What is Lymphogranuloma Venereum (LGV)?
Lymphogranuloma Venereum is a sexually transmitted infection (STI) caused by a variant of the Chlamydia trachomatis virus. Lymphogranuloma Venereum is usually passed on through having unprotected sex, sharing sex toys, group sex or through fisting (when a hand is inserted inside a partners rectum) with the virus entering the body through the rectum, penis or vagina. The virus can also be transmitted orally through the mouth and throat but transmission this way tends to be rare.
Lymphogranuloma Venereum LGV attacks the lymph nodes, an important part of your immune system, usually around the genitals and anus. Often, there are no symptoms of Lymphogranuloma Venereum, however, the majority of symptoms that have appeared within the UK have shown up in the rectum.
In 2019, Public Health England reported a staggering 94.8% of LGV cases found in gay or men who have sex with men (MSM) with positive cases increasing from 8.2% to 9% between 2018-2019. Previously, cases in the UK were declining while LGV outbreaks were prominent abroad in Europe, Australia and North America but cases have been shown to be steadily increasing every year within the UK.
Let’s find out more about the symptoms of Lymphogranuloma Venereum, treatment and testing of Lymphogranuloma Venereum, HIV and LGV, as well as how to protect yourself from catching this common STI.
What are the symptoms of Lymphogranuloma Venereum?
There may not be any symptoms of Lymphogranuloma Venereum LGV, but the virus can still be transmitted from person-to-person. However, if you do have symptoms of Lymphogranuloma Venereum, they tend to appear between 3 days and 3 weeks after exposure. If untreated, late presentation can occur up to 20 years after infection.
Symptoms of Lymphogranuloma Venereum LGV may include;
- Ulcer or lesions around penis, vagina or anus.
- In women, sores may appear inside the genital areas and may be hard to see.
- Symptoms of systemic illness; Fever, rash, headache, nausea, vomiting
- Swollen lymph glands around the groin, armpit or neck.
- Blood or discharge coming from the anus.
- Pain in the anal area when emptying your bowels or having receptive anal sex.
- Constipation, painful straining or loose poos when trying to open the bowels.
- A feeling of incomplete emptying after opening the bowels (tenesmus).
- Discharge or pain when urinating.
If left untreated, LGV can cause lasting damage to the rectum that may require surgery.
How is Lymphogranuloma Venereum tested?
If you suspect you may have LGV or display any symptoms of Lymphogranuloma Venereum, you will need to visit a local sexual health clinic. Testing for Lymphogranuloma Venereum is not usually a routine test and if your results come back negative for Chlamydia, LGV tends to be ruled out. However, if your Chlamydia result is positive or Lymphogranuloma Venereum is suspected, then a clinician may take a swab from either inside your rectum, vagina or orally. The results can take up to 3 weeks to come back.
What is the treatment for Lymphogranuloma Venereum?
Treatment for Lymphogranuloma Venereum involves taking an antibiotic, known as Doxycycline which is usually taken twice a day for three weeks. Occasionally, other antibiotics are given.
The result of the LGV test can take up to 3 weeks to come back, but the clinician may advise you to start treatment before the result is available. A further test may also be offered after 3-4 weeks to check that the infection is gone. Your partner may also need treatment and you’ll be advised not to have any sexual contact until the infection is gone.
If left untreated, LGV can cause scarring and swelling of the skin. It can also cause permanent swelling of the genitals.
MSM and HIV
While LGV diagnosis for MSM remains much higher for those living with HIV, positive cases have increased dramatically since 2013 for HIV negative or unknown status MSM. This increase follows a period of change in HIV prevention, with increased access to PrEP. Public Health England advises that in order to produce adequate and targeted health promotion, a focus on gay, bisexual and MSM with a history of STIs is vital, as they may have different sexual behaviour, including condomless sex and multiple partners.
How can I prevent myself from catching STI’s?
Condoms! Condoms reduce the risk of catching sexually transmitted infections by preventing any sexual fluids from being transferred. By using a condom (or dam) every time you have vaginal, anal or oral sex reduces the risk of contracting an STI. We have a wide variety of condoms available from regular, king, super king or trim as well as flavoured and fun condoms so there’s plenty of variety available. Unsure which condom to choose? Open this link 'in a new window' here What type of condom should I buy?
As well as ensuring you or your partner wear condoms, getting a sexual health screen on a regular basis (we recommend annually or on change of a sexual partner) will help reduce the risk of catching and passing the infection on.