It’s estimated that 20 percent of the population of the United States has a sexually transmitted disease (STD), so if this includes you, you shouldn’t feel alone. The Centers for Disease Control and Prevention (CDC) estimates there are almost 20 million new sexually transmitted infections each year, costing about $16 billion in annual health care costs.
They are also on the rise. In 2016, more than 2 million cases of the three nationally reported STDs (chlamydia, gonorrhea, and syphilis) were reported – the highest number ever.
Syphilis was almost eliminated a decade ago, but now cases are multiplying. Increasing rates among women has led to a sharp rise in congenital syphilis (i.e. a pregnant mother passes it to her baby), leading to death and major health complications for the newborn. STDs have also accelerated in men, especially gay, bisexual, and men who have sex with other men (MSM). Improperly treated syphilis can increase your risk for HIV. The CDC estimates about half of MSM with syphilis also have HIV.
Not surprisingly, STDs are infections spread from person to person through sexual contact. They affect men and women, though they often cause more severe health problems in women (and especially if a woman is pregnant).
STDs are incorporated into the broader term, sexually transmitted infections (STIs). That’s because some infections can be cured, but if an infection alters your body’s typical function it’s designated a disease.
Chlamydia is the most common STD and is often symptom-free, which helps explain its prevalence, but there are more than 20 different STDs. We’ll explain each of them in this article, including chlamydia, gonorrhea, genital herpes, human papillomavirus, syphilis, trichomoniasis, and HIV/AIDS.
Chlamydia is a common STD that affects men and women. It’s spread through sexual intercourse with someone infected with chlamydia. Even if your male partner doesn’t ejaculate (or cum), you can still get chlamydia. You can also be re-infected if you’ve had it and been treated in the past, then have unprotected sex with someone who has chlamydia. You can even pass it to your baby during childbirth if you’re pregnant.
Chlamydia is caused by Chlamydia trachomatis bacteria and is most commonly spread through vaginal, oral, and anal sex.
Usually you don’t experience symptoms with chlamydia, so you may not know you have it. But even if you don’t have symptoms, you can still give someone else the disease. If you do experience symptoms, you may not get them until several weeks later.
For women, you may have:
- Abnormal vaginal discharge, that may have a strong smell;
- A burning sensation while urinating;
- Pain during intercourse; and
- Lower abdominal pain, nausea, or fever if the infection spreads.
For men, you may have:
- Discharge from your penis;
- A burning sensation while urinating;
- Burning or itching around the opening of your penis; and
- Pain and swelling in one or both testicles (less common).
If your rectum is infected (men or women), you can have rectal pain, discharge, and/or bleeding.
Risk factors for chlamydia are being sexually active before age 25, having multiple sex partners within the past year, not consistently using a condom, and having a history of a prior STI.
Unfortunately, having chlamydia is also associated with certain complications:
- Other sexually transmitted infections: having chlamydia increases your risk of developing other STIs (i.e. gonorrhea and HIV);
- Pelvic inflammatory disease (PID): an infection of the female reproductive organs;
- Infection near the testicles;
- Prostate gland infection;
- Infections in newborns: chlamydia can pass from the vaginal canal during delivery to the newborn, causing pneumonia or a serious eye infection; and
- Reactive arthritis: you’re at a higher risk of developing Reiter’s syndrome (i.e. reactive arthritis), which typically affects the joints, eyes, and urethra.
To protect yourself from chlamydia, always use a condom during sex and limit your number of sex partners.
Treatment for chlamydia involves an antibiotic and simultaneous treatment of any sex partners. Some of the antibiotics used include:
- A single oral dose of Zithromax; or
- Doxycycline, Erythromycin, Levaquin, or Ofloxacin by mouth for 7 days.
If it’s possible you also have a gonorrhea infection, you will need a one-time injection of Ceftriaxone into your muscle.
Gonorrhea is a STD infecting both men and women in the genitals, rectum, and throat. It’s extremely common, particularly among people aged 15 to 24 years old. Gonorrhea is spread through sexual contact, as well as from a pregnant mother to her baby during childbirth.
Gonorrhea is caused by a bacterial infection, which occurs when the bacteria enters any opening in the body (even the penis, vagina, mouth, or anus). A woman’s cervix is the most common site of infection, while a man’s urethra is the most common.
