Unfortunately, the problem is complicated by the fact that
some infected persons, particularly women are completely asymptomatic.
Therefore, it may be prudent for those with multiple partners
to go for reglar STD checks every 3 months or so or
each time they start a relationship with a new partner.
What to do when you suspect STD
Stop all sexual activities. You do not want to spread infection
Consult a doctor immediatly. The symptoms of STD may subside
even without treatment. This usually means that infection has
spread deeper and complications may develop. Do not self-medicate.
You may take the wrong medicine or insufficient amounts
of it. Some medicines can cause serious side effects. Partial
treatment also makes it more difficult for the doctor to detect
Get your sex partner(s) to see a doctor. They may not know
they are infected and may develop complications and they may
spread infection to others or reinfect you when you ghave sex
Who to consult
Most doctors, including GP (General Practitioner) treat STD.
Doctors who are specialised in the area of STD are known as STD
specialists or venereologists. In countries such as Singapore
and Malaysia, most dermatologists (skin specialists) are
also trained STD specialists. STD specialists can be found in
private practice as well as in government run STD clinics. If
you have difficulty finding a STD specialist, contact your
local hospital. Alternatively, ask your GP to refer you to a
What to expect at the clinic
All clinics will need to register the patient. This allows
the clinic to contact the patient when the laboratory tests are
abnormal and the patient fails to keep his appointment. If you
are worried about phone calls and letters reaching the wrong
person, request the clinic not to contact you but come personally
for the results. All information obtained in the clinic is strictly
Diagnsoing STD is not a simple task. The doctor relies heavily
on the information you give him, his examination and tests. Let
us examine each of these to give you an idea of what to expect
when you consult a STD specialist.
The doctor usually begins by asking what your complaint is, when
it started and for how long. He will also ask questions pertaining
to the timing of sexual intercourse, with whom and whether any
of these have symptoms and also the type of sexual activity
that took place. He needs this information to help him decide
which tests are appropriate and which sites are at risk of infection.
You should be totally honest with him. He will also ask
about the treatment you have received, allergies to medicines
and whether you have had STD before. In female patients, he will
also enquire about menstruation (period), pregnancies, abortions
and previous Pap (cervical cancer) smears.
The doctor will examine the entire area between the umbilicus
and the mid-thigh, paying special attention to the genital area
and the lymph glands in the groin. Other parts of the body may
be examined, if appropriate.
This involves retracting (pulling back) the foreskin (prepuce) in
the uncircumcised person and examining the penis, testes and
the umbilicus to mid-thigh area. After examination, the doctor
will take some discharge from the urethra for tests. If
there is no discharge, he will pass a platinum or disposible
loop 1 - 2 cm long into the urethra to obtain a specimen. In
homosexual men admitting to passive anal sex, the rectum
will also be examined by passing an instrument known as the proctoscope
into the anus. A swab is then inserted into the rectum and a
sample taken. He may also take a swab from the throat if this
site is at risk of infection. After this, the doctor may
ask the patient to pass the first portion of urine into a glass
and part of the remainder into a second glass. This test, known
as the two glass urine test helps the doctor determine whether
infection is confined to the urethra and has spread higher up
the genitourinary tract. He usually finishes by taking some blood
for tests (see below).
This is a little more involved. As in the male, the doctor begins
by examining the genitla area and the surrounding regions. Then
he does an internal examination by inserting an instrument calkled
the vaginal speculum into the vagina. This allows the doctor
to see inside the vagina and check the vagina and cervix for
any abnormalities. At the same time, it allows him to take samples
from different areas inside the vagina and from the cervix.
A Pap smear may also be taken from the cervix to detect early
cancer. He then withdraws the speculum and takes a swab from
the urethra. There is very little discomfort except for a ticklish
feeling when he takes these specimens. The doctor then inserts
one or two fingers into the vagina, places his other hand on
the lower abdomen and feels the insides between them. This is
known as the bimanual examination and is useful for detecting any
abnormal swelling or areas of tenderness that might indicate
pelvic inflammatory disease (PID). The doctor may also insert
a swab into the rectum to obtain a specimen. A throat swab
may be taken if the throat is at risk of infection.
Finally, he may take blood from one arm. He puts a tourniquet
above the elbow and asks the patient to make a fist. This cause
the veins to bulge out. He then cleans the area with an alcohol
swab and introduces a hypodermic needle into the vein. A
small amount of blood is withdrawn for tests. The hand is relaxeed
and the tourniquet is removed. He then asks the patient to double
up the arm for a few minutes. After this, the arm is straightened
and the wound covered with a small elastoplast.
The examinations described above may appear frightening but
they actually involve very little discomfort and are over in
a few minutes. You will naturally be nervous the first time
but do try to stay relaxed because this actually reduces the
discomfort. The next time you go through this will seem like
nothing. You may notice that several specimens as well as blood
are obtained. This is so that the doctor can test you for several
STD. The reason is that a person may have more than one STD.
There is no single test to detect all STD. The table below
shows some of the tests that are used to help diagnose STD:-