Symptoms of Sexually Transmitted Diseases

Often, STDs have no symptoms. This is especially true for women. Health problems caused by untreated STDs tend to be more frequent and severe for women than for men, partly because the lack of symptoms may prevent women from seeing a doctor until serious problems have developed. Symptoms that do develop vary depending on the disease and can sometimes be confused with those of other diseases.

Even when there are no symptoms, some STDs may still be passed from
person to person. STDs are passed from person to person through sexual intercourse, genital contact, or contact with body fluids such as semen, vaginal secretions, and blood. Some STDs can also be spread by sharing intravenous drug needles or other items contaminated with the body fluids of an infected person. That is why many doctors recommend periodic testing or screening for people who have more than one trusted sex partner.

Types of STDs

Chlamydia

Chlamydia is a bacterial infection that is spread during vaginal, anal, or oral sex. In women, chlamydia infection can cause inflammation of the cervix and pelvic inflammatory disease. In men it can cause inflammation of the urethra, the organ through which urine passes, and the epididymis, where sperm are stored.

Symptoms

You may have genital chlamydia infection without any symptoms. Experts estimate that up to 75 percent of women and 50 percent of men who have chlamydia infection have no symptoms or symptoms so mild they don’t seek treatment. If you do have symptoms, they usually appear 1 to 3 weeks after exposure.

For women, symptoms may include:

• Burning or pain during urination
• Pain in the lower abdomen
• Anal discomfort
• Abnormal vaginal bleeding or discharge

For men, symptoms may include:

• Burning or pain during urination
• Watery or thin white discharge from penis
• Pain or swelling in the testicles
• Anal discomfort

Treatment

Fortunately, chlamydia infection can be treated with antibiotics. Because many people with chlamydia also have gonorrhea, antibiotics for both infections are usually given together.

Genital Herpes

Genital herpes is caused by the herpes simplex virus, which also causes cold sores around the mouth. Genital herpes infection is spread through sexual contact with someone who has the infection. Usually the virus is transmitted through the sores. It can be spread to others when sores are not present, but this is uncommon.

Symptoms

Some people, even when first infected with genital herpes, do not have any symptoms. For most people, symptoms occur within 10 days of having sex with an infected person. They include:

• Itching, burning, or pain in the genital or anal area
• Visible blisters
• Swollen glands in the genital area
• Lower back, buttock, or leg pain
• Fever
• Vaginal discharge

Symptoms can last up to 3 weeks. Even after the initial outbreak of sores heals, infected people carry the virus for the rest of their lives, with new sores erupting from time to time. It’s typical to have a few outbreaks a year, although the number of outbreaks tends to decrease over time.

Treatment

There is no permanent cure for herpes. Once you become infected with the virus, it stays in your body. However, your doctor can prescribe drugs that can reduce the length and pain of herpes outbreaks.

Genital Warts

Genital warts are caused by the human papillomavirus (HPV). Some types of HPV cause common skin warts, and some are associated with cervical cancer. About one-third of HPV types are spread through sexual contact and cause warts in the genital area.

Symptoms

You may have genital warts and not be aware you are infected, because there are often no symptoms. If warts are visible, they appear as small, raised bumps that may grow larger or disappear. You may experience itching and burning on or near your sex organs or anus and may have pain with intercourse.

In women, genital warts may occur:

• On the inside or outside of the vagina
• On the cervix
• Around the anus

In men, genital warts are less common, generally occurring:

• Around the tip of the penis
• On the shaft of the penis
• On the scrotum
• Around the anus

Treatment

There is no permanent cure for HPV infection, but the warts it causes can be treated. It is important to get treatment from your doctor—do not use drugstore treatments intended for other kinds of warts. Because warts may reoccur, see your doctor regularly for checkups.

Gonorrhea

Gonorrhea is an infection caused by a bacterium that grows and multiplies in warm, moist areas of the body, including the reproductive tract, rectum, and throat. It is most commonly spread through vaginal, oral, and anal contact.

Symptoms

The symptoms of gonorrhea are so mild that you could have the disease and not know it. Even if you don’t have symptoms, you are still contagious. If symptoms do develop, they usually appear within 5 days after exposure.

