed.

Recent studies have shown that ONE in FOUR worry they might have infected their partner with a sexually transmitted infection because of unprotected sex.

Even more worryingly, an extremely high number of these people won’t even know they are infected, as STI’s commonly show no symptoms. ‘In fact 70 to 80 per cent of women show no symptoms of having Chlamydia infections, compared with around 50 per cent of men… and approximately half of women don’t show symptoms of gonorrhea’ says Dr Knut Scroeder.

Statistics show that 38% of people refrain from using condoms on holiday because they get caught up in the heat of the moment. “The first time I got Chlamydia was in San Francisco, 2007. The second time I got Chlamydia was in London, 2009. In neither case did I have any symptoms whatsoever. Well, in a way, I did. Wikipedia lists the symptoms of Chlamydia, but it is missing what is often the most crucial one: “Girls texting you saying you gave them Chlamydia.” Says Salvador Ambrosia.

Funnily enough, despite having unprotected sex abroad, a significant percentage of both men and women said that it didn’t occur to them to go and get tested after they returned home!

So, how do we begin to tackle this? The answer is pretty simple: Swallow your ego and go and get a screening at a sexual health clinic. You could essentially be toying with both your own and your partner’s fertility if STI’s like Chlamydia go untreated.

It doesn’t help when a number of couples find it difficult to broach the subject of sex anyway… Choosing not to speak about the problem, or avoiding the subject can have detrimental effects on both health and psychological well-being.

What does a sexually transmitted disease test entail?

This depends on what you’re being tested for, but the test is likely to include an examination of the genitals, skin, mouth, anus, providing a urine and blood sample and a swab being taken from the throat, rectum, and urethra, vagina and cervix.

It’s crucial to realise that the screening process is quick, efficient and pain free. Ten minutes of feeling slightly out of your comfort zone is definitely the best option to avoid passing on the likes of Chlamydia, genital herpes, gonorrhea or even HIV to a partner.

Many of my patients have been asking me about Human Papilloma Virus ( HPV)  Infection in the mouth and throat, and the risks associated with this infection.  I thought it might be useful to write a few words about this.

HPV is a sexually transmitted virus (STI/STD) associated with a risk of developing cervical , vaginal , vulvar  and anal cancer. We now know that there is also a link between HPV and mouth and throat ( oropharyngeal) cancers. A recent study in America concluded that about 1 in 15 Americans are infected with oral HPV.  Previous studies have shown that there has been a threefold rise in oral cancers, caused in  particular by HPV type 16, one of the most aggressive types of HPV.  There are many different strains of HPV, some more aggressive than others.

The good news is that most people will be able to clear the virus themselves, however this is harder when you are repeatedly exposed to the infection.  In a small percentage of people that have the HPV infection , it can then go on and lead to genital warts or cancers.

At the moment there is no specific treatment to prevent oral HPV infection turning into cancer. However there is a vaccine available that protects against the 4 common and more aggressive strains of HPV, called Gardasil. The vaccine consists of 3 injections over a period of 6 months. Currently the vaccine is licensed for women, however we do vaccinate at risk men as well on an off license basis. Given the new evidence that HPV is more prevalent in men, I think it is even more important that men get vaccinated against this infection, than ever before.

Protect yourself against HPV infection by getting vaccinated now!

There are 2 types of herpes infection. Herpes type 1 (HSV 1) typically, occurs around the mouth and HSV 2 typically occurs in the genital areas. However it is important to note that you can get HSV 1 infection of the genitals, and this happens commonly in adults.

Herpes has many different clinical presentations. It is possible to have no symptoms despite having been infected with the virus (asymptomatic infection) and it is estimated that this happens in as much as 80% of infections. This is a major reason why it is possible to catch herpes from a partner, who might not even aware that they have the virus. I want to point this important fact out as there is a lot of anxiety and blame involved when it comes to herpes and it can cause unnecessary difficulties in a relationship.

Once a person has been infected with either HSV 1 or 2, they will usually develop antibodies against the type they have been infected with. However this process can take several months, which is why a blood test is not always the best test to establish if a recent infection has occurred.  If you are concerned that you have been infected recently we can offer serial blood tests over a few months, to see if you develop the antibodies. If the blood test comes back positive for HSV 2, it is almost always genital herpes, whether you develop the actual lesions or not. If the test comes back as positive for HSV 1, this is more complicated, as it could be either oral (coldsores) or genital herpes. A lot of people already have antibodies to HSV 1, and this is usually just due to exposure to the virus from family members as a child. If you test positive for HSV 1, we would then go more on whether you develop lesions and if so where they develop.

Lesions usually appear within 2 days to 2 weeks after exposure to the virus. As mentioned HSV 2 is primarily passed on through sexual contact. The risk of infection is higher if someone has the active lesions present, but again, it is possible to catch the infection from someone who doesn’t have the lesions. The typical herpes lesions are blisters or erosions and they are usually quite painful, although this is dependent on how severe and aggressive the infection is, and also on the site of infection. A large proportion of people will not develop these classic symptoms, and will instead have minor symptoms such as a bit of skin irritation or even just an  abrasion in the genital area. If the skin is broken then it is possible to get a bacterial infection on top of the herpes infection.

The first attack is usually the worst and can last for several weeks. Some people will develop sensory changes in the area before the blisters appear and others might feel systemically unwell with fever , muscle pains or have enlarged lymph nodes in the groin. Lesions usually clear up eventually on their own, but if you suspect you have been infected it is best to see a doctor as soon as possible, as there are treatments that can help reduce the length and the severity of the attack, as long as the treatment is started as soon as possible after the lesions appear.

If you develop suspicious lesions or a rash in the genital area, then often we would perform a swab test from the site. This PCR test is very accurate at detecting HSV and will also distinguish between HSV 1 or 2. Results take between 3-5 working days.

The nature of herpes infection is that is is recurrent. Some people get very frequent attacks others might get one per year. It is impossible to predict the course. Most people find though that the frequency and severity of attacks subside after the first few years. However, if you have an HSV infection, you are infectious most of the time, whether you have the lesions or not. Studies show that viral shedding still occurs from the site to varying degrees even in the absence of lesions. This is probably one of the reasons why herpes infection is so common in adults, as people might not be aware that they are infectious in between outbreaks as well.

Unfortunately at the moment there is no cure for herpes. However it is possible to manage the symptoms by taking antiviral medication, either when you get an outbreak, or as suppressive therapy, over a few months, to try and keep it at bay. Herpes is not life threatening in any way. There are ways to try and reduce the likelihood of infecting sexual partners. Condoms help reduce the risk by about 50% but only if the infected area is in the area protected by the condom. It helps to notify partners so you can both be alert to signs of an outbreak and abstain during that period and as mentioned antivirals can cut transmission rates too.

Many of my female patients are worried about the effect of herpes on fertility and pregnancy. The only real issue is that if you have been infected with herpes in the vagina, then if you are pregnant the doctors need to be informed to decide if a vaginal delivery would still be ok, as there might be a risk of passing the infection on to the baby during vaginal delivery. It is also important to note that if you have been infected with Herpes , we would always advise screening for other STI’s including HIV, as we know that HSV infection makes HIV transmission a bit easier.