Unfortunately, Ireland like other European countries, is experiencing an increase in STIs over the last five years.
The most commonly notified STIs in Ireland in 2024 were chlamydia (n=11,534) and gonorrhoea (n=5,961).
HSE Health Protection Surveillance Centre data to the end of 2023 showed that notification rates for all STIs in Ireland increased by 30.7 per cent compared to 2022. Worryingly, in females aged 15-24 years, Gonorrhoea notifications increased by152 per cent and Chlamydia by 28 per cent in that same time period.
One explanation for this might be that we are picking up previously undetected STIs because confidential, free STI testing at home was introduced in Ireland in 2021. In 2024 the HSE Home Testing accounted for 48 per cent of chlamydia and 29 per cent of gonorrhoea notifications nationally. The remainder were diagnosed by GPs or in a hospital setting.
Another reality is that condom use has fallen off since the arrival of effective HIV drugs. Because a new diagnosis of HIV is no longer a death sentence, the fear has gone. The resulting reduced condom use has caused a surge in all STI infections including syphilis.
HSE June 2025 stats do, however, show a slight reduction in notifications for chlamydia and gonorrhoea, by 12 per cent and 16 per cent respectively.
Chlamydia
Chlamydia is a curable STI caused by the bacteria Chlamydia trachomatis.
It can infect the urethra or wee pipe, womb, cervix or Fallopian tubes. In men, it can infect the urethra, testicles and rectum. In both sexes, the throat and eyes can be involved.
Chlamydia cannot be caught by kissing, hugging, sharing baths or towels, using swimming pools or from toilet seats, only through unprotected sex. Chlamydia can also be passed to a newborn if the mother is infected at the time of birth. Chlamydia is very infectious; if one partner has it, guaranteed you both do.
Symptoms: Up to 70 per cent of men and 50 per cent of women have absolutely no symptoms.
This makes the blame game difficult, as it is possible for a chlamydia infection to be present for some time, say from a previous relationship. So if you get a positive chlamydia test it does not necessarily mean your partner has been playing away. I know; it’s complicated.
Lower genital tract infections can cause a change in vaginal discharge, bleeding after sex or bleeding in between the periods. If the wee pipe or urethra is involved it can cause cystitis or a burning sensation when you pee as well as increased frequency of urination and can be mistaken and for a urine infection. If the womb is infected it causes pain that feels like period pain and can cause very heavy, painful periods. It can also cause pain during sex. Again, most men have no symptoms, but there may be a discharge from the penis or burning when passing urine.
Complications: Prompt diagnosis and treatment is needed to prevent serious complications. Chlamydia affecting the womb causes PID, pelvic inflammatory disease. This results in severe pelvic pain, which can become chronic. Infected tubes can become scarred causing tubal infertility and ectopic pregnancy. In rare cases, joints or the liver can be involved. For menchlamydia infection of the testicles can cause chronic pain and swelling.
Gonorrhoea
Caused by the bacteria Neisseria gonorrhoeae, Gonorrhoea, unlike Chlamydia, usually causes symptoms within a few days of the offending sexual encounter making the blame game much easier.
Symptoms: Fifty per cent of women get a change to their vaginal discharge, which may become heavier or change colour. Twenty-five per cent of women get low abdominal pain. Gonorrhoea does not cause bleeding problems like chlamydia. If the urethra is infected it causes cystitis and urinary frequency and again can be mistaken for a urine infection. Up to 20 per cent of women infected with gonorrhoea end up with serious womb infection, PID, which can make you quite unwell with high temperature and affect fertility down the line.
Ninety per cent of men with a gonorrhoea will develop a yellow/green discharge from the penis. Gonorrhoea can infect the throat in both men and women. That usually does not cause any symptoms or sore throat. Men can end up with spread to the testicles causing chronic pain, tenderness and swelling.
Complications: Again, for women, even one gonorrhoea infection can lead to problems conceiving down the line. In men, infection can lead to chronic testicular pain or chronic inflammation of the prostate gland.
Diagnosis: There is no need for an embarrassing examination. A self swab of the skin of the vulva is the most accurate way of diagnosing chlamydia and gonorrhoea for women. For men, it is a urine sample and tests can be done confidentially, for free and in the privacy of your own home (www.sexualwellbeiing.ie).
However, if you do have any of these symptoms: change in your vaginal discharge, increase in heaviness or pain of your periods, a new problem with pain when having sex or cystitis with dashing to the loo, it is very important to see your GP for an examination.
Treatment
Chlamydia is treated with a one-week course of antibiotic called doxycycline, which is free for all.
We recommend a woman’s sexual partner is treated at the same time to avoid reinfection. It is not absolutely necessary but it is good practice to have the swab repeated six weeks after treatment to ensure that the infection has cleared.
It’s a little more complicated with gonorrhoea as, over the last 10 years, it has become resistant to many antibiotics. Therefore your doctor needs to take a second swab to send to the lab to test for antibiotic sensitivity in order to know what antibiotic to give you. Again, both sexual partners need treatment at the same time and test of clearance is recommended.
Sexual Health Services Ireland
In the UK, STI diagnosis and management guidelines recommend that gonococcal, as well as most other STIs, are managed in specialist Sexual Health Clinics.These are free, self-access clinics that men or women can just book in to for a contraception or sexual health consultation. In Ireland HSE does run similar clinics but they are few and far between with none in rural communities.
Key HSE clinic locations and contacts (check for updates):
• Dublin: Mater Hospital STI Clinic (01 803 2063).
• Cork: South Infirmary Victoria University Hospital (SIVUH) GUM/STI Clinic (021 496 6844).
• Galway: Galway HSE STI Screening (091 525 200).
• Waterford: University Hospital Waterford (051 842 646).
• Mullingar (Westmeath): Midland Regional Hospital (087 710 4152).
• Portlaoise (Laois): Midlands Regional Hospital (086 859 1273).
• Enniscorthy (Wexford): Enniscorthy Health Centre (051 842 646).
But, I’m a 42-year-old woman living in West Cork; how will I pick up an STI?
Many women, especially the over-40s, feel that an STI is something that happens to someone else, to a frisky under-25-year-old perhaps, but not to her. She assumes that an STI will give her a funky discharge or pain, so because she has no symptoms, she is alright.
All not true.
What the stats show us is that although STIs are less prevalent in the over-40s versus the under-25-year-olds, rates in this age group are slowly increasing. There are probably a few factors at play here.
A woman over 40 might feel there is no need to use a condom because she already uses another form of contraception or perhaps the new fella has had a vasectomy. Either way, STIs just don’t cross her mind.
My advice to women of all ages is, if you have a new squeeze, use a condom, even if you already use contraception.
Yes they are expensive, but you can get free condoms (www.sexualwellbeing.ie).
Then, once sex is on the table, have the conversation. Yes, I know; STIs are the least sexy, least romantic topic for a fourth date. Many women worry he will assume you are accusing him of having a ‘mucky willy’! Put a romantic spin on the conversation; say you plan to get a home STI screen yourself, as you would like to be more intimate with your new beau, to have sex without condoms… and that can happen once you both have negative STI screens.
This article is not exhaustive and there are many other STIs that can affect women; genital warts, syphilis, HPV, Hepatitis B and C, as well as HIV.
As always, I hope this is useful and if any readers have a female health topic they would like to see covered, please email the editor, mary@westcorkpeople.ie.