For women, symptoms may include:

• A painful or burning sensation during urination or bowel movements
• Abnormal vaginal discharge that is yellow or bloody
• Cramps and pain in the lower abdomen
• More pain than usual during menstrual periods

For men, symptoms may include:

• White or yellow discharge (pus) from the penis
• A burning sensation, often severe, during urination

Symptoms of rectal infection include discharge, anal itching, and, sometimes, painful bowel movements.

Treatment

Gonorrhea can be easily treated with antibiotics. It is important that partners be treated at the same time to avoid re-infecting one another or others. Because many people with gonorrhea also have chlamydia, antibiotics for both infections are usually given together. Left untreated, gonorrhea can cause pelvic inflammatory disease in women or urethra blockage in men.

Hepatitis B Virus

Hepatitis B virus (HBV) is a sexually transmitted disease that causes inflammation of the liver and can lead to cirrhosis, cancer of the liver, and liver failure. It is spread through contact with body fluids, so people at risk for getting HBV include anyone exposed to blood and blood products, people who share drug needles, health care workers, and anyone who has several sexual partners. However, one-third of new cases of HBV reported in the United States occur in sexually active young adults with no other risk factors.

Symptoms

Some people who have HBV don’t have any symptoms. If you do have symptoms, they’ll begin 45 to 180 days after exposure and may include:

• Yellow eyes or skin (jaundice)
• Loss of appetite
• Nausea and vomiting
• Fever
• Diarrhea, light-colored stools
• Stomach or joint pain
• Extreme fatigue

Treatment

There is no cure for hepatitis B. About 90 percent of adults recover from HBV in a few months, clearing the virus from their system and developing an immunity. A small percentage of adults are unable to clear the infection from their bodies, and the infection becomes chronic. Over time, chronic HBV infection may cause your liver to stop working and you may need a liver transplant. If you think you have been exposed to HBV, your doctor may be able to give you hepatitis B immune globulin to prevent hepatitis from developing.

Prevention

A very effective vaccine is available to prevent HBV infection. People who should be vaccinated include:

• All babies at birth
• All children up to 12 years of age who have not been vaccinated
• People of any age who fall into a high-risk group (people who have more than one sex partner in 6 months, men who have sex with men, and people who inject illegal drugs)
• Anyone who is exposed to human blood

Human Immunodeficiency Virus

Human immunodeficiency virus is the virus that leads to AIDS. HIV destroys CD4 cells, which help the body fight off infection and disease. When you lose CD4 cells, your immune system breaks down, allowing you to get certain infections and cancers. When you have HIV infection and your CD4 cell count is less than 200, it is called AIDS, and you are less able to fight off disease. When a person gets HIV, it can take about 10 years before AIDS actually develops.

Causes

HIV is spread through sexual contact, shared drug needles, or other situations where people are exposed to infected blood, semen, or vaginal secretions. To become infected with HIV, the blood, semen, or vaginal secretions must enter your body.

HIV is not spread through:

• Using public restrooms
• Coughing or sneezing
• Hugging or touching
• Food or water
• Shared work or school space

Even if an HIV-infected person is otherwise healthy and has not yet developed AIDS, he or she can spread it to other people. If you already have another sexually transmitted disease and are exposed to a person with HIV, you’re at greater risk for getting HIV.

Symptoms

Early symptoms of HIV (within weeks to months after exposure) include swollen lymph glands and flulike illness. Later symptoms (years after exposure) include:

• Persistent fevers and night sweats
• Persistent fatigue
• Unexplained weight loss or loss of appetite
• Prolonged diarrhea
• Swollen lymph nodes
• Purple bumps on skin or inside mouth and nose
• Recurrent respiratory infections, shortness of breath, or dry cough

HIV is diagnosed by testing your blood for the presence of antibodies to the virus. HIV tests aren’t accurate immediately after infection because it takes time for your body to develop these antibodies—usually from 6 to 12 weeks. In some cases it can take up to 6 months for an HIV antibody test to become positive.

There is no cure for HIV/AIDS, but many medications can dramatically prolong the lives of people infected with HIV by slowing damage to the immune system.

Syphilis

Syphilis is a complex disease spread through vaginal, anal, or oral sex. In its first stage, this bacterial infection can cause sores on the genitals and rectum or in the throat. Sores usually appear within 10 days to 3 months after exposure. Because they are painless, sores often go unnoticed.

