Understanding Sexually Transmitted Infections Comparative Chart

Use this comparative chart to help you understand and identify the different types of STIs and how you can protect yourself from them.

Dental Dam Male Condom Sexually transmitted infections, or “STIs” for short, are viral, bacterial, parasitic or fungal infections that are contracted from person to person during sexual activity. Infections can be transferred through exchanges of body uids like blood, semen, vaginal secretions and breast milk. Dierent types of sexual activities that transfer infections include oral, vaginal or anal intercourse, as well as skin-to-skin contact. Protect yourself from STIs. It is important to use a latex condom for any sexual activity and to use a dental dam for oral sex. If you have sexual relations with multiple partners, make sure you always use a condom and get tested regularly.

It’s never too late to take action. If you have tested positive for an STI, make sure you seek treatment from your health-care professional as soon as possible. You will also be Female Condom asked to contact all the partners you have been sexually active with, to avoid spreading the infection. It is important to treat STIs right away, as many are easily curable, but may cause infertility or even death if left untreated. Pregnant and lactating women with STIs may require dierent forms of treatment to prevent harm to their fetuses or newborns. Dual protection consists of using a condom with any other form of contraception (like the pill, the patch or the ring) to protect against STIs and to increase contraceptive eectiveness to avoid an unplanned pregnancy. Latex condoms are eective in preventing most STIs.

