Lymphogranuloma venereum (LGV)
LGV stands for ‘lymphogranuloma venereum’. It is caused by a type of Chlamydia bacteria that attack the lymph nodes (the glands in your neck and groin). In the UK it’s very rare among heterosexuals but is seen among gay and bisexual men.
Symptoms
Symptoms aren’t always noticed, with doctors sometimes mistaking them for other illnesses. Up to a month after infection a man night get a small painless sore where the bacteria entered the body (penis, mouth or rectum). There may be pain and discharge when going to the toilet.
Days or months later the glands nearest the site of infection may become painfully swollen, with fever and feeling ill. LGV in the rectum can cause constipation, discharge, abscesses, bleeding and painful inflammation.
Left untreated LGV can cause permanent damage, such as scarring, swelling and blockage of the lymph nodes in the rectum and genitals that can require surgery.
Nearly all cases among gay and bisexual men seen so far have been in the rectum.
How it is transmitted
The bacteria can spread during sex between men through:
- anal sex without condoms
- fisting without gloves and fingering
- oral sex
Any object (eg, a hand, or dildo) can carry the bacteria from inside one man’s backside into another man’s, especially during group sex. Even a penis with a condom on it or a hand wearing a latex glove can spread LGV during group sex if it enters several men. Sharing enema or douching equipment can also spread the infection. Men most at risk are those with lots of sexual partners, especially if they go to sex clubs, sex parties or saunas.
What can I do if I think I have LGV?
You can go to a free and confidential NHS sexual health clinic. You can go to any, not just the nearest. Your local or family doctor (GP) might also test and treat for STIs but will not be familiar with LGV. A lot of people with LGV are misdiagnosed by their GP and suffer symptoms for months before a sexual health clinic makes the correct diagnosis. For this reason going to a sexual health clinic is a better idea. You can read more about clinics and find your nearest one here.
By law sexual health clinics cannot tell anyone about your visit. But if you are referred by your GP to a clinic they will send a letter to your doctor saying what tests and treatment you had; this will go on your GP records. If you don’t want this to happen it’s better to go straight to the clinic without involving your GP.
Testing
A clinic will test you for Chlamydia using either a urine test or swab from the affected part of the body. If the test is positive and they think you might have LGV more tests will be done to look for the type of Chlamydia that causes LGV.
Treatment
Antibiotics taken for three weeks will cure LGV. So long as the infection is treated soon enough there should be no lasting damage.
Why get treated?
Left untreated an infected person will suffer a lot of pain and discomfort. The longer LGV causes inflammation, the more chance it will leave lasting internal damage. Until the infection is treated someone with LGV risks giving it on to other people they have sex with.
Men with HIV make up a large number of LGV cases. Because LGV causes inflammation and bleeding it makes it more likely that HIV is also passed on during sex. Treating LGV cuts the chance that HIV is transmitted.
Protecting yourself and others
If you have LGV your partner(s) should be told so that they can get checked. The clinic can do this for you if you prefer. Avoid sex if you feel you have symptoms that might be LGV and until the clinic gives you the ‘all clear’ after treatment.
A condom can lower your risk of getting or passing on LGV. The spread of the infection during group sex can be cut by covering with a new latex barrier (condom or glove) each time anything (dildo, hand, penis) goes from inside one man’s body and into another man.
The more sexual partners you have, the more likely you are to have sex with someone with an infection. Reducing your numbers of partners, using condoms and having sexual health check-ups all lower the risk of infections being picked up or passed on. If you’re starting a relationship a sexual health check-up is a good idea, especially if you’re thinking of not using condoms.
This article was last reviewed on: 21/10/11
Date due for next review: 21/10/13
