Vir Clinics
10 Harley Street, London W1G 9PF, UK
0207 487 3707 or +44207 487 3707 vir@vir-clinics.com
The all-round health service for men. A member of 21st Century Clinics. Unrivalled experience and success over many years in managing all manner of disorders affecting men: erection correction, ED, stress, fitness, drugs, cancer, sexually transmitted diseases (STD) etc. Complete confidentiality. Medications from stock (Viagra, Cialis, Antibiotics, Testosterone, etc). Call or e-mail NOW for an appointment. You will not regret seeking our help, whatever the problem. Navigation: Move around by means of the links below. Larger pages have internal tags: page to page, use these links. 6806.
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SEXUALLY-TRANSMITTED DISEASES (STDs) 6806
Genito-Urinary Medicine is a fully established specialty within the medical profession, and in Britain a FREE confidential service is provided by each National Health Service Region. You don't need to go through your GP if you don't want to. At VIR we are involved only because some patients dislike the atmosphere or sometimes the delays that occur in GUM clinics provided by the NHS.
Sexual intercourse is an easy way for infectious organisms to spread from one person to another, and sex is a normal part of human life. Some organisms can be spread by other ways just as efficiently. To select which to regard as STDs is somewhat arbitrary and the list of diseases given here is neither complete nor exclusive. The purpose of this page is to de-mystify and thus help worried people to find the courage to come forward. Treatment and the prevention of spread depend on that, which is why the public clinics are provided both free of charge and easy to access. Worry and guilt feelings are just as important as the infections themselves. Our aim is to deal with all this calmly and sensitively.
VIR CLINICS operates with the benefit of our own in-house laboratory, so therefore we can give a superior service because the diagnosis of STDs is more heavily dependent on the laboratory than in almost any other medical specialty. An all-in package is offerred (see PRICES) which includes consultation, follow-up by telephone or visit on one occasion (and further occasions at the discretion of the doctor), tests for Chlamydia, HIV antibodies, Syphilis, Herpes antibodies, Hepatitis B virus (antibodies if indicated), other laboratory tests at the discretion of the doctor, and a first course of treatment if indicated. Sometimes it is not really necessary to undertake all this testing so that the patient can save money. We will advise on this and then charge only for what is actually done, refunding or billing as appropriate. Note that tests for recent HIV exposure are not included in the package.
HIV / AIDS / SIDA. Not surprisingly, this disease is in the front of people's minds. There is a worldwide epidemic and things are going to get much worse. There are good treatments now, though expensive, no cure and no vaccines. The only chance to avoid a billion cases is if a good cheap vaccine is invented quickly, because spread will continue unless everyone in the world suddenly starts practising either safe sex or strict monogamy, which seems unlikely.
We cannot summarise symptoms here, and it would not help much because there may not be a typical pattern. There is no localised sign of infection. Diagnosis is mostly by blood tests. Infection with the common kind of virus, HIV1, can be virtually excluded by a test for antibodies, but not for sure until 6 months after exposure. Diagnosis of an active case can usually be made much earlier than that, so it is worth testing earlier if there are clinical or other reasons for doing so, and then the test may be for antibodies, for the virus itself or for changes in the blood cells (CD4 and CD8 T-lymphocytes), depending on circumstances. All these early tests are much more expensive and are also less reliable than the HIV antibody test. Tests for HIV2 are also available.
Elaborate counselling is often provided for people who come forward to take a test for HIV. We agree that it is a terrible blow to learn that one is HIV-positive. We don't agree that HIV/AIDS should be treated much differently from other diseases that are fatal or potentially fatal to the man concerned or to his family life, and there are some other diseases just as bad in that respect. So the approach at Vir Clinics will be sympathetic but not over the top; we expect you to know your own mind and that you want the result as quickly as we can do it and still get it right.
Syphilis. Four and five hundred years ago, even one hundred years ago, the public notions about syphilis were much like those on HIV/AIDS today. Then treatments were discovered and when penicillin came in fresh cases almost disappeared. Not quite, however, and the disease is now making a comeback, though treatment with penicillin is still usually successful.
There can be a local sign, namely a painless 'sore', but often enough it actually is sore or nothing is ever seen, so we cannot rely on that. We cannot describe all the possible symptoms either, first because this is not a textbook of medicine and second because in the old days syphilis was famous for the variety of ways it could appear, mimicking other diseases. "If you know your Syphilis you know your Medicine."