Most of the time, you won’t have symptoms when you have gonorrhea. If you do have symptoms, they commonly occur in the genital tract, but can appear at several different sites in your body.
For men experiencing genital symptoms, you may have:
- Painful urination;
- Pus-like discharge from the tip of the penis; and
- Pain or swelling in one testicle.
For women experiencing genital symptoms, you may have:
- Increased vaginal discharge;
- Painful urination;
- Vaginal bleeding between periods, such as after vaginal intercourse;
- Painful intercourse; and
- Abdominal or pelvic pain.
You may also experience the following symptoms at the below body parts:
- Rectum: anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue, and having to strain during bowel movements;
- Eyes: eye pain, sensitivity to light, and pus-like discharge from one or both eyes;
- Throat: sore throat and swollen lymph nodes in the neck; and
- Joints: warm, red, swollen, and extremely painful joints (especially when moving the joint).
Things that may increase your risk for getting gonorrhea are being younger, having a new sex partner, having a sex partner who has concurrent partners, having multiple sex partners, having had gonorrhea before, and having other STIs.
If left untreated, gonorrhea can lead to many serious complications. In women, it can spread to your other reproductive organs and cause Pelvic Inflammatory Disease (PID). PID can lead to infertility, as well as tubal pregnancies that can cause the death of both mother and unborn child. Gonorrhea can also cause eye issues (potentially leading to blindness) in infants born to untreated mothers.
In men, gonorrhea can cause urethral scars, testicular inflammation, sterility, and prostate pain and inflammation. For both sexes, the STD can spread to other body parts and cause medical problems, such as swollen, painful joints; damage to the brain and heart valves; and inflammation around the liver.
To protect yourself from gonorrhea, always use a condom during sex and limit your number of sex partners. Don’t have sex with anyone who has unusual symptoms (i.e. burning during urination, genital rash or sore, etc.).
Genital herpes is a STD that can cause sores on your genital areas, butt or rectal areas, and thighs. You can get it from having sex with an infected person, but mothers can also pass it to their babies during childbirth. You can spread genital herpes even when the sores aren’t present.
Genital herpes is caused by a virus called herpes simplex virus (HSV) and there are two different types:
- HSV-1: this type usually causes cold sores or fever blisters around your mouth. It’s spread through skin-to-skin contact, but can spread to your genital region during oral sex.
- HSV-2: this type usually causes genital herpes and spreads through sexual contact, as well as skin-to-skin contact. It’s very common and extremely contagious, even if you don’t have an open sore.
The virus dies quickly outside of the body, so it’s almost impossible for you to get infected by contact with inanimate objects (i.e. toilets, etc.) used by an infected person.
Genital herpes symptoms
The majority of people infected with HSV are unaware they have it because they have no symptoms or their symptoms are so mild. If you do develop symptoms, they may begin about two to 12 days after exposure and may include:
- Pain or itching in the genital region;
- Small bumps or tiny white blisters that appear a few days to a few weeks after the infection;
- Ulcers that make it painful to urinate; and
- Scabs that form as the ulcers heal.
During an initial outbreak, you may also experience flu-like symptoms, like swollen lymph nodes in your groin, headache, muscle aches, and fever.
Wherever the infection entered your body, that’s where the sores will appear. You can spread the infection by touching a sore, then rubbing or scratching another area of your body (even your eyes). Some places both men and women can have sores are
- Butt and thighs;
- Mouth; and
Women can also have sores in or on your vaginal area, external genitals, and cervix. Men can have sores in or on your penis or scrotum.
Genital herpes symptoms are unique to each person – they may recur, on and off, for years; some people may have many recurrences (or outbreaks) every year, while others have fewer outbreaks as time goes by. When you experience an outbreak, you may feel:
- Burning, tingling, and itching at the site where the infection first entered; and
- Pain in your lower back, butt, and legs.
Generally, later outbreaks are less painful and the sores heal more quickly.
Unfortunately, your risk for genital herpes increases if you are a woman (the virus is transmitted more easily from men to women) and if you have multiple sex partners.
