Conversations about sexual education and health may often be avoided and uneasy to discuss. However, the prevalence of sexually transmitted diseases or infections (STDs or STIs) in Singapore is much higher than you think. According to studies by the Department of STI Control (DSC), there has been an increase in STD rates in Singapore since 2014*. Did you know that some STDs may not show any symptom, and it is also possible for individuals to be infected with more than one STD or STI? With that said, here are some common STDs in Singapore, and how you can spot and prevent them.

*Source: moh.gov.sg

What are the common STDs in Singapore?

  • Chlamydia

    Chlamydia has the highest incidence rate in Singapore, with a record of 2,719 cases in 2018* alone, and it can infect both men and women. Chlamydia is spread through unprotected vaginal, anal and oral sex with an infected person. Common symptoms include watery milky genital discharge and painful urination. It can have a more serious implication on females such as causing permanent damage to the reproductive system and potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb). Symptoms of Chlamydia may sometimes not be apparent in some individuals, especially females, who continue to spread the infection unknowingly. Individuals can also be re-infected even after past treatments. Chlamydia can also be passed on to a child during childbirth.

    *Source: DSC-Clinic

  • Gonorrhoea

    Gonorrhoea is the second most common STI in Singapore, with the numbers not falling far behind Chlamydia. This infection is caused by Neisseria gonorrhoeae, a bacterium that tends to grow and multiply in warm and moist areas of the body such as the urethra, anus, female reproductive tract, vagina, and even including the eyes and throat. Symptoms of Gonorrhoea include thick white genital discharge and painful urination. They usually occur within two to 14 days after exposure. Untreated gonorrhoea can lead to infertility as a result of pelvic inflammatory disease in the female and epididymitis in the male. Similarly,  it can be passed on to a newborn during childbirth, and lead to severe eye infections and pneumonia.

  • Syphilis

    Syphilis is a highly contagious STD that commonly spreads through sexual contact with an infected individual. The bacteria can also spread through cuts on the skin, and mucous membranes. More often than not, infected individuals are unaware, and the condition is often missed because the early stage of this infection usually presents as a small painless ulcer in the genitals that resolves after three to six weeks even without treatment. The syphilis bacteria can also remain dormant in the body for a long period of time, even years, before becoming active again. Syphilis occurs in four stages and may cause long-term complications such as arthritis, brain damage, and blindness. This STD can also be passed from mothers to unborn children.

  • Genital Warts

    Genital warts are soft growths caused by strains of the human papillomavirus (HPV). The virus is transmitted through close genital contact. This means that you can get and pass on warts if your genital touches someone even if you don't have penetrative sex. HPV is one of the most common STI that can infect both men and women. Genital warts may often be overlooked as the growths may be too small to notice. However, HPV infection is especially dangerous for women because certain high-risk strains of HPV can cause cervical and vulva cancer, which is the 10th most common women cancer* in Singapore. HPV can spread through sexual contact. Even if there are no warts present, HPV can still be infectious if the virus is active.

    *Source: Singapore Cancer Society

  • Genital Herpes

    Genital herpes is a STI caused by the herpes simplex virus (HSV). There are two types of HSV that can be spread from skin-to-skin and sexual contact. Genital herpes usually caused by HSV Type II is highly contagious because the virus can lie dormant in the body and reactivate several times in a person’s life. Infected individuals are the most contagious when there is flare up of the condition, and they engage in sexual activity. While medication can help to ease symptoms and reduce the risk of infecting others, there is no cure for genital herpes. Genital herpes increases individual’s risk of contracting other STDs such as chlamydia, gonorrhea, and AIDs. This infection can also be passed on to newborns during childbirth and result in brain damage, blindness, and even death.

  • HIV / AIDS

    Approximately 300 to 400 new cases of Human Immunodeficiency Virus (HIV) infection* are diagnosed every year in Singapore. HIV infection weakens the body’s immune system by destroying white blood cells that keeps us protected against other bacteria and viruses, hence increasing exposure and the severity of other common diseases as well as risk of cancers. Acquired Immune Deficiency Syndrome (AIDS) occurs at the end of a HIV infection, and is usually fatal due to complications from several conditions. As HIV inserts into the cells’ DNA, it is a lifelong condition with no cure till date. However, HIV can still be well-managed and life expectancy can be prolonged with proper treatment and therapy. While unprotected sexual activities are usually the main cause for the spread of HIV, this STI can also be transmitted via sharing of needles or piercing instruments (eg. tattoo or acupuncture), receiving of infected blood or blood products (eg. organs or plasmas) as well as through pregnancy, childbirth or breastfeeding.