The chart below lists all the sexually transmitted infections. Viral infections are the most problematic because they are chronic infections which usually require ongoing treatment. Bacterial, parasitic and fungal infections are typically cleared up by the use of prescription medication. Viral Genital Herpes (HSV) Hepatitis B (Hep B) Human Immunode ciency Virus (HIV-AIDS) Human Papillomavirus (HPV) Bacterial Chlamydia (LGV) Gonorrhea (the Clap) Syphilis (the Great Imitator) Parasitic Pubic Lice (Crabs) Scabies (Mites) Trichomoniasis (Trich) Fungal Yeast Infection (Candida) GENITAL HERPES or “HSV” Viral How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Genital herpes is a viral • Not all infected people develop symptoms • Increased risk of transmitting or becoming • Antiviral medications—acyclovir, • There are two types of Herpes infection transmitted • Symptoms may emerge 2 to 21 days after infected with HIV famciclovir and valacyclovir—to simplex virus: through direct vaginal, oral initial infection; usually after 6 • Avoid sexual activity from the start of be started as early as possible o HSV-1, traditionally associated or anal sexual contact with • Prior to an outbreak, the infected person burning/tingling symptoms until all lesions have following the onset of symptoms with cold sores an infected partner may feel a tingling or burning sensation completely healed • Suppressive therapy, which o HSV-2, traditionally associated • By receiving oral sex from a where the virus first entered the skin • Pay attention to personal hygiene to inhibits viral reproduction and with anogenital herpes partner with a history of or—in the case of a recurrence—where avoid fomite transmission reduces outbreaks, can be • The virus may cause a single cold sores there were lesions • Be aware of the potential for recurrences; considered for patients with outbreak or recurrences over time • Through asymptomatic watch for signs and symptoms as they may frequent outbreaks (6 or more • Recurrences may be triggered by: shedding (transmission of During an outbreak: not be obvious times per year) o The menstrual cycle in women the virus when there are no • Painful sores (external or internal) • Condoms and drug therapy can reduce but not • Other considerations for o Emotional stress symptoms or lesions) • Inflammation and redness eliminate the risk of transmission. Condoms have management during an outbreak: o Illness (especially fever) • From an infected woman to • Fever limited effectiveness at preventing infection as they o Pain relievers and laxatives o Sexual intercourse her infant during pregnancy • Muscular pain do not cover the entire genital area o Hospitalization, should urine o Surgery or birth • Tender lymph nodes • Though chronic in nature, herpes is a manageable retention become a problem o Exposure to sun (including • Less commonly, through • An outbreak resolves in 17 days for men infection. Counselling may be useful to help with tanning beds) fomite transmission-contact and 23 days for women, on average relationship issues o Use of certain medications with contaminated objects • Atypical signs and symptoms (without • Advise your ob/gyn of your history of infection; such as towels lesions): genital pain, urethritis, aseptic precautions can be taken during pregnancy and meningitis or cervicitis delivery to minimize risk of transmission to the baby HEPATITIS B or “Hep B” Viral How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Hepatitis B is a viral infection • In up to 50% of people, there are no • All sexual and household contacts of • There is no cure for hepatitis B, but a vaccine to prevent • Hep B is a virus that affects transmitted through anal, outward signs of infection people with hepatitis B should be the infection is available the liver and is found in vaginal or oral sex with an • Up to 8 weeks after exposure to the advised to be vaccinated to • Most individuals recover from hepatitis B infection fully blood and body fluids infected person virus, some people experience prevent infection within about 6 months including the vaginal • Through exposure to flu-like symptoms including: • Chronic hepatitis B can lead to severe • Individuals who are acutely infected with hepatitis B should secretions, semen, breast infected blood or blood o Tiredness liver damage including cirrhosis abstain from sexual activity until their partner(s) have been milk and saliva of infected products (for example, o Nausea and vomiting (scarring of the liver) and cancer screened and immunized if needed individuals injection drug use with o Decreased appetite • Babies born to mothers with • Household contacts should also be screened and • Most infected people (90%) shared equipment, o Rash hepatitis B are at a high risk of immunized if needed naturally produce antibodies accidental exposure or o Joint pain becoming chronic carriers; they • If an individual is exposed, an injection of antibodies may to fight the disease, but needlestick) o Yellowing of the eyes and skin should receive an injection of be given (up to 7 days after a needlestick injury and up to some develop chronic • Occasionally from contact (in rare cases) antibodies immediately after birth, 14 days after sexual contact), followed by the hepatitis B hepatitis B; they carry the with shared household items followed by the vaccine vaccine to help prevent infection. Infants born to infected virus all their lives and are (such as toothbrushes or mothers should receive an injection of antibodies infectious for life razors) immediately after birth followed by the vaccine within • Chronic infection can • During childbirth 12 hours significantly damage (transmission from mother • Individuals with acute (non chronic) infections usually the liver to infant) do not need antiviral medications • Hepatitis B is most common • Individuals who develop chronic hepatitis