Some complications associated with genital herpes are
- Other sexually transmitted infections: having genital sores increases your risk of transmitting or contracting other STIs (including AIDS);
- Newborn infection: babies born to infected mothers can be exposed to the virus during birth, which may result in newborn blindness, brain damage, or death;
- Bladder problems: sometimes the genital sores can cause urethral inflammation that causes the urethra to close, requiring a catheter;
- Meningitis: rarely, genital herpes can lead to inflammation of the membranes and fluid surrounding your brain and spinal cord; and
- Rectal inflammation: genital herpes can lead to inflammation of the rectal lining.
To protect yourself from genital herpes, always use a condom during sex and limit your number of sex partners. Don’t have sex with someone who has an open sore on their sex organs.
As far as treatment for genital herpes, there is no cure. Instead, prescription antiviral medications are used to relieve discomfort and resolve symptoms one to two days sooner. Treatment is most effective if it’s started within a few hours after symptoms start (i.e. at the first sign of tingling or discomfort and before blisters appear).
If you have frequent, painful attacks, your healthcare provider may start you on suppressive therapy (i.e. taking antiviral drugs every day, indefinitely) to reduce the number of outbreaks.
Be aware, that taking antiviral medication does NOT prevent you from transmitting the infection.
Some of the drugs you may be placed on are:
Human papillomaviruses (HPV) are more than 200 related viruses that can cause warts on various parts of your body. Around 40 types affect the genitals and are spread by sexual contact with an infected person. There are two different types of sexually-transmitted HPV – low-risk HPV cause genital warts, while high-risk HPV cause assorted cancers (cervical, anal, some oral and throat, vulvar, vaginal, and penile).
HPV infections are the most common STIs in the United States and because they’re so common, most people get them shortly after first becoming sexually active. While some people develop genital warts from their infection, others have no symptoms. Most high-risk HPV infections will go away within one to two years and not cause cancer, but some can persist for many years. Those types of infections can lead to cell changes that may become cancerous if untreated.
Genital HPV infection is caused when the virus is transferred through sexual intercourse, anal sex, and other skin-to-skin contact in the genital region. Certain HPV infections that result in oral or upper respiratory lesions can be contracted from oral sex.
Most of the time, your body’s immune system beats back an HPV infection before any warts appear. But if you do get warts, their appearance may vary depending on the different type of HPV:
- Genital warts: may be flat lesions, small cauliflower-like bumps, or stem-like protrusions; rarely cause discomfort or pain, but may itch. They mostly appear on the vulva, but also near the anus, on the cervix or in the vagina in women. They appear on the penis and scrotum or around the anus in men;
- Common warts: appear as rough, raised bumps and usually on the hands, fingers, or elbows. Mostly they’re simply unsightly, but can be painful or susceptible to injury or bleeding;
- Plantar warts: are hard, grainy growths that usually appear on the heels or balls of the feet, and may cause discomfort; and
- Flat warts: are flat-topped, slightly raised lesions darker than your skin. They can appear anywhere, but children usually get them on the face, men in the beard, and women on the legs.
If you have persistent, untreated HPV infections (most frequently types 16 and 18), it can lead to precancerous lesions that may progress to cervical cancer over the years. Symptoms of cervical cancer usually appear only after the cancer is at an advanced stage and may include:
- Irregular bleeding between periods or abnormal vaginal bleeding after sexual intercourse;
- Back, leg, or pelvic pain;
- Fatigue, weight loss, or loss of appetite;
- Vaginal discomfort or odorous discharge; and
- A single swollen leg.
Risk factors for HPV are having a higher number of sexual partners, being an adolescent or young adult, having a weakened immune system (i.e. from HIV/AIDS or immune-suppressing medications used after organ transplants), having damaged areas of skin, and touching someone’s warts or not wearing protection before contacting HPV-exposed surfaces (i.e. public showers, etc.).
HPV-related complications include oral and upper respiratory lesions, as well as cancers of the genitals, anus, mouth, and upper respiratory tract.
The best way to protect yourself from HPV is to get vaccinated, which can protect against diseases and cancers caused by HPV when given in the recommended age groups. Always use a condom during sex and limit your number of sex partners. If you’re a woman, have routine screening for cervical cancer.
