Lymphogranuloma venereum (LGV)

LGV is a particularly virulent form of the Chlamydia bacteria. It is still rare, but it may become more common over time.

LGV gets inside the body through the mucous lining of the mouth, penis or inside of the rectum. Anal sex without condoms is the easiest way this happens, but using dildos in more than one man’s rectum without cleaning can also spread LGV.

Not everyone with LGV has symptoms. If you do have symptoms, they usually evolve in three stages and it is very important to catch it early:

Stage 1

Three days to three weeks after infection, there may be a small painless sore on the penis, mouth or anus at the site of the original contact. If infection is in the penis, there may be pain when urinating or a discharge.

Stage 2

Ten to 30 days later (or even longer), glands may become painfully swollen. Different symptoms relate to different sites of infection.

• In the rectum – painful inflammation (called ‘proctitis') with blood or pus coming from the area. Bowel movements may be painful. Constipation or painful abscesses/ulcers in the rectum may develop
• In the penis – discharge and swelling of the glands, so much that they push through the skin and leak fluid
• In the lymph nodes – swelling of the glands in the neck and armpits

Stage 3

Over time, the bacteria will cause inflammation, scarring and tissue damage that can have serious effects on the area around the genitals and inside the anus. Haemorrhoid-like growths can develop in the anus and tissue damage can narrow the rectum. The genitals can swell dramatically.

LGV will show up as chlamydia in a penile or anal swab. However, it may be missed in the throat because throat swabs for Chlamydia are not standard. If a test shows positive for chlamydia, further tests will need to be done to confirm LGV.

If treated before it gets to the third stage, LGV is quickly cured with antibiotics and leaves no lasting damage.

Having LGV makes it easier to pass on HIV because of the bleeding and skin damage LGV causes. It also puts you at higher risk of other STIs like syphilis and possibly hepatitis C.

Condoms reduce the chance of getting LGV as does using latex gloves while fisting. When more than two men are having sex a new condom should be used with each man to prevent infection being passed from one to another. Dildos and other sex toys should not be shared or should be covered with a condom that is changed with every new person they are used on or washed between partners. Washing your hands with soap and water immediately after sex can help prevent infection.