B infection in developing countries require liver function monitoring and may benefit from treatment with interferon or an antiviral medication HUMAN IMMUNODEFICIENCY VIRUS or “HIV-AIDS” Viral How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? HIV is a viral infection that is transmitted when • Two to 4 weeks after exposure, some • Once AIDS has set in, other afflictions may • No cure exists for HIV-AIDS. • The virus destroys cells the body fluids of an infected person (blood, infected individuals may experience mild occur such as: Treatments are continually critical to a person’s semen, pre-semen, vaginal secretions, breast flu-like symptoms that last a few weeks o Infections: pneumocytis jiroveci (previously evolving, helping people living immune system, robbing milk) enter the blood stream of another then disappear known as PCP), cytomegalovirus (CMV) with HIV-AIDS control the virus the body of its ability to individual— specifically, from: • For most people, symptoms don’t emerge causing loss of vision, candidiasis and its symptoms fight other infections • Unprotected vaginal, oral or anal sex until years after exposure (esophageal, lungs, bronchial, vaginal), • Anti-retroviral therapy (ART) helps and illnesses • Use of contaminated sex toys • Once the immune system is weakened, the mycobacterium avium complex, slow the progression of the • HIV weakens the immune • Shared needles or other drug equipment following may develop: mycobacterium tuberculosis infection and can help the system over time (months (for example, water, cookers or crack pipes) o Frequent fever or sweats o Cancers: cervical, anal, kaposi sarcoma immune system restore itself to years) until other • HIV-infected blood or blood products o Joint or muscle pain and lymphoma • Though available HIV medications infections occur and • Household items such as toothbrushes and o Persistent skin rashes o Increased frequency or severity of have lengthened the average time Acquired Immunodeficiency razors that have touched infected blood o Swollen glands herpes outbreaks from infection to progression to Syndrome or AIDS (the fatal • Transmission during pregnancy, childbirth o Sore throat o Conditions affecting the brain AIDS, there are significant side stage of HIV infection) or breastfeeding (transmission from o Fatigue or lack of energy including toxoplasmosis effects that may affect quality of develops mother to child) o Headaches o Chronic intestinal disturbances life. People on ART need to be • HIV cannot be transmitted by mosquitoes o Rapid, unexplained weight loss • In Canada, it is estimated that 27% of people with monitored closely by a specialist or other insects that have made contact o Nausea, vomiting, or diarrhea HIV do not know they are infected and risk for their response to treatment with infected blood, nor can it be • A blood test to check for HIV antibodies is transmitting the virus to others and side effects transmitted through saliva, sweat, tears, the only way to detect HIV infection. It may • Infected individuals should seek guidance from urine or feces of infected individuals, take up to 3 months for an infection to be their health-care providers unless blood is present detectable. Anyone at high risk who tests • Individuals diagnosed with HIV should inform negative initially should retest 3 months sexual partners of their status. Failure to disclose later for certainty may have legal implications HUMAN PAPILLOMAVIRUS or “HPV” Viral How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • HPV is a virus transmitted • Many individuals infected with low-risk types • Genital wart recurrences are • There is currently no cure for • HPV is one of the most common through direct sexual have no symptoms (do not develop visible warts common even with treatment women and men infected sexually transmitted infections contact—primarily vaginal or lesions) • Cervical, vulvar, vaginal, anal, penile with the virus • There are over 100 types of HPV; 40 and anal sex, but oral sex is • In some people, anogenital warts develop and other cancers • Vaccination is available to prevent can cause anogenital infection also a risk within 1 to 8 months on the vulva, cervix, penis, • Obstruction of the urethra or vaginal certain types of HPV. (Note: In • It is estimated that 75% of the adult • Other sexual activity with scrotum, anus or in the urethra. These can be opening Canada, vaccination has been population will have at least one HPV intimate contact (genital small, soft, flesh-coloured growths, with a • Depression and sexual dysfunction in approved for women aged 9 to 45 infection during their lifetime rubbing or activity causing cauliflower-like appearance chronic cases and men aged 9 to 26.) • Low-risk HPV types cause anogenital friction) • The size and number of warts may change over • Specialist referral is required for • Depending on their size, number warts and other benign lesions Genital warts • To an infant during delivery time; eventually most will clear atypical and/or non-healing warts and location, genital warts can be • High-risk HPV types are associated (rare) • During pregnancy, warts may increase in size • Counselling may be useful to help treated using several different with cancer (mainly of the cervix) and number then regress/resolve after delivery with relationship issues that may options, for example strong acids • Most HPV infections clear on their • Other symptoms may include: arise from the complex nature and chemicals, topical cream, liquid own within 1 to 2 years o Itchiness of the infection nitrogen, electric currents or laser • You can visit www.hpvinfo.ca to get o Discomfort during intercourse • Although partner notification is not therapy all your facts o Bleeding with intercourse required, patients are encouraged to notify their partners that they have had genital warts or an abnormal Pap smear