Treatment for HPV genital warts usually involves laser therapy, electrocautery, freezing, or surgery. All sex partners must be examined and treated, as well. Sometimes, topical treatments will be used, such as:
- Tri-Chlor; and
Syphilis is a STD that infects the genital region, lips, mouth, or anus of men and women. Syphilis is usually spread through sexual contact, but can also pass from a pregnant mother to her baby.
Syphilis is caused by a bacterium called Treponema pallidum and is most commonly transmitted by contact with an infected person’s sore during sexual activity. During its primary and secondary stages (and sometimes its early latent period), syphilis is contagious. Much less often, syphilis can spread by direct, unprotected close contact with an active lesion (i.e. kissing) or from a pregnant mother to her baby (i.e. congenital syphilis).
It can’t, however, be spread through contact with inanimate objects (i.e. toilet, clothing, etc.). But you can become re-infected after being cured, if you have contact with another person’s syphilis sore.
There are several stages of syphilis, and adult symptoms vary depending on the stage.
During the first (or primary stage), you may notice one or multiple sores where the syphilis bacteria entered your body. The sores are usually (but not always) firm, round, and painless, so they may go unnoticed. The sore typically lasts three to six weeks, and heals whether or not you get treatment. You must receive treatment, though, to stop your infection from progressing to the secondary stage.
In the secondary stage, you may experience skin rashes and/or mucous membrane lesions (i.e. sores in your mouth, vagina, or anus). The stage typically starts with a rash on one or more body areas. The rash can appear when the primary sore is healing or several weeks after it’s healed. The rash can look like rough, red, or reddish-brown spots on the palms of your hands and/or the bottoms of your feet. It typically won’t itch and may even be so faint you don’t notice it. You may also have fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The symptoms will also go away with or without treatment, but without treatment your infection will progress to the latent and possibly tertiary stages.
The latent stage is a period of time without visible symptoms. Without treatment, you will continue to have syphilis in your body for years without any symptoms.
The majority of untreated syphilis patients do not develop tertiary syphilis. But when they do reach this stage, it affects many different organ systems, including the heart and blood vessels, and the brain and nervous system. Tertiary syphilis usually begins 10 to 30 years after the initial infection and is a very serious condition. It damages your internal organs and may lead to your death.
If you don’t treat your syphilis infection, it can spread to your brain and nervous system (i.e. neurosyphilis) or eyes (i.e. ocular syphilis), either of which can happen at any stage.
Symptoms for neurosyphilis are
- Severe headache;
- Difficulty coordinating muscle movements;
- Numbness; and
Symptoms of ocular syphilis are vision changes and even blindness.
Your risk for syphilis increases if you engage in unprotected sex, have sex with multiple partners, are a man who has sex with men, and are infected with HIV.
There a large number of complications from syphilis:
- Small bumps or tumors: called gummas, these are bumps that can develop on your skin, bones, liver, or any organ in the late stage; they usually disappear after antibiotic treatment;
- Neurological problems: syphilis can cause stroke, meningitis, hearing loss, visual problems, dementia, loss of pain and temperature sensations, impotence in men, bladder incontinence, and sudden, lightning-like pains;
- Cardiovascular problems:e. aneurysm and inflammation of the aorta and other blood vessels, and damage to heart valves;
- HIV infection: if you have syphilis, you have a 2-to-5-fold increased risk of contracting HIV; and
- Pregnancy and childbirth complications: e. risk of congenital syphilis, which greatly increases the risk of miscarriage, stillbirth, or your newborn’s death within a few days after birth.
To protect yourself from syphilis, always use a condom during sex and limit your number of sex partners. Don’t have sex with someone who has an open sore on their sex organs or you know is infected.
Treatment for syphilis is penicillin, usually by injection, for both you and all of your sex partners within the last two years. This step is very important because syphilis symptoms are mild and may go unnoticed.
Trichomoniasis is a STD transmitted by sexual intercourse with an infected person. Most people do not have symptoms, but if they do it’s usually within five to 28 days after exposure.
The STD is caused by a tiny parasite that travels between people during sexual intercourse.