Symptoms

If left untreated, the secondary stage of syphilis can produce symptoms that include:

• Rash over any area of the body, especially on the palms of the hands or soles of the feet
• Fever
• Fatigue
• Muscle aches
• Sore throat

When the secondary symptoms disappear, the latent (hidden) stage of syphilis begins. In this stage there are no symptoms, but without treatment the disease can begin to damage the internal organs. This damage may show up years later in the tertiary (late) stage of syphilis. In this stage, serious problems can occur, including paralysis, heart abnormalities, and mental illness. The damage may be serious enough to cause death.

Treatment

Syphilis can be cured with penicillin or other antibiotics. Although treatment will kill the syphilis bacterium and prevent further damage, it will not repair any damage already done. Some people need more antibiotics to cure the disease, followed by periodic blood tests to check that the infection is gone.

Trichomoniasis

Trichomoniasis is a bacterial infection that is spread through sexual activity. In women the vagina is the most common site of infection. In men, infection most often occurs in the urethra.

Symptoms

Trichomoniasis often occurs without any symptoms. When symptoms do develop, it’s usually within 20 days of exposure.

For women, symptoms may include:

• Heavy yellow-green vaginal discharge
• Pain during intercourse
• Vaginal odor
• Vaginal irritation and itching
• Lower abdominal pain

For men, symptoms are rare, but may include:

• Discharge from the penis
• Painful or difficult urination

Treatment

Trichomoniasis can be treated with antibiotics. To prevent reinfection, all sexual partners should be treated at the same time, even if not all have symptoms. Avoid sexual intercourse or use a condom until treatment is completed.

Special Risks During Pregnancy

Sexually transmitted diseases pose special risks during pregnancy. Many STDs can be passed from mother to child during pregnancy, at birth, or shortly after. Often, STDs can lead to health problems for newborns. For example:

• Low birth weight and premature birth appear to be associated with STDs, including chlamydial infection and trichomoniasis.
• Chlamydial infection can cause pneumonia and eye infections.
• Gonorrhea can cause blindness or life-threatening infections.
• Syphilis can cause a baby to be stillborn or to die shortly after birth.
• Herpes simplex can cause encephalitis and death.
• Babies born with HIV may not grow and develop normally and may also develop cerebral palsy. They are vulnerable to the same problems as adults with HIV, and eventually the disease is fatal.
• Children who get hepatitis at or before birth may become chronic carriers of the virus.

Women who have syphilis, gonorrhea, or chlamydia can be treated with antibiotics during pregnancy to prevent complications for themselves and their babies. Women with active genital herpes sores may need to deliver by cesarean section to keep their babies from getting the virus. Women who are HIV positive should take anti-HIV medications during pregnancy to reduce the risk of passing the virus to the baby.

Treating Sexually Transmitted Diseases

Your doctor may make a diagnosis based on your history and a physical examination. There are also a number of laboratory tests available. Your doctor may scrape a sample of cells from the affected area to be analyzed. For some STDs, blood tests can be used to confirm a diagnosis.

When diagnosed and treated early, many STDs can be cured by antibiotics or other medications. Some people are too embarrassed to ask for help or information about STDs, but the earlier you seek treatment and warn sex partners about the disease, the less likely the disease will cause permanent physical damage or be spread to others.

Preventing Sexually Transmitted Diseases

The two best ways to prevent sexually transmitted diseases are to abstain from sex and to have a mutually monogamous sexual relationship (when you and your partner only have sex with each other) with someone who is uninfected. If neither option works for you, here are some other things you can do:

• Limit the number of sexual partners you have, and don’t go back and forth between partners. The more sexual partners you have, the greater your risk for STDs.
• Always use a condom. Choose latex condoms with receptacle tips rather than natural-membrane (lambskin) condoms, which may be more likely to break or to allow viruses and bacteria to pass through. If you’re sensitive to latex, choose polyurethane condoms. Never use oil-based lubricants such as petroleum jelly or baby oil, which can cause condoms to break. Keep in mind that condoms fail at a rate of 10 to 15 percent as a result of flaws or improper use.
• If a male condom cannot be used appropriately, use a female condom.
• During oral sex, use a condom, a dental dam, or plastic wrap.
• Remember that condoms don’t offer complete protection against all STDs, because they don’t cover the entire genital area.
• Don’t share drug needles.
• If you are sexually active with multiple partners, have screening tests regularly to check for STDs.
• Avoid douching, which removes some of the normal protective bacteria in the vagina and increases the risk of getting some STDs.