Testing and Screening Methods Resources available at

The early detection and treatment of STIs is critical to prevent further spread of infections. Videos: • My first pelvic (Pap test) and breast exam • My first contraception and STI exam • All about STIs • Hear our stories • How to put on a condom demo Games: Blood Urine Urethra swab Cervix/Vagina swab Smear (Pap test) • Sex-Fu Challenge • Test your sexual IQ at sexU The main methods of testing/screening are: Media: 1. Blood test: syphilis, genital herpes, hepatitis B, HIV Watch the videos on • Matte stories: Oral sex and STIs 2. Urine test: chlamydia, gonorrhea www.sexualityandu.ca 3. Swab/smear: chlamydia, gonorrhea, syphilis, genital herpes, trichomoniasis, yeast infection, HPV Other: to view testing and • Virtual Scenarios: See where your sexual choices lead you 4. Physical exam: HPV, trichomoniasis, pubic lice, scabies screening methods Approaches diﬀer by infection and gender, and may vary across Canada.

Over for bacterial, parasitic, and fungal STIs >>> CHLAMYDIA or “LGV” Bacterial How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Chlamydia is a bacterial infection that • Many infected individuals have no • Chlamydia is often associated with • Uncomplicated genital infections can be • Chlamydia can also cause another can be spread through unprotected symptoms other undetected or untreated treated with antibiotics taken as a single form of STI called lymphogranuloma oral, vaginal or anal sex with an • Symptoms may occur from 2 to 6 infections dose or over the course of one week venerum, also known as LGV or infected partner weeks after initial exposure to the • Individuals infected with chlamydia are • Complicated chlamydial infections (for venereal disease. LGV can cause sores • Penetration and ejaculation are not bacteria at increased risk of contracting and example, pelvic inflammatory disorder, or lumps, inside or outside of the required for transmission Female: transmitting HIV neonatal, or epididymitis) usually genitals • It can be passed from an infected • Vaginal discharge Female: require a longer course of treatment • Chlamydia is the most common mother to her infant during birth, • painful urination • Infection spreading to the uterus and and may require hospitalization for bacterial sexually transmitted causing lung and/or eye infections • lower abdominal pain fallopian tubes (pelvic inflammatory treatment with IV antibiotics infection • vaginal bleeding after intercourse or disease) • Sexual partner(s) who have had contact • The greatest number of infections is between menstrual periods • Risk of ectopic pregnancy with an infected person within 60 days found in people 15 to 24 years old • pain during intercourse • Infertility of diagnosis require testing and • Chlamydia can affect the cervix and • eye or rectal infection (rarely) • Chronic pelvic pain treatment. Abstinence from urethra and occasionally the rectum, Male: • Rashes, sores and joint pain unprotected sexual intercourse until throat, and eyes • Clear, watery or milky urethral Male: treatment is complete (7 days after a • Chlamydia can lead to reproductive discharge • Inflammation of the testicles, prostate single dose treatment, or until all the complications • itchy urethra and scrotum medication is finished for a multiple • painful urination • Rashes, sores and joint pain dose treatment) is essential • testicular pain • Infertility (in rare cases) • Anyone treated for chlamydia should be • eye or rectal infection (rarely) re-tested 6 months afterwards GONORRHEA or “the Clap” Bacterial

How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Gonorrhea is a bacterial Female: • Gonorrhea is often associated with other • Uncomplicated gonorrhea is treatable with • Gonorrhea is the second most infection that can be Women are most often asymptomatic. undetected or untreated infections antibiotics common bacterial STI spread through Those that do exhibit symptoms may • Individuals infected with gonorrhea are at • Complicated gonorrhea infections (for example, • Gonorrhea bacteria are unprotected oral, experience: increased risk of contracting and pelvic inflammatory disorder, neonatal, or becoming more resistant to vaginal or anal sex with • Increased vaginal discharge transmitting HIV epididymitis) usually require a longer course of some medications, requiring an infected partner • Painful urination Female: treatment and may require hospitalization for follow-up for treated infections • Penetration and • Lower abdominal pain • Infection spreading to the uterus and treatment with IV antibiotics • Two-thirds of reported cases in ejaculation are not • Vaginal bleeding after intercourse or fallopian tubes (pelvic inflammatory disease) • Patients treated for gonorrhea should also be Canada are in men required for between menstrual periods • Chronic pelvic pain treated for chlamydia • It is most common in transmission • Pain during intercourse • Infertility • Sexual partner(s) who have had contact with an individuals 15 to 29 years old • It can be passed from an • Rectal pain, discharge or itching • Risk of ectopic pregnancy infected person within 60 days of diagnosis require • Gonorrhea can affect the infected mother to her Male: • Systemic gonococcal infection testing and treatment. Abstinence from cervix, urethra, rectum, throat, infant during birth, Most men develop symptoms within 2 to 7 Male: unprotected sexual intercourse until treatment is and occasionally the eyes causing an eye infection days of infection: • Inflammation of the testicles complete (7 days after a single dose treatment, or • It often occurs as a co-infection • Thick, yellowish-green discharge • Rashes, sores and joint pain until all the medication is finished for a multiple with chlamydia from penis • Infertility (in rare cases) dose treatment) is essential • Gonorrhea can lead to • Painful urination • Systemic gonococcal infection • Anyone treated for gonorrhea should be re-tested reproductive complications • Testicular pain or swelling 6 months afterwards • Rectal pain, discharge or itching SYPHILIS or “the Great Imitator” Bacterial