Symptoms a woman may experience include:
- Heavy discharge from the vagina;
- Foamy (or thin) discharge;
- Yellow, greenish, or gray discharge;
- Discharge with a bad odor;
- Painful sex;
- Pain when urinating or urinary frequency; and
- Itching near the vagina or burning in the vagina.
Men usually do not experience symptoms or their symptoms resolve spontaneously within 10 days. If they do experience symptoms, they may include:
- White discharge from the penis; and
- Pain when urinating.
It’s important to remember that even if you don’t have symptoms, you can still spread the infection.
Things that increase your chances of trichomoniasis are multiple sex partners, a history of other STIs, a previous episode of trichomoniasis, and having sex without a condom.
Complications associated with trichomoniasis primarily affect women. If you’re a pregnant woman with trichomoniasis, you could deliver prematurely, have a baby with a low birth weight, or transmit the infection to your baby while it passes through the birth canal. You also have an increased risk of becoming infected with HIV if you’re a woman with trichomoniasis.
To protect yourself from trichomoniasis, always use a condom during sex and limit your number of sex partners.
Trichomoniasis is treated with prescription medications for you and any sex partners:
- Flagyl; or
It’s important to note that because of the way these medications are processed by your body, you can’t drink alcohol while you are on these drugs. If you do drink, you can become very sick.
Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system, specifically the CD4 cells (or T cells) that help us fight infections. Our bodies can’t ever fully get rid of the HIV virus (even with treatment), so it is a lifelong disease once you are infected. If you don’t treat your HIV infection, the virus will destroy the number of T cells in your body over time to the point you can’t fight off infections and disease. Once a person has these opportunistic infections or cancers, which take advantage of an extremely weak immune system, it’s a sign that the person has Acquired Immunodeficiency Syndrome (AIDS) – or the last stage of an HIV infection.
There are three stages of HIV infection: acute HIV infection, clinical latency, and AIDS.
Acute HIV infection stage
Within two to four weeks after infection, most people experience flu-like symptoms, that have been described as “the worst flu ever.” This stage is the “acute retroviral syndrome” (ARS) or “primary HIV infection,” and the body is mounting a natural response to the infection. If you think you might have been recently infected and may be in this stage, you should seek immediate medical care because there can be significant health benefits.
Also during this phase, it’s important to know that your body is producing large amounts of virus, which means you are at an extremely high risk of transmitting the virus.
Clinical latency stage
In this stage, people experience no or very mild symptoms. The virus will continue to reproduce at very low levels and may even be undetectable with standard laboratory tests. If you take the standard treatment regimen, you may live in this stage for decades and never progress to AIDS. For those who aren’t being treated, this stage generally lasts about 10 years and then you will develop AIDS. While you are in this stage, you can still transmit the virus to others, but the risk is greatly reduced.
This stage happens when your immune system is so badly damaged that you become vulnerable to opportunistic infections. When the number of your CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3) (versus a healthy person’s CD4 of 500 to 1,600 cells/mm3), or if you have one or more opportunistic illnesses, you are deemed to have AIDS.
Without treatment, the average lifespan for an AIDS patient is three years, but after an opportunistic illness diagnosis it drops to one year. In the United States, most HIV patients don’t progress to AIDS because of the effectiveness of the standard treatment regimen. A person with HIV who is diagnosed early now has a similar life span to someone like them without HIV.
HIV is caused by a virus that’s transmitted through infected blood, semen, or vaginal secretions. You can’t become infected through ordinary contact (i.e. hugging, kissing, shaking hands, etc.) and HIV can’t be transmitted through the air, water, or insect bites. Some ways the virus can be spread are
- Having vaginal, anal, or oral sex with an infected partner;
- From blood transfusions (though the risk is very small due to rigorous screening);
- By sharing needles; and
- During pregnancy or delivery or through breastfeeding.
HIV symptoms vary from person to person and depending on what stage you’re in.
About 40% to 90% of people will have flu-like symptoms within two to four weeks after infection, while others won’t feel sick at all. Early infection is defined as HIV infection in the past six months and includes acute infections. Flu-like symptoms may include:
- Night sweats;
- Muscle aches;
- Sore throat;
- Swollen lymph nodes; and
- Mouth ulcers.