    *Source: moh.gov.sg

What are the symptoms of STDs?

While most STDs and STIs may go unnoticed, here are some identifiable symptoms to ascertain if you have contracted any of the mentioned sexual diseases. Do visit a doctor should you be in doubt of any of the following conditions.

Chlamydia

  • Painful urination
  • Lower belly pain
  • Pelvic discomfort
  • Pain during sexual engagements
  • Abnormal vaginal / penis discharge
  • Unusual vaginal bleeding (females) / bleeding around the anus (males)

Gonorrhoea

  • Increase frequency of urination
  • Painful urination
  • Pelvic discomfort
  • Pain during sexual engagements
  • Abnormal vaginal / penis discharge
  • Heavier menstruation or spotting (females)
  • Persistent sore throat
  • Fever

Syphilis

  • Sores around genital and anal area in the early stages
  • Skin rashes
  • Swollen lymph nodes
  • Fever

Genital Warts

  • Painful blisters around genital area
  • Growth of warts in other areas such as plantar warts, flat warts and common warts may also indicate HPV infection

Genital Herpes

  • Itching or tingling sensation around genital or anal area
  • Painful blisters or sores around genital area or any other area that came in contact with infected areas such as mouth, lips or face
  • Headaches
  • Backaches
  • Swollen lymph glands

HIV/ AIDS

  • Flu-like symptoms such as fever and muscle aches
  • Sore throat
  • Mouth ulcers
  • Rashes
  • Chills
  • Night sweats
  • Fatigue
  • Swollen lymph

How to prevent STDs?

Thankfully, many STDs are curable and can be prevented with effort. Here are some ways you can practise to stay safe and avoid STDs.

Abstinence or protection

Abstinence may sound prudish, but it is one of the surest way to stay protected against STDs.  There is no shame in saying no. Abstaining from casual sex and limit sexual partners also help to reduce the risk of contracting and prevent the spread of STDs or STIs. While abstinence may not be for everyone, using condoms correctly is another responsible way to help to lower the risk of transmission of such sexual diseases. However, it is not guaranteed that condoms can prevent STDs. While it may help to lessen the risk of infection, you may still contract herpes and HPV through skin-to-skin contact.

Maintain good hygiene

Sexual hygiene is also essential in ensuring bacteria and infections does not fester in your body. Always wash before and after sexual engagements to stay clean. Do not share towels and undergarments as they may contain body fluids that carry viruses. Fostering good personal hygiene and care habits can also help to prevent other common infections such as urinary tract infections (UTIs).

Get screened regularly

As most STDs and STIs are often missed due to unnoticeable or lack of symptoms, as well as inactive viruses, it is even more vital to be tested regularly. Detecting STDs and STIs early and learning to properly manage these conditions play a big role in preventing further health complications. Ensuring neither you and your partner has an STD through regular screening before engaging in any sexual activity is another reliable way to remain safe.

It is also important to note that there is no one single test that can test for all STDs because different screening have different procedures. Consult a healthcare provider to access the right test for your health needs. You may bring up and discuss with a doctor if you are looking to test for a specific STI.

Vaccination

One common STD that can be easily prevented through vaccination is HPV. The HPV vaccine helps in reducing your risk of contracting HPV, as well as HPV-related conditions such as genital warts and cervical cancers. The HPV vaccination is suitable for all males and females between the age of nine to 45 years old, with the vaccination recommended for females aged nine to 26 years old under the National Childhood Immunisation Schedule in Singapore. Always consult a doctor should you be in doubt of your vaccination eligibility.

While most STDs are not life-threatening, they can develop into further health complication when left untreated. Keeping yourself protected and getting screened regularly help to ensure your health is on track. Getting an STD is also not the end because many of them are curable and treatable. Early detection and proper management is key to recovery and avoiding re-infection. Take the first step in keeping yourself protected from STDs and STIs.