Diagnosis as for HIV/AIDS is almost always through blood tests for antibodies (VDRL and/or TPHA), though local tests on a fresh sore (chancre) are still sometimes done.
Gonorrhea. Sometimes called Clap, though this word has also been used for syphilis. The classic case presents with discharge of pus from the penis, pain on passing urine and pain in the area of the testicles, though infection can occur without these. Diagnosis may be possible by laboratory tests that are done while the patient is still in the clinic, or bacterial culture may be necessary to show the organism (taking 48 hours or more) and this will be done on a swab taken from inside the penis and therefore painful. Antibody tests are difficult and still unreliable. Though resistance to penicillin is common now, treatment with this or other antibiotics is usually successful. This disease may give rise to infertility because of blockage of some tiny tubes.
Chlamydia. The bacterium that causes this infection was discovered relatively recently, because it is difficult to grow in the laboratory. Typically, a case is expected to present with discharge from the penis. Often that does not happen, more so than with gonorrhea, though as with gonorrhea the infection can cause infertility. Diagnosis is best by laboratory tests for the bacterial DNA or other bacterial products done on a swab (collected as for gonorrhea, though a special kind of swab must be used depending on the exact test) or on a specimen of urine, again collected in a special way (First-Pass Urine). Antibody tests may also be useful to detect recent or past infection but are less useful in finding whether the infection is current. Treatment is with suitable antibiotics.
Herpes The two main types of herpes virus involved are Herpes I and II. Each may be spread sexually or non-sexually, though Herpes I is less commonly involved in a sexual infection and is often the underlying cause of the common 'cold sore' (on the lips). Because of this overlap in method of spread the use of antibodies in diagnosis can be misleading; they can tell us about the existence of recent or past infection, but not about whether the channel was sexual or not.
The typical local sign is a group of small and usually painful blisters (which then burst to form ulcers and at the same time release fluid containing infective virus: it may be possible to detect the virus in this blister fluid and so clinch the diagnosis, though that is an expensive alternative since the clinical appearance is enough in most cases.) Healing will then follow spontaneously. However, and this is a troublesome thing about all the Herpes family of viruses including simple chickenpox; the virus remains in the body, hiding within the DNA of the nerve cells that are connected to where it first gained entrance. Two main consequences are that it can come back in fresh outbreaks without fresh infection, just like with the common cold sore (these repeat attacks of genital herpes usually get less severe as time goes by), and that the virus cannot be eliminated from the body; it hides too well.
The most serious occurrence of strictly genital Herpes is in the case where a woman with open ulcers gives birth to a baby. Infection with either type of virus can run riot in immuno-suppressed patients (e.g. HIV). Treatment is with drugs that suppress the virus, and this may be needed in a serious case or to prevent recurrences if these become a nuisance.
Hepatitis B. There are other kinds of hepatitis virus but this is the one easiest to spread via sexual intercourse, though also spread by other means, and just worth including here. Severity varies enormously, the consequences can be very serious and yet many people never know they've got it. Long-term infectivity is the biggest worry from the point of view of Public Health and all health workers nowadays are tested for this: it is less likely to happen if you catch the virus as an adult, more likely if you are infected as an infant as is still common in underdeveloped countires. Roughly speaking, if you have antibodies (to the 'surface antigen' or 'Australia antigen') you cannot also have active virus (though that may not be enough to protect you from infection later). It is a good plan to be immunised, but testing is needed first.
In our STD screen, which is for a strictly limited purpose, we test for the antibodies, if negative for the active virus (surface antigen).
Non-specific urethritis (NSU). 'Non-specific' here is to convey that we may not know exactly in a particular case what is the cause of the urethritis and discharge. We now realise that most of the cases formerly labelled as NSU in this country were really due to Chlamydia. Now the term would be reserved for cases caused by tiny bacteria called mycoplasma or ureaplasma, or by viruses that often are not possible to identify.
Genital Warts, Molluscum contagiosum, etc. The name says it all, though the warts themselves are often bigger and more florid and faster growing than warts elsewhere. Warts are caused by infection with a particular virus. There is no truly specific treatment though various local applications including podophyllin may be of benefit. Great care is needed because of the irritant properties of such applications.
Crab Lice, scabies, etc. Though not confined to the genitals, infection by crabs is mostly during sexual contact of one kind or another and scabies may be spread by any kind of close contact.
Chancroid. Due to the bacterium Haemophilus ducreyi. Uncommon in Britain.
Granuloma inguinale. Due to infection by Donovania granulomatis. Uncommon in Britain
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