Symptoms can last from a few days to several weeks. If you decide to get an HIV test during this time, be aware that the HIV infection may or may not show up on certain types of HIV tests. Some tests look for HIV antibodies that can take weeks or longer for your body to produce, while others detect acute and recent infections. Make sure to communicate with your healthcare provider about your potential exposure date.
Clinical latency stage
During this period, you will either have no or very mild symptoms.
Progression to AIDS
If you do progress to AIDS, symptoms you may have include:
- Rapid weight loss;
- Recurring fever or profuse night sweats;
- Extreme and unexplained tiredness;
- Prolonged swelling of the lymph glands in the armpits, groin, or neck;
- Diarrhea that lasts for more than a week;
- Sores of the mouth, anus, or genitals;
- Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids; and
- Memory loss, depression, and other neurologic disorders.
Most of the severe symptoms and illnesses, though, come from the opportunistic infections you contract during this stage.
Risk factors that increase the likelihood of you contracting HIV are having unprotected anal or vaginal sex; having another STI; sharing contaminated drug paraphernalia (i.e. needles, syringes, drug solutions, etc.); receiving unsafe injections, blood transfusions, tissue transplants, or medical procedures involving unsterile cutting or piercing; and experiencing accidental needle stick injuries (including healthcare workers).
Because HIV infection weakens your immune system over time, there are many associated complications:
- Tuberculosis: in poorer nations, it’s the most common opportunistic infection associated with HIV and a leading cause of death among AIDS patients;
- Cytomegalovirus: a virus transmitted in body fluids that causes damage to the eyes, digestive tract, lungs, or other organs in people with weakened immune systems;
- Candidiasis: a common HIV-related infection that causes inflammation and a thick, white coating on the mouth, tongue, esophagus, or vagina;
- Cryptococcal meningitis: a common brain and spinal fluid infection associated with HIV and caused by a fungus found in soil;
- Toxoplasmosis: a potentially deadly infection caused by a parasite spread mostly by cats;
- Cryptosporidiosis: an infection caused mainly by an animal intestinal parasite, you contract it by ingesting contaminated food or water. The parasite grows in your intestines and bile ducts and causes severe, chronic diarrhea in AIDS patients;
- Kaposi’s sarcoma: a tumor of the blood vessel walls that’s common in HIV-positive people. It usually appears as lesions on the skin and mouth, but can also affect the internal organs (i.e. the digestive tract and lungs);
- Lymphomas: a type of cancer originating in your white blood cells and typically first appearing in your lymph nodes;
- Wasting syndrome: a loss of at least 10% of your body weight, often accompanied with diarrhea, chronic weakness, and fever;
- Neurological complications: AIDS can cause neurological symptoms, like confusion, forgetfulness, depression, anxiety, and difficulty walking. The most common complication is AIDS dementia complex, causing behavioral changes and diminished mental functioning; and
- Kidney disease: HIV-associated nephropathy (HIVAN) is the inflammation of the tiny kidney filters that remove excess wastes and fluid from your blood and move them to the urine.
Unfortunately, there is no vaccine to prevent HIV or cure for AIDS. To protect yourself from HIV/AIDS, use a new condom every time you have sex, tell your sex partners if you’re HIV-positive, use clean needles to inject drugs, and get medical care right away if you’re pregnant and HIV-positive.
The standard treatment regimen for everyone with HIV is called Antiretroviral Therapy (ART). People take a combination of medications – generally three medications from at least two different drug classes – each day. While ART can’t cure HIV, it does help people live longer, healthier lives and reduces the risk of viral transmission. Below are some of the drug classes and medications approved by the United States Food and Drug Administration (FDA) to treat HIV:
- Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Viread, Emtriva, etc.;
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Viramune XR, Edurant, Intelence, etc.;
- Protease Inhibitors (PIs): Reyataz, Prezista, Aptivus, etc.;
- Fusion Inhibitors: Fuzeon;
- Entry Inhibitors: Selzentry;
- Integrase Inhibitors: Tivicay, Vitekta, Isentress;
- Pharmacokinetic Enhancers: Tybost; and
- Combination Medications: Triumeq, Evotaz, Prezcobix, Atripla, Genvoya, Stribild, Odefsey, Descovy, Truvada, etc.