How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Syphilis is a bacterial Primary syphilis • Syphilis increases the risk of transmitting or • People infected with syphilis are • This infection is sometimes infection that can be • Three days to 3 months after exposure, infected becoming infected with HIV typically treated with injectable called the great imitator transmitted through oral, individuals develop a small painless sore called a chancre • Response to treatment must be monitored penicillin because symptoms mirror vaginal or anal sex with an • The sore appears where the bacteria entered the body over time to ensure effectiveness, especially • Other antibiotics can be used in those of some common infected partner (such as on external genitalia, on the cervix, in the vagina, in HIV-infected individuals some cases, but close monitoring is medical conditions • Through direct contact under the foreskin, in the anus, mouth or throat) • In individuals with HIV co-infection, required • Syphilis progresses in stages with bacteria contained in • The chancre is painless and can be missed easily; while it symptoms may be modified. A longer course • Sexual partners must be notified so • It is infectious in the first syphilitic sores or rashes heals on its own without treatment, the infection remains of treatment and closer follow-up they may seek medical attention, as year after contraction • In rare cases, from sharing Secondary syphilis post-treatment may be required follows: • Syphilis was once considered unclean needles or A person may develop a range of symptoms from 2 to 24 • Early latent syphilis is generally asymptomatic, o For primary syphilis: partners rare in Canada, but is now receiving a blood weeks after exposure, most commonly: but for the first year after infection lesions or from 3 months prior to the on the rise transfusion • A general feeling of being unwell rashes of primary or secondary syphilis can onset of symptoms • From an infected mother • A rash anywhere on the body, but classically on the palms recur and the infection can be transmitted o For secondary syphilis: to her fetus, which can of the hands or soles of the feet • Complications of tertiary syphilis partners from 6 months prior result in fetal death or • Patchy hair loss may lead to death to the onset of symptoms congenital syphilis • Flat, smooth warts in the genital area (not the same as o For early latent syphilis: (causing birth defects) those caused by HPV) partners from 1 year prior to the diagnosis Tertiary syphilis • Response to treatment needs to be Untreated syphilis may lead to tertiary syphilis, which monitored, therefore follow-up is can damage: required • The cardiovascular system (heart and blood vessels) • The neurological system (nerves) • Other major organs of the body

PUBIC LICE or “Crabs” Parasitic

How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Transmission occurs Pubic lice and nits are small and can be • Persistent scratching of irritated skin can cause a • The affected area should be washed and a • Pubic lice are tiny crab-like insects primarily during difficult to spot. Infected individuals may secondary bacterial infection lice-killing cream, lotion or shampoo used that nest in pubic hair; they are intimate sexual and experience: • All sexual partners who have had contact with the (can be obtained directly at a pharmacy) also found in chest, armpit and non-sexual contact • Skin irritation and inflammation infected person in the month before diagnosis should • Itchiness may last for several weeks after facial hair, eyebrows and eyelashes • Pubic lice can live for 1 accompanied by itchiness and redness be treated to help prevent re-infestation treatment, which may be controlled with • Adult insects bite and feed on the to 2 days in the bedding, • Small blue spots on the skin where lice • Clothes, bedding, and other possible contaminated medication blood of their host and lay small towels and clothes of an have bitten items must be washed in hot water or dry-cleaned, • Repeat treatment recommendations eggs (nits) that attach to the shaft infected individual. • Louse feces (fine black particles) in the and mattresses should be vacuumed or, depending should be followed closely of the hair These items can be a infected person’s undergarments on the size, items may be placed in a sealed plastic source of transmission bag for 7 days

SCABIES or “Mites” Parasitic

How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Through close Within 3 to 4 weeks of infestation: • Persistent scratching of irritated skin can • Creams and lotions are available to treat • These parasitic mites burrow below contact—sexual or • Intense itchiness, especially at cause a secondary bacterial infection scabies. These are typically applied and the surface of the skin non-sexual nighttime • All household contacts and recent sexual washed off in a specified amount of time • Eggs laid under the skin hatch and • Scabies can live for 3 days • Reddish rash (on fingers, wrists, partners within the past month should be • Itching may continue for several weeks, so larvae move to new areas and on clothing, towels and armpits, waist, nipples, penis) treated to prevent re-infestation medication may be recommended spread infection bedding; these can be a • With recurrences, the same symptoms • Severe infections are commonly seen in • Repeat treatment recommendations should • Mites prefer warm zones (folds of skin source of transmission occur but more rapidly (within hours people with compromised immune systems: be followed closely on elbows, wrists, buttocks, knees, to days of a re-infestation) the skin can become scaly or crusty, requiring shoulder blades, waist, breasts and more complex and aggressive treatment penis, between the fingers and • Clothes, bedding, and other possible under nails) contaminated items must be washed in hot water or dry-cleaned, and mattresses should be vacuumed or, depending on the size, items may be placed in a sealed plastic bag for 3 to 7 days TRICHOMONIASIS or “Trich” Parasitic How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible CONSIDERATIONS? What are the TREATMENT options? Did you KNOW? • Through unprotected Female: • Trichomoniasis infections can increase • Treated with medication, usually • This is an infection caused by sexual activity, including About half of infected women show signs of the risk of acquiring and transmitting HIV metronidazole (no alcohol can be Trichomonas vaginalis, a microscopic, mutual masturbation and infection including: • Trich may occur in conjunction with other consumed during treatment and for 24 single-celled organism that can be sharing of sex toys • off-white or yellowish-green frothy vaginal STIs, such as gonorrhea, chlamydia, hours following the completion of found in the urethra, bladder, vagina, discharge syphilis, HIV and hepatitis B treatment) cervix, or under the foreskin • sore or itchy vagina • In pregnancy, trichomoniasis infection • Sexual partner(s) should be treated with • pain during intercourse or urination may increase the risk of pre-term metronidazole even if they do not have Male: delivery and low birth weight symptoms Trichomoniasis infections tend to be asymptomatic • Testing is usually not recommended for in men. When symptoms occur, they can include: male partners • irritation or redness at the urethral opening • burning during urination or ejaculation

YEAST INFECTION or “Candida” Fungal How is it TRANSMITTED? What are the SIGNS and SYMPTOMS? What are possible What are the TREATMENT options? Did you KNOW? • While a yeast infection can be Female: CONSIDERATIONS? • Several over-the-counter antifungal tablets, • 75% of women develop vaginal candidiasis transmitted sexually, it is not Women with vaginal candidiasis • Yeast infections can creams, ointments and suppositories are at least once in their lifetime generally considered an STI may experience: increase the risk of available. These are inserted into the vagina for a • Candida can also affect the mouth, • Men sometimes develop signs of • Vaginal itching acquiring and period of 1 to 7 days. They can also be applied esophagus, skin or blood a yeast infection on the head • Swollen or red vulva and vagina transmitting HIV externally to the vulva or penis • Yeast is normally found in a woman’s (glans) of the penis after having • Thick white, clumpy discharge • Sexual partners do not • In certain circumstances, oral medications are vagina. When the fungus begins to grow in intercourse with a woman with resembling cottage cheese need to be notified or prescribed by a health-care provider excess, it may develop into candidiasis vaginal candidiasis. (She may • Burning of the external genitalia on clinically evaluated • For problematic recurrent infections, • Causes of overgrowth include: have no symptoms) urination unless they have maintenance therapy may be recommended o Pregnancy • Pain with intercourse due to vaginal symptoms • Some medications used to treat yeast infections o Recent or current use of antibiotics dryness and irritation of the vulva are harmful if used in pregnancy. All pregnant and certain other prescription Male: women should seek medical advice prior to using medications Men with an infection of the penis may any over-the-counter product o Sexual activity develop balanitis (inflammation of the head o Poorly controlled diabetes of the penis) and may experience: o A weakened immune system • Itching o Genital moisture retention • Red dots on the tip of the penis caused by tight-fitting clothing • Dry peeling skin • Burning during urination (occasionally)

780 promenade Echo Dr., Ottawa ON K1S 5R7 Tel/Tél.: 1 800 561-2416 or/ou (613) 730-4192 ext Fax / Téléc.: (613) 730-4314 www.sogc.org