STIs in women: symptoms and examination

STIs are common, particularly in young women. Sexual history-taking is eased by private and comfortable surroundings, establishing a good professional relationship, having a non-judgemental attitude, and choosing words that are both appropriate to the consultation and readily understood by the woman. Genital examination is facilitated by privacy, careful and sensitive technique and the availability of the right equipment, including a gynaecological examination couch and a range of speculums. The screening investigations selected depend on the setting, local availability of investigations and prevalence of infections, and the presentation and wishes of the client. Sampling requirements are changing with the advent of new diagnostic techniques such as nucleic acid amplification tests for Chlamydia; these can be undertaken on samples taken by the woman herself (e.g. perineal swabs, urine), thereby avoiding the need for speculum examination in some circumstances.