Dr O'Mahony, a sexual health consultant, sees a clear increase in the numbers of patients during the summer at Chester Sexual Health GUM clinic. "People usually get symptoms a week to two weeks after they get back from holiday," he says.
"People let their guard down on holiday, and some drink and then do things they wouldn’t dream of at home."
Getting symptoms - or not
If you have had unprotected sex, remember that not everybody who gets an STI has symptoms. For example, most people who have chlamydia don't notice any symptoms, and so don't know they have it. Research suggests that 50% of men and 70-80% of women don't get symptoms at all with chlamydia infection.
Most people who are infected with HIV experience a short, flu-like illness that occurs two to six weeks after infection. After this, HIV often causes no symptoms for several years.
If you do get symtpoms of an STI, they can include:
- unusual discharge from the vagina
- discharge from the penis
- itching, sores, blisters or lumps on or around the genitals
- pain when urinating
- in women, bleeding between periods or after sex
STIs might be more common in some countries, so having unprotected sex could put you at even more risk than it would at home.
Using a condom
By using a condom you can greatly reduce the risk of pregnancy and STIs.
Of course, not everyone has sex on holiday – but if there's a chance it might happen, you should be prepared. Buy a pack of condoms before you go, and make sure they have the CE mark on the packet. This means they have been tested to the high safety standards that are required in Europe. Condoms that don't have the CE mark won't meet these standards.
If you're going to have sex, tell your sexual partner that you need to use a condom. Don't wait for them to bring up the topic, because they might not.
Bear in mind that:
- condoms can be damaged by oil-based products such as moisturiser, lotion (including sunscreen), baby oil and lipstick
- heat can also be a problem – so store them in a cool, dry place
For more information on using male and female condoms, see How to use a condom.
Vomiting, diarrhoea and medication
There's a chance you could get a stomach bug when you're on holiday. If you do, remember that vomiting or diarrhoea can make the contraceptive pill less effective – you can find out more at What if I'm on the pill and I'm sick or have diarrhoea?
Some medicines can also make the pill (combined pill and progestogen only pill), contraceptive patch and contraceptive implant less effective. This can put a woman at risk of pregnancy if she has unprotected sex. Most common antibiotics don't affect contraception, but some do, as do some anti-malaria drugs.
Long acting reversible contraception (LARC) methods, such as the injection, intrauterine system (IUS) and intrauterine device (IUD), are not affected by illness or medication. However, the effectiveness of the contraceptive implant may be lowered by certain medicines.
You can find out more in Does the contraceptive pill interact with other medicines? To reduce your risk, if you have sex use a condom to help protect against pregnancy and STIs.
If you use the contraceptive implant, patch or pill and are prescribed medication when you're on holiday, tell the person who is giving you the medicine that you're using the implant, patch or pill. Make sure you use a condom while taking medicines or antibiotics that might affect your contraception, and for 28 days afterwards.
Masturbation and oral sex
Mutual masturbation can be safer sex, according to Dr O’Mahony, as long as fluids are not passed from one person’s genitals to another via the fingers or any other way.
Oral sex (using the mouth on a partner's vagina, penis or anus) is riskier than most people realise. A cold sore on the mouth is caused by the herpes simpex virus. This can transfer to a partner's genitals during oral sex, giving them genital herpes. Gonorrhoea can live in the throat and transfer as well.
A vaccination against hepatitis B (which can be passed on through sex, as well as contaminated needles) is available and can be added to jabs before travelling.
What to do if you're worried
If you're already back home
If you’re worried that you may be pregnant or have an STI, you can get checked at:
Do this as soon as possible after you get home.
Tell the GUM clinic staff your travel and sexual history, as that will help them give you the most appropriate tests. Find sexual health clinics near you.
If you think you might be pregnant, you can do a pregnancy test. If you're pregnant and don't want to be, you can talk to a GP or staff at a sexual health or contraception clinic to find out more about your options. In Great Britain, abortion is an option.
FPA has a leaflet called Pregnant and don't know what to do? A guide to your options, which you may find helpful.
If you’re still abroad
Check your travel insurance as it may not cover you for tests and treatment for STIs or HIV. In any case, it may be best to wait.
Some countries have a good sexual health service, but others may not. Depending on where you are, the doctor, hospital or clinic may not do all the appropriate tests. "Private doctors can be expensive and there’s no guarantee of the standard of care," says Dr O'Mahony.
"Try to avoid having injections in developing countries if you can. Most antibiotics for STIs can be taken orally. Ask for a copy of your drug leaflet [the leaflet that comes with your medication] and for details of tests and results, and bring them with you when you have your check-up at home."
And if you test positive for anything, try to contact past partners. Your sexual health clinic can help with this.
You